剖宫产后子宫瘢痕妊娠的彩色多普勒超声诊断及应用价值

目的探讨剖宫产术后子宫瘢痕妊娠的超声诊断价值及在治疗随访中的意义。方法对20例子宫瘢痕妊娠的超声声像图做回顾性分析。比较保守治疗前后子宫下段包块形态大小、内部血流信号及阻力指数的变化。结果 20例患者中,6例单纯孕囊型,11例不均质包块型,其中有12例保守治疗患者,治疗前瘢痕处包块内部及孕囊周边血流信号丰富,阻力指数低;治疗后7天病灶轻度缩小,内部血流信号及阻力指数无明显变化、30天病灶明显缩小,血流信号明显减少或消失,阻力指数升高。结论超声检查是诊断子宫瘢痕妊娠的声像图具有一定的特征性,结合彩色多普勒超声可做定性定位诊断,帮助临床制定治疗方案及随访观察。

Diagnosis and application value of Colour Doppler Ultrasonic Examination for Caesarean Scar Pregnancy

Objective To evaluate the significance of color Doppler ultrasound in the diagnosis and treatment follow-up of cesarean scar pregnancy.Methods Make a retrospectively analysis to the clinical data of 20 cases with cesarean scar pregnancy.Compare the lower uterine segment mass,shape and size,the internal flow signals and resistance index changes in the contrast before and after conservative treatment.Results Among the 20 cases,the sonographic appearance showed 6 cases were gestational sac-type and 11 cases were mixed mass-type.the scar mass of internal blood flow signal is rich,low resistance index before treatment,while after the treatment of 7 days lesions with mild narrowing,no significant change in the internal flow signal and the resistance index,30 days lesions significantly reduced,blood flow signal significantly reduced or disappeared,increased resistance index in 12 cases of conservative treatment of patients.Conclusion Ultrasonography is of certain characteristics in the sonographic diagnosis of uterine scar pregnancy,it can make the qualitative and locational diagnosis combined with color Doppler ultrasound,and help clinicians to draw up treatment programs and follow-up.