经阴道彩超对子宫下段瘢痕妊娠的诊断价值

目的探讨经阴道彩超扫查对剖宫产术后子宫下段瘢痕妊娠(CSP)的诊断价值。方法回顾性分析2010年1月²013年12月经阴道彩超扫查的剖宫产术后CSP 18例临床资料,并与手术病理诊断结果进行比较,探讨其诊断符合率。结果经阴道彩超明确诊断为CSP 16例,未明确诊断1例,误诊1例,诊断符合率88.89%(16/18);手术病理诊断为CSP 18例,诊断符合率100.00%(18/18),二者的诊断符合率无统计学差异(p>0.05)。结论经阴道彩超扫查能清晰显示孕囊着床部位与子宫下段瘢痕的关系,以及子宫下段瘢痕处肌层的厚度\血流分布等情况,诊断符合率高,是剖宫产术后子宫下段瘢痕妊娠首选的扫查方法。

VALUE OF TRANSVAGINAL ULTRASOUND IN THE DIAGNOSIS OF LOWER CESAREAN SCAR PREGNANCY

Objective To evaluate the diagnostic value of transvaginal ultrasound scanning for the lower caesarean scar pregnancy （CSP） after cesarean section.Methods A retrospective analysis was conducted for 18 cases of CSP patients with transvaginal ultrasound scanning in our department from January 2010 to December 2013 after cesarean section, to com-pare the surgical pathology results,to explore the diagnosis accordance rate.Results Transvaginal ultrasound diagnosed 16 CSP cases, except one case of undefinite diagnosis and one case of misdiagnosis, with diagnosis accordance rate of 88.89% （16/18）; surgical pathology diagnosed 18 CSP cases, with diagnosis accordance rate of 100.00% （18/18）, which had no significant difference （ p 〉0.05 ） .Conclusion Transvaginal ultrasound scanning can clearly show the relation be-tween gestational sac implantation site and lower caesarean scar, the muscle thickness of lower caesarean scar, and the blood flow distribution, with high diagnosis accordance rate, which is the preferred scanning method for the lower caesarean scar pregnancy after cesarean section.