剖宫产切口瘢痕妊娠的MRI、超声表现及诊断价值

目的分析剖宫产切口瘢痕妊娠的MRI及超声表现,评估其诊断价值。方法回顾性分析我院收治的经手术及病理证实为剖宫产切口瘢痕妊娠的44例患者的临床资料,所有患者均完成CT及MRI检查。结果 44例剖宫产切口瘢痕妊娠患者,阴道超声检出34例,准确率77.27%,其中单纯孕囊型检出19例,不均质包块型检出15例,误诊10例,4例误诊为宫颈妊娠,6例误诊为宫内妊娠;MRI检出剖宫产切口瘢痕妊娠43例,准确率为97.73%,检出单纯孕囊型27例,漏诊1例,15例不均质包块型均检出。MRI单纯囊性检出率及整体诊断符合率均高于阴道超声诊断(P0.05)。结论在剖宫产切口瘢痕妊娠患者的临床诊断中,采用MRI诊断准确率高于阴道超声,可将MRI作为阴道超声诊断的辅助手段。

The Diagnostic Value and Imaging Findings of MRI and Ultrasonography for Cesarean Scar Pregnancy

Objective To analyze the MRI and ultrasonographic findings of cesarean scar pregnancy and to evaluate the diagnostic value.Methods The clinical data of 44 cases of patients with cesarean scar pregnancy confirmed by surgery and pathology in our hospital were retrospectively analyzed. All patients completed CT and MRI examination and the imaging data were complete.Results In the 44 cases of patients with cesarean scar pregnancy, 34 cases were detected by transvaginal ultrasonography and the accuracy rate was 77.27%. Among them, there were 19 cases detected of simple gestational sac type, 15 cases of heterogeneous mass type, 10 cases misdiagnosed and 4 cases misdiagnosed as cervical pregnancy and 6 cases misdiagnosed as intrauterine pregnancy; MRI detected that there were 43 cases of cesarean scar pregnancy and the accuracy rate was 97.73%. There were 27 cases of simple gestational sac type, 1 cases of missed diagnosis and 15 cases of heterogeneous mass type detected. The detection rate of MRI in simple gestational sac type and general diagnostic coincidence rate were higher than those of transvaginal ultrasonography (P<0.05).Conclusion In the clinical diagnosis of patients with cesarean scar pregnancy, to adopt MRI, the diagnostic accuracy rate is higher than that of transvaginal ultrasonography. MRI can be taken as an auxiliary means of transvaginal ultrasonography in diagnosis.