经阴道超声检查对剖宫产后子宫疤痕早期妊娠的诊断价值

目的 探讨剖宫产术后子宫下段疤痕早期妊娠的声像图特征,评价经阴道超声检查对子宫下段疤痕妊娠的诊断价值.方法 采用经阴道超声检查对15例子宫下段疤痕妊娠进行检查,观察妊娠囊的位置、子宫切口部位的同声、疤痕处肌层厚度、妊娠囊与子宫切口两者的关系以及血流分布.结果 15例子宫疤痕妊娠病例超声诊断正确14例,误诊1例,诊断符合率为93.3％.所有患者宫腔内未见妊娠囊,在子宫下段疤痕处见周边有滋养层强回声的妊娠囊声像,经CDFI观察疤痕处滋养层内见较丰富的血流信号,测其RI为低阻血流,平均RI值低于0.5.根据声像特征将子宫下段疤痕早期妊娠分为妊娠囊完整嵌于疤痕处胚囊型、妊娠囊向宫腔内生长的“茄”型、流产后宫腔内混合性回声三型.结论 经阴道超声检查在剖宫产术后子宫下段疤痕妊娠的早期有重要的诊断价值.

Diagnosis value of transvaginal ultrasound inspection for the uterine scar after cesarean section with early pregnancy

Objective To explore sonographic features of the lower uterine segment cesarean section scar with early pregnancy, and to evaluate the diagnosis value of transvaginal ultrasound for lower uterine segment scar pregnancy. Methods The transvaginal color Doppler ultrasound was used in 15 cases of uterine scar pregnancy to check the next section to observe the location of the gestational sac, uterine incision site of the echo, the thickness of muscle scars, gestational sac and the uterine incision, and the relationship between blood flow distribution. Results In 15 cases of uterine scar pregnancy, ultrasound correctly diagnosed, 14 cases of misdiagnosis, diagnostic coincidence rate was 93.3%. All patients with no intrauterine gestational sac surrounded by the trophoblast echogenic gestational sac audio and video, showed the lower uterine segment scar. We observed the scars were seen in the trophoblast with more abundant blood flow signals, measured by the CDFI RI of low resistance to blood flow, mean RI values less than 0.5. The imaging characteristics of the lower uterine segment scar in early pregnancy were divided into gestational sac integrity embedded in the scar at the embryo sac type, gestational sac to the intrauterine growth of the ＂tomato＂, three types of abortion harem cavity mixed echo. Conclusions Transvaginal ultrasound in the early lower uterine segment cesarean section scar pregnancy has important diagnostic value.