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目的探讨经阴道超声及MRI对剖宫产术后瘢痕妊娠(CSP)的诊断价值。方法选择80例手术后病理组织诊断均为符合子宫瘢痕处妊娠(绒毛滋养叶细胞及蜕膜组织)患者,年龄21~45岁,平均年龄31.33岁。孕1~7次,既往剖宫产次数1~2次。观察经阴道超声和MRI的表现,对比分析两种诊断方法的诊断效能。结果 80例患者经MRI及阴道超声检查均清楚显示在子宫宫腔下段剖宫产瘢痕部位存在异常回声。80例患者手术前有78例经阴道超声诊断为CSP,2例为宫颈管包块(准确率为97.5%)。74例经MRI诊断为CSP,1例为宫颈妊娠,4例为囊性结构,1例为积血(准确率为92.5%)。二者诊断效能比较,差异无统计学意义(P>0.05)。结论经阴道超声检查是早期诊断CSP的有效方法 ,与MRI有相同的诊断效能。
Objective To investigate the value of transvaginal sonography and MRI in the diagnosis of post-cesarean scar pregnancy (CSP). Methods 80 cases of postoperative pathological diagnosis are consistent with uterine scar pregnancy (villous trophoblast cells and decidual tissue) patients, aged 21 to 45 years, mean age 31.33 years. Pregnancy 1 to 7 times, the previous cesarean section 1 to 2 times. Transvaginal sonography and MRI were performed to evaluate the diagnostic efficacy of the two diagnostic methods. Results 80 patients with MRI and vaginal ultrasound examination showed clearly in the uterine segment of the uterus cesarean scar abnormal echo. Eighty patients underwent transvaginal ultrasonography to diagnose CSP in 78 patients and cervical canal in 2 patients (accuracy was 97.5%). 74 cases were diagnosed as CSP by MRI, 1 case was cervical pregnancy, 4 cases were cystic structures and 1 case was hemorrhage (accuracy rate was 92.5%). There was no significant difference between the two diagnostic efficacy (P> 0.05). Conclusion Transvaginal ultrasonography is an effective method for the early diagnosis of CSP and has the same diagnostic efficacy as MRI.