摘要
目的探讨经阴道彩色多普勒超声(TVCDS)对早期诊治子宫切口妊娠(CSP)的临床价值。方法回顾性分析33例CSP的超声图像特征及术后结果,以评价TVCDS对早期诊治子宫切口妊娠的临床价值。结果 33例患者中,经TVCDS正确诊断30例,诊断符合率90.91%,误诊3例分别为滋养叶细胞疾病、不全流产和宫颈妊娠各1例,误诊率约为9.09%。典型声像图特征为子宫下段原切口瘢痕有不均质、混合性回声包块,并向前壁凸出,仅见一层菲薄浆膜层,其他部分肌层回声尚均匀,团块周边彩色血流丰富,频谱多普勒能够检测到大量静脉样血流频谱及高速低阻的动脉血流频谱,阻力指数<0.6。治疗后超声随访显示病灶逐渐缩小,内部及周边血流信号逐渐减少。结论 TVCDS是诊断CSP最为直观、准确、简便的方法,有助于临床选择恰当的治疗手段并评估疗效,具有重要的临床应用价值。
Objective To explore the clinical value of transvaginal color doppler sonography （TVCDS） in early diagnosis and treatment of the cesarean scar pregnancy（CSP）. Methods Thirty three cases with CSP confirmed by surgery and pathology were retrospectively analyzed according to postoperative pathological diagnosis and the characteristics of TVCDS. Results Among 33 patients of CSP, 30 cases were accurately diagnosed, the accuracy rate was 90.91% ,3 cases were misdiagnosed（including one case misdiagnosed as uterine cervical pregnancy,one as trophoblastic disease,another of incomplete abortion）, misdiagnosis rate was 9.09 %. Typical sonographic features ： original lower uterine segment incision scar has not homogeneous, mixed echo mass, protruding anterior to see only meager serosa layer, the other part is still muscle echo uniform, the color of blood surrounding clumps rich stream, spectral Doppler can detect a large spectrum of venous blood samples and high speed low-resistance arterial flow spectrum, resistance index 〈0.6. After treat ment, ultrasound follow-up display： the lesions gradually reduced, internal and peripheral blood flow signal is gradually reduced. Conclusion TVCDS is not only the most intuitive, accurate and convenient method for the diagnosis of CSP, but also help to choose appropriate clinical treatment and to assess efficacy, has important clinical value.
出处
《西部医学》
2015年第4期589-591,共3页
Medical Journal of West China
关键词
经阴道
彩超
切口妊娠
诊断
治疗
Transvaginal
Ultrasound
Incision pregnancy
Diagnosis
Treatment
