摘要
目的探讨静脉超声造影在剖宫产瘢痕部位妊娠(CSP)诊断中的应用价值。方法对常规彩色多普勒超声检查怀疑CSP且要求终止妊娠的43例患者进行静脉超声造影,以正常子宫肌层作为参照,观察病灶处造影剂最早出现位置、增强强度、分布范围及病灶与瘢痕处肌层的关系。分析比较常规超声与超声造影结果。结果 CSP超声造影表现为子宫瘢痕妊娠物附着处呈"团块状"或"半环状"早增强及高增强,随着造影剂注入,孕囊型CSP整个孕囊呈"面包圈"样改变,包块型CSP包块周边呈不均匀性强化,内部呈斑片状、团块状增强或完全无增强。常规超声与手术和病理检查结果符合40例(40/43,93.0%);超声造影与手术和病理检查结果符合43例(43/43,100%)。常规超声显示7例妊娠物与肌层分界不清,造影后3例肌层可清晰显示,4例为组织物植入肌层。结论 CSP的静脉超声造影声像图特征明显,有助于该病的准确诊断,同时静脉超声造影可正确判断妊娠物与肌层关系,为临床治疗提供更准确详实的信息。
Objective To investigate the value of intravenous contrast enhanced ultrasonography(CEUS) in the diagnosis of cesarean scar pregnancy( CSP). Methods CEUS were performed in 43 patients who suspected CSP by conventional color doppler ultrasonography and requested termination of pregnancy. With normal myometrium as a reference,the earliest location,enhancement intensity and distribution of contrast agent in the lesion and the relationship between the lesion and the myometrium of scar was observed. The results of CEUS were analyzed and compared. Results The CEUS of CSP showed that the attachment of uterine scar pregnancy showed" lumpy" or“ semicircular”early enhancement and high enhancement. With the injection of contrast agent,the whole gestational sac of bursa type CSP showed“ doughnut”changes,and the periphery of mass type CSP showed inhomogeneous enhancement with patchy,lumpy or no enhancement inside the lesion. The results of conventional ultrasound were consistent with those of operation and pathology in 40 cases(93.0%), and the results of CEUS were consis tent in 43 cases(100%). Conventional ultrasound showed that the boundary between pregnancy and myometrium was unclear in 7 cases in which the myometrium could be clearly displayed in 3 cases and the myometrium was implanted in 4 cases after angiography. Conclusion The characteristics of CEUS in CSP were obvious,which was helpful to the accurate diagnosis of the disease. And the CEUS could correctly determine the relationship between lesion and muscular layer,providing more information for the clinical treatment of CSP.
作者
涂艳萍
刘向娇
王丽敏
陈燕
尚宁
张玉兰
李荔
Tu Yanping;LIU Xiangjiao;WANG Limin;CHEN Yan;SHANG Ning;ZHANG Yulan;LI li(Department of ultrasound,Guangdong Women and Children Hospital,Guangzhou 510010,China)
出处
《实用医学杂志》
CAS
北大核心
2019年第10期1669-1672,共4页
The Journal of Practical Medicine
基金
广东省医学科学技术研究基金资助(编号:B2016076)
关键词
超声检查
造影剂
剖宫产术
子宫
瘢痕妊娠
ultrasonography
contrast media
cesarean section
uterus
cesarean scar pregnancy
