摘要
目的探讨阴道超声适当联合磁共振在剖宫产术后子宫瘢痕憩室(cesarean scar diverticulum,CSD)中的应用价值。方法回顾性分析2014年1月至2016年2月期间在同济大学附属第一妇婴保健院因CSD行经阴道子宫憩室修补术的199例患者的临床资料。分析比较这些患者的超声和磁共振的影像学特征,测量CSD长度、宽度、深度、残留肌层厚度、深度/残留肌层厚度。结果199例患者术前超声检查有7例漏诊;而术前磁共振检查均诊断有憩室。155例患者术前超声和磁共振测量的长度[(7.74±3.14)mm,(8.57±3.70)mm;P=0.007],宽度[(13.18±5.66)mm,(16.62±4.12)mm;P<0.001]组间差异均有统计学意义。155例患者术前超声和磁共振测量的深度[(7.55±3.32)mm,(7.17±2.84)mm;P=0.173],残留肌层厚度[(2.56±1.09)mm,(2.46±0.92)mm;P=0.232]、深度/残留肌层厚度(3.61±2.71,3.36±2.00;P=0.229)组间差异均无统计学意义。187例术前超声显示CSD形状以三角形和楔形多见;子宫位置以后位子宫多见。175例患者术后3个月超声随访检查,其中82例仍存在憩室,憩室大小较术前明显缩小(P<0.001),术后残留肌层厚度[(5.53±1.96)mm]较术前明显增厚[(2.43±1.10)mm,P<0.001]。结论阴道超声检查未见憩室,仍高度怀疑憩室的患者需行磁共振检查。预行经阴道憩室修补术,考虑盆腔粘连的患者需行磁共振检查。阴道超声联合磁共振在剖宫产术后CSD中起着重要的作用。
Objective To evaluate application value of transvaginal ultrasound(TVU)properly combined magnetic resonance imaging(MRI)in cesarean scar diverticulum(CSD).Methods From January 2014 to February 2016,199 patients underwent vaginal Repair of CSD in Shanghai First Maternity and infant Hospital,Tongji University School of Medicine.Imaging features of ultrasound and magnetic resonance of these patients were retrospectively analyzed.The measurement parameters of CSD were length,width,depth and thickness of the remaining muscular layer(TRM),depth/TRM.Results There were 7 patients missed diagnosis among 199 patients enrolled preoperative ultrasound examination and 199 patients were all diagnosed with CSD by magnetic resonance imaging.Totally 155 patients underwent both ultrasound and magnetic resonance examination before operation.The length[(7.74±3.14)mm,(8.57±3.70)mm,P=0.007],width[(13.18±5.66)mm,(16.62±4.12)mm,P<0.001]detected by ultrasound and magnetic resonance examination had statistical significance.In these patients,the depth[(7.55±3.32)mm,(7.17±2.84)mm;P=0.173],the thickness of residual muscular layer[(2.56±1.09)mm,(2.46±0.92)mm;P=0.232],the depth/thickness of residual muscular layer(3.61±2.71,3.36±2.00;P=0.229)detected by ultrasound and magnetic resonance examination had no statistical significance.There were no statistically significant differences between the depth[(7.55±3.32)mm],residual muscular layer thickness[(2.56±1.09)mm],depth/residual muscular layer thickness(3.61±2.71)measured by ultrasound and depth[(7.17±2.84)mm],residual muscular layer thickness[(2.46±0.92)mm],and depth/residual muscular layer thickness(3.36±2.00)measured by magnetic resonance imaging(P>0.05).The morphology of CSD was usually triangular and wedge-shape.The position of uterus with CSD was usually retroflexed uterus.After operation,there were still 82 cases had CSD,but diverticulum were smaller than pre-operation(P<0.05)and the thickness of residual muscular layer after operation(5.53±1.96)mm was significantly thicke
作者
杨清
陈萍
朱家樑
洪向丽
吕小利
Yang Qing;Chen Ping;Zhu Jialiang;Hong Xiangli;Lyu Xiaoli(Department of Ultrasound,Shanghai First Maternity and Infant Hospital,Tongji University School of Medicine,Shanghai 200040,China;Department of Radiology,Shanghai First Maternity and Infant Hospital,Tongji University School of Medicine,Shanghai 200040,China)
出处
《中华生殖与避孕杂志》
CAS
CSCD
北大核心
2019年第11期909-913,共5页
Chinese Journal of Reproduction and Contraception
关键词
超声检査
磁共振成像
剖宫产术
子宫瘢痕憩室
Ultrasonography
Magnetic resonance imaging
Cesarean section
Cesarean scar diverticulum
