磁共振诊断剖宫产术后子宫切口妊娠的临床意义

磁共振诊断剖宫产术后子宫切口妊娠的临床意义
司马斌;邱小伟
【期刊名称】《温州医学院学报》
【年(卷),期】2014(000)012
【摘要】目的：探讨剖宫产术后子宫切口瘢痕妊娠（CSP）的磁共振（MR）影像特点。

方法：回顾性分析2013年1月至2013年9月经手术及病理证实的11例CSP患者的MR检查资料，总结其MR影像特征。

结果：11例CSP均清楚显示孕囊，其中4例呈囊状信号特征，位于子宫下段前壁瘢痕处，囊壁厚薄均匀；4例中1例孕囊位于子宫肌层，3例向子宫肌层浸润的同时向宫腔内生长。

7例孕囊表现为混杂信号包块影，向子宫前壁肌层浸润生长，部分突入宫腔，其中1例同时向宫腔外突出，局部肌层信号不连，子宫轮廓改变，膀胱受压。

增强后扫描团块影血供丰富，表现为包块内结节状、团片状明显不均匀强化，7例均见切口处或切口周围明显强化，积血及囊液区无明显强化。

11例CSP均能清楚显示手术瘢痕。

增强扫描见孕囊附着处瘢痕明显结节状及团片状强化。

结论：MR对CSP的诊断可以提供有价值的信息，是一种安全有效的检查方法。

%Objective: To analyze MR ifndings of cesarean scar pregnancy (CSP).Methods: The MR ifnd-ings in 11 patients who were diagnosed as CSP by surgery and pathology from January 2013 to September 2013 were retrospectively analyzed, and the features of the MR ifndings were summarized.Results: All gestational sacs (11) were clearly detected by MR. Among the 11 cases, gestational sac presented as cystic mass with smooth margin located within the scar of uterine wall at the lower anterior uterus in 4 cases. In 1 of the 4 cases,
gestation-al sac was found within the myometrium, whereas in the remaining 3 cases, gestational sac was found partially within the myometrium with extension into the uterine cavity. In the remaining 7 of the 11 cases, gestational sac presented as irregular, multilobolated mass, growing deeply into the myometrium as well as into the uterine cav-ity. In 1 of the 7 cases, gestational sac was found growing outside the uterine cavity, the signal of the uterine wall was disconnected, and the bladder was pressured. In the 7 cases, gestational sacs were rich in blood supply. An enhancing solid component with a heterogeneous mass could be seen. 7 cases showed mass enhancement in the surgical scars or around the scars, and no enhancement in the part of hemorrhage and liquid. The Cesarean scar was clearly detected by MR.Conclusion: The test of MR is safe and effective, which can provide useful infor-mation in the diagnosis of CSP.【总页数】4页(P905-908)
【作者】司马斌;邱小伟
【作者单位】浙江省中西医结合医院放射科，浙江杭州 310003;浙江省中西医结合医院放射科，浙江杭州 310003
【正文语种】中文
【中图分类】R445.2
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