剖宫产术后子宫瘢痕妊娠的超声诊断分析

目的探讨彩色多普勒超声检查在剖宫产术后子宫瘢痕妊娠（CSP）诊断中的应用价值及不同类型CSP的超声声像图特点方法选择2008年1月至2012年12月于北京军区总医院经病理学检查确诊的38例CSP患者为研究对象,按照超声检查方式的不同,将其分为经阴道超声组（n=28,接受经阴道彩色多普勒超声检查）和经腹部超声组（n=10,接受经腹部彩色多普勒超声检查）。比较两组患者的诊断符合率,并分析不同类型CSP的超声声像图特点。本研究遵循的程序符合北京军区总医院超声科人体试验委员会所制定的伦理学标准,得到该委员会批准,分组征得受试对象本人的知情同意,并与之签署临床研究知情同意书。结果 12008-2012年CSP年发生率呈逐年递增趋势。2两组诊断符合率比较（100%vs70%）,差异有统计学意义（P〈0.05）。3CSP患者的彩色多普勒超声分型示瘢痕处孕囊型CSP患者为17例（44.7%）,包块型CSP为11例（28.9%）,宫腔下段及瘢痕处孕囊型CSP为10例（26.3%）。结论 CSP具有特征性彩色多普勒超声表现。经阴道彩色多普勒超声检查对CSP的诊断优势明显,经阴道及经腹部彩色多普勒超声联合应用可使CSP病灶的检查更为全面。

Diagnostic Analysis of Color Doppler Ultrasonic Examination for Caesarean Scar Pregnancy

Objective To evaluate the significance of color Doppler ultrasound in the diagnosis of cesarean scar pregnancy （CSP） and analyze the ultrasonographic features of different CSP types. Methods From January 2008 to December 2012, the clinical data of 38 cases with CSP were analyzed retrospectively. They were divided into transvaginal group （n = 28） and abdominal group （n = 10） according to different ultrasound types. The diagnosis coincidence rate were compared between two groups, and the ultrasonographic features of different CSP types were analyzed. The study protocol was approved by the Ethical Review Board of Investigation in Human Being of Beijing Military General Hospital. Informed consent was obtained from each participants. Results （1）The incidence rate of CSP increased year by year from 2008 to 2012. （2）The diagnosis coincidence rate of transvaginal ultrasound was higher than that of abdominal ultrasound. （3）The ultrasonic showed exogenic type were 17 cases（44. 7%）, endogenous type were 10 cases（26.3%）, asymmetrical mass were 11 cases（28. 9%） in the study. Conclusions CSP has characteristic ultrasonogram. Transvaginal ultrasound holds many obvious advantages in diagnosing CSP. The combined application of transvaginal ultrasound and abdominal ultrasound can make a clear diagnosis result. Key words] Ultrasonography,doppler,color; Cesarean section; Pregnancy,ectopic; Cicatrix