目的：探讨3D玻璃体成像技术结合彩色多普勒超声在瘢痕妊娠诊断中的应用价值。方法回顾性分析2009年5月~2012年7月我院收治的83例剖腹产瘢痕妊娠患者的经腹、经阴道以及3D玻璃体模式彩色多普勒超声图像。结果83例患者中：①孕囊型40例，其中25例有活胎芽，15例无胎芽或胎芽停育；38例胎囊较小、胎芽小或无，故采取甲氨蝶呤（MTX）及介入治疗，2例行子宫半切手术；②团块型42例，其中全子宫切除7例，25例MTX及介入治疗，10例保守治疗；③超声误诊1例，诊断准确率为98.8%。两种类型患者的绒毛种植区均可见较丰富的血流信号，3D成像成彩团样。结论3D玻璃体成像技术结合彩色多普勒超声可为瘢痕妊娠的定位和定性诊断提供较准确的信息，有助于临床选择合适的治疗方案，估计病程及转归。%Objective To explore the application value of 3D vitreous imaging technology combined with color doppler ultrasound in the diagnosis of caesarean scar pregnancy. Methods 83 patients who suffered from caesarean scar pregnancy were treated in our hospital from May 2009 to July 2012. Abdominal ultrasound images, transvaginal ultrasound images and 3D vitreous ultrasound images of 83 patients were retrospectively analyzed. ResuIts Among 83 patients with caesarean scar pregnancy:① 40 were gestational sac type, among which 25 patients with a live embryo bud and 15 patients without any embryo bud or with a diapaused embryo; 38 patients who have a small foetal sac or small embryo bud or don’t have any embryo bud received methotrexate(MTX) and interventional therapy, the other 2 patients received hysterectomy. ② 42 were heterogeneous mass type, among which 7 patients received hysterectomy, 25 patients received MTX and interventional therapy, 10 patients received conservative treatment. ③ one patient was misdiagnosis, so the diagnosis rate was 98.8%. For both type, abundant blood flow signals were showed in chorionic villus cultivation area on 3D imaging. ConcIusion 3D vitreous imaging technology combined with color doppler ultrasound can provide more accurate infromation for positioning and qualitative diagnosis of caesarean scar pregnancy, which is helpful for the chosen of optimal treatment method in clinic and the estimation of disease course and prognosis.
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