宫腔镜联合MRI在剖宫产切口憩室诊断中的价值

摘要

Objective:To compare the coincidence rates between hysteroscopy combined with magnetic resonance imaging (MRI) and hysteroscopy combined with transvaginal ultrasound imaging for post-cesarean section scar diverticulum (PSCD), and provide better detection method for clinical diagnosis.Methods: 99 suspected patients with scar diverticulum who had suffered cesarean section were enrolled in this study. They were confirmed by hysteroscopy after they were detected by MRI and transvaginal ultrasound. The coincidence rate, rate of missed diagnosis, thickness and width of diverticulum were calculated and measured. And then the PCSD were somatotyped depended on the thickness of diverticulum, and the repair surgery of diverticulum by using hysteroscopy combined with laparoscopy was applied when the thickness less than 3mm, and nothing was applied when that achieved or exceeded 3mm.Results: The coincidence rate of MRI (98%)was significant higher than that of transvaginal ultrasound(85%) (x2=10.875,P<0.05).Conclusion: At present, hysteroscopy combined with MRI was the optimal mean for diagnosis of post-cesarean section scar diverticulum.%目的:通过宫腔镜联合磁共振成像(MRI)或阴道B超对剖宫产切口憩室(PCSD)诊断符合率的比较,为临床诊断提供检查方法及依据.方法:选取在医院就诊的有剖宫产史切口憩室的患者99例,所有患者均先行MRI和经阴道B超两种方式检查,再予宫腔镜明确诊断;分别得出诊断符合率及漏诊率,测量憩室厚度及宽度,并对剖宫产术后PCSD分型,其中厚度<3 mm,实施宫腔镜联合腹腔镜憩室切除修补术;憩室厚度≥3 mm,不予处理.结果:MRI和经阴道B超两种诊断符合率分别为98%和85%,MRI检查的诊断符合率明显高于经阴道B超,其差异有统计学意义(x2=10.875,P<0.05).结论:宫腔镜联合MRI检查是目前诊断PCSD最佳方法.