磁共振成像对剖宫产瘢痕妊娠的诊断价值

摘要

Objective To study the value of magnetic resonance imaging (MRI) for diagnosing caesarean scar pregnancy. Methods The MRI and clinical features of caesarean scar pregnancy of 5 patients were analysed. Re-sults The caesarean scar and gestational sac were well showed by MRI, which located at the anterior inferior wall of uterus and had hypointensity by T1WI and T2WI. All gestational sacs were cystic and had a long T1 and long T2 ap-pearance. The myometrium between the gestational sac and bladder thinned significantly and the average diameter was 3 mm (range from 1 to 4 mm), of all cases,there was 1 case growed towards bladder with extrusion. The ultrasound guided curettage was performed at 4 cases, and 1 case received laparoscopic monitoring curettage. Conclusion MRI can show the caesarean scar pregnancy perfectly, which will do help for choosing the method of clinical treatment.%目的：探讨磁共振成像（MRI）对剖宫产瘢痕妊娠的诊断价值。方法收集我院临床证实为剖宫产瘢痕妊娠的MRI图像5例，分析其MRI影像学表现和临床资料。结果5例瘢痕和孕囊均显示良好，瘢痕位于子宫体下部前壁，表现为T1WI及T2WI条样低信号。5例孕囊均呈囊状，表现为边界清楚的囊样长T1长T2信号影。瘢痕处肌层明显变薄，肌层厚度平均3 mm，其中1例向膀胱方向突出生长，瘢痕处肌层厚度1 mm。本组中4例在超声引导下行清宫术，而瘢痕处肌层厚度1 mm者行腹腔镜监护下清宫术，所有患者手术顺利。结论 MRI能很好地显示剖宫产瘢痕妊娠，有利于临床处理方式的选择。