摘要
目的探讨数字减影血管造影(DSA)影像学研究,以评价剖宫产子宫瘢痕妊娠(CSP)的血液供应及异常供血情况。方法搜集62例CSP患者的临床及DSA影像资料,分析采用双盲法,分析内容包括妊娠囊血供类型、妊娠囊供血血管、妊娠囊异常供血。将妊娠囊有除子宫动脉以外的异常供血者分为A组,无异常供血者分为B组,对两组的妊娠囊血供类型、妊娠囊供血血管进行比较。结果妊娠囊呈乏血供型占24.2%(15/62),一般血供型40.3%(25/62),富血供型35.5%(22/62);子宫动脉上行支供血者占36.2%(17/47),下行支25.5%(12/47),上下行支均参与供血者38.3%(18/47);17.7%(11/62)的患者妊娠囊有异常供血,异常供血来源以膀胱动脉为主;A、B组的三种妊娠囊血供类型相比差异具有统计学意义(P<0.05),其中富血供型与乏血供型、一般血供型间差异均具有统计学意义(P<0.05);A、B组的三种妊娠囊供血血管相比差异具有统计学意义(P<0.05),其中下行支供血、上下行支供血与上行支供血间差异均具有统计学意义(P<0.05)。结论对CSP的妊娠囊血液供应及异常供血的DSA影像学研究,可以对超声、MRI等影像诊断进行有益的补充,指导子宫动脉栓塞(UAE)术中完全栓塞妊娠囊血供,降低清宫术中大出血风险。
Objective To study the blood supply and abnormal blood supply in cesarean section scar pregnancy(CSP)through the imaging of DSA.Methods The clinical and DSA imaging data of 62 patients with CSP were collected,and double-blind method was performed in DSA imaging analysis,the contents included:the type of blood supply;the blood supply vessel;and the abnormal blood supply of gestation sac.The patients with or without abnormal blood supply of gestation sac except uterine artery were divided into group A and group B,and the types of blood supply and the blood vessels of gestation sac between the two groups compared.Results In 62 cases of CSP,lack of blood supply type accounted for 24.2%(15/62),general blood supply type 40.3%(25/62)and rich blood supply type 35.5%(22/62);In the blood supply vessel of gestation sac,superior branch of uterine artery accounted for 36.2%(17/47),inferior branch 25.5%(12/47),superior and inferior branch 38.3%(18/47).17.7%(11/62)of the patients had abnormal blood supply in the gestation sac,and the main source of abnormal blood supply was the bladder artery;There was significant difference in three types of blood supply of gestation sac between group A and B(P<0.05),and there was significant difference between rich blood supply type and lack bloo1 d supply type or general blood supply type(P<0.05);There was significant difference in three types of blood supply vessels of gestation sac between group A and B(P<0.05),and there was significant difference between inferior branch or superior and inferior branch and superior branch(P<0.05).Conclusion The DSA imaging study of blood supply and abnormal blood supply of gestation sac in CSP can be used to supplement the imaging diagnosis of ultrasound and MRI,and it can guide UAE to embolize the blood supply of gestation sac completely and reduce the risk of massive bleeding during curettage.
作者
张伟
王觅
王莉杰
侯保萍
ZHANG Wei;WANG Mi;WANG Lijie(Department of Interventional Radology,The First People's Hospital of Zhengzhou,Zhengzhou,Henan Province 450004,P.R.China)
出处
《临床放射学杂志》
CSCD
北大核心
2020年第9期1860-1864,共5页
Journal of Clinical Radiology
基金
河南省医学科技攻关计划联合共建项目(编号:2018020735)
