摘要
目的探究阴道超声联合磁共振成像(MRI)动态增强扫描对剖宫产瘢痕妊娠(CSP)的诊断价值。方法回顾性分析我院产科2015年10月至2017年10月临床怀疑为CSP的120例患者的病例资料。所有患者均在术前行阴道超声检查,对超声检查无法明确诊断的患者再行MRI动态增强扫描。以手术病理结果为金标准,分析阴道超声联合MRI动态增强扫描的诊断价值。结果术后经病理证实为CSP89例。阴道超声诊断CSP的敏感性、特异性及准确性分别为95.51%、67.74%、88.33%,Kappa值为0.675,一致性一般;阴道超声联合MRI动态增强扫描诊断CSP的敏感性、特异性及准确性分别为98.88%、90.32%、96.67%,Kappa值为0.911,一致性较好;阴道超声联合MRI动态增强扫描诊断的特异性及准确性均显著高于单纯阴道超声诊断,差异有统计学意义(χ2=4.769,6.006,P<0.05)。结论阴道超声联合MRI动态增强扫描有助于提高CSP的诊断效能,降低漏诊率,对阴道超声检查高度存疑的患者可进行MRI进一步检查,以提高CSP的诊断准确性。
Objective To investigate the diagnostic value of vaginal ultrasound combined with magnetic resonance imaging(MRI)dynamic contrast-enhanced scanning in the diagnosis of cesarean scar pregnancy(CSP).Methods The data of 120 patients clinically suspected with CSP from October 2015 to October 2017 in the hospital were retrospectively analyzed.All patients underwent vaginal ultrasonography before surgery,and MRI dynamic contrast-enhanced scanning was performed on patients who could not be clearly diagnosed by ultrasound examination.Taking surgical pathological results as the golden standard,the diagnostic value of vaginal ultrasound combined with MRI dynamic contrast-enhanced scanning was analyzed.Results There were 89 cases with CSP confirmed by pathology after surgery.The sensitivity,specificity and accuracy by vaginal ultrasound for the diagnosis of CSP and the Kappa value were 95.51%,67.74%,88.33%and 0.675,respectively.The consistency was general.The above four indexes by vaginal ultrasound combined with MRI dynamic contrast-enhanced scanning for the diagnosis of CSP were 98.88%,90.32%,96.67%and 0.911,respectively.The consistency was good.The specificity and accuracy of the diagnosis by vaginal ultrasound combined with MRI dynamic contrast-enhanced scanning were significantly higher than those by vaginal ultrasound alone(χ2=4.769,6.006,P<0.05).Conclusion Transvaginal ultrasound combined with MRI dynamic contrast-enhanced scan is helpful to improve the diagnostic efficiency of CSP and reduce the rate of missed diagnosis.
作者
张亚娜
陈圆圆
方玲丽
ZHANG Ya-na;CHEN Yuan-yuan;FANG Ling-li(Department of Obstetrics and Gynecology,Gongan people's Hospital,Jingzhou 434300,Hubei Province,China)
出处
《中国CT和MRI杂志》
2020年第12期95-98,共4页
Chinese Journal of CT and MRI
基金
湖北省自然科学基金项目(编号:2016CBD0267)。
关键词
阴道超声
磁共振成像
剖宫产
瘢痕妊娠
Vaginal Ultrasound
Magnetic Resonance Imaging
Cesarean Section
Cesarean Section Pregnancy
