CAJ | 학술논문

目的：探索剖宫产术后子宫切口妊娠（CSP）妊娠囊及子宫的MRI表现，并评估MRI在切口妊娠诊断及治疗中的价值。方法分析2010～2013年临床或B超怀疑切口妊娠，并取得手术及病理结果的16例病例，总结其MR影像特征、临床治疗方法及预后。结果16例病人中，2例排除CSP诊断，14例确诊为CSP，妊娠物均位于子宫下段峡部疤痕周围；14例CSP病人中8例病人妊娠物内部信号均匀，呈T1WI低、T2WI高信号，包膜呈T2WI略高、T1WI等信号，增强扫描仅有包膜轻度强化，另外6例病人妊娠物内部信号不均匀，T2WI呈高低混杂信号，T1WI可见高信号影，增强扫描呈不均匀强化，4例向宫腔内生长为主，10例向肌层内生长为主；14例CSP患者，6例为超声监测下高危负吸术，8例行子宫动脉栓塞术后高危负吸术，另外2例排除CSP的患者，分别行高危负吸术和药流术。结论 MRI能为临床治疗方案的选择提供重要的参考价值。
목적：탐색부궁산술후자궁절구임신（CSP）임신낭급자궁적MRI표현，병평고MRI재절구임신진단급치료중적개치。방법분석2010～2013년림상혹B초부의절구임신，병취득수술급병리결과적16례병례，총결기MR영상특정、림상치료방법급예후。결과16례병인중，2례배제CSP진단，14례학진위CSP，임신물균위우자궁하단협부파흔주위；14례CSP병인중8례병인임신물내부신호균균，정T1WI저、T2WI고신호，포막정T2WI략고、T1WI등신호，증강소묘부유포막경도강화，령외6례병인임신물내부신호불균균，T2WI정고저혼잡신호，T1WI가견고신호영，증강소묘정불균균강화，4례향궁강내생장위주，10례향기층내생장위주；14례CSP환자，6례위초성감측하고위부흡술，8례행자궁동맥전새술후고위부흡술，령외2례배제CSP적환자，분별행고위부흡술화약류술。결론 MRI능위림상치료방안적선택제공중요적삼고개치。
Objective To analyze the MRI feature of cesarean scar pregnancy(CSP)for treatment planning.Methods MRI of 16 patients with suspected CSP from 2010 to 2013 was retrospectively analyzed and compared with surgical findings.Results All gestational sacs were clearly demonstrated on MRI with 14 embedded in the anterior cervix and diagnosed as CSP.The gestational sacs were cystic(8/14)or heterogeneous(6/14),located within the uterine cavity(4/14)or deeply implanted in the scar(10/14).Suction and curettage were performed in 6/14 and uterine artery embolization in 8/14.Two patients were diagnosed as early abortion and treated by suction and curettage.Conclusion MRI is useful in the management of CSP.