Liu Qian, Zhang Ruifang, Wang Xue, Liu Kun, Bai Guanghui, Huang Yanan, Zhu Huanle, Yan Zhihan
Department of Radiology, Second Affiliated Hospital, Wenzhou Medical University, Wenzhou 325027, China.
Department of Radiology, Second Affiliated Hospital, Wenzhou Medical University, Wenzhou 325027, China. Email:
Zhonghua Yi Xue Za Zhi. 2014 Dec 9;94(45):3589-92.
To explore the magnatic resonance imaging (MRI) features of cesarean scar pregnancy (CSP) and analyze the diagnostic value of MRI for early CSP.
The 3.0 T MRI and ultrasonic findings of 81 patients with CSP were analyzed. The sensitivity, specificity and accuracy of two methods was calculated respectively for the diagnosis of CSP. The diagnostic value of each method was evaluated with receiver-operating-characteristics (ROC) analysis.
Among them, the final pathological diagnoses were CSP (n = 68) and early uterine pregnancy (n = 13). Among 68 cases of CSP, 52 cases were detected and 16 cases incorrectly diagnosed by ultrasound. Among 13 cases of early uterine pregnancy, 11 cases were correctly diagnosed and 2 cases misdiagnosed. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of ultrasound for diagnosing CSP were 76.5% (52/68), 11/13, 77.8% (63/81), 96.3% (52/54) and 40.7% (11/27) respectively. Among 68 cases of CSP, 64 cases were detected and 4 cases incorrectly diagnosed by MRI. Among 13 cases of uterine pregnancy, 10 cases were diagnosed correctly and 3 cases misdiagnosed. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of MRI for diagnosis of CSP were 94.1% (64/68), 10/13, 91.4% (74/81), 95.5% (64/67) and 10/14 respectively. The ROC analysis yield the area under curve (AUC) of MRI and ultrasonography were 0.941(P = 0.000) and 0.867(P = 0.000) respectively.
The sensitivity and accuracy of MRI are better than those of ultrasound in the diagnosis of CSP. And MRI is quite important for choosing appropiate therapeutic protocols.
探讨剖宫产瘢痕妊娠（CSP）的磁共振成像（MRI）特征，并分析MRI对早期CSP的诊断价值。
分析81例CSP患者的3.0 T MRI及超声检查结果。分别计算两种方法诊断CSP的灵敏度、特异度和准确度。采用受试者操作特征（ROC）分析评估每种方法的诊断价值。
其中，最终病理诊断为CSP（n = 68）和早期子宫妊娠（n = 13）。68例CSP中，超声检出52例，误诊16例。13例早期子宫妊娠中，超声正确诊断11例，误诊2例。超声诊断CSP的灵敏度、特异度、准确度、阳性预测值和阴性预测值分别为76.5%（52/68）、11/13、77.8%（63/81）、96.3%（52/54）和40.7%（11/27）。68例CSP中，MRI检出64例，误诊4例。13例子宫妊娠中，MRI正确诊断10例，误诊3例。MRI诊断CSP的灵敏度、特异度、准确度、阳性预测值和阴性预测值分别为94.1%（64/68）、10/13、91.4%（74/81）、95.5%（64/67）和10/14。ROC分析显示，MRI和超声的曲线下面积（AUC）分别为0.941（P = 0.000）和0.867（P = 0.000）。
MRI诊断CSP的灵敏度和准确度优于超声。且MRI对选择合适的治疗方案非常重要。
