Department of Ultrasonography, The Second people's Hospital of Liaocheng City Affiliated to Shandong First Medical University, Shandong Province, China.
Department of imaging, The Second people's Hospital of Liaocheng City Affiliated to Shandong First Medical University, Shandong Province, China.
J Coll Physicians Surg Pak. 2020 Mar;30(3):240-244. doi: 10.29271/jcpsp.2020.03.240.
To investigate the value of Doppler ultrasound in evaluating the efficacy of high intensity focused ultrasound (HIFU) in treatment of cesarean section scar pregnancy.
Observational study.
Department of Ultrasonography, The Second people's Hospital of Liaocheng City Affiliated to Shandong First Medical University, China, from January 2015 to December 2017.
Forty-six patients with cesarean section scar pregnancy treated with HIFU were enrolled. Doppler ultrasound images, blood flow resistance index (RI) and β-human chorionic gonadotropin (β-hCG) levels were analyzed.
Among 46 patients, 31 cases (68.89%) were embryo sac type while 15 cases (32.61%) were mass-type. After 4 weeks of HIFU treatment, among 31 cases of embryo sac type of cesarean scar pregnancy, slightly increased echogenicity and thickened walls of yolk sac were observed in 15 cases (48.39%), heart beat disappeared in 12 cases (38.71%) and fetal heart rate as still regular in four cases (12.90%). Among 15 cases of mass-type treated with 4 weeks of HIFU, echogenicity was slightly elevated at first, then echogenicity of center zone decreased, resulting in mixed echoes, finally the volumes of mass decreased to varying degrees and blood flow reduced significantly, leading to slight strong mull echoes. Compared with before treatment of HIFU, RI levels were higher after 4 weeks treatment of HIFU (p<0.001), while the blood β-hCG levels were lower (p<0.001).
Doppler ultrasound can provide accurate qualitative diagnosis of cesarean section scar pregnancy, and possess higher clinical value in evaluating the treatment efficacy of cesarean section scar pregnancy with HIFU.
探讨多普勒超声在评估高强度聚焦超声（HIFU）治疗剖宫产瘢痕妊娠疗效中的价值。
观察性研究。
中国，山东第一医科大学附属聊城市第二人民医院超声科，2015 年 1 月至 2017 年 12 月。
纳入 46 例接受 HIFU 治疗的剖宫产瘢痕妊娠患者，分析多普勒超声图像、血流阻力指数（RI）和β-人绒毛膜促性腺激素（β-hCG）水平。
46 例患者中，孕囊型 31 例（68.89%），包块型 15 例（32.61%）。HIFU 治疗 4 周后，孕囊型剖宫产瘢痕妊娠 31 例中，卵黄囊壁增厚、回声增强 15 例（48.39%），胎心消失 12 例（38.71%），胎心仍规则 4 例（12.90%）。包块型 15 例 HIFU 治疗 4 周后，回声先稍增高，继而中心区回声减低，呈混合回声，最终包块体积不同程度缩小，血流明显减少，呈稍强密集回声。HIFU 治疗 4 周后 RI 水平高于治疗前（p<0.001），β-hCG 水平低于治疗前（p<0.001）。
多普勒超声能为剖宫产瘢痕妊娠提供准确的定性诊断，对评估 HIFU 治疗剖宫产瘢痕妊娠的疗效具有较高的临床价值。
