Department of Obstetrics, Yueyang People's Hospital, No. 263, Baling East Road, Yueyang, 414000, Hunan, China.
Department of Gynaecology, Yueyang People's Hospital, Yueyang, 414000, Hunan, China.
BMC Med Imaging. 2024 Sep 13;24(1):239. doi: 10.1186/s12880-024-01405-2.
We aimed to probe the diagnostic value of transvaginal color Doppler ultrasound (TV-CDU) parameters in cesarean scar pregnancy (CSP) and CSP sub-types, and the relevant factors affecting patients' surgical effects.
Seventy-five CSP patients (all requested termination of pregnancy) were selected as the observation group, and 75 normal pregnant women with a history of cesarean section were selected as the control group. All the study subjects underwent TV-CDU and their cesarean scar muscle (CSM) thickness, minimum sagittal muscle thickness and resistance index (RI) of blood flow in the anterior wall of the lower uterine segment were calculated. The diagnostic value of CSM, minimum sagittal muscle thickness, and RI for CSP and CSP sub-types was analyzed. The patients in the observation group were grouped into the effective group and the ineffective group according to whether the surgical treatment was effective or not, and the independent factors affecting CSP efficacy were analyzed.
The observation group had lower CSM, minimum sagittal muscle thickness and RI than the control group. CSM, RI, and minimum sagittal thickness in patients with type II CSP were lower than those in patients with type I, and these indicators in patients with type III were lower than those in patients with type II. The area under the curve (AUC) of CSM, RI and minimum sagittal muscle thickness in combination for CSP diagnosis and the AUC for CSP sub-types were higher than those of each indicator alone. Gestational sac size and CSM were independent factors affecting CSP treatment.
Changes in TV-CDU parameters facilitates CSP diagnosis after cesarean section. CSM, minimum sagittal muscle thickness changes, and RI in combination possesses high value for CSP diagnosis and CSP sub-types. Gestational sac size and CSM are independent factors affecting CSP treatment.
探讨经阴道彩色多普勒超声（TV-CDU）参数在剖宫产术后子宫瘢痕妊娠（CSP）及 CSP 各亚型中的诊断价值，以及影响患者手术效果的相关因素。
选取 75 例 CSP 患者（均要求终止妊娠）作为观察组，另选取同期 75 例有剖宫产史的正常孕妇作为对照组。所有研究对象均行 TV-CDU 检查，计算剖宫产子宫瘢痕（CSM）厚度、最小子宫下段矢状肌厚度及下段前壁血流阻力指数（RI）。分析 CSM、最小子宫下段矢状肌厚度、RI 对 CSP 及 CSP 各亚型的诊断价值。观察组患者根据手术治疗效果分为有效组和无效组，分析影响 CSP 疗效的独立因素。
观察组 CSM、RI 及最小子宫下段矢状肌厚度均低于对照组。Ⅱ型 CSP 患者 CSM、RI、最小子宫下段矢状肌厚度均低于Ⅰ型，Ⅲ型患者均低于Ⅱ型。CSM、RI、最小子宫下段矢状肌厚度联合对 CSP 诊断的曲线下面积（AUC）及对 CSP 各亚型的 AUC 均高于各指标单独检测。妊娠囊大小及 CSM 是影响 CSP 治疗的独立因素。
TV-CDU 参数变化有助于剖宫产术后 CSP 的诊断。CSM、最小子宫下段矢状肌厚度变化及 RI 联合对 CSP 诊断及 CSP 各亚型具有较高的诊断价值。妊娠囊大小及 CSM 是影响 CSP 治疗的独立因素。
