Qiao Li, Lu Jingjing, Zhang Bihong, Liu Aiqun, Wang Xiaohua, Wang Mei, Li Jian, Meng Jiabao
Department of ultrasound, Zhongshan Boai Hospital, Zhongshan, China.
Department maternity, Shenzhen Luohu District People's Hospital, Shenzhen, China.
Ann Med. 2025 Dec;57(1):2523558. doi: 10.1080/07853890.2025.2523558. Epub 2025 Jun 30.
To evaluate the accuracy of multimodal vaginal ultrasound in assessing post-caesarean scar healing.
A systematic review and meta-analysis were conducted on Chinese and English studies using multimodal vaginal ultrasound to diagnose poor scar healing post-CS. Two researchers screened literature based on inclusion/exclusion criteria. Quality assessment and meta-analysis (RevMan 5.4, Stata14.0, Meta-DiSc1.4) were performed for various diagnostic indicators.
Twenty-five high-quality studies identified key ultrasound markers: hypoechoic/anechoic scars (sensitivity 92%, specificity 91%), thinning/discontinuity of the myotomy layer (sensitivity 95%, specificity 90%), blurred incision contour (sensitivity 99%, specificity 91%), absent blood flow (sensitivity 92%, specificity 91%), irregular lesion morphology (sensitivity 95%, specificity 90%), uneven myometrial echogenicity (sensitivity 94%, specificity 91%), lower uterine segment thickness ≤3.73 mm (sensitivity 90%, specificity 88%), and myometrial lining ≤1.5 mm (sensitivity 90%, specificity 92%).
Multimodal vaginal ultrasound is highly accurate in detecting poor CS scar healing, aiding early intervention to prevent complications.
评估多模态经阴道超声在评估剖宫产术后瘢痕愈合情况中的准确性。
对使用多模态经阴道超声诊断剖宫产术后瘢痕愈合不良的中英文研究进行系统综述和荟萃分析。两名研究人员根据纳入/排除标准筛选文献。对各种诊断指标进行质量评估和荟萃分析（RevMan 5.4、Stata14.0、Meta-DiSc1.4）。
25项高质量研究确定了关键超声标志物：低回声/无回声瘢痕（敏感性92%，特异性91%）、肌层变薄/连续性中断（敏感性95%，特异性90%）、切口轮廓模糊（敏感性99%，特异性91%）、无血流信号（敏感性92%，特异性91%）、病变形态不规则（敏感性95%，特异性90%）、子宫肌层回声不均匀（敏感性94%，特异性91%）、子宫下段厚度≤3.73 mm（敏感性90%，特异性88%）以及肌层内膜≤1.5 mm（敏感性90%，特异性92%）。
多模态经阴道超声在检测剖宫产术后瘢痕愈合不良方面具有高度准确性，有助于早期干预以预防并发症。
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