| 引用本文： |
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杨 清,陈风华,任 敏,等.剖宫产术后子宫瘢痕憩室的标准化超声量化及月经异常关系的探讨[J].同济大学学报（医学版）,2019,40(6):847-852. [点击复制]
- YANG Qing,CHEN Feng-hua,REN Min,et al.Correlation of standardized imaging measurement of cesarean scar diverticulum with menstrual abnormality[J].同济大学学报（医学版）,2019,40(6):847-852. [点击复制]
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| 摘要: |
| 目的 探讨剖宫产术后子宫瘢痕憩室（cesarean scar diverticulum, CSD）检查的标准化测量及憩室与月经异常延长时间的关系。方法 收集2014年1月至2016年2月230例因CSD导致月经延长并在同济大学附属第一妇婴保健院行经阴道子宫憩室修补术患者临床资料。回顾性分析患者阴道超声和磁共振的影像学特征及临床资料。子宫矢状面测量憩室的宽度和深度，横断面测量憩室的长度。量化参数为CSD宽度、深度(depth, D)、长度、残留肌层厚度（residual myometrial thickness, RMT）、残留肌层厚度/深度、憩室容积。根据月经异常延长时间分为月经延长≥15d组、月经延长11~14d组和月经延长8~10d组。分析憩室的宽度、深度、长度与月经延长时间的相关性。结果 超声的宽度、深度、长度均随着月经时间延长而增大，差异有统计学意义（P<0.05）；月经延长时间≥15d组残留肌层厚度/深度、RMT/（RMT+D）减小，差异有统计学意义（P<0.05）。3组间残留肌层厚度、憩室容积差异无统计学意义（P>0.05）。憩室的宽度、深度、长度与月经延长时间成正相关，其中超声长度相关程度最大（相关系数0.478）；而RMT/D、RMT/（RMT+D）与月经异常延长时间成负相关。230例术前超声发现剖宫产后子宫疤痕憩室形状以三角形和楔形多见；子宫位置以后位子宫多见。术后3个月超声随访检查，109例仍存在憩室，憩室尺寸较术前明显缩小(P<0.05)。结论 标准化的量化测量和统一的术语能更准确地分析数据，得到确实的结果，实现资源共享，有益于临床医生采取适当的治疗方式。憩室的宽度、深度、长度与月经延长时间正相关，尤其长度与月经延长时间的相关性最大。残留肌层厚度与月经延长时间无关。 |
| 关键词: 超声量化 月经异常 剖宫产术 子宫瘢痕憩室 |
| DOI：10.16118/j.1008-0392.2019.06.014 |
| 投稿时间：2019-08-07 |
| 基金项目: |
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| Correlation of standardized imaging measurement of cesarean scar diverticulum with menstrual abnormality |
| YANG Qing,CHEN Feng-hua,REN Min,ZHANG Hai-xia,Lü Xiao-li |
| (Dept. of Ultrasonography, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai 200040, Chin;Dept. of Radiology, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai 200040, China) |
| Abstract: |
| Objective To investigate the standardized measurement of cesarean scar diverticulum（CSD) with menstrual abnormality. Methods From January 2014 to February 2016, 230 patients underwent vaginal repair of cesarean scar diverticulumin our hospital.The ultrasonography and MRI scans were performed. The imaging measurement parameters of cesarean scar diverticulum included the length, width, depth and residual myometrial thickness, RMT，RMT/D and diverticular volume. The correlation of measurement parameters with abnormal menstrual bleeding time was analyzed. Results The width and depth of diverticulum were measured on sagittal plane and the length of diverticulum was measured on transverse plane. The width, depth, and length were correlated with increase of menstrual period（P<0.05). When the menstrual extension time was≥15 days, RMT/D and RMT/（RMT+D) were smaller than those in patients with period <15 days（P<0.05). There was no significant difference in RMT and diverticulum volume between the groups（P>0.05). The width, depth and length of diverticulum were positively correlated with the prolonged period of menstruation, among which the ultrasonic length was moderately correlated with the prolonged period of menstruation（r=0.478,P<0.05）. The RMT/D and RMT/（RMT+D) were negatively correlated with prolonged abnormal menstruation. The morphology of cesarean scar diverticulum was usually retroflexed uterus. There were residual cesarean scar diverticulums after operation in 109 cases, but size was smaller than that of pre-operation（P<0.05). Conclusion Standardized quantitative imaging measurement and unified terminology can more accurately analyze the cesarean section diverticulum, which is beneficial for clinicians to adopt appropriate treatment methods. |
| Key words: ultrasonic quantitation system menstrual disorders cesarean section cesarean scar diverticulum |
