Objective:To investigate the value of ultrasound for the differential diagnosis of normal intrauterine pregnancy (IUP) versus cesarean scar pregnancy (CSP).Methods:We analyzed 222 ultrasound images between 5 and 10 weeks of gestation in our hospital from January 2015 to January 2017:74 cases of CSP as the research group,148 cases of IUP [74 cases of intrauterine pregnancy-none cesarean delivery (IUP-NCD) and 74 cases of intrauterine pregnancy-cesarean delivery (IUP-CD)] as the control group.The vertical distance of the center of the gestational sac (GS) relative to the mediatriee of the corpus uteri was calculated.Results:The distance to the center of the GS relative to the mediatrice of the corpus uteri was statistically significant different between the IUP group and the CSP group (P＜0.05),but there was no significant difference between the IUP-NCD group and the IUP-CD group (P＞0.05).Compared with the CSP group,the difference were statistical significant in the IUP-NCD group and the IUP-CD group (P＜0.05).The diagnosis accuracy of CSP of the application of the distance to the center of the GS relative to the mediatrice of the corpus uteri was not different from that of the surgical pathology diagnosis (P＜0.05).Conclusion:The distance to the center of the GS relative to the mediatrice of the corpus uteri could be used as an easy method for sonographic differentiation of IUP and CSP between 5 and 10 weeks of gestation.%目的:探讨超声对孕早期正常富内妊娠(IUP)和刮宫产瘢痕妊娠(CSP)的鉴别诊断价值.方法:选取2015年1月至2017年1月在广西医科大学第一附属医院超声科行早孕期(孕5～10周)超声检查的222例孕妇,其中74例为CSP(CSP组),148例为IUP(IUP组).IUP组包括74例无剖宫产史IUP(IUP-NCD组)和74例剖宫产术后IUP(IUP-CD组).观察各组超声图像,测量子宫矢状切面妊娠囊(GS)中心相对于宫体中垂线的垂直距离.结果:IUP组和CSP组GS中心相对于宫体中垂线的垂直距离比较,差异有统计学意义(P＜0.05),IUP-NCD组与IUP-CD组比较,差异无统计学意义(P＞0.05),IUP-NCD组、IUP-CD组分别与CSP组比较,差异有统计学意义(P＜0.05);经超声GS中心对于宫体中垂线的垂直距离诊断CSP的准确率为95.94％,与手术病理诊断相比较,差异无统计学意义(P＞0.05).结论:应用GS中心相对于宫体中垂线的垂直距离诊断CSP具有较高的准确率,可以作为一种简单鉴别诊断孕5～10周IUP和CSP的超声检查方法.
展开▼
