Chinese Medical Sciences Journal ›› 2022, Vol. 37 ›› Issue (2): 151-158.doi: 10.24920/003870

• 论著 • 上一篇    下一篇

3D T2W SPACE MRI评估剖宫产后1年至2年子宫瘢痕及子宫形态变化

戚亚菲1,何泳蓝1,丁宁1,马良坤2,钱天翼3,李源2,薛华丹1,*(),金征宇1   

  1. 1中国医学科学院北京协和医院放射科,北京 100005
    2中国医学科学院北京协和医院妇产科,北京 100005
    3西门子公司MR事业部,北京,100102
  • 收稿日期:2020-12-20 接受日期:2022-02-28 出版日期:2022-06-30 发布日期:2022-07-07
  • 通讯作者: 薛华丹 E-mail:bjdanna95@163.com

Assessment of Changes in the Cesarean Scar and Uterus Between One and Two Years after Cesarean Section Using 3D T2w SPACE MRI

Yafei Qi1,Yonglan He1,Ning Ding1,Liangkun Ma2,Tianyi Qian3,Yuan Li2,Huadan Xue1,*(),Zhengyu Jin1   

  1. 1Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
    2Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
    3MR Collaborations NE Asia, Siemens Healthcare, Beijing 100102, China
  • Received:2020-12-20 Accepted:2022-02-28 Published:2022-06-30 Online:2022-07-07
  • Contact: Huadan Xue E-mail:bjdanna95@163.com

摘要:

目的 使用高分辨3D T2加权磁共振(3D T2w SPACE MRI)评估剖宫产后1年至2年子宫瘢痕及子宫形态变化。
方法 我们前瞻性纳入剖宫产后1年女性志愿者,使用高分辨3D T2w SPACE MRI探究其1年至2年子宫瘢痕及子宫形态变化,同时招募无生育史的志愿者作为对照组。所有数据均由两名经验丰富的放射科医生测量。使用配对样本t检验或独立样本t检验比较所有符合正态分布的数据。
结果 46名女性在剖宫产后1年接受了盆腔磁共振检查,其中15名在剖宫产后2年再次进行了检查。剖宫产后2年子宫长度(5.75±0.46 cm)、子宫前壁肌层厚度(1.45±0.35 cm)均显著大于剖宫产后1年子宫长度(5.33±0.59 cm)与子宫前壁肌层厚度(1.25±0.27 cm)(t = -2.363,-2.175,P = 0.033,0.048)。剖宫产后2年子宫前壁肌层厚度(1.45±0.35 cm)与对照组(1.58±0.21 cm)比较无统计学差异(P = 0.170)。9名女性在剖宫产后1年后存在子宫瘢痕憩室,产后2年瘢痕憩室仍然存在。产后1年至2年子宫瘢痕厚度、高度、宽度无明显变化(P > 0.05)。
结论 3D T2w SPACE MRI可用于评估剖宫产后1年至2年子宫瘢痕及子宫形态变化,提供整体的形态学细节。剖宫产后瘢痕形态在产后1年达到相对稳定,子宫形态在产后2年接近正常。

关键词: 剖宫产, 子宫瘢痕, 子宫形态, 3D T2W SPACE MRI

Abstract:

Objective To evaluate changes in morphology of the cesarean scar and uterus between one and two years after cesarean section using high-resolution, three dimensional T2-weighted sampling perfection with application optimized contrast using different flip angle evolutions Magnetic Resonance Imaging (3D T2w SPACE MRI).
Methods This prospective study was performed to investigate morphological changes in the cesarean scars and uterus from one to two years after cesarean section using high-resolution, 3D T2w SPACE MRI. The healthy volunteers having no childbearing history were recruited as the controls. All data were measured by two experienced radiologists. All data with normal distribution between the one-year and two-year groups were compared using a paired-sample t test or independent t test.
Results Finally, 46 women took a pelvic MR examination one year after cesarean section, and a subset of 15 completed the same examination again after two years of cesarean section. Both the uterine length and the anterior wall thickness after two years of cesarean section (5.75 ± 0.46 and 1.45 ± 0.35 cm) were significantly greater than those measured at one year (5.33 ± 0.59 and 1.25 ± 0.27 cm) (t = -2.363 and -2.175, P= 0.033 and 0.048). No significant difference was shown in myometrial thickness two years after cesarean section (1.45 ±0.35 cm) with respect to the control group (1.58 ± 0.21 cm, P= 0.170). Nine women who underwent MRI twice were considered to have scar diverticula one year after cesarean section, and still had diverticula two years after cesarean section. The thickness, height, and width of the uterine scar showed no significant change from one to two years (all P > 0.05).
Conclusions 3D T2w SPACE MRI provides overall morphologic details and shows dynamic changes in the scar and the uterus between one and two years after cesarean section. Scar morphology after cesarean section reached relatively stable one year after cesarean section, and uterine morphology was closer to normal two years after cesarean section.

Key words: uterine cesarean, scar, uterine morphology, 3D T2w SPACE MRI

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