Study on the Diagnosis and Imaging Characteristics of Uterine Scar Diverticulum after Cesarean Section Using Transvaginal Three-dimensional Ultrasound
Objective:To explore the diagnostic efficacy of transvaginal three-dimensional ultrasound for cesarean scar diverticulum and its morphological imaging characteristics.Method:The study subjects were 96 women who underwent cesarean section at Ganzhou Women and Children's Health Care Hospital from January 2021 to March 2023 and had a transvaginal three-dimensional ultrasound examination 12 months postoperatively.Among them,34 cases diagnosed with scar diverticulum were included in the scar diverticulum group,while 62 cases with good scar healing were included in the control group.Using the results of magnetic resonance imaging (MRI) as the gold standard,the diagnostic efficacy of three-dimensional vaginal ultrasonography for uterine scar diverticulum after cesarean section was analyzed,structural characteristics of scar diverticulum (length,width and depth of scar diverticulum),blood flow parameters in the muscle layer around scar[vascularization index (VI),flow index (FI),vascularization flow index (VFI)],and blood flow distribution around the scar in HD flow mode were observed.Result:The menstrual duration in the scar diverticulum group was longer than that in the control group,and the proportion of anteverted uteri was higher than that in the control group,the number of cesarean section was more than that of control group (P<0.05).The length,width and depth of scar diverticula in retroverted uteri were significantly greater than those in anteverted uteri,and the residual myometrial thickness was less than in anteverted uteri (P<0.05).Compared with the control group,VI,FI and VFI in the scar diverticulum group were significantly higher (P<0.05).The area around the scar showed a blood flow distribution within a range of 2 cm,the blood flow of the control group was mainly concentrated in grade 0 and grade Ⅰ,while the blood flow of the scar diverticulum group was mainly in grade Ⅱ and grade Ⅲ,the difference of blood flow distribution between the two groups was statistically significant (P<0.05).The diagnostic efficacy was evaluated using the ROC curve,and the AUC for diagnosing scar diverticula with transvaginal three-dimensional ultrasound was 0.954,with a sensitivity and specificity of 94.1％ and 96.8％,respectively.Conclusion:Transvaginal three-dimensional ultrasound demonstrates high diagnostic efficacy for uterine scar diverticulum after cesarean section,effectively revealing its morphological imaging characteristics and providing a non-invasive,efficient diagnostic tool for clinical use.
万方数据
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