The Study Of The Uterine Scar Diverticulum Was Studied By The Three-Dimensional Doppler Ultrasonography

As the two-child policy open,again scar uterus pregnancy complications associated with gradually attention by clinicians,clinical gradually focused on how to prevent the happening of the cesarean delivery complications,including uterine scar diverticulum is one of the common complications of cesarean delivery At the same time,uterine scar diverticulum oftenaccompanied by menstrual extension Clinical symptom such as menstrual blood dripping wet is endless,belong to the motherland medicine such as menstrual extension ren,one of kidney and blood stasis type is the card typePurpose:The formation mechanism and etiology of scar diverticulum in uterus are not yet clear,and the study of the characteristics and clinical value of scar diverticulum in uterus has not been widely carried out.This study bytransvaginal ultrasound screening cases of uterine scar diverticulum and uterine scar complete group,analysis of general clinical data of two groups of cases,joint application of transvaginal ultrasound HDflow model to observe the uterine scar diverticulum muscular morphological structure and scarperipheral blood flow characteristics,the quantitative analysis of uterine scar the size of the diverticulum,shape,volume,muscular layer surrounding the blood flow parameters of small blood vessels,explore the uterine scar diverticulum related influencing factors,and the size of the scardiverticulum and uterine position,scar formation and the relationship between cesarean delivery times,diverticulum scar diverticulum morphologicalstructure,scar formation characteristics of the small blood vessels and its clinical value.Method:Select 141 cases from March 2014 to February 2014 to our hospital outpatient and the inpatient treatment had more than one time history of cesarean section,and the selection of traditional Chinese medicine,the kidney and blood stasis type patients respectively in menstruation 6¹0 days for both patients via vaginal ultrasound examination,according to the scar is divided into two groups:uterine scar diverticulum and uterine scar whole group,including scar diverticulum group 70 cases,scar group,71 cases of complete;Collected two groups of cases of clinical data,via vaginathree-dimensional power doppler ultrasound examination,the scar HDflow mode grading distribution of muscular blood scar 3 d imaging,measure thediverticulum depth,width,height,residual muscle layer thickness,using three-dimensional power doppler ultrasound acquisition required for offline use 3 d image and the background of Vocal software processing calculation analysis of scar diverticulum,uterine scar volume of blood flow parameters VI,FI and VFI valuesResults:1.Comparison of the uterine position:the posterior position of the uterus in the cicatrial diverticulum was 67.12%,and the posterior proportion of the whole group was 32.9%,which was found that thec^（17）=15.673,P=0.000;It can be seen that the posterior uterine type is related to the formation of scar diverticulum.2.Three dimensional ultrasonography of scar diverticulum:the depth comparison of scar diverticulum formed by anterior and posterior uterus（3.92mm±0.99mm&5.20mm±1.94mm）、The width of the comparison（11.07mm±2.54mm&13.99mm±3.95mm）、the higher（6.89mm±1.89mm&8.71mm±3.05mm）、Residual muscle thickness comparison（3.38mm±0.56mm&3.00mm±0.71mm）,The depth,width,height and residual muscular thickness of the posterior uterine uterus were higher than that of the anterior uterus,and there were statistical differences.The blood flow parameters of the peripheral muscle of the two groups were compared（0.63±0.06&0.57±0.09）There was a statistical difference.There was no statistical difference between the PSV values and PI values in the two groups.3.Comparison of cesarean section:the average number of cesarean section of the cicatrix diverticulum was 1.84±0.637,and the total number of cesarean section of the scar was 1.57±0.711 times,compared with P=0.006.The mean number of cases of cesarean section had significant difference in both groups,each group were 1,2 times,many times（three or more）and uterus before and after a comparison between groups,before there was no statisticallysignificant difference uterine cesarean delivery times,after a number of uterine cesarean section proportion difference was statistically significant.4.Menstrual days:each menstrual days menstrual cycle scar diverticulum group was 11.77±2.97（day）,scar a complete set of menstruation was 5.63±1.11 days（days）,menstrual days scar diverticulum group was obviously higher than that of full set of scar,the difference was statisticallysignificant.5.In the HDflow pattern,the blood flow is distributed in the area around the scarring of the scarring,and in the case of the"scar",the"scarring"is mainly in the"II"and"III"of the blood flow,and the"scar"is the main body of the scar,which is primarily"0"and"I".6.The blood flow parameters of the peripheral muscles of the diverticulum of the uterus were significantly higher than that of the scar tissue in the peripheral blood flow index（VI）,FI value,and VFI value of the peripheral blood flow index of the cicatrial diverticulum in the 6th¹0 days of the menstrual period.The difference was statistically significant between the two groups（P=0.000）,FI value（P=0.001）,and VFI value（P=0.000）.Conclusion:1.The posterior uterus is more likely to form a cervical scarring than the anterior uterine postoperative;2.The depth,width,height,and residual thickness of the scar on the back of the uterus is more evident than the scar on the anterior side of the uterus.3.As the number of caesarean increased,the likelihood of the uterine scarring in the uterus was increased.4.The scarring in the diverticular and the scar tissue,the period of the period of the scar is prolonged,and the period is a long period of time.5.The fine blood flow detection technique of HDflow pattern,overcast 3d energy doppler and Vocal software can be used to observe the distribution of blood flow in the peripheral muscles of the uterine scar diverticulum,which can help diagnosis and differential diagnosis of scar diverticulum.