目的 分析剖宫产切口妊娠(CSP) MRI影像学特点及其诊断价值。方法 回 顾性收集我院37例CSP患者临床资料，所 有患者均经手术病理确诊，且进行MRI检 查，分析患者MRI影像学特点并探讨其诊 断价值。结果 共37例CSP患者妊娠囊位于 子宫前壁下段，23例孕囊为单纯囊状结 构，囊体T1WI、T2WI、脂肪抑制T2WI分 别呈低信号、高信号、高信号。14例孕 囊呈混杂信号，与肌层分界不清，内部 可见T1WI稍低或等信号、T2WI低或高信 号、脂肪抑制T2WI低或高信号。内生型 CSP患者15例，外生型CSP患者22例。内 生型CSP瘢痕最薄厚度和孕囊体积分别为 (4.49±1.71)mm和(86.25±31.48)cm3 ， 均大于外生型CSP的(2.28±1.03)mm和 (63.91±28.05)cm3 (P<0.05)；孕囊类型 与外生型CSP无显著差异(P>0.05)；孕囊 与瘢痕接触面面积和孕囊周围血供丰富 比率分别为(3.17±0.96)cm2 和26.67%， 小于外生型CSP的(4.05±1.12)cm2 和 72.73%(P<0.05)。以手术病理结果为标 准，MRI对CSP诊断正确率为89.19%。结论 MRI扫描可显示CSP影像学特征，且内生型 与外生型孕囊在瘢痕最薄厚度、孕囊体积 和孕囊周围血供丰富程度均有显著差异， 临床可根据相关特征表现提高诊断准确 率。

Objective To analyze the MRI imaging features and diagnostic value of cesarean scar pregnancy (CSP). Methods The clinical data of 37 patients with CSP admitted to our hospital were collected retrospectively. All patients were diagnosed with surgical pathology and were given MRI examination. The MRI imaging features were analyzed, and the diagnostic value was explored. Results The gestational sac of 37 CSP patients were located in the lower part of anterior uterine wall, and the gestational sac of 23 patients was a simple cystic structure, and T1WI, T2WI, and fat suppression T2WI showed low signal, high signal and high signal respectively. A total of 14 cases of gestational sac showed mixed signals with unclear muscular boundary, and there was slightly low or equal signal in T1WI, low or high signal in T2WI and low or high signal in fat suppression T2WI. There were 15 cases with endogenous CSP and 22 cases with exogenous CSP. The thinnest scar thickness and the gestational sac volume of endogenous CSP were (4.49±1.71)mm and (86.25±31.48)cm3 respectively, which were greater than those of exogenous CSP with (2.28±1.03)mm and (63.91±28.05)cm3 (P<0.05). There was no significant difference in gestational sac type compared with exogenous CSP (P>0.05) The contact area between gestational sac and scar and the rich ratio of blood supply around gestational sac were (3.17±0.96)cm2 and 26.67% respectively, which were lower than those of exogenous CSP with (4.05±1.12)cm2 and 72.73% (P<0.05). Based on the results of surgical pathology, the diagnostic accuracy of MRI for CSP was 89.19%. Conclusion MRI scan can show the CSP imaging features, and there were significant differences in the thinnest scar thickness, the gestational sac volume and the rich blood supply around the gestational sac between the endogenous and exogenous gestational sacs, and the diagnostic accuracy can be improved according to relevant features.