目的 探讨剖宫产术后疤痕妊娠 产妇的MRI影像学特征及其对治疗方案的 指导意义。方法 回顾分析经手术证实 为子宫瘢痕妊娠32例患者临床资料，分 析其MRI影像学成像特点，并根据成像 特点分析其手术治疗特点。结果 ①32例 患者中，MRI图像的孕囊清晰可见，子宫 峡部可见稍长T1、稍短T2信号影(剖宫产 瘢痕)，强化不明显；②妊娠囊包膜完整 者，MRI上表现为长T1或稍长T1、长T2环 形信号影，囊内容物表现为长T1长T2信 号，T2WI图像上较包膜信号强；妊娠囊 包膜不完整者，其图像主要表现为稍长 T1信号，稍长、等或稍短T2信号；③共 8例患者孕囊完全植入子宫肌层，在子 宫前呈“C”形、“反3”形，24例患者 的孕囊呈宫腔内生长趋势，子宫肌层浸 润，植入子宫壁较浅，与肌层有明显分 界；④患者根据妊娠囊植入情况及子宫 壁最薄处情况，主要采取腹腔镜下CSP电 切术治疗。结论 CSP患者的MRI的影像学 表现具有一定特异性，可为CSP患者治疗 方案提供参考。

Objective To explore the MRI findings of cesarean scar pregnancy (CSP) and their guiding significance for the treatment. Methods The clinical data of 32 patients with CSP confirmed by operation were analyzed retrospectively. The MRI findings were analyzed, and the characteristics of operation were analyzed according to the imaging findings. Results ①MRI images of the 32 cases showed clear gestation sac, and the uterine isthmus showed slightly long T1 and slightly short T2 signal (caesarean scar), with unobvious enhancement. ②MRI of pregnant women with intact gestation sac showed T1 or slightly longer T1 and long T2 annular signal. The contents of the sac showed long T1 and long T2 signal with strong capsule signal on T2WI. Images of those with incomplete gestation sac showed slightly longer T1 signal, slightly longer, equal or slightly shorter T2 signal. ③There were 8 cases with gestation sac complete implanted in uterine myometrium. The uterus was C-shaped or anti-3 shaped. The gestation sacs of 24 cases showed intrauterine growth trend, the myometrium was involved and the implanted uterine wall was shallow, with clear boundary with the muscle layer. ④Patients were treated by laparoscopic CSP electrocision according to the condition of the gestation sac implantation and the thinnest wall of the uterus. Conclusion MRI findings of patients with CSP are specific, which can provide reference for the treatment of CSP.