摘要
目的探讨经阴道三维超声对剖宫产瘢痕部位妊娠的早期预测价值。方法回顾性分析2016年4月-2018年4月佛山市妇幼保健院临床诊断为剖宫产瘢痕部位妊娠的患者142例。术前均行经阴道三维超声及经阴道二维超声检查。比较2种检查方式的诊断符合率,分析对切口孕囊型、包块型、部分切口及部分宫腔孕囊型剖宫产瘢痕部位妊娠的诊断结果,并计算2种检查方法的敏感性及特异性。结果52例患者确诊为剖宫产瘢痕部位妊娠,其中切口孕囊型22例,包块型13例,部分切口及部分宫腔孕囊型17例。经阴道二维超声阳性诊断符合率为55.74%(34/61),经阴道三维超声检查阳性诊断符合率为85.45%(47/55),2种检查方法比较,差异有统计学意义(P<0.05),经阴道三维超声检查阳性诊断符合率高于经阴道二维超声检查。2种检查方法检查切口孕囊型剖宫产瘢痕部位妊娠结果比较,差异无统计学意义(P>0.05)。经阴道三维超声检查对包块型、部分切口及部分宫腔孕囊型剖宫产瘢痕部位妊娠的确诊率高于经阴道二维超声检查(P<0.05)。经阴道三维超声检查诊断剖宫产瘢痕部位妊娠的敏感性、特异性、ROC曲线下面积均高于经阴道二维超声检查。结论经阴道三维超声应用于剖宫产瘢痕部位妊娠的早期诊断,具有较高的敏感性及特异性,阳性符合率高,为提高临床诊断准确性提供客观依据。
Objective To explore the value of transvaginal three-dimensional ultrasound in the early prediction of cesarean scar pregnancy.Methods A retrospective analysis was made on 142 cases of uterine scar pregnancy clinically diagnosed in our hospital from April 2016 to April 2018.All cases were examined by transvaginal threedimensional ultrasound and transvaginal two-dimensional ultrasound before operation.The diagnostic accuracy of the two methods was compared,and the results of the diagnosis of cicatricial pregnancy after cesarean section,such as gestation sac type,block type,partial incision and partial uterine cavity type caesarean section,were calculated,and the sensitivity and specificity of the two methods were calculated.Results A total of 52 cases were diagnosed as cesarean scar pregnancy,including 22 cases of incision gestational sac type,13 cases of mass type,17 cases of partial incision and partial uterine cavity gestational sac type.The positive diagnostic coincidence rate of transvaginal two-dimensional ultrasound was 55.73%(34/61),and that of transvaginal three-dimensional ultrasound was 85.45%(47/55).The positive diagnostic coincidence rate of transvaginal three-dimensional ultrasound was higher than that of transvaginal two-dimensional ultrasound(P<0.05).There was no significant difference between the two methods in the results of scar pregnancy in incision gestational sac cesarean section(P>0.05).The diagnostic rate of transvaginal three-dimensional ultrasonography for cesarean scar pregnancy of mass type,partial incision type and partial uterine cavity gestational sac type was higher than that of transvaginal two-dimensional ultrasonography(P<0.05).The sensitivity,specificity and area under ROC curve of transvaginal three-dimensional ultrasound in the diagnosis of cesarean scar pregnancy are higher than those of transvaginal two-dimensional ultrasound(P<0.05).Conclusion The application of transvaginal three-dimensional ultrasound in the early diagnosis of cesarean scar pregnancy has high sensitivity
作者
宁浩杰
韦德湛
谢宏基
罗慧
陈洁莹
林紫晴
符锦英
Hao-jie Ning;De-zhan Wei;Hong-ji Xie;Hui Luo;Jie-ying Chen;Zi-qing Lin;Jin-ying Fu(B ultrasonic room,Women and Children’s Hospital of Foshan,Foshan,Guangdong 528000,China)
出处
《中国现代医学杂志》
CAS
2020年第11期69-73,共5页
China Journal of Modern Medicine
基金
广东省佛山市卫生和计生委科研项目(No:20170120)。
