摘要
目的评估经腹部三维超声(3D-TAS)联合经阴道三维超声(3D-TVS)检查在剖宫产术后瘢痕妊娠(CSP)患者早期诊断和分型中的应用价值。方法选取2020年3月至2023年3月洛阳市第一人民医院收治的疑似CSP者135例,均接受3D-TAS、3D-TVS检查,以术后病理作为“金标准”,分析3D-TAS、3D-TVS单独及联合检查在CSP者早期诊断和分型中的价值。结果135例疑似CSP患者中,术后病理证实CSP 100例(74.07%),非CSP 35例(25.93%)。且3D-TAS与3D-TVS联合检查诊断早期CSP的敏感度、准确率均明显高于3D-TAS、3D-TVS单独检查,而漏诊率、阴性预测值均明显低于3D-TAS、3D-TVS单独检查,差异均有统计学意义(P<0.05)。术后病理证实,100例CSP患者中Ⅰ型25例、Ⅱ型57例、Ⅲ型18例;3D-TAS、3D-TVS联合检查分型结果:Ⅰ型18例、Ⅱ型45例、Ⅲ型17例,分型检出率为80.00%(80/100),与病理结果CSP分型一致性检验较好(Kappa值为0.769,95%可信区间0.598~0.881,P<0.001)。结论3D-TAS、3D-TVS联合检查对CSP患者具有较高的早期诊断价值,并能为CSP分型诊断提供可靠依据,故可作为剖宫产术后再次妊娠患者筛查CSP的首选方式。
Objective To evaluate the application of three-dimensional transabdominal ultrasound(3D-TAS)combined with three-dimensional transvaginal ultrasound(3D-TVS)in the early diagnosis and classification of patients with cesarean scar pregnancy(CSP)after cesarean section.Methods A total of 135 suspected CSP patients admitted to Luoyang First People′s Hospital from March 2020 to March 2023 were examined by 3D-TAS and 3D-TVS.Taking postoperative pathology as the“gold standard”,the early diagnosis and typing value of 3D-TAS and 3D-TVS alone and combined examination in CSP patients were analyzed.Results Among 135 suspected CSP patients,100 cases(74.07%)were confirmed by postoperative pathology,and 35 cases(25.93%)were non-CSP.The sensitivity and accuracy of 3D-TAS combined with 3D-TVS in diagnosing early CSP were significantly higher than those of 3D-TAS and 3D-TVS alone,while the missed diagnosis rate and negative predictive value were significantly lower than those of 3D-TAS and 3D-TVS alone,with statistical significance(P<0.05).Postoperative pathology confirmed that among 100 CSP patients,25 cases were typeⅠ,57 cases were typeⅡand 18 cases were typeⅢ.The results of 3D-TAS and 3D-TVS combined examination showed that there were 18 cases of typeⅠ,45 cases of typeⅡand 17 cases of typeⅢ,and the detection rate of typing was 80.00%(80/100),which was in good agreement with CSP typing of pathological results(Kappa value=0.769,95%CI:0.598-0.881,P<0.001).Conclusion The combined examination of 3D-TAS and 3D-TVS has high early diagnostic value for CSP patients,and can provide a reliable basis for CSP typing diagnosis,so it can be used as the first choice for screening CSP for pregnant women after cesarean section.
作者
郝永和
赵丽
徐晨
HAO Yonghe;ZHAO Li;XU Chen(Department of Ultrasound,Luoyang First People′s Hospital,Luoyang,Henan 471000,China;Department of Obstetrics and Gynecology,Luoyang First People′s Hospital,Luoyang,Henan 471000,China)
出处
《现代医药卫生》
2024年第7期1143-1146,共4页
Journal of Modern Medicine & Health
关键词
经阴道三维超声
经腹部三维超声
瘢痕妊娠
剖宫产术
诊断
分型
Three-dimensional transabdominal ultrasound
Three-dimensional transvaginal ultrasound
Cesarean scar pregnancy
Cesarean section
Diagnostic
Class ification
