经阴道二维、三维超声对异位妊娠的诊断价值

Diagnostic value of transvaginal two-dimensional and three-dimensional ultrasound on ectopic pregnancy

目的探讨经阴道二维、三维超声在诊断异位妊娠中的价值。方法对49例经腹二维超声检查后疑有异位妊娠患者进行阴道二维、三维超声成像,并与其宫腔镜、手术病理结果对比分析。结果 49例患者三维成像均获得了满意的冠状切面图像,输卵管妊娠42例,其中诊断宫角妊娠5例,肌壁间妊娠1例,误诊1例肌壁间妊娠(误为宫内正常早孕);二维超声诊断输卵管妊娠42例,宫角妊娠2例,误诊5例:3例宫角妊娠误诊为输卵管间质部妊娠、2例肌壁间妊娠均误诊为宫内早孕。超声诊断结果与病理结果和宫腔镜比较,三维超声准确率为97.9%,二维超声为89.7%,二者比较差异有统计学意义(P<0.05)。结论三维超声对异位妊娠的特异性和敏感性均优于二维超声,有非常好的临床应用价值。

Objective To investigate the diagnostic value of transvaginal two-dimensional（2D） and three-dimensional（3D）ultrasound on ectopic pregnancy.Methods Transvaginal 2D and 3D ultrasonography was performed for 49 patients who were suspected to have ectopic pregnancy by abdomen 2D ultrasonography,and the results were compared with hysteroscope check-up and operation pathology examination results.Results All of the 49 cases got satisfied coronary section images in 3D scanning.Of all the cases,42 cases were oviduct pregnancy,5 cases were diagnosed as corneal pregnancy,1 case was muscle pregnancy,while 1 case of muscle pregnancy was misdiagnosed（be misdiagnosed as uterus normal early pregnancy）;In 2D scanning,42 cases were diagnosed as oviduct pregnancy,2 cases were corneal pregnancy,while 5 cases were misdiagnosed： 3 cases of corneal pregnancy were misdiagnosed as oviduct pregnancy,2 cases of muscle pregnancy were all misdiagnosed as uterus early pregnancy.Compared the with hysteroscope check-up and operation pathology examination results,the accuracy rate of 3D ultrasonic examination was 97.9%,while 2D examination was 89.7%,and there was significant difference between the two accuracy rates（P0.05）.Conclusion 3D ultrasonic scanning is superior to 2D ultrasonic scanning both in specificity and sensitivity in diagnosing ectopic pregnancy,so is worthy clinical application.