经阴道三维超声联合断层超声显像在早期切口妊娠诊断中的价值

The value of transvaginal 3D ultrasound combined with tomographic ultrasound imaging in the diagnosis of early cesarean scar pregnancy

目的探讨经阴道三维超声及断层超声显像技术(TUI)对剖宫产后子宫切口妊娠早期诊断的价值。方法对临床拟诊为切口妊娠的58例患者行经阴道二维及三维超声联合TUI技术检查,以手术病理结果为金标准,将经阴道二维检查结果与经阴道三维联合TUI技术检查结果作对照,比较两者对剖宫产后子宫切口妊娠早期诊断的敏感性、特异性和准确性。结果 58例患者中,病理证实切口妊娠25例,宫腔内妊娠33例,经阴道二维超声诊断切口妊娠敏感度80%(20/25),特异度61%(20/33),准确度69%(40/58)。经阴道三维联合TUI技术诊断切口妊娠敏感度84%(21/25),特异度76%(25/33),准确度79%(46/58)。结论经阴道三维联合TUI技术对切口妊娠诊断的敏感性、特异性及准确性均较经阴道二维超声高,经阴道三维联合TUI可作为切口妊娠的一种新型的诊断方法。

Objective To explore the value of transvaginal three-dimensional ultrasound and tomographicultrasoundimaging TUI in the early diagnosis of uterine incision pregnancy after cesarean section. Methods Fifty eight patients who were clinically diagnosed of suspected incisional pregnancy were examined by transvaginal two-dimensional ultrasound and transvaginal 3D ultrasound combined with TUI technique; then we would name surgery patho-logical results as the gold standard, by comparing the examination result of transvaginal two-dimensional ultrasound and that of transvaginal 3D ultrasound combined with TUI technique,thus to compare the sensitivity, specificity and accuracy of the two methods in the early diagnosis of uterine incisional pregnancy after cesarean section. Results In all of the 58 patients, 25 cases of incisional pregnancy and 33 cases of intrauterine pregnancy were diagnosed by pathology;the sensitivity of transvaginal two-dimensional ultrasound to diagnosis of incisional pregnancy was 80% 20/25 , the specificity was 61% 20/33 and the accuracy was 69% 40/58 ; the sensitivity of transvaginal three-dimensional ultrasound combined with TUI technique in the diagnosis of incisional pregnancy was 84% 21/25 , the speci-ficity was 76% 25/33 and the accuracy was 79% 46/58 . Conclusion The combination of transvaginal 3D ultrasound and TUI technique can have higher result of sensitivity, specificity and accuracy in the diagnosis of incisional pregnancy than that of transvaginal two-dimensional ultrasound, for which transvaginal three-dimensional ultrasound combined with TUI can be used as a new diagnostic method for the diagnosis of incisional pregnancy.