未破裂型输卵管妊娠与妊娠黄体的TV-CDFI声像特征及鉴别诊断特点

TV-CDFI ultrasonographic features and differential diagnosis characteristics of unruptured tubal pregnancy and pregnant corpus luteum

目的探讨经阴道彩色多普勒超声(TV-CDFI)鉴别诊断未破裂型输卵管妊娠与妊娠黄体的临床价值。方法选择2013-2015年该院妇产科收集的67例未破裂型输卵管妊娠(输卵管妊娠组)和74例宫内早孕合并妊娠黄体女性(黄体组),两组均于术前接受了TV-CDFI检查,分析两组的影像学特点和差异。结果输卵管妊娠组的高回声率(73.13%)显著高于黄体组(8.11%),差异有统计学意义(P<0.05)。输卵管妊娠组主要表现为不均质包块型(61.19%),黄体组主要表现为厚壁囊型(79.73%),差异有统计学意义(P<0.05)。输卵管妊娠组的超声血流特征主要表现为半环状、点状/线状,黄体组主要表现为环形,差异有统计学意义(P<0.05)。输卵管妊娠组的收缩期动脉血流峰值流速低于黄体组,血流阻力指数高于黄体组,差异均有统计学意义(P<0.05)。TV-CDFI鉴别诊断未破裂型输卵管妊娠与妊娠黄体的敏感度为95.52%,特异度为91.89%,漏诊率为4.48%,误诊率为8.11%。结论 TV-CDFI对鉴别诊断未破裂型输卵管妊娠与妊娠黄体具有较高的临床实用价值。

Objective To investigate the clinical value of transvaginal color Doppler flow imaging(TV-CDFI)in the differential diagnosis of unruptured tubal pregnancy and pregnant corpus luteum.Methods Sixty-seven cases of unruptured tubal pregnancy and 74 cases of intrauterine pregnancy complicating pregnant corpus luteum in the department of obstetrics and gynecology of this hospital during January 2015 were selected as the tubal pregnancy group and corpus luteum group respectively.The two groups received the preoperative TV-CDFI examination.Then the imaging characteristics and difference in the two groups were analyzed.Results The hyperechoic rate in the tubal pregnancy group was 73.13%,which was significantly higher than 8.11%in the corpus luteum group,the difference had statistical significance(P<0.05).The main manifestations in the tubal pregnancy group were heterogeneous mass type(61.19%),while which in the corpus luteum group was thick wall cyst type(79.73%),the difference had statistical significance(P<0.05).The ultrasonic blood flow characteristics in the tubal pregnancy group mainly were manifested by semi-ring,dot/line,which in the corpus luteum group were ring type,the difference had statistical significance(P<0.05);the peak flow rate of systolic artery blood flow(PSV)in the tubal pregnancy group was lower than that in the corpus luteum group,while the vascular resistance index(RI)was higher than that in the corpus luteum group,the difference was statistically significant(P<0.05).The sensitivity of TV-CDFI in the differential diagnosis of unruptured tubal pregnancy and pregnant corpus luteum was 95.52%,the specificity was 91.89%,the missed diagnosis rate was 4.48%and the misdiagnosis rate was 8.11%.Conclusion TV-CDFI for in the differential diagnosis of unruptured tubal pregnancy and pregnant corpus luteum has higher clinical practical value.