三维超声自由解剖成像技术对早期宫角与间质部妊娠的诊断价值

Three dimensional ultrasound omniview technology in diagnosis of early interstitial pregnancy and cornual pregnancy

目的探讨三维经阴道超声自由解剖成像技术(3DTVUOT)对早期宫角妊娠(CP)与间质部妊娠(ITP)的定性诊断价值。方法回顾性分析35例CP和36例ITP患者的临床资料。均因临床疑诊早期CP或ITP被序贯予以二维经阴道超声(2DTVU)和3DTVUOT检查,对妊娠病灶与宫腔的相通情况、病灶周围肌层完整性和厚度情况等进行比较分析;以手术-病理结果作为诊断金标准,对两种检查方法应用于CP和ITP定性诊断中的敏感性、特异性及准确性进行比较。结果CP患者的妊娠病灶与宫腔相通率(91.43%)高于ITP(8.33%),病灶周围包绕肌层的厚度(6.08±1.35)mm高于ITP(1.95±0.58)mm,完整性(100%)亦高于ITP的(72.22%),组间比较差异均有统计学意义(P<0.05)。2DTVU定性诊断CP和ITP的敏感性(86.11%)、特异性(77.14%)及准确性(81.68%)均明显低于3DTVUOT(分别94.44%、85.71%、90.14%),组间差异具有统计学意义(P<0.05)。结论3DTVUOT对CP和ITP的早期定性诊断,具有较高的可靠性,优于2DTVU,可在临床推广应用。

Objective To explore the clinical value of three dimensional transvaginal ultrasound omniview technology(3DTVUOT)in the qualitative diagnosis of early interstitial pregnancy and cornual pregnancy.Methods The clinical data of 35 CP and 36 ITP patients treated in Mianyang Central Hospital were retrospectively analyzed.Two dimensional transvaginal sonography(2DTVU)and 3DTVUOT were performed successively because of clinical suspected early CP or ITP.The communication between gestational lesions and uterine cavity,as well as the integrity and thickness of myometrium around the lesions,were compared and analyzed.In operation pathological findings as the gold standard for diagnosis,and the sensitivity,specificity and accuracy of two methods in qualitative diagnosis of CP or ITP were compared and analyzed.Results In CP patients,the rate of communicating with uterine cavity(91.43%)was higher than that of ITP(8.33%).The thickness of surrounding muscle layer(6.08±1.35 mm)was higher than that of ITP(1.95±0.58 mm),and the integrity(100%)was also higher than that of ITP(72.22%).The difference between the two groups was statistically significant(P<0.05).The sensitivity(86.11%),specificity(77.14%)and accuracy(81.68%)of 2DTVU qualitative diagnosis of CP and ITP were significantly lower than those of 3DTVUOT(94.44%,85.71%,90.14%,respectively),and the difference between the two groups was statistically significant(P<0.05).Conclusion 3DTVUOT is more reliable than 2DTVU in qualitative diagnosis of early CP and ITP,and it is worthy of clinical application.