经阴道三维断层超声成像联合超声造影对切口妊娠的诊断价值

Value of transvaginal three-dimensional tomographic ultrasonography imaging combined with contrast-enhanced ultrasound in the diagnosis of incision pregnancy

目的研究经阴道三维断层超声成像联合超声造影对切口妊娠的诊断价值。方法选择2018年1月至2020年1月收治的100例疑似切口妊娠患者,分别实施经阴道三维断层超声成像、超声造影诊断。以病理诊断为金标准,比较两种方式单一诊断和联合诊断的准确度、灵敏度、特异度及影像学表现。结果病理诊断结果显示,切口妊娠90例;经阴道三维断层超声成像联合超声造影的诊断准确度90.00%、灵敏度94.44%、特异度50.00%;经阴道三维断层超声成像的诊断准确度65.00%、灵敏度66.67%、特异度50.00%;经超声造影的诊断准确度67.00%、灵敏度67.78%、特异度60.00%。经阴道三维断层超声成像联合超声造影的诊断准确度、灵敏度高于单一诊断方式(P<0.05)。联合诊断结果显示,病灶均位于人体子宫下段前峡部,和子宫前壁分界不清,病灶显示向人体宫腔内生长,小部分深入人体前峡部切口处,前峡部显示肌层菲薄。结论经阴道三维断层超声成像联合超声造影诊断切口妊娠的效果显著,能提高检出率。

Objective To study the value of transvaginal three-dimensional tomographic ultrasonography imaging combined with contrast-enhanced ultrasound in the diagnosis of incision pregnancy.Methods A total of 100 patients with suspected incisional pregnancy admitted from January 2018 to January 2020 were selected as the research objects,and transvaginal three-dimensional tomographic ultrasonography imaging and contrast-enhanced ultrasound were performed for diagnosis respectively.The diagnostic accuracy,sensitivity,specificity and imaging findings of the two methods single diagnosis and combined diagnosis were compared using pathological diagnosis as the gold standard.Results The results of pathological diagnosis showed that there were 90 cases of incisional pregnancy.The diagnostic accuracy,sensitivity and specificity of transvaginal three-dimensional tomographic ultrasonography imaging combined with contrast-enhanced ultrasound were 90.00%,94.44%and 50.00%respectively.The diagnostic accuracy,sensitivity and specificity of transvaginal three-dimensional tomographic ultrasonography imaging were 65.00%,66.67%and 50.00%respectively.The diagnostic accuracy,sensitivity and specificity of contrast-enhanced ultrasound were 67.00%,67.78%and 60.00%respectively.The diagnostic accuracy and sensitivity of transvaginal three-dimensional tomographic ultrasonography imaging combined with contrast-enhanced ultrasound were higher than those of single diagnosis(P<0.05).Combined diagnosis results showed that the lesions were located in the anterior isthmus of the lower segment of the human uterus,and the boundary with the anterior wall of the uterus was not clear.The lesions showed intrauterine growth,and a small part of them penetrated into the incision of anterior isthmus.The anterior isthmus showed thin muscular layer.Conclusion Transvaginal three-dimensional tomographic ultrasonography imaging combined with contrast-enhanced ultrasound in the diagnosis of incision pregnancy has a significant effect,which can improve the detection rate.