MRI参数及血β-HCG诊断子宫瘢痕妊娠的效能及疗效评估价值分析

Efficacies of MRI Parameters and Blood β-HCG in Diagnosis of Uterine Scar Pregnancy and Their Values in Evaluation of Therapeutic Effect

目的分析MRI参数及血β-人绒毛膜促性腺激素(β-HCG)诊断子宫瘢痕妊娠的效能,并探究其评估疗效的价值。方法选取2019年3月—2021年3月我院97例子宫瘢痕妊娠作为研究组及79例剖宫产后因下腹不适、阴道出血行MRI检查者作为对照组,比较2组剩余肌层厚度、瘢痕厚度、病灶旁正常肌层厚度、血β-HCG水平,分析MRI参数与血β-HCG的相关性,探究MRI参数、血β-HCG诊断子宫瘢痕妊娠的效能;分析研究组不同疗效的影响因素。结果研究组剩余肌层厚度较对照组小,瘢痕厚度、血β-HCG较对照组大(P<0.01)。Pearson相关性分析发现,剩余肌层厚度与血β-HCG呈负相关(r=-0.523,P<0.01),瘢痕厚度与血β-HCG呈正相关(r=0.676,P<0.01)。受试者工作特征曲线分析显示,剩余肌层厚度、瘢痕厚度、血β-HCG诊断子宫瘢痕妊娠的曲线下面积(AUC)均在0.7以上,具有良好诊断效能,其中以血β-HCG的AUC最大,为0.996。无效者剩余肌层厚度较有效者小,瘢痕厚度、血β-HCG较有效者大(P<0.05,P<0.01)。剩余肌层厚度、瘢痕厚度、血β-HCG是子宫瘢痕妊娠患者疗效的影响因素(P<0.01)。结论MRI参数剩余肌层厚度、瘢痕厚度及血β-HCG在诊断子宫瘢痕妊娠方面具有良好效能,且上述指标均与子宫瘢痕妊娠患者疗效显著相关。

Objective To analyze efficacies of MRI(magnetic resonance imaging)parameters and bloodβ-human chorionic gonadotrophin(β-HCG)in diagnosis of patients with uterine scar pregnancy(USP)and to explore their values in evaluation of therapeutic effect.Methods A total of 97 patients with USP between March 2019 and March 2021 were selected as research group,while 79 patients undergoing MRI examinations due to lower abdominal discomfort and vaginal bleeding after cesarean section(C-section)at the same period were selected as control group.The thickness of residual myometrium,scar thickness,the thickness of normal muscle layer adjacent to the lesion and bloodβ-HCG levels were compared between two groups.Correlations between MRI parameters with bloodβ-HCG levels were analyzed.Efficacies of MRI parameters and bloodβ-HCG in diagnosis of USP patients were explored.The influencing factors of different therapeutic effects in research group were analyzed.Results In research group,the thickness of remaining myometrium was smaller,while scar thickness andβ-HCG were larger than those in control group(P<0.01).Pearson correlation analysis showed that the thickness of residual myometrium was negatively correlated with bloodβ-HCG(r=-0.523,P<0.01),while scar thickness was positively correlated with bloodβ-HCG(r=0.676,P<0.01).The receiver operating characteristic(ROC)curve showed that the areas under the ROC curve(AUC)of thickness of residual myometrium,scar thickness and bloodβ-hCG in diagnosis of USP patients were all more than 0.7,which meant well diagnostic efficiency.The AUC of bloodβ-HCG was the largest(0.996).In ineffective patients,the thickness of remaining myometrium was smaller,while the scar thickness and bloodβ-HCG were larger than those in effective patients(P<0.05,P<0.01).The thickness of residual myometrium,scar thickness and bloodβ-HCG were influencing factors of therapeutic effect in patients with USP(P<0.01).Conclusion MRI parameters including the thickness of residual myometrium and scar thickness and bloodβ-HCG have good efficacies in diagnosis of patients with USP,and the above indexes are significantly correlated with the therapeutic effects of patients with USP.