彩色多普勒超声诊断稽留流产与不典型葡萄胎的图像特点及诊断价值分析

Analysis of Image Characteristics and Diagnostic Value of Color Doppler Ultrasound in the Diagnosis of Missed Miscarriage and Atypical Hydatidiform Mole

目的:探讨与分析彩色多普勒超声诊断稽留流产与不典型葡萄胎的图像特点及诊断价值。方法:选择2018年1月~2022年12月在本院进行诊治的异常早期妊娠患者88例作为研究对象,所有患者均给予经阴道彩色多普勒超声检查,记录图像特征并判断诊断价值。结果:在88例患者中,病理判断为稽留流产50例(稽留流产组),葡萄胎38例(不典型葡萄胎组)。不典型葡萄胎组病灶或病灶相邻宫壁肌层内的血流阻力指数与搏动指数均低于稽留流产组(P<0.05);ROC曲线结果显示,RI、PI及联合诊断鉴别稽留流产、不典型葡萄胎的AUC分别为0.816、0.853、0.917;采用经阴道彩色多普勒超声诊断的敏感性与特异性分别为84.00%(42/46)、89.47%(34/38)。结论:稽留流产与不典型葡萄胎的彩色多普勒超声图像特征重叠部分较多,但不典型葡萄胎组病灶或病灶相邻宫壁肌层内的血流阻力指数与搏动指数都普遍低于稽留流产组,彩色多普勒超声对二者的鉴别诊断具有一定的价值,临床上可根据实际情况进行合理选择。

Objective:To explore and analysis the imaging characteristics and diagnostic value of color Doppler ultrasound in the diagnosis of missed miscarriage and atypical hydatidiform mole.Methods:From January 2018 to December 2022,88 cases of patients with abnormal early pregnancy who were diagnosed and treated at our hospital were selected as the research subjects.All patients were given transvaginal color Doppler ultrasound to record image features and assess diagnostic value.Results:Among the 88 patients,50 cases were diagnosed as missed abortion(missed abortion group)and 38 cases were diagnosed as atypical mole(atypical mole group).The resistance index and pulsatility index of blood flow within the myometrium of the uterine wall adjacent to the lesion or lesion were lower in the group of atypical gravidarians than in the group of induced abortions(P<0.05);ROC curve results showed that the AUC of RI,PI and combined diagnosis for diagnosing missed abortion and atypical mole were 0.816,0.853 and 0.917.The sensitivity and specificity of diagnosis using transvaginal color Doppler ultrasound was 84.00%(42/46)and 89.47%(34/38).Conclusion:The features of the color Doppler ultrasound images of missed abortion and atypical mole were more overlapping,but the blood flow resistance index and pulse index in the lesion or adjacent uterine wall muscle in the atypical mole group were generally lower than those in the missed abortion group.Color Doppler ultrasound has certain value in the differential diagnosis of the two groups,and can be rationally selected according to the actual situation in clinical practice.