经阴道超声在异位妊娠、早孕期卵巢黄体囊肿鉴别诊断中的价值

Value of Transvaginal Ultrasound in the Differential Diagnosis of Ectopic Pregnancy and Ovarian Corpus Luteum Cyst in Early Pregnancy

目的:探讨经阴道超声在异位妊娠、早孕期卵巢黄体囊肿中的鉴别诊断价值.方法:选取2021年4月至2023年5月于本院就诊的150例异位妊娠患者为研究对象并将其纳入异位妊娠组;另选取150例早孕期卵巢黄体囊肿患者纳入黄体囊肿组.两组患者均经临床结果确诊.比较两组患者超声指标及血流分布情况、超声血流参数及血流频谱分布形态.比较经腹部及经阴道超声两种检查方式的诊断效能.结果:异位妊娠组患者点状或条状血流占比高于黄体囊肿组,环状、半环状血流分布占比低于黄体囊肿组,差异均有统计学意义(P<0.05);异位妊娠组血流搏动指数(PI)、血流阻力指数(RI)值均高于黄体囊肿组,差异均有统计学意义(P<0.05);异位妊娠组极低阻力型占比低于黄体囊肿组,低阻力型、高阻力型占比高于黄体囊肿组,差异均有统计学意义(P<0.05).经阴道超声的灵敏度、特异度、准确度均高于经腹部超声,漏诊率及误诊率低于经腹部超声,差异均有统计学意义(P<0.05).结论:在异位妊娠、早孕期卵巢黄体囊肿使用经阴道超声检查,具有较高的鉴别诊断价值,可为临床鉴别诊断提供可靠依据.

Objective:To explore the value of transvaginal ultrasound in the differential diagnosis of ectopic pregnancy and ovarian luteal cysts in early pregnancy.Methods:A total of 150 patients with ectopic pregnancy who were treated in our hospital from April 2021 to May 2023 were selected as the study subjects and included in ectopic pregnancy group.In addition,150 patients with early pregnancy ovarian luteal cysts were selected and included in corpus luteum cyst group.Both groups of patients were diagnosed through clinical results.The ultrasound indicators and blood flow distribution,ultrasound blood flow parameters,and blood flow spectrum distribution morphology were compared between the two groups,and the diagnostic efficacy of the two examination methods(transabdominal and transvaginal ultrasound)were compared.Results:The proportion of punctate or linear blood flow in ectopic pregnancy group was higher than that in corpus luteum cyst group,while the proportion of circular and semi-circular blood flow distribution was lower than that in corpus luteum cyst group,and the differences were statistically significant(P<0.05).The blood flow pulsatility index(PI)and blood flow resistance index(RI)values of ectopic pregnancy group were higher than those of corpus luteum cyst group,and the differences were statistically significant(P<0.05).The proportion of extremely low resistance type in ectopic pregnancy group was lower than that in corpus luteum cyst group,while the proportion of low resistance type and high resistance type was higher than that in corpus luteum cyst group,and the differences were statistically significant(P<0.05).The sensitivity,specificity,and accuracy of transvaginal ultrasound were higher than those of transabdominal ultrasound,while the rates of missed diagnosis and erroneous diagnosis were lower than those of transabdominal ultrasound,and the differences were statistically significant(P<0.05).Conclusion:Transvaginal ultrasound examination in ectopic pregnancy and ovarian corpus luteum cysts in early pregnancy has high dfferential diagnostic value and can provide reliable basis for clinical differential diagnosis.