彩超图像及血流频谱特征在异位妊娠病灶破裂、卵巢黄体破裂中的鉴别诊断价值研究

Study on the Differential Diagnostic Value of Color Doppler Ultrasound Images and Blood Flow Spectrum Characteristics in the Rupture of Ectopic Pregnancy Lesions and Ovarian Corpus Luteum Rupture

目的 研究彩超图像及血流频谱特征在异位妊娠病灶破裂、卵巢黄体破裂中的鉴别诊断价值。方法 回顾性分析2019年1月至2022年12月于河南省生殖妇产医院检查的102例患者,其中46例异位妊娠病灶破裂患者为异位妊娠病灶破裂组,56例卵巢黄体破裂患者为卵巢黄体破裂组,观察两组患者彩超图像特征差异,比较两组患者血流频谱特征[阻力指数(RI)、搏动指数(PI)、收缩期峰值流速(PSV)]、卵巢体积和液性暗区深度。以受试者工作曲线(ROC)分析RI、PI、PSV、卵巢体积、液性暗区深度联合鉴别诊断异位妊娠病灶破裂、卵巢黄体破裂的价值。结果 彩超图像中,异位妊娠病灶破裂组中部分可见胎芽、假性妊娠囊,血流表现以“点状”“条状”为主,血流频谱特征多样。卵巢黄体破裂组血流表现以“半环状/环状”为主,血流频谱特征以极低/低阻力型为主。血流频谱特征中,异位妊娠病灶破裂组RI、PI显著高于卵巢黄体破裂组,差异均有统计学意义(P <0.05);异位妊娠病灶破裂组PSV、卵巢体积、液性暗区深度显著低于卵巢黄体破裂组,差异均有统计学意义(P <0.05)。RI、PI、PSV、卵巢体积、液性暗区深度水平联合鉴别诊断异位妊娠病灶破裂、卵巢黄体破裂的曲线下面积(AUC)为0.866,灵敏度为84.87%,特异度为76.79%。结论 彩超下异位妊娠病灶破裂、卵巢黄体破裂图像特征及血流频谱特征存在明显差异,为临床鉴别诊断提供依据。

Objective To study the differential diagnostic value of color Doppler ultrasound images and blood flow spectrum characteristics in the rupture of ectopic pregnancy lesions and ovarian corpus luteum rupture.Methods A retrospective analysis was conducted on 102 patients examined in Henan Reproductive and Obstetric Hospital from January 2019 to December 2022.Among them,46 patients with ruptured ectopic pregnancy lesions were included in the ectopic pregnancy lesion rupture group,and 56 patients with ruptured ovarian corpus luteum were included in the ovarian corpus luteum rupture group.The differences in color Doppler ultrasound image characteristics between the two groups were observed,and the blood flow spectrum characteristics[resistance index(RI),pulsatility index(PI),peak systolic velocity(PSV)],ovarian volume,and depth of fluid dark areas were compared.The value of RI,PI,PSV,ovarian volume,and depth of fluid dark areas in the differential diagnosis of ruptured ectopic pregnancy lesions and ruptured ovarian corpus luteum was analyzed using receiver operating characteristic(ROC)curves.Results In the color Doppler ultrasound images,some cases in the ectopic pregnancy lesion rupture group showed embryonic buds and pseudogestational sacs,with blood flow mainly appearing as“dot-like”and“strip-like”patterns,and diverse blood flow spectrum characteristics.In the ovarian corpus luteum rupture group,the blood flow mainly appeared as“semi-annular/annular”patterns,with blood flow spectrum characteristics mainly showing very low/low resistance types.The RI and PI in the ectopic pregnancy lesion rupture group were significantly higher than those in the ovarian corpus luteum rupture group,with statistically significant differences(P<0.05).The PSV,ovarian volume,and depth of fluid dark areas in the ectopic pregnancy lesion rupture group were significantly lower than those in the ovarian corpus luteum rupture group,with statistically significant differences(P<0.05).The area under the curve(AUC)for the combined differential diagnosis of ruptured ectopic pregnancy lesions and ruptured ovarian corpus luteum using RI,PI,PSV,ovarian volume,and depth of fluid dark areas was 0.866,with a sensitivity of 84.87%and a specificity of 76.79%.Conclusion There are significant differences in the image characteristics and blood flow spectrum characteristics of ruptured ectopic pregnancy lesions and ruptured ovarian corpus luteum under color Doppler ultrasound,providing a basis for clinical differential diagnosis.