多平面联合OmniVien自由解剖成像技术对间质部妊娠与宫角妊娠的诊断价值

Value of multiplane combined OmniVien free anatomical imaging for the diagnosis of interstitial pregnancy and uterine horn pregnancy

目的探究多平面联合OmniVien自由解剖成像技术对间质部妊娠(ITP)与宫角妊娠(CP)的诊断研究价值。方法回顾性分析2019年12月至2023年12月赣州市妇幼保健院收治的经手术检查确诊的32例ITP患者及38例CP患者的临床资料。所有研究对象均行术前二维阴道超声检查、多平面联合OmniVien自由解剖成像技术检查。计算多平面联合OmniVien自由解剖成像技术检查ITP及CP的准确度、特异度、灵敏度、阳性预测值及阴性预测值,从而分析其诊断价值。结果多平面联合OmniVien自由解剖成像技术图像特征显示,CP超声表现为妊娠囊位于左侧宫角内,孕囊大部分位于宫腔并有蜕膜包绕,小部分被宫角肌层包绕且宫角最薄处肌层厚度>5 mm;ITP的超声表现为子宫体腔空虚,右侧间质部见混合回声包块距离宫腔外侧缘>1 cm,该包块的肌层厚度<5 mm。右侧间质部混合包块不与宫腔相连接,存在“间质线特征”;经分析,多平面联合OmniVien自由解剖成像技术检查ITP及CP的准确度高于二维超声检查,且特异度、灵敏度、阳性预测值及阴性预测值均高于二维阴道超声检查,差异有统计学意义(P<0.05),而多平面联合诊断结果与病理学检查结果具有高度一致性(Kappa=0.788)。结论多平面联合OmniVien自由解剖成像技术的ITP及CP图像更加清晰,能够更直观地呈现宫腔、宫底肌层和宫腔内膜的关系,准确判断病灶位置,同时其诊断效能高于二维阴道超声检查。

Objective To explore the value of combined OmniVien free anatomical imaging for interstitial pregnancy(ITP)and cornual pregnancy(CP).Methods Clinical data of 32 patients with ITP and 38 patients with CP diagnosed by surgical examination admitted to Ganzhou Maternal and Child Health Hospital from December 2019 to December 2023 were retrospectively analyzed.All subjects underwent preoperative two-dimensional vaginal ultrasonography and OmniVien free anatomic imaging.The accuracy,specificity,sensitivity,positive predictive value and negative predictive value of ITP and CP were calculated by OmniVien free anatomic imaging technique,so as to analyze their diagnostic value.Results The image characteristics of the multi-plane OmniVien free anatomical imaging technology showed that CP ultrasound showed that the pregnancy sac was located in the left uterine horn,most of the pregnancy sac was located in the uterine cavity and was surrounded by decidua,a small part was surrounded by the uterine muscle layer,and the thickness of the muscle layer at the thinnest uterine horn was greater than 5 mm.The ultrasonography of ITP showed that the uterine body cavity was empty,and the mixed echo mass was found in the right interstitial area more than 1cm away from the lateral margin of the uterine cavity,and the muscle thickness of the mass was less than 5mm.The mixed mass of the right interstitial part does not connect with the uterine cavity,and there is"interstitial line feature".After analysis,the accuracy of ITP and CP detected by OmniVien free anatomic imaging technology was higher than that of 2D ultrasound,and the specificity,sensitivity,positive predictive value and negative predictive value were higher than that of 2D vaginal ultrasound,the differences were statistically significant(P<0.05).The results of multiplanar combined diagnosis were highly consistent with those of pathological examination(Kappa=0.788).Conclusion The ITP and CP images of multi-plane combined OmniVien free anatomical imaging technology are more clear,and can more intuitively present the relationship between uterine cavity,fundal muscle layer and endometrium,accurately determine the location of lesions,and its diagnostic efficiency is higher than that of two-dimensional vaginal ultrasound.