阴道超声鉴别诊断早期宫角妊娠与输卵管间质部妊娠的临床价值

Clinical Value of Transvaginal Ultrasound in Differential Diagnosis of Early Cornual Pregnancy and Tubal Interstitial Pregnancy

目的分析早期宫角妊娠与输卵管间质部妊娠的阴道超声鉴别诊断价值及准确性。方法收集2021年2月-2023年4月铜鼓县人民医院62例早期宫角妊娠与输卵管间质部妊娠患者临床资料,比较患者的超声图像特征,分析患者的超声定量参数,以及经阴道三维超声对患者的诊断效能。结果孕囊外凸和宫腔完整在输卵管间质部妊娠患者中的比例均高于早期宫角妊娠,输卵管间质部妊娠患者中周边肌层完整的比例低于早期宫角妊娠(P<0.05);两组宫角膨隆和间质线征占比比较,差异无统计学意义(P>0.05);输卵管间质部妊娠患者舒张末血流速度(EDV)高于早期宫角妊娠患者,而孕囊周边肌层包绕厚度和动脉阻力指数(RI)均低于早期宫角妊娠患者(P<0.05);两组血流收缩期峰值流速(PSV)比较,差异无统计学意义(P>0.05);经超声诊断早期宫角妊娠、输卵管间质部妊娠的准确率为91.94%,灵敏度为92.31%,特异度为91.30%。结论阴道超声检查能够提升异位妊娠患者诊断效果,明确早期宫角妊娠与输卵管间质部妊娠,为疾病临床诊疗提供准确且全面参考依据。

Objective To analyze the value and accuracy of transvaginal ultrasound in the differential diagnosis of early cornual pregnancy and interstitial tubal pregnancy.Methods The clinical data of 62 patients with early cornual pregnancy and interstitial tubal pregnancy in Tonggu County People's Hospital from February 2021 to April 2023 were collected.The ultrasonic image characteristics of the patients were compared,the ultrasonic quantitative parameters of the patients were analyzed,and the diagnostic efficacy of transvaginal three-dimensional ultrasound was analyzed.Results The proportion of gestational sac protrusion and uterine cavity integrity in patients with interstitial tubal pregnancy was higher than that in early cornual pregnancy,and the proportion of peripheral muscular layer integrity in patients with interstitial tubal pregnancy was lower than that in early cornual pregnancy(P<0.05).There was no significant difference in the proportion of uterine horn bulging and interstitial line sign between the two groups(P>0.05).The end-diastolic blood flow velocity(EDV)in patients with interstitial tubal pregnancy was higher than that in patients with early cornual pregnancy,while the thickness of the muscular layer around the gestational sac and the arterial resistance index(RI)were lower than those in patients with early cornual pregnancy(P<0.05).There was no significant difference in peak systolic velocity(PSV)between the two groups(P>0.05).The accuracy of ultrasound in the diagnosis of early cornual pregnancy and tubal interstitial pregnancy was 91.94%,the sensitivity was 92.31%,and the specificity was 91.30%.Conclusion Transvaginal ultrasonography can improve the diagnostic effect of patients with ectopic pregnancy,clarify early cornual pregnancy and interstitial tubal pregnancy that can provide accurate and comprehensive reference for clinical diagnosis and treatment of diseases.