Comparison of the application value of transvaginal ultrasound and transabdominal ultrasound in the diagnosis of ectopic pregnancy

BACKGROUND Ectopic pregnancy(EP) is one of the most common acute abdominal diseases in gynecology. Once the condition of EP is delayed, it may lead to massive hemorrhage, shock, and even death in a short time, seriously threatening the patient’s life. Early diagnosis is the key to preventing and improving the prognosis of EP.Transabdominal ultrasound(TAS) and transvaginal ultrasound(TVS) are the main diagnostic methods for abdominal diseases. The purpose of this study is to explore the application value and effect of TAS and TVS in the diagnosis of EP,hoping to provide more valuable references for the diagnosis of EP.AIM To explore the application value of TAS and TVS in the diagnosis of EP and to improve the level of clinical diagnosis.METHODS A total of 140 patients with EP admitted to our hospital from July 2018 to July 2020 were selected for this study. All patients were divided into two groups according to the examination methods. 63 patients who underwent abdominal ultrasound examination were set as the TAS group, while 77 patients who underwent TVS examination were set as the TVS group. We compared the diagnostic accuracy and misdiagnosis rates between the two types of ultrasound examinations, as well as the postoperative pathological results of the two diagnostic methods for different types of ectopic pregnancies. We also analyzed the sonograms for the presence of mixed ectopic masses,adnexal masses, ectopic gestational sacs, the presence or absence of visible embryo and fetal heart in the ectopic sac shadow, and the detection of fluid in the rectal fossa of the uterus, such as the adnexal area, yolk sac, and embryo, etc. In addition, the diagnosis time, days of gestational sac appearance, operation time, endometrial thickness, and blood flow resistance index were compared as well.RESULTS After performing both types of ultrasound examinations in 140 patients with EP, we found that the diagnostic accuracy of TVS was significantly higher than that of TAS, and the misdiagnosis rate was significantly lower than that of TAS. The differences were statistically significant(P < 0.05). In addition, the detection rate of TVS was better than that of TAS for the presence of mixed masses,adnexal masses, ectopic gestational sacs, the presence or absence of visible embryo and fetal heart in the shadow of the ectopic sac, and sonograms such as the adnexal area, yolk sac, and embryo,etc. The coincidence rate of its postoperative pathological examination results was significantly higher than those of TAS. The diagnosis time and the days of gestational sac appearance by TVS were significantly shorter than that by TAS, and the operation time was earlier than that by TAS.What’s more, the detection rates of the endometrial thickness ￡ 1.5 mm and blood flow resistance ￡0.5 were significantly higher in TVS diagnosis of EP than in TAS. All differences were statistically significant(P < 0.05).CONCLUSION Compared with TAS, TVS has the advantages of high detection accuracy and good sonogram performance.

Clinical study in diagnosis of placental implantation abnormality with transabdominal Doppler ultrasound

Objective: To evaluate the ultrasonographic charateristics and the diagnostic value in placental implantation abnormality (PIA) with transabdominal Doppler ultrasound, and improve the rate of diagnosis accuracy in the prenatal and postnatal of PIA with transabdominal Doppler ultrasound, for early diagnosis and treatment, to avoid hysterectomy caused by fatal bleeding. Methods: There were 61 cases complicated with PIA by operation and pathologically confirmed in our hospital. 33 cases were prenatal PIA, and 28 cases were postnatal PIA. The sonographic characteristics of PIA were summarized, the sensitivity and false negative rate of transabdominal Doppler ultrasound were analyzed with the results of surgical and pathological diagnosis. Results: In the images of prenatal PIA, the incidence of abundant blood flow signals in muscular layer of the placenta was the highest, which could reached 85.7%, followed by placenta 'vortex' and placenta previa;placental remnants were major sonographic performance in postnatal PIA, the incidence rate was 100%, followed by abundant blood flow signals in muscular layer of the placenta and disappeared boundary between myometrium and placenta. 14 cases could be diagnosed as prenatal PIA accurately by transabdominal Doppler ultrasound, the sensitivity was 42.4%, and the false negative rate was 57.6%. 21 cases could be diagnosed as postnatal PIA accurately by transabdominal Doppler ultrasound, the sensitivity was 75.0%, and the false negative rate was 25.0%. Conclusions: The specificity was low in prenatal PIA by transabdominal Doppler ultrasound, but the false negative rate was high. If necessary, the diagnostic accuracy could be improved combined with MRI. The specificity was much higher in postnatal PIA, and the false negative rate was low. The ultrasonography of PIA has some certain characteristics, we should strengthen the consciousness of the diagnosis in PIA, especially in the prenatal PIA, and improve the auxiliary diagnosis.

Clinical significance of B-mode ultrasound found bladder trabeculation in BPH patients

Objective To study the role of bladder trabeculation found by B-mode ultrasound in evaluating the degree of bladder outlet obstruction ( BOO ) and the bladder function in benign prostatic hyperplasia ( BPH) patients. Methods Conducted prospective research to determine differences in clinical data and urodynamic

Diagnostic value of different color ultrasound diagnostic method in endometrial lesions

BACKGROUND Endometrial lesions include endometrial cancer and inferior fibroids.Among them,endometrial cancer as a malignant tumor seriously endangers the life and health of patients.Ultrasonography is an important means of diagnosing female reproductive system diseases,and it is of critical value for the early diagnosis of endometrial cancer.However,different ultrasound inspection programs have achieved different results.It is of great significance to choose a suitable inspection program.AIM To explore the diagnostic efficacy of different ultrasonic examination methods in clinical endometrial lesions.METHODS The 140 patients with endometrial lesions who were treated in our hospital from April 2018 to October 2019 were used as the research subjects.All patients underwent transvaginal color ultrasound and transabdominal color ultrasound.We compared the diagnostic coincidence and image display effects of the two different examination methods,and the endometrial thickness,blood flow,uterine effusion and resistance index of different diseases were observed by transvaginal color ultrasound.RESULTS The diagnostic coincidence rate of all types of diseases of transvaginal color ultrasound was significantly higher than that of transabdominal color ultrasound(P=0.001,0.005,0.001 and 0.001).In addition,the excellent and good rate of image display of transvaginal color ultrasound was higher than that of transabdominal color ultrasound(P=0.001).There were significant differences in endometrial thickness in patients with different types of endometrial lesions through the transvaginal color examination(P=0.001).The incidence rate of uterine effusion in patients with endometrial carcinoma was significantly higher than that in patients with other types of endometrial lesions(P=0.001),and the rate of the blood flow was the highest(P=0.001).The comparison of blood flow resistance index indicated that the blood flow resistance index in endometrial cancer patients was the lowest,which shows that the difference was statistically significant(P=0.001).CONCLUSION The overall diagnostic efficacy of transvaginal color ultrasound in the clinical diagnosis of endometrial lesions is better than that of transabdominal color ultrasound,which held higher diagnostic coincidence rate and image display effect.There were significant differences in the thickness of the endometrium and the blood flow in different types of lesions.

Contrast-enhanced ultrasound imaging for intestinal lymphoma

BACKGROUND Intestinal lymphoma is a rare tumor.Contrast-enhanced ultrasound(CEUS)findings of intestinal lymphoma have not been reported previously,and the relationship between CEUS and clinicopathological features and prognostic factors is still unknown.AIM To describe the B-mode US and CEUS features of intestinal lymphoma and investigate the correlation of CEUS and histopathological features.METHODS This was a single-center retrospective study.Eighteen patients with histologically confirmed intestinal lymphoma underwent B-mode US and CEUS examinations between October 2016 and November 2019.We summarized the features of Bmode US and CUES imaging of intestinal lymphoma and compared the frequency of tumor necrosis in intestinal lymphomas with reference to different pathological subtypes(aggressive or indolent)and clinical stage(early or advanced).The time–intensity curve parameters of CEUS were also compared between patients with normal and elevated serum lactate dehydrogenase.RESULTS In B-mode imaging,four patterns were observed in intestinal lymphoma:Mass type(12/18,66.7%),infiltration type(1/18,5.6%),mesentery type(4/18,22.2%)and mixed type(1/18,5.6%).All cases were hypoechoic and no cystic areas were detected.On CEUS,most cases(17/18,94.4%)showed arterial hyperechoic enhancement.All cases showed arterial enhancement followed by venous wash out.A relatively high rate of tumor necrosis(11/18,61.1%)was observed in this study.Tumor necrosis on CEUS was more frequent in aggressive subtypes(10/13,76.9%)than in indolent subtypes(1/5,20.0%)(P=0.047).There were no correlations between tumor necrosis and lesion size and Ann Arbor stage.There was no significant difference in time–intensity curve parameters between normal and elevated lactate dehydrogenase groups.CONCLUSION B-mode US and CEUS findings of intestinal lymphoma are characteristic.We observed a high rate of tumor necrosis,which appeared more frequently in aggressive pathological subtypes of intestinal lymphoma.

Application and prospects of AI-based radiomics in ultrasound diagnosis

Artificial intelligence (AI)-based radiomics has attracted considerable research attention in the field of medical imaging, including ultrasound diagnosis. Ultrasound imaging has unique advantages such as high temporal resolution, low cost, and no radiation exposure. This renders it a preferred imaging modality for several clinical scenarios. This review includes a detailed introduction to imaging modalities, including Brightness-mode ultrasound, color Doppler flow imaging, ultrasound elastography, contrast-enhanced ultrasound, and multi-modal fusion analysis. It provides an overview of the current status and prospects of AI-based radiomics in ultrasound diagnosis, highlighting the application of AI-based radiomics to static ultrasound images, dynamic ultrasound videos, and multi-modal ultrasound fusion analysis.

A Study on the Temperature Correlation of B-mode Ultrasonic Image Gray for Noninvasive Temperature Monitoring in Hyperthermia

This paper deals with the temperature correlation of gray scale of B-mode ultrasound image from heated tissue. In this study, many in-vitro fresh pig livers are heated in a temperature range from 28 ℃ to 45℃, from which a series of B-mode ultrasonic images of livers were obtained. The gray-value is evaluated from the ultrasound images respectively. A correlation of the mean gray value of the selected regions (12×12 pixels) in B-mode ultrasonic images of liver and its temperature was pointed out. And the experiment results agreed the evaluation well. And it is possible to monitor the tissue temperature changing in hyperthermia using this correlation.

经阴道联合经腹部超声检查诊断异位妊娠效果

目的:分析经阴道超声、经腹部超声及联合检测对异位妊娠临床诊断价值。方法:选取本院2020年6月-2023年6月收治的110例疑似异位妊娠患者临床资料,均接受病理检查、行经阴道超声和经腹部超声检测。对比不同超声方式检测诊断结果,不同超声检测对不同类型异位妊娠诊断符合率,不同超声检测的图像特征;受试者工作特征曲线(ROC)分析不同超声方式检测对异位妊娠诊断价值。结果:6例失访,最终104例参与研究,其中病理诊断阳性95例,阴性9例;经阴道超声阳性检出率为75.8%,阴性检出率为22.2%;经腹部超声阳性检出率为77.9%,阴性检出率为22.2%;两种超声方式联合检测阳性检出率89.5%,阴性检出率88.9%,联合检测阳性、阴性检出率高于经阴道超声和经腹部超声检测(均P<0.05);与经阴道超声和经腹部超声检测相比,联合检测对不同类型异位妊娠的诊断符合率提升,对附件包块、宫内假孕囊、盆腔积液、心管搏动、胎芽、胎心和卵黄囊检出率提升(P<0.05);联合检测诊断异位妊娠的曲线下面积(AUC)为0.892,高于经阴道超声检测的AUC(0.510)和经腹部超声检测的AUC(0.501)(P<0.05)。结论:经阴道超声和经腹部超声联合检测诊断异位妊娠效能提高。

经腹部超声、经阴道超声、剪切波弹性成像联合检查对宫颈癌的诊断价值

目的探讨经腹部超声、经阴道超声、剪切波弹性成像联合检查对宫颈癌的诊断价值。方法选取98例宫颈病变患者,所有患者均行经腹部超声、经阴道超声、剪切波弹性成像及病理检查。病理检查结果显示,宫颈癌患者58例,宫颈上皮内瘤变(CIN)患者24例,其他宫颈良性病变患者16例。比较宫颈癌、CIN及其他宫颈良性病变患者弹性模量值的最大值及平均值。以病理检查结果为金标准,分析经腹部超声、经阴道超声、剪切波弹性成像单独及联合检查对宫颈癌的诊断价值。结果宫颈癌患者弹性模量值的最大值及平均值均高于CIN及其他宫颈良性病变患者,差异均有统计学意义(P﹤0.05)。经腹部超声、经阴道超声、剪切波弹性成像联合检查诊断宫颈癌的灵敏度、特异度、准确度、阳性预测值、阴性预测值分别为94.83%、95.00%、94.90%、96.49%、92.68%,均高于三者单独检查。结论经腹部超声、经阴道超声、剪切波弹性成像联合检查对宫颈癌具有较高的诊断效能。

血清指标联合经阴道腹部超声对早期异位妊娠的诊断价值

目的分析血清β-人绒毛膜促性腺激素(β-HCG)、癌抗原199(CA199)、孕酮(P)水平检测联合经阴道、腹部超声对早期异位妊娠的诊断价值。方法选取2020年10月至2023年10月烟台市烟台山医院收治的93例拟诊早期异位妊娠患者作为研究对象,其中经术后病理确诊为早期异位妊娠患者82例(观察组),年龄(31.35±3.16)岁;另选取同期正常宫内妊娠产妇105例作为对照组,年龄(31.57±3.22)岁。回顾性收集研究对象的临床资料,分析两组研究对象的血清β-HCG、CA199、P水平,经阴道、经腹部超声声像表现及早期异位妊娠的诊断结果。统计比较采用t检验、χ^(2)检验,绘制受试者操作特征曲线(ROC)。结果观察组血清β-HCG、CA199、P水平均低于对照组(均P<0.05)。93例初诊早期异位妊娠患者均进行病理学检查,82例为阳性;经阴道超声检查:72例真实早期异位妊娠;经腹部超声检查:69例真实早期异位妊娠。经腹部超声检查中子宫直肠窝积液、原始心管搏动、附件区包块、宫内未见孕囊的患者占比均低于经阴道超声(均P<0.05)。绘制ROC,经阴道超声、经腹部超声、血清β-HCG、CA199、P水平单独及联合检测的曲线下面积(AUC)分别为0.716、0.657、0.630、0.605、0.691、0.910,灵敏度为65.85%、63.41%、70.73%、58.54%、68.29%、86.59%,特异度为72.73%、72.73%、63.64%、72.68%、63.64%、81.82%。结论早期异位妊娠患者中血清β-HCG、CA199、P水平及经阴道、经腹部超声检测均存在异常表达情况,联合检测对早期异位妊娠患者具有较高的诊断价值,可作为早期异位妊娠临床诊治的靶点。

阴道彩超联合经腹超声对输卵管妊娠与妊娠黄体囊肿的诊断价值

目的分析阴道彩超联合经腹超声对输卵管妊娠与妊娠黄体囊肿的诊断价值。方法选取2019年1月至2022年9月在周口市中心医院接受诊疗的54例输卵管妊娠患者纳入观察组,将同期诊疗的50例妊娠黄体囊肿患者纳入对照组,两组均经阴道彩超和经腹超声检查,对比两组包块相关超声参数、血流动力学参数及血流频谱形态,并对比体位改变后包块与同侧卵巢位置变化。结果观察组包块高回声和不均质包块占比高于对照组(P<0.05),两组包块直径、环壁厚度差异无统计学意义(P>0.05)。观察组包块血流分布以点/线居多,对照组包块以环状居多,差异有统计学意义(P<0.05),观察组动脉收缩期峰值流速(PSV)低于对照组,血管阻力指数(RI)高于对照组(P<0.05)。观察组包块中高阻、低阻型血流频谱低于对照组,极低阻型血流频谱高于对照组(P<0.05)。观察组包块与同侧卵巢相对位置变化率低于对照组(P<0.05)。结论阴道彩超联合经腹超声可观察包块血流分布情况、频谱形态和同侧卵巢相对位置改变,对输卵管妊娠与妊娠黄体囊肿的鉴别诊断价值较高,值得推广应用。

经腹超声在溃疡性结肠炎中的研究进展

溃疡性结肠炎(ulcerative colitis,UC)是一种原因不明的慢性炎症性疾病,长期病程、反复发作是其临床特点。其需要定期随访监测,以指导治疗优化、改善远期结局并预防并发症。经腹超声作为一种无创、经济、易行的检查手段,在UC的疾病监测和疗效评估中具有重要价值。本文总结国内外相关文献,对经腹超声在UC中的研究进展作一概述。

Flexi-bar振动杆联合核心训练对产后压力性尿失禁人群盆底功能的影响

目的:探索Flexi-bar振动杆联合核心训练对女性产后压力性尿失禁盆底功能、尿失禁程度以及生活质量的影响。方法:选取符合入组标准的产后轻、中度压力性尿失禁女性45例,随机分为凯格尔运动组(Kegel组)、核心组、Flexi-bar振动杆组(Flexi-bar组),每组15例,进行为期12周的盆底肌训练。Kegel组进行传统盆底肌收缩训练,核心组进行核心动作训练,Flexi-bar组在核心组基础上增加手持flexi-bar振动杆的主动振动训练。训练前后采用经腹超声(TAUS)测量,国际尿失禁咨询委员会尿失禁问卷简表(ICIQ-SF),尿失禁生活质量问卷(I-QOL)评估3组训练效果。结果:12周训练后,3组的膀胱底最大上抬距离和上抬维持时间、I-QOL评分均较训练前明显增高(P<0.01),ICIQ-SF评分明显减小(P<0.01);Flexi-bar组膀胱底最大上抬距离和上抬维持时间较核心组和Kegel组增高(P<0.05),Flexi-bar组和核心组I-QOL评分较Kegel组增高(P<0.05);核心组膀胱底上抬距离和上抬维持时间与Kegel组比较、Flexi-bar组I-QOL评分与核心组比较及3组组间ICIQ-SF评分比较差异无统计学意义。结论:3种训练方法均可增强盆底功能,减轻压力性尿失禁严重程度,提高生活质量。Flexi-bar联合核心训练改善盆底功能的效果更优,Flexi-bar联合核心训练或单独核心训练对生活质量的改善程度高于Kegel训练。

经腹壁超声与螺旋CT诊断微小输尿管结石价值分析

目的评价经腹壁超声和螺旋CT平扫对输尿管微小结石检出的诊断价值。方法回顾分析我院近三年172例急性肾绞痛患者的经腹壁超声和螺旋CT影像资料,比较两种方法对输尿管微小结石检出率是否存在差异,并评价两种方法诊断一致性。结果172例急性肾绞痛患者平均年龄为42.3±14.2(岁)。61例(36.1%)位于上段,30例(17.7%)位于中段,78例(46.2%)位于下段。下段结石直径分别与上段和中段结石直径存在统计学差异(P<0.05)。5mm常规CT平扫诊断准确率、漏诊率和误诊率分别为93.0%、5.2%和1.8%,显著优于经腹壁超声的诊断准确率(45.9%)、漏诊率(45.3%)和误诊率(8.8%)。螺旋CT平扫和经腹壁超声检查诊断输尿管微小结石的一致性差。经腹壁超声的输尿管各段微小结石检出率显著低于CT平扫(P<0.05)。超声检出组输尿管微小结石直径显著大于和未检出组(P<0.05)。结论经腹壁超声的输尿管微小结石检出率低,当初筛发现输尿管扩张时,应用螺旋CT平扫诊断效果更好。

经腹肠道超声在克罗恩病诊治中的临床应用

克罗恩病(Crohn's disease,CD)是一种复发性、全身性炎症性疾病,CD诊断需要结合临床表现、实验室检查、影像学检查、内镜及病理组织学检查进行综合判断,且病程中需要进行长期反复的随访。经腹肠道超声(transabdominal bowel ultrasound,TBUS)由于其无创、快速、无辐射、价格便宜等优点,有望辅助有侵入性的内镜检查作为CD重要随访手段。该文就TBUS在CD诊治中临床应用的价值做一简要综述。

经阴道及经腹部彩色多普勒超声在子宫肌瘤及子宫腺肌病中的诊断价值

目的探究经阴道、经腹部彩色多普勒超声在子宫肌瘤及子宫腺肌病中的诊断价值。方法选取2019年1月至2021年12月吉安市中心人民医院收治的70例疑似子宫肌瘤、子宫腺肌病患者作为研究对象,均接受经阴道、经腹部彩色多普勒超声诊断,以病理诊断结果为金标准,分析经阴道、经腹部彩色多普勒超声在子宫肌瘤、子宫腺肌病中的诊断价值。结果金标准结果显示,子宫肌瘤31例,子宫腺肌病30例;经阴道彩色多普勒超声诊断子宫肌瘤的准确度、灵敏度、特异度分别为92.86%、96.77%、89.74%,均高于经腹部彩色多普勒超声的67.14%、74.19%、61.54%,差异有统计学意义(P<0.05);经阴道彩色多普勒超声对子宫腺肌病的诊断灵敏度、特异度分别为88.57%、93.33%、85.00%,均高于经腹部彩色多普勒超声的68.57%、73.33%、65.00%,差异有统计学意义(P<0.05);经阴道彩色多普勒超声对子宫肌瘤、子宫腺肌病诊断检出率为95.08%,高于经腹部彩色多普勒超声的73.77%,差异有统计学意义(P<0.05);子宫肌瘤舒张期峰值流速(Vd)快于子宫腺肌病,阻力指数(RI)、搏动指数(PI)均低于子宫腺肌病,收缩期峰值流速(Vs)慢于子宫腺肌病,差异有统计学意义(P<0.05)。结论与经腹部彩色多普勒超声相比,经阴道彩色多普勒超声可提升子宫肌瘤、子宫腺肌病中诊断准确性,且两种疾病血流状态存在显著差异,可用于鉴别诊断。

经腹部彩色多普勒超声与经阴道彩色多普勒超声诊断子宫内膜癌的价值分析

目的:分析经腹部彩色多普勒超声与经阴道彩色多普勒超声诊断子宫内膜癌的价值。方法:选取2020年1月—2022年12月南京市高淳人民医院收治的疑似子宫内膜癌患者78例作为研究对象,受试者均进行经腹部彩色多普勒超声与经阴道彩色多普勒超声检查,以病理检查结果为“金标准”,比较经腹部彩色多普勒超声与经阴道彩色多普勒超声检查对子宫内膜癌的诊断效能。结果:病理结果显示,78例疑似子宫内膜癌患者中,阳性72例(占比92.31%)。经阴道彩色多普勒超声诊断子宫内膜癌的灵敏度、准确率高于经腹部彩色多普勒超声,差异有统计学意义(P<0.05);经腹部彩色多普勒超声与经阴道彩色多普勒超声诊断子宫内膜癌的特异度、阳性预测值、阴性预测值比较,差异无统计学意义(P>0.05)。结论:相较于经腹部彩色多普勒超声,经阴道彩色多普勒超声诊断子宫内膜癌的灵敏度、准确率更高,值得临床应用并推广。

经阴道联合经腹彩色多普勒超声对卵巢畸胎瘤的诊断效能探究

目的:分析卵巢畸胎瘤由经阴道彩色多普勒超声(TVS)联合经腹彩色多普勒超声(TAS)诊断的一致性和准确度。方法:回顾性分析2021年1月-2023年10月西华县人民医院85例卵巢畸胎瘤患者的临床资料。所有患者入院后均行TVS、TVS检查。以手术病理检查结果作为金标准,分析比较TVS、TVS联合TAS诊断卵巢畸胎瘤的一致性及诊断价值。结果:手术病理检查结果显示,85例卵巢畸胎瘤患者中78例为成熟卵巢畸胎瘤,7例为未成熟卵巢畸胎瘤。TVS诊断卵巢畸胎瘤的一致性较强(Kappa=0.635,P<0.05),TVS联合TVS诊断卵巢畸胎瘤的一致性强(Kappa=0.927,P<0.05),TVS联合TVS诊断卵巢畸胎瘤的灵敏度、特异度、准确度、阳性预测值、阴性预测值均略高于TVS,但差异无统计学意义(P>0.05)。结论:TVS联合TAS诊断卵巢畸胎瘤结果与手术结果的一致性强。

经阴道与经腹部彩超诊断剖宫产后瘢痕妊娠的效能比较

目的:比较经阴道与经腹部彩色多普勒超声(彩超)诊断剖宫产后瘢痕妊娠(CSP)的效能。方法:选取2019年1月至2022年6月在该院就诊的76例疑似CSP患者进行前瞻性研究,所有患者依次接受经腹部、经阴道彩超检查,以术后病理检查结果为金标准,评估经阴道、经腹部彩超对CSP的诊断效能,并比较两种超声与病理检查对3种类型CSP的诊断符合率。结果:76疑似CSP患者中,金标准诊断检出CSP 65例(85.53%),其中Ⅰ型36例、Ⅱ型16例、Ⅲ型13例;非CSP 11例,其中难免流产6例、子宫峡部妊娠3例、宫颈妊娠2例。经阴道彩超诊断CSP的灵敏度、准确度分别为95.38%、92.11%,高于经腹部彩超的76.92%、72.37%,漏诊率为4.62%,低于经腹部彩超的23.08%,差异均有统计学意义(P<0.05);两种超声诊断CSP的特异度、误诊率比较,差异均无统计学意义(P>0.05)。经阴道彩超诊断CSP类型的结果与病理检查结果的一致性(Kappa=0.921)高于经腹部彩超(Kappa=0.614)。结论:经阴道彩超诊断CSP的灵敏度、准确度均高于经腹部彩超,漏诊率低于经腹部彩超,且更有利于区分不同类型CSP。临床针对疑似CSP患者,可优先采取经阴道彩超诊断。

四维超声联合经腹部超声心动图在胎儿先天性心脏病筛查中的应用研究

目的探讨四维超声联合经腹部超声心动图在胎儿先天性心脏病产前筛查中的临床价值。方法选取2020年4月至2023年4月该院行产前筛查的2013例孕妇,进行四维超声、经腹部超声心动图检查,以出生后超声心动图检查结果或引产后尸检结果为“金标准”,分析四维超声、经腹部超声心动图筛查胎儿先天性心脏病的效能。结果2013例孕妇中,56例经“金标准”证实胎儿存在先天性心脏病,而经腹部超声心动图检出46例,四维超声共检出48例,二者联合检出55例。四维超声、经腹部超声心动图筛查胎儿先天性心脏病的灵敏度、准确度、阴性预测值低于二者联合筛查时,差异有统计学意义(P<0.05)。四维超声联合经腹部超声心动图的筛查结果与“金标准”的检查结果具有极好一致性(kappa值=0.972,P<0.001)。四维超声、经腹部超声心动图筛查房间隔缺损的准确率低于二者联合筛查时,差异有统计学意义(P<0.05)。结论四维超声联合经腹部超声心动图具有较高的灵敏度、准确度,能够更有效地筛查胎儿先天性心脏病,特别是房间隔缺损。