Double contrast-enhanced two-dimensional and three-dimensional ultrasonography for evaluation of gastric lesions

AIM： To investigate the value of two-dimensional （2D） and three-dimensional （3D） double contrast-enhanced ultrasonography （DCUS） imaging for evaluation of gas- tric lesions. METHODS： 2D and 3D DCUS imaging with both oral and intravenous administrations of contrast agents was used to assess gastroscopiclly-confirmed gastric lesions in 46 patients with benign and malignant diseases. Initially, liquid-based ultrasound contrast agent （Xinzhang） was given orally at dose of 500-600 mL for conventional ultrasound examination of the gastric lesions, and then a microbubble-based contrast agent （SonoVue） was injected intravenously at dose of 1.2-2.4 mL in bolus fashion to assess the perfusion pattern of the lesions using contrast imaging modes. The parameters derived from time-intensity curves including the arrival time （AT）, time to peak （lq-P）, peak intensity （PI） and en- hanced intensity （EI） were measured on the 2D DCUS imaging. 3D DCUS of the lesions was acquired to dem- onstrate the value of this imaging mode. RESULTS： There were 22 cases with benign lesions including chronic gastritis （n= 5）, gastric ulcer （n = 9）, gastric polyps （n = 3）, gastric stromal tumors （n = 5）, and 24 cases with malignant lesions including gastric cancer （n = 20）, gastric cardia carcinoma （n = 3） and post-operative recurrent gastric cancer （n = 1） in the study, The oral contrast-enhanced ultrasonography （CEUS） imaging of the stomach clearly demonstrated the anatomy of the stomach and morphologic features of gastric lesions, With optimal scanning window and imaging display under oral CEUS, intravenous CEUS clearly showed the perfusion of gastric lesions with various characteristic manifestations. Both 2D and 3D DCUS images clearly demonstrated normal gastric wall as a three-layer structure, from the inside out, hypere- choic mucosa, hypoechoic muscularis and hyperechoic serosa, respectively. There were statistical significant differences of AT （8.68±2.06 vs 10.43 ±2.75, P = 0.017）, PI （34.64 ± 6.63 vs 29.58 ± 8.22, P = 0.023） and EI （29.72 ± 6.69 vs 22.66 ± 7.01, P = 0.001） between malignant lesions and normal gastric wall. However, no differences of AT, PI and EI between benign lesions and normal gastric wall tissue were found. 3D DCUS could intuitively display morphological features and vascularities of the lesions with multiplanar and volume views. 3D DCUS imaging provided comprehen- sive information complementary to 2D imaging. The crater or wellhead appearances and feeding vessels as well as distorted nourishing vasculature of gastric carcinoma were better seen with 3D imaging than 2D imaging. CONCLUSION： DCUS imaging can simultaneouslydisplay the anatomic and perfusion features of gastric lesions. 3D DCUS can provide additional information to 2D DCUS for evaluation of gastric lesions.

Transvaginal Ultrasonographic Measurement of Lower Uterine Segment in Term Pregnant Patients with Previous Cesarean Section

Background: With an aim to reduce the rates of repeat cesarean section in women with a previous scar, prediction of scar rupture or dehiscence is important. If we could predict the risk of rupture by measuring the scar thickness closer to term, we could pursue a trial of scar safely. Aims: To evaluate the use of ultrasound measured thickness of lower uterine segment as one of the predictors of scar rupture or dehiscence in labour and establish a cut off beyond which trial of labour can be attempted safely. Methodology: 187 randomly selected pregnant women with history of one previous cesarean section in the past who satisfied the inclusion criteria, attending the outpatient clinic over a period of six months, at a tertiary level teaching institution in southern India were selected and counseled to undergo a transvaginal measurement of the scar region. These women were then followed up until delivery and the outcome of trial of scar, successful vaginal delivery, rupture or dehiscence of uterus was analysed in relation to the scar thickness and various other contributing factors. Results: 187 women with history of previous cesarean section, attending the outpatient clinic were randomly chosen to undergo trans vaginal scan at term. 52 underwent elective cesarean section and 135 went through trial of scar. The median cut-off of the lower uterine segment in this study population of 135 was 2.4 mm. The sensitivity was 90.9%, specificity was 43.5%, positive predictive value was 12.5%, and negative predictive value was 98.3% at this cut-off for scar rupture or dehiscence. Conclusions: The lower uterine scar thickness could be a useful tool to predict scar rupture. This could aid in making decisions regarding induction of labour with oxytocin in women with previous cesarean section.

A COMPARATIVE STUDY OF TRANSVAGINAL ULTRASONOGRAPHY AND PELVIC ARTERIOGRAM IN ASSESSMENT OF PATIENTS WITH GESTATIONAL TROPHOBLASTIC TUMOUR

Objective:To compare the reliability of transvaginal ultrasonography with pelvic arteriography in the assessment of patients with gestational trophoblastic disease. Methods. Transvaginal ultrasonography was performed in 24 patients with gestational trophoblastic tumour. Within one week after ultrasound investigation, pelvic arteriography was carried out in each patient. Of 24 cases, 16 patients hadn’t been treated by chemical reagent, 5 had accepted 2 to 5 courses of chemotherapy, and 3 had achieved complete remission before both investigations performed. Results. In 3 patients with complete remission, 2 had no evidence of abnormal findings either on transvaginal ultrasonography or on pelvic arteriography, 1 showed intramyometrial lesions by both methods. In the remaining 21 patients, all demostrated a abnormal uterine image, and 5 of them accompanied with the finding of parametrium metastatic signs by transvaginal ultrasonography; these abnormal results were confirmed by pelvic arteriographic imaging. However, in two cases without clinical and ultrasonic signs of parametrium metastasis, pelvic arteriography indicated the early metastasis of parametrium ves- sels. Conclusions. Even though it is difficult to predict the early parametrium metastasis in patients with gestational trophoblastic disease by B-ultrasonic investigation, our data would support the introduction of transvaginal ultrasonography in the diagnosis and evaluation of gestational trophoblastic tumour.

Comparison of point and two-dimensional shear wave elastography of the spleen in healthy subjects

BACKGROUND Few systematic comparative studies of the different methods of physical elastography of the spleen are currently available.AIM To compare point shear wave and two-dimensional elastography of the spleen considering the anatomical location(upper,hilar,and lower pole).METHODS As part of a prospective clinical study,healthy volunteers were examined for splenic elasticity using four different ultrasound devices between May 2015 and April 2017.The devices used for point shear wave elastography were from Siemens(S 3000)and Philips(Epiq 7),and those used for two-dimensional shear wave elastography were from GE(Logiq E9)and Toshiba(Aplio 500).In addition,two different software versions(5.0 and 6.0)were evaluated for the Toshiba ultrasound device(Aplio 500).The study consisted of three arms:A,B,and C.RESULTS In study arm A,200 subjects were evaluated(78 males and 122 females,mean age 27.9±8.1 years).In study arm B,113 subjects were evaluated(38 men and 75 women,mean age 26.0±6.3 years).In study arm C,44 subjects were enrolled.A significant correlation of the shear wave velocities at the upper third of the spleen(r=0.33088,P<0.0001)was demonstrated only for the Philips Epiq 7 device compared to the Siemens Acuson S 3000.In comparisons of the other ultrasound devices(GE,Siemens,Toshiba),no comparable results could be obtained for any anatomical position of the spleen.The influencing factors age,gender,and body mass index did not show a clear correlation with the measured shear wave velocities.CONCLUSION The absolute values of the shear wave elastography measurements of the spleen and the two different elastography methods are not comparable between different manufacturers or models.

经阴道二维超声检查在诊断宫腔粘连中的应用

目的探究经阴道二维超声诊断宫腔粘连的应用价值。方法研究组选取2022年1月至2024年1月收治的70例宫腔粘连患者,对照组则为同期接受健康体检的70例女性,均进行阴道二维超声检查。比较2组的超声参数子宫动脉搏动指数(PI)、阻力指数(RI)、收缩期流速与舒张期流速比值(S/D)以及子宫内膜厚度,并比较不同程度宫腔粘连患者上述指标情况,分析宫腔粘连程度与上述指标的相关性。采用受试者工作特征(ROC)曲线评价经阴道二维超声对宫腔粘连的诊断效能。结果研究组子宫动脉PI、RI、S/D高于对照组,子宫内膜厚度低于对照组(P<0.01)。随着宫腔粘连程度的加重,患者PI、RI、S/D呈逐渐上升趋势,子宫内膜厚度呈逐渐下降趋势(P<0.01);宫腔粘连程度与PI、RI、S/D呈正相关,而与子宫内膜厚度呈负相关(P<0.05)。ROC曲线分析显示,PI、RI、S/D、子宫内膜厚度诊断宫腔粘连的曲线下面积(AUC)分别为0.684、0.634、0.814、0.671,4项联合诊断宫腔粘连的AUC为0.905。结论经阴道二维超声能较好评估宫腔粘连患者的粘连程度与子宫内膜情况。

腹部超声辅助经阴道超声检查诊断异位妊娠的应用价值

目的观察腹部超声辅助经阴道检查应用于异位妊娠孕妇的诊断价值。方法回顾性分析2021年1月—2023年1月佛山市妇幼保健院100例疑似异位妊娠孕妇的临床资料,以上患者均先实施腹部超声检查,而后行经阴道超声检查。观察不同检查方式的诊断符合率,对不同检查方式的声像图特征进行分析。结果腹部超声检查符合率为80.0%,误诊率为12.0%,漏诊率为8.0%;经阴道超声检查符合率为87.0%,误诊率为10.0%,漏诊率为3.0%;联合超声检查符合率为98.0%,误诊率为0,漏诊率为2.0%;联合超声检查诊断符合率高于腹部超声检查、经阴道超声检查,差异有统计学意义(P<0.05)。联合超声检查宫内假孕囊、附件区域包块分别为56.0%、69.0%;腹部超声检查宫内假孕囊、附件区域包块分别为28.0%、47.0%,经阴道超声检查宫内假孕囊和附件区域包块分别为47.0%、63.0%。联合超声检查下宫内假孕囊、附件区域包块的诊断阳性率高于经阴道超声检查、腹部超声检查,差异有统计学意义(P<0.05)。结论在异位妊娠临床诊断工作中,腹部超声辅助下实施经阴道超声检查可以获得比较高的诊断符合率。因此必要时可将腹部超声检查、经阴道超声检查联合使用,可以显著减少误诊、漏诊。

经阴道三维能量多普勒超声联合二维剪切波弹性成像预测备孕女性妊娠结局的临床价值

目的应用经阴道三维能量多普勒超声(3D-PDI)联合二维剪切波弹性成像(2D-SWE)评估备孕女性子宫内膜容受性,探讨其预测妊娠结局的临床应用价值。方法选取在我院接受卵泡检测的87例备孕女性,均于排卵第7~8天(种植窗期)行经阴道3D-PDI检查,于增殖期行2D-SWE检查,然后随访6周,根据妊娠结局将其分为受孕组31例和未受孕组56例。比较两组子宫内膜厚度、容积、回声类型、血流分型、子宫螺旋动脉搏动指数(PI)、阻力指数(RI)、收缩期峰值流速与舒张末期流速比值(S/D)、血管化指数(VI)、血流指数(FI)、血管化血流指数(VFI),以及子宫内膜杨氏模量平均值(以下简称杨氏模量值)的差异。绘制受试者工作特征(ROC)曲线分析经阴道3D-PDI和2D-SWE参数单独及联合应用对备孕女性妊娠结局的预测价值。结果受孕组子宫内膜厚度和FI均高于未受孕组,S/D和子宫内膜杨氏模量值均低于未受孕组,差异均有统计学意义(均P<0.05);两组子宫内膜容积、回声类型、血流分型及PI、RI、VI、VFI比较差异均无统计学意义。ROC曲线分析显示,子宫内膜厚度、FI、S/D和子宫内膜杨氏模量值预测备孕女性妊娠结局的曲线下面积分别为0.789、0.851、0.853和0.840,联合应用的曲线下面积为0.895,高于各参数单独应用,差异均有统计学意义(均P<0.05)。结论经阴道3D-PDI联合2D-SWE可准确评估备孕女性子宫内膜容受性,对预测其妊娠结局有较好的临床应用价值。

探究经阴道和经腹部超声联合诊断多囊卵巢综合征的临床价值

目的:探讨经阴道和经腹部超声联合诊断多囊卵巢综合征(PCOS)的价值。方法:选取2020年1月—2023年12月暨南大学附属顺德医院收治的100例疑似PCOS患者,均行经腹部超声(TAUS)、经阴道超声(TVUS)检查,并以临床综合诊断为金标准,统计TAUS与TVUS对PCOS的检出情况及诊断价值;并经Kappa检验验证不同方法与金标准的一致性;比较PCOS与非PCOS患者在卵巢面积增加、多囊性征象、髓质回声异常征象方面的差异。结果:100例疑似患者经金标准确诊76例。TAUS检出70例,阳性率为92.11%(70/76);TVUS检出71例,阳性率为93.42%(71/76);联合检查检出75例,阳性率为98.68%(75/76);联合检查诊断PCOS的灵敏度、准确率高于TAUS、TVUS单一检查,阴性预测值高于TAUS检查,差异有统计学意义(P<0.05);Kappa检验显示,TAUS与金标准的一致性尚可(Kappa值=0.646);TVUS与金标准的一致性尚可(Kappa值=0.719);联合检查与金标准的一致性极好(Kappa值=0.919);PCOS患者卵巢面积增加、多囊性征象、髓质回声异常占比分别为19.74%、69.74%、78.95%,均高于非PCOS患者的0、16.67%、20.83%,差异有统计学意义(P<0.05)。结论:TAUS、TVUS在PCOS诊断中具有一定价值,联合检查可提高诊断效能,使得诊断灵敏度、准确度得到明显提升,利于减少漏诊、误诊,实现疾病早期针对性治疗。

三维能量多普勒超声预测子宫腺肌病患者体外受精-胚胎移植后妊娠结局的临床价值

目的探讨经阴道三维能量多普勒超声(3D-PDUS)预测子宫腺肌病患者体外受精-胚胎移植(IVF-ET)后妊娠结局的临床价值。方法选取在我院接受IVF-ET的子宫腺肌病不孕患者100例(研究组),以及同期单纯不孕患者40例(对照组),均于IVF-ET前行经阴道3D-PDUS观察子宫内膜与肌层交界区(EMI)的形态,获取EMI平均厚度、容积及血管化指数(VI)、血流指数(FI)、血管化血流指数(VFI),比较两组上述参数的差异。记录研究组患者妊娠结局,比较妊娠患者与未妊娠患者EMI形态、平均厚度、容积及VI、FI、VFI的差异。采用二元Logistic回归分析筛选子宫腺肌病患者IVF-ET后妊娠结局的独立影响因素;绘制受试者工作特征(ROC)曲线分析经阴道3D-PDUS预测子宫腺肌病患者IVF-ET后妊娠结局的诊断效能。结果研究组EMI形态正常占比、FI均低于对照组,差异均有统计学意义(均P<0.05);两组EMI平均厚度、容积及VI、VFI比较差异均无统计学意义。研究组患者接受IVF-ET后成功妊娠60例,未妊娠40例;妊娠患者EMI形态正常占比、平均厚度、容积及VI、FI、VFI均高于未妊娠患者,差异均有统计学意义(均P<0.001)。二元Logistic回归分析显示,EMI容积和VFI均为子宫腺肌病患者IVF-ET后妊娠结局的独立影响因素(OR=4.725、2.160,均P<0.05)。ROC曲线分析显示,EMI容积和VFI预测子宫腺肌病患者IVF-ET后妊娠结局的曲线下面积分别为0.795和0.672,对应的截断值分别为3.085 cm3和0.597。结论经阴道3D-PDUS能较好地预测子宫腺肌病患者IVF-ET后妊娠结局,具有一定的临床价值。

经腹部超声检查联合经阴道超声检查在妇产科急腹症中的应用价值

目的探究经腹部超声检查(Transabdominal Ultrasonography,TAS)联合经阴道超声检查(Transvaginal Ultrasonography,TVS)在妇产科急腹症中的应用价值。方法方便选取2021年5月—2023年4月江苏省泗洪嘉宝妇产医院收治的156例急腹症患者为研究对象,所有患者均采取TAS及TVS。以临床综合诊断结果作为金标准,对比TAS及TVS单项检查及二者联合检查的诊断价值。结果根据临床综合诊断结果显示,156例急腹症患者中,普通腹痛15例,妇科急腹症141例。在妇科急腹症中,急性盆腔炎31例,异位妊娠60例,黄体破裂25例,卵巢囊肿蒂扭转25例。TAS、TVS联合检查急性盆腔炎符合率(21.28%)、异位妊娠破裂符合率(41.13%)、黄体破裂符合率(14.18%)、卵巢囊肿蒂扭转符合率(17.02%)均高于TAS、TVS单独检查符合率,差异有统计学意义(χ^(2)=6.492、7.278、8.766、6.833,P均<0.05)。TAS联合TVS诊断妇科急腹症的准确度为92.95%,特异度为93.33%,灵敏度为92.91%,均高于TAS、TVS单一诊断的准确度、特异度及灵敏度,差异有统计学意义(P均<0.05)。结论针对妇产科急腹症患者,TAS联合TVS具有较高的诊断价值,其联合诊断准确率与临床综合诊断结果相近。

Importance of timely diagnosis and intervention in uterine artery pseudoaneurysm caused by hysteroscopic surgery

This manuscript explores the case on the occurrence of uterine artery pseudoaneurysm(UAP)during hysteroscopy endometrial polypectomy and the subsequent successful treatment via uterine artery embolization(UAE).Moreover,we focus on the management and treatment options for UAP in patients of advanced maternal age.A pseudoaneurysm is an extraluminal blood collection with a disrupted flow that communicates with the parent vessel via a defect in the arterial wall.The reported case involved a 48-year-old primiparous woman who developed a UAP after uterine polyp removal.The study enhances the understanding of UAP,a rare but potentially life-threatening condition,by providing a detailed and well-documented account of the comprehensive case presentation,effective use of medical imaging techniques for diagnosis,successful postoperative patient management following UAE,and practical clinical recommendations for clinicians managing similar cases.Overall,this study highlights the importance of considering UAP as a differential diagnosis in patients with abnormal vaginal bleeding following hysteroscopic surgery.Additionally,this manuscript recommends that clinicians with a high index of suspicion for UAP promptly request ultrasonography and computed tomography to facilitate early diagnosis.UAE is suggested as a primary treatment due to its effectiveness and safety,particularly in facilities capable of avoiding hysterectomy.

经阴道超声检查在异位妊娠早期临床诊断中的应用价值

目的:探讨经阴道超声检查在异位妊娠(EP)早期临床诊断中的应用价值.方法:选取2021年3月至2023年1月郑州市第十五人民医院收治的118例疑似EP患者为研究对象.对其采取经阴道超声及腹部超声进行EP早期诊断.以临床综合检查结果为参照标准,比较两种检查方式对早期诊断EP的效能,并评估诊断价值.结果:本研究纳入的118例疑似EP患者中,经临床综合检查诊断的EP患者为107例.经阴道超声检查诊断EP的灵敏度、特异度、阳性预测值、阴性预测值,均高于腹部超声检查;而误检率则低于腹部超声,差异均有统计学意义(P<0.05).结论:临床诊断EP时,采用经阴道超声检查,相较于腹部超声检查具有更高灵敏度,利于更好早期诊断EP患者,同时其声像图具有清晰、分辨率更高等特点,利于提高EP检出准确性及时效性,可为EP患者的早期临床诊治提供更为详细依据.

经阴道超声辅助子宫动脉化疗栓塞术联合腹腔镜病灶切除术治疗外生型剖宫产瘢痕部位妊娠的效果及其预后

目的:探讨外生型剖宫产瘢痕部位妊娠应用阴道超声辅助子宫动脉化疗栓塞术联合腹腔镜病灶切除术治疗的效果及其对预后的影响。方法:纳入2018年4月—2020年4月临沂市中心医院收治的60例外生型剖宫产瘢痕部位妊娠患者,并根据手术方式不同分为腹腔镜组30例和超声辅助组30例,比较两组治疗情况。结果:与腹腔镜组比较,超声辅助组术中出血量更小,手术时间更短(P<0.05)。两组β-人绒毛膜促性腺激素(β-HCG)、月经恢复时间和术前及术后1个月促卵泡激素(FSH)、促黄体激素(LH)、雌二醇激素(E_(2))、抗缪勒氏管激素(AMH)等分泌功能指标水平与术后不良反应发生率、再妊娠率、复发率比较,差异均无统计学意义(P> 0.05)。结论:阴道超声辅助子宫动脉化疗栓塞术联合腹腔镜病灶切除术的临床疗效显著,预后较好,且不会负性影响患者卵巢内分泌功能及远期妊娠。

经阴道超声对宫外孕的诊断准确性及特异性分析

目的 分析经阴道超声对宫外孕的诊断准确性及特异性。方法 选取60例疑似宫外孕患者作为研究对象,先采取经腹部超声检查,之后采取经阴道超声检查。比较两种检查方式的超声影像检出情况、诊断效能、血流参数。结果 经阴道超声检查对宫内假孕囊、附件区包块、卵黄囊的检出率分别为48.33%、36.67%、38.33%,均明显高于经腹部超声检查的18.33%、20.00%、16.67%(P<0.05)。两种检查方式对胚芽的检出率无明显差异(P>0.05)。经腹部超声检查的准确性、特异性、灵敏度分别为73.33%(44/60)、54.55%(18/33)、96.30%(26/27),经阴道超声检查的准确性、特异性、灵敏度分别为90.00%(54/60)、87.88%(29/33)、92.59%(25/27),经阴道超声检查的准确性、特异性均明显高于经腹部超声检查(P<0.05)。经阴道超声检查的动脉血管搏动指数(0.91±0.23)、阻力指数(0.58±0.13),均明显高于经腹部超声的(0.60±0.15)、(0.41±0.12)(P<0.05)。结论 宫外孕患者经阴道超声检查的诊断效能较高,便于及时明确病情,为该疾病治疗提供科学的参考依据,值得临床借鉴。

经阴道和经腹部超声检查在宫腔内良性增生疾病的诊断效能比较

目的比较宫腔内良性增生疾病采用经阴道和经腹部超声检查的诊断效能。方法41例子宫肌瘤、45例子宫腺肌症、38例子宫腺肌瘤患者,均经手术组织病理学检查确诊。入院后患者均同时进行经阴道和经腹部超声检查,以病理检查结果为对照,比较子宫肌瘤、子宫腺肌症及子宫腺肌瘤患者经阴道和经腹部超声检查的检出率;比较经阴道超声检查的病灶血流动力学及彩色多普勒血流显像(CDFI)血流信号分级。结果经阴道超声检查子宫肌瘤、子宫腺肌症、子宫腺肌瘤的检出率分别为97.56%(40/41)、95.56%(43/45)、92.11%(35/38),明显高于经腹部超声的75.61%(31/41)、73.33%(33/45)、71.05%(27/38),差异有统计学意义(P<0.05)。子宫肌瘤、子宫腺肌症、子宫腺肌瘤患者经阴道超声检查的病灶血流收缩期峰值速度[(60.43±1.54)、(67.80±2.42)、(71.88±1.38)m/s]、舒张期峰值速度[(4.28±0.35)、(28.95±0.32)、(5.54±0.28)m/s]、搏动指数[(1.18±0.20)、(1.38±0.15)、(1.34±0.12)]、阻力指数[(0.55±0.16)、(0.74±0.12)、(0.76±0.10)]比较差异均有统计学意义(P<0.05)。子宫腺肌症、子宫腺肌瘤患者经阴道超声检查的病灶血流收缩期峰值速度、舒张期峰值速度及搏动指数、阻力指数均高于子宫肌瘤患者,子宫腺肌瘤患者收缩期峰值速度高于子宫腺肌症患者,舒张期峰值速度低于子宫腺肌症患者,差异具有统计学意义(P<0.05)。子宫肌瘤、子宫腺肌症、子宫腺肌瘤患者的CDFI血流信号分级比较差异有统计学意义(P<0.05)。结论子宫肌瘤、子宫腺肌症及子宫腺肌瘤采用经阴道超声检查的检出率明显高于经腹部超声检查,且通过经阴道超声的病灶血流动力学参数及CDFI血流信号分级有助于提高3种疾病的鉴别诊断效果。

经阴道超声联合超声造影对剖宫产瘢痕妊娠的诊断价值

目的 分析经阴道超声(transvaginal ultrasonography,TVS)联合超声造影(contrast-enhanced ultrasound,CEUS)在剖宫产瘢痕妊娠(cesareanscarpregnancy,CSP)诊断中的应用价值。方法 回顾性分析2022年1月至2023年11月嘉兴市第一医院收治并经手术病理证实的60例CSP患者,术前接受TVS与CEUS检查,比较TVS、CEUS单独及联合诊断对CSP的检出率和分型诊断情况,使用受试者操作特征曲线(receiver operating characteristic curve,ROC曲线)分析TVS、CEUS鉴别孕囊型剖宫产瘢痕妊娠(gestational cesarean scar pregnancy,GCSP)的效能。结果 60例CSP患者中,手术病理证实GCSP 53例,包块型剖宫产瘢痕妊娠(mass cesarean scar pregnancy,MCSP)7例;TVS联合CEUS对CSP的检出率为98.33%,显著高于TVS或CEUS单独检测(P<0.05),CEUS对CSP的检出率显著高于TVS(P<0.05);TVS联合CEUS对GCSP的检出率为100.00%,显著高于TVS或CEUS单独检测(P<0.05),TVS联合CEUS鉴别GCSP的曲线下面积(area under the curve,AUC)最大,为0.857,敏感度100.00%,特异性71.40%;TVS联合CEUS对MCSP的检出率显著高于TVS(P<0.05)。结论 TVS联合CEUS可有效提高CSP的临床检出率,有利于CSP分型的诊断,具有重要应用价值。

经阴道彩色多普勒超声诊断IVF-ET术后宫内外复合妊娠效果及腹腔镜手术后妊娠结局

目的:探究经阴道彩色多普勒超声在体外受精-胚胎移植(IVF-ET)术后宫内外复合妊娠(HP)诊断应用及腹腔镜手术效果。方法:回顾性分析2020年3月-2022年12月本院生殖医学科接收的80例IVF-ET后HP患者临床资料,分析其超声诊断正确率、临床表现、超声声像图特征、腹腔镜手术及妊娠结局。结果:经阴道彩色多普勒超声诊断确诊71例,诊断正确率为88.8%,4例(5.0%)延迟诊断,5例(6.3%)误诊;异位妊娠67例(83.8%)位于子宫附件,13例(16.3%)位于宫角/间质;65例(81.2%)有盆腔积液;超声征象32例(40.0%)为附件区或宫角包块,4例(42.5%)为孕囊或胚芽,14例(17.5%)为胎心及心管搏动。患者均行腹腔镜手术治疗,其中9例(11.3%)发生严重并发症,6例(7.5%)中转开腹手术治疗,50例(62.5%)妊娠自然分娩,21例(26.3%)剖宫产,9例(11.3%)流产。结论:经阴道彩色多普勒超声诊断IVF-ET术后HP的主要手段,诊断符合率近90%,对临床有一定指导意义。

腹部联合经阴道超声检查诊断卵巢囊肿的价值

目的:探讨腹部超声联合经阴道超声检查在卵巢囊肿诊断中的价值。方法:选取2022年12月—2023年12月聊城市莘县妇幼保健院就诊的疑似卵巢囊肿患者100例为研究对象。患者均接受腹部超声检查、经阴道超声检查及病理学检查。以病理学检查结果为“金标准”,分析腹部超声联合经阴道超声检查诊断卵巢囊肿的效能。结果:联合检查灵敏度、准确度高于腹部超声、经阴道超声检查,特异度低于腹部超声、经阴道超声检查(P<0.05);经阴道超声检查灵敏度、准确度高于腹部超声(P<0.05)。结论:腹部超声联合经阴道超声检查在卵巢囊肿诊断中的价值较高。

经腹部与经阴道超声联合检查在多囊卵巢综合征中的诊断价值及影像指标分析

目的:分析经腹部与经阴道超声联合检查在多囊卵巢综合征(PCOS)中的诊断价值及影像指标。方法:选取2021年5月—2023年6月东营市东营区人民医院接收的90例PCOS患者(设为PCOS组)以及同期到本院检查的80例健康受试者(设为对照组)作为研究对象。所有研究对象先后接受经腹部超声与经阴道超声检查,比较健康受试者与PCOS患者卵泡数量、卵巢间质面积(S)、卵巢体积(OV)、卵巢切面总面积(A)及S/A值等的超声特征;比较PCOS患者TAUS与TVS检查的卵巢面积增加、髓质回声异常、多囊性征象检出情况;比较TAUS与TVS检查诊断PCOS的准确率、误诊漏诊率。结果:PCOS组卵泡数量多于对照组,OV、S、A、S/A值大于对照组,差异有统计学意义(P<0.05)。TVS与TAUS以及二者联合检查检出PCOS患者卵巢面积增加的占比,差异无统计学意义(P>0.05);TAUS与TVS联合检查检出PCOS患者髓质回声异常的占比高于TAUS与TVS单一检查,TAUS与TVS联合检查检出PCOS患者多囊性征象的占比高于TAUS单一检查,差异有统计学意义(P<0.05)。TAUS与TVS联合检查诊断PCOS的准确率高于TAUS与TVS单一检查,误诊漏诊率低于TAUS与TVS单一检查,差异有统计学意义(P<0.05)。结论:经腹部与经阴道超声联合检查能够更加全面地观察PCOS的病理特征,提高诊断价值。

经阴道超声检查在卵巢囊肿患者中的诊断价值

目的探讨卵巢囊肿患者接受经阴道超声检查的诊断价值。方法选择卵巢囊肿患者168例为研究对象,均接受经阴道超声检查。以病理结果为金标准,分析经阴道超声检查的诊断效能。结果168例卵巢囊肿患者的病理诊断结果显示,良性病变160例、恶性病变8例。经阴道超声检查的准确性、敏感性、特异性、阳性预测值及阴性预测值分别为98.21%(165/168)98.75%(158/160)、87.50%(7/8)、99.37%(158/159)77.78%(7/9),与病理结果比较,差异无统计学意义(P>0.05)。160例良性病变患者中,巧克力囊肿、卵巢冠囊肿、炎性卵巢囊肿、卵巢囊肿蒂扭转、卵巢黄体囊肿分别有71例、56例、18例、1例、14例,经阴道超声检查的阳性率分别为43.75%(70/160)、34.38%(55/160)、11.25%(18/160)、0.63%(1/160)、8.75%(14/160),与病理诊断结果比较,差异无统计学意义(P>0.05)。结论卵巢囊肿患者接受经阴道超声检查的诊断效能良好,诊断结果可为患者的治疗提供有效参考,值得临床推广使用。