经阴道彩色多普勒超声对异位妊娠诊断价值的研究  

The study of the diagnostic value of transvaginal color doppler ultrasound in ectopic pregnancy

作　　者：侯智文[1] 陈效华[1] 李丹丹[1] 高振森[1] 寇光玲 HOU Zhiwen;CHEN Xiaohua;LI Dandan;GAO Zhensen;KOU Guangling(Department of Ultrasound,Weifang Peoples Hospitaly Weifang 261041,China)

机构地区：[1]潍坊市人民医院超声科,山东潍坊261041

出　　处：《潍坊医学院学报》2020年第5期325-327,F0003,共4页Acta Academiae Medicinae Weifang

基　　金：潍坊市卫生健康委员会科研项目计划(项目编号:2013004)。

摘　　要：目的探讨经阴道超声(TVS)对异位妊娠(EP)诊断价值,为EP的早期诊断及治疗提供依据。方法对178例临床疑似EP患者行经腹超声(TAS)及TVS检查。先行TAS组检查,再行TVS检查,确定宫内无妊娠囊后,行双附件区及盆腹腔扫查,如发现EP后应用彩色多普勒血流显像(CDFI)观察妊娠囊及包块血流情况,将TAS与TVS结果与手术病理进行对比分析。结果 178例临床疑似EP患者中,手术病理确诊158例,TVS诊断164例,符合156例,诊断符合率98.1%;TAS诊断EP 116例,符合106例,诊断符合率67.1%.TVS诊断EP的敏感性、特异性、准确性、阳性预测值、阴性预测值分别为98.7%,80.0%,96.6%,97.5%,88.9%;TAS诊断EP的敏感性、特异性、准确性、阳性预测值、阴性预测值分别为67.1%,50.0%,65.2%,91.4%,16.1%,两者比较差异有显著性(P<0.01);对EP早期检出率明显高于TAS(P<0.01)。结论 TVS可更清晰显示EP的位置、大小,胚芽及原始心管搏动等,能对早期EP做出诊断,对临床提供可靠的参考依据。Objective To discuss the diagnostic value of transvaginal ultrasound(TVS) in ectopic pregnancy(EP),providing the evidence forthe early diagnosis and treatment of EP.Methods One hundred and seventy-eight patients suspected EP were examined by transabdominal ultrasound(TAS) and TVS.Examined by TAS first and then by TVS.Examining of the bilateral accessory area and abdominopelvic cavity if confirming that there was no pregnancy sac in intrauterine.Color doppler flow imaging(CDFI) was applied to observe the blood flow of pregnancy sac and cyst after EP was found,and then compared the results of TVS and TAS to the surgical pathology.Results Among 178 cases of suspected EP,158 cases were confirmed,TVS diagnostic were 164 cases,there were 156 cases conformed,the diagnose accordance ratewas 98.1%.In the 116 cases of EP diagnosed by TAS,there were 106 cases conformed to EP with the diagnose accordance rate was 67.1%.The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of TVS in EP diagnosis were respectively 98.7%,80.0%,96.6%,97.5% and 88.9%.The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of TAS were 67.1%,50.0%,65.2%,91.4% and 16.1%,respectively(P<0.01).The detection rate of early EP was significantly higher than TAS(P<0.01).Conclusion TVS show more clearly the position,size,germ and original heart beats tube or yolk sac of the EP.It can make early diagnosis to EP,and provide reliable reference frame for clinical treatment.

关 键 词：异位妊娠 彩色多普勒血流显像 阴道超声 腹部超声 输卵管妊娠 

分 类 号：R445.1[医药卫生—影像医学与核医学]