彩色多普勒联合3D-Glassbody能量多普勒超声对剖宫产瘢痕妊娠诊断价值  

Value of Color Doppler Combined with 3D-Glassbody Power Doppler in Diagnosis of Patients with Cesarean Scar Pregnancy

作　　者：孙亚楠[1] 郭婧 纪月华 杨波[1] 祝玉芬 邵娟 苗蕊 石文新 刘秀萍[1] SUN Ya-nan;GUO Jing;JI Yue-hua;YANG Bo;ZHU Yu-fen;SHAO Juan;MIAO Rui;SHI Wen-xin;LIU Xiu-ping(Department of Obstetrics and Gynecology,the 980th Hospital of PLA Joint Logistics Support Forces,Shijiazhuang 050082,China)

机构地区：[1]解放军联勤保障部队第九八〇(白求恩国际和平)医院妇产科,石家庄050082

出　　处：《临床误诊误治》2021年第9期89-94,共6页Clinical Misdiagnosis & Mistherapy

基　　金：河北省医学科学研究重点课题(20191188)。

摘　　要：目的探讨彩色多普勒联合3D-Glassbody能量多普勒超声对剖宫产瘢痕妊娠诊断价值。方法选取2015年10月—2020年5月就诊经二维超声初步诊断为剖宫产瘢痕妊娠122例,采取彩色多普勒超声、彩色多普勒联合3D-Glassbody能量多普勒超声和MRI 3种方法分别检查,以病理检查结果为金标准,探讨彩色多普勒超声、彩色多普勒联合3D-Glassbody能量多普勒超声和MRI 3种检查方法对剖宫产瘢痕妊娠诊断价值;比较不同分型剖宫产瘢痕妊娠患者Vocal血管参数;评价Vocal血管参数对重度剖宫产瘢痕妊娠预测价值。结果McNemar检验结果显示,彩色多普勒超声、彩色多普勒联合3D-Glassbody能量多普勒超声和MRI对剖宫产瘢痕妊娠诊断价值与病理检查比较差异无统计学意义(P>0.05);Kappa检验结果显示,彩色多普勒超声、彩色多普勒联合3D-Glassbody能量多普勒超声和MRI对剖宫产瘢痕妊娠诊断价值与病理检查具有一致性(P<0.05或P<0.01)。对剖宫产瘢痕妊娠诊断彩色多普勒联合3D-Glassbody能量多普勒超声与病理检查一致性的Kappa值为0.865,敏感度、特异度、阳性预测值和阴性预测值分别为95.29%、91.89%、96.43%和89.47%。Kruskal-wallis H检验结果显示,不同分型剖宫产瘢痕妊娠患者血管化指数(VI)、血流指数(FI)和血管化血流指数(VFI)总体比较差异有统计学意义(P<0.01)。受试者工作特征曲线分析结果显示,VI、FI和VFI对重度剖宫产瘢痕妊娠预测价值的曲线下面积分别为0.845、0.755和0.832,最佳截断值分别为4.47、1.21和15.39。结论彩色多普勒联合3D-Glassbody能量多普勒超声可进一步提高对剖宫产瘢痕妊娠的诊断价值,与病理检查诊断一致性较好,且Vocal血管参数对重度剖宫产瘢痕妊娠有一定预测价值。Objective To investigate the value of color Doppler combined with 3D-Glassbody power Doppler in diagnosis of patients with cesarean scar pregnancy.Methods A total of 122 patients with cesarean scar pregnancy preliminarily diagnosed by two-dimensional ultrasound between October 2015 and May 2020 were recruited in this study.All the patients were examined by color Doppler ultrasound,color Doppler combined with 3D-Glassbody power Doppler and magnetic resonance imaging(MRI)respectively.Pathological results were taken as the gold standard to explore values of color Doppler ultrasound,color Doppler combined with 3D-Glassbody power Doppler and MRI in diagnosis of patients with cesarean scar pregnancy.Vocal vascular parameters of cesarean scar pregnancy patients with different types were compared,and values of Vocal vascular parameters in prediction of severe cesarean scar pregnancy were also evaluated.Results McNemar test results showed that there were no significant differences in values among color Doppler ultrasound,color Doppler combined with 3D-Glassbody power Doppler,MRI and pathological examination in diagnosis of cesarean scar pregnancy(P>0.05).Kappa test results showed that values of color Doppler ultrasound,color Doppler combined with 3D-Glassbody power Doppler,MRI and pathological examination in diagnosis of cesarean scar pregnancy were consistent(P<0.05 or P<0.01).Kappa value of consistency between color Doppler combined with 3D-Glassbody power Doppler with pathological examination in diagnosis of cesarean scar pregnancy was 0.865,and the sensitivity,specificity,positive predictive value and negative predictive value were 95.29%,91.89%,96.43%and 89.47%respectively.Results of Kruskal-wallis H test showed that the overall differences in vascularization index(VI),blood flow index(FI)and vascularization blood flow index(VFI)among patients with different types of cesarean scar pregnancy were statistically significant(P<0.01).Analysis results of areas under receiver operating characteristic curve(AUC)of VI,FI and

关 键 词：妊娠 异位 剖宫产术 超声检查 多普勒 彩色 超声检查 多普勒 3D-Glassbody能量 血管化指数 血流指数 血管化血流指数 诊断 

分 类 号：R714.22[医药卫生—妇产科学]