经阴道超声宫颈弹性成像参数联合宫颈前角预测高危孕妇早产价值  

Predictive value of the parameters of elastography of cervix by transvaginal ultrasound combined with anterior uterocervical angle for the preterm delivery of high-risk pregnant women

作　　者：李慧[1] 夏琳 张帆[1] LI Hui;XIA Lin;ZHANG Fan(The First Affiliated Hospital of Henan University,Kaifeng,Henan Province,475000)

机构地区：[1]河南大学第一附属医院,开封475000

出　　处：《中国计划生育学杂志》2023年第2期412-415,共4页Chinese Journal of Family Planning

基　　金：河南省医学科技攻关计划项目(LHGJ20220655)。

摘　　要：目的:探究经阴道超声宫颈弹性成像(E-cervix)参数联合宫颈前角对高危孕妇早产的预测价值。方法:收集本院2021年1月-2022年6月收治的高危孕妇82例临床资料,根据妊娠结局分为早产组(n=14)和足月产组(n=68)。分别在孕16~18周和孕22~24周进行应变超声弹性成像和经阴道二维超声检查,对比两组宫颈弹性参数[弹性对比指数(ECI)、宫颈外口应变率/宫颈内口应变率(IOS/EOS)、硬度比(HR)]和宫颈前角;绘制受试者工作特征曲线(ROC)分析ECI、IOS/EOS、HR以及宫颈前角预测高危孕妇早产价值。结果:孕16~18周时,ECI、IOS/EOS、HR和宫颈前角两组比较无差异(P>0.05);孕22~24周时,早产组ECI、IOS/EOS低于足月产组,HR和宫颈前角高于足月产组(P<0.05);ECI、IOS/EOS、HR以及宫颈前角预测高危孕妇早产的曲线下面积(AUC)分别为0.731、0.776、0.834、0.816,灵敏度分别为71.4%、64.3%、78.6%和78.6%,特异度分别为88.2%、85.3%、82.4%和80.9%,4项联合预测(AUC为0.926、灵敏度92.9%、特异度95.6%)。高于单项检测(P<0.05)。结论:E-cervix弹性成像参数联合宫颈前角对高危孕妇早产的预测价值较高。Objective: To study the predictive value of the parameters of elastography of cervix(E-cervix) by transvaginal ultrasound combined with anterior uterocervical angle for the preterm delivery of high-risk pregnant women. Methods: The clinical data of 82 high-risk pregnant women from April 2021 to May 2022 were collected, and these women were divided into group A(14 women with premature delivery) and group B(68 women with full-term delivery) according to the clinical pregnancy outcomes. E-cervix and transvaginal two-dimensional ultrasound were performed on the women in the two groups during 16-18 gestational weeks and 22-24 gestational weeks. The values of cervical elastic parameters, such as elastic contrast index(ECI), internal/external os strain(IOS/EOS), and hardness ratio(HR), and the anterior cervix angle of the women were compared between the two groups. The predictive value of the values of ECI, IOS/EOS, HR, and anterior cervical angle for the preterm delivery of the high-risk pregnant women was analyzed by receiver operating characteristic(ROC) curve. Results: There were no significant differences in the values of ECI, IOS/EOS, HR, and anterior cervical angle of the women during 16-18 gestational weeks between the two groups(P>0.05). The values of ECI and IOS/EOS of the women in group A during 22-24 gestational weeks were significantly lower than those of the women in group B, while the values of HR and anterior cervical angle of the women in group A were significantly higher(P<0.05). The area under the curve(AUC) of the values of ECI, IOS/EOS, HR, and anterior cervical angle of the high-risk women for predicting their preterm delivery were 0.731, 0.776, 0.834, and 0.816,respectively,the sensitivity of which were 71.4%,64.3%,78.6%,and 78.6%,respectively,and the specificity of which were 88.2%,85.3%,82.4%,and 80.9%,respectively.The AUC,the sensitivity,and the specificity of the combined values of ECI,IOS/EOS,HR,and anterior cervical angle of the high-risk women for predicting their preterm delivery were 0.92

关 键 词：高危孕妇 早产 超声宫颈弹性成像 宫颈前角 预测 

分 类 号：R445.1[医药卫生—影像医学与核医学] R714.21[医药卫生—诊断学]