三维VOCAL技术及MRI检查在子宫切口瘢痕妊娠中的诊断价值  

Diagnostic value of three-dimensional VOCAL technique and MRI in uterine incision scar pregnancy

作　　者：张萌萌 韩紫娜 马素红 韩冰 ZHANG Mengmeng;HAN Zina;MA Suhong;HAN Bing(Department of Ultrasound,the Second People′s Hospital of Hengshui,Hengshui Hebei 053000,China)

机构地区：[1]河北省衡水市第二人民医院超声科,河北衡水053000

出　　处：《新疆医科大学学报》2023年第8期1041-1045,共5页Journal of Xinjiang Medical University

基　　金：衡水市科技计划项目(2020014065Z);河北省医学科学研究课题项目(20210772)。

摘　　要：目的探讨三维超声容积测量(Virtual organ computer-aided analysis,VOCAL)技术及磁共振成像技术(Magnetic resonance imaging technique,MRI)检查在子宫切口瘢痕妊娠中的诊断价值。方法选取2020年10月-2022年11月河北省衡水市第二人民医院169例瘢痕妊娠女性(研究组),另选取同期169例剖宫产术后正常妊娠女性(对照组)。两组均进行MRI及三维VOCAL检查,比较两组三维VOCAL参数[血管化血流指数(Vascularized blood flow index,VFI)、血流指数(Blood flow index,FI)、血管形成指数(Vascularity index,VI)]及MRI参数(不均匀强化率、剩余肌层厚度),并比较三维VOCAL技术及MRI检查对瘢痕妊娠诊断情况。结果研究组不均匀强化率、VFI、FI、VI高于对照组,剩余肌层厚度小于对照组(P<0.05)。三维VOCAL检查、MRI检查单独及联合诊断敏感度、准确度、阴性预测值比较,差异有统计学意义(P<0.05),联合检查特异度、阳性预测值与三维VOCAL、MRI单独检查间差异无统计学意义(P>0.05)。结论三维VOCAL联合MRI较单独检查,可提升子宫切口瘢痕妊娠诊断敏感度与准确度,降低漏诊及误诊风险,值得推广。Objective To investigate the diagnostic value of three-dimensional ultrasound volume measurement(VOCAL)and magnetic resonance imaging(MRI)in uterine incision scar pregnancy.MethodsA total of 169 patients with scar pregnancy in the Second People′s Hospital of Hengshui City,Hebei Province from October 2020 to November 2022 were selected(study group),and 169 women with normal pregnancy after cesarean section were selected as control group.MRI and three-dimensional VOCAL examination were performed in both groups.Three-dimensional VOCAL parameters[Vascularized Blood flow index(VFI),blood flow index(FI)and Vascularity index(VI)]and MRI parameters(uneven enhancement rate and residual muscle thickness)were compared between the two groups,and the diagnosis of scar pregnancy by three-dimensional VOCAL technique and MRI examination was compared.ResultsThe uneven enhancement rate,VFI,FI,VI in the study group were higher than those in the control group,and the thickness of the remaining muscle layer was lower than that in the control group(P<0.05).There was a statistically significant difference in sensitivity,accuracy,and negative predictive value between 3D VOCAL examination and MRI examination alone and in combination(P<0.05).There was no significant difference in specificity,positive predictive value between the combined examination and 3D VOCAL and MRI examination alone(P>0.05).ConclusionCompared with single examination,three-dimensional VOCAL combined with MRI can improve the sensitivity and accuracy of the diagnosis of uterine incision scar pregnancy,reduce the risk of missed diagnosis and misdiagnosis,and is worth promoting.

关 键 词：瘢痕妊娠 三维VOCAL技术 磁共振成像技术 

分 类 号：R445[医药卫生—影像医学与核医学]