超声宫颈弹性成像联合子宫颈长度测量对孕早中期高危孕妇早产的评估价值  

Value of cervical elastographic parameters combined with cervical length at the first and second trimester in the evaluation of preterm birth in high-risk pregnant women

作　　者：杨文涛[1] 孙芹 Yang Wentao;Sun Qin(Department of Ultrasound,Jiaozuo People’s Hospital,Jiaozuo 454002,China;Department of Ultrasound,Jiaozuo Hospital of Traditional Chinese Medicine,Jiaozuo 454003,China)

机构地区：[1]焦作市人民医院超声科,焦作454002 [2]焦作市中医院超声科,焦作454003

出　　处：《中国实用医刊》2023年第23期74-77,共4页Chinese Journal of Practical Medicine

摘　　要：目的研究超声宫颈弹性成像联合子宫颈长度测量对孕早中期高危孕妇早产的评估价值。方法病例对照研究,抽取2020年3月至2023年1月焦作市人民医院收治的115例孕早中期高危孕妇作为研究对象,根据最终妊娠结局分为早产组(21例)与足月产组(94例)。采用彩色多普勒诊断仪分别在孕16~18、22~24周对两组孕妇进行检查,获得其宫颈弹性成像参数[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)],测量子宫颈长度;采用受试者工作特征曲线分析宫颈弹性成像参数、子宫颈长度对孕妇早产的预测价值。结果孕16~18周时,两组子宫颈长度比较差异未见统计学意义(P>0.05);孕22~24周时,早产组子宫颈长度短于足月产组(P<0.05)。孕16~18周时,两组弹性成像参数比较差异未见统计学意义(P>0.05);孕22~24周时,早产组ECI、IOS/EOS低于足月产组,HR高于足月产组(P<0.05)。受试者工作特征曲线结果显示,宫颈弹性成像参数、子宫颈长度单独及联合检查预测孕妇早产的曲线下面积分别为0.790、0.696、0.756、0.714、0.936,联合检查预测价值高于单独检查。结论超声宫颈弹性成像参数与子宫颈长度对孕早中期高危孕妇早产的预测价值较高。Objective To investigate the value of cervical elastographic parameters combined with cervical length at the first and second trimester in the evaluation of preterm birth in high-risk pregnant women.Methods This study was a case control study.One hundred and fifteen cases of high-risk pregnant women at the first and second trimester,who were treated in Jiaozuo People’s Hospital from March 2020 to January 2023,were selected;and they were divided into premature group(21 cases)and full-term birth group(94 cases)according to pregnancy outcome.All participants were examined at 16-18 weeks and 22-24 weeks of pregnancy using color-Doppler sonography;and the elastographic parameters,including elastic contrast index(ECI),internal ostium/external ostium(IOS/EOS),hardness ratio(HR),and cervical length were measured.Receiver operating characteristic curve was plotted to evaluate the predictive value of elastographic parameters and cervical length on preterm birth.Results At 16-18 weeks of pregnancy,there was no statistically significant difference in cervical length between the two groups(P>0.05);at 22-24 weeks of pregnancy,the cervical length of the premature group was shorter than that of the full-term group(P<0.05).At 16-18 weeks of pregnancy,there was no statistically significant difference in elastic imaging parameters between the two groups(P>0.05);at 22-24 weeks of pregnancy,ECI and IOS/EOS in the preterm delivery group were lower than those in the full-term delivery group,while HR was higher than that in the full-term delivery group(P<0.05).Results of receiver operating characteristic curves showed that the area under the curve of ECI,IOS/EOS,HR,cervical length alone and combination of them for predicting preterm birth in pregnant women were 0.790,0.696,0.756,0.714,and 0.936,indicating that the predictive value of combined test was better than that of separate test.Conclusions Ultrasound cervical elastography parameters and cervical length are of great predictive value for preterm birth in high-risk pregnant women

关 键 词：早产 高危孕妇 孕早中期 超声宫颈弹性成像 子宫颈长度 预测价值 

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]