阴道三维超声结合间质线征对早期宫角妊娠与输卵管间质部妊娠的临床鉴别价值分析  

Analysis of clinical differential value of three-dimensional vaginal ultrasound combined with interstitial line sign in early cornual pregnancy and interstitial ectopic pregnancy

作　　者：蔡晓燕 冼云开 利倩芝 林海龙 蒋双兰 林淑莲 CAI Xiao-yan;XIAN Yun-kai;LI Qian-zhi(Dongguan Eighth People's Hospital(Dongguan Children's Hospital),Dongguan 523320,China)

机构地区：[1]东莞市第八人民医院(东莞市儿童医院),523320

出　　处：《中国现代药物应用》2024年第6期83-86,共4页Chinese Journal of Modern Drug Application

基　　金：广东省东莞市社会发展科技项目(项目编号:20211800900292)。

摘　　要：目的分析阴道三维超声结合间质线征对早期宫角妊娠与输卵管间质部妊娠的临床鉴别价值。方法选取64例早期异位妊娠患者,根据患者的手术及病理检查结果分为宫角妊娠组(n=36)和间质部妊娠组(n=28)。两组患者均进行阴道二维超声检查和阴道三维超声检查。比较两种检查方法的诊断准确率,两组患者阴道三维超声检查的检出特征,两种检查方法对宫角妊娠及输卵管间质部妊娠诊断的Kappa一致性。结果阴道三维超声检查的宫角妊娠诊断准确率和间质部妊娠诊断准确率分别为88.89%和92.86%,明显高于阴道二维超声检查的69.44%和60.71%,差异有统计学意义(P<0.05)。阴道三维超声检查显示,间质部妊娠组的病变包块外凸发生率21.43%、宫角膨隆发生率89.29%、周边肌层厚度厚占比28.57%低于宫角妊娠组的72.22%、100.00%、72.22%,间质线征发生率85.71%高于宫角妊娠组的36.11%,差异有统计学意义(P<0.05)。两组的病变位置、周层边界和子宫内膜连续情况比较,差异无统计学意义(P>0.05)。Kappa一致性检验显示,阴道三维超声对宫角妊娠和输卵管间质部妊娠的诊断一致性较高(Kappa=0.713、0.602),阴道二维超声对宫角妊娠的诊断一致性一般(Kappa=0.511)、对输卵管间质部妊娠的诊断一致性较低(Kappa=0.480)。结论阴道三维超声对早期宫角妊娠和输卵管间质部妊娠的诊断准确率较高,且具有较好的诊断效能,可以结合影像征象和阴道三维超声检查是否发现间质线征来作为早期宫角妊娠和输卵管间质部妊娠的鉴别诊断要点。Objective To analyze the clinical differential value of three-dimensional vaginal ultrasound combined with interstitial line sign in early cornual pregnancy and interstitial ectopic pregnancy.Methods 64 patients with early ectopic pregnancy were selected and divided into cornual pregnancy group(n=36)and interstitial ectopic pregnancy group(n=28)according to the results of surgery and pathological examination.Both groups underwent two-dimensional and three-dimensional vaginal ultrasound examination.Comparison was made on the diagnostic accuracy of the two examination methods,the detection characteristics of three-dimensional vaginal ultrasound in the two groups,and the Kappa consistency between the two examination methods for the diagnosis of cornual pregnancy and interstitial ectopic pregnancy.Results The diagnostic accuracy of threedimensional vaginal ultrasound for cornual pregnancy and interstitial ectopic pregnancy were 88.89%and 92.86%,which were significantly higher than 69.44%and 60.71%of two-dimensional vaginal ultrasound,and the difference was statistically significant(P<0.05).Three-dimensional vaginal ultrasound showed that the incidence of protruding lesions in the interstitial ectopic pregnancy group was 21.43%,the incidence of dilation of the uterine horn was 89.29%,and the proportion of thickened peripheral muscle was 28.57%,which were lower than 72.22%,100.00%,and 72.22%in the cornual pregnancy group;the incidence of interstitial line sign was 85.71%,which was higher than 36.11%in the cornual pregnancy group;the difference was statistically significant(P<0.05).There was no significant difference in lesion location,peripheral boundary and endometrial continuity between the two groups(P>0.05).Kappa consistency test showed that there was high consistency in the diagnosis of cornual pregnancy and interstitial ectopic pregnancy by three-dimensional vaginal ultrasound(Kappa=0.713,0.602);the diagnostic consistency of two-dimensional vaginal ultrasound was general in cornual pregnancy(Kappa=0.511)and low i

关 键 词：阴道三维超声 阴道二维超声 间质线征 宫角妊娠 输卵管间质部妊娠 鉴别 

分 类 号：R445.1[医药卫生—影像医学与核医学] R714.22[医药卫生—诊断学]