宫颈弹性成像技术对宫颈机能不全孕妇保胎治疗的临床意义探讨  

The Clinical Significance of Cervical Elastography in the Treatment of Pregnant Women with Cervical Insufficiency

作　　者：韩小羽 王丽丽 彭丽琴 黄雪媚 田成园 周欣[1] Han Xiaoyu;Wang Lili;Peng Liqin;Huang Xuemei;Tian Chengyuan;Zhou Xin(Department of Ultrasound,Jiangxi Maternal and Child Health Hospital,Nanchang 330006,China;Department of Ultrasound,Duchang Maternal and Child Health Hospital,Jiujiang,Jiangxi 332600,China)

机构地区：[1]江西省妇幼保健院超声科,南昌市330006 [2]九江市都昌县妇幼保健院超声科,江西省九江市332600

出　　处：《中国超声医学杂志》2024年第10期1126-1129,共4页Chinese Journal of Ultrasound in Medicine

基　　金：江西省卫生健康委科技计划项目(No.202211147)。

摘　　要：目的探讨宫颈弹性成像技术对宫颈机能不全孕妇保胎治疗的临床应用价值。方法选取因宫颈机能不全住院保胎治疗的单胎孕妇82例,根据治疗方案和妊娠结局分为4组:保守治疗足月组(32例)、保守治疗早产组(17例)、宫颈环扎足月组(16例)和宫颈环扎早产组(17例),比较各组间闭合段宫颈的ECI、HR、IOS、EOS、Ratio IOS/EOS、CL以及宫颈环扎组内的宫颈环扎线处应变值、宫颈环扎线处比宫颈外口应变比值和宫颈环扎线至宫颈外口距离,绘制各参数ROC曲线并分析预测保胎疗效的截断值及效能。结果与足月组比较,早产组ECI显著增加,HR显著降低,保守治疗组内早产组EOS增加,宫颈环扎组内早产组宫颈环扎线处应变值显著增加,以上差异均有统计学意义(P<0.05)。保守治疗组和宫颈环扎组ECI的ROC曲线下面积分别为0.807、0.765。结论宫颈弹性参数评估宫颈机能不全孕妇保胎疗效优于宫颈长度。Objective To investigate the clinical application value of transvaginal ultrasound elastography of cervix in the treatment of pregnant women with cervical insufficiency.Methods A total of 82 cases of singlet pregnant women who were clinically diagnosed with cervical insufficiency and hospitalized for fetal preservation were selected in the study.They were divided into four groups:the conservative treatment term group(32 cases),the conservative treatment premature birth group(17 cases),the cervical cerclage term group(16 cases)and the cervical cerclage premature birth group(17 cases),according to treatment plan and pregnancy outcome.Transvaginal ultrasound E-cervix cervical elastic imaging technique was used to obtain the elasticity contrast index(ECI),hardness ratio(HR),internal cervical ostium(IOS),external cervical ostium(EOS),ratio IOS/EOS,cervix length(CL),the strain value at the cervical cervix ligature line,the strain ratio at the cervical ligature line to the external cervical,and the distance from the cervical ligature line to the external cervical in the cervical cervix group.The ROC curve of each parameter was plotted and the cutoff value and efficacy of predicting the curative effect of fetal protection were analyzed.Results Compared with the full-term groups,the ECI values in the preterm groups were significantly increased.HR values were significantly decreased.EOS values in the conservative treatment term group were increased.In the cervical cerclage term group,the strain value at the cervical cervix ligature line was significantly increased.Those differences were statistically significant(P<0.05).The area under ROC curve of ECI was 0.807 in the conservative treatment group and 0.765 in cervical cerclage group.Conclusions Cervical elasticity index is better than cervical length in the evaluation of pregnant women with cervical dysfunction.

关 键 词：E-cervix宫颈弹性成像技术 宫颈机能不全 宫颈环扎术 

分 类 号：R445.1[医药卫生—影像医学与核医学] R714.2[医药卫生—诊断学]