MRI联合AMH、PAPP-A、β-HCG对剖宫产术后早期子宫瘢痕妊娠的评估价值研究  

Study on Evaluated Value of MRI Combined with AMH,PAPP-A andβ-HCG on Early Cesarean Scar Pregnancy after Cesarean Section

作　　者：国萍 李青[1] 夏冉 GUO Ping;LI Qing;XIA Ran(Department of Gynaecology and Obstetrics,Anqing Municipal Hospital,Anqing Medical Center of Anhui Medical University,Anqing 246003,Anhui Province,China)

机构地区：[1]安庆市立医院安徽医科大学安庆医学中心妇产科,安徽安庆246003

出　　处：《中国CT和MRI杂志》2024年第11期112-114,共3页Chinese Journal of CT and MRI

摘　　要：目的探究核磁共振(MRI)联合β-人绒毛膜促性腺激素(β-HCG)、血抗苗勒氏管激素(AMH)、妊娠相关血浆蛋白A(PAPP-A)对剖宫产术后早期子宫瘢痕妊娠(CSP)的评估价值。方法选取2021年12月至2023年12月我院收治的103例疑似剖宫产术后早期CSP患者,所有受试者均接受MRI检查,并检测其AMH、PAPP-A、β-HCG水平,以手术病理结果为标准,将其分为CSP组和非CSP组,采用受试者工作特征(ROC)曲线分析AMH、PAPP-A、β-HCG对剖宫产术后早期CSP的预测价值,以手术病理结果为标准,采用Kappa一致性检验分析MRI联合AMH、PAPP-A、β-HCG对剖宫产术后早期CSP的预测价值。结果CSP组AMH水平高于非CSP组,PAPP-A、β-HCG水平低于非CSP组(P<0.05);AMH、PAPP-A、β-HCG预测剖宫产术后早期CSP的曲线下面积(AUC)分别为0.780、0.751、0.884,其中β-HCG的AUC最大,敏感度为78.16%,特异度为87.50%(P均<0.05);四者联合诊断的准确率为91.26%,敏感度为94.25%,特异度为75%。结论MRI联合AMH、PAPP-A、β-HCG对剖宫产术后早期CSP具有较高的诊断价值,其且准确度高于单一指标。Objective To explore the evaluated value of magnetic resonance imaging(MRI)combined with blood anti-Müllerian hormone(AMH),pregnancy-associated plasma protein A(PAPP-A)andβ-human chorionic gonadotropin(β-HCG)on early cesarean scar pregnancy(CSP)after cesarean section.Methods 103 patients with suspected early CSP after cesarean section in the hospital were selected from December 2021 to December 2023.All subjects received MRI examination,and the AMH,PAPP-A,andβ-HCG levels were detected.Based on the surgical pathology result,they were divided into CSP group and non-CSP group.Receiver operating characteristic(ROC)curve was used to analyze the predictive value of AMH,PAPP-A,andβ-HCG on early CSP after cesarean section.Taking the surgical pathology result as the standard,Kappa consistency test was used to analyze the predictive value of MRI combined with AMH,PAPP-A,andβ-HCG on early CSP after cesarean section.Results The AMH level in the CSP group was higher than that in the non-CSP group while the PAPP-A andβ-HCG levels were lower than those in the non-CSP group(P<0.05).The areas under curves(AUCs)of AMH,PAPP-A,andβ-HCG for predicting early CSP after cesarean section were 0.780,0.751 and 0.884 respectively.β-HCG had the largest AUC,with a sensitivity of 78.16%and a specificity of 87.50%(all P<0.05).The accuracy rate,sensitivity and specificity of the combined diagnosis of the four indicators were 91.26%,94.25%and 75%.Conclusion MRI combined with AMH,PAPP-A andβ-HCG has high diagnostic value on early CSP after cesarean section,and its accuracy is higher than that of a single indicator.

关 键 词：子宫瘢痕妊娠 核磁共振 抗苗勒氏管激素 妊娠相关血浆蛋白A Β-人绒毛膜促性腺激素 

分 类 号：R445.2[医药卫生—影像医学与核医学]