经阴超声、经腹超声在异位妊娠及术后卵巢储备功能中的诊断价值研究  

Diagnostic value of transvaginal ultrasound and transabdominal ultrasound in ectopic pregnancy and postoperative ovarian reserve function

作　　者：高素娟 邹莹莹 孟繁繁 Gao Su-juan;Zou Ying-ying;Meng Fan-fan(Department of Ultrasound Diagnosis,Xinyang Maternal and Child Health Hospital,Xinyang 464000,Henan,China)

机构地区：[1]信阳市妇幼保健院超声诊断科,河南信阳464000

出　　处：《四川生理科学杂志》2024年第12期2671-2673,2698,共4页

摘　　要：目的:探讨经阴道彩色多普勒超声(Transvaginal color Doppler ultrasound,TVCDU)在异位妊娠(Ectopic Pregnancy,EP)及术后卵巢储备功能中的应用价值。方法:回顾性选取2022年2月-2023年2月期间本院收治的96例EP疑似患者为研究对象。患者均进行TVCDU、经腹彩色多普勒超声(Transabdominal color Doppler ultrasound,TACDU)检查。以腹腔镜结果为“金标准”,比较两种检查方式诊断结果及诊断效能,比较两种检查方式不同部位EP检出率,分析EP确诊患者性激素测定及克罗米芬刺激实验(Clomiphene stimulation experiment,CCCT)结果,比较不同卵巢储备功能EP患者超声指数[卵巢最大平面平均直径(Ovarian maximum plane average diameter,MOD)、卵巢间质动脉峰值流速(Peak flow rate of the ovarian interstitial arteries,PSV)、窦卵泡数(The number of sinus follicles,AFC)、搏动指数(Pulsatility index,PI)、阻力指数(Drag index,RI)]。结果:TVCDU诊断灵敏度为97.65%(83/85)、特异度为81.82%(9/11)、准确度为95.83%(92/96),TACDU诊断灵敏度为82.35%(70/85)、特异度为72.73%(8/11)、准确度为81.25%(78/96);TVCDU诊断准确度、灵敏度、阴性预测值高于TACDU,漏诊率低于TACDU,且TVCDU输卵管妊娠检出率、子宫角妊娠检出率及总检出率高于TACDU(P<0.05);性激素测定及CCCT共计确诊卵巢储备功能下降患者39例,卵巢储备功能正常患者46例;卵巢储备功能下降患者超声指数MOD、PSV、AFC值低于功能正常患者(P<0.05)。结论:TVCDU检查对EP具有较高诊断价值,且对术后卵巢储备功能具有一定评估价值,可作为临床诊断EP、评估术后卵巢储备功能的有效检查方式。Objective:To investigate the application value of transvaginal color Doppler ultrasound(TVCDU)in ectopic pregnancy(EP)and postoperative ovarian reserve function.Methods:A retrospective study was conducted on 96 patients suspected of having EP admitted to our hospital from February 2022 to February 2023.All patients underwent TVCDU and transabdominal color Doppler ultrasound(TACDU)examinations.Using laparoscopic results as the"gold standard",the diagnostic results and diagnostic efficacy of the two examination methods were compared,as well as the detection rate of EP in different locations.The results of sex hormone determination and Clomiphene stimulation experiment(CCCT)in patients with confirmed EP were analyzed,and the ultrasound indices[ovarian maximum plane average diameter(MOD),peak flow rate of the ovarian interstitial arteries(PSV),the number of sinus follicles(AFC),pulsatility index(PI),and resistance index(RI)]were compared among EP patients with different ovarian reserve functions.Result:The diagnostic sensitivity of TVCDU was 97.65%(83/85),specificity 81.82%(9/11),accuracy 95.83%(92/96),and the diagnostic sensitivity of TACDU was 82.35%(70/85),specificity 72.73%(8/11),accuracy 81.25%(78/96).The diagnostic accuracy,sensitivity and negative predictive value of TVCDU were higher than TACDU,the missed diagnosis rate was lower than TACDU,and the detection rate of tubal pregnancy,horn pregnancy and total detection rate of TVCDU were higher than TACDU(P<0.05).Sex hormone determination and CCCT confirmed 39 patients with decreased ovarian reserve function,46 patients with normal ovarian reserve function.The values of MOD,PSV and AFC in the patients with decreased ovarian reserve were lower than those in the patients with normal ovarian reserve(P<0.05).Conclusion:TVCDU has high diagnostic value for EP,and has certain evaluation value for postoperative ovarian reserve function,which can be used as an effective examination method for clinical diagnosis of EP and evaluation of postoperative ovarian reserve functi

关 键 词：经阴道彩色多普勒超声 经腹彩色多普勒超声 异位妊娠 诊断 卵巢储备功能 

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]