超声子宫中位线法联合彩色多普勒血流成像诊断剖宫产切口部妊娠(Ⅱ型)的研究  

Study on ultrasonic median uterine line combined with CDFI in the diagnosis of cesarean scar pregnancy(TypeⅡ)

作　　者：任苓 廖慧芳 程芳玲 张朋燕 王圆圆 郑嘉明 谭丹丹 REN ling;LIAO Hui-fang;CHENG Fang-ling;ZHANG Peng-yan;WANG Yuan-yuan;ZHENG Jia-ming;TAN Dan-dan(Department of Ultrasound Medicine,The First Affiliated Hospital of Gannan Medical University;Deaprtment of Ultrasound Medicine,Nankang People's Hospital;The First Clinical Medical School of Gannan Medical University,Ganzhou,Jiangxi 341000;Cardiology Department of Guangyuan Central Hospital,Guangyuan,Sichuan 628000)

机构地区：[1]赣南医科大学第一附属医院超声医学科 [2]南康区人民医院超声科 [3]赣南医科大学第一临床医学院,江西赣州341000 [4]四川省广元市中心医院心脏功能科,四川广元628000

出　　处：《赣南医科大学学报》2025年第3期244-247,共4页JOURNAL OF GANNAN MEDICAL UNIVERSITY

基　　金：江西省卫生健康委员会科技计划项目(20191083)。

摘　　要：目的:分析超声子宫中位线法联合彩色多普勒血流成像(Color doppler flow imaging,CDFI)诊断剖宫产切口部妊娠(Cesarean scar pregnancy,CSP)的可行性。方法:收集2018年1月至2021年1月于赣南医科大学第一附属医院经超声诊断并病理证实的CSP患者(52例)及同期在其他医院行早孕期检查超声提示妊娠囊位置低、来赣南医科大学第一附属医院行超声复查并经3个月后随访确诊为正常宫内妊娠孕妇(165例)的病历资料,分析子宫中位线法及子宫中位线法联合CDFI诊断CSP的敏感度及特异度,并分析诊断CSP剖宫产肌层血流阻力指数(Resistance index,RI)的最佳截点值。结果:子宫中位线法诊断CSP的敏感度为98%,特异度为84.8%;子宫中位线法联合CDFI(串联方式)诊断CSP的敏感度为94.2%,特异度为98.2%。ROC曲线分析显示,剖宫产肌层RI诊断CSP的曲线下面积(Area under curve,AUC)为0.959(95%CI:0.923~0.995,P<0.001),截点值为0.53,敏感度98.1%,特异度93.3%。结论:应用经阴道二维超声子宫中位线法联合CDFI诊断Ⅱ型CSP具有明显优势。Objective:To analyze the feasibility of midline method combined with color doppler flow imaging(CDFI)in the diagnosis of cesarean scar pregnancy(CSP).Methods:Collected medical records on CSP patients(52 cases)who were diagnosed and pathologically confirmed by ultrasound at The First Affiliated Hospital of Gannan Medical University from January 2018 to January 2021,and who underwent early pregnancy examinations in other hospitals during the same period,and who were diagnosed with normal intrauterine pregnancy in other hospitals,and were diagnosed with normal intrauterine pregnancy in Gannan Medical University(165 cases)after follow-up 3 months later.Analysis of sensitivity and specificity of uterine median method and uterine median method combined with CDFI to diagnose CSP,and the best cut-off value of blood flow Resistance index(RI)in the diagnosis of CSP was analyzed.Results:The sensitivity and specificity of uterine midline method were 98%and 84.8%respectively.The sensitivity and specificity of midline method combined with CDFI(tandem mode)in the diagnosis of CSP were 94.2%and 98.2%respectively.ROC curve analysis showed that the AUC for the diagnosis of CSP by cesarean section myographic RI was 0.959(95%CI:0.923-0.995,P<0.001),cut-off value was 0.53,sensitivity 98.1%,specificity 93.3%.Conclusion:The diagnosis of typeⅡCSP by transvaginal 2-D ultrasound combined with CDFI has obvious advantages.

关 键 词：剖宫产切口部妊娠 超声检查 多普勒 彩色 剖宫产肌层血流 

分 类 号：R445.1[医药卫生—影像医学与核医学]