摘要
目的探讨经阴道二维及三维多普勒超声血流参数在剖宫产瘢痕妊娠(CSP)诊断中的应用价值。方法纳入60例CSP孕妇作为观察组,另选择同期剖宫术后正常妊娠的60例孕妇作为对照组。采用经阴道二维多普勒超声测量两组孕囊着床处滋养血管的搏动指数、阻力指数及收缩期峰值血流速度(PSV);采用经阴道三维多普勒超声测量两组孕囊着床处滋养血管的血管指数、血流指数和血管血流指数(VFI)。采用受试者工作特征(ROC)曲线分析PSV、血管指数、血流指数、VFI及四者联合对CSP的诊断价值。结果观察组三维多普勒超声血管指数、血流指数、VFI均高于对照组,而二维多普勒超声PSV低于对照组(均P<0.05);两组二维多普勒超声搏动指数、阻力指数差异均无统计学意义(均P>0.05)。ROC曲线分析结果显示,PSV、血管指数、血流指数、VFI、四者联合诊断CSP的曲线下面积分别为0.779、0.768、0.636、0.775、0.994(均P<0.05),联合诊断的曲线下面积均大于单一参数(均P<0.05)。结论孕囊着床处滋养血管经阴道二维超声PSV及经阴道三维多普勒超声血管指数、血流指数、VFI,对CSP均具有一定的诊断价值,四者联合应用可提高对CSP的诊断效能。
Objective To explore the application value of transvaginal two-dimensional and three-dimensional Doppler ultrasound flow parameters in the diagnosis of cesarean scar pregnancy(CSP).Methods Sixty CSP pregnant women were enrolled as observation group,another concurrent 60 pregnant women with normal pregnancy after cesarean section as control group.Vasa vasorum pulsatility index,resistance index,peak systolic velocity(PSV)at implantation site of gestational sacs were measured by transvaginal two-dimensional Doppler ultrasound in both groups;and vasa vasorum vascularization index,flow index and vascularization flow index(VFI)at implantation site of gestational sacs were measured by transvaginal three-dimensional Doppler ultrasound in both groups.Receiver operating characteristic(ROC)curve was employed to analyze the diagnostic value of PSV,vascularization index,flow index,VFI,and their combination for CSP.Results The observation group had higher vascularization index,flow index and VFI on transvaginal three-dimensional Doppler ultrasound,and higher PSV on transvaginal two-dimensional Doppler ultrasound as compared with the control group(all P<0.05).There were no statistically significant differences between the two groups in pulsatility index or resistance index on transvaginal two-dimensional Doppler ultrasound(all P>0.05).ROC curve analysis results showed that the areas under the curve of PSV,vascularization index,flow index,VFI,and their combination in diagnosing CSP were 0.779,0.768,0.636,0.775 and 0.994,respectively(all P<0.05),and their combination got greater area under the curve than each of them(all P<0.05).Conclusion At implantation site of gestational sacs transvaginal two-dimensional ultrasound vascular parameter PSV and three-dimensional Doppler ultrasound flow parameters vascularization index,flow index,and VFI are of definite diagnostic value for CSP,and their combination use might improve diagnostic efficiency for CSP.
作者
林紫晴
伍丽娟
成宇璐
冯艳萍
韦德湛
LIN Zi-qing;WU Li-juan;CHENG Yu-lu;FENG Yan-ping;WEI De-zhan(Foshan Maternal and Child Health Hospital,Foshan 528000,China)
出处
《广西医学》
CAS
2020年第4期398-400,409,共4页
Guangxi Medical Journal
基金
广东省佛山市卫生和计生局医学科研课题(20180127)。
关键词
剖宫产瘢痕妊娠
经阴道二维多普勒超声
经阴道三维多普勒超声
超声参数
诊断价值
Cesarean scar pregnancy
Transvaginal two-dimensional Doppler ultrasound
Transvaginal three-dimensional Doppler ultrasound
Ultrasound parameter
Diagnostic value
