摘要
目的:分析经阴道超声、MRI联合血清β-HCG水平对剖宫产术后早期子宫瘢痕妊娠(cesareanscarpregnancy,CSP)的诊断价值。方法:回顾性分析2014年1月至2017年12月合肥市第三人民医院收治的43例拟诊为剖宫产术后早期子宫瘢痕妊娠患者的临床资料。所有患者均接受MRI检查、经阴道超声检查以及血清β-HCG水平检测,对三种方法的联合诊断价值进行分析。结果:43例拟诊的CSP患者经手术和病理证实最终确诊为CSP35例,单独经阴道超声、MRI、血清β-HCG、经阴道超声联合MRI、经阴道超声与MRI联合血清β-HCG诊断后正确诊断分别为34例、36例、23例、39例以及40例,它们的诊断敏感度和准确率分别为(82.86%,79.07%)、(57.14%,53.49%)、(85.71%,83.72%)、(91.43%,90.69%)、(94.29%,93.02%),差异有统计学意义(P<0.05);而在诊断特异度方面分别为(62.50%,37.50%,75.00%,87.50%,87.50%),无统计学差异(P>0.05)。手术和病理证实孕囊40例、原始心管搏动15例、卵黄囊23例、胚芽19例、孕囊内出血31例、宫腔积血37例,经阴道超声和MRI分别诊断38例和36例,12例和0例,20例和6例,15例和6例,3例和28例,19例和33例。结论:采用经阴道超声、MRI联合血清β-HCG水平检测可以有效提高剖宫产术后早期子宫瘢痕妊娠的诊断准确性,具有重要的临床诊断价值。
Objective:The purpose of this study was to investigate the value of transvaginal sonography and MRI combined with serumβ-HCG in the diagnosis of early stage uterine scar pregnancy after cesarean section.Methods:The clinical data of 43 cases diagnosed as early pregnancy uterine scar after cesarean section were retrospectively analyzed from January 2014 to December 2017 in our hospital.All patients underwent MRI examination,transvaginal ultrasonography and serumβ-HCG level to analyze the diagnostic value of the three methods.Results:Forty-three CSP patients confirmed by surgery and pathology were confirmed by CSP,after transvaginal ultrasound,MRI,serumβ-HCG and transvaginal ultrasound combined with MRI,transurethral ultrasound and MRI combined serumβ-HCG diagnosis,the correct diagnosis was 34 cases,36 cases,23 cases,39 cases and 40 cases.Their diagnostic sensitivity and accuracy were(82.86%,79.07%),(57.14%,53.49%),(85.71%,83.72%),(91.43%,90.69%),(94.29%,93.02%),respectively.The difference was statistically significant(P<0.05),but the diagnostic specificity was(62.50%,37.50%,75.00%,87.50%,87.50%),respectively,with no statistical difference(P>0.05);40 cases of gestational sac confirmed by operation and pathology,15 cases of original cardiac tube beating,23 cases of yolk sac,19 cases of germ,31 cases of gestational sac hemorrhage,37 cases of uterine hemorrhage,transvaginal ultrasound and MRI were diagnosed 38 and 36 cases,12 cases and 0 cases,20 cases and 6 cases,15 cases and 6 cases,3 cases and 28 cases,19 cases and 33 cases.Conclusion:Transvaginal ultrasound and MRI combined with serumβ-HCG levels can effectively improve the diagnostic accuracy of early stage uterine scar pregnancy after cesarean section,which has important clinical diagnostic value.
作者
李家菊
丁颖
王永丽
王修丽
周兆欣
LI Jia-ju;DING Ying;WANG Yong-li(Function Department,the Third People's Hospital of Hefei,Hefei 230041,Anhui Province,P.R.C.)
出处
《中国数字医学》
2020年第3期129-131,共3页
China Digital Medicine
