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经阴道超声联合超声造影对剖宫产瘢痕妊娠的 诊断价值
Diagnostic value of transvaginal ultrasonography combined with contrast- enhanced ultrasound for cesarean scar pregnancy
收稿日期:  
DOI:10.3969/j.issn.1673-9701.2024.19.007
关键词:  剖宫产  瘢痕妊娠  阴道超声  超声造影
Key Words:
基金项目:浙江省嘉兴市医学重点学科-医学影像学(2023-ZC-015)
作者单位
顾亚惠 嘉兴市第一医院超声科浙江嘉兴 314000 
易云云 嘉兴市第一医院超声科浙江嘉兴 314000 
侯云龙 嘉兴市第一医院超声科浙江嘉兴 314000 
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摘要:目的 分析经阴道超声(transvaginal ultrasonography,TVS)联合超声造影(contrast-enhanced ultrasound,CEUS)在剖宫产瘢痕妊娠(cesarean scar pregnancy,CSP)诊断中的应用价值。方法 回顾性分析2022年1月至2023年11月嘉兴市第一医院收治并经手术病理证实的60例CSP患者,术前接受TVS与CEUS检查,比较TVS、CEUS单独及联合诊断对CSP的检出率和分型诊断情况,使用受试者操作特征曲线(receiver operating characteristic curve,ROC曲线)分析TVS、CEUS鉴别孕囊型剖宫产瘢痕妊娠(gestational cesarean scar pregnancy,GCSP)的效能。结果 60例CSP患者中,手术病理证实GCSP 53例,包块型剖宫产瘢痕妊娠(mass cesarean scar pregnancy,MCSP)7例;TVS联合CEUS对CSP的检出率为98.33%,显著高于TVS或CEUS单独检测(P<0.05),CEUS对CSP的检出率显著高于TVS(P<0.05);TVS联合CEUS对GCSP的检出率为100.00%,显著高于TVS或CEUS单独检测(P<0.05),TVS联合CEUS鉴别GCSP的曲线下面积(area under the curve,AUC)最大,为0.857,敏感度100.00%,特异性71.40%;TVS联合CEUS对MCSP的检出率显著高于TVS(P<0.05)。结论 TVS联合CEUS可有效提高CSP的临床检出率,有利于CSP分型的诊断,具有重要应用价值。
Abstract:Objective To analyze the application value of transvaginal ultrasonography (TVS) combined with contrast-enhanced ultrasound (CEUS) in the diagnosis of cesarean scar pregnancy (CSP). Methods Sixty patients with CSP confirmed by operation and pathology admitted to the First Hospital of Jiaxing from January 2022 to November 2023 were retrospectively analyzed. TVS and CEUS were examined before operation. The detection rate and type diagnosis of CSP were compared between TVS and CEUS alone and combined diagnosis. The receiver operating characteristic (ROC) curve was used to analyze the efficiency of TVS and CEUS in identifying gestational cesarean scar pregnancy (GCSP). Results Among the 60 patients with CSP, 53 patients with GCSP and 7 patients with mass cesarean scar pregnancy (MCSP) were confirmed by surgery and pathology. The detection rate of CSP by TVS combined with CEUS (98.33%) was significantly higher than that by TVS or CEUS (P<0.05), and the detection rate of CSP by CEUS was significantly higher than that by TVS (P<0.05). The detection rate of GCSP by TVS combined with CEUS (100.00%) was significantly higher than that by TVS or CEUS (P<0.05). The area under the curve (AUC) of TVS combined with CEUS for identifying GCSP was the largest, which was 0.857. The sensitivity was 100.00%, and the specificity was 71.40%. The detection rate of MCSP by TVS combined with CEUS was significantly higher than that by TVS (P<0.05). Conclusion TVS combined with CEUS can effectively improve the clinical detection rate of CSP, which is conducive to the diagnosis of CSP classification, and has important application value.
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