摘要
目的 比较经阴道超声、3.0T磁共振成像(MRI)扫描以及经阴道超声联合3.0TMRI扫描用于异位妊娠诊断的价值,为异位妊娠早期筛查提供参考依据.方法 以2019年2月—2022年12月在四川省达州市达川区人民医院就诊的130例疑似异位妊娠患者为研究对象,所有患者均接受经阴道超声、3.0T MRI扫描检查,以手术病理或临床随访结果为金标准,评价经阴道超声、MRI检查与临床诊断结果的一致性,比较经阴道超声、3.0T MRI扫描以及经阴道超声联合3.0T MRI扫描诊断异位妊娠的敏感度、特异度、准确度.结果 130例疑似异位妊娠患者中,108例经手术病理确诊为异位妊娠、22例经随访确诊为非异位妊娠.经阴道超声诊断异位妊娠的敏感度、特异度、准确度分别为85.19％(92/108)、54.55％(12/22)、80.00％(104/130),与临床诊断结果的一致性为 0.358.3.0T MRI 扫描诊断异位妊娠的敏感度、特异度、准确度分别为92.59％(100/108)、81.81％(18/22)、90.77％(118/130),与临床诊断结果的一致性为0.694.经阴道超声联合3.0T MRI扫描诊断异位妊娠的敏感度、特异度、准确度分别为98.15％(106/108)、72.73％(16/22)、93.85％(122/130),与临床诊断结果的一致性为0.764.经阴道超声联合3.0T MRI扫描诊断异位妊娠的敏感度(x2=11.88,P＜0.01)和准确度(x2=10.96,P＜0.01)均明显高于经阴道超声.结论 经阴道超声联合3.0T MRI扫描可为异位妊娠提供更丰富诊断信息,与临床诊断结果一致性较高,且相较单纯经阴道超声检查能提高诊断敏感度、准确度.
Abstract
Objective To compare the value of transvaginal ultrasound,3.0T magnetic resonance imaging(MRI)scan-ning alone and in combination for diagnosis of ectopic pregnancy,so as to provide insights into early screening of ectopic pregnancy.Methods This study enrolled a total of 130 patients with suspected ectopic pregnancy admitted to Dachuan People's Hospital in Dazhou City,Sichuan Province,China between February 2019 and December 2022.All patients under-went transvaginal ultrasound examination and 3.0T MRI scanning.The consistency of transvaginal ultrasound and 3.0T MRI with clinical diagnostic results was evaluated with surgical pathology or clinical follow-up results as the golden standards.The sensitivity,specificity,and accuracy of transvaginal ultrasound and 3.0T MRI,alone and in combination,were com-pared for diagnosis of ectopic pregnancy.Results Of the 130 patients with suspected ectopic pregnancy,108 cases were confirmed with ectopic pregnancy by surgical pathology,and 22 cases were confirmed without ectopic pregnancy by clinical follow-up.The sensitivity,specificity,and accuracy of transvaginal ultrasound were 85.19％(92/108),54.55％(12/22),and 80.00％(104/130),respectively,with 0.358 consistency with clinical diagnostic results.The sensitivity,specificity,and ac-curacy of 3.0T MRI were 92.59％(100/108),81.81％(18/22),and 90.77％(118/130),respectively,with 0.694 consistency with clinical diagnostic results.The sensitivity,specificity,and accuracy of transvaginal ultrasound combined with 3.0T MRI were 98.15％(106/108),72.73％(16/22),and 93.85％(122/130),respectively,with 0.764 consistency with clinical diagnost-ic results.In addition,the sensitivity and accuracy of transvaginal ultrasound combined with 3.0T MRI were significantly higher than transvaginal ultrasound alone for diagnosis of ectopic pregnancy(x2=11.88 and 10.96,both P＜0.01).Conclusion Transvaginal ultrasound combined with 3.0T MRI may provide more diagnostic information for ectopic preg-nancy,and is highly consistent with the clinical diagnostic results.In addition,transvaginal ultrasound combined with 3.0T MRI improves the diagnostic sensitivity and accuracy for ectopic pregnancy than transvaginal ultrasound alone.
NETL
NSTL
万方数据