Study on the application value of ultrasound imaging in the diagnosis of acute abdomen in obstetrics and gynecology
Objective To explore the application value of ultrasound imaging in the diagnosis of acute abdomen in obstetrics and gynecology.Methods 86 patients with acute abdomen in obstetrics and gynecology were selected as the research samples,and color Doppler ultrasound diagnostic equipment was used to perform transabdominal and vaginal ultrasound examinations.The gold standard for diagnosis was the results of hysteroscopy.For the diagnosis of acute abdomen in obstetrics and gynecology,different ultrasound techniques were used to compare the results of ectopic pregnancy,torsion of ovarian cyst pedicle,and rupture of corpus luteum.The consistency between the diagnostic results of different ultrasound methods and the results of hysteroscopy was analyzed.Results Hysteroscopic diagnosis:among 86 patients with acute abdomen in obstetrics and gynecology,there were 45 cases of ectopic pregnancy,21 cases of torsion of ovarian cyst pedicle and 20 cases of rupture of corpus luteum.The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of abdominal ultrasound in diagnosing ectopic pregnancy were 71.11% ,70.73% ,70.93% ,72.73% and 69.05% ,and those of vaginal ultrasound were 88.89% ,90.24% ,89.53% ,90.91% and 88.10% ,and those of abdominal ultrasound combined with vaginal ultrasound were 100.00% ,100.00% ,100.00% ,100.00% and 100.00% .The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of abdominal ultrasound combined with vaginal ultrasound were higher than those of single examination(P<0.05).The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of vaginal ultrasound were higher than those of abdominal ultrasound(P<0.05).Regarding the ectopic pregnancy,the consistency between abdominal ultrasound combined with vaginal ultrasound,single vaginal ultrasound and the gold standard reached a high level(Kappa=0.884 and 0.740),while the consistency between single abdominal ultrasound and gold standard was only moderate(Kappa=0.657).The sensitivity,specificity,accuracy,positive predictive value,negative predictive value of abdominal ultrasound were 66.67% ,83.08% ,79.07% ,56.00% and 88.52% ,and those of vaginal ultrasound were 76.19% ,87.69% ,84.88% ,66.67% and 91.94% ,and those of abdominal ultrasound combined with vaginal ultrasound were 100.00% ,98.46% ,98.84% ,95.45% and 100.00% .The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of abdominal ultrasound combined with vaginal ultrasound were higher than those of single examination(P<0.05).Regarding the torsion of ovarian cyst pedicle,the consistency analysis between abdominal ultrasound combined with vaginal ultrasound and the diagnostic gold standard reached a high level(Kappa=0.879),while the consistency analysis between single examination of vaginal and abdominal ultrasound and the gold standard was only moderate(Kappa=0.646 and 0.562).The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of abdominal ultrasound were 70.00% ,84.85% ,81.40% ,58.33% and 90.32% ,and those of vaginal ultrasound were 80.00% ,89.39% ,87.21% ,69.57% and 93.65% ,and those of abdominal ultrasound combined with vaginal ultrasound were 100.00% ,98.48% ,98.84% ,95.24% and 100.00% .The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of abdominal ultrasound combined with vaginal ultrasound were higher than those of single examination(P<0.05).Regarding the rupture of corpus luteum,the consistency analysis between abdominal ultrasound combined with vaginal ultrasound and the gold standard reached a high level(Kappa=0.875),while the consistency analysis between single examination of vaginal and abdominal ultrasound and the gold standard was only moderate(Kappa=0.630 and 0.551).Conclusion Transvaginal ultrasound has good value in the diagnosis of acute abdomen in obstetrics and gynecology,and can accurately detect ectopic pregnancy,torsion of ovarian cyst pedicle,and rupture of corpus luteum.Especially,combined ultrasound scanning from the vagina and abdomen is of higher diagnostic value,and can be more sensitive and accurate to judge the type of acute abdomen in patients.
Obstetrics and gynecologyAcute abdomenEctopic pregnancyTorsion of ovarian cyst pedicleRupture of corpus luteumDiagnosisTransvaginal ultrasoundAbdominal ultrasound
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