Han Huijuan, Mo Xinhai, Ma Yuqin, Zhou Yuqing, Zhang Bo
Department of Ultrasound, Shanghai Changning Maternity and Infant Health Hospital, Shanghai, China.
Department of Ultrasound in Medicine, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China.
Front Pharmacol. 2019 Jul 9;10:767. doi: 10.3389/fphar.2019.00767. eCollection 2019.
The purpose of this study was to explore the application of transvaginal two-dimensional and three-dimensional power Doppler ultrasound in pregnancy corpus luteum to predict the final outcome of early intrauterine pregnancy. This is a prospective observational cohort study. Six hundred early intrauterine pregnant women in Shanghai Changning Maternity and Infant Health Hospital were selected as the research objects from January 2015 to December 2015. According to the follow-up of 12 weeks, these pregnant women were divided into the normal pregnancy group (group A, = 512) and the terminational pregnancy group (group B, = 88). They all underwent both transvaginal two-dimensional ultrasound and three-dimensional power Doppler ultrasound to obtain relevant parameters of corpus luteum, namely, the average diameter of the corpus luteum (D), resistance index (RI), pulsatility index (PI), corpus luteum volume (V), vascularization index (VI), blood flow index (FI), and vascularized blood flow index (VFI). Among them, V, VI, FI, and VFI were calculated with the virtual organ computer-aided analysis method. Receiver operator characteristic (ROC) curves were drawn. The corresponding diagnostic cut-off, sensitivity, and specificity were calculated and compared. Compared with group A, the D, V, VI, FI, and VFI of corpus luteum in group B were statistically significant lower while RI and PI were statistically significant higher ( < 0.05). The diagnostic cut-off values in the prediction of early intrauterine pregnancy outcomes were D: 14.48, RI: 0.56, PI: 0.81, V: 3.89, VI: 21.48, FI: 38.99, and VFI: 10.21 respectively, and the sensitivity and specificity were D (99.2%, 67.0%), RI (98.9%, 65.0%), PI (78.4%, 89.1%), V (95.1%, 78.4%), VI (74.%, 90.9%), FI (91.8%, 90.9%), and VFI (93.9%, 87.5%) respectively. The area under the ROC curve of the combined index (RI + FI) was 0.963, which was not significantly higher compared with any single index, and both the sensitivity and specificity were 94.3%. Both transvaginal two-dimensional and three-dimensional ultrasonography are of high diagnostic value in predicting the early intrauterine pregnancy outcomes.
本研究旨在探讨经阴道二维及三维能量多普勒超声在妊娠黄体中的应用，以预测早期宫内妊娠的最终结局。这是一项前瞻性观察性队列研究。选取2015年1月至2015年12月在上海长宁区妇幼保健院的600例早期宫内妊娠孕妇作为研究对象。根据12周的随访情况，将这些孕妇分为正常妊娠组（A组，n = 512）和终止妊娠组（B组，n = 88）。她们均接受经阴道二维超声和三维能量多普勒超声检查，以获取黄体的相关参数，即黄体平均直径（D）、阻力指数（RI）、搏动指数（PI）、黄体体积（V）、血管化指数（VI）、血流指数（FI）和血管化血流指数（VFI）。其中，V、VI、FI和VFI采用虚拟器官计算机辅助分析方法计算。绘制受试者工作特征（ROC）曲线。计算并比较相应的诊断临界值、敏感性和特异性。与A组相比，B组黄体的D、V、VI、FI和VFI在统计学上显著降低，而RI和PI在统计学上显著升高（P < 0.05）。预测早期宫内妊娠结局的诊断临界值分别为：D为14.48，RI为0.56，PI为0.81，V为3.89，VI为21.48，FI为38.99，VFI为10.21，敏感性和特异性分别为：D（99.2%，67.0%），RI（98.9%，65.0%），PI（78.4%，89.1%），V（95.1%，78.4%），VI（74.%，90.9%），FI（91.8%，90.9%），VFI（93.9%，87.5%）。联合指标（RI + FI）的ROC曲线下面积为0.963，与任何单一指标相比均无显著升高，敏感性和特异性均为94.3%。经阴道二维和三维超声在预测早期宫内妊娠结局方面均具有较高的诊断价值。
