虚拟器官计算机辅助分析在测量绒毛膜下血肿与血清孕酮体积比中的诊断效能
Diagnostic efficacy of virtual organ computer-assisted analysis in measuring the volume ratio of subchorionic hematoma with serum progesterone.
作者信息
Shen Lin-Ling, Shi Jing, Ding Chang-Wei, Dai Gao-Le, Ma Qi
机构信息
Department of Ultrasound, The Second Affiliated Hospital of Soochow University, Suzhou 215004, Jiangsu Province, China.
Department of Ultrasound, Wuxi People's Hospital of Nanjing Medical University, Wuxi 211103, Jiangsu Province, China.
出版信息
World J Clin Cases. 2024 Jun 16;12(17):3053-3060. doi: 10.12998/wjcc.v12.i17.3053.
BACKGROUND
Subchorionic hematoma (SCH) is a common complication in early pregnancy characterized by the accumulation of blood between the uterine wall and the chorionic membrane. SCH can lead to adverse pregnancy outcomes such as miscarriage, preterm birth, and other complications. Early detection and accurate assessment of SCH are crucial for appropriate management and improved pregnancy outcomes.
AIM
To evaluate the diagnostic efficacy of virtual organ computer-assisted analysis (VOCAL) in measuring the volume ratio of SCH to gestational sac (GS) combined with serum progesterone on early pregnancy outcomes in patients with SCH.
METHODS
A total of 153 patients with SCH in their first-trimester pregnancies between 6 and 11 wk were enrolled. All patients were followed up until a gestational age of 20 wk. The parameters of transvaginal two-dimensional ultrasound, including the circumference of SCH (Cs), surface area of SCH (Ss), circumference of GS (Cg), and surface area of GS (Sg), and the parameters of VOCAL with transvaginal three-dimensional ultrasound, including the three-dimensional volume of SCH (3DVs) and GS (3DVg), were recorded. The size of the SCH and its ratio to the GS size (Cs/Cg, Ss/Sg, 3DVs/3DVg) were recorded and compared.
RESULTS
Compared with those in the normal pregnancy group, the adverse pregnancy group had higher Cs/Cg, Ss/Sg, and 3DVs/3DVg ratios ( < 0.05). When 3DVs/3DVg was 0.220, the highest predictive performance predicted adverse pregnancy outcomes, resulting in an AUC of 0.767, and the sensitivity, specificity were 70.2%, 75% respectively. VOCAL measuring 3DVs/3DVg combined with serum progesterone gave a diagnostic AUC of 0.824 for early pregnancy outcome in SCH patients, with a high sensitivity of 82.1% and a specificity of 72.1%, which showed a significant difference between AUC.
CONCLUSION
VOCAL-measured 3DVs/3DVg effectively quantifies the severity of SCH, while combined serum progesterone better predicts adverse pregnancy outcomes.
背景
绒毛膜下血肿（SCH）是早期妊娠的常见并发症，其特征是子宫壁与绒毛膜之间有血液积聚。SCH可导致不良妊娠结局，如流产、早产及其他并发症。早期发现并准确评估SCH对于恰当处理及改善妊娠结局至关重要。
目的
评估虚拟器官计算机辅助分析（VOCAL）测量SCH与妊娠囊（GS）体积比并联合血清孕酮对SCH患者早期妊娠结局的诊断效能。
方法
纳入153例孕6至11周的孕早期SCH患者。所有患者随访至孕20周。记录经阴道二维超声参数，包括SCH周长（Cs）、SCH表面积（Ss）、GS周长（Cg）、GS表面积（Sg），以及经阴道三维超声的VOCAL参数，包括SCH三维体积（3DVs）和GS三维体积（3DVg）。记录并比较SCH大小及其与GS大小的比值（Cs/Cg、Ss/Sg、3DVs/3DVg）。
结果
与正常妊娠组相比，不良妊娠组的Cs/Cg、Ss/Sg和3DVs/3DVg比值更高（<0.05）。当3DVs/3DVg为0.220时，预测不良妊娠结局的性能最高，曲线下面积（AUC）为0.767，敏感性、特异性分别为70.2%、75%。VOCAL测量3DVs/3DVg联合血清孕酮对SCH患者早期妊娠结局的诊断AUC为0.824，敏感性高，为82.1%，特异性为72.1%，AUC之间存在显著差异。
结论
VOCAL测量的3DVs/3DVg能有效量化SCH的严重程度，而联合血清孕酮能更好地预测不良妊娠结局。
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