经腹与经阴道超声诊断异位妊娠符合率的Meta分析

目的：应用荟萃（Meta）分析探讨经腹超声与经阴道超声对异位妊娠诊断符合率。方法：采用Review Manager4.2软件,应用Meta分析固定效应模型和随机效应模型对1995年1月—2008年12月国内外有关经腹与经阴道超声诊断异位妊娠符合率的研究进行综合定量评价。结果：经筛选并纳入本次Meta分析的文献共22篇。累计经阴道超声组2010例,经腹超声组2015例,RR随机值为1.37（95%CI1.24～1.52）,差别有统计学意义（P〈0.00001）。结论：经阴道超声诊断异位妊娠优于经腹超声,有条件的单位应将经阴道超声作为诊断异位妊娠的首选方法。     

经腹部超声与经阴道超声诊断异位妊娠的临床价值观察

目的：调查研究经腹部超声与经阴道超声诊断异位妊娠的临床价值。方法：采用随机数字表法将104例异位妊娠患者分成观察组和对照组各52例,给予观察组患者经阴道超声诊断方法,给予对照组患者经腹部超声诊断的方法,对比两组患者诊断异位妊娠的符合率以及不同超声声像图的阳性率。结果：观察组经阴道超声检查确诊45例,诊断符合率为86．5％,对照组经腹部超声检查确诊32例,诊断符合率为61．5％,两者相比具有显著的差异性（P〈0．01）。观察组患者检查的超声声像图所显示的附件包块、胚芽形成以及原始血管搏动等检测指标的阳性率均高于对照组,且差异具有统计学意义（P〈0．05）。结论：异位妊娠经过阴道超声诊断的阳性率高于经腹部超声检查,且操作简单,安全性较高,值得在临床上进一步推广运用。     

经阴道超声对异位妊娠的诊断价值

目的:探讨经阴道超声对异位妊娠的诊断价值。方法:回顾分析127例经手术、病理证实的异位妊娠的声像图特征。结果:经阴道超声检查漏诊2例,误诊2例,异位妊娠超声检出率及定位正确率为96．8%。结论:经阴道超声对异位妊娠的诊断有较大的临床应用价值。     

彩色多普勒超声对异位妊娠的诊断价值

目的:探讨彩色多普勒超声对异位妊娠的诊断价值.方法:对临床确诊的异位妊娠患者应用经腹部彩色多普勒超声和经阴道彩色多普勒超声检查,比较两种检查技术的诊断符合率。结果:经阴道彩色多普勒超声的诊断符合率(75.6%)明显高于应用经腹部彩色多普勒超声(24.4%)。结论:经阴道彩色多普勒超声具有高分辨率特征,使异位妊娠的诊断率得以提高,在临床中具有较高的应用价值。     

早期异位妊娠经腹与经阴道彩色超声诊断对比分析

目的：探讨和分析对异位妊娠应用经腹部与经阴道彩色超声的临床诊断价值。方法：选择92例相关患者,对比经腹部和经阴道超声诊断的结果,并分别与病理诊断结果相比较。结果92例选取对象经腹部和经阴道超声检查的诊断准确率分别为70．7％和94．6％,两者相对比发现有显著性差异（P〈0．05）。结论：经阴道超声诊断早期异位妊娠在诊断准确率上优于经腹部超声诊断方式,且该诊断方式的分辨率较高,能为临床医师提供更多准确的参考信息,有利于病灶的确诊和及时治疗。     

腹部超声与阴道超声在诊断早期妊娠的应用比较

目的：探讨和分析在诊断早期妊娠患者中采用阴道超声与腹部超声的临床应用价值。方法：对我院收治的50例早期妊娠患者同时经腹及经阴道彩色超声检查,观察检查结果。结果：同一时期经腹超声确诊宫内早孕43例,附件区包块1例,宫内妊娠6例,经阴道超声确诊早孕46例,宫内妊娠提示孕卵枯萎2例,附件区包块2例,对照后发现,经腹超声符合率86％,经阴道超声符合率92％,经腹误诊3例。漏诊1例。结论：在临床上,对早期妊娠患者采用阴道超声检查,具有更高的诊断准确率,为临床诊断和治疗提供了有力的依据,值得在临床上进行推广和应用。     

经阴道与经腹部彩色多普勒超声诊断早期异位妊娠的价值

目的分析经阴道与经腹部彩色多普勒超声诊断早期异位妊娠的价值。方法选取2014年5月~2015年7月我院收治的早期异位妊娠患者120例作为研究对象,将其随机分为观察组和对照组,各60例,对照组采用经腹部彩色多普勒超声进行诊断,观察组采用经阴道彩色多普勒超声进行诊断,对比两组患者的诊断效果。结果对照组诊断出异位妊娠38例(63.33%),观察组诊断出异位妊娠55例(91.66%),观察组诊断效果明显优于对照组,差异有统计学意义(P0.05)。结论通过经阴道和经腹部彩色多普勒超声诊断比较,经阴道彩色多普勒超声的检测率、准确率高,诊断时间早。进行早期异位妊娠诊断时,应首选经阴道彩色多普勒超声,值得临床推广与使用。     

经阴道彩色多普勒超声诊断异位妊娠的临床价值

目的通过对异位妊娠二维声像图及彩色多普勒血流特征的分析，提高对异位妊娠诊断和鉴别诊断的水平。方法对手术病理证实的72例异位妊娠患者附件包块的二维图像和血流频谱特征进行回顾性分析。结果异位妊娠包块中的血流显像有特征性表现：血流阻力指数〈0．4。72例中38例为非典型异位妊娠，二维超声诊断符合率为50．2％，结合彩色多普勒技术诊断符合率为98．8％。结论经阴道彩色多普勒超声检查，对异位妊娠诊断的准确性高，在诊断非典型异位妊娠方面有较高的使用价值。     

不同途径彩色多普勒超声诊断剖宫产瘢痕妊娠44例比较分析

目的:探讨3种不同途径的彩色多普勒超声诊断方法对剖宫产瘢痕妊娠(CSP)诊断的准确性。方法:选择2009年1月至2013年12月,泰山医学院附属医院以及泰安市中心医院共收治经临床以及术后病理证实的CSP患者44例,根据彩色多普勒超声的不同途径分为经腹组(13例)、经阴道组(17例)、经腹联合经阴道组(14例),比较3组的诊断准确率和误诊率,以及误诊导致的误治情况。结果:1经腹组诊断准确8例(61.5%),误诊5例(38.5%);经阴道组诊断准确13例(76.5%),误诊4例(23.5%),经腹联合经阴道组诊断准确13例(92.9%),误诊1例(7.1%)。210例误诊患者中,经腹组误诊为稽留流产的3例患者以及经阴道组误诊为稽留流产的1例患者口服戊酸雌二醇后行负压吸引术时发生大出血,其中3例术后给予纱条填塞宫腔压迫方止血,另1例因出血难以控制中转开腹行局部病灶切除术加子宫修补术。经腹组误诊为宫颈妊娠的2例患者,经阴道组误诊为宫颈妊娠的3例患者以及经腹部联合阴道组误诊为宫颈妊娠的1例患者均行子宫动脉栓塞术并动脉内注射甲氨蝶呤,然后行负压吸引术,方治疗成功。结论:经腹联合经阴道彩色多普勒超声检查较经腹及经阴道彩色多普勒超声检查的诊断准确率高,而误诊率最低,推荐临床上选择经腹联合经阴道彩色多普勒超声检查作为诊断CSP检查方法。     

经腹经阴道对宫颈妊娠的超声诊断价值

目的：探讨超声诊断宫颈妊娠的价值。方法：采用GELOGIQ5彩色多普勒超声诊断仪,经腹经阴道对子宫及宫颈进行纵、横多角度探测。结果：超声能对宫颈妊娠做出迅速、准确的诊断。结论：经腹经阴道对宫颈妊娠有较好的早期诊断价值。     

剖宫术后瘢痕妊娠经腹部及经阴道彩色多普勒联合应用的误诊分析

目的：经手术及病理证实的67例剖宫术后瘢痕妊娠经腹部彩色多普勒（TAS）及经阴道彩色多普勒（TVS）超声表现及对其中12例误诊原因进行回顾分析,提高超声对其诊断准确率。方法：对67例本院经手术及病理证实的剖宫产术后瘢痕妊娠经腹部及经阴道彩色多普勒检查结果进行回顾性对比分析,并查找其中12例误诊原因。结果：剖宫术后瘢痕妊娠（Caesarean Scar Pregnancy,cps）,TAS＋TVS诊断符合率81％,TAS＋TVS检查诊断符合率较TAS诊断符合率显著提（P〈0．01）。结论：TAS＋TVS可提高剖宫术后瘢痕妊娠的早期诊断准确率,同时能动态观察病灶及血供情况,对指导临床治疗方案及监测治疗效果等方面具有重要意义,停经时间短、妊娠囊占据宫腔、妊娠囊过小及只贴着瘢痕表面、混合包块型者、血供多少以及结合临床不紧密是误诊的重要原因。     

经腹与经阴道超声诊断宫颈囊肿两种方法对比分析

目的:探讨经腹超声(transabdominal ultrasonographyTAS)与经阴道超声(transvaginal ultrasonography TVS)诊断宫颈囊肿的漏诊原因及临床意义。方法:选取2008年2月-2009年10月来我院妇科就诊及体检行TAS诊断的已婚妇女655例,2010年1月2010年12月来我院妇科就诊及体检行TVS诊断的已婚妇女479例,将两种检查方式对宫颈囊肿诊断结果进行对比分析。结果:TAS诊断宫颈囊肿诊断率14%,TVS诊断率56.9%;172例宫颈囊肿,TAS诊断率55.8%。TVS诊断率100%。结论:经腹超声诊断宫颈囊肿较经阴道超声有很大的漏诊率,经阴道超声诊断宫颈囊肿敏感性高,可作为检查宫颈囊肿的首选方法。     

The use of a vaginal probe in the diagnosis of ectopic pregnancy

Summary 75 patients with suspected ectopic pregnancy, referred to the department of Gynaecology and Obstetrics of the RWTH-Aachen between July 1987 and May 1988, were examined by means of transvaginal sonography. The sonographic findings were subsequently vaudated by clinical and/or surgical means. An ultrasound diagnosis of an ectopic pregnancy could not be confirmed in only 3 out 25 such cases.     

The use of transvaginal ultrasonography in the diagnosis of ectopic pregnancy

Despite advances in diagnosis made by the introduction of serum beta-subunit of human chorionic gonadotropin determinations and transabdominal ultrasonography, ectopic gestations still present a major diagnostic challenge. The increased resolution of the transvaginally introduced high-frequency ultrasound transducer probes seems to solve this diagnostic problem. In this study 145 patients were referred for ultrasonographic workup because of a suspected ectopic gestation. In 38 patients a diagnosis could be made with classical transabdominal scanning. One hundred seventeen patients required additional transvaginal scanning with a 5.0 and a 6.5 MHz probe. In 98 patients a diagnosis was made during the first transvaginal scan; nine patients were rescanned within 3 days for the final diagnosis. In 56 patients, ectopic pregnancy was successfully ruled out by transvaginal scanning. Thirty-nine ectopic pregnancies were diagnosed. Only one false-positive identification was made. The sensitivity of diagnosing ectopic pregnancy by high-frequency transvaginal sonography was 100%; the specificity was 98.2%. The positive predictive value of this method was 98%, and the negative predictive value was 100%. The rate of the beating fetal heart was seen in the tube (23%). The high number of unruptured tubal pregnancies in this series (66%) suggests the possibility of an early diagnosis that may have therapeutic implications. The use of higher-frequency transvaginal transducer probes improves the diagnosis of the ectopic gestation.     

Hemorrhagic ovarian cyst detection by transvaginal sonography: the great imitator

The sonograms of 102 hemorrhagic ovarian cysts (HOC) were reviewed to ascertain the full spectrum of sonographic findings as visualized by transvaginal sonography (TVS). The diagnoses, in 11 cases, were proven by surgery and the rest have undergone conservative follow-up until resolution (clinically and sonographically). The accurate diagnosis of HOCs by transabdominal sonography is quite difficult. The appearance of these cysts as visualized by TVS is described. We advise TVS as a better means for identification of HOCs, thus decreasing the rate of diagnostic invasive procedures.     

Comparative study of transperineal and transabdominal sonography in the diagnosis of placenta previa

AIM: To assess the role of transperineal sonography (TPS) in the diagnosis of placenta previa in the third trimester and to compare it with transabdominal sonography (TAS). METHODS: Seventy-five suspected cases of placenta previa were subjected to TAS with half full bladder and to the TPS with empty bladder to visualize the inner surface of the cervix and inferior edge of the placenta. The presence or absence of placenta previa was confirmed at delivery. RESULTS: TAS depicted the inferior edge of placenta in 98.7% of cases compared to 96% with TPS. Internal cervical os was visualized in 98.7% with TAS compared to 100% with TPS. Placenta previa was confirmed at delivery in 74 cases with one false positive in TPS, six false positive in TAS. The positive predictive value (PPV) value in the diagnosis of placenta previa was 92% with TAS compared to 98.6% with TPS. Accuracy of TPS in diagnosing placenta previa was 98.7%. PPV in the diagnosis of minor degree placenta previa was less 86.36% with TAS compared to TPS 100% though for major degree both are in agreement. CONCLUSION: TPS is a valuable procedure to compliment TAS in the diagnosis of placenta previa and helps to exclude false positive and to determine the mode of delivery, although it cannot replace TAS.     

经阴道彩色超声检查联合血清学指标对异位妊娠保守治疗结局的预测

目的:了解阴道彩色超声波检查(TVCDS)联合血清学指标对异位妊娠保守治疗结局的预测价值。方法:根据TVCDS血流信号联合血清学β-hCG、孕酮(P)建立异位妊娠保守治疗评分表,并以Elito评分表为对照,对122例拟行保守治疗的异位妊娠进行评分,采用氨甲蝶呤联合米非司酮进行保守治疗并追踪治疗结局。结果:阴道彩超联合血清学3项指标评分法曲线下面积显著高于Elito法曲线下面积(0.936vs0.890,P<0.05)。本法评分值≤6分是预测保守治疗成功的最佳临界值,准确度为92.6%,阳性预测值达95.9%。血清β-hCG<5000U/L、P<47.55nmol/L、阴道彩超血流信号<半环的保守治疗成功率显著升高(P<0.001)。结论:经TVCDS联合血清学指标评分法;评分≤6可有效预测异位妊娠保守治疗的成功。     

Transvaginal and transabdominal ultrasound for the diagnosis of placenta praevia.

This randomised prospective study was designed to evaluate the use of transvaginal (TVS) and transabdominal (TAS) ultrasound in the diagnosis of placenta praevia and its effect on length of stay in hospital. One hundred and thirty patients with antepartum haemorrhage (APH) and/or malpresentation with a suspicion of placenta praevia were referred to the scanning department of Aberdeen Maternity Hospital and Princess Badee'a Teaching Hospital from July 1993 to December 1996. Fifty-eight patients had an ultrasound because of antepartum haemorrhage and 72 had a malpresentation and/or unstable lie. All examinations were performed by the same authors. Placenta praevia was diagnosed in 13 (22.4%) out of 58 cases presenting with APH and in five (7%) out of 72 cases presenting with malpresentation. There was a high false positive rate in the detection rate of placenta praevia using TAS (23%) compared with TVS (11.5%) which is higher than other reported figures (2-6%). The mean length of stay in hospital of the group in whom the results were released was 9.2 days compared with those not released where it was 15.7 days. The difference was significant (P <0.05). This study suggests that the traditional transabdominal approach to the diagnosis of placenta praevia can be improved upon. TVS is a safe method and with improved accuracy over TAS can reduce the length of stay in hospital.