标题：子宫内膜厚度及声像图特征在异位妊娠鉴别诊断中的应用价值

      作者：田永梅，张 娟，陈玉伟
    （煤炭总医院功能科，北京 100028）

      卷次： 2012年23卷20期

      【摘要】 目的 探讨子宫内膜厚度及超声声像图特征在异位妊娠鉴别诊断中的应用价值。方法 回顾
性分析 150例在我院就诊的疑似异位妊娠患者的声像图资料，包括异位妊娠组 80例、正常宫内妊娠组 30例，
宫内妊娠自发流产组 40例，观察各组研究对象子宫内膜声像图特征并测量子宫内膜厚度，同时进行对比分
析。结果 异位妊娠的声像图特征以三线征多见，三线征诊断异位妊娠的特异性和敏感性分别为 92.86%和
56.25%，阳性预测值为90%，阴性预测值为65%；异位妊娠组平均子宫内膜厚度为(9.64±3.97) mm，较正常宫内妊娠
[(13.49±4.53) mm]和宫内妊娠自发流产组薄[(12.62±6.99) mm](P<0.05)；评估子宫内膜厚度判断异位妊娠、宫内妊
娠自发流产和正常宫内妊娠的价值，ROC曲线下面积分别为0.70，0.55和0.73。结论 异位妊娠的子宫内膜厚度
较正常宫内妊娠和自发流产薄，声像图特征以三线征多见，该征象具有较高的特异性和预测价值，但敏感性欠佳。

      【关键词】 经腹超声；异位妊娠；子宫内膜；厚度；声像图特征

      【中图分类号】 R714.22 【文献标识码】 A 【文章编号】 1003—6350(2012)20—099—03<

br>Value of endometrial thickness and sonographic patterns in the differential diagnosis of ectopic pregnancy.
TIAN
Yong-mei, ZHANG Juan, CHEN Yu-wei. Department of Function, Chinese Coal General Hospital, Beijing 100028, CHINA

【Abstract】 Objective To investigate the value of endometrial thickness and sonographic patterns in the dif-
ferential diagnosis of ectopic pregnancy. Methods Ultrasonographic data of 150 patients with the suspicion of ecto-
pic pregnancy were reviewed, including 30 patients of . ectopic pregnancy (group A), 30 patients of normal intrauter-
ine pregnancy (group B), 40 patients of spontaneous abortion (group C). The endometrial thickness and sonographic
patterns were analyzed and compared. Results The specificity of the trilaminar pattern in diagnosing ectopic preg-
nancy was 92.86%, and the sensitivity was 56.25%. The positive predictive value was 90%, and the negative predic-
tive value was 65%. The mean endometrial thickness was thinner in group A [(9.64±3.97) mm] than group B [(13.49±
4.53) mm] and group C [(12.62±6.99) mm], P<0.05. The receiver operator curve for the endometrial thickness as pre-
dictor for ectopic pregnancy, spontaneous abortion and normal intrauterine pregnancy was analyzed. The areas under
the curve were 0.70, 0.55 and 0.73, respectively. Conclusion The endometrial thickness tends to be thinner in pa-
tients of ectopic pregnancy. The trilaminar pattern has high specificity and positive predictive value but low sensitivity.

      【Key words】 Trans-abdominal ultrasonography; Ectopic pregnancy; Endometrial; Thickness; Sonographic pattern