Application Of Transvaginal Color Doppler Ultrasound In The Diagnosis And Efficacy Evaluation Of Early Scar Pregnancy

Objective:(1)To investigate the diagnosis value of transvaginal color Doppler ultrasound in crearean scar pregnancy,and aimed to assess the characteristic ultrasound performance of the two types(massive type and gestational scar type).(2)The relationship between the blood flow characteristics and the blood b-HCG value before and after treatment was analyzed.The value of Ultrasound in judging the therapeutic effect of scar pregnancy was analyzed.Methods:(1)50 patients with scar pregnancy confirmed by pathology in our hospital were observed,all patients underwent cesarean section before.All patients underwent Color Doppler ultrasound examination,the characteristic ultrasound performance of the two types scar pregnancy were asessed.(2)The change of lesion size and resistance index of blood flow were observed by transvaginal color Doppler ultrasound before and after treatment,and the changes ofb-HCG level in blood were measured by radioimmunoassay before and after the treatment.(3)SPSS 22.0 software was used for statistical analysis.Measured data were expressed as mean±standard deviation.The inter-group analysis was conducted using the ton test,and the count data was analyzed with chi-square test.Linear correlation analysis was performed before and after treatment for RI values and blood ?-HCG values,P<0.05 considered the difference statistically significant.Results:(1)50 cases were confirmed by pathological examination in32 cases of scar pregnancy,18 cases of gestational scar pregnancy,18 cases of gestational sac type by color Doppler ultrasound,30 cases with block type,and 2 cases without examination,and the diagnostic coincidence rate was 96%(30+18/ 50).(2)Transvaginal ultrasound examination showed that the massive type scar pregnancy was the heterogeneous echo mass at the lower segment of the uterus.The shape was irregular,the texture was uneven,the uterine isthmus and the margin of themasses were not clear,and the local swelling was local.The endocardium of the lower segment of the uterine cavity is not clear.The gestational scar type mainly showed typical pregnancy image in the incision of lower segment of uterus.The anterior wall of uterine isthmus showed obvious vascular pulsation or obvious signs of blood flow.Some patients were with larger gestational scar,the cervical morphology was normal.(3)The color blood flow spectrum before treatment in scar pregnancy showed that the resistance index of arterial blood flow was low,the content of b-HCG in blood was higher,the blood flow resistance index increased gradually after treatment,and the content of serum b-HCG reduced.(4)The increase of resistance index before and after treatment of scar pregnancy is significantly correlated with the decrease of serum b-HCG level by radioimmunoassay.There was no significant difference in the arterial resistance index and the serum b-HCG level between the two types.Conclusion:(1)The transvaginal color Doppler ultrasound can not only diagnose the early scar pregnancy more accurately,but also can correctly judge the type of the early scar pregnancy.(2)The changes of the serum b-HCG value were predicted by the transvaginal color Doppler ultrasonography by monitoring the size of the lesions of the scar pregnancy and the change of the arterial blood flow resistance index(RI),so as to evaluate the therapeutic effect of scar pregnancy.Therefore,transvaginal color Doppler ultrasound plays an important role in early diagnosis,diagnosis and curative effect evaluation of cicatricial pregnancy.