目的:回顾性评价MRI对妊娠早期子宫输卵管交界性妊娠的诊断价值。
方法:这项回顾性研究涉及59例(2016年1月至2021年7月)术前影像学诊断为子宫输卵管交界性妊娠的患者。使用手术和病理报告作为参考标准,我们确定了22例上外侧腔内(角状)妊娠和37例间质妊娠.两位资深放射科医生,对病人的信息视而不见,回顾MRI图像并根据原始解释标准确定每个MRI特征.任何分歧都是通过讨论达成共识来解决的。根据参考标准计算每个MRI特征的敏感性和特异性。
结果:上外侧腔内妊娠组的子宫内膜厚度大于间质组(p=0.001)。子宫内膜厚度的截止值为11.5mm,特异性,曲线下面积为77.3%,64.9%,和0.743。诊断上外侧腔内妊娠的两个关键特征是“内侧游离边缘”和“内侧游离边缘加上截止子宫内膜厚度”。“内侧游离边缘的敏感性和特异性分别为100%和94.9%,分别。内侧游离边缘加截止以上子宫内膜厚度的敏感性和特异性分别为77.3%和100%,分别。诊断间质妊娠的关键特征是一个完整的外侧交界区,其中敏感性和特异性分别为94.6%和100%,分别。
结论:MRI可用于区分妊娠早期的腔内妊娠和间质妊娠。
结论:•我们证明了间质妊娠和上外侧腔内妊娠的MRI诊断标准。•MRI可用于识别复杂的间质妊娠,孕囊伸入子宫腔的人。
OBJECTIVE: To retrospectively evaluate the diagnostic value of MRI for the uterotubal junctional pregnancies during the first trimester.
METHODS: This retrospective study involved 59 patients (January 2016 to July 2021) with a preoperative imaging diagnosis of uterotubal junctional pregnancy. Using operative and pathological reports as the reference standard, we identified 22 patients with upper-lateral intracavitary (angular) pregnancy and 37 patients with interstitial pregnancy. Two senior radiologists, blinded to the patients\' information, reviewed the MRI images and determined each MRI feature based on the original interpretation criteria. Any disagreement was resolved by discussion to achieve a consensus. The sensitivity and specificity of each MRI feature were calculated according to the reference standard.
RESULTS: The endometrial thickness in the upper-lateral intracavitary pregnancy group was larger than in the interstitial group (p = 0.001). The cutoff value of the endometrial thickness was 11.5 mm with a sensitivity, specificity, and area under the curve that were 77.3%, 64.9%, and 0.743, respectively. Two key features to diagnose upper-lateral intracavitary pregnancy were \"medial free edge\" and \"medial free edge plus above-cutoff endometrial thickness.\" The sensitivity and specificity of the medial free edge were 100% and 94.9%, respectively. The sensitivity and specificity of the medial free edge plus above-cutoff endometrial thickness were 77.3% and 100%, respectively. The key feature to diagnose interstitial pregnancy was an \"intact lateral junctional zone,\" of which the sensitivity and specificity were 94.6% and 100%, respectively.
CONCLUSIONS: MRI can be used to differentiate the upper-lateral intracavitary pregnancy and interstitial pregnancy during the first trimester.
CONCLUSIONS: • We demonstrated MRI diagnostic criteria for the interstitial pregnancy and upper-lateral intracavitary pregnancy. • MRI might be used to identify the complex interstitial pregnancies, those with a gestational sac protruding into the uterine cavity.