Application Value Of Transvaginal Three-Dimensional Energy Doppler Ultrasound In Conservative Treatment Of Ectopic Pregnancy

Objective To explore the value of three-dimensional power doppler angiography(3D-PDA)combined with virtual Organ Computer-Aided analysis(VOCAL)software in the early diagnosis of ectopic pregnancy(EP)by measuring the ultrasound indicators of EP mass,and the efficacy of evaluating the treatment effect and predicting the treatment outcome during the conservative treatment of EP,so as to provide a reference for clinical practice.Methods A total of 77 EP patients diagnosed and hospitalized in Wenzhou People’s Hospital from January 2019 to June 2022 were selected as the research objects.The patients who successfully received a single injection of Methotrexate(MTX)were included in the single injection success group,the patients who successfully received a second injection of MTX were included in the second injection success group,and the patients who failed the second injection of MTX were included in the failure group.The age,menopause time,ultrasound data of EP mass during diagnosis and treatment,and blood Human Chorionic Gonadotropin(HCG)values of all EP patients were collected.By comparing and analyzing the Volume(V),Vascularization Index(VI),Flow Index(FI),Vascularization Flow Index(VFI)and HCG of EP mass before treatment among the three groups,the predictive value of the above indexes for the treatment outcome before treatment was explored.Then the V,VI,FI,VFI,HCG and the change rate of each parameter of the three groups were compared and analyzed on the 4th and 7th day of the treatment.The correlation between ultrasound indicators and HCG levels and the treatment outcome in the process of EP conservative treatment was explored.To determine the efficacy of V,VI,FI,VFI,HCG and the change rate of each parameter in predicting the outcome of MTX conservative treatment.Among the 77 enrolled subjects,66 patients with menstrual cessation time ≤45 days were selected to record the ultrasonic parameters of their initial EP mass and HCG level.Normal pregnant women with menstrual cessation time ≤45 days were selected to record the ultrasonic data and HCG level of the corpus luteum of pregnancy.The differences of V,VI,FI and VFI between EP mass and corpus luteum gestation as well as the differences of HCG levels between EP patients and normal pregnant women were compared and analyzed.ROC curve was established to calculate AUC,and the efficacy of V,VI,FI,VFI and HCG in the identification of EP mass and corpus luteum gestation was discussed.Result(1)The blood flow parameters VI,FI and VFI of corpus luteum were significantly higher than those of EP(P<0.01).(2)The blood flow parameters VI,FI and VFI had high efficacy in differentiating EP mass from corpus luteum of pregnancy(P<0.01).(3)The ultrasound indexes(V,VI,FI and VFI)of EP mass measured by 3D-PDA combined with VOCAL software could predict the treatment outcome before MTX injection(P<0.01).(4)In the process of MTX treatment,the ultrasonic index,HCG and the change rate of their parameters had the efficacy to evaluate the therapeutic effect and predict the outcome of treatment(P<0.01).Conclusion 1.3D-PDA combined with VOCAL software to measure the blood flow parameters(VI,FI,VFI)of EP mass can effectively differentiate EP from corpus luteum of pregnancy.It can provide more diagnostic confidence when two-dimensional ultrasound diagnosis is insufficient,and provide help for early diagnosis of EP.2.3D-PDA combined with VOCAL software can predict the treatment method and outcome of EP before drug conservative treatment by measuring the ultrasound indexes(V,VI,FI,VFI)of EP mass,and can evaluate the treatment effect and predict the treatment outcome in time during the treatment process.Ultrasonic indicators combined HCG monitoring at the same time,can choose treatment way for clinical doctors in and evaluate the effect of the treatment to provide more help.