The Value Of Ultrasonic Diagnosis In Tubal Pregnancy By Comparing The Between-side Differences Of PI And RI Of Uterine And Tubal Arteries

Objective:To explore the value of pulsatility index (PI) and resistivity index (RI) of uterine and tubal arteries in the diagnosis of tubal pregnancy (TP).The assessment of the between-side differences of PI and RI of uterine and tubal arteries might provide valuable information for the diagnosis of TP.Methods:Sixty-nine patients with TP were taken as case group and sixty-two patients with intrauterine pregnancy (IUP) as control group. Their first-time ultrasonic data including the characteristics of mass, the position of corpus luteum (CL), the spectra of bilateral uterine and tubal arteries as well as the level of serum β-HCG were analyzed. According to the position of CL and the level of β-HCG, the case group was devided into group A (TP was at the same side with CL and serum β-HCG was less than or equal to800mIU/ml), group B (TP was at the same side with CL and serum β-HCG was more than800mIU/ml) and group C (TP was at the different side with CL). The side with CL was defined as functioning side and the side without CL was defined as nonfunctioning side. PI and RI of uterine and tubal arteries were compared on the functioning side to the nonfunctioning side in each group. Then the between-side differences of PI and RI of uterine and tubal arteries were compared between the case group (group A, group B) and the control group,respectively. All the data were processed and analyzed using SPSS13.0.Results:CLs were all displayed in each group (100%). In the case group, sixty-four TP masses in sixty-nine TP patients (92.7%) were displayed in ultrasound. Sixty-two TP masses were at the functioning side (89.8%) and seven TP masses were at the nonfunctioning side (10.2%). Spectra of all uterine and tubal arteries in the control group and the case group were obtained satisfactorily. In the control group, the differences of PI and RI of uterine arteries between the functioning side and the nonfunctioning side were not statistically significant (P>0.05), while PI and RI of tubal arteries were lower on the functioning side than on the nonfunctioning side and the differences were statistically significant (P<0.05). In the case group (group A), the between-side differences of PI and RI of uterine arteries were of no statistic significance (P>0.05), while PI and RI of tubal arteries were lower on the functioning side than on the nonfunctioning side and the differences were statistically significant (P<0.05). In the case group (group B), PI and RI of uterine and tubal arteries were both lower on the functioning side than on the nonfunctioning side and the differences were statistically significant (P<0.05). In the case group (group C), the between-side differences of PI and RI of uterine arteries and tubal arteries were not statistically significant (P>0.05).There were no statistic differences in the between-side differences of PI and RI either in uterine or tubal arteries between the control group and group A (P>0.05). The between-side differences of PI and RI in uterine arteries were higher in group B than in the control group and the differences were statistically significant (P<0.05), while there were no statistic differences in those of tubal arteries between group B and the control group (P>0.05). Using a cutoff point of18.88%and3.89%for the percentage of the between-side differences of PI and RI in uterine arteries, the sensitivity and specificity in diagnosing TP were56.25%,82.23%and56.25%,64.52%, respectively.Conclusion:1.PI and RI of tubal arteries are more influenced by CL than those of uterine arteries.2.When serum P-HCG is less than or equal to800mIU/ml, it is helpless in diagnosing TP by comparing the between-side differences of PI and RI of uterine arteries.3. When serum β-HCG is more than800mIU/ml, and there is no intrauterine or extrauterine positive discoveries in ultrasound, if the percentage of the between-side differences of PI is more than18.88%and (or) that of RI is more than3.89%in uterine arteries, it is probably that the side with lower resistance has the existence of TP and it is not related with the position of CL.4.It can not differentiate TP (located at the same side with CL) from IUP by evaluating the between-side differences of PI and RI of tubal arteries. And whether or not it helps to diagnose TP (located at the different side with CL) still needs further research.