The Preliminary Application Of Ultrasound Elastography In Diagnosis And Differential Diagnosis Of The Ectopic Pregnancy Mass

Objective: To explore the value of ultrasound elasticity imaging in the diagnosis and differential diagnosis of ectopic pregnancy. Methods:(1) 35 patients with ectopic mass, 35 patients with uterine fibroid and 35 persons with solid corpus luteum, who was accept the hospital treatment in Longgang district maternity and child care hospital, were examined by Ascendus ultrasound diagnostic equipment. The position, size, shape, internal echo, border, peak systolic velocity, resistance index, menopause days and HCG values were recorded. The size of mass was measured on both elastic image and routine ultrasound image. Elastic score and strain ratio was given in a double blind method by two doctors. The SPSS 16.0 statistical package was used for statistical analysis. The normality test of the date was analysed in Kolmogorov-Smirnov method; The difference of size measured in elasticity image and dimensional ultrasound of this three kinds of mass was analysed in paired T-test; The strain rate difference between ectopic pregnancy mass and the other two kind of mass were analysed in two- independent samples T-test; The elastic score difference between ectopic pregnancy mass and the other two kinds of mass was analysed in rank sum test.(2) The correlation of elastic diagnos parameters and routine examination parameters of ectopic pregnancy mass was analysed. The consistency of elastic score and strain ratio given by two doctors was comparied. Results:(1) Ultrasound elasticity image and conventional ultrasound have same detection rate of ectopic pregnancy mass, but ultrasound elasticity could clearly show the boundary of ectopic pregnancy mass.(2) There was significant differences between elastic score of ectopic pregnancy mass and Corpus luteum(P<0.05), but no significant differences between elastic score of ectopic pregnancy mass and Uterine fibroids(P>0.05).(3) The size of ectopic pregnancy mass, uterine fibroids and corpus luteum which measured both on the two-dimensional gray-scale image and the elasticity image was have no significant statistically difference(P>0.05).(4) The strain ratio(SR) of ectopic pregnancy mass was have no significant statistically difference with uterine fibroids’(P>0.05), but there was have significant statistically difference with Corpus luteumo’s(P<0.05).(5) There was a linear regression relationship between strain ratio(SR) and the size of the ectopic pregnancy mass.There was no significant correlation with other parameters.(6) The elasticity score of ectopic pregnancy mass has correlation with SR. There was no significant correlation with other parameters.(7) The consistency of elasticity score and strain ratio of this masses given by two doctors was excellent.Conclusion:(1)Ultrasound elasticity image and conventional ultrasound have the same detection rate of ectopic pregnancy mass, but ultrasound elasticity can clearly show the boundary of ectopic pregnancy mass. Ultrasound elasticity may identify ectopic pregnancy mass and corpus luteum well, but it is difficult to identify myometrium pregnancy and uterine fibroids. It can be used as an effective supplementary means for the diagnosis and differential diagnosis of ectopic pregnancy.(2) The strain ratio(SR) and the elasticity score of ectopic pregnancy mass have moderate correlation with ectopic pregnancy mass size which suggest that ectopic mass size may be one of the factors of ectopic pregnancy mass’ elastic parameters.