Abstract:

Objective To evaluate the diagnostic value of gastrointestinal filling contrast-enhanced ultrasound (GIC-US) for gastroduodenal diseases in pregnant women, and to compare it with the result of gastroscopy. Methods A total of 144 pregnant women with upper gastrointestinal symptoms were enrolled and divided into the early-mid pregnancy group (gestational age ≤28 weeks, n=93) and the late pregnancy group (gestational age >28 weeks, n=51). All patients underwent both GIC-US and gastroscopy. Using the result of gastroscopy as the reference standard, sensitivity, specificity, accuracy, positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio (+LR), and negative likelihood ratio (-LR) of GIC-US were calculated. The diagnostic performance between the two groups was compared, and the McNemar test was used to analyze the difference in detection rates between the two methods. Results The overall sensitivity, specificity, accuracy, PPV and NPV of GIC-US were 90.15%, 66.67%, 88.19%, 96.75% and 38.10%, respectively, with a+LR of 2.70 and a -LR of 0.15. The early-mid pregnancy group showed higher sensitivity (93.02% vs. 84.78%), specificity (71.43% vs. 60.00%) and accuracy (91.40% vs. 82.35%) compared with those of the late pregnancy group. The overall detection rate of gastroscopy was 91.67% (132/144) compared with 85.42% (123/144) for contrast-enhanced ultrasound, showing no statistically significant difference (P=0.052). The tolerance of patients to GIC-US was significantly better than that of gastroscopy (VAS score: 1.49±1.12 vs. 4.67±1.66, P<0.01). Conclusion GIC-US can serve as an important non-invasive auxiliary method for the screening and diagnosis of gastroduodenal diseases during pregnancy, with better diagnostic performance, particularly in the early-to-mid trimester.

Key words: pregnancy, stomach diseases, duodenal diseases, gastroscopy, gastrointestinal filling contrast-enhanced ultrasound