超声诊断少见部位异位妊娠及漏误诊分析

Ultrasonographic diagnosis of special ectopic pregnancy and analysis of the reasons for misdiagnosis

目的探讨超声对少见部位异位妊娠的诊断价值及漏误诊原因。方法对64例少见部位异位妊娠患者行经腹和/或经阴道超声检查(32例同时经腹及经阴道超声检查),其二维及彩色多普勒超声检测结果与手术及病理结果对照分析,并对16例漏误诊病例进行分析。结果经腹和/或经阴道超声检查提示异位妊娠48例(48/64),其中23例未能作出准确位置诊断,16例漏误诊;32例经腹配合经阴道超声检查,提示异位妊娠28例。结论超声显像在少见部位异位妊娠诊断中具有重要作用,配合经阴道超声检查可提高诊断准确率,但对准确位置判断有一定困难,漏误诊的主要原因是未能详细询问病史及未结合hCG检查结果。

Objective To evaluate the value of ultrasonography in the diagnosis of special ectopic pregnancy （SEP） and to analyze the reasons for misdiagnosis. Methods Ultrasonography was performed in 64 patients with SEP. The sonographic features of two-dimensional ultrasound and color Doppler of SEP were analyzed. The sonographic results were correlated with surgical and pathologic findings; and the 16 patients whose ectopic pregnancy were misdiagnosed or undetected were analyzed. Results Among the 64 cases, transabdominal and/or transvaginal ultrasonography prompted ectopic pregnancy in 48 cases, however, the accurate position of ectopic pregnancy was not identified in 23 cases; and 16 cases were misdiagnosed. Thirty-two cases underwent both transabdominal and transvaginal uhrasonography, which suggested ectopic pregnancy in 28 cases. Conclusions Ultrasonography plays an important role in the diagnosis of SEP. Although there are some difficulties in identifying the accurate positions of SEP, combined use of transvaginal ultrasonography can improve the accuracy rate of diagnosis. Failure to obtain the detailed medical history and hCG test result is the main reason for misdiagnosis.