不典型异位妊娠的声像图分析

Sonographic analysis of untypical ectopic pregancy

目的分析和总结不典型输卵管、宫颈、宫角及卵巢妊娠的声像图特点。方法对临床未知妊娠部位的38例患者行二维、彩色多普勒及脉冲多普勒超声观察,并与手术及病理结果对照分析。结果不典型输卵管妊娠表现为输卵管增粗,横切面可见小的厚壁囊性结构,内无卵黄囊及胚芽,彩色血流显像无明显血流信号;卵巢妊娠未破裂时包块周围常可见卵巢组织,卵巢妊娠发生流产或破裂时,超声诊断较为困难;早期宫颈妊娠子宫外形呈葫芦状,宫颈膨大,可见以实性为主的囊实性包块,宫颈内口关闭;早期宫角妊娠时患侧宫角增大,厚壁的囊性结构与宫腔相通,周围有较厚均匀一致的肌层环绕。结论掌握不典型输卵管妊娠、卵巢妊娠及宫颈、宫角妊娠的声像图特点,可提高超声对异位妊娠的诊断能力。

Objective To analyze the sonographic features of untypical tubal pregnancy, cervical, ovarian and angular pregnancy. Methods 38 patients with unknown pregnancy position were observed by 2D, color Doppler flow imaging and pulse Doppler imaging. The results of sonography were compared with that of the pathology. Results Untypical tubal pregnancy was with enlarged uterine tube. Unruptured ovarian pregnancy had characteristic of ovarian tissue surrounded the gestation sac or inhomogeneous echoic mass, while ruptured ovarian pregnancy was difficult to diagnose. The sonographic feature of cervical pregnancy was that the shape of uterus was like gourd. The volume of cervix was enlarged, the inhomogeneous echoic areas could be seen in the cervix, and the internal os was closed. When amphicytula was implanted in the cornua uteri, in the sonography enlarged cornua uteri could be seen, gestation sac or inhomogeneous echoic mass was surrounded by uniform myometrium. Conclusion The diagnostic efficacy of ultrasound can be improved by mastering the features of untypical tubal, cervical, ovarian, angular pregnancy.