经阴道彩色多普勒超声在输卵管妊娠的早期临床诊断价值

Clinical Value for Early Diagnosis of Oviducal Pregnancy by Combining Transvaginal Color Doppler Imagine

目的探讨经阴道彩色多普勒超声结合HCG测定在输卵管妊娠早期诊断的价值.方法对87例临床手术及病理检查证实的输卵管妊娠的经阴道超声检查结果结合尿、血HCG测定进行分析.结果输卵管妊娠可表现为未破裂孕囊型、管状低回声流产型和破裂混合团块型,附件区可探及阻力指数(R I)0.44±0.11的动脉血流频谱;未破裂孕囊型、管状低回声流产型和破裂混合团块型的附件区团块内部及周边血流丰富程度呈递减趋势,同时血流信号的丰富程度与血β-HCG测定值呈正相关,阻力指数与血β-HCG测定值呈负相关.子宫动脉峰值流速(PSV)、R I以及附件区团块PSV与血β-HCG测定值无关.结论经阴道彩色多普勒超声检查结合临床表现以及尿、血HCG的测定对输卵管妊娠的早期诊断具有临床实用价值.

Objective To explore the clinical value for early diagnosis of oviducal pregnancy by combining transvaginal color Doppler imagine and HCG. Methods The results of transvaginal color Doppler ultrasonic examination of 87 cases were proved by operation and pathological examination and then were analyzed by combining the testing results of urine and blood HCG. Results Oviducal pregnancy were typed as unruptured pregnant vesica, tubular low echo abortion and ruptured mixed mass. Spectrum of arterial blood flow was detected in appendix with the resistance indexes （RI） of 0. 44 ±0. 11. No descending tendency of blood richness was detected in the three types. Serumβ- HCG was found positively correlated with blood richness and negatively correlated with RI. The PSV of uterine artery, RI and the PSV of the mixed mass in appendix were not correlated with serumβ- HCG. Conclusions It can be of an important clinical value for early diagnosis of oviducal pregnancy to combine transvaginal color Doppler imagine, clinical manifestation and HCG.