经腹和经阴道超声联合应用鉴别诊断子宫角部和输卵管间质部妊娠

Differential diagnostic value of treansabdominal and transvainal ultrasonic examination in patients with uterus cornea pregnancy and tubal interstitial pregnancy

目的探讨经腹和经阴道超声检查在子宫角部妊娠和输卵管间质部妊娠鉴别诊断中的价值。方法列经手术病理证实的18例子宫角部妊娠和23例输卵管间质部妊娠的声像图特点进行对比分析。结果41例子宫角部妊娠和输卵管间质部妊娠超声表现为孕囊型和混合型两种类型。孕囊型共30例,孕囊位于子宫角部14例,超声诊断符合率92.8%(13/14);超声表现为孕囊位于膨大的宫角内,与子宫内膜相连或隐约相连;孕囊周围有厚度均匀的肌层组织.厚9～12 mm。孕囊位于输卵管间质部16例,超声诊断符合率93.8%(15/16)。超声表现为宫角有不同程度的膨出.孕囊边缘与子宫内膜存在2～7 mm,不等的距离;孕囊周围肌层组织厚度<9mm。混合型共11例,宫角妊娠4例,间质部妊娠7例。结论联合应用经腹和经阴道超声检查有助于对子宫角部妊娠和输卵管间质部妊娠的孕囊型鉴别,有一定的临床意义。

Objective To explore the value of differential diagnosis of transabdominal and transvaginal ultrasonic examination in patients with uterus cornea pregnancy and tubal interstitial pregnancy. Methods Ultrasonic feature were analyzed and compared in 18 patients with uterus cornea pregnancy and 23 patients with tubal interstitial pregnancy, which were evidented during the operation and pathologic examination. Results There were two patterns of sonogram in 41 cases with uterus cornea pregnancy and tubal interstitial pregnancy. 30 cases in bryosac like pattern. 14 cases were in uterus cornea pregnancy, the accurate rate of ultrasonic diagnosis was 92.8%（13/14）. Ultrasonic feature were bryosac were in intern of extend uterus cornea and combines with endometrium. Thicken of bryosac round muscle measure 9 - 12 mm. 16 were in tubal interstitial pregnancy, the accurate rate of ultrasonie diagnosis was 93.8% （15/16） the ultrasonic feature were extend degree of uterus cornea were difference. The length extent between bryosac marginal and endometrium measure 2 - 7 mm. The thickness of bryosac marginal muscle was thin than 9mm. 11 cases in mixed pattern, 4 patients with uterus cornea pregnancy and 7 patients with tubal interstitial pregnancy. Conclusion It has great value that the combination of transabdominal ultrasound（TAS） and transvaginal ultrasound（TVS） were used in clinical treatment in differential diagnosis of uterus cornea pregnancy and tubal interstitial pregnancy.