经阴道彩色多普勒超声诊断妊娠黄体的价值

Diagnosis Value of Pregnant Corpus on Transvaginal Color DopplerImaging

目的:探讨阴道彩色多普勒超声(TVS-CDFI)诊断妊娠黄体的价值。方法:对68例我院妇科门诊诊断为早期妊娠的妇女行经阴道彩色多普勒超声检查,观察记录子宫内妊娠囊情况、附件有无包块、确定卵巢内妊娠黄体,观察记录妊娠黄体的大小、形态、内部回声特点及血供分布特点,随访复查B超了解附件区包块变化情况。结果:根据附件区包块内部回声特点分为三型:低回声型47例、混合回声型19例、无回声型2例。其中以低回声型多见。彩色多普勒血流显示(CDFI)68例附件区包块周边探及环状、半环状彩色血流信号,脉冲多普勒测及低速低阻动脉频谱[阻力指数:(0.46±0.03)cm/s,收缩期峰值流速(13.14±5.87)cm/s]。68例超声诊断妊娠黄体65例,误诊3例,均经临床随访复查或微创手术证实。结论:TVS-CDFI是妊娠黄体的无创性检查手段,正确认识妊娠黄体对于早期妊娠的诊断与鉴别诊断具有重大意义。

Objective To explore the diagnosis value of early pregnant corpus on TVS-CDFI. Methods 68 patients who were diagnosed as early pregnancy by our gynecologic clinics were detected on TVS-CDFI. The condition of gestation bag and whether there is adnexal masses was observed to make sure whether pregnant corpus is inside the ovary. The size, form, configuration and blood flow changes in the pregnant corpus arteries were observed and recorded. The changes of adnexal masses were followed up and reexamined. Results The two dimensional sonograms of corpus lutenm of early pregnancy can be divided into 3 types according to the configuration： 47 cases with a round hypo-echoic structure found, 19 cases with a mixed-echoic structure found, 2 cases with echo-flee area. The round hypo-echoic structure found is the most. Transvaginal color Doppler imaging types revealed the luteal blood flow patterned a circumferential rim around the entire luteal cyst wall, a hemicycle rim around the cyst wall. PW showed low velocity and low resistance pattern （RI： 0.46± 0.03 cm/s; PI： 13.14±5.87 cm/s）. Pregnant corpus was identified in 65 out of 68 and 3 cases were diagnostic errors. The result was confirmed by follow-up and reexamination or minimally invasive operation. Conclusion Transvaginal color Doppler imaging is a nontraumatic method for diagnosis of pregnant corpus. It＇s very valuable to recognise pregnant corpus correctly for early pregnancy diagnosis and differential diagnosis.