超声子宫内膜厚度及“三线征”变化在宫外孕诊断中的价值

Diagnostic Value of Ultrasonography for Observing Endometrial Thickness and Three-line Pattern in Ectopic Pregnancy

目的探讨超声观察子宫内膜厚度及"三线征"变化在宫外孕诊断中的价值。方法回顾性地分析2005-2008年我院诊治的170例宫外孕可疑病例的声像图资料,分3组(宫外孕组、宫内孕正常组和宫内孕自然流产组)进行内膜厚度及超声形态学方面的对照研究。结果62.2%宫外孕患者的子宫内膜呈"三线征"改变,61.1%宫外孕患者内膜厚径<0.8cm。正常宫内孕病例中,95.7%患者内膜显著增厚,回声增强呈"葱头样",71.7%内膜厚径在1.5cm以上。宫内孕自然流产病例,内膜回声相对较低,内膜厚径0.6～1.5cm,多在0.8～1.2cm。结论经超声观察子宫内膜厚度及形态学呈"三线征"变化,并结合附件区声像图特点及尿HCG化验,能够对宫外孕的诊断提供有价值的信息。

Objective To investigate the diagnostic value of ultrasonagraphy for endometrium thickness and three - line pattern in ectopic preqnancy. Methods From 2005 observing to 2008, 170 cases with doubtful ectopic pregnancy were enrolled. For each case, uhrasonography was performed with endometrium, specially the endometrial location, shape and thickness. Results In most cases with ectopic pregnancy, endometrium was central and thickening with enhanced echo and not showed clearly, and 62.2% endometrial three - line pattern was detected, the thickness of endometrium was less than 0. 8cm in 61.1% cases. In normal pregnancy, the endometrium was showed clearly, markedly thickening and enchaned echo, the thickness was between 1.2 and 2. 3 cm and 71.7% cases more than 1.5cm, the thickening endometrium appeared to be in shape of shuttle-like in early stage and in shape of onion -like in late stage in 95.7% cases. In cases with spontaneous abortion, the ultrasonographic echo of endometrium was low, the fluid in uterine cavity was found in most cases, the thickness of endometrium was between 0. 6 and 1.5cm and mostly between 0. 8 and 1.2cm. Conclusion Combined with the appendix uhrasonographic imaging, endometrial thickness and urinary hCG measurement, the trans abdominal uhrasonography of endometrium has important value in the diagnosis of ectopic pregnancy.