输卵管妊娠的超声分析

Ultrasonic analysis of tubal pregnancy

目的探讨输卵管妊娠的声像图特征,以早期发现和诊断。方法回顾性分析73例经手术和病理证实的输卵管妊娠患者的经腹及经阴道超声资料,从包块分型、血流分级分析输卵管妊娠的声像图特点。结果本组73例输卵管妊娠患者宫旁、附件区探及不均质包块者52例,占71.2%;CDFI显示包块内血流信号:0级11例,Ⅰ级32例;Ⅱ级7例,Ⅲ级2例。"双环状"征13例,囊周边探及血流信号:Ⅱ级8例,Ⅲ级5例。宫内外同时妊娠2例。手术证实输卵管妊娠流产型、破裂型的声像图多以包块形式出现;输卵管妊娠未破裂型的声像图呈"双环状"征。经腹结合经阴道超声对输卵管妊娠的诊断准确率为91.8%。结论超声及早检测出"双环状"征声像图,界限不清的附件区包块,盆腔积液,对输卵管妊娠的诊断及附件区包块的鉴别诊断有重要的临床价值。

Objective To explore the sonogram features of tubal pregnancy for early detection and diagnosis. Methods Seventy-three patients with tubal pregnancy were confirmed by surgery and pathology, their transabdominal and transvaginal uhrasonic information was analyzed retrospectively. Then the mass type, blood flow characteristics were analyzed. Results In 73 cases of tubal pregnancy, non-homogeneous masses were detected in the annex area or next to the uterus in 52 eases（71.2% , 52/73 ） , CDFI showed the blood flow signals in masses：11 cases of 0 grade ,32 cases of Ⅰ grade. There were 13 cases of ＂doublering＂ sign, 2 cases of pregnancy in exterior and interior of uterus. Blood flow signals were detected in cyst perimeter：8 cases of Ⅱ grade ,5 cases of Ⅲ grade. The sonograms appearance of abortion and disruption in tubal pregnancy was masses which were confirmed by surgery, and the sonogram appearance of non-disruption in tubal pregnancy was ＂double-ring＂ sign. The accuracy rate of transabdominal combined with transvaginal uhrasound in diagnosis of tubal pregnancy was 91.8%. Conclusion Ultrasound can early detect the sonogram of ＂double-ring＂ sign, ill-defined mass in the annex area and the fluidify in pelvic cavity, it has important clinical value in differential diagnosis of tubal pregnancy and annex masses.