腔内彩色多普勒超声诊断子宫肌壁间妊娠并文献回顾

Diagnosis of intramural pregnancy by endoluminal color Doppler ultrasonography and review of the literature

目的探讨子宫肌壁间妊娠的超声声像图特征,评价腔内彩色多普勒超声对子宫肌壁间妊娠的诊断价值。方法对6例子宫肌壁间妊娠患者超声检查,总结其声像图特点,与手术及病理检查结果相结合,并对子宫肌壁间妊娠相关文献回顾。结果子宫肌壁间妊娠的超声特征可分为三型:孕囊型和包块型表现为宫腔内空虚,在子宫肌层可见孕囊或包块声像,孕囊或包块与子宫腔不相通,孕囊周边或包块内血流丰富;破裂型表现为腹腔积血。结论腔内彩色多普勒超声对诊断子宫肌壁间妊娠有重要价值。

Objective To explore the ultrasound characteristics of intramural pregnancy and evaluate its diagnostic value.Methods Intramural pregnancy was diagnosed by endoluminal ultrasonography and confirmed by surgery and pathological examination in 6 patients.The position of the gestational sac,ultrasound findings,distribution of color Doppler flow signals were observed and analyzed together with their surgical and pathological results based on literature review.Results There were three types of ultrasound characteristics：gestational cyst type,mass type and uterine rupture type.The gestational cyst type ormass type presented with an empty uterus and a gestational sac ormixed mass was found in the myometrium,which can be separated from the endometrium.The sac ormass did not communicate with the uterine cavity,and abundant blood flow was observed about the sac or in the mass,while massive hemoperitoneum was found in the uterine rupture type.Conclusion Endoluminal ultrasound is of high value in the diagnosis of intramural pregnancy.