超声对异位妊娠诊断价值的探讨

目的探讨超声对异位妊娠的诊断价值。方法对经手术病理证实为异位妊娠的患者50例超声声像图进行回顾性分析,并与病理结果进行对照分析。结果超声诊断与病理诊断的符合率为90%(45/50)。50例患者子宫正常大小或轻度增大,宫内未见妊娠囊声像。其中45例一侧附件区可见异常包块回声。根据声像图表现可分为胎块型21例,破裂型16例,流产型5例,陈旧型3例。诊断不符合5例中。50例中20例行彩超检查,宫内均未检出异常血流信号,其中14例可在附件区包块内/或包块周边探及较丰富的滋养动脉血流信号;检出率为70%。结论超声对异位妊娠具有较高的诊断准确率,附件区包块内探及妊娠囊声像以及彩色多普勒于包块内检出滋养层动脉血流信号为其特征性表现。

Objective To study the value of ultrasonography in diagnosis of ectopic pregnancy. Methods Ultrasonic features of pelvic masses in 50 cases with ectopic pregnancy verified by pathological diagnosis were retrospectively studied in comparison with those of surgery and pathology. Results The accuracy rate of ultrasonic diagnosis was 90%. Ultrasound showed normal or litter bigger uterus with endomenterium and highly echcoing, empty uterine cavity. Abnormal masses could be detected at one of appendix in 45 cases, consist of gestational sac type in 21 cases, ruptured type in 16 cases, abortion type in 5 cases and old lump type in 3 cases. Five cases were misdiagnosised. Color Doppler blood flow features： abundant nutrient artery blood flow could be dectected in or around masses in 14 cases. The dectection rate of nutrient artery blood flow in ectopic pregnancy was 70%. Conclusion Ultrasonic diagnosis is capable of confirming extra-uterine pregnancy at a high level, the characteristic ultrasound manifestation of ectopic pregnancy are that gestation sac is detected in masses and abundant nutrient artery blood flow could be dectected in masses.