超声断层显像技术及经阴经腹超声检查结合血HCG对异位妊娠诊断的价值探讨

The Value of Color Ultrasound with TUI and Transvaginal Scan and HCG in Ecotopic Pregnancy Diagnosis

目的探讨经阴经腹彩色多普勒超声(彩超)及超声断层显像技术(TUI)结合血人绒毛促性腺激素(HCG)检测诊断异位妊娠(EP)的特征性依据,提高EP诊断的准确性。方法 对188例疑似早期EP者测定血HCG,进行二维经阴经腹彩超及TUI检查,测定子宫内膜厚度及血流分布,测量子宫动脉及滋养动脉血流频谱,并进行比较。结果 188例经阴经腹彩超诊断EP患者中,经手术病例证实EP 183例,超声诊断符合率为97.3%。其超声声像图特征为:(1)附件区妊娠囊内可见胎儿或者卵黄囊,伴或不伴胎心搏动,183例患者中有17例(9.0%)有胎心搏动;(2)Donut征(输卵管环),本组患者中98例(52.1%)有Donut征;(3)附件区内可探及混合性包块,有时伴有少量积液,本组60例(31.9%)患者可探及混合性包块;(4)8例(4.3%)患者仅表现为盆腔积液。血HCG平均为(3 320±2 342)mU/ml。结论 TUI及经阴经腹超声检查能准确迅速地取得EP的证据,结合血HCG检测是早期诊断EP的较好手段;TUI能提供多断面显示,可减少小病灶的漏诊。

Objective To study transvaginal scan and transabdom inal color Doppler sonography and TUI combined HCG with color doppler ultrasound in Pregnancy Diagnosis. Methods 188 cases were diagnosed in doubtful early ectopic pregnancy,all patients underwent transvaginal scan and transabdom inal color Doppler sonography and TUI,tested the thickness and blood flow of uterine endometrium,measured the blood flow of uterus artery and nutrient artery,compared with the results. Results Diagnose accordance rate was 97.3%.（1）It could be seen fetus or yolk sac in appendix,have or not fetal heart impulse.17 cases（9.0%）had fetal heart impulse in 183 patients.（2）Donut signe（uterine tube ring）：98 cases（52.1%） had Donut signe.（3）mixing lump was found out in appendix,some times had a small quantity of fluidify.60 cases（31.9%）was found out mixing lump.（4）8 cases（4.3%）showed pelvic cavity fluidify only.Level of blood HCG was（3 320±2 342）mU/ml. Conclusion TUI and transvaginal scan and transabdom inal color Doppler sonography can quickly diagnose ectopic pregnancy accurately,This is a good method to the early diagnosis of EP combined with blood HCG.TUI can supply multiple section display,decrease the missed diagnosis of small focus.