经阴道彩色多普勒超声检查对非典型宫外孕的临床诊断价值

Transvaginal color Doppler ultrasonography in the diagnosis of atypical ectopic pregnancy

目的:探讨经阴道彩色多普勒超声检查对非典型宫外孕的的临床诊断价值。方法:回顾性分析4年来经手术病理证实的32例非典型宫外孕患者的阴道彩超二维图像、血流分布及频谱特征。结果:经阴道彩超清晰显示非典型宫外孕病灶,其声像图表现为:附件区囊实性包块20例(62.5%),附件区实性包块9例(28.1%),仅见输卵管局部增粗膨大3例(9.4%);宫内"假孕囊"征4例(1.3%);子宫内膜增厚25例(78.1%),子宫内膜不增厚7例(21.9%);全部病例有腹盆腔积液征象;可检测到滋养血流信号29例(90.6%),脉冲多普勒频谱呈增宽的高速低阻力的血流频谱,测量阻力指数(RI)为0.40±0.07,未探及到血流信号3例(9.4%)。彩超诊断正确率为81.3%(26/32)。结论:经阴道彩超图像清晰、操作简单快速、无需充盈膀胱;通过非典型宫外孕的声像图及血流频谱表现特征进行早期诊断的正确率较高,应作为临床首选检查方法。

Objective：To investigate clinical diagnostic value of transvaginal color Doppler ultrasound on atypical ectopic pregnancy.Methods：Transvaginal color Doppler ultrasound two-dimensional images,blood flow distribution and frequency spectrum characteristics of 32 atypical ectopic pregnancy patients confirmed by operative pathological diagnosis in past 4 years were retrospectively analyzed.Results：Transvaginal color Doppler ultrasound displayed atypical ectopic pregnancy lesions clearly：20 cases（62.5%） with annex area pouch and solid bag piece,9 cases（28.1%） with annex area solid bag piece,3 cases（9.4%） had only oviduct local increase coarse swollen;4 cases（1.3%） with intrauterine ＂false pregnancy sac＂ signs;25 cases（78.1%） with and 7 cases（21.9%） without endometrial thickening;all cases with abdominal pelvic cavity accumulated fluid pine;nourish blood flow signal was detected in 29 cases（90.6%）,pulsed Doppler spectrum showed the high-speed low resistance widened bloods tream spectrum,the resistance index was 0.40±0.07,3 cases（9.4%） were failed to explore blood flow signal.Color Doppler ultrasound diagnostic accuracy rate was 81.3%（26/32）.Conclusion：Transvaginal color Doppler ultrasound display images clearly and fast,don＇t need to fill bladder.Early diagnosis of the atypical ectopic pregnancy based on ultrasonographic and blood flow spectrum performance characteristics has high accuracy rate,and should be a preferred choice in clinical examination.