经腹及经阴道超声对宫角妊娠的诊断与分析

Diagnosis and analysis of cornual pregnancy with combined abdominal and transvaginal color Doppler ultrasound

目的探讨经腹及经阴道超声联合诊断宫角妊娠的价值。方法回顾性分析148例经腹及经阴道超声首次诊断为可疑宫角妊娠患者的超声声像图特点,评价其准确率。结果经手术和(或)病理证实,77例为宫角妊娠,29例为输卵管间质部妊娠,42例为宫内妊娠。84例超声首次诊断为可疑孕囊型宫角妊娠,诊断准确率为46.43%(39/84);经动态观察1～2周后二次诊断准确率为88.64%(39/44)。64例超声首次诊断为可疑包块型宫角妊娠,诊断准确率为59.37%(38/64);经动态观察1周后二次诊断准确率为66.66%(38/57)。结论对经腹及经阴道超声首次诊断为可疑宫角妊娠、特别是可疑孕囊型宫角妊娠者,进行动态观察并二次诊断是有必要的。

Objective To investigate the diagnostic value of combined abdominal and transvaginal color Doppler ultrasound for cornual pregnancy.Methods Ultrasonic image features of 148 patients with suspected cornual pregnancy by combined abdominal and transvaginal color Doppler ultrasound were retrospectively analyzed.The diagnostic accuracy rate of combined abdominal and transvaginal color Doppler ultrasound for cornual pregnancy was evaluated.Results According to surgery and pathology results,77 cases were confirmed cornual pregnancy,29 were interstitial tubal pregnancy,42 were intrauterine pregnancy.Totally 84 cases were suspected gestational sac type cornual pregnancy diagnosed by initial ultrasound,and the accuracy rate was 46.43%（39/84）.The second diagnostic accuracy rate was 88.64%（39/44） after dynamic follow-up observation of 1—2 weeks.A total of 64 cases were suspected mass type cornual pregnancy by initial ultrasound,and the accuracy rate was 59.37%（38/64）.The second diagnostic accuracy rate was 66.66%（38/57） after one week dynamic follow-up observation.Conclusion It is necessary to perform dynamic follow-up observation and second diagnosis when cornual pregnancy was diagnosed by initial combined abdominal and transvaginal color Doppler ultrasound,especially for gestational sac cornual pregnancy.