宫角妊娠的超声特征与误诊分析

Analysis of Ultrasound Features and Misdiagnosis of Cornual Pregnancy

目的分析宫角妊娠的声像学特征及误诊原因,以提高超声诊断符合率。方法对经病理证实的15例宫角妊娠患者的术前超声检查资料,进行分析。结果宫角妊娠的超声声像图特征:(1)子宫增大,两侧宫角不对称,向外隆起侧宫角部可见妊娠囊或包块回声;(2)妊娠囊或包块与子宫内膜向连;(3)妊娠囊或包块周围均有较完整的子宫肌层包绕;(4)彩超显示来自宫角部的血流供应妊娠囊或包块。15例宫角妊娠中,超声宫角妊娠诊断符合率约为66.7%(10/15),误诊率约为33.3%(5/15),误诊5例,其中2例误诊为输卵管间质部妊娠,2例误诊为宫腔偏宫角部妊娠,1例误诊为子宫肌瘤1例。结论超声对宫角妊娠有较高诊断价值,检查者应提高对该病的认识及鉴别诊断避免误诊。

Objective To analyze the ultrasound features and causes of misdiagnosis of cornual pregnancy in order to improve ultrasound diagnostic accuracy. Methods The clinical data of 15 cases with cornual pregnancy confirmed pathologically were retrospectively analyzed. Results The ultrasound image features of cornual pregnancy were：（ 1） Uterine enlargement,uterine horn asymmetry,and gestation sac or block echo existed in the bulge region of uterine horn.（ 2）The gestation sac or uterine block echo connected with the endometrial.（ 3） The gestation sac or uterine block echo was surrounded by myometrial.（ 4） The gestation sac or uterine block echo was supplied by the blood from uterine horn according to CDFI. Among 15 cases of cornual pregnancy,the ultrasound diagnostic accuracy was 66. 7%（ 10 /15）,the misdiagnosis rate was 33. 3%（ 5 /15）,specifically,2 cases were misdiagnosed as interstitial tubal pregnancy,2 cases were misdiagnosed as uterine partial uterine horn pregnancy,1 case was misdiagnosed as hysteromyoma. Conclusions Ultrasound has high diagnostic value in diagnosing cornual pregnancy,the examiner should improve the recognition and diagnosis of the disease in order to avoid misdiagnosis.