磁共振成像对输卵管妊娠的诊断价值

The value of MRI in the diagnosis of tubal pregnancy

目的探讨输卵管妊娠的磁共振成像(MRI)表现及诊断价值。方法回顾分析37例手术病理证实的输卵管妊娠病例,所有病例均行MRI平扫及超声检查,12例行钆喷酸葡胺(Gd-DTPA)增强扫描。结果37例输卵管妊娠中,间质部妊娠9例,峡部妊娠11例,壶腹部17例。MRI定位准确率67.6%,定性准确率91.9%,均高于同期超声诊断。34例显示孕囊包块呈囊性、囊实性改变。其中12例增强扫描孕囊呈斑片状、条索状、边缘强化及无强化。3例未见明确孕囊。盆腔积液、积血9例,输卵管积液、积血3例,局部多发流空血管20例,子宫内膜增厚16例。结论 MRI能全面显示输卵管妊娠的直接征象及间接征象,对病变的定性、定位诊断有很高应用价值。

Objective To investigate the MRI manifestations and diagnostic value of tubal pregnancy. Methods retrospective analysis of 37 cases of surgical pathology confirmed cases of tubal pregnancy, all cases were performed MRI scan and ultrasound examination, 12 routine Gd-DTPA enhancement scanning. Results In 37 cases of tubal pregnancy, interstitial pregnancy 9 cases, 11 cases of spondylolysis pregnancy, 17 cases of periampullary. MRI local-ization accuracy 67.6%, qualitative accuracy 67.6%, ultrasonic diagnosis were higher than the same period. Thirty-four cases showed pregnant bursa bag piece, show cystic change, sac. Twenteen cases of enhanced scan pregnant bursa was patchy, strengthen a funicular, edge and without reinforcement.Did not see clearly pregnant bursa in 3 cases.Pelvic cavity accumulates fluid, 9 cases of hemorrhage and tubal effusion, hemorrhage in 3 cases, local multiple flow of 20 patients with empty vessels endometrial thickening in 16 cases. Conclusion MRI can fully display direct signs and indirect signs of tubal pregnancy, positioning and qualitative diagnosis of lesions has a high application value.