输卵管假性动脉瘤超声表现

Ultrasonoimagedata features of artery pseudoaneurysm of the fallopian tube

目的总结输卵管假性动脉瘤的超声特征,探讨超声在输卵管假性动脉瘤诊治中的价值。方法回顾性收集2018年1月至2022年8月于首都医科大学附属北京妇产医院就诊的输卵管假性动脉瘤患者5例,对其超声图像及临床特征进行总结分析。结果5例输卵管假性动脉瘤均经病理证实为伴发于输卵管妊娠,其中壶腹部妊娠4例,间质部妊娠1例。灰阶超声表现均为附件区或包裹于子宫角肌层内的伴有液性无回声区的非均质团块,彩色多普勒超声见血流射入无回声区,频谱多普勒呈高速低阻。3例就诊于人绒毛膜促性腺激素(hCG)上升期,2例就诊于hCG下降期。结论假性动脉瘤形成可能是输卵管妊娠破裂的一个高危因素,其愈合与hCG下降可不同步,应给予关注。超声是检出输卵管假性动脉瘤的有效手段。

Objective To summarize the ultrasonoimagedata features of artery pseudoaneurysm of the fallopian tube,and evaluate the value of ultrasound in its treatment.Methods Ultrasound images and clinical data of five patients with artery pseudoaneurysm of the fallopian tube admitted to our hospital from January 2018 to August 2022 were collected and analyzed.Results All the cases were pathologically confirmed to be secondary to tubal ectopic pregnancy;four cases were tubal ampulla pregnancy and one case was interstitial tubal pregnancy.On gray-scale ultrasonography,the artery pseudoaneurysm of the fallopian tube manifested as a mass with a fluid sonolucent area outside the uterus or wrapped in the muscle layer of the cornua uteri,and the gestational sac was seen beside the fluid sonolucent area in two cases.Blood flow leaking into the false cavity directly was seen on color Doppler.Pulse Doppler revealed an arterial blood flow spectrum with high speed and low resistance index.Three cases were diagnosed during the rising stage of serum human chorionic gonadotropin(hCG),while two cases were diagnosed during the descent phase of serum hCG.Conclusion Artery pseudoaneurysm may be another risk factor for rupture of tubal ectopic pregnancy,and its healing and endometrial degeneration are two different processes.It should be alert that artery pseudoaneurysm could rupture even when hCG is negative.Ultrasonography is effective in detecting artery pseudoaneurysm.