未破型异位妊娠的超声诊断

Ultrasonic Diagnosis of Un-ruptured Ectopic Pregnancy

目的 探讨超声对未破型异位妊娠发生部位诊断的临床价值。方法 回顾性分析经手术及病理证实的未破型异位妊娠的超声图像特征。结果 输卵管峡部、壶腹部妊娠表现为子宫一侧的环状回声包块 ;输卵管间质部妊娠表现为一侧宫角的向外膨隆 ,胎囊外侧缘无子宫肌壁的环绕 ;宫角妊娠表现为一侧宫角的饱满 ,胎囊外侧有肌壁的包绕 ,下段与宫腔相通 ;残角子宫妊娠表现为位于子宫一侧的正圆形囊性包块 ,周围环绕子宫肌壁 ;宫颈妊娠表现为宫颈增大 ,子宫呈葫芦形 ,内口紧闭 ,宫颈内有胎囊。结论 腹部超声 (TAS)、阴道超声(TVS)联合检查 。

Objective To probe the clinical value of ultrasonic diagnosis to find out the originated position of un ruptured ectopic pregnancy(UREP).Methods We retrospectively analysed the characteristics of UREP on sonograms which were confirmed by operation and pathology.Results The UREP originated from isthmus and ampulla appeared as a unilateral circular echoic mass;UREP from the interstitial portion of the oviduct revealed a unilateral bulging out of the uterus cornis and there was no uterine muscular wall encircled on the lateral side of the embryonic sac;UREP from unilateral uterua cornis shown as unilateral full cornis,there was muscular wall encircled at the lateral side and the lower part of the sac communicated with uterine cavity;UREP from residual cornis appeared as a unilateral round sac like mass encircled with uterine muscular wall;UREP from cervix displayed an enlarged cervix which was calabash like with inner os closed and the embryonic sac was in the cervix.Conclusions The combination of transabdominal ultrasound(TAS)and transvaginal ultrasound(TVS)associated with comprehensive clinical analysis will improve the origination diagnosis of UREP.