妊娠黄体的超声识别在输卵管妊娠诊断中的价值

目的探讨经阴道超声对妊娠黄体的正确识别在输卵管妊娠诊断中的价值。方法对80例经临床手术及病理证实的输卵管妊娠病例进行回顾性分析，观察妊娠包块和卵巢内妊娠黄体的形态结构及两者位置关系，并将输卵管妊娠中“输卵管环”型包块及厚壁囊肿型妊娠黄体的囊壁分别与子宫内膜回声作比较。结果80例输卵管妊娠患者，检测出妊娠黄体76例，输卵管妊娠包块与妊娠黄体在同侧者65例（86％），不同侧者11例（14％）。妊娠黄体主要形态特征为薄壁囊肿型、厚壁囊肿型、低回声型、薄壁囊肿内部点状回声型，输卵管妊娠包块主要为“输卵管环”型及低回声型。输卵管妊娠包块中的“输卵管环”囊壁大多是高于（38％）或等于（42％）子宫内膜回声；而厚壁囊肿型妊娠黄体其囊壁回声大多是低于子宫内膜回声（82％），两者比较差异有统计学意义（P〈0．01）。结论正确认识妊娠黄体的形态结构及其与输卵管妊娠包块的不同点在输卵管妊娠的诊断中有重要的意义。

The value of pregnant corpus luteum identified by ultrasound in the diagnosis of tubal pregnancy

Objective To explore the value of pregnant corpus lutenm identified by transvaginal ultrasound in the diagnosis of tubal pregnancy. Methods Eighty patients with tubal pregnancy confirmed by operation and pathol- ogy were analyzed retrospectively. Pregnancy mass and ovarian corpus luteum morphology and positional relationship between the two were observed. And the wall echoes of tubal ring type mass and thick-walled corpus luteum were compared with endometrial echo respectively. Results Among all 80 patients, 76 cases of pregnant corpus luteum were detected. There were 65 cases of tubal pregnancy mass and corpus luteum of pregnancy on the same side （86%） and 11 cases on different side （15%）. The main morphological characteristics of corpus luteum included thin-walled cyst, thick-walled cyst, hypoecho, thin-walled cyst within point-like hyperechoes. The main types of tubal pregnancy include tubal ring and hypoecho. The wall echoes of tubal ring type mass were mostly higher（38%） than equal（42%） of endometrial echo. While the wall echoes of thick-walled cystic corpus luteum cyst were mostly below the endometrial echo （82%）. There was significant difference between the two groups（P〈0.01）. Conclusion Correct un-derstanding of the morphological structure of pregnant corpus luteum and the difference between pregnant corpus lu-teum and tubal pregnancy mass was of great importance in the diagnosis of tubal pregnancy.