经阴道超声检查在子宫间质部妊娠与宫角部妊娠超声诊断与鉴别中的价值

目的探讨经阴道超声在子宫间质部妊娠与宫角部妊娠声像图特点及鉴别要点的作用及预后评估。方法经阴道超声行纵切及横切面扫查：①观察妊娠囊是否位于子宫底（纵切面）及一侧宫角（横切面）;②判定妊娠囊与蜕膜化子宫内膜的关系;③妊娠囊与外周子宫肌层的关系;④将超声检查的提示性诊断与临床手术后及病理结果对照。结果本组随机观察52例,28例超声提示宫角部妊娠,后经手术及病理证实26例,另2例随妊娠进展,在1～2周后随访时演变为宫内正常妊娠。超声提示间质部妊娠24例,后均经临床证实。结论经阴道超声行纵切及横切面扫查在鉴别间质部妊娠与宫角部妊娠时确有重要价值。尤其当妊娠囊大小约在1.5～2.5cm时,定位诊断准确率较高。

The value of ultrasonic distinguished diagnosis between interstitial portion pregnancy and uterine cornual pregnancy by transvaginal sonography(TVS)

Objective Discuss the ultrasonic features and differential characteristics between interstitial portion pregnancy and uterine cornual pregnancy and evaluate prognosis by transvaginal sonography （TVS）.Scan slit and transverse section by transvaginal sonography （TVS）：①observe the location of the gestational cyst （GS）,which is in uterine fundus （slit section） or uterine cornual （transverse section）;②judge the relations between the GS and deciduate endometrium;③judge the relations between the GS and myometrium;④all the sonographic results were compared with the surgical pathologic findings.In the randomized 52 patients,28 patients were diagnosed as uterine cornual pregnancy by sonography,and then 26 patients were approved as uterine comual pregnancy by the surgical pathologic findings with the development pregnancy,the others 2 patients evolve into intratuterine pregnancy after 1～2w.24 patients with interstitial portion pregnancy diagnosed by sonography were proved by clinical examinations.Scanning slit and transverse section by transvaginal sonography （TVS）,it has high value in distinguished diagnosis between interstitial portion pregnancy and uterine corneal pregnancy.Especially in the GS with 1.5～2.5cm,The orientational diagnosed veracity is superior.