宫角妊娠与输卵管间质部异位妊娠的超声诊断

目的 探讨超声对宫角妊娠与输卵管间质部妊娠(间质部妊娠)的诊断价值.方法 应用经阴道超声和/或经腹部超声检查,对33例经手术病理和临床保守治疗证实的宫角妊娠与间质部妊娠的声像图特征进行分析.重点观察子宫角部位妊娠囊或妊娠包块与子宫内膜的关系、与外周肌层厚度的关系;彩色多普勒观察妊娠囊或妊娠包块的血供情况.结果 24例宫角妊娠,超声诊断符合率83.3%(20/24),3例笼统诊断异位妊娠,1例误诊为间质部妊娠;9例间质部妊娠,超声诊断符合率66.7%(6/9),2例笼统诊断异位妊娠,1例误诊为宫内早孕.结论 经阴道超声与腹部超声联合检查对宫角妊娠与间质部妊娠具有较高的定位诊断价值,对临床决策治疗方案具有指导意义.

Diagnosis of Uterine Cornual Pregnancy and Interstitial Tubal Pregnancy with Ultrasonography

Objective To explore the diagnostic value of cornual pregnancy and tubal pregnancy in oviduct with ultrasound.Methods With transvaginal and transabdominal ultrasonic examination,ultrasonic features were analyzed and compared in 33 cases with uterin cornual pregnancy and tubal interstitial pregnancy,which were proved du ring the operation and pathologic examination and clinical conservative treatments.More attention was paid to the correlation of the gestational sacs(GS) or the pregnancy lump located in the uterine cornu with the endometrium and the thickness of uterine muscularis.The blood purvey of GS or the pregnancy lump was observed under the Color Doppler.Results 24 cases were cornual pregnancy,and the accurate rate of ultrasonic diagnosis was 83.3%(20/24).3 cases were generally diagnosed as ectopic pregnancy and 1 case was misdiagnosis.9 cases were interstitial tubal pregnancy and the accurate rate of ultrasonic diagnosis was 66.7%(6/9).2 cases were generally diagnosed as ectopic pregnancy and 1 case was misdiagnosed as early pregnant.Conclusions Transabdominal examination used together with transvaginal ultrasonic examination is of high value in diagnosing the location of the interstitial tubal pregnancy and uterine cornual pregnancy.It can direct effect clinical treatments.