经阴道超声诊断早期输卵管妊娠的价值

目的:探讨经阴道超声对早期输卵管妊娠的诊断价值.方法:对临床疑诊异位妊娠的患者均采用经阴道探头探查盆腔,了解宫内是否有孕囊,清晰显示卵巢并仔细寻找附件区有无异常回声及其与同侧卵巢的关系,从而诊断早期输卵管妊娠180例.结果:全部患者均于治疗前经阴道超声提示或确诊为输卵管妊娠并于术后病理证实.结论:经阴道超声具有无创性、可重复性及准确性高的特点,是早期诊断输卵管妊娠的首选影像学检查手段.     

彩超诊断宫内宫外同时活胎妊娠1例

患者女,37岁。孕二产一;因“停经56天,阴道少量流血”就诊。 常规行彩超检查所见：子宫体积增大,宫腔内可见一3．3cm×2．0cm妊娠囊,囊内见胎芽及原始心管搏动。     

Role of MRI in the early diagnosis of tubal ectopic pregnancy

Objective

To determine the role of MRI in the early diagnosis of tubal ectopic pregnancy (EP).

Methods

Clinical and MRI features of 27 cases of tubal pregnancy were reviewed.

Results

A thick-walled gestational sac (GS)-like structure was demonstrated lateral to the uterus in all cases. On T2-weighted images, the thick wall typically exhibited 3 discrete rings in 22 cases (81 %), among which 17 cases (63 %) displayed small vessels and 6 cases (33 %) exhibited small areas of fresh haemorrhage inside the thick wall. The contents demonstrated non-specific liquid in 26 %, papillary solid components in 56 %, and fresh blood or fluid-fluid level in 19 % of the cases. Dilatation of the affected fallopian tube associated with hematosalpinx was demonstrated in 18 cases (67 %) and marked enhancement of the tubal wall was observed in 22 cases (81 %). No correlation was found between the size of the GS and the estimated gestational age (r?=?0.056).

Conclusion

MRI plays an important role in the early diagnosis and management of tubal pregnancy. The characteristic MRI features include a GS-like structure with a “three rings” appearance on T2-weighted images, presence of solid components in the sac, dilatation of the affected fallopian tube with hematosalpinx, and tubal wall enhancement.

Key Points

? MR imaging has served as a problem-solving procedure in ectopic pregnancy. ? MR imaging features can be criteria for early diagnosis of tubal pregnancy. ? Detailed assessment of ectopic implantation is necessary for management decision-making.

     

Co-existent intrauterine and ectopic tubal pregnancy

A case of co-existent intrauterine and ectopic pregnancy is described in a patient from overseas. The difficulty in diagnosis and management is discussed, together with recent literature.     

Gray-scale ultrasound in tubal pregnancy

Sonographic signs were correlated with clinical data, surgical findings, and pathology in 15 patients withtubal pregnancy. Sonograms showed absence of intrauterine gestation in 12 patients. In 3, structures resembling gestational sacs were produced by decidual reaction and blood in the uterine cavity separating the endometrial echoes. The uterus was normal in size in 6 cases. Almost all sonograms showed a pelvic mass (usually adnexal) displacing the uterus. Seven patients had predominantly sonolucent masses, 3 had complex masses, and 4 had both types. Only one woman exhibited a definite gestational sac in an extrauterine location. Four patients had a negative pregnancy test at the time of sonography. Meticulous sonographic technique and a high index of suspicion will facilitate the diagnosis of tubal pregnancy in most cases.     

经阴道彩色多普勒超声诊断异位妊娠的临床价值

异位妊娠是指孕卵在子宫腔外着床发育的异常妊娠过程，俗称宫外孕。以输卵管妊娠最常见。病因常由于输卵管管腔或周围的炎症，引起管腔通畅不佳，阻碍孕卵正常运行，使之在输卵管内停留着床发育，导致输卵管妊娠流产或破裂。在流产或破裂前往往无明显症状，也可有停经、     

输卵管妊娠术后持续性异位妊娠的危险因素分析

目的 探讨输卵管妊娠患者术后发生持续性异位妊娠(PEP)的危险因素.方法 选取2000年1月－2020年12月在上海交通大学医学院附属国际和平妇幼保健院接受输卵管妊娠手术且术后发生PEP的38例患者为PEP组,同时选择同期行相同手术且手术成功、术后恢复良好的152例患者为对照组.回顾性分析两组患者的临床资料,记录并分析...     

彩色多普勒超声诊断宫外孕的影像学特征研究

 目的探讨彩色多普勒超声诊断宫外孕影像学特征.方法对手术病理证实的103例宫外孕患者附件区包块的彩色多普勒超声影像学特征进行回顾性研究,并与病理结果进行对照分析.结果(1)二维图像表现:子宫饱满或轻度增大,宫腔内未见胎囊,子宫内膜回声增强、增厚,增厚的内膜周围无明显的血流信号,附件区可见类圆形包块.其中胎囊性28例,占27.2%,包块型75例,占72.8%.(2)彩色多普勒血流特征:103例中67例在附件区包块内/或包块周边处记录到较丰富的滋养动脉血流,宫外孕滋养动脉血流检出率为65%.脉冲多普勒频谱特征为频谱增宽的高速低阻力的血流频谱,测量收缩期峰值流速为20～36 cm/s,舒张期峰值流速为11～18 cm/s,阻力指数(RI)为0.33～0.50,平均0.42±0.03.结论掌握宫外孕彩色多普勒影像学特征及血流分布的特异性,为临床医生及时选择恰当的治疗方案,评估宫外孕的预后,可提供有价值的参照信息.     

经阴道超声在宫外孕早期诊断中的临床应用

超声诊断中经腹部超声检查对非典型宫外孕及早期宫外孕易漏诊或误诊[1,2].我院利用经阴道超声检查对宫外孕患者实施早期诊断,明显提高了诊断率.本文对2009年6月～2012年6月间对320例早期宫外孕患者经腹超声(transabdominal sonography,TAS)与经阴道超声(transvag-inal sonography,TVS)检查临床资料进行回顾性分析,探讨经腹部及经阴道超声检查对早期宫外孕的诊断价值.     

输卵管妊娠保留输卵管手术治疗141例

目的:探讨保留输卵管手术在异位妊娠要求保留生育能力患者治疗中的重要性。方法:回顾性地详细介绍了141例保留输卵管手术的术式,术中术后及随访的治疗。结论:对比保留输卵管手术与辅助生育技术,阐明了保留输卵管手术的现实意义及重要性,进一步说明腹腔镜下保留输卵管手术的优越性及其将成为未来治疗的趋势,同时又指出在现有腹腔镜技术不能完成的手术时,如间质部妊娠,经腹手术保留输卵管仍是安全可靠的治疗方式。     

经阴道超声联合腹部超声诊断异位妊娠临床价值分析

目的探讨经阴道超声检查联合腹部超声在异位妊娠患者中的诊断价值。方法选取我院收治的108例疑似异位妊娠患者,比较经阴道超声检查、腹部超声检查检出率与两者联合对不同分型检出状况对比。结果经阴道超声检查、腹部超声检查、两者联合诊断检出率分别为70.4%、74.1、96.3%,误诊率分别为29.6%、25.9%、3.7%,与经阴道超声检查与腹部超声检查单一诊断比较,联合诊断误诊率更低,检出率更高(P<0.05);子宫内膜息肉样病变经腹部超声检查诊断特异度、准确度、敏感性分别为72.0%、 70.4%、 69.0%;子宫内膜息肉样病变经阴道超声检查诊断特异度、准确度、敏感性分别为76.9%、83.3%、89.3%;腹部超声检查对流产型、未破裂型、破裂型检查率分别为66.7%、63.0%、74.6%,经阴道超声检查对流产型、未破裂型、破裂型检查率分别为66.7%、51.9%、85.7%,在流产型、未破裂型、破裂型疾病诊断中,经阴道超声检查对诊断价值更高(P<0.05)。结论对疑似异位妊娠患者进行经阴道超声检查联合腹部超声检查,诊断的特异度、准确度与敏感性较高。     

异位妊娠的B超诊断(附128例分析)

异位妊娠是妇产科常见的急腹症之一。本文回顾性总结了自1992年9月～2002年7月B超诊断的异位妊娠128例，探讨其声像特点及分型的临床意义。     

经阴道与经腹部超声诊断异位妊娠的临床分析

为探讨经阴道与经腹部超声检查在异位妊娠诊断中的应用效果,我院于2010年2月～2011年9月对收治的异位妊娠患者分别采用经阴道超声(transvaginalsonography,TVS)和腹部超声(transabdominal sonography,TAS)进行检查,对比二者在诊断异位妊娠中的符合率,现将分析结果报     

B超在输卵管妊娠诊断与治疗中的价值

目的 :研究腹部B超 (TAS)和阴道B超 (TVS)在输卵管妊娠诊断和治疗中的价值。方法 :回顾性总结近 2年来 15 0例输卵管妊娠在TAS和TVS声像图上的特点及其治疗中B超的应用价值。结果 :输卵管妊娠声像图特点为卵巢外混合型或非均质性包块 ,盆腔或腹腔积液。TAS和TVS诊断输卵管妊娠的符合率分别为 86%和 96.4%。结论 :B超对诊断输卵管妊娠有重要价值 ,TVS对输卵管妊娠未破裂型敏感性高 ,而TAS能更全面了解破裂型的积液范围 ,TVS更有利于治疗方法的选择。     

经阴道B超与腹部B超在异位妊娠诊断中的临床分析

本文对2010年8月～2012年3月来我院就诊的106例疑似异位妊娠患者经阴道B超和经腹部B超检查结果进行对比研究[1～3],探讨经阴道B超与经腹部B超在异位妊娠临床诊断中的应用价值。1材料与方法本组106例患者,年龄21～43岁,平均28.6岁,停经时     

Magnetic resonance imaging in tubal and non-tubal ectopic pregnancy

Ectopic pregnancy is the leading cause of pregnancy-related death in the first trimester. Ectopic pregnancy is usually diagnosed by clinical, laboratory, and sonographic findings, with implantation most commonly located in the ampullary part of the fallopian tube. However, pregnancies that develop at unusual implantation sites, such as angular, interstitial, cornual, cervical, ovarian, cesarean scar, and abdominal cavity pregnancies, may rarely occur. Although ultrasound is considered the primary pregnancy-related imaging modality, it may not be able to illustrate the implantation site in certain types of pregnancy. Magnetic resonance imaging (MRI) has gained popularity as an imaging tool for evaluating pregnant patients, and it is used as a problem-solving tool in special circumstances, including ectopic pregnancy. MRI can confirm abnormal implantation site, and distinguish rupture from nonrupture cases before management. Other benefits include absence of ionizing radiation, superb soft tissue contrast, and sensitivity sufficient for identifying hemorrhage and its stages. This article summarizes imaging findings in tubal and non-tubal ectopic pregnancy with an emphasis on the roles and protocols of MRI, key MRI features, and differential diagnosis.     

黄体破裂与不典型宫外孕破裂的超声鉴别诊断

卵巢黄体破裂与宫外孕破裂是妇产科常见急腹症,起病急,以腹痛为主要症状,常为撕裂样或阵发性,典型的宫外孕破裂临床诊断并不困难,而不典型宫外孕破裂和卵巢黄体破裂的诊断和鉴别诊断有时较困难,容易造成误诊,现将经手术和病理证实的35例卵巢黄体破裂和63例不典型宫外孕患者进行回顾性分析.     

输卵管插管介入治疗输卵管妊娠

目的探讨经输卵管途径治疗输卵管妊娠的可行性及临床疗效,降低插管难度,缩短手术时间。方法采用介入输卵管插管方法,插管前行宫颈外口注入阿托品0．5mg,插管成功后注入甲氨喋呤70mg治疗114例输卵管妊娠。结果113例获得成功,1例中转手术,未出现严重并发症。结论宫颈外口注入阿托品后输卵管插管治疗妊娠是简单、安全、微创、迅速有效的方法。