超声增强型血流显像技术在早孕合并部分不典型葡萄胎诊断中的价值

目的分析早孕合并部分不典型葡萄胎的二维和增强型血流显像(e-Flow)声像图特征,以提高早孕合并部分不典型葡萄胎的诊断率。方法回顾性分析经刮宫和病理检查证实早孕合并部分不典型葡萄胎24例的二维和e-Flow声像图特征。结果刮宫前超声提示早孕合并部分不典型葡萄胎17例,7例误诊。17例早孕合并部分不典型葡萄胎的二维声像图表现:①子宫略大于或等于正常妊娠月份,宫腔内妊娠囊变小、形态失常,妊娠囊周围可见细小、形态不规则的类蜂窝状无回声区;②宫腔内等或稍高回声团,部分病例可见少量不规则液暗区,无或仅有少量水泡状暗区。17例早孕合并部分不典型葡萄胎的e-Flow表现:宫腔病灶内以及相邻肌壁间可探及丰富血流信号。结论不典型葡萄胎声像图复杂,需要结合临床各项指标;二维超声对不典型葡萄胎无特异性,e-Flow显像可以在宫腔内异常回声团记录到低速血流信号,因此e-Flow技术对部分不典型葡萄胎有较高的诊断价值。

The diagnosis value of enbance-flow imaging technology of ultrasound in early pregnancy complicated with atypical hydatidiform mole

Objective To analyze the 2D and enhance-flow（e-Flow） imaging characteristics of pregnancy complicated with atypical hydatidiform mole in order to improve the diagnosis ratio of early pregnancy complicated with atypical hydatidiform mole. Methods Retrospective analysis of the sonographic characteristics of two-dimensional and e-Flow of 24 cases which were confirmed by uterine curettage and pathological examination in early pregnancy complicated with atypical hydatidiform mole. Results The ultrasound prompted early pregnancy complicated with atypical hydatidiform mole in 17 cases before curettage, seven cases were misdiagnosed. The sonographic features of 17 cases of pregnancy complicated with atypical hydatidiform mole were： （~） uterine slightly greater than or equal to the month of pregnancy, intrauterine gestational sac became small, abnormal morphology, gestational sac seen around the small, irregular in shape the class of honeycomb echo free zone; （~） intrauterine or slightly high echo, some cases can see few irregular liquid dark area, no or only a small amount of vesicular darkarea; e-Flow 17 cases early preg- nancy combined with some atypical hydatidiform mole： uterine cavity lesions and adjacent intramural probe found rich blood flow signal. Conclusion The sonography of atypical mole were complex. The diagnosis requires a combination of clinical indicators. Two-dimensional ultrasound has no specificity for the diagnosis of atypical hydatidiform mole, but e-Flow imaging can record low blood flow signal in the uterine cavity abnormalities, therefore e-Flow technology has high value in the diagnosis of atypical hydatidiform mole.