经阴道彩色多普勒超声对宫内外早早孕的鉴别

目的 探讨经阴道彩色多普勒超声（TV-CD）鉴别宫内早早孕及早期宫外孕的价值。方法对105例处于早早孕阶段（孕周小于40天）的孕妇进行TV-CD检查，观察子宫内膜形态，测量其厚度及血流频谱，检测结果与最终妊娠结果进行对照分析。结果宫内正常早早孕组子宫内膜显示清晰，增厚，厚度常〉1．5cm，早期增厚的内膜呈条梭状，后期呈“葱头样”改变，其血流阻力指数（RD常〈0．4；宫内早早孕流产型子宫内膜显示欠清晰，回声较低，内膜厚度多数为0．8～1．2cm，其血流RI常〈0．5；宫外早早孕组子宫内膜显示欠清晰，厚度常〈1．2cm，其血流RI常〉0．5。结论TV-CD检测子宫内膜厚度及其血流指数并观察其形态，结合附件区声像图特点及绒毛膜促性腺激素（HCG）化验结果，能够对宫内外早早孕诊断提供非常有价值的信息。

TVCD for differential diagnosis of very early intrauterine and very early ectopic pregnancy

Objective To explore the clinical value of TVCD in testing the thickness and blood flow of uterine endometrium and observing uterine endometrium for differential diagnosis of very early intrauterine pregnancy and very early ectopic pregnancy. Methods The thickness, shape and blood flow of uterine endometrium in 105 cases of very early pregnancy (pregnant time less 40 days) were tested and compared with the last pregnancy results. Results In the group of very early intrauterine pregnancy, the endometrium was displayed clearly, markedly thickening and usually > 1.5 cm. The thickening endometrium appeared to be in shape of shuttle-like in early stage and in shape of onion-like in late stage. The resistant index (RI) of the blood flow for uterine spiral artery was often < 0.4 . In the group of spontaneous abortion, the endometrium was not displayed clearly, the ultrasonographic echo was low, the thickness of endometrium was between 0.8 - 1.2 cm, and the RI of the blood flow for uterine spiral artery was often <0.5 ; In the group of very early ectopic pregnancy, the endometrium was not displayed clearly, the thickness of endometrium was often <1.2 cm, and the RI of the blood flow for uterine spiral artery was often >0.5 . Conclusion Combined with the appendix ultrasonographic imaging and urinary HCG measurement, TVCD has important clinical value for the differential diagnosis of very early intrauterine pregnancy and very early ectopic pregnancy by testing the thickness and blood flow of endometrium and by observing endometrial shape.