经阴道超声检查判断未破裂型输卵管妊娠位置的价值

目的 探讨经阴道超声检查判断未破裂型输卵管妊娠具体部位的价值.方法 回顾性分析经阴道超声检查及腹腔镜手术治疗的未破裂型输卵管妊娠89例,将超声提示异位妊娠病灶的具体方位及声像图特点与腹腔镜手术作对比.结果 89例输卵管妊娠中,间质部妊娠3例（3.3％）,峡部妊娠17例（19.1％）,壶腹部妊娠62例（69.7％）,伞端漏斗部妊娠7例（7.9％）.术前经阴道超声检查判断输卵管妊娠具体部位,与腹腔镜手术对照,总符合率达73.0％ （65/89）,经Kappa检验,Kappa=0.498,提示具有一般的一致性.胎囊型25.0％ （8/32）探及原始心管搏动及血流信号,输卵管环型27.3％ （12/44）周围探及半环状血流信号,部分团块型测及“怪异型”血流曲线图.结论 经阴道超声检查判断未破裂型输卵管妊娠的具体部位有一定的准确性,可为临床提示解剖位置作参考.

Value of transvaginal ultrasonography to judge the location of unruptured tubal pregnancy

Objective To evaluate the value of transvaginal Ultrasonography （TVU） in judging the specific site of unrup- tured tubal pregnancy. Methods The images of 89 cases diagnosed as the unruptured tubal pregnancy were analyzed retrospec- tively. The specific site of each case was diagnosed by TVU and compared with the lapar6scopic results. Results Of the 89 ca- ses, 3 （3.3%） were interstitial pregnancy, 17 （19.1%） were isthmic pregnancy, 62 cases （69.7%） of graviditas ampullaris and 7 cases （7.9%） of umbrella end infundibulum pregnancy. The specific site of 89 cases diagnosed by TVU were compared with the laparoscopic surgery inspection results. The total coincidence rate was 73.0% （65/89） and the Kappa consistency check showed a statistical moderate consistency results （Kappa=0. 498）. In these types of cases, 25.0% （8/32） of the embryo sac type cases had the primitive heart pulse and blood flow signal, 27.3% （12/44） of the tubal ring type cases had the half ring sign of the blood flow signal, and some cases of the mass type had the heterotypic Doppler spectrum. Conclusion There is a certain accuracy in judging the specific site of unruptured tubal pregnancy by TVU that can give an anatomic reference to the cli- nicians.