经阴道超声诊断异位妊娠的价值

目的探讨(早期)异位妊娠(EP)的经阴道超声(TVS)诊断应用价值.方法对146例不规则少量阴道流血(或)下腹痛的育龄妇女或停经后经腹B超(TAS)提示宫腔内未见孕囊者疑EP的均行TVS检查,观察宫内是否有孕囊,仔细寻找识别卵巢及肿块结构并分清其关系,必要时结合彩色多普勒,观察肿块血流成像,分晰其血流频谱.结果 TVS能很好地显示子宫、卵巢、未破孕囊及含血(块)肿块的声像结构.识别出完整的卵巢,是输卵管异位妊娠确诊的关键;彩色多普勒血流成像(CDFI)所记录的滋养层血流频谱或怪异频谱是二维TVS的补充,二者结合诊断EP的准确性高达97%.结论 TVS诊断EP简单、无创、准确性高,是诊断早期异位妊娠的首选方法.

Transvaginal Ultrasound Diagnosis of Ectopic Pregnancy

Objective To evaluate the value of early ectopic pregnency disgnosed with tansvaginal ultrasound(TVS). Methods A total of 146 cases with clinically suspected as ectopic pregnancy(EP)without viginal bleeding or small lower abdominal pain,or without gestational sac in the uterus were observed with TVS after catamenia stopped,We inspected whether there was gestational sac in the uterus,searched,identified the ovarian and the masses carefully and discriminated their relationships.We also paid attention to the color flow in the masses on CDFI. Results TVS could show the uterus,ovary,unruptured gestational sacs and bleeding masses clearly.How to identify the intact ovary was the key for the accurate diagnosis of EP in the oviduct.Doppler flows in the trophoderm or weird flows which were found on CDFI could be a complementary of 2-D TVS.The diagnostic accuracy of combining 2-D TVS and CDFI for EP was up to 97%. Conclusions TVS is a simple,non-invasive and very accurate method for the diagnosis of EP and is the first method for early diagnosis of EP too.