输卵管妊娠的CT表现和特点

目的探讨输卵管妊娠的CT表现和特点。方法对38例临床怀疑为异位妊娠的患者进行超声检查和CT平扫、增强检查：其中34例手术及病理证实为输卵管妊娠。结果CT诊断输卵管妊娠的敏感度为97．06％，特异度为75．00％，准确度为94．73％。CT诊断输卵妊娠的直接征象为附件区包块内发现完整(4／34，11．8％)或变形的妊娠囊(14／34，41．2％)；间接征像为附件区囊性包块中发现有可强化的异常密度影(8／34，23．5％)；附件区混杂性包块，以实性成分为主，增强后呈轻、中度不均匀强化(19／34，55．9％)；盆腔内子宫旁大片稍高密度影，无明显强化(3／34，8．8％)；子宫直肠窝内可见血性密度影(23／34，67．6％)。输卵管妊娠cT表现特点可归类为孕囊型(4／34，11．8％)；囊肿型(8／34，23．5)；包块型(17／34，50％)；陈旧包块型(2／34，5．90％)；出血型(3／34，8．8％)。输卵管妊娠影像表现与妊娠部位有关；输卵管妊娠影像表现与临床症状有关。结论输卵管妊娠的CT表现有一定的特点，在盆腔肿块的诊断与鉴别诊断时可提供有力的帮助。对临床、B超诊断不肯定的患者，CT是有效的补充检查方法。

CT appearance and features of tubal pregnancy

Objective To investigate the CT appearance and features of tubal pregnancy.Methods Precontrast and postcontrast CT scans were employed in 38 patients who were clinically and ultrasonographically suspected of tubal pregnancy.34 of them were verified as tubal pregnancy through operative pathology.Results 1.The direct CT imaging feature was the whole pregnancies sac (4/34,11.8%) or half-baked pregnancies sac (14/34,41.2%); 2.The indirect CT imaging features were: (1) abnormal density image,which could be enhanced,in a cystic mass around adnexal area (8/34,23.5%); (2) mix density mass around adnexal area,which was mainly solid and had mild to moderate inhomogeneous enhancement (19/34,55.9%); (3) large area irregular shadow with high density were found beside the uterus,with no enhancement (3/34,8.8%).(4) bloody density in uterus-rectum-fossa(23/34,67.6%).3.The CT imaging features of tubal pregnancy was classified as: (1) Pregnant sac type (4/34,11.8%); (2) Cystic (8/34,23.5%); (3) Massive type (17/34,50%); (4) Chronic mass type (2/34,5.9%); (5) Bleeding type (3/34,8.8%).4.The CT imaging appearance of tubal pregnancy related with the pregnancy location; 5.The CT imaging appearance of tubal pregnancy related with the clinical significant.Conclusion The CT imaging appearance of tubal pregnancy has some features,which can help in the diagnosis or differential diagnosis of the pelvis masses.CT scan is an effective supplementary attempt to the clinically and ultrasonographically suspected tubal pregnancy patients.