经阴道彩色多普勒超声对宫角妊娠的诊断与鉴别诊断  

Value of transvaginal color Doppler sonography in differential diagnosis of cornual pregnancy

作　　者：袁岩[1] 蔡胜[1] 李建初[1] 

机构地区：[1]中国医学科学院中国协和医科大学北京协和医院超声诊断科,北京100730

出　　处：《中华超声影像学杂志》2008年第9期789-792,共4页Chinese Journal of Ultrasonography

摘　　要：目的探讨经阴道彩色多普勒超声对宫角妊娠的诊断与鉴别诊断价值。方法回顾性分析我院经手术及病理证实的30例宫角妊娠患者的灰阶及彩色多普勒超声结果，分析妊娠物的部位、大小、形态、内部回声及其血流分布等特征，测量阻力指数。结果30例宫角妊娠病例根据其声像图特点分为妊娠囊型（10例）及包块型（20例）。总病例超声诊断正确率为43．3％（13／30），妊娠囊型为90％（9／10），包块型为20％（4／20）。在17例误诊或未明确诊断的患者中，1例妊娠囊型宫角妊娠误诊为宫内孕，11例包块型宫角妊娠误诊为滋养细胞疾病．5例包块型宫角妊娠超声未能明确诊断。结论经阴道彩色多普勒超声对宫角妊娠的诊断与鉴别诊断具有一定的临床应用价值，但包块型宫角妊娠容易误诊，需充分结合临床和实验室资料进行分析。Objective To explore the efficacy of transvaginal color Doppler sonography（TV-CDS） in the diagnosis and differential diagnosis of cornual pregnancy. Methods The characteristics of gray-scale and color Doppler ultrasonography of 30 patients with cornual pregnancy confirmed by surgery and pathology, were studied retrospectively. The position, size, figure, echogenicity and vascular pattern of the pregnancy tissue were evaluated,and the resistance index was calculated. Results The 30 patients were classified into two groups：group A with typical gestational sac and group B with abnormal mass in the area of corner. The overall diagnostic accuracy for these patients was 43.3 % （13/3） and classified as 90 % （9/10） accuracy for group A and 20% （4/20） for group B. Among the 17 patients who were misdiagnosed or diagnosed unclearly by TV-CDS,one patient in group A was misdiagnosed as a normal pregnancy, 11 patients in group B were misdiagnosed as gestational trophoblastic disease and the rest 5 patients in group B were diagnosed unclearly. Conclusions TV-CDS is useful for differential diagnosis of cornuaI pregnancy. The cornual pregnancy with abnormal mass is usually misdiagnosed, and therefore clinical features and laboratory data should be fully evaluated for its diagnosis.

关 键 词：腔内超声检查 妊娠 异位 诊断 鉴别 

分 类 号：R686[医药卫生—骨科学]