经阴道超声诊断异位葡萄胎的价值探讨  

Value of transvaginal ultrasonographic in diagnosis of ectopic molar pregnancy

作　　者：于娜 王军梅[1] 罗佳敏[1] 秦佳乐 YU Na;WANG Junmei;LUO Jiamin;QIN Jiale(Department of Ultrasound,Gynecology and Obstetrics Hospital Affiliated to Medical College of Zhejiang University, Hangzhou 310006,China)

机构地区：[1]浙江大学医学院附属妇产科医院超声二科 [2]浙江省子宫恶性肿瘤诊治技术研究中心,杭州310006

出　　处：《临床超声医学杂志》2019年第6期455-457,共3页Journal of Clinical Ultrasound in Medicine

基　　金：国家自然科学基金青年项目(81601515);浙江省医药卫生一般研究计划(2016KYB164、2019KY092);浙江省公益技术研究社会发展项目(2016C33153)

摘　　要：目的分析异位葡萄胎的经阴道超声特征,探讨超声对其的诊断及在随访中的临床价值。方法选取经病理诊断为异位葡萄胎的患者9例,回顾性分析其临床资料、超声图像、手术情况及病理特征。结果9例患者平均年龄(37.30±5.33)岁,首发临床症状均为停经、阴道异常流血和腹痛,均行手术治疗。超声检查示4例葡萄胎发生部位为输卵管,3例为前峡部疤痕处,2例为宫角,所有病灶定位均与手术一致。超声表现为6例见不均质回声,3例见形态不规则胚囊样无回声区伴或不伴卵黄囊及胚芽。结论经阴道超声可对异位葡萄胎病灶部位做出准确判断,具有较好的临床应用价值,但其诊断金标准仍依赖于病理学检查。Objective To analyze the ultrasonographic features of ectopic molar pregnancy,and to explore the clinical value of ultrasonic diagnosis and follow-up. Methods Nine cases with ectopic molar pregnancy confirmed by pathologic diagnosis were enrolled.The clinical data,ultrasound files,surgical conditions and pathological features were reviewed. Results The average age of 9 patients was(37.30±5.33)years old.The initial clinical symptoms were menopause,abnormal vaginal bleeding and abdominal pain.Ultrasound images showed that the location of hydatidiform mole was fallopian tube(4 cases), anterior isthmic scar(3 cases)and uterine horn(2 cases),which were totally consistent with the situation in the operation.The sonographic appearance of the lesion was heterogeneous echo region (6 cases),embryo sac-like heterogeneous echo with or without follicular sac and germ(3 cases).Conclusion Transvaginal ultrasound is able to identify the location of ectopic molar pregnancy,but diagnostic gold standard still depends on pathological diagnosis.

关 键 词：超声检查 经阴道 异位葡萄胎 

分 类 号：R445.1[医药卫生—影像医学与核医学] R714.22[医药卫生—诊断学]