子宫角妊娠经腹和经阴道超声诊断及误诊分析  

Diagnosis and Misdiagnosis of Angular Pregnancy by Transabdominal Ultrasound and Transvaginal Ultrasonography

作　　者：高玉伟[1] 姜凡[1] 顾莉莉[1] 解翔[1] Gao Yuwei;Jiang Fan;Gu Lili;Xie Xiang(Department of Ultrasound,the Second Hospital Affilliated to Anhui Medical University,Hefei,Anhui 230601,China)

机构地区：[1]安徽医科大学第二附属医院超声诊断科,合肥市230601

出　　处：《中国超声医学杂志》2020年第6期571-573,共3页Chinese Journal of Ultrasound in Medicine

摘　　要：目的探讨经腹和经阴道超声诊断子宫角妊娠的价值及超声声像图特点。方法回顾分析本院经手术病理确诊的子宫角妊娠患者的术前首诊超声诊断及声像图表现,比较经腹和经阴道超声诊断的准确率。结果入组患者52例,其中经腹超声检查26例,经阴道超声检查者26例,两组诊断准确率分别为46.2%vs80.8%,差异有统计学意义(P=0.010)。术前超声误诊19例,其中经腹部超声者14例,经阴道超声者5例。经腹部超声误诊为:宫腔内妊娠6例,输卵管妊娠3例,诊断不明确者5例(均为盆腔杂乱包块)。经阴道超声误诊为:子宫肌瘤2例,输卵管间质部妊娠2例,滋养细胞疾病1例。结论经阴道超声对子宫角妊娠的诊断与鉴别诊断具有较高的准确率,并明显优于经腹部超声。Objective To explore the diagnostic value and ultrasonographic features of angular pregnancy by transabdominal ultrasound and transvaginal ultrasonography.Methods The originally ultrasonographic date of confirmed cases of angular pregnancy were anlysised restrospectivly in our hospital,and the diagnostic accuracy of eransabdominal and eransvaginal ultrasound was compared.Results There were 52 patients enrolled in the study,including 26 patients examined by transabdominal ultrasound,and 26 patients examined by transvaginal ultrasonography.The accuracy rate was 46.2%vs 80.8%in 2 groups,which showed no statistical significance(P=0.010).A total of 19 cases were misdiagnosed by preoperative ultrasound,14 cases were misdiagnosed by transabdominal ultrasound,and 5 cases were misdiagnosed by transvaginal ultrasonography.In the group of transabdominal ultrasound:6 cases were misdiagnosed as intrauterine pregnancy,3 cases were misdiagnosed as tubal pregnancy,5 cases were indefinite diagnosed(diagnosed as pelvic disorderly mass).In the group of transvaginal ultrasonography:2 cases were misdiagnosed as hysteromyoma,2 cases were misdiagnosed as interstitial tubal pregnancy,1 case was misdiagnosed as gestational trophoblastic disease.Conclusions Transvaginal ultrasonography is more accurate than transabdominal ultrasound in the diagnosis and differential diagnosis of angular pregnancy.

关 键 词：子宫角妊娠 输卵管间质部妊娠 异位妊娠 超声 

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]