特殊部位异位妊娠超声检查的特点分析  

Analysis of the characteristics of ultrasoundexamination of ectopic pregnancy in special parts

作　　者：高丽娟 GAO Lijuan(Department of Ultrasound,Yichun Hospital of Traditional Chinese Medicine,Yichun,Jiangxi,336000,China)

机构地区：[1]宜春市中医院超声科,江西宜春336000

出　　处：《当代医学》2021年第11期22-24,共3页Contemporary Medicine

摘　　要：目的分析特殊部位异位妊娠超声检查的特点。方法回顾性分析本院2018年1月至2019年12月经临床手术证实的80例特殊部位异位妊娠患者的临床资料,所有患者均给予超声(经腹联合经阴道)诊断,以手术结果为标准,分析超声诊断对特殊部位异位妊娠诊断与手术结果的一致性及特殊部位异位妊娠的超声影像特征。结果经Kappa检测,超声诊断不同类型特殊部位异位妊娠与手术诊断结果的一致性较好(Kappa=0.810,P=0.000),超声诊断的特殊部位异位妊娠的误诊率为13.75%;瘢痕妊娠孕囊型的超声特点:孕囊完全或部分着床于子宫瘢痕位置,血流信号可见环状或条索状滋养血流,局部肌层存在缺损或肌层较薄;混合型包块的超声特点:瘢痕位置可见不均匀回声,浆膜层局部外凸或不完整,包块周边可见低速低阻血流信号。输卵管间质部的超声特点:宫腔内未见孕囊,子宫旁一侧可见孕囊或不均匀包块,孕囊周边肌层厚度<5 mm,孕囊周边可见环状高回声,呈间质线样征,周边肌层较薄弱或有缺损。宫角妊娠的超声特点:孕囊位于一侧宫角且宫角增大膨出,孕囊或包块与宫腔内膜互通,且周边存在完整肌层包绕。卵巢妊娠的超声特点:宫腔内未见孕囊,孕囊型一侧卵巢内可见孕囊、卵黄囊、胚芽及胎心管搏动,囊壁较厚且绒毛膜光环明显,包块型可见混合型回声,周边卵巢实质内可见卵泡或黄体,包块内可见条状、点状血流信号。腹腔妊娠:原发性腹腔妊娠超声特点,子宫大小、形态、回声正常,宫旁一侧可见孕囊样回声,周边呈增强厚壁回声,可探及胚芽且可见心管搏动,甚至可探及不均匀的胎盘回声,内散在斑点状强回声,腹腔可探及腹腔积液,内见条索状分隔,且胎盘周边可见丰富蓝红色血流包绕;继发性腹腔妊娠超声特点,子宫增大、子宫内膜增厚且呈不均匀回声,可见腹腔积液,大网膜上可探及羊膜囊�Objective To analyze the characteristics of ultrasonographic examination of ectopic pregnancy in special parts. Methods A retrospective analysis of the clinical data of 80 patients with ectopic pregnancy at special sites confirmed by surgery in our hospital from January 2018 to December 2019. All patients were diagnosed by ultrasound(transabdominal combined with transvaginal), and the surgical results were the standard analyze the consistency between the diagnosis of ectopic pregnancy in special sites and the results of surgery and the ultrasound imaging characteristics of ectopic pregnancy in special sites. Results The results of Kappa detection showed that the results of ultrasound diagnosis of ectopic pregnancy in different types of special sites and surgical diagnosis were consistent(Kappa=0.810, P=0.000). The misdiagnosis rate of ectopic pregnancy in special sites diagnosed by ultrasound was 13.75%;scar pregnancy ultrasound characteristics of gestational sac type: the gestational sac was completely or partially implanted on the uterine scar, the blood flow signal could show circular or cord-like nourishing blood flow, the local muscle layer was defective or thin;mixed mass ultrasound features: uneven echoes could be seen at the location of the scar, the serosal layer was locally convex or incomplete, and low-velocity and low-impedance blood flow signals could be seen around the mass. Ultrasound characteristics of the interstitial part of the fallopian tube: no gestational sac was seen in the uterine cavity, a gestational sac or uneven mass can be seen on the side of the uterus, the thickness of the muscular layer around the gestational sac wass less than 5 mm, and a ring-shaped hyperechoic was seen around the gestational sac. Quality line-like sign, the surrounding muscle layer was weak or defective. Ultrasound characteristics of cornual pregnancy: the gestational sac was located on one side of the uterine horn and the uterine horn was enlarged and bulged, the gestational sac or mass communicates with the en

关 键 词：异位妊娠 特殊部位 超声检查 影像学特点 

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]