孕早期经阴道联合经腹超声用于临床诊断宫内外复合妊娠  

Early pregnancy transvaginal ultrasound combined with transabdominal ultrasound for clinical diagnosis of heterotopic pregnancy

作　　者：张莉[1] 杨小红[1] 赵胜[1] 周思 包艳娟 ZHANG Li;YANG Xiaohong;ZHAO Sheng;ZHOU Si;BAO Yanjuan(Department of Ultrasound,Maternal and Child Health Hospital of Hubei Province,Wuhan 430070,China)

机构地区：[1]湖北省妇幼保健院超声科,湖北武汉430070

出　　处：《中国医学影像技术》2023年第5期723-726,共4页Chinese Journal of Medical Imaging Technology

摘　　要：目的 观察孕早期经阴道(TVS)联合经腹超声(TAS)对于临床诊断宫内外复合妊娠(HP)的价值。方法 回顾性分析32例超声诊断并经临床证实的HP孕妇,其中28例经辅助生殖技术受孕、4例自然受孕,观察HP、尤其异位妊娠(EP)超声表现。结果 32例HP中,宫内妊娠(IUP)超声表现包括24例孕囊内见卵黄囊及存活胚芽,1例孕囊内见卵黄囊及无胎心胚芽,6例孕囊内仅见卵黄囊而无胚芽,1例宫内见孕囊样无回声。EP超声表现为7例Ⅰ型(胎囊型)周边环状高回声结构,CDFI见环状血流信号;7例Ⅱ型(包块型)呈不均质中等或高回声团块,内可见小圈样无回声区,CDFI可于周边见少许血流信号;18例Ⅲ型(破裂型)声像图表现多样,多呈不均质杂乱回声团块,范围较大,形态不规则,边界不清,均伴盆腔积液、部分合并腹腔积液,CDFI见团块内少许或无血流信号。结论 孕早期TVS联合TAS所见有助于临床诊断HP。Objective To observe the value of early pregnancy transvaginal ultrasound(TVS)combined with transabdominal ultrasound(TAS)for diagnosing heterotopic pregnancy(HP).Methods Data of 32 pregnant women with HP diagnosed with ultrasound and confirmed clinically were retrospectively analyzed,including 28 conceived through assisted reproductive technology and 4 conceived naturally.The ultrasonic characteristics of HP,especially of ectopic pregnancy(EP)were observed.Results Among 32 HP,ultrasonic findings of intrauterine pregnancy(IUP)included 24 cases of yolk sac and embryo in the gestational sac,1 case of yolk sac and embryo without heartbeat in the gestational sac,6 cases of only yolk sac in the gestational sac and 1 case of no echo in the uterus.The ultrasonic findings of EP were as follows:7 cases of typeⅠ(fetal sac type)with peripheral circular hyperechoic structure,CDFI showed peripheral circular blood flow signals;7 cases of typeⅡ(mass type)presented as heterogeneous with medium to high echogenic masses,most with anechoic area like a small circle inside,CDFI showed blood flow signal around the mass;18 cases of typeⅢ(ruptured type)with diverse sonographic manifestations,most presented as large areas heterogeneous echogenic masses,with irregular shapes and unclear boundaries,all complicated with pelvic fluid accumulation and partially complicated with intraperitoneal fluid accumulation,CDFI showed little or no blood flow signal in the masses.Conclusion Findings of early pregnancy TVS combined with TAS were helpful for clinical diagnosis of HP.

关 键 词：妊娠 异位 超声检查 

分 类 号：R714[医药卫生—妇产科学] R445.1[医药卫生—临床医学]