经阴道彩色多普勒超声对宫角妊娠与输卵管间质部妊娠的诊断与鉴别诊断(1)
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[摘要] 目的：探讨经阴道超声对宫角妊娠与间质部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例宫角妊娠及29例间质部妊娠的灰阶及彩色多普勒超声结果。结果：59例宫角妊娠和间质部妊娠根据其声像图特点分为妊娠囊型(41例)和包块型(18例)。总病例超声诊断正确率为88.1%(52/59)，妊娠囊型为100.0%(41/41)，包块型为61.1%(11/18)。在7例包块型误诊或未明确诊断的患者中，1例宫角妊娠误为宫内孕，2例宫角妊娠与间质部妊娠相互误诊，2例误诊为滋养细胞肿瘤，2例未能明确诊断。结论：经阴道彩色多普勒超声检查对宫角妊娠与间质部妊娠的诊断与鉴别诊断有一定的临床应用价值，但包块型容易误诊，需充分结合临床和实验室资料进行分析。
[关键词] 宫角妊娠；输卵管间质部妊娠；腔内超声检查
[中图分类号]R714.22 [文献标识码] C[文章编号] 1673-7210(2009)03(c)-063-03
Diagnosis and differential diagnosis of cornual pregnancy and interstitial tubal pregnancy with transvaginal color Doppler sonography
LUO Hongying, YAN Linlin, LI Jing, LI Hongping, XIAO Yali, ZHANG Songtao
(Department of Ultrasonic Diagnostics,Xiangnan College, Chenzhou 423000,China)
[Abstract] Objective: To explore the efficacy of transvaginal color Doppler sonography(TV-CDS) in the diagnosis and differential diagnosis of cornual pregnancy and tubal pregnancy. Methods:The characteristics of gray-scale and color Doppler ultrasonography of 30 cases of comual pregnancy and 29 cases of interstitial tubal pregnancy confirmed by surgery and pathology were studied retrospectively. Results:59 cases were divided into typical gestational sac group and abnormal mass group.The overall diagnostic accuracy was 88.1%(52/59), diagnostic accuracy for gestational sat group was 100%(41/41),for abnormal mass group was 61.1%(11/18). Among the 7 cases in abnormal mass group who were misdiagnosed or diagnosed unclearly by TV-CDS，one case was misdiagnosed as normal pregnancy,two cases of cornual pregnancy and tubal pregnancy were mutual misdiagnosis,two cases were misdiagnosed as gestational trophoblastic disease and the rest two were diagnosed unclearly. Conclusion:TV-CDS is useful for differential diagnosis of cornual pregnancy and interstitial tubal pregnancy.The abnormal mass is easily misdiagnosed, therefore clinical feature and laboratory data should be fully evaluated for its diagnosis.
[Key words] Cornual pregnancy;Interstitial tubal pregnancy;Endosonography
宫角妊娠及输卵管间质部妊娠发生率低，仅占异位妊娠的4.2%，但却是一种易引起胚胎绒毛对病灶局部肌层及血管侵蚀后、最终突破着床部位而发生致命的腹腔内大出血的一种严重的病理性妊娠。本研究回顾性分析我院近年来经手术及病理证实的上述两种异位妊娠的临床资料及经阴道彩色多普勒超声(transvaginal color Doppler sonography,TV-CDS)检查结果 ......
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