未破裂型宫外孕与妊娠小黄体囊肿经阴道的超声鉴别(1)
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[摘要] 目的 对未破裂型宫外孕与妊娠小黄体囊肿经阴道的超声进行对比研究，以提高宫外孕的早期检出率。方法 对80例未破裂型宫外孕(孕囊型)和105例妊娠小黄体囊肿超声图像进行回顾性分析。结果 69.5%(73/105)黄体囊肿周围有卵泡回声，而无一例宫外孕孕囊周围有小卵泡回声(P<0.01)；73.8%(59/80)宫外孕孕囊囊壁回声高于内膜回声，而仅有5.7%(6/105)黄体囊肿高于内膜回声(P<0.01)；76.2%(61例)宫外孕孕囊囊壁回声比卵巢实质回声高，而90.5%(95例)黄体囊肿囊壁回声等于或低于卵巢实质回声(P<0.01)。结论 通过对未破裂型宫外孕及妊娠小黄体囊肿的经阴道超声，比较两者与卵巢的关系、与子宫内膜回声的对比，可以鉴别未破裂型宫外孕与妊娠小黄体囊肿，未破裂型宫外孕位于卵巢外，囊壁回声大多高于内膜及卵巢实质。
[关键词] 未破裂型宫外孕；妊娠小黄体囊肿；经阴道超声
[中图分类号] R445.1 [文献标识码] B [文章编号] 1673-9701(2011)23-72-02
Sonographic Comparision of Unruptured Ectopic Gestation with Pregnancy Corpus Luteum
ZHANG Li
Department of Ultrasound, the People’s Hospital of Fenghua City in Zhejiang Province, Fenghua 315500, China
[Abstract] Objective To discuss the ultrasound features of unruptured ectopic gestation and pregnancy corpus luteum for improving detection of early unruptured ectopic gestation. Methods Sonograms in 80 cases with unruptured ectopic gestation and 105 cases with pregnancy corpus luteum were retrospectively reviewed. Results There were small anechoic follicles periphery of 69.5% (73/105) in 105 pregnancy corpus luteum compared with none of follicle in unruptured ectopic gestation (P<0.01), 73.8% of 80 unruptured ectopic gestation ectopic walls was more echogenic than that of the endometrium vs that only in 6 cases (5.7%) of the pregnancy corpus luteum (P<0.01), 76.2% of 80 ectopic walls was more echogenic than that of the ovarian tissue, but 90.5% of 105 pregnancy corpus luteum walls was equal or less than that of the ovarian tissue (P<0.01). Conclusion The unruptured ectopic gestation is an extra-ovarian adnexal cyst on sonography and with more echogenic wall than that in endometrium or ovarian tissue.
[Key words] Unruptured ectopic gestation; Corpus luteum; Transvaginal ultrasound
早孕经阴道超声中，经常会碰到怀孕早期宫腔内一枚囊性暗区，未见卵黄囊及胚芽，不能完全肯定是真孕囊及假孕囊，而附件区可及似黄体囊肿及未破裂型宫外孕包块图像样回声，不能区分是早早孕形成的黄体囊肿还是未破裂型宫外孕包块。由于两者在声像图上有共同之处，因此对我们超声诊断造成一定的困扰。宫外孕属于妇产科急症，一旦破裂可形成严重后果，需要手术治疗，而准确诊断早期未破裂型宫外孕可以对患者进行保守治疗，降低患者的手术风险，减轻患者的痛苦，可以尽可能地保留患侧输卵管的生育能力，因此鉴别诊断未破裂型宫外孕和妊娠小黄体囊肿这两种疾病，对减少误诊有着很重要的临床意义。
1 资料与方法
1.1 研究对象
对2006年1月～2008年12月我院妇产科经手术病理证实和经保守治疗、血β-HCG下降的80例未破裂型宫外孕作为研究组 ......
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