摘要
目的总结子宫角妊娠超声声像图特征和鉴别诊断要点。方法与手术病理检查结果对比,对常规腹部超声及经阴道超声诊断的93例子宫角妊娠患者的术前超声声像图表现及超声分型特征进行总结。结果与手术病理诊断结果对比显示,术前超声诊断子宫角妊娠与手术病理诊断符合66例(82.5%,66/80),其中妊娠囊型子宫角妊娠55例,混合包块型子宫角妊娠11例;误诊为输卵管间质部妊娠11例、残角子宫妊娠2例、绒癌1例;术前超声误诊率为17.5%(14/80);术前超声表现为附件区异位妊娠包块13例,术中显示为子宫角妊娠包块破裂,超声未定位和分型诊断。子宫角妊娠的超声特征为妊娠囊位于膨隆的一侧子宫角,周边有薄层肌壁包绕,子宫角妊娠包块与宫内膜相连。14例子宫角妊娠误诊原因:(1)超声显示子宫角包块与子宫内膜不连接、包块不为子宫肌层包绕,误诊为输卵管间质部妊娠。(2)子宫角外侧肌层厚,误诊为残角子宫妊娠。(3)子宫角包块血流丰富,肌层菲薄,误诊为绒癌。结论经腹部联合经阴道超声能对子宫角妊娠病变做出准确诊断,依据超声诊断要点综合评估有助于子宫角妊娠的鉴别诊断。
Objective To summarize the ultrasonographic features and differential diagnosis of uterine cornual pregnancy.Methods Trans-abdominal and trans-vaginal ultrasound were performed in 93 uterine cornual pregnancy patients before surgery,ultrasonographic findings of uterine cornual pregnancy through different two approaches were analyzed and compared with surgical and pathologic findings.ResultsIn contrast with surgical and pathological diagnosis,66 cases（82.5%,66/80） of uterine cornual pregnancy were accurately diagnosed by ultrasonography before surgery,these cases were divided into gestational sac pattern （55 cases） and mixed mass pattern（11 cases）; 11 cases were misdiagnosed as interstitial tubal pregnancy,2 cases were misdiagnosed as pregnancy in rudimentary horn,1 case was misdiagnosed as choriocarcinoma,misdiagnosed rate were 17.5%（14/80）; uterine cornual pregnancy presented as adnexal mass in ultrasound in 13 cases,while ruptured uterine cornual mass were found in surgery,in which location and type of the masses couldn＇t be accurately diagnosed by ultrasound.Ultrasonographic features of uterine cornual pregnancy presented as a gestational sac located in extended cornual of uterus,surrounded by thin myometrium,and connected with endometrium.The misdiagnosed causes were： （1） Uterine cornual mass was not connected with endometrium or surrounded by thin myometrium,which were misdiagnosed as interstitial tubal pregnancy.（2） Uterine cornual pregnancy with thick lateral myometrium were misdiagnosed as pregnancy in rudimentary horn.（3）Uterine cornual pregnancy presented as cornual mass with abundant blood flow was misdiagnosed as choriocarcinoma.Conclusions Uterine cornual pregnancy can be accurately diagnosed by trans-abdominal and trans-vaginal ultrasound.Ultrasonographic features are helpful in differential diagnosis of uterine cornual pregnancy.
出处
《中华医学超声杂志（电子版）》
2012年第6期57-61,共5页
Chinese Journal of Medical Ultrasound(Electronic Edition)
关键词
超声检查
异位妊娠
鉴别诊断
Ultrasonography
Ectopic pregnancy
Differential diagnosis
