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目的:探讨经阴道彩色多普勒超声检查对非典型宫外孕的的临床诊断价值。方法:回顾性分析4年来经手术病理证实的32例非典型宫外孕患者的阴道彩超二维图像、血流分布及频谱特征。结果:经阴道彩超清晰显示非典型宫外孕病灶,其声像图表现为:附件区囊实性包块20例(62.5%),附件区实性包块9例(28.1%),仅见输卵管局部增粗膨大3例(9.4%);宫内“假孕囊”征4例(1.3%);子宫内膜增厚25例(78.1%),子宫内膜不增厚7例(21.9%);全部病例有腹盆腔积液征象;可检测到滋养血流信号29例(90.6%),脉冲多普勒频谱呈增宽的高速低阻力的血流频谱,测量阻力指数(RI)为0.40±0.07,未探及到血流信号3例(9.4%)。彩超诊断正确率为81.3%(26/32)。结论:经阴道彩超图像清晰、操作简单快速、无需充盈膀胱;通过非典型宫外孕的声像图及血流频谱表现特征进行早期诊断的正确率较高,应作为临床首选检查方法。
Objective: To investigate the clinical value of transvaginal color Doppler ultrasonography in the diagnosis of atypical ectopic pregnancy. Methods: A retrospective analysis of 32 cases of atypical ectopic pregnancy proved by surgery and pathology was retrospectively analyzed. The vaginal color Doppler images, blood flow distribution and spectral characteristics were retrospectively analyzed. Results: Transvaginal ultrasonography clearly showed the atypical ectopic pregnancy lesions. The sonographic findings showed that 20 cases (62.5%) had cystic solid mass in the accessory area and 9 (28.1%) solid mass in the attachment area, 3 cases (9.4%) had thick enlargement, 4 cases (1.3%) had intrauterine pregnancy and pseudocyst, and 25 cases (78.1%) had thickening of the endometrium and 7 cases (21.9%) did not thicken the endometrium, ; All cases had signs of pelvic fluid effusion; 29 cases (90.6%) of the nourishing blood flow signals were detected, and the pulse Doppler spectrum showed widened high-speed and low-resistance blood flow spectrum with the measured resistance index (RI) of 0.40 ± 0.07, no detection of blood flow signal in 3 cases (9.4%). The correct rate of color Doppler ultrasound was 81.3% (26/32). Conclusion: The transvaginal color Doppler ultrasound images are clear, easy and fast to operate, and do not need to fill the bladder. Early diagnosis of early diagnosis of atypical ectopic pregnancy with ultrasonography and blood flow spectrum features is of high accuracy and should be used as the first choice of clinical examination.