宫角妊娠超声诊断和鉴别诊断.doc

 PAGE \* MERGEFORMAT 7 宫角妊娠超声诊断和鉴别诊断 　　【摘要】 目的：探讨超声在宫角妊娠诊断及鉴别诊断中的价值。方法：回顾性分析4例宫角妊娠患者的超声图像特征。结果：4例宫角妊娠均为超声提示诊断。宫角妊娠图像特征：子宫横径增宽，宫角部明显膨突，宫腔内见偏心孕囊回声，孕囊位于宫角部位，并与子宫内膜线连续，而且其周围见完整的肌壁层。结论：经阴道及腹部超声诊断宫角妊娠准确率高，可为临床及时处理及随访观察提供可靠的依据。 【关键词】 宫角妊娠； 超声 中图分类号 R714.22 文献标识码 B 文章编号 1674-6805（2014）4-0044-02 Ultrasonic Diagnosis and Differential Diagnosis of Uterine Horn Pregnancy/YUAN Li.//Chinese and Foreign Medical Research，2014，12（4）：44-45 【Abstract】 Objective：To investigate the value of ultrasonography diagnosis and differential diagnosis in uterine horn pregnancy.Method：The ultrasonogram features of 4 cases with uterine horn pregnancy were retrospectively analyzed.Result：4 cases with uterine horn pregnancy were all ultrasonic diagnosis.The image characteristics of uterine horn pregnancy：Embryo sac was interlinked with the uterus and joined with endometrium，there was a relative thick and complete myometrium around the embryo sac.The uterine horn was projecting and the swelling part was close to the uterus body.Rich nutrient blood flow signal could be detected at the place of embryo sac by color Doppler detecting.Conclusion：Ultrasonography for uterine horn pregnancy diagnosis through vagina and abdomen could achieve high accuracy which could facilitate an earlier clinical treatment and provide reliable evidence for the follow-up observation. 【Key words】 Uterine horn pregnancy； Ultrasonography First-author’s address：Jinyang Hospital of Guiyang City，Guiyang 550081，China 宫角妊娠是一种胚胎种植在接近子宫与输卵管开口交界处的宫角部的子宫腔内的妊娠。宫角妊娠较为少见，早期多无症状，临床诊断困难，且常被临床误诊为正常宫内妊娠或输卵管间质部妊娠，若发生破裂则严重危及患者生命[1]。随着超声仪器分辨率的提高及阴道超声和彩色多普勒超声在妇产科的广泛应用，宫角妊娠可得到早期诊断及治疗。对2006年3月-2013年3月经临床及手术证实的4例宫角妊娠患者的超声图像表现进行分析，现报告如下。 1 资料与方法 1.1 一般资料 本组共4例患者，年龄24～32岁，中位年龄28岁。4例患者均有停经史，停经36～85 d不等，尿hCG阳性、血hCG增高。1例为带环受孕，2例曾有剖宫产史及人工流产史，1例有人工流产术反复清宫未净史。 1.2 超声检查 应用麦迪逊V10彩色多普勒超声诊断仪，腹部探头频率为3～5 MHz，阴道探头频率为4～9 MHz。患者取仰卧位，行常规腹部超声及阴道超声检查，扫查包括纵切、横切面，观察子宫大小、形态、宫腔妊娠囊着床的位置，宫角部有无突出，孕囊与宫腔内膜的关系，同时观察双附件、子宫直肠陷窝有无异常声像。彩色多普勒检测