文章摘要

宫外孕破裂的多普勒超声声像图和血流频谱特征及临床鉴别诊断

作者: 1符俊娟, 1颜雪萍
1 海南省妇女儿童医学中心超声科,海口 570206
通讯: 符俊娟 Email: a36088548@163.com
DOI: 10.3978/j.issn.2095-6959.2021.08.013

摘要

目的:探讨宫外孕破裂的多普勒超声声像图和血流频谱特征以及超声在临床鉴别诊断中的价值。方法:收集经手术病理证实的宫外孕破裂患者(62例)和卵巢黄体破裂患者(50例),分别记为宫外孕破裂组与卵巢黄体破裂组。比较2组阴道超声检查情况,总结宫外孕破裂的超声声像图和血流频谱特征,观察阴道超声对宫外孕破裂的鉴别诊断价值。结果:宫外孕破裂组附件区包块形态、边界、回声和液性暗区等表现与卵巢黄体破裂组相似,但前者可见胎芽、原始心动和假性妊娠囊,有助于鉴别诊断。多普勒超声检查显示宫外孕破裂组血流表现以“点状”和“条状”为主,血流频谱类型多样化,卵巢黄体破裂组血流表现以“半环状/环状”为主,血流频谱以极低/低阻力型为主,2组比较差异有统计学意义(P<0.05),宫外孕破裂组血流参数、卵巢体积和液性暗区深度均低于卵巢黄体破裂组,差异有统计学意义(P<0.05)。结论:经阴道多普勒超声检查能提供较丰富的宫外孕破裂声像图表现和血流频谱特征,为临床鉴别诊断宫外孕破裂提供重要依据。
关键词: 宫外孕破裂;阴道多普勒超声;声像图;血流频谱;卵巢黄体破裂;鉴别诊断

Characteristics of Doppler ultrasound and blood flow spectrum and clinical differential diagnosis of ectopic pregnancy rupture

Authors: 1FU Junjuan, 1YAN Xueping
1 Department of Ultrasound, Hainan Women and Children’s Medical Center, Haikou 570206, China

CorrespondingAuthor: FU Junjuan Email: a36088548@163.com

DOI: 10.3978/j.issn.2095-6959.2021.08.013

Abstract

Objective: To investigate the characteristics of Doppler ultrasonography and blood flow spectrum of ectopic pregnancy rupture and its clinical value in differential diagnosis. Methods: The patients with ectopic pregnancy rupture (62 cases) and ovarian corpus luteum rupture (50 cases) confirmed by surgery and pathology were collected and recorded as the ectopic pregnancy rupture group and the ovarian corpus luteum rupture group respectively. Compare the 2 groups of vaginal ultrasound examination, summarize the characteristics of ultrasound and blood flow spectrum of ectopic pregnancy rupture, and observe the value of vaginal ultrasound in the differential diagnosis of ectopic pregnancy rupture. Results: The morphology, boundary, echo and fluid dark area of the adnexal mass in the ruptured ectopic pregnancy group were similar to those in the ruptured corpus luteum group, but the fetal bud, primitive cardiac and pseudocyst of pregnancy could be seen in the former group, which was helpful for the differential diagnosis. Doppler ultrasonography examination showed that the blood flow of ectopic pregnancy rupture group was mainly “dot” and “strip”, and the blood flow spectrum types were diversified. The blood flow performance of ovarian corpus luteum rupture group was mainly “semicircular/annular”, and the blood flow spectrum was extremely low/low resistance type. There was significant difference between the 2 groups (P<0.05). The blood flow parameters, ovarian volume and depth of liquid dark area in ectopic pregnancy rupture group were lower than those in the ovarian corpus luteum rupture group, and the difference was significant (P<0.05). Conclusion: Transvaginal Doppler ultrasonography can provide abundant ultrasonographic features and blood flow spectrum characteristics of ectopic pregnancy rupture, and provide important basis for clinical differential diagnosis of ectopic pregnancy rupture.
Keywords: ectopic pregnancy rupture; vaginal Doppler ultrasound; ultrasonogram; blood flow spectrum; ovarian corpus luteum rupture; differential diagnosis