Atri M, Bret P M, Tulandi T, Senterman M K
Department of Diagnostic Radiology, McGill University, Montreal, Que, Canada.
Radiology. 1992 Dec;185(3):749-53. doi: 10.1148/radiology.185.3.1279740.
A prospective study was performed with 25 patients with ectopic pregnancies (EPs) who underwent treatment with transvaginal administration of methotrexate. Nineteen patients (76%) had positive responses to this treatment, and six (24%) had to undergo surgery: five because of increasing abdominal pain and one because of vaginal bleeding. The ultrasonographic (US) resolution of the EP was long and lagged behind the resolution at testing of levels of beta subunit of human chorionic gonadotropin (beta-hCG) in all patients. The fallopian tube in 12 (63%) of the responding group initially increased in diameter from a mean of 2.22 cm to a mean of 3.84 cm. In 13 (68%) of the responding group, it became more vascular at color Doppler examination. Eleven (92%) of the 12 EPs that increased in size also became more vascular. The increase in tubal size and vascularity, in spite of the falling beta-hCG level, represents a healing process and should cause no concern about the follow-up of these patients.
对25例接受甲氨蝶呤经阴道给药治疗的异位妊娠（EP）患者进行了一项前瞻性研究。19例患者（76%）对该治疗有阳性反应，6例（24%）不得不接受手术：5例是因为腹痛加剧，1例是因为阴道出血。在所有患者中，EP的超声（US）消退时间较长，且落后于人绒毛膜促性腺激素β亚基（β-hCG）水平检测的消退时间。在有反应的组中，12例（63%）输卵管最初直径从平均2.22 cm增加到平均3.84 cm。在有反应的组中，13例（68%）在彩色多普勒检查时血管增多。在12例增大的EP中，11例（92%）血管也增多。尽管β-hCG水平下降，但输卵管大小和血管增多代表一个愈合过程，对这些患者的随访不应引起担忧。
