Atri M, de Stempel J, Bret P M
Department of Diagnostic Radiology, Montreal General Hospital, Quebec, Canada.
J Clin Ultrasound. 1992 May;20(4):255-61. doi: 10.1002/jcu.1870200406.
The transvaginal approach has significantly improved the accuracy of ultrasonography for the detection of ectopic pregnancy. However, there has been limited emphasis given to determining the sensitivity of ultrasonography when a hematosalpinx was used as a specific finding to identify an ectopic pregnancy. The sensitivity of transvaginal ultrasonography was evaluated for the detection of a hematosalpinx defined as an "echogenic homogeneous or inhomogeneous, rounded or elongated structure" in a group of patients with surgically proven ectopic pregnancy. Retrospectively, transvaginal ultrasonography showed a hematosalpinx in 16 out of 18 (88.8%) tubal pregnancies. In 6/6 (100%) patients with a ruptured tube and 10/12 (83.3%) patients with an unruptured tube, a hematosalpinx was detected sonographically. A gestational sac with a live embryo was seen in 26.3% of these patients. The significance of identifying a hematosalpinx, predictability of rupture and implication in the treatment of ectopic pregnancy are discussed.
经阴道超声检查方法显著提高了超声检测异位妊娠的准确性。然而，当以输卵管积血作为识别异位妊娠的特定表现时，对于确定超声检查的敏感性方面的重视有限。在一组经手术证实为异位妊娠的患者中，评估经阴道超声检查检测定义为“回声均匀或不均匀、圆形或椭圆形结构”的输卵管积血的敏感性。回顾性分析显示，在18例输卵管妊娠中有16例（88.8%）经阴道超声检查发现输卵管积血。在6例（100%）输卵管破裂患者和12例中的10例（83.3%）未破裂输卵管患者中，超声检查发现了输卵管积血。在这些患者中有26.3%可见有活胚胎的妊娠囊。本文讨论了识别输卵管积血的意义、破裂的可预测性以及在异位妊娠治疗中的意义。
