Tekay A, Jouppila P
Department of Obstetrics and Gynecology, University of Oulu, Finland.
Obstet Gynecol. 1992 Dec;80(6):995-9.
To evaluate the potential benefits of transvaginal color Doppler in the diagnostic evaluation of tubal pregnancies.
Fifty-two women with suspected tubal pregnancy were examined by transvaginal ultrasonography and color Doppler. Those with positive scans were referred for exploratory laparoscopy. The area of the tubal pregnancy was examined by color flow imaging and the resistance indexes (RIs) of the artery blood flows were calculated. The pulsatility indexes (PIs) of both uterine arteries were also measured and serum beta-hCG was quantitated.
Tubal pregnancy was diagnosed by transvaginal ultrasonography in 38 of the patients. There were two false-negative and two false-positive results. Color flow in the trophoblastic tissue was detected in 50% of the tubal pregnancies, and the mean (+/- standard deviation) RI of the trophoblastic flows was 0.51 +/- 0.12. The RIs of the trophoblastic flows tended to decrease at higher beta-hCG levels, and 88.2% of the cases with detectable trophoblastic flow had beta-hCG above 800 mIU/mL. The average PI of the uterine arteries was 2.28 +/- 0.89. The PIs of the ipsilateral uterine arteries were significantly lower in the patients with trophoblastic flow than in those without it.
By monitoring trophoblastic activity, color Doppler may differentiate between active and inactive disease and could assist in choosing the correct treatment.
评估经阴道彩色多普勒在输卵管妊娠诊断评估中的潜在益处。
对52例疑似输卵管妊娠的女性进行经阴道超声检查和彩色多普勒检查。扫描结果阳性者接受腹腔镜探查。通过彩色血流成像检查输卵管妊娠区域，并计算动脉血流的阻力指数（RI）。同时测量双侧子宫动脉的搏动指数（PI）并对血清β - 人绒毛膜促性腺激素进行定量分析。
经阴道超声检查确诊38例输卵管妊娠患者。有2例假阴性和2例假阳性结果。50%的输卵管妊娠患者滋养层组织中检测到血流信号，滋养层血流的平均（±标准差）RI为0.51±0.12。滋养层血流的RI在β - 人绒毛膜促性腺激素水平较高时趋于降低，88.2%可检测到滋养层血流的病例β - 人绒毛膜促性腺激素水平高于800 mIU/mL。子宫动脉的平均PI为2.28±0.89。有滋养层血流的患者同侧子宫动脉的PI显著低于无滋养层血流的患者。
通过监测滋养层活性，彩色多普勒可区分活跃和不活跃疾病，并有助于选择正确的治疗方法。
