From the Department of Radiology, University of Florida College of Medicine, Jacksonville, FL.
Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX.
J Comput Assist Tomogr. 2021;45(3):374-382. doi: 10.1097/RCT.0000000000001148.
Ectopic pregnancy (EP) is a known cause of maternal mortality and may be misdiagnosed in up to 50% of pregnant female individuals (Ann Emerg Med. 1996;28(1):10-17). Magnetic resonance imaging, with its superior soft tissue resolution, is a valuable alternative diagnostic modality to diagnose EP when transvaginal ultrasound results are inconclusive. Although an extrauterine gestational sac is the most specific finding, there are other key MRI findings that can aid in diagnosing EP. As availability of MRI access in the emergency department setting increases across the nation, its utility in women with a positive pregnancy test has also increased. Specific MRI findings that are diagnostic of EP include absence of intrauterine pregnancy, adnexal mass separate from the ovary, and hemoperitoneum. In addition, intrauterine ectopic locations, especially intramural, cornual, and cervical pregnancies, can be diagnosed with increased accuracy with the help of MRI. Magnetic resonance imaging is also useful in excluding potential mimics of EP, including adnexal cysts, ovarian neoplasms, and fibroids. In summary, providing an accurate diagnosis and determining the precise location of an EP, which is supported by the use of MRI, is imperative for guiding a patient's treatment to prevent a potentially fatal outcome.
宫外孕（EP）是导致产妇死亡的已知原因，多达 50%的孕妇可能被误诊（Ann Emerg Med. 1996;28(1):10-17）。磁共振成像（MRI）具有出色的软组织分辨率，是在经阴道超声检查结果不确定时诊断 EP 的一种有价值的替代诊断方法。尽管宫外妊娠囊是最特异的发现，但还有其他关键的 MRI 发现可以帮助诊断 EP。随着全国范围内急诊部门 MRI 可用性的增加，其在妊娠试验阳性妇女中的应用也有所增加。诊断 EP 的具体 MRI 发现包括宫内妊娠缺失、附件肿块与卵巢分离以及血腹。此外，在 MRI 的帮助下，宫内异位部位，特别是子宫壁内、子宫角和宫颈妊娠，也可以更准确地诊断。MRI 还可用于排除 EP 的潜在类似物，包括附件囊肿、卵巢肿瘤和肌瘤。总之，提供准确的诊断并确定 EP 的准确位置，这是使用 MRI 支持的，对于指导患者的治疗以防止潜在的致命后果至关重要。
