Parvey H R, Dubinsky T J, Johnston D A, Maklad N F
Department of Radiology, University of Texas Health Science Center, L. B.J. General Hospital, Houston 77026, USA.
AJR Am J Roentgenol. 1996 Dec;167(6):1479-85. doi: 10.2214/ajr.167.6.8956581.
We undertook this study to evaluate whether sonographic imaging of an intrauterine chorionic rim or arterial flow can help diagnose an early intrauterine pregnancy.
One hundred sixty-nine women with early intrauterine pregnancies and 69 women with ectopic pregnancies underwent pelvic sonography. All sonograms were examined for a chorionic rim (an echogenic rim bordering an intrauterine fluid collection) or a double decidual sac. Of these 238 patients, 126 also underwent Doppler examination for endometrial arterial flow.
The chorionic rim and double decidual sac had sensitivities for intrauterine pregnancy of 80% and 64%, respectively, and specificities of 97% and 100%, respectively. Intrauterine arterial flow with either peak systolic velocity greater than or equal to 15 cm/sec or resistive index less than or equal to 0.55 had a sensitivity of 70% and a specificity of 95%, Combining these two signs led to sensitivities and specificities of approximately 90%. Similar test performance was observed in patients having intrauterine pregnancies that lacked an embryo, yolk sac, or amniotic remnant.
The chorionic rim and low-impedance endometrial arterial flow can indicate an intrauterine pregnancy even when the double decidual sac is not seen. These two signs are particularly useful for patients with intrauterine pregnancies that show no other sonographic findings.
我们开展这项研究以评估子宫内绒毛膜边缘或动脉血流的超声成像是否有助于诊断早期宫内妊娠。
169例早期宫内妊娠女性和69例异位妊娠女性接受了盆腔超声检查。所有超声图像均检查有无绒毛膜边缘（围绕子宫内液性暗区的高回声边缘）或双蜕膜囊。在这238例患者中，126例还接受了子宫内膜动脉血流的多普勒检查。
绒毛膜边缘和双蜕膜囊对宫内妊娠的敏感性分别为80%和64%，特异性分别为97%和100%。收缩期峰值速度大于或等于15 cm/秒或阻力指数小于或等于0.55的子宫内动脉血流，其敏感性为70%，特异性为95%。将这两个征象结合起来，敏感性和特异性约为90%。在没有胚胎、卵黄囊或羊膜残余物的宫内妊娠患者中也观察到了类似的检测性能。
即使未见到双蜕膜囊，绒毛膜边缘和低阻力子宫内膜动脉血流也可提示宫内妊娠。这两个征象对无其他超声检查结果的宫内妊娠患者尤为有用。
