| 黎全华,李洁,杨慧霞,田捧,张红彬,刘冰,申玉鑫,张文哲,张力莹,吴娟,栗河舟.腹腔妊娠超声表现[J].中国医学影像技术,2025,41(1):113~117 |
| 腹腔妊娠超声表现 |
| Ultrasonic manifestations of abdominal pregnancy |
| 投稿时间：2024-06-29 修订日期：2024-09-20 |
| DOI：10.13929/j.issn.1003-3289.2025.01.024 |
| 中文关键词: 妊娠,腹腔 超声检查 |
| 英文关键词:pregnancy, abdominal ultrasonography |
| 基金项目: |
| 作者 | 单位 | E-mail | | 黎全华 | 郑州大学第三附属医院超声医学科, 河南 郑州 450052 | | | 李洁 | 郑州大学第三附属医院超声医学科, 河南 郑州 450052 | | | 杨慧霞 | 郑州大学第三附属医院超声医学科, 河南 郑州 450052 | | | 田捧 | 郑州大学第三附属医院超声医学科, 河南 郑州 450052 | | | 张红彬 | 郑州大学第三附属医院超声医学科, 河南 郑州 450052 | | | 刘冰 | 郑州大学第三附属医院超声医学科, 河南 郑州 450052 | | | 申玉鑫 | 郑州大学第三附属医院超声医学科, 河南 郑州 450052 | | | 张文哲 | 郑州大学第三附属医院医学影像科, 河南 郑州 450052 | | | 张力莹 | 郑州大学第三附属医院医学影像科, 河南 郑州 450052 | | | 吴娟 | 郑州大学第三附属医院超声医学科, 河南 郑州 450052 | | | 栗河舟 | 郑州大学第三附属医院超声医学科, 河南 郑州 450052 | lihezhou67@126.com |
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| 中文摘要: |
| 目的 观察腹腔妊娠超声表现。方法 回顾性分析18例经手术及病理证实的腹腔妊娠的孕妇超声及临床资料。结果 孕早期15例,术前超声均未能诊断腹腔妊娠,但宫腔内未见明显孕囊回声而于盆腔内见包块,位于附件区8例、子宫前方2例、子宫后方2例,附件区及子宫前方1例、宫颈后方1例、紧邻宫壁1例,周围均未见明显输卵管回声。孕中期2例,分别于孕13+6周、21周经超声诊断腹腔妊娠,孕囊分别位于子宫左侧及子宫后方;孕晚期1例,于孕35+4周经超声诊断腹腔妊娠,孕囊位于子宫右侧;上述3例超声均表现为孕囊位于子宫外侧,孕囊周边未见子宫肌层包裹,宫腔内无胎盘种植,胎儿周边均见积液回声。腹腔妊娠术前超声诊断率16.67%(3/18)。结论 孕早期发现异位妊娠包块较大,或孕囊位于宫颈旁、子宫前后方及宫壁,且包块周边未见输卵管样回声时,应考虑腹腔妊娠可能。孕中晚期腹腔妊娠超声表现为孕囊位于子宫外侧,孕囊周边无子宫肌层包裹,宫腔内无胎盘种植,以及胎儿周边见积液回声;经腹联合经阴道超声有助于提高腹腔妊娠诊断率。 |
| 英文摘要: |
| Objective To observe the ultrasonic manifestations of abdominal pregnancy. Methods Ultrasonic and clinical data of 18 pregnant woman with abdominal pregnancy diagnosed by operation and pathology were retrospectively analyzed. Results Among 15 cases in first trimester,no preoperative ultrasonic diagnosis of abdominal pregnancy was obtained. Ultrasound showed no gestational sac in uterine cavity but mass in pelvic cavity, which located in the adnexal region in 8 cases, in the front and the post of uterus each in 2 cases, while in the adnexal region and the front of uterus in 1 case, in the post of the cervix in 1 case, and closed to uterine wall in 1 case, without obvious tubal echo around mass in all 15 cases. There were 2 cases of abdominal pregnancy in the second trimester, which were first diagnosed with ultrasound at 13+6 weeks and 21 weeks, with gestational sac located on the left side of uterus and behind the uterus, respectively. One case of abdominal pregnancy in the third trimester was first diagnosed with ultrasound at 35+4 weeks, with gestational sac located on the right side of uterus. Ultrasonic manifestations of the above three cases all showed gestational sac located outside the uterus without myometrium wrapping around the gestational sac nor placenta implanted in uterus, while echoes of fluid accumulation were detected around fetus. The ultrasonic diagnosis rate of abdominal pregnancy was 16.67% (3/18). Conclusion In the first trimester, if the ectopic pregnancy mass was large or the gestational sac located adjacent to the cervix, anterior or posterior to uterus and on the uterine wall, also no fallopian tube-like echo around the mass, the possibility of abdominal pregnancy should be considered. Ultrasonic manifestations of abdominal pregnancy in the second and third trimester present as gestational sac outside uterine cavity without wrapping uterine muscle layer around, no placenta implantation in uterine cavity, as well as echoes of fluid accumulation around fetus. Transabdominal combined with transvaginal ultrasound could improve diagnostic rate of abdominal pregnancy. |
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