经阴道彩色多普勒能量超声对早期诊断输卵管异位妊娠的临床研究

摘要

目的：探讨经阴道彩色多普勒能量超声(TV-CDE)在早期诊断输卵管异位妊娠的检测价值。方法：应用TV-CDE技术对98例临床疑诊异位妊娠患者的附件区包块行阴道二维超声图像、血流显像及频谱特征进行对照分析，对Vs、Vd、RI、PI值进行测量，分析了TV-CDE对异位妊娠定性的可行性。结果：①异位妊娠包块血流信号丰富，血管连续性好，能较完整显示血管床、血管网及范围广的低流速血流信号；②脉冲多普勒取样为滋养层周围性血流频谱，其特征为：频谱增宽、单相或双相持续存在、阻力降低(RI＝0.44±0.04)、舒张期血流丰富的动脉频谱；③具有鲜明丰富的滋养层周围性彩色血流频谱特征的“输卵管环”是早期输卵管妊娠的特征性表现，并提示是输卵管完整存在的标志。结论：TV-CDE是目前诊断早期异位妊娠有价值的检测手段，其血流频谱特征和“输卵管环”具有特殊诊断及鉴别诊断意义，尤其是对异位妊娠早期诊断具有特异性。%Objective:To assess the value of transvaginal color Dopplerenergy(TV-CDE)in the diagnosis of early salpingian ectopic pregnancy.Methods：TV-CDE were performed in the diagnosis of salpingian ectopic pregnancy.Imaging and blood flow spectrum were analyzed,Vs,Vd,RI and PI were measured.Results:TV-CDE could show the signals of blood flow very well.The trophoblast blood flow spectrum could be easily detected with the guide of CDE.The ultrasonic findings were characterized by broad arterial flow spectrum,high diastolic component of the low resistance trophoblastic flow,RI＝0.40～0.51 with single or biphasic spectrum.The salpingian ring with high blood flow indicated early and complete salpingian pregnancy.Eighty six cases were confirmed by operation.The overall diagnostic coincidence rate was 98.98%.Conclusions:TV-CDE is worthy of diagnosing salpingian pregnancy.