Diagnostic Clues to Ectopic Pregnancy
Diagnostic Clues to Ectopic Pregnancy
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DOI：
10.1148/rg.286085506
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发表时间：
2008-10-01
期刊：
影响因子：
5.5
通讯作者：
Dogra, Vikram S.
中科院分区：
文献类型：
--
作者：
Lin, Edward P.;Bhatt, Shweta;Dogra, Vikram S.
异位妊娠约占所有妊娠的2%，是妊娠早期妊娠相关死亡的最常见原因。初步评估包括激素测定和盆腔超声检查（US）。有盆腔疼痛沿着异常β人绒毛膜促性腺激素水平应考虑异位妊娠。输卵管是异位妊娠最常见的部位。与卵巢分离的附件包块和输卵管环征是输卵管妊娠最常见的表现。其他类型的异位妊娠包括间质妊娠、宫角妊娠、卵巢妊娠、宫颈妊娠、瘢痕妊娠、腹腔内妊娠和异位妊娠。间质妊娠发生于妊娠囊植入输卵管肌层段。宫角妊娠是指胚泡着床于双角子宫或分隔子宫的宫角内。当卵子受精并保留在卵巢内时发生卵巢妊娠。子宫颈妊娠是由于子宫颈管内的着床引起的。在疤痕妊娠中，植入发生在先前剖宫产的疤痕内。在腹腔内妊娠中，着床发生在腹腔内。异位妊娠是指同时发生宫内妊娠和宫外妊娠。在超声图像上可以看到子宫内和子宫外的一系列发现。虽然许多超声检查结果本身是非特异性的，但当其中几个被发现时，超声在描述异位妊娠方面的特异性大大提高。(C)RSNA，2008 center dot radiographics.rsnajnls.org
Ectopic pregnancy accounts for approximately 2% of all pregnancies and is the most common cause of pregnancy-related mortality in the first trimester. Initial evaluation consists of hormonal assays and pelvic ultrasonography (US). A history of pelvic pain along with an abnormal beta human chorionic gonadotropin level should trigger an evaluation for an ectopic pregnancy. The fallopian tube is the most common location for an ectopic pregnancy. An adnexal mass that is separate from the ovary and the tubal ring sign are the most common findings of a tubal pregnancy. Other types of ectopic pregnancy include interstitial, cornual, ovarian, cervical, scar, intraabdominal, and heterotopic pregnancy. Interstitial pregnancy occurs when the gestational sac implants in the myometrial segment of the fallopian tube. Cornual pregnancy refers to the implantation of a blastocyst within the cornua of a bicornuate or septate uterus. An ovarian pregnancy occurs when an ovum is fertilized and is retained within the ovary. Cervical pregnancy results from an implantation within the endocervical canal. In a scar pregnancy, implantation takes place within the scar of a prior cesarean section. In an intraabdominal pregnancy, implantation occurs within the intraperitoneal cavity. Heterotopic pregnancy occurs when an intrauterine and an extrauterine pregnancy occur simultaneously. A spectrum of intra-and extrauterine findings may be seen on US images. Although many of the US findings are nonspecific by themselves, when several of them are seen, the specificity of US in depicting an ectopic pregnancy substantially improves. (C) RSNA, 2008 center dot radiographics.rsnajnls.org