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目的了解输卵管妊娠的超声造影表现,探讨超声造影技术的临床应用价值。方法采用CnTI技术及SonoVue,对43例疑似输卵管妊娠病例进行二维超声及超声造影检查,总结其声像表现并与手术病理对照分析。结果43例患者中24例行手术治疗,超声确诊输卵管妊娠21例,3例误诊,另19例接受保守治疗或失访。与手术病理对照,二维超声在14例患者附件区发现Donut环,其中7例造影时环壁均匀强化,术中腹腔内无出血或仅有少量出血;7例环壁不均匀强化,术中示输卵管积血。4例二维超声示附件区Donut环及其周围不规则形混合回声,造影时仅见Donut环强化,术中可见输卵管伞端有血块包绕。3例二维超声示附件区不规则混合回声肿块,造影时肿块内见长圆形或“腊肠形”薄壁样强化,术中可见输卵管内及盆腔血块,病理于血块中发现绒毛组织。结论不同类型的输卵管妊娠超声造影表现不同,超声造影可在一定程度上反映其病理改变,有利于输卵管妊娠诊断和鉴别诊断。
Objective To understand the echocardiography of tubal pregnancy and to explore the clinical value of ultrasound contrast imaging. Methods Using CnTI and SonoVue, 43 cases of suspected tubal pregnancy were examined by two-dimensional ultrasonography and contrast-enhanced ultrasound, and the sonographic findings were summarized and compared with the surgical pathology. Results Of the 43 patients, 24 cases underwent surgical treatment. 21 cases of tubal pregnancy were diagnosed by ultrasound, 3 cases were misdiagnosed, and the other 19 cases received conservative treatment or lost. In contrast to the surgical pathology, Donut rings were found in the attachment area of 14 patients by two-dimensional ultrasonography. Among them, 7 cases were homogeneously reinforced on the wall of the ring, no intra-abdominal hemorrhage or only a small amount of bleeding during operation; Show tubal hemorrhage. 4 cases of two-dimensional ultrasound showed Donut ring around the attachment area and irregular shaped echo, angiography seen only Donut ring enhancement, surgery can be seen at the end of tubal blood clot wrapped. 3 cases of two-dimensional ultrasound showed irregular attachment of echo mass, angiography lumps seen in the oval or “sausage-shaped” thin-walled enhancement, intraoperative tubal and pelvic blood clots can be found in the blood clots pathological villi. Conclusion Different types of tubal pregnancy with contrast-enhanced ultrasound show that contrast-enhanced ultrasound can reflect the pathological changes to a certain degree, which is good for the diagnosis and differential diagnosis of tubal pregnancy.