Original articles

Features of magnetic resonance imaging and its value in clinicaldiagnosis of ectopic pregnancy

Expand
  • 1. Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China;
    2. Department of Radiology, International Peace Matemal & Child Care Hospital, Shanghai 200030, China

Received date: 2017-06-20

  Online published: 2017-12-25

Abstract

Objective: To investigate the manifestation and value of magnetic resonance imaging(MRI) in clinical diag-nosis of ectopic pregnancy(EP). Methods: Ultrasonic and clinical data in 58 cases of ectopic pregnancy confirmed by clini-cal or pathology in our hospital from July 2013 to April 2017 were collected and features of MR imaging were retrospectively analyzed. The diagnostic accuracy of ultrasound and MRI were calculated and compared. Results: Of all the 58 patients, the accuracy rate of MRI in diagnosis of ectopic pregnancy was 91.38%(53 cases), and was higher than that of ultrasound (77.59%, 45 cases)(P<0.05). MRI could show complete gestational sac and cystic, solid-cystic or heterogeneous mass imaging in 56 cases. The mass of pregnancy sac was round or oval and the boundary with surrounding tissue was clear on MR imaging. The high signal in T1W imaging was related to the hemorrhage of gestational sac. Two cases of ruptured pregnancy sac showed imaging with irregular mass, heterogeneous SI in T1WI and T2WI, and signal of scattered or patchy bleeding was found in the mass, with high SI in T1WI and slightly higher SI in T2WI; imaging of hemorrhage in gestational sac and pelvic hemorrhage were the characteristic features. Conclusions: MRI can clearly reveal the anatomic relationship between embryo sac and its surrounding structures, identifying the location and showing the implantation of gestational sac clearly. For cases of ectopic pregnancy which are difficult to diagnose by ultrasound, MRI examination could be performed, which is of important reference value for evaluation of the disease and selection of treatment options.

Cite this article

YE Lan, ZHANG Huan, QIAN Zhaoxia . Features of magnetic resonance imaging and its value in clinicaldiagnosis of ectopic pregnancy[J]. Journal of Diagnostics Concepts & Practice, 2017 , 16(06) : 650 -655 . DOI: 10.16150/j.1671-2870.2017.06.017

References

[1] 谢幸, 苟文丽. 妇产科学[M]. 8版. 北京: 人民卫生出版社,2015:51.
[2] 陶丽群, 方圆. 特殊部位异位妊娠临床分析[J]. 浙江临床医学,2016,18(5):871-872.
[3] 中华医学会妇产科学分会计划生育学组. 剖宫产术后子宫瘢痕妊娠诊治专家共识(2016)[J]. 中华妇产科杂志,2016,51(8):568-572.
[4] 王燕捷, 翟妍, 张震宇. 剖宫产瘢痕妊娠的临床特征与处理结局[J]. 中华医学杂志,2017,97(13):986-990.
[5] Tamai K, Koyama T, Togashi K.MR features of ectopic pregnancy[J]. Eur Radiol,2007,17(12):3236-3246.
[6] 李留霞, 余静丽. 宫腹腔镜联合治疗子宫瘢痕妊娠50例临床分析[J]. 中国医药指南,2014,12(6):128-129.
[7] 骆亚平, 王彦龙, 杨丽. 宫腹腔镜联合诊治剖宫产术后子宫瘢痕妊娠8例临床分析[J]. 实用妇产科杂志,2012,28(12):1070-1071.
[8] 赵辉, 杨保军, 冯力民. 特殊部位异位妊娠53例临床分析[J]. 中国内镜杂志,2010,16(4):374-381.
[9] 杨雅琦, 王宜, 拓福娟, 等. 异位妊娠发病的相关危险因素分析[J]. 中国医药导报,2016,13(8):88-91.
[10] 宋蕾, 王一凡, 张丽, 等. 彩色多普勒超声在诊治剖宫产子宫疤痕妊娠中的价值[J]. 医学影像学杂志,2012, 22(9):1541-1543.
[11] 杨伟洪, 向先俊, 刘鹏程, 等. MRA、CTA 在经子宫动脉介入治疗中的应用价值[J]. 临床放射学杂志,2012,31(2):295-297.
[12] 陶可伟, 郭晓利, 李杰, 等. 剖宫产瘢痕部位妊娠的CT表现及其分型[J]. 实用医学杂志,2014,30(20):3311-3313.
[13] 宣兰萍. 超声在50例特殊部位异位妊娠诊断中的价值[J]. 中国计划生育学杂志,2017,25(5):340-342.
[14] 朱颖, 王霄英. 异位妊娠的MRI 诊断及鉴别诊断[J]. 实用放射学杂志,2016,32(3):388-391.
[15] Takahashi A1, Takahama J, Marugami N, et al. Ectopic pregnancy: MRI findings and clinical utility[J]. Abdom Imaging,2013,38(4):844-850.
[16] 冷芹, 张英, 许孝凤, 等. 孕前体质指数孕期体质指数增长幅度与妊娠并发症及新生儿结局的关系[J]. 安徽医学,2017,38(9):1123-1126.
[17] Ko HS, Lee Y, Lee HJ, et al.Sonographic and MR fin-dings in 2 cases of intramural pregnancy treated conserva-tively[J]. J Clin Ultrasound,2006,34(7):356-360.
[18] Si MJ, Gui S, Fan Q, et al.Role of MRI in the early diag-nosis of tubal ectopic pregnancy[J]. Eur Radiol,2016, 26(7):1971-1980.
[19] Kucera E, Helbich T, Sliutz G, et al.The modern mana-gement of interstitial or intramural pregnancy--is MRI and "alloyed" diagnostic gold standard or the real thing?[J]. Fertil Steril,2000,73(15):1063-1064.
[20] Srisajjakul S, Prapaisilp P, Bangchokdee S.Magnetic re-sonance imaging in tubal and non-tubal ectopic pregnancy[J]. Eur J Radiol,2017,93:76-89
[21] 言伟强, 陈桂平, 戴益如. 妊娠相关并发症的MRI诊断[J]. 实用放射学杂志,2015,31(9):1490-1492.
[22] 陈宏. 运用MR诊断卵巢囊性病变的临床价值分析[J]. 中外医学研究,2016,14(20):64-65.
[23] 邵硕, 齐先龙, 郑宁, 等. MRI对卵巢肿瘤的诊断价值[J]. 医学影像学杂志,2017,27(2):316-318.
[24] Köroğlu M1, Kayhan A, Soylu FN, et al. MR imaging of ectopic pregnancy with an emphasis on unusual implantation sites[J]. Jpn J Radiol,2013,31(2):75-80.
Outlines

/