Sonographic Findings of Transvaginal Color Doppler Ultrasound in Ectopic Pregnancy

Overview

Journal J Med Ultrason (2001)

Specialty Radiology

Date 2016 Jun 10

PMID 27277617

Citations 1

Authors

Tatsuya Fukami

Makoto Emoto

Riko Tamura

Tatsuhiko Kawarabayashi

Affiliations

Soon will be listed here.

Abstract

Purpose: The objective of this study was to retrospectively assess whether the sonographic findings from transvaginal color Doppler ultrasound (TV-CDU) are helpful in the diagnosis of ectopic pregnancy.

Methods: Thirty-four patients who received surgery for ectopic tubal pregnancies were preoperatively evaluated using TV-CDU. The presence or absence of color vascularity within the ectopic masses was examined. The relationship between the presence or absence of blood flow in the tubal mass and the corpus luteum cyst, or the serum β-hCG values, was evaluated.

Results: Color vascularity within the adnexal mass was detected in 27 of 34 (79.4%) patients with ectopic pregnancies by TV-CDU. Color vascularity within the mass was observed in 18 of 24 (75.0%) patients with a questionable adnexal mass that had no obvious gestational sac in B-mode images. Moreover, color vascularity was seen in all four patients with a serum β-human chorionic gonadotropin (β-hCG) value of less than 500 mIU/ml. However, it was difficult to identify the blood flow of the adnexal mass in six of the nine (66.7%) patients with a corpus luteum cyst in the ipsilateral ovary. No relationship was observed between the serum β-hCG concentrations and the resistance indices, or the peak systolic velocity.

Conclusions: The detection of color vascularity by TV-CDU in patients with an ectopic pregnancy is helpful for diagnosis, especially for patients with either a questionable adnexal mass in B-mode images or lower serum β-hCG concentrations.

Citing Articles

Sonographic vascularity indices' study in ectopic pregnancies, after methotrexate treatment.

Chitzios D, Balaouras D, Papasozomenou P, Balaouras G, Mikos T, Daniilidis A Eur J Obstet Gynecol Reprod Biol X. 2024; 22:100316.

PMID: 38778876 PMC: 11109317. DOI: 10.1016/j.eurox.2024.100316.

References

Wherry K, Dubinsky T, Waitches G, Richardson M, Reed S . Low-resistance endometrial arterial flow in the exclusion of ectopic pregnancy revisited. J Ultrasound Med. 2001; 20(4):335-42. DOI: 10.7863/jum.2001.20.4.335. View

Taylor K, Ramos I, Feyock A, Snower D, Carter D, Shapiro B . Ectopic pregnancy: duplex Doppler evaluation. Radiology. 1989; 173(1):93-7. DOI: 10.1148/radiology.173.1.2675192. View

Chew S, Anandakumar C, Vanaja K, Wong Y, Chia D, Ratnam S . The role of transvaginal ultrasonography and colour Doppler imaging in the detection of ectopic pregnancy. J Obstet Gynaecol Res. 1996; 22(5):455-60. DOI: 10.1111/j.1447-0756.1996.tb01057.x. View

Thompson R, Trudinger B, Cook C . Doppler ultrasound waveform indices: A/B ratio, pulsatility index and Pourcelot ratio. Br J Obstet Gynaecol. 1988; 95(6):581-8. DOI: 10.1111/j.1471-0528.1988.tb09487.x. View

Stefanovic V, Cacciatore B, Ylostalo P . Tubal artery blood flow in evaluation of tubal pregnancy. Acta Obstet Gynecol Scand. 1996; 75(8):745-7. DOI: 10.3109/00016349609065739. View

Emoto M, Obama H, Horiuchi S, Miyakawa T, Kawarabayashi T . Transvaginal color Doppler ultrasonic characterization of benign and malignant ovarian cystic teratomas and comparison with serum squamous cell carcinoma antigen. Cancer. 2000; 88(10):2298-304. DOI: 10.1002/(sici)1097-0142(20000515)88:10<2298::aid-cncr14>3.0.co;2-s. View

Saxon D, Falcone T, Mascha E, Marino T, Yao M, Tulandi T . A study of ruptured tubal ectopic pregnancy. Obstet Gynecol. 1997; 90(1):46-9. DOI: 10.1016/S0029-7844(97)00180-4. View

Shalev E, Peleg D, Tsabari A, Romano S, Bustan M . Spontaneous resolution of ectopic tubal pregnancy: natural history. Fertil Steril. 1995; 63(1):15-9. DOI: 10.1016/s0015-0282(16)57289-6. View

Tulandi T, Hemmings R, Khalifa F . Rupture of ectopic pregnancy in women with low and declining serum beta-human chorionic gonadotropin concentrations. Fertil Steril. 1991; 56(4):786-7. DOI: 10.1016/s0015-0282(16)54619-6. View

10.

Kirchler H, Seebacher S, Alge A, Muller-Holzner E, Fessler S, Kolle D . Early diagnosis of tubal pregnancy: changes in tubal blood flow evaluated by endovaginal color Doppler sonography. Obstet Gynecol. 1993; 82(4 Pt 1):561-5. View

11.

Nyberg D, Mack L, Laing F, Jeffrey R . Early pregnancy complications: endovaginal sonographic findings correlated with human chorionic gonadotropin levels. Radiology. 1988; 167(3):619-22. DOI: 10.1148/radiology.167.3.3283831. View

12.

Atri M . Ectopic pregnancy versus corpus luteum cyst revisited: best Doppler predictors. J Ultrasound Med. 2003; 22(11):1181-4. DOI: 10.7863/jum.2003.22.11.1181. View

13.

Chen P, Sickler G, Dubinsky T, Maklad N, Jacobi R, Weaver J . Sonographic detection of echogenic fluid and correlation with culdocentesis in the evaluation of ectopic pregnancy. AJR Am J Roentgenol. 1998; 170(5):1299-302. DOI: 10.2214/ajr.170.5.9574606. View

14.

Kurjak A, Zalud I, Schulman H . Ectopic pregnancy: transvaginal color Doppler of trophoblastic flow in questionable adnexa. J Ultrasound Med. 1991; 10(12):685-9. DOI: 10.7863/jum.1991.10.12.685. View

15.

Tekay A, Jouppila P . Color Doppler flow as an indicator of trophoblastic activity in tubal pregnancies detected by transvaginal ultrasound. Obstet Gynecol. 1992; 80(6):995-9. View

16.

Pellerito J, Taylor K, Hammers L, Scoutt L, Ramos I, Meyer W . Ectopic pregnancy: evaluation with endovaginal color flow imaging. Radiology. 1992; 183(2):407-11. DOI: 10.1148/radiology.183.2.1561341. View

17.

Emerson D, Cartier M, Altieri L, Felker R, Smith W, Stovall T . Diagnostic efficacy of endovaginal color Doppler flow imaging in an ectopic pregnancy screening program. Radiology. 1992; 183(2):413-20. DOI: 10.1148/radiology.183.2.1561342. View

18.

Hirata A, Soper D, Bump R, Hurt W . Ectopic pregnancy in an urban teaching hospital: can tubal rupture be predicted?. South Med J. 1991; 84(12):1467-9. DOI: 10.1097/00007611-199112000-00014. View

19.

Atri M, Chow C, Kintzen G, Gillett P, Aldis A, Thibodeau M . Expectant treatment of ectopic pregnancies: clinical and sonographic predictors. AJR Am J Roentgenol. 2001; 176(1):123-7. DOI: 10.2214/ajr.176.1.1760123. View