Sonographic comparison of the tubal ring of ectopic pregnancy with the corpus luteum.

Abstract

OBJECTIVE:

Pregnant patients without a sonographically visible intrauterine pregnancy and with a thick-walled cystic adnexal structure present a dilemma. This study compared the utility of various sonographic features in differentiating between the tubal ring of ectopic pregnancy and the corpus luteum.

METHODS:

Retrospective review of first-trimester transvaginal sonograms revealed a cystic adnexal structure in 79 women. Each structure was evaluated for 6 specific sonographic characteristics: echogenicity of its wall compared with that of the ovary and endometrium, wall thickness in 2 planes, color Doppler flow distribution and percentage of wall circumference, and internal texture.

RESULTS:

Forty-one (52%) of the 79 women had ectopic pregnancies, and 38 (48%) had corpora lutea. Eleven (32%) of 35 ectopic walls were more echogenic than the endometrium, compared with none of the corpora lutea. A cyst wall less echogenic than the endometrium was more likely in corpora lutea (84% versus 31%; P < .0001). More than twice as many ectopic rinds were more echogenic than ovarian tissue compared with corpora lutea (76% versus 34%; P < .0001). The only predictive internal texture feature was a clear pattern, which was more common in the corpora lutea (P < .01, Fisher exact test). There was no significant difference in mural flow distribution or extent between the 2 groups.

CONCLUSIONS:

Ancillary sonographic signs to distinguish between an ectopic pregnancy and a corpus luteum include decreased wall echogenicity compared with the endometrium and an anechoic texture, which suggests a corpus luteum.

• Authors: Marjorie W Stein, Zina J Ricci, Leon Novak, Jeffrey H Roberts, Mordecai Koenigsberg
• Journal: Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine (J Ultrasound Med) Vol. 23 Issue 1 Pg. 57-62 (Jan 2004) ISSN: 0278-4297 [Print] England
• PMID: 14756354 (Publication Type: Journal Article)

Topics

• Adolescent
• Adult
• Chi-Square Distribution
• Corpus Luteum (diagnostic imaging)
• Diagnosis, Differential
• Female
• Humans
• Pregnancy
• Pregnancy Trimester, First
• Pregnancy, Ectopic (diagnostic imaging)
• Retrospective Studies
• Ultrasonography, Doppler, Color
• Ultrasonography, Prenatal