Ultrasonography and magnetic resonance imaging findings in a patient with an unruptured interstitial pregnancy

Hamada, Satoko; Naka, Osamu; Moride, Naoko; Higuchi, Kazuhiko; Takahashi, Hiroyuki

doi:10.1016/s0301-2115(97)02708-5

Cited by 11 publications

(6 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…At MRI, interstitial pregnancy can be highly suspected by recognition of a GS-like structure located lateral to the cornua surrounded by the myometrium (Fig. 6) [16,[35][36][37]. The presence of the intact junctional zone between the uterine cavity and the GS-like structure may also support the diagnosis [35], and this finding implies that the GS is not within the uterine cavity.…”

Section: Interstitial Pregnancymentioning

confidence: 99%

MR features of ectopic pregnancy

2007

View full text Add to dashboard Cite

Ectopic pregnancy (EP), in which a fertilized ovum implants outside the uterine cavity, is the leading cause of pregnancy-related death in the first trimester. EP is usually suspected by a positive pregnancy test and an empty uterus on transvaginal sonography (TVS). Although TVS is the initial modality of choice, it may occasionally fail to demonstrate the implantation site. When TVS findings are indeterminate, magnetic resonance imaging (MRI) may provide better delineation of the focus of EP owing to its excellent tissue contrast. The key MRI features of EP include gestational sac (GS)-like structures that typically appear as a cystic sac-like structure, frequently associated with surrounding acute hematoma of distinct low intensity on T2-weighted images. In tubal pregnancy, an enhanced tubal wall on postcontrast images may be another diagnostic finding. Ruptured EP is inevitably associated with acute hematoma outside these structures. In intrauterine EP, recognition of the relationship between GS-like structure and the myometrium can aid in differentiating from normal pregnancy. Diagnostic pitfalls include heterotopic pregnancy, decidual changes in endometrial cyst and theca lutein cysts mimicking GS-like structures. Knowledge of a spectrum of clinical and MRI features of EP is essential for establishing an accurate diagnosis and determining appropriate management.

show abstract

Section: Interstitial Pregnancymentioning

confidence: 99%

MR features of ectopic pregnancy

2007

View full text Add to dashboard Cite

show abstract

“…Early diagnosis of interstitial pregnancy is difficult, but can be made by transabdominal/transvaginal ultrasound according to three sonographic criteria: (i) an empty uterine cavity; (ii) a chorionic sac seen separately and < 1 cm from the most lateral edge of the uterine cavity, and (iii) a thin myometrial layer surrounding the chorionic sac 3 . The use of colour and pulsed Doppler ultrasonography may increase diagnostic sensitivity 4 . However, findings can occasionally be misleading, e.g.…”

Section: Discussionmentioning

confidence: 99%

Conservative treatment of interstitial pregnancy

1999

View full text Add to dashboard Cite

Objective To report a case of interstitial pregnancy diagnosed and treated laparoscopically by cornual resection, and to review the literature in order to provide a perspective on alternative treatment options for this condition. Case report A 42-year-old woman with persistent pelvic pain, elevated levels of beta-human chorionic gonadotrophin (b-hCG) and a negative ultrasound scan had an initial negative diagnostic laparoscopy. Symptoms continued and repeat ultrasound suggested an asymmetric fundal pregnancy. Repeat laparoscopy revealed an interstitial pregnancy and laparoscopic cornual resection was undertaken. Recovery was uneventful and she was discharged 2 days postoperatively. Current perspective When interstitial pregnancy is detected early, treatment options include expectant management, systemic methotrexate, or local injection of methotrexate, potassium chloride or prostaglandin into the gestational sac. Surgical intervention by hysteroscopic removal or laparoscopic cornual excision/cornuostomy can be employed in the case of failed medical treatment or advanced pregnancy. Conclusion The early diagnosis of interstitial pregnancy should enable a conservative approach, whether medical or surgical, to be undertaken when treating this rare and potentially fatal condition.

show abstract

“…These criteria are not useful in the case of a heterotopic pregnancy. The use of color and pulsed Doppler ultrasonography and magnetic resonance imaging may increase diagnostic sensitivity and improve diagnostic accuracy in such cases (4).…”

Section: Figurementioning

confidence: 99%