(Radiology Review) By assessing a paraovarian pelvic mass with ultrasound imaging, clinicians could rule out ectopic pregnancy, retrospective study results suggest.
Because of its high morbidity, ectopic pregnancy should be excluded when an adnexal mass without an intrauterine pregnancy is demonstrated. An adnexal mass, however, could be either an ectopic pregnancy or a corpus luteum, Drs. Michael Blaivas and Matthew Lyon explain in their report, published in the Journal of Ultrasound in Medicine (May 2005, Vol. 24:5, pp. 599-603).
Drs. Blaivas and Lyon from the Medical College of Georgia in Augusta re-evaluated the endovaginal ultrasound videos of pregnant patients who had presented with signs or symptoms of concern for ectopic pregnancy over an 18-month period. Among the 78 patients with an adnexal mass without intrauterine pregnancy, 27 showed independent movement of the mass and ovary, which was more commonly found in patients with ectopic pregnancy.
"Independent movement of a mass and ovary was defined as movement of the mass away from the ovary, sliding past the ovary or rotation past the ovary," they stated. Twenty-three patients had an ectopic pregnancy confirmed, and only two of these patients showed no separation of the paraovarian mass and ovary with abdominal palpation and endovaginal transducer probing. Six patients without ectopic pregnancy had mass separation from the ovary.
"The tubal ring, a strong indicator of ectopic pregnancy on pelvic sonography, is classically described as a thick-walled adnexal structure that is either cystic or homogeneous in nature," they described. Color Doppler of ectopic pregnancy shows a characteristic 'ring of fire,' but corpus luteum may also show this color Doppler pattern.
According to the authors, independent movement of an adjacent mass and ovary, with abdominal and cervical palpation, was strongly associated with ectopic pregnancy.
"Reliability of Adnexal Mass Mobility in Distinguishing Possible Ectopic Pregnancy from Corpus Luteum Cysts"
Michael Blaivas and Matthew Lyon
Section of Emergency Ultrasound, Department of Emergency Medicine
Medical College of Georgia
1120 15th St, AF-2056
Augusta, GA 30912-4007 USA
J Ultrasound Med 2005 (May); 24:599-603
By Radiology Review
May 19, 2005
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