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Role of MRI in the early diagnosis of tubal ectopic pregnancy

  • Magnetic Resonance
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Abstract

Objective

To determine the role of MRI in the early diagnosis of tubal ectopic pregnancy (EP).

Methods

Clinical and MRI features of 27 cases of tubal pregnancy were reviewed.

Results

A thick-walled gestational sac (GS)-like structure was demonstrated lateral to the uterus in all cases. On T2-weighted images, the thick wall typically exhibited 3 discrete rings in 22 cases (81 %), among which 17 cases (63 %) displayed small vessels and 6 cases (33 %) exhibited small areas of fresh haemorrhage inside the thick wall. The contents demonstrated non-specific liquid in 26 %, papillary solid components in 56 %, and fresh blood or fluid-fluid level in 19 % of the cases. Dilatation of the affected fallopian tube associated with hematosalpinx was demonstrated in 18 cases (67 %) and marked enhancement of the tubal wall was observed in 22 cases (81 %). No correlation was found between the size of the GS and the estimated gestational age (r = 0.056).

Conclusion

MRI plays an important role in the early diagnosis and management of tubal pregnancy. The characteristic MRI features include a GS-like structure with a “three rings” appearance on T2-weighted images, presence of solid components in the sac, dilatation of the affected fallopian tube with hematosalpinx, and tubal wall enhancement.

Key Points

• MR imaging has served as a problem-solving procedure in ectopic pregnancy.

• MR imaging features can be criteria for early diagnosis of tubal pregnancy.

• Detailed assessment of ectopic implantation is necessary for management decision-making.

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Abbreviations

EP:

Ectopic pregnancy

US:

Ultrasound

GS:

Gestational sac

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Acknowledgements

The scientific guarantor of this publication is the corresponding author Dr Jiang-Min Zhao, who is the head of the department of radiology. The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article. This study has received funding from the Health and Family Planning Commission of Shanghai, China (Project Number: 14QNYS01) and the Science and Technology Commission of Shanghai, China (Project Number: 10411953400). No complex statistical methods were necessary for this paper. Institutional review board approval was obtained. Written informed consent was waived by the institutional review board. No study subjects or cohorts have been previously reported. Methodology: retrospective, diagnostic or prognostic study, performed at one institution.

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Authors and Affiliations

  1. Department of Radiology, Shanghai No. 9 People’s Hospital, Affiliated to Shanghai Jiao Tong University School of Medicine, No.280, Mohe Road, Shanghai, 201900, China

    Ming-Jue Si, Shuang Gui, Zhi-Xin Li & Jiang-Min Zhao

  2. Department of Gynecology-Obstetrics, Shanghai No. 9 People’s Hospital, Affiliated to Shanghai Jiao Tong University School of Medicine, No.280, Mohe Road, Shanghai, 201900, China

    Qin Fan

  3. Department of Pathology, Shanghai No. 9 People’s Hospital, Affiliated to Shanghai Jiao Tong University School of Medicine, No.280, Mohe Road, Shanghai, 201900, China

    Hong-Xiu Han & Qian-Qian Zhao

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  1. Ming-Jue Si
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  2. Shuang Gui
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  3. Qin Fan
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  6. Zhi-Xin Li
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Correspondence to Jiang-Min Zhao.

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Si, MJ., Gui, S., Fan, Q. et al. Role of MRI in the early diagnosis of tubal ectopic pregnancy. Eur Radiol 26, 1971–1980 (2016). https://doi.org/10.1007/s00330-015-3987-6

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  • DOI: https://doi.org/10.1007/s00330-015-3987-6

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