A Study Of Ectopic Pregnancy MRI Features And Its Correlation With The Serum Level Of VEGF

Objective(1)To analyse the value of MRI in the diagnosis of 31 patients with ectopic pregnancy.(2)To assess the value of VEGF in the diagnosis of intrauterine early pregnancy and ectopic pregnancy.(3)To discuss the relationship between the MRI features of EP and VEGF .Materials and Methods(1)31 patients with EP were performed MRI plain scan and enhancement scan, and all cases were proved by operation and pathology.(2) Serum VEGF Concentration in 31 cases of EP were detected in umbilical venous blood 3ml by Double antibody sandwich enzyme linked immunosorbent assay(ELISA),and 30 cases of normal pregnancy as compared group were also tested SPSS16.0 software package was used for T-test and analyzed Serum VEGF Concentration change between intrauterine early pregnancy and EP and to investigate concentration changes of serum VEGF and sensitivity and specificity between intrauterine early pregnancy and EP.(3) To evaluate MRI features'correlation with serum expression of VEGF studied.Results(1) 22 cases of periampullary Pregnancy(right 14 cases,left 8 cases),9 cases of interstitial pregnarcy(right 6 cases,left 3 cases). 31 cases demonstrated cystic heterogeneoussignal intensity next to the uterine body,ring-shaped,the size of the GS is 1.0x0.5x1.0cm-4.0x4.0x4.0cm; the GS have clear boundary in 12 cases,and indistinct border in 19 cases ; the GS exhibit low-intermediate intensity on T1-weighed images in 31 cases and slice shape high signal existed in GS of 24 cases of them ,and on T2-weighed images these GS exhibit high intensity . all cases exhibit high signal on T1/SPIR。T1WI,T1WI/SPIR enhance ,the wall of gastrula and the node exhibit intermediate, high enhancement,no enhancement in the cysts.7cases have the same or opposite side ovarian cyst。14cases of all cases exhibit low-intermediate enlargement.16cases have the fluid of pelvic cavity .(2) Serum VEGF concentrations show statistically significant differences between intrauterine early pregnancies. When threshold concentrations of a serum VEGF level >189pg/ml were used, intrauterine early pregnancy could be distinguished from EP with a sensitivity of90%,a specificity of86%.(3) There is no correlation between VEGF and sites of the tubal pregnancy(p > 0.0 5 ),VEGF expression of EP are relating to the size of GS , hemorrhage, endometrial thicking and postcontrast enhancement,p < 0.0 5 ,but had not correlate with the fluid of pelvic cavity, p>0 .05.Conclusion(1) MRI is helpful in making accurate diagnosis for the location,nature of the GS,and sensitive in detecting hemorrhage of GS, Indirectly to react blood supply of GS and Its living after enhancement.(2)When threshold concentrations of a serum VEGF level >189pg/ml were used, intrauterine ealy pregnancy could be distinguished from EP with a sensitivity of 90%,a specificity of 86%. It was of good diagnostic value for the earlier EP,and can be used for the differential diagnosis of IUEP and EP(3)EP MRI features were closely related to VEGF expression . when the GS diameter is greater than 3cm , companyed with hemorrhage, endometrial thicking et al, suggest that GS-like structure may have high risk of rupture.