Skip to main content
SpringerLink
Log in

Use of magnetic resonance analysis for clinical evaluation of the peripheral area of gestational sac in bleeding and non-bleeding ectopic pregnancy cases

  • Original Article
  • Published:
Reproductive Medicine and Biology

Abstract

Purpose

To evaluate preoperative magnetic resonance (MR) imaging features of bleeding and non-bleeding ectopic pregnancy (EP) by comparison with surgical findings.

Methods

Eighteen suspected EP cases underwent preoperative MR imaging. We classified 8 cases as the bleeding group and 7 cases as the non-bleeding group with or without intra-abdominal bleeding and/or hematoma at the site of EP, and compared, retrospectively, gestational sac (GS)-like structure, particularly the peripheral area of the GS via MR analysis. Excluded were 3 cases that were insufficient for assessing extrauterine GS-like structure: ruptured tubal pregnancy and uterine horn pregnancy.

Results

GS-like structures were typically observed as low intensity on T1-weighted image (T1WI) and as high intensity on T2-weighted image (T2WI). In non-bleeding cases, most peripheral areas of the GS were of intermediate intensity on T1WI and high intensity on T2WI. Most bleeding cases were of high intensity on T1WI and low to high intensity on T2WI. Furthermore, the peripheral area of the GS was of higher intensity on T1WI with fat suppression than on T1WI.

Conclusions

It is clear that MR imaging is effective for diagnosis of cases of suspected EP. EP conditions may be predicted by signal intensity of the peripheral area of the GS via MR analysis.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Abdel LS, Hjalmar AS. Transvaginal sonography in the management of ectopic pregnancy. Acta Obstet Gynecol Scand. 1995;74:293–6.

    Article  Google Scholar 

  2. Shalev E, Yarom I, Bustan M, Bustan M, Weiner E, Ben-Shlomo I. Transvaginal sonography as the ultimate diagnostic tool for the management of ectopic pregnancy: experience with 840 cases. Fertil Steril. 1998;69:62–5.

    Article  PubMed  CAS  Google Scholar 

  3. Condous G, Okaro E, Khalid A, Lu C, Van Huffel S, Timmerman D, et al. The accuracy of transvaginal ultrasonography for the diagnosis of ectopic pregnancy prior to surgery. Hum Reprod. 2005;20:1404–9.

    Article  PubMed  Google Scholar 

  4. Atri M, Leduc C, Gillett P, Bret PM, Reinhold C, Kintzen G, et al. Role of endovaginal sonography in the diagnosis and management of ectopic pregnancy. Radiographics. 1996;16:755–74.

    PubMed  CAS  Google Scholar 

  5. Kataoka ML, Togashi K, Kobayashi H, Inoue T, Fujii S, Konishi J. Evaluation of ectopic pregnancy by magnetic resonance imaging. Hum Reprod. 1999;14:2644–50.

    Article  PubMed  CAS  Google Scholar 

  6. Nagayama M, Watanabe Y, Okumura A, Amoh Y, Nakashita S, Dodo Y. Fast MR imaging in obstetrics. Radiographics. 2002;22:563–80.

    PubMed  Google Scholar 

  7. Kinoshita T, Ishii K, Higashiiwai H. MR appearance of ruptured tubal ectopic pregnancy. Eur J Radiol. 1999;32:144–7.

    Article  PubMed  CAS  Google Scholar 

  8. Takeuchi K, Yamada T, Oomori S, Ideta K, Moriyama T, Maruo T. Comparison of magnetic resonance imaging and ultrasonography in the early diagnosis of interstitial pregnancy. J Reprod Med. 1999;44:265–8.

    PubMed  CAS  Google Scholar 

  9. Hricak H, Lacey C, Schriock E, Fisher MR, Amparo E, Dooms G, et al. Gynecologic masses: value of magnetic resonance imaging. Am J Obstet Gynecol. 1985;153:31–7.

    PubMed  CAS  Google Scholar 

  10. Hamada S, Naka O, Moride N, Higuchi K, Takahashi H. Ultrasonography and magnetic resonance imaging findings in a patient with an unruptured interstitial pregnancy. Eur J Obstet Gynecol Reprod Biol. 1997;73:197–201.

    Article  PubMed  CAS  Google Scholar 

  11. Nishino M, Hayakawa K, Kawamata K, Iwasaku K, Takasu K. MRI of early unruptured ectopic pregnancy: detection of gestational sac. J Comput Assist Tomogr. 2002;26:134–7.

    Article  PubMed  Google Scholar 

  12. Yoshigi J, Yashiro N, Kinoshita T, Ouchi T, Kitagaki H. Diagnosis of ectopic pregnancy with MRI: efficacy of T2*-weighted imaging. Magn Reson Med Sci. 2006;5:25–32.

    Article  PubMed  Google Scholar 

  13. Tamai K, Koyama T, Togashi K. MR features of ectopic pregnancy. Eur Radiol. 2007;17:3236–46.

    Article  PubMed  Google Scholar 

  14. Takeuchi H, Kuwatsuru R. The indications, surgical techniques, and limitations of laparoscopic myomectomy. JSLS. 2003;7:89–95.

    PubMed  Google Scholar 

  15. Kuroda K, Takeuchi H, Kitade M, Kikuchi I, Shimanuki H, Kumakiri J, et al. Assessment of tubal disorder as a risk factor for repeat ectopic pregnancy after laparoscopic surgery for tubal pregnancy. J Obstet Gynecol Res. 2009;35:520–4.

    Article  Google Scholar 

  16. Kumakiri J, Takeuchi H, Kitade M, Kikuchi I, Shimanuki H, Kubo M, et al. Interstitial pregnancy with huge adenomyosis uteri managed laparoscopically by using pre-operative and intra-operative imaging: case report. BJOG. 2005;112:1578–80.

    Article  PubMed  Google Scholar 

  17. Bradley WG Jr. MR appearance of hemorrhage in the brain. Radiology. 1993;189:15–26.

    PubMed  Google Scholar 

  18. Lozeau AM, Potter B. Diagnosis and management of ectopic pregnancy. Am Fam Physician. 2005;72:1707–14.

    PubMed  Google Scholar 

  19. Hajenius PJ, Mol F, Mol BW, Bossuyt PM, Ankum WM, van der Veen F. Interventions for tubal ectopic pregnancy. Cochrane Database Syst Rev. 2007;1:CD000324.

  20. Wong JA, Clark JF. Correlation of symptoms with age and location of gestation in tubal pregnancy. J Natl Med Assoc. 1968;60:221–3.

    PubMed  CAS  Google Scholar 

  21. Della-Giustina D, Denny M. Ectopic pregnancy. Emerg Med Clin N Am. 2003;21:565–84.

    Article  Google Scholar 

  22. Murray H, Baakdah H, Bardell T, Tulandi T. Diagnosis and treatment of ectopic pregnancy. CMAJ. 2005;173:905–12.

    Article  PubMed  Google Scholar 

  23. Hajenius PJ, Mol BW, Ankum WM, van der Veen F, Bossuyt PM, Lammes FB. Clearance curves of serum human chorionic gonadotrophin for the diagnosis of persistent trophoblast. Hum Reprod. 1995;10:683–7.

    PubMed  CAS  Google Scholar 

  24. Balci O, Ozdemir S, Mahmoud AS, Acar A, Colakoglu MC. The efficacy of multiple-dose methotrexate treatment for unruptured tubal ectopic pregnancy and conversion rate to surgery: a study on 294 cases. Fertil Steril. 2010;93:2415–7.

    Article  PubMed  CAS  Google Scholar 

  25. Kemmann E, Trout S, Garcia A. Can we predict patients at risk for persistent ectopic pregnancy after laparoscopic salpingotomy? J Am Assoc Gynecol Laparosc. 1994;1:122–6.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Juntendo University Faculty of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan

    Masako Kuroda, Keiji Kuroda, Mari Kitade, Iwaho Kikuchi, Jun Kumakiri, Shozo Matsuoka & Satoru Takeda

  2. Clinical Sciences Research Institute, University of Warwick, Coventry, CV2 2DX, UK

    Keiji Kuroda

  3. Department of Radiology, Juntendo University Faculty of Medicine, Tokyo, Japan

    Ryohei Kuwatsuru

Authors
  1. Masako Kuroda
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Keiji Kuroda
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ryohei Kuwatsuru
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Mari Kitade
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Iwaho Kikuchi
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Jun Kumakiri
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Shozo Matsuoka
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Satoru Takeda
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Keiji Kuroda.

About this article

Cite this article

Kuroda, M., Kuroda, K., Kuwatsuru, R. et al. Use of magnetic resonance analysis for clinical evaluation of the peripheral area of gestational sac in bleeding and non-bleeding ectopic pregnancy cases. Reprod Med Biol 11, 95–100 (2012). https://doi.org/10.1007/s12522-011-0114-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12522-011-0114-5

Keywords

Search

Navigation