Evaluation of ectopic pregnancy by magnetic resonance imaging

Patients (n = 37) suspected of ectopic pregnancy were prospectively evaluat ed with magnetic resonance (MR) imaging to assess the capability of MR imag ing in the diagnosis of ectopic pregnancy. Five levels of confidence were d efined: diagnostic, suspicious, equivocal, questionable, and negative, Tuba l wall enhancement and presence of tubal haematoma or gestational sac-like structure were considered diagnostic findings. There were 21 diagnostic, tw o suspicious, eight equivocal, and six negative findings, MR findings mere compared with the surgical findings in 18 patients. Surgical confirmation w as obtained in 12 diagnostic, two suspicious, and four equivocal studies. U sing the MR diagnostic criteria for tubal pregnancy, MR had 12 true positiv e, three true negative, three false negative, and no false positive results for the diagnosis of tubal pregnancy. Retrospective analysis of the signal intensity of haematoma and ascites was performed for these 18 surgically c onfirmed cases. The predominant signal intensity of tubal haematoma was an intermediate signal on T1-weighted image (WI) and a low signal on T2WI, Asc ites showed signal intensity higher than that of urine on T1WI in 100% of 1 3 cases. In conclusion, MR imaging with use of intravenous contrast materia l allows a specific diagnosis of tubal pregnancy, recognizing tubal wall en hancement and fresh tubal haematoma.