USG findings in Ectopic pregnancy

RING OF FIRE - DOPPLER SCAN

• Ultrasonographic findings
• Tubal findings in 80-95%
  • Tubal hematoma (40-60%)
    • Heterogeneous mass
  • Tubal ring (50%): Echogenic ring separate from ovary
    • ± Yolk sac ± embryo
  • Tubal ring "lights up" with color Doppler
    • "Ring of fire"
    • May show small EP missed otherwise
  • Pulsed Doppler findings
    • High-velocity, low-resistance flow
• Ovary findings with tubal ectopic
  • 85% tubal EP on same side as corpusluteum
  • Corpusluteum(CL) appearance is variable
    • Corpusluteumcan mimic EP
  • CorpusluteumDoppler findings
    • Similar to "ring of fire" but in ovary
• Uterine findings
  • Thick echogenic endometrium
    • Decidual reaction
    • Endometrial cysts
  • "Pseudogestational sac" sign
    • Decidual cast of blood
    • No double-decidual sac sign of IUP
  • Heterotopic pregnancy is rare
    • IUP + EP
• Echogenic fluid in cul-de-sac
  • Blood in peritoneal space
  • Anechoic fluid considered physiologic
  • Clotted blood often mass-like
  • Blood may be isolated finding
    • 73% will have EP if echogenic fluid seen
• Ultrasound negative in 5-10% of cases
• source: auntminnie.com