USG findings in Ectopic pregnancy

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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

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