ARRS 2022 Abstracts


E1510. Ectopic Pregnancy: Usual and Unusual Presentations
  1. Andrew Peacock; Naval Medical Center San Diego
  2. Prajeet Kaza; Naval Medical Center San Diego
  3. Mary Hargis; Naval Medical Center San Diego
  4. Richard Montgomery; Naval Medical Center San Diego
  5. Jennifer Foley; Naval Medical Center San Diego
Ectopic pregnancy is the leading cause of first trimester mortality in the United States. Estimated to affect 0.6–2% of all pregnancies, it is a common clinical entity that warrants provider familiarity. Although the incidence of ectopic pregnancy has remained relatively stable over the past 3 decades, unusual presentations are becoming more prevalent with the increased use of assisted reproduction.

Educational Goals / Teaching Points
This educational exhibit seeks to reinforce the variable sonographic imaging appearances and locations of ectopic pregnancy to maximize radiologist recognition, and ultimately reduce patient morbidity and mortality. The presentation will also briefly describe the utility and appropriateness of advanced imaging in the evaluation and follow-up of clinically and sonographically ambiguous cases, such as distinguishing high endometrial implantation from interstitial pregnancy.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
Ultrasound is the workhorse for emergency department imaging evaluation of pregnant patients with pelvic complaints. The ultrasound appearance of ectopic pregnancy is widely variable, ranging from a well-formed gestational sac with an identifiable embryo to a non-specific adnexal mass. Additionally, multiple ectopic locations are described, ranging from cervical to intraperitoneal, and including simultaneous intrauterine and ectopic gestations.

It is critical that the radiologist be familiar with the spectrum of presentations and locations of ectopic pregnancy to ensure accurate and timely diagnosis.