Incidental detection of interstitial pregnancy on CT imaging

Abstract

Ectopic pregnancy is a potentially life-threatening condition. Detection of ectopic pregnancy on CT images is rare. In this case, we describe the CT findings of interstitial pregnancy both before and after rupture. If CT images demonstrate the presence of a strong enhancing ring-like mass in the pelvis, ectopic pregnancy should be considered.

Keywords: Ectopic pregnancy; Hemoperitoneum; Interstitial pregnancy; Tomography, spiral volumetric computed.

Fig. 1

Imaging findings are presented for 37-year-old woman with interstitial pregnancy. A. Initial contrast enhanced axial CT image shows strong enhancing ring-like mass (arrow) that represents gestational sac without hemoperitoneum. Mass abuts uterine fundus in right pelvis. B. Follow-up CT image obtained after four days shows amorphous hematoma (arrowheads) with massive hemoperitoneum caused by ruptured interstitial pregnancy. Previous strong enhancing ring-like mass in right pelvis is now seen as heterogeneous enhancing mass (arrow) after rupture of interstitial pregnancy. C. Coronal multiplanar reconstruction CT image shows heterogeneous enhancing mass (arrow) that abuts uterine fundus (arrowheads), suggestive of interstitial pregnancy. Note that there is hypodense line between mass and uterine fundus. CT image demonstrates hematoma around uterus and hemoperitoneum.