妇产科疾病的超声诊断ENGLISH课件

妇产科疾病的超声诊断-ENGLISH2023/7/3妇产科疾病的超声诊断ENGLISHSangreal--------uterusTHEDAWINCICODE妇产科疾病的超声诊断ENGLISHPelvicCavityPosterior:Occupiedbyrectum,colon,andileumAnterior:bladder,ureters,ovaries,fallopiantubes,uterus,andvaginaNORMALANATOMY妇产科疾病的超声诊断ENGLISHPre-inspection:Moderatebladderfilling

妇产科疾病的超声诊断ENGLISHUterusHollow,pear-shapedorganDividedintofundus,body,andcervixUsuallyanteflexedandantevertedCoveredwithperitoneumexceptanteriorlybelowtheoswhereperitoneumisreflectedontobladderSupportedbylevatoranimusclesandpelvicfasciaRoundligamentkeepsuterusinposition妇产科疾病的超声诊断ENGLISHUterinesizePrepubertal:3cmlongby0.5to1.0cmwideMenarcheal:8cmlongby4cmwidePostmenopausal:3.5to5.5cmlongby1to2cmwideNormalsize:2~3(thick)×4~5(width)×7~8cm(length)妇产科疾病的超声诊断ENGLISHUterinelongitudinaldiameter

Uterinewidediameter

UterusbeforeandaftertheTrail

妇产科疾病的超声诊断ENGLISHlength7~8cmbeforeandaftertheTrail

2~3cmwidth4~5cm妇产科疾病的超声诊断ENGLISHUterinePositionMidlineanteversion:mostcommon;degreeofanteversionisbladderdistentiondependentRightorleft:normalvariantinabsenceofpelvicmassesRetroverted:entireorgandisplacedposteriorlyRetroflexed:bodydisplacedwithrespecttocervix妇产科疾病的超声诊断ENGLISHUltrasonographyofnormaluterusUterineserosalayer:Linearhigh-echo;clear,smooth;

Myometrium:Homogeneousmiddle-echo;Endometria:Themiddlelineofhighecho,aroundtheweakecho.Itiswellknownthattheendometriumchangesdynamicallyinresponsetocyclichormonalflux.妇产科疾病的超声诊断ENGLISHUterineserosalayer

Myometrium

Endometria

Normaluterustransabdominalultrasonography妇产科疾病的超声诊断ENGLISHTransvaginalsagittalviewoftheuterus.Theroundedfundusisshowntowardtheleftoftheimagewiththeendometrialstriperummingthroughthemiddleoftheuterinecavity.MyometriumEndometriaUterineserosalayer妇产科疾病的超声诊断ENGLISHFallopianTube（输卵管）Infundibulum:funnel-shapedlateraltubethatprojectsbeyondthebroadligamenttooverlietheovariesAmpulla:sidestpartofthetubewherefertilizationoccursIsthmus:hardestpart;liesjustlateraltotheuterusLength:12cm;suppliedbyovarionarteriesandveins妇产科疾病的超声诊断ENGLISHOvary（卵巢）AlmondshapedAttachedtobackofthebroadligamentbymesovarium;sometimescalledsuspensoryligamentoftheovaryLiesinovarianfossaFossaisboundedbyexternaliliacvessels,ureter,andobturatornerveReceivesbloodfromovarianarteryBlooddrainedbyovarianveinintoinferiorvenacavaonright;onleftbyovarianveinintolertrenalvein妇产科疾病的超声诊断ENGLISHSonographyofthenormalovaryAnovoidhomogeneousechodensity;follicularcystsareoftenpresent.Thebestsonographicmarkerfortheovaryisidentificationofafollicularcyst,whichhastheclassicappearanceofbeingthinwalledandanechoicwiththrough-transmissionposteriorly.妇产科疾病的超声诊断ENGLISHTransabdominalsagittalimageshowstheleftovaryposteriortotheurinarybladder妇产科疾病的超声诊断ENGLISHTransvaginalsagittalimageoftheovaryovarianfollicle妇产科疾病的超声诊断ENGLISHFollicularwallflow妇产科疾病的超声诊断ENGLISHCommonDiseasesofObstetricsandGynecologyGynecology：Leiomyoma；Carcinoma;；OvarianTumors;Inflammatorymass;etc.Obstetrics：

Naturalpregnancy；Abnormalpregnancy;etc.妇产科疾病的超声诊断ENGLISHTheuterusLeiomyoma/Hysteromyoma妇产科疾病的超声诊断ENGLISHCharacteristicsofLeiomyomasMostcommonpelvictumorSmoothmusclecellcompositionFibrosisoccursafteratrophicofdegenerativechangesDegenerationoccurswhenfibroidsoutstriptheirbloodsupply;calcificationMaybepedunculatedClinical:enlargeduterus,profuseandprolongedbleeding,pain妇产科疾病的超声诊断ENGLISHUterineLocationsofleiomyomasSubmucosalErodeintoendomertialcavity–heavybleeding;infertilityIntramuralMayenlargetocausepressureonadjacentorgans;infertilitySubserosalMayenlargetocausepressureonadjacentorgans妇产科疾病的超声诊断ENGLISHSubserousmyomaBroadligamentmyomaCervicalmyomaintramurousmyomaSubmucousmyoma妇产科疾病的超声诊断ENGLISHUltrasonicperformanceTwo-dimensional：①IncreaseduterinebodyorFormdisorders；②Sphericalhypoechoicareaintheuterinebody，Rearechoattenuation；③WithcalcificationorCysticchange,etc；④Signsofoppression；ColorDoppler：Tumoraroundwiththebloodflowsignalintheshapeofringorsemi-circularring；Dopplerspectrum：Mediumresistanceindex，RI0.6±0.1。妇产科疾病的超声诊断ENGLISHintramurousmyoma妇产科疾病的超声诊断ENGLISHSubserousmyomaintramurousmyoma妇产科疾病的超声诊断ENGLISHSubserousmyoma妇产科疾病的超声诊断ENGLISHCervicalmyoma妇产科疾病的超声诊断ENGLISHAbundanttumorbloodflowMUT妇产科疾病的超声诊断ENGLISHRI0.61妇产科疾病的超声诊断ENGLISHSubmucousmyomawithcalcification妇产科疾病的超声诊断ENGLISHTeratoma

DermoidTummors

（卵巢良性囊性畸胎瘤/皮样囊肿)Pathology：derivesfromgermcell，themostcommonovarianneoplasm,constituting20%ofovariantumors.upto20%arebilateral.About80%occurinwomenofchildbearingage.妇产科疾病的超声诊断ENGLISHSizerangesfromsmallto40cmUnliateral,roundtoovalmassContainsfaty,sebaceousmaterial,hair,cartilage,bone,teethClinical:asymptomatictoabdominalpain,enlargementandpressure;pedunculated,subjecttotorsionSonography:Cystic/complex/solidmass,echogeniccomponents;acousticshadowing妇产科疾病的超声诊断ENGLISHSpecialUltrasoundFindings:1.Acysticmass:

withanechogenicmuralnodule2.Apastesign：particulateliptinite3.Afluffofhairsign4.Afat-fluidlevelsign：withfluidlevelinthecyst,fatabove,fluidbelow.5.Acomplexmass妇产科疾病的超声诊断ENGLISHcysticteratomaofovaryAcysticmassPastesignFluffofhairsign妇产科疾病的超声诊断ENGLISHPastesignFat-fluidlevelsignAcomplexmass妇产科疾病的超声诊断ENGLISHA8yearsoldgirl,cuttingoffathreekilogramsbenignteratoma妇产科疾病的超声诊断ENGLISHTheroleofUltrasoundinObstetrics妇产科疾病的超声诊断ENGLISHTRIMESTERSFirsttrimester=0to12weeksofgestationSecondtrimester=13to26weeksofgestationThirdtrimester=27to42weeksofgetsationPosttermpregnancy=>42weeksofgestation妇产科疾病的超声诊断ENGLISHIndicationsforFirst-TrimesterSonographyConfirmpresenceofintrauterinepregnancyEvaluateforsuspectedectopicpregnancyDefinecauseofvaginalbleedingDeterminegestationalageConfirmsuspectedmultiplegestationsAidininvasiveproceduresEvaluatepelvicmassesDetectuterineabnormalities妇产科疾病的超声诊断ENGLISHNaturalpregnancy妇产科疾病的超声诊断ENGLISHNonagepregnancy

(First-Trimester)Definition：Pregnancybefore12weekend.妇产科疾病的超声诊断ENGLISH5weekspregnant—Gestationalsac；6-7weekspregnant—Germ;7-8Weeks—Primitivehearttubepulse；8-11weeks—Yolksac;9weeks—Embryonic,placenta.TheNormalFirstTrimester妇产科疾病的超声诊断ENGLISHSonographicFeaturesofaNormalGestationalSacShape:roundofovalPosition:fundalormiddleportionofuterus;acenterpositionrelativetoendometriumContour:smoothWall:echogenic;3mmofmoreinthickness妇产科疾病的超声诊断ENGLISHInternallandmarks:yalksacpresentwhengestationalsacislargerthan10mm;embryopresentwhengestationalsacislargerthan18mmGrowth:1mmperday(range:0.7mmto1.5mmperday)妇产科疾病的超声诊断ENGLISH4-5weekspregnantInthegestationalsacwecanseeaembryopoint,theearliestembryo.妇产科疾病的超声诊断ENGLISH7weekspregnant

Fetuswasabout4mm，wecanseeapparentheartthrob,andsmalllimbbud.妇产科疾病的超声诊断ENGLISH8weekspregnant

Three-dimensionalultrasoundshowitsbeginningoftheshapeofahuman.妇产科疾病的超声诊断ENGLISHUmbilicalbordEmbryonicheadEmbryonicabdomen妇产科疾病的超声诊断ENGLISHYolksacEmbronicheadAmnioticsac妇产科疾病的超声诊断ENGLISH9weekspregnant

Knownasafetal，Developmentofthevariouspartsofthefetus,tendstoimprove.妇产科疾病的超声诊断ENGLISH12weekspregnantThespineisidentifiable,asthetwobead-likehighecho.Ears,limbs,bonescanbeshownandmeasurement.妇产科疾病的超声诊断ENGLISHUltrasoundoftheSecondandThirdTrimesters妇产科疾病的超声诊断ENGLISHIndicationsforSecond-and

Third-TrimesterEstimategestationalageforpatientswithuncertaindatesEvaluateuterinesizeandclinicaldatediscrepanciesEvaluatefetalgrowthEstimatefetalweightDeterminefetalpresentationEvaluatefetallife妇产科疾病的超声诊断ENGLISHprovideadjuncttoamniocentesis,percutaneousumbilicalbloodsamplingprocedure,orcerclageplacementEvaluateuterineabnormalityEvaluateabnoumalmaternalserumalpha-fetoproteinvaluesEvaluateabnormalamnioticfluidEvaluateplacentaEtc.妇产科疾病的超声诊断ENGLISHTheSecond-and

Third-Trimester

(Metaphaseandterminalprengancy)Mid-pregnancy:13-27weekspregnancy.Late-pregnancy:Morethan28weeksofpregnancy.妇产科疾病的超声诊断ENGLISHScanningTechniquesSurveyuterusObservecardiacactivityDeterminepositionandnumberofthefetusandplacentaAssessamnioticfluidLookforuterineofplacentalmassesandfetalanomalies妇产科疾病的超声诊断ENGLISHCheckcontents1、Fetalhead：BPD

biparietaldiameter;2、Fetalabdomen:ACabdomencircumference;3、Fetallimb：FLfemurlength;4、Others：Placenta,Fetalheartrate,Amnioticfluid,etc.妇产科疾病的超声诊断ENGLISH1、FetalheadMeasuringtheBiparietalDiameter(BPD)Obitainbiparietaldiameterofthefetalheadatthetransverselevelofthemidbrain:falx,cavumseptipellucidi,andthalamicnucleiMakesuretheheadissymmetricandovalMeasurefromoutertoinnermarginsoftheskullInthethirdtrimester,theBPDisnotasaccurateinpredictingfetalage妇产科疾病的超声诊断ENGLISHFetalhead,after12weekendpregnant妇产科疾病的超声诊断ENGLISHFetalsideprofile,wecanobserveitsforehead,nose,lip,andchin,etc.妇产科疾病的超声诊断ENGLISH2、FetalabdomenThehepatobiliarysystem:liver,portvenoussysterm,hepaticveinsandarteries,gallbladder,andbileductsThegastrointestinalsystem:theesophagus,stomach,smallandlargeintestines(colon)妇产科疾病的超声诊断ENGLISHTheurinarysystem:kidneys,adrenalglands,ureters,bladder.Thefetalabdomencircumference（AC)

isthemostwidelymeasured妇产科疾病的超声诊断ENGLISHMeasuringtheAbdominalCircumference(AC)TheACshouldbetakenfromaroundtransverseimagewiththeumbilicalportionoftheleftportalveinmidlinewithintheliverTheoutermarginoftheabdominalwallshouldbemeasuredTheabdominalwallmeasurementistheleastaccurate妇产科疾病的超声诊断ENGLISHThefetallivergallbladderstomachportvenousspinegallbladderstomach妇产科疾病的超声诊断ENGLISH3、FetallimbsTheupperlimbs:theulnatheradiusthehumerusThelowerlimbs:thefemur/thethighbonethefibulathetibiaThefemuristhemostwidelymeasuredlongbone（FLfemurlength）妇产科疾病的超声诊断ENGLISHFemurmeasurementHyperechoniclinearstructurerepresentstheossifiedportionofthefemoualdiaphysisandcorrespondstofemorallengthmeasurementfromthegreatertrochantertothefemoralcondylesThemormalfemurhasastraightlaeralborderandacurvedmedialborderFemurlengthmaybeusedwiththesameaccuracyasBPDtopredictgestationalageFemurl