妇产科疾病的超声诊断（英文）课件

妇产科疾病的超声诊断2011-ENGLISHUltrasonographyonGynecologyandObstetrics妇产科疾病的超声诊断2011-ENGLISHSangreal--------uterusTHEDAWINCICODE妇产科疾病的超声诊断2011-ENGLISHPelvicCavityPosterior:Occupiedbyrectum,colon,andileumAnterior:bladder,ureters,ovaries,fallopiantubes,uterus,andvaginaNORMALANATOMY妇产科疾病的超声诊断2011-ENGLISHPre-inspection:Moderatebladderfilling

妇产科疾病的超声诊断2011-ENGLISHUterusHollow,pear-shapedorganDividedintofundus,body,andcervixUsuallyanteflexedandantevertedCoveredwithperitoneumexceptanteriorlybelowtheoswhereperitoneumisreflectedontobladderSupportedbylevatoranimusclesandpelvicfasciaRoundligamentkeepsuterusinposition妇产科疾病的超声诊断2011-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2011-ENGLISHUterinelongitudinaldiameter

Uterinewidediameter

UterusbeforeandaftertheTrail

妇产科疾病的超声诊断2011-ENGLISHlength7~8cmbeforeandaftertheTrail

2~3cmwidth4~5cm妇产科疾病的超声诊断2011-ENGLISHUterinePositionMidlineanteversion:mostcommon;degreeofanteversionisbladderdistentiondependentRightorleft:normalvariantinabsenceofpelvicmassesRetroverted:entireorgandisplacedposteriorlyRetroflexed:bodydisplacedwithrespecttocervix妇产科疾病的超声诊断2011-ENGLISHUltrasonographyofnormaluterusUterineserosalayer:Linearhigh-echo;clear,smooth;

Myometrium:Homogeneousmiddle-echo;Endometria:Themiddlelineofhighecho,aroundtheweakecho.Itiswellknownthattheendometriumchangesdynamicallyinresponsetocyclichormonalflux.妇产科疾病的超声诊断2011-ENGLISHUterineserosalayer

Myometrium

Endometria

Normaluterustransabdominalultrasonography妇产科疾病的超声诊断2011-ENGLISHTransvaginalsagittalviewoftheuterus.Theroundedfundusisshowntowardtheleftoftheimagewiththeendometrialstriperummingthroughthemiddleoftheuterinecavity.MyometriumEndometriaUterineserosalayer妇产科疾病的超声诊断2011-ENGLISHFallopianTube（输卵管）Infundibulum:funnel-shapedlateraltubethatprojectsbeyondthebroadligamenttooverlietheovariesAmpulla:sidestpartofthetubewherefertilizationoccursIsthmus:hardestpart;liesjustlateraltotheuterusLength:12cm;suppliedbyovarionarteriesandveins妇产科疾病的超声诊断2011-ENGLISHOvary（卵巢）AlmondshapedAttachedtobackofthebroadligamentbymesovarium;sometimescalledsuspensoryligamentoftheovaryLiesinovarianfossaFossaisboundedbyexternaliliacvessels,ureter,andobturatornerveReceivesbloodfromovarianarteryBlooddrainedbyovarianveinintoinferiorvenacavaonright;onleftbyovarianveinintolertrenalvein妇产科疾病的超声诊断2011-ENGLISHSonographyofthenormalovaryAnovoidhomogeneousechodensity;follicularcystsareoftenpresent.Thebestsonographicmarkerfortheovaryisidentificationofafollicularcyst,whichhastheclassicappearanceofbeingthinwalledandanechoicwiththrough-transmissionposteriorly.妇产科疾病的超声诊断2011-ENGLISHTransabdominalsagittalimageshowstheleftovaryposteriortotheurinarybladder妇产科疾病的超声诊断2011-ENGLISHTransvaginalsagittalimageoftheovaryovarianfollicle妇产科疾病的超声诊断2011-ENGLISHFollicularwallflow妇产科疾病的超声诊断2011-ENGLISHCommonDiseasesofObstetricsandGynecologyGynecology：Leiomyoma

；Carcinoma;；OvarianTumors;Inflammatorymass;etc.Obstetrics：

Naturalpregnancy

；

Abnormalpregnancy;etc.妇产科疾病的超声诊断2011-ENGLISHTheuterusLeiomyoma/Hysteromyoma妇产科疾病的超声诊断2011-ENGLISHCharacteristicsofLeiomyomasMostcommonpelvictumorSmoothmusclecellcompositionFibrosisoccursafteratrophicofdegenerativechangesDegenerationoccurswhenfibroidsoutstriptheirbloodsupply;calcificationMaybepedunculatedClinical:enlargeduterus,profuseandprolongedbleeding,pain妇产科疾病的超声诊断2011-ENGLISHUterineLocationsofleiomyomasSubmucosalErodeintoendomertialcavity–heavybleeding;infertilityIntramuralMayenlargetocausepressureonadjacentorgans;infertilitySubserosalMayenlargetocausepressureonadjacentorgans妇产科疾病的超声诊断2011-ENGLISHSubserousmyomaBroadligamentmyomaCervicalmyomaintramurousmyomaSubmucousmyoma妇产科疾病的超声诊断2011-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2011-ENGLISHintramurousmyoma妇产科疾病的超声诊断2011-ENGLISHSubserousmyomaintramurousmyoma妇产科疾病的超声诊断2011-ENGLISHSubserousmyoma妇产科疾病的超声诊断2011-ENGLISHCervicalmyoma妇产科疾病的超声诊断2011-ENGLISHAbundanttumorbloodflowMUT妇产科疾病的超声诊断2011-ENGLISHRI0.61妇产科疾病的超声诊断2011-ENGLISHSubmucousmyomawithcalcification妇产科疾病的超声诊断2011-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2011-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2011-ENGLISHSpecialUltrasoundFindings:1.Acysticmass:

withanechogenicmuralnodule2.Apastesign：particulateliptinite3.Afluffofhairsign4.Afat-fluidlevelsign：withfluidlevelinthecyst,fatabove,fluidbelow.5.Acomplexmass妇产科疾病的超声诊断2011-ENGLISHcysticteratomaofovaryAcysticmassPastesignFluffofhairsign妇产科疾病的超声诊断2011-ENGLISHPastesignFat-fluidlevelsignAcomplexmass妇产科疾病的超声诊断2011-ENGLISHA8yearsoldgirl,cuttingoffathreekilogramsbenignteratoma妇产科疾病的超声诊断2011-ENGLISHTheroleofUltrasoundinObstetrics妇产科疾病的超声诊断2011-ENGLISHTRIMESTERSFirsttrimester=0to12weeksofgestationSecondtrimester=13to26weeksofgestationThirdtrimester=27to42weeksofgetsationPosttermpregnancy=>42weeksofgestation妇产科疾病的超声诊断2011-ENGLISHIndicationsforFirst-TrimesterSonographyConfirmpresenceofintrauterinepregnancyEvaluateforsuspectedectopicpregnancyDefinecauseofvaginalbleedingDeterminegestationalageConfirmsuspectedmultiplegestationsAidininvasiveproceduresEvaluatepelvicmassesDetectuterineabnormalities妇产科疾病的超声诊断2011-ENGLISHNaturalpregnancy妇产科疾病的超声诊断2011-ENGLISHNonagepregnancy

(First-Trimester)Definition：Pregnancybefore12weekend.妇产科疾病的超声诊断2011-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2011-ENGLISHSonographicFeaturesofaNormalGestationalSacShape:roundofovalPosition:fundalormiddleportionofuterus;acenterpositionrelativetoendometriumContour:smoothWall:echogenic;3mmofmoreinthickness妇产科疾病的超声诊断2011-ENGLISHInternallandmarks:yalksacpresentwhengestationalsacislargerthan10mm;embryopresentwhengestationalsacislargerthan18mmGrowth:1mmperday(range:0.7mmto1.5mmperday)妇产科疾病的超声诊断2011-ENGLISH4-5weekspregnantInthegestationalsacwecanseeaembryopoint,theearliestembryo.妇产科疾病的超声诊断2011-ENGLISH7weekspregnant

Fetuswasabout4mm，wecanseeapparentheartthrob,andsmalllimbbud.妇产科疾病的超声诊断2011-ENGLISH8weekspregnant

Three-dimensionalultrasoundshowitsbeginningoftheshapeofahuman.妇产科疾病的超声诊断2011-ENGLISHUmbilicalbordEmbryonicheadEmbryonicabdomen妇产科疾病的超声诊断2011-ENGLISHYolksacEmbronicheadAmnioticsac妇产科疾病的超声诊断2011-ENGLISH9weekspregnant

Knownasafetal，Developmentofthevariouspartsofthefetus,tendstoimprove.妇产科疾病的超声诊断2011-ENGLISH12weekspregnantThespineisidentifiable,asthetwobead-likehighecho.Ears,limbs,bonescanbeshownandmeasurement.妇产科疾病的超声诊断2011-ENGLISHUltrasoundoftheSecondandThirdTrimesters妇产科疾病的超声诊断2011-ENGLISHIndicationsforSecond-and

Third-TrimesterEstimategestationalageforpatientswithuncertaindatesEvaluateuterinesizeandclinicaldatediscrepanciesEvaluatefetalgrowthEstimatefetalweightDeterminefetalpresentationEvaluatefetallife妇产科疾病的超声诊断2011-ENGLISHprovideadjuncttoamniocentesis,percutaneousumbilicalbloodsamplingprocedure,orcerclageplacementEvaluateuterineabnormalityEvaluateabnoumalmaternalserumalpha-fetoproteinvaluesEvaluateabnormalamnioticfluidEvaluateplacentaEtc.妇产科疾病的超声诊断2011-ENGLISHTheSecond-and

Third-Trimester

(Metaphaseandterminalprengancy)Mid-pregnancy:13-27weekspregnancy.Late-pregnancy:Morethan28weeksofpregnancy.妇产科疾病的超声诊断2011-ENGLISHScanningTechniquesSurveyuterusObservecardiacactivityDeterminepositionandnumberofthefetusandplacentaAssessamnioticfluidLookforuterineofplacentalmassesandfetalanomalies妇产科疾病的超声诊断2011-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2011-ENGLISH1、

FetalheadMeasuringtheBiparietalDiameter(BPD)Obitainbiparietaldiameterofthefetalheadatthetransverselevelofthemidbrain:falx,cavumseptipellucidi,andthalamicnucleiMakesuretheheadissymmetricandovalMeasurefromoutertoinnermarginsoftheskullInthethirdtrimester,theBPDisnotasaccurateinpredictingfetalage妇产科疾病的超声诊断2011-ENGLISHFetalhead,after12weekendpregnant妇产科疾病的超声诊断2011-ENGLISHFetalsideprofile,wecanobserveitsforehead,nose,lip,andchin,etc.妇产科疾病的超声诊断2011-ENGLISH2、FetalabdomenThehepatobiliarysystem:liver,portvenoussysterm,hepaticveinsandarteries,gallbladder,andbileductsThegastrointestinalsystem:theesophagus,stomach,smallandlargeintestines(colon)妇产科疾病的超声诊断2011-ENGLISHTheurinarysystem:kidneys,adrenalglands,ureters,bladder.Thefetalabdomencircumference（AC)

isthemostwidelymeasured妇产科疾病的超声诊断2011-ENGLISHMeasuringtheAbdominalCircumference(AC)TheACshouldbetakenfromaroundtransverseimagewiththeumbilicalportionoftheleftportalveinmidlinewithintheliverTheoutermarginoftheabdominalwallshouldbemeasuredTheabdominalwallmeasurementistheleastaccurate妇产科疾病的超声诊断2011-ENGLISHThefetallivergallbladderstomachportvenousspinegallbladderstomach妇产科疾病的超声诊断2011-ENGLISH3、FetallimbsTheupperlimbs:theulnatheradiusthehumerusThelowerlimbs:thefemur/thethighbonethefibulathetibiaThefemuristhemostwidelymeasuredlongbone（FLfemurlength

）妇产科疾病的超声诊断2011-ENGLISHFemurmeasurementHyperechoniclinearstructurerepresentstheossifiedportionofthefemoualdiaphysisandcorrespondstofemorallengthmeasurementfromthegreatertrochantertothefemoralcondylesThemormalfemurhasastraigh