Choroid plexus dysmorphism detected by transvaginal sonography: the earliest sign of fetal hydrocephalus.

Fetal intracranial pathology detected in the early second trimester during 1237 transvaginal sonographic scans is presented. In a sharp contrast to simple choroid cysts, which disappear at the end of the second trimester as part of a benign course, gross distortion of the choroid plexus was found to be related to the later diagnosis of hydrocephalus. Three patterns of this abnormality are early absence of the plexus, hypoplasia and shrinkage, and "Swiss cheese" appearance. Ventriculomegaly in hydropic fetuses does not distort the normal architecture of the choroid plexus. Certain abnormal features of the choroid plexus, observed as early as the 14th week, menstrual age, are landmarks of developing hydrocephalus, currently detectable only later in pregnancy.     

未破裂型输卵管妊娠136例阴道超声声像分析

目的 探讨未破裂型输卵管妊娠阴道超声声像特征及误诊原因。方法 回顾性分析经临床和病理对比的136例未破裂型输卵管妊娠病例的F)1道超声声像特征。结果 宫外胚囊声像35例，卵巢旁小包块58例，盆腔一侧橄榄形或管状包块43例，误诊5例。结论 未破裂型输卵管妊娠阴道超声声像有一定特征，其共性为卵巢旁境界清晰，形态规则不均质包块。     

经阴道彩色多普勒超声诊断局部中晚期宫颈癌

目的探讨经阴道彩色多普勒超声诊断局部中晚期宫颈癌的价值及宫颈癌的声像图特征。方法对106例经手术与病理证实的宫颈癌患者的二维声像图及CDFI表现进行了回顾性分析。结果局部中晚期宫颈癌经阴道彩色多普勒声像图表现具有特征性:宫颈增大、宫颈部低回声肿块、正常宫颈管结构消失、宫颈外浸润性肿块等图像改变;宫颈肿块内异常丰富彩色血流,呈“火球样”改变;而早期宫颈癌宫颈无明显增大及特异性改变;宫颈部肿块内血流动脉阻力指数平均0.41。结论经阴道彩色多普勒超声对局部中晚期宫颈癌病变范围、是否周围侵犯、肿块的血供情况等具有较大诊断价值,可作为局部中晚期宫颈癌治疗前常规的辅助检查方法。     

Comparison of first trimester transvaginal anatomy scan to the second trimester structural survey in normal weight and obese populations: a pilot study

Purpose: To compare visualization of first trimester fetal anatomic transvaginal ultrasound (TVUS) to the second trimester transabdominal anatomic ultrasound (TAU) in normal weight and obese patients.

Materials and methods: In a prospective cross-sectional study design, 25 women underwent a TVUS between 12 and 14 weeks, and a TAU at 18–22 weeks. For each anatomic structure, the percentage of patients achieving optimal visualization was recorded. Risk ratios for visualizing a structure in the second trimester versus the first were calculated.

Results: Twenty-five patients underwent a TVUS and 24 completed the TAU. The average BMI in the obese and nonobese groups was 34?kg/m² and 23?kg/m², respectively. All structures were more consistently visualized during the TAU for the both groups. The cardiac views, hands and feet were more difficult to visualize in all the patients at both scan times but were more frequently visualized in the TAU. For the obese patients, hands, feet, cardiac and spine views were less frequently visualized in both the scans. The posterior fossa and profile views were more difficult to obtain in the TVUS.

Conclusions: The first trimester TVUS detects many of the structures assessed during an anatomic survey; however, it is not superior to the second trimester TAU in normal weight and obese patients.     

腹腔镜结合阴道超声诊治子宫外异位妊娠116例分析

目的:探讨腹腔镜结合阴道超声诊治子宫外异位妊娠的价值。方法:回顾性分析2006～2010年吉林大学第一医院妇产科腹腔镜手术治疗子宫外异位妊娠116例患者的临床资料。结果 :116例患者均诊断明确,行输卵管切除术108例,保留输卵手术管3例,卵巢部分切除及修补术4例,膀胱壁病灶切除1例。平均手术时间为56.97 min,术后平均住院日3.99天,无并发症及持续性异位妊娠发生。结论:腹腔镜结合阴道超声诊治子宫外异位妊娠准确、可靠,有利于早期异位妊娠的诊断。     

经阴道彩色多普勒超声对卵巢癌的诊断价值

目的探讨经阴道彩色多普勒超声检查对卵巢癌的诊断价值。方法对86例拟诊为卵巢癌的患者行经阴道及经腹部彩色多普勒超声检查,并同术后病理进行对照,比较两种检查方法对卵巢癌诊断的特异性、敏感性、阳性预测值及阴性预测值。结果经阴道彩色多普勒超声对卵巢癌的诊断阳性预测值、阴性预测值高于经腹部超声,敏感性高于经腹部超声,两种检查方法的特异性无显著差异。结论彩色多普勒超声检测卵巢癌具有较高的准确率,对于卵巢癌临床的初步定性诊断具有较高的价值。     

不同类型药物流产不全患者经阴道彩色多普勒超声特征分析

目的:探讨经阴道彩色多普勒超声在药物流产后出血原因鉴别中的应用价值。方法:选择100例药物流产不全患者,均接受经阴道彩色多普勒超声检查,观察子宫大小、残留物形状、宫腔内残留物周边及内部血流情况,同时检测其血流阻力指数RI。所有患者均接受清宫治疗并对残留物进行病理活检,根据活检结果分为绒毛膜蜕膜组与非绒毛膜蜕膜组,回顾性分析两组彩色多普勒超声表现的差异。结果:绒毛膜蜕膜组子宫增大例数明显多于非绒毛膜蜕膜组(P0.05);绒毛膜蜕膜组宫腔内残留物形状以团块状为主,而非绒毛膜蜕膜组以片状为主,两组比较具有统计学差异(P0.01);绒毛膜蜕膜组宫腔内残留物周边及内部血流丰富例数明显多于对照组(P0.01);绒毛膜蜕膜组宫腔内残留物血流阻力指数RI小于非绒毛膜蜕膜组(P0.05)。结论:采用经阴道彩色多普勒超声能有效的鉴别药物流产后出血的原因,为临床治疗提供依据。     

Transvaginal ultrasound for diagnosis of deeply infiltrating endometriosis

Deeply infiltrating endometriosis is the clinical form of the disease that is generally associated with conditions of more intense pain and may require more complex surgical management, consequently resulting in greater risks to the patient. In recent years, various investigators have confirmed the usefulness of methods such as magnetic resonance imaging (MRI), transrectal ultrasound and transvaginal ultrasound (TVUS) for the diagnosis of deep endometriotic lesions. The objectives of the present study are to describe the method used to perform TVUS for the detection of deeply infiltrating endometriosis, and to discuss the clinical benefits that the data obtained may offer clinicians providing care for patients suspected of having this type of endometriosis.