经腹及阴道超声联合扫查对子宫腺肌病的诊断价值

目的 探讨经腹及阴道超声联合扫查在子宫腺肌病中的诊断价值。方法 216例子宫腺肌病患者均行TAS或TAS＋TVS检查,将超声结论与手术及病理诊断进行对照分析。结果超声诊断与病理诊断对照,TAS组超声诊断符合率为12．1％,明显低于TAS＋TVS组（72．1％）。结论 TVS＋TAS可提高子宫腺肌病的诊断准确率,联合扫查是一种重要的检测手段。     

阴道超声在子宫腺肌病诊断中的价值

目的评价阴道超声检查在子宫腺肌病诊断中的价值。方法对378例子宫腺肌病患者行阴道超声检查,并对比手术记录,病理检查结果。结果术前诊断子宫腺肌病378例,术后经手术及病理检查确诊369例,诊断符合率97.6%。结论经阴道超声检查诊断子宫腺肌病能明显提高检出率和诊断符合率。     

经腹及阴道超声对子宫腺肌病诊断的再认识

目的：探讨子宫腺肌病超声声像图特征及分型,分析及误诊原因。方法：回顾性分析经手术和病理证实的196例子宫腺肌病患者,并对其声像图进行综合分析。结果：（1）根据手术和病理分析,将子宫腺肌病病理形态学特征在声像图上的表现分为五型;（2）1999年1月至2001年1月超声诊断符合率62．4％,明显高于1991年1月至1998年12月的9．7％;（3）经腹及经阴道联合扫查组超声诊断符合率为72．9％,明显高于经腹扫查组的14．9％。结论：掌握子宫腺肌病的病理变化特点和声像图表现,提高对本病的认识,减少误诊率。     

经阴道与经腹超声对诊断子宫腺肌病的对比分析

目的:探讨超声诊断子宫腺肌病的价值。方法:对手术后病理证实的子宫腺肌病75例患者经腹或经阴道检查的诊断准确率进行对比分析。结果:经阴道超声检查符合率为80%,经腹超声检查诊断符合率为31%。结论:经阴道超声检查诊断子宫腺肌病的符合率明显高于经腹部超声检查。     

经阴道及经腹部超声诊断子宫腺肌病

目的：比较经阴道超声（TVS）及经腹部超声（TAS）对子宫腺肌病的诊断作用。方法：应用TVS及TAS诊断子宫腺肌病。结果：25例术前TVS结果与术后病理对照，超声诊断符合率88％，48例术前TAS结果与术后病理对照，超声诊断符合率33％（P＜0.001)。结论：TVS能够清晰显示子宫大小、形态、宫壁厚度、肌壁回声特点，其诊断准确率高于TAS。     

经腹及经阴道超声联合诊断子宫腺肌病

目的 总结子宫腺肌病经腹(TAS)及经阴道彩色多普勒超声(TVCS)的声像图特征.方法 对136例子宫腺肌病患者行TAS及TVCS检查,并将超声结果与病理结果对比.结果 子宫腺肌病声像图可分为弥漫型、局灶型、合并肌瘤型.与病理结果比较,经阴道超声诊断子宫腺肌病符合率94.1%,误诊率3.7%,漏诊率2.2%.结论 联合经腹及经阴道彩色多普勒超声检查,能显著提高子宫腺肌病的诊断率.     

经阴道彩色多普勒超声鉴别子宫腺肌瘤和子宫肌瘤

目的评价阴道彩色多普勒超声（TVCDS）对子宫腺肌瘤和子宫肌瘤的鉴别价值。方法对59例子宫腺肌瘤及171例子宫肌瘤的患者进行术前经腹超声和TVCDS检查，并与术后病理结果对比分析。结果超声诊断子宫肌腺瘤的符合率为93．2％。诊断子宫肌瘤的符合率为90％。结论经阴道彩色多普勒超声在诊断和鉴别子宫隙肌瘤及子宫肌瘤上具有重要价值。     

经阴道超声对子宫肌腺病的诊断价值探讨

目的　探讨经阴道超声检查在子宫肌腺病诊断中的应用价值。方法　 5 0例子宫肌腺病患者行经腹超声 (TAS)检查 ,2 3例行经阴道超声 (TVS)及彩色多普勒能量图 (CDE)检查 ,其中 5 0例加行血CA12 5检查。TAS及TVS两组对照并与手术及病理诊断对照分析。结果　TVS组与病理诊断符合 2 0例 ,TAS组与病理诊断符合 2 3例 ,两者敏感性分别为 86.9% ,46% ,特异性分别为 92 .9% ,95 .6%。 3 1例血CA12 5 >3 5IU/ml,占 63 %。结论　经阴道超声检查是诊断子宫肌腺病的主要依据之一 ,联合血CA12 5检查可提高子宫肌腺病的诊断率。彩色多普勒能量图的诊断价值有待进一步探讨。     

彩色多普勒超声对子宫腺肌病的诊断价值

目的:探讨彩色多普勒超声对子宫腺肌病的诊断价值。方法:采用经阴道彩色多普勒超声(TVCDS)和经腹部彩色多普勒超声(TAS)检测有痛经等症状者63例。结果:超声诊断子宫腺肌病63例。合并盆腔内膜异位症者18例。手术治疗者42例,术后经病理证实者36例,诊断符合率85.7%(36/42)。TVCDS诊断符合率89.3%(25/28),TAS诊断符合率71.4%(10/14)。结论:彩色多普勒超声检查是目前诊断子宫腺肌病的主要方法之一,其具有无创及可重复性强的特点,可作为子宫腺肌病诊断和疗效评估的常规检查项目。TVCDS及TAS联合应用可提高子宫腺肌病的超声诊断符合率。     

经阴道彩超对子宫腺肌病的分型诊断

目的：探讨经阴道彩色多普勒超声对子宫腺肌病的分型诊断价值。方法：本组342例子宫腺肌病超声诊断结果均与手术病理对照。结果：超声诊断符合率94％；声像图常见类型：弥漫型87例，占25％；局限型255例，占75％(其中前壁型39例，后壁型167例；腺肌瘤型46例；宫颈型3例)。结论：经阴道彩超的分型诊断有利于对子宫腺肌病超声特征的重新识别，提高诊断率。     

经阴道超声对宫外孕早期诊断的价值

目的应用经阴道超声检查,诊断宫外孕,评估经阴道超声对宫外孕的早期诊断价值。方法５７例我院住院病人,均经手术病理证实。所有病例均先经腹部超声观察,再经阴道超声检查。结果５７例患,超声诊断为宫外孕５１例,超声诊断符合率为９１％。根据病程的不同时期声像图表现为４种不同类型。结论经阴道超声对宫外孕早期诊断有较高价值,是早期宫外孕简单、有效的首选检查方法。     

Transvaginal sonography in the diagnosis of adenomyosis: which findings are most accurate?

OBJECTIVES: To evaluate the accuracy of various transvaginal sonographic findings in adenomyosis by comparing them with histopathological results and to determine the most valuable sonographic feature in the diagnosis of adenomyosis. METHODS: In this prospective study, 70 consecutive patients scheduled for hysterectomy underwent preoperative transvaginal sonography. If at least one of the following sonographic features was present, a diagnosis of adenomyosis was made: heterogeneous myometrial echotexture, globular-appearing uterus, asymmetrical thickness of the anteroposterior wall of the myometrium, subendometrial myometrial cysts, subendometrial echogenic linear striations or poor definition of the endometrial-myometrial junction. The sonographic features were compared with the histopathological results. RESULTS: The prevalence of adenomyosis was 37.1% (26/70 patients). The sensitivity, specificity, positive (PPV) and negative (NPV) predictive values and accuracy of transvaginal ultrasound for the diagnosis of adenomyosis were 80.8%, 61.4%, 55.3%, 84.4% and 68.6%, respectively. We found that a regularly enlarged uterus with a globular appearance, subendometrial echogenic linear striations and myometrial cysts had the highest accuracy for the diagnosis of adenomyosis. Of all findings evaluated, heterogeneous myometrium was the most common in patients with adenomyosis (21/26 patients), but it had a poor specificity. The presence of subendometrial linear striations was the most specific sonographic feature (95.5%) and it had the highest PPV (80.0%) for the diagnosis of adenomyosis. CONCLUSIONS: The presence of subendometrial echogenic linear striations, a globular configuration and myometrial cysts on transvaginal ultrasound supports the diagnosis of adenomyosis. Among the transvaginal ultrasound diagnostic findings of adenomyosis, subendometrial linear striations have the highest diagnostic accuracy.     

经阴道彩色多普勒超声对输卵管妊娠及妊娠黄体的鉴别诊断

目的探讨阴道彩色多普勒超声对输卵管妊娠及妊娠黄体的鉴别诊断价值。方法分析46例输卵管妊娠及妊娠黄体的阴道彩色多普勒超声图像特点。结果 46例患者术前均行阴道彩色多普勒超声检查提示为输卵管妊娠,其中44例与手术及病理组织学符合,阴道彩色多普勒超声与病理组织学符合率为95.65%;2例术前阴道彩色多普勒超声诊断输卵管妊娠,手术中证实为妊娠黄体,1周后确诊为宫内妊娠。结论经阴道彩色多普勒超声检查对输卵管妊娠与妊娠黄体的鉴别诊断具有重要的临床应用价值。     

经腹部超声联合经阴道超声诊断血管前置的临床价值

目的探讨经腹部超声联合经阴道超声在产前诊断血管前置中的临床价值。 方法回顾性分析2018年1月至2019年12月在首都医科大学附属北京妇产医院因临床疑诊血管前置而行剖宫产手术的病例54例。以术后胎盘检查结果为"金标准"，对产前经腹部超声联合经阴道超声的检查结果进行分析，应用四格表计算得出其诊断血管前置的敏感度、特异度、阳性预测值、阴性预测值和准确性。 结果54例患者中，经腹部超声联合经阴道超声诊断血管前置47例，其中误诊3例，漏诊2例；5例因临床出血疑似诊断而手术，联合超声及术后证实均无血管前置。经腹部超声联合经阴道超声诊断血管前置的敏感度、特异度、阳性预测值、阴性预测值和准确性分别为95.7%（44/46）、62.5%（5/8）、93.6%（44/47）、71.4%（5/7）和90.1%（49/54）。 结论经腹部超声联合经阴道超声可为产前诊断血管前置提供更多的诊断信息和依据，减少干扰因素，具有良好的诊断效能，值得临床推广应用。     

Transvaginal ultrasound guided biopsies in the diagnosis of pelvic lesions

Uterine arterial embolisation in the management of fibroids can only be carried out if the preoperative diagnosis has been made accurately. It is particularly important to exclude adenomyosis or malignancies. In medicine the gold standard is a histological diagnosis. We have used transvaginal ultrasound guided gun biopsy of the uterus or ovaries in the office setting, in order to obtain a tissue sample for histological conformation of the preliminary ultrasound findings. Twenty two patients scheduled to undergo uterine arterial embolisation with an equivocal ultrasound diagnosis were biopsied. In eight (36.4%) patients the preliminary ultrasound diagnosis of adenomyosis was confirmed histologically, and in nine (40.9%) patients the ultrasound diagnosis of leiomyoma was confirmed histologically. In two patients the ultrasound diagnosis of a benign ovarian mass was confirmed histologically. In the remaining three (13.6%) patients, the preliminary ultrasound diagnosis was incorrect. One patient was thought to have a leiomyoma where the histology was of a benign adenomatoid tumor, another patient was thought to have a sarcoma where the histology was of a leiomyoma, and one patient thought to have adenomyosis was shown to have a normal myometrium. There were no procedure related complications. This simple office based technique is safe, and effective.     

经腹部超声联合经阴道超声检查诊断妇产科急腹症

目的：探讨经腹部超声联合经阴道超声检查在妇产科急腹症诊断中的价值。方法：选择2013年1月～2016年6月经本院临床及病理确诊的妇产科急腹症患者110例为对象,所有患者均采用经腹部超声联合经阴道超声检查,比较超声检查诊断结果与临床病理诊断结果的符合率,并分析各类急腹症的超声影像表现。结果：经腹部超声联合经阴道超声检查诊断妇产科急腹症的符合率97.27%(107/110),与临床病理结果比较差异无统计学意义(P＞0.05);诊断异位妊娠的符合率96.77%(30/31),诊断宫内孕流产的符合率94.44%(17/18),诊断卵巢囊肿破裂的符合率93.33%(14/15),诊断急性盆腔炎、卵巢肿瘤蒂扭转、子宫内膜异位症、胎盘早剥的符合率均为100%(23/23、10/10、8/8、5/5),与临床病理结果比较差异无统计学意义(P＞0.05)。结论：经腹部超声联合经阴道超声检查在诊断妇产科急腹症中,与临床病理结果的符合率高,是一种可行的方案。     

子宫肌瘤B超漏、误诊原因分析

目的 探讨子宫肌瘤B超漏、误诊的原因。方法 回顾性分析676例疑为“子宫肌瘤”而手术患者的术前超声诊断，并与病理结果对照。结果 超声检出子宫肌瘤648例，检出率95.9%(648/676)；术后病理确诊为子宫肌瘤650例；超声诊断与病理符合533例；漏误诊143例。漏误诊率21.2%(143/676)。肌瘤误诊为其它疾病89例，其它疾病误诊为肌瘤26例，漏诊28全郇常见的误诊是子宫腺肌症，其次是附件，内膜疾病等。结论 造成子宫肌瘤漏误诊原因是部分子宫肌瘤声像图无特异性及未重视病史等。     

Intrauterine cystic adenomyosis:Report of two cases

BACKGROUND Cystic adenomyosis is a special type of adenomyosis. Its clinical manifestations lack specificity. Pelvic ultrasound and nuclear magnetic resonance imaging can help clarify the diagnosis. Because cystic uterine adenomyosis is rare in clinical work, it can be easily misdiagnosed or its diagnosis can be missed. Early surgical treatment and postoperative drug treatment can alleviate dysmenorrhea,menorrhagia, anemia, and other symptoms.CASE SUMMARY Two cases complained about abnormal vaginal bleeding and were diagnosed with intrauterine cystic adenomyosis by gynecological ultrasound and pathological examination. The clinical manifestations included dysmenorrhea,hypermenorrhea, and a history of cesarean section. Both cases underwent a surgery, and chocolate-like liquid was released from the cystic mass in the uterus and the manifestations were relieved.CONCLUSION Intrauterine cystic adenomyosis could be diagnosed by pathological examination and treated by hysterectomy or hystscopy to release the liquid inside.     

子宫内膜癌经阴道超声表现与肌层浸润深度的相关性研究

目的探讨子宫内膜癌经阴道超声表现与病理诊断肌层浸润深度的相关性。方法46例子宫内膜癌术前均经阴道超声观测子宫三径之和、宫内膜厚度、彩色血流分布特点及血流阻力指数。根据病理检查肌层浸润深度分为Ⅰa期9例,Ib期22例,IC期15例。结果子宫三径之和为12．9～27．4cm,宫内膜厚度为4．7～65．0mm,在Ⅰa期、Ⅰb期、Ⅰc期的子宫三径之和、宫内膜厚度逐渐增大,差异有统计学意义（P〈0．05）。37例探及血流信号,血流显示率80．4％;Ⅰa、Ⅰb期、Ⅰc期血流显示率逐渐增大,差异有统计学意义（P〈0．05）。肌层浸润越深,阻力指数越低,各期比较无统计学差异（P〉0．05）。结论子宫内膜癌经阴道超声表现与病理诊断肌层浸润深度相关,经阴道超声检查可作为子宫内膜癌的术前检查方法。