经阴道二维、三维超声对异位妊娠的诊断价值

目的探讨经阴道二维、三维超声在诊断异位妊娠中的价值。方法对49例经腹二维超声检查后疑有异位妊娠患者进行阴道二维、三维超声成像,并与其宫腔镜、手术病理结果对比分析。结果 49例患者三维成像均获得了满意的冠状切面图像,输卵管妊娠42例,其中诊断宫角妊娠5例,肌壁间妊娠1例,误诊1例肌壁间妊娠(误为宫内正常早孕);二维超声诊断输卵管妊娠42例,宫角妊娠2例,误诊5例:3例宫角妊娠误诊为输卵管间质部妊娠、2例肌壁间妊娠均误诊为宫内早孕。超声诊断结果与病理结果和宫腔镜比较,三维超声准确率为97.9%,二维超声为89.7%,二者比较差异有统计学意义(P<0.05)。结论三维超声对异位妊娠的特异性和敏感性均优于二维超声,有非常好的临床应用价值。     

实时超声对非赘生性卵巢囊肿的诊断价值

目的探讨二维超声、彩色多普勒超声(CDFI)及经阴道彩超(TVCD)对非赘生性卵巢囊肿的诊断价值，确定其声像图诊断要点，以提高诊断的准确性。方法545例非赘生性囊肿均经治疗后随访、经阴道超声引导下穿刺及手术病理证实，491例与B超诊断结果相符合(90．09％)。结果超声诊断卵泡囊肿174例、黄体囊肿94例、黄素囊肿58例、巧克力囊肿126例、多囊卵巢综合征39例，误诊54例。误诊54例中畸胎瘤24例，包块型官外孕13例，炎性包块17例。超声诊断符合率90．09％，误诊率9．91％。结论二维超声、CDFI及TVCD对非赘生性卵巢囊肿的诊断和鉴别诊断，具有一定的临床价值。     

输卵管系膜囊肿8例多层螺旋CT分析

目的:探讨多层螺旋CT对输卵管系膜囊肿的诊断价值。方法:分析经手术病理证实的8例输卵管系膜囊肿的CT表现。结果:8例在CT检查前均经B超提示为盆腔囊性占位,CT检查示:5例表现为单房囊性肿块影,3例表现为多房性肿块、内有间隔,增强后5例囊壁轻度强化、囊内无强化,3例囊内间隔及囊壁有轻度强化。结论:多层螺旋CT诊断输卵管系膜囊肿具有重要价值,结合超声表现,可提高其诊断准确性。     

经阴道二维联合三维超声对剖宫产后子宫瘢痕妊娠的诊断价值

目的研究经阴道二维联合三维超声对剖宫产术后子宫瘢痕妊娠(CSP)的诊断价值。方法选取手术治疗的CSP患者60例,术前进行超声检查时随机分为二维组、二维及三维组,观察瘢痕妊娠的二维声像图表现、血流供应特点及三维成像特征,并与术后结果相对照,比较两组间的诊断准确率。结果经手术病理证实,经阴道二维组30例患者Ⅰ型9例,Ⅱ型10例,Ⅲ型4例,诊断符合率为76.67%。经阴道二维及三维组30例患者Ⅰ型9例,Ⅱ型14例,Ⅲ型5例,诊断符合率为93.33%,两组诊断符合率差异具有统计学意义(P0.05)。结论三维超声能更直观、立体的显示妊娠囊的位置、形态,经阴道二维联合三维超声能显著提高CSP的诊断准确率,为临床早诊断早治疗提供切实有效的诊断方法。     

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。     

经阴道超声在输卵管间质部妊娠中的应用

目的:分析经阴道超声在输卵管间质部妊娠中的应用效果。方法:回顾分析我院2017年2月至2019年4月期间收治的输卵管间质部妊娠患者62例,各患者均接受经阴道二维超声和三维超声检查,并将检查结果与手术病理检查或妊娠结局进行比较分析,以明确经阴道超声检查输卵管间质部妊娠的效果。结果:62例患者接受二维、三维阴道超声检查后,孕囊与宫腔相通率为12.90%(8/62),孕囊附近肌层包绕厚度为(2.12±0.85)mm,RI为(0.45±0.10),EDV为(0.27±0.08)m/s,PSV为(0.46±0.17)m/s。比较确诊率,阴道三维超声检查确诊率93.55%高于阴道二维超声检查率66.13%,数据差异有统计学意义(P<0.05)。结论:临床诊断输卵管间质部妊娠时,采用经阴道三维超声方式,此方式可提供更多妊娠囊、宫腔形态的声学信息,诊断准确性更高。     

经阴道三维超声与二维超声检查在育龄妇女的宫腔病变诊断中的价值研究

目的:探究在育龄妇女的宫腔病变诊断中采用经阴道三维超声检查与经阴道二维超声检查的价值,并对其进行分析与探讨。方法:选取2020年2月至2021年2月于我院妇科就诊的宫腔病变的育龄妇女63例作为研究对象,在患者入院后先后分别对其进行经阴道二维超声检查、经阴道三维超声检查以及宫腔镜检查。以宫腔镜检查结果作为金标准,对比经阴道三维超声检查与经阴道二维超声检查的诊断准确率以及诊断分型准确率。结果:本次收治的63例宫腔病变的育龄妇女,经阴道三维超声检查的诊断准确率为93.65%,经阴道二维超声检查的诊断准确率为76.19%,诊断准确率差异具有统计学意义,P<0.05;经阴道三维超声检查的分型诊断率高于经阴道二维超声检查的分型诊断率,分型诊断率差异无统计学意义,P>0.05。结论:经阴道三维超声检查在育龄妇女的宫腔病变诊断价值高于经阴道二维超声检查。     

经阴道三维超声成像在子宫内膜息肉诊断中的应用价值分析

目的观察经阴道三维超声成像在子宫内膜息肉诊断中的应用价值。方法回顾性分析收治的140例初诊子宫内膜息肉样病变患者的临床资料,均接受经阴道二维及三维超声检查,观察二维超声与三维超声的检出率,并与病理诊断结果进行比较。结果经阴道三维超声检查对子宫内膜息肉检出灵敏度及准确率均高于二维超声检查,差异有统计学意义(P0.05)。结论经阴道三维成像在子宫内膜息肉诊断中较二维超声更具应用价值,具有更高的诊断灵敏度及准确率。     

经阴道子宫输卵管四维超声诊断输卵管通畅性

目的探讨经阴道子宫输卵管四维超声诊断输卵管通畅性的临床价值。方法随机选取2016年5月至2017年12月临床资料完整的不孕症女性患者208例,均经输卵管造影确诊,且符合卵泡不成熟性不育的诊断标准。208例中经腹部多普勒超声检查63例,经阴道子宫输卵管四维超声检查78例,经腹与经阴道超声联合检查67例。回顾性分析208例不孕患者的临床资料,比较经腹与经阴道超声诊断准确率及不良反应。结果腹部超声诊断准确率为92. 06%(58/63),阴道子宫输卵管四维超声准确率为97. 44%(76/78),经腹与经阴道超声联合准确率为98. 51%(66/67),超声联合与腹部超声诊断准确率比较,差异有统计学意义(P <0. 05)。腹部超声正确诊断58例中,发现不良反应15例(25. 86%);经阴道超声正确诊断76例中,发生不良反应21例(27. 63%),两组轻度、中重度不良反应比较,差异未见统计学意义(P>0. 05)。结论经阴道子宫输卵管四维超声能立体显示输卵管走行方向和扭曲程度,其不良反应与腹部超声比较未见明显增加,可依据患者病情联合应用经腹和经阴道超声诊断女性早期不孕症,以提高诊断准确性,减少漏诊和误诊。     

360°腔内三维超声在阴道周围囊性病变诊断中的价值

目的：探讨经阴道360°腔内三维超声在阴道周围囊性病变中的应用价值。方法：常规经阴道超声检查发现阴道周围囊性病变42例,先利用二维超声观察阴道周围囊性病变大小、位置及与阴道、尿道和直肠的关系,再利用经阴道360°腔内三维超声获取矢状切面、横切面、冠状切面、任意切面图像,不同视角观察阴道周围囊性病变的空间关系,从而进行定位诊断。结果：常规经阴道超声检查发现阴道周围囊性病变42例,经手术病理、尿道镜、肾盂输尿管造影证实阴道壁囊肿21例、尿道旁腺囊肿13例、尿道憩室3例、先天性输尿管异位开口2例、骶尾部囊性畸胎瘤3例。经阴道360°腔内三维超声检查诊断符合率为95.23%(40/42),经阴道常规二维超声检查诊断符合率为71.42%(30/42),经阴道360°腔内三维超声检查与经阴道常规二维超声检查诊断符合率比较,差异具有统计学意义（P<0.05）。结论：经阴道360°腔内三维超声是准确、方便、快捷诊断阴道周围囊性病变的影像学手段,具有重要的应用价值。     

宫内节育器位置异常的三维超声诊断

目的 探讨三维超声诊断宫内节育器（IUD）位置异常的准确性及应用价值。方法 54例二维超声诊断或可疑IUD异常的患者，均用Voluson530D彩色多普勒三维超声经阴道重新成像分析。结果 二维超声诊断符合率为61.11%。结合二维超声，三维超声诊断符合率可提高至100%。结论 三维超声可显示宫腔及IUD的全貌，对IUD位置判断明确，对临床异常IUD的处理有很大的帮助。     

三维超声成像在产前诊断中的初步临床应用研究

目的：评估三维超声在产前诊断及评价胎儿畸形中的应用价值。方法：对46例中晚期娠的高危发行二维及三维超声检查,并对照其检查结果：结果：在35例正常胎儿中,三维超声可提供更多的诊断信息,排除了畸形的存在,在11例异常胎儿中,有6例（54％）3DUS可对诊断提供帮助。结论：3DUS可对胎儿畸形的诊断提供帮助,可作为二维超声的补充在产前诊断中发挥重要的作用。     

经直肠三维高频超声诊断前列腺癌

目的：探讨经直肠三维高频超声城像对前列腺癌的诊断价值。方法：应用Combison^R530三维超声成像仪（7.5MHz经直肠探头）检测46例前列腺癌,对其声像图表现进行回顾性分析。结果：前列腺癌在超声声像图上可表现为单纯结节型,结节浸润型及弥漫浸润型三种改变。三维超声新技术通过多平面观察,可获得比二维超声更多的诊断信息,提高了前列腺癌的超声诊断率（尤其对后二型病变）,本组诊断符合率为82.6％,且更容易观察前列腺病灶与包膜及邻近结构之间的空间位置关系,有助于对肿瘤进行分期。结论：经直肠三维超声为操作者提供了更丰富的诊断信息,明显提高了前列腺癌的超声诊断率。     

超声检查在腮腺肿块诊断中的应用价值

目的探讨超声检查在腮腺肿块诊断中的应用价值。方法应用高频超声对40例腮腺肿块进行二维及彩超检查，并与cT检查对比，全部病例均经手术病理证实。结果超声对病灶的检出率为100％，对腮腺良性肿瘤的诊断符合率为88．4％，恶性肿块为71．4％。结论二维及彩超对腮腺肿块的诊断及良恶性鉴别有重要诊断价值，与CT比较无差异。     

产前二维及三维超声诊断胎儿畸形的对比研究

目的：通过比较二维及三维超声对胎儿畸形的检出率,评价其在产前断中的优劣。方法：二维及三维超声检查65例,比较、并评估两者提供的诊断信息有无差别。结果：三维超声胎儿畸形检出率（90.7%）明显优于二维超声（73.8%）尤其是在胎儿颅面部及体表畸形中,三维超声可提供更多诊断信息。结论：三维超声在产前胎儿畸形的诊断中有广泛的应用前景。     

Evaluation of the Accuracy of 3‐Dimensional Ultrasonography of the Kidney Using an In Vitro Renal Model

Objective. Three‐dimensional ultrasonography (3DUS) has recently become a reality because of advances in ultrasound probes and machine processing ability. We have developed an anthropomorphic phantom of the human loin to assess both the accuracy of 3DUS of the kidney and its potential usefulness for training in ultrasonographically guided percutaneous renal intervention. Methods. The model was built with easily available and inexpensive materials such as agar and latex with known ultrasonographic properties. The accuracy of 2‐dimensional ultrasonography (2DUS) and 3DUS was assessed by measuring the dimensions of the pelvicalyceal system (PCS) ultrasonographically (pelvis width and calyx diameters) and then comparing these with measurements obtained at the time of construction. Radiology interventional trainees then punctured the PCS with 2DUS and 4‐dimensional ultrasonographic (real‐time/time‐resolved 3DUS) guidance and reported the phantom's performance. Results. The 3‐dimensional nature of the model's PCS could be clearly visualized on 2DUS and 3DUS, and the scan characteristics were very similar to those in real life. Measurements using 3DUS proved to be closer to the true dimensions of the model's PCS than those using 2DUS. The mean error percentage for 2DUS measurements was ?10.2%, and that for 3DUS was ?2.2% (P < 0.0001). Interventional trainees were satisfied with the “tissue feel” and level of difficulty posed on puncturing the phantom. Conclusions. Three‐dimensional ultrasonography proved to be more accurate than 2DUS for intrarenal measurements using this in vitro renal model. Three‐dimensional ultrasonography has the potential to ease diagnostic renal scanning with the ability to further scrutinize and postprocess the scanned volumes. The model was realistic in its anthropomorphic properties and simulated human tissue during puncture.     

Assessment of portal vein invasion in pancreatic cancer by fusion 3-dimensional ultrasonography.

OBJECTIVE: The purpose of this study was to assess the usefulness of a newly developed imaging technique, fusion 3-dimensional ultrasonography (3DUS) in the diagnosis of portal vein (PV) invasion in patients with pancreatic cancer (PC). METHODS: Fourteen patients with proven PC were examined by fusion 3DUS presented as shaded volume-rendering and multiplanar reconstruction images. The surgical findings were obtained in all patients (12 with resection and 2 without). The findings were compared with those of 2-dimensional ultrasonography (2DUS), contrast-enhanced computed tomography (CT), dynamic CT (DCT), angiography, and surgical findings. Portal vein invasion was assessed by 3 independent radiologists for each modality, and objectivity of the assessment was examined by interobserver variability analysis (kappa value). RESULTS: On the basis of surgical findings, the accuracy rates of 2DUS, fusion 3DUS, DCT, and angiography were 78.6%, 92.9%, 85.3%, and 66.7%, respectively. The kappa values of 2DUS, fusion 3DUS, DCT, and angiography for PV invasion were 0.57, 0.90, 0.63, and 0.49, respectively, being most objective in fusion 3DUS. CONCLUSIONS: Fusion 3DUS is useful for diagnosis of PV invasion of PC.     

Transvaginal ultrasonography with and without saline infusion in assessment of myometrial invasion of endometrial cancer.

OBJECTIVE: The purpose of this study was to determine the diagnostic accuracy of saline infusion ultrasonography (SIUS) compared with transvaginal ultrasonography (TVUS) in the assessment of myometrial invasion of endometrial cancer. METHODS: A total of 53 patients with endometrial cancer were examined preoperatively with TVUS and SIUS with respect to myometrial invasion. All patients were postmenopausal. Ultrasonographic findings were compared with histopathologic findings of the surgical specimens. RESULTS: The median age of the patients +/- SD was 64 +/- 7 years (range, 51-77 years). In all patients, the procedure was well tolerated. The median thickness of malignant endometria was 17 +/- 9 mm (range, 2-51 mm). The specimens consisted of 40 endometrioid adenocarcinomas, 2 serous papillary carcinomas, 5 clear cell adenocarcinomas, 2 adenosquamous carcinomas, 3 mixed types, and 1 undifferentiated carcinoma. There were 18 grade G1, 24 G2, and 11 G3 cases. On histopathologic examination, superficial myometrial invasion (50% of the myometrium) was present in 28 (52.8%). For superficial myometrial invasion, evaluation by TVUS was accurate in 19 (76.0%) of 25 cases, and evaluation by SIUS was accurate in 18 (72.0%) of 25. For deep myometrial invasion, evaluation by TVUS was accurate in 24 (85.7%) of 28 cases, and evaluation by SIUS was accurate in 27 (96.4%) of 28. CONCLUSIONS: Transvaginal ultrasonography is a reliable method for assessing myometrial invasion of endometrial cancer. Saline infusion ultrasonography showed slightly better accuracy in the assessment of myometrial invasion than TVUS, but the differences were not statistically significant.     

Role of Doppler Ultrasonography in the Triage of Acute Scrotum in the Emergency Department

Objective. The purpose of this study was to examine the triage role of scrotal Doppler ultrasonography (DUS) as the primary preoperative diagnostic tool in patients presenting to the emergency department (ED) with acute scrotum. Methods. Patients who presented to the ED with acute scrotum and underwent scrotal DUS in the ultrasound unit over a 3‐year period (2004–2007) were included in the study. Patient characteristics, DUS findings, and clinical management were retrospectively collected and reviewed. Doppler ultrasonographic diagnoses were compared with histopathologic findings for patients who underwent exploration and with final diagnoses at the time of discharge for patients undergoing medical treatment. Results. A total of 620 consecutive patients with 669 DUS examinations were included. The most common scrotal DUS diagnoses were epididymitis, hydrocele, varicocele, and orchitis. Scrotal trauma was present in 77 cases. Hospitalization followed the initial ED evaluation for 155 patients; 68 underwent surgery. Testicular torsion was ultrasonographically suspected in 20 patients and confirmed in 18. Scrotal malignancy was incidentally diagnosed in 13 patients and testicular hematoma in 8. Doppler ultrasonography for the diagnosis of testicular torsion had 94% sensitivity, 96% specificity, 95.5% accuracy, an 89.4% positive predictive value (PPV), and a 98% negative predictive value (NPV). Doppler ultrasonography for the diagnosis of testicular malignancy had 92% sensitivity, 95% specificity, 94% accuracy, a 78.5% PPV, and a 98% NPV. Conclusions. Scrotal DUS is a highly sensitive preoperative diagnostic tool, thereby validating its routine use in the initial triage of patients with acute scrotum presenting to the ED.     

颅外段椎动脉扭曲的三维透明成像特征及诊断价值

目的探讨三维透明成像(3DUS)对颅外段椎动脉扭曲的诊断价值,并阐述其超声特征。方法对145例患者290条椎动脉进行二维彩色多普勒检查和三维透明成像,并对椎动脉扭曲病例测量扭曲点与直行段血管内径与收缩期峰值血流速度(PSV)、速度时间积分(VTI)、舒张期血流速度(EDV)以及阻力指数(RI),分析比较椎动脉扭曲的二维彩色多普勒超声成像与三维透明成像诊断特征。结果三维透明成像对椎动脉扭曲的检出率(6%),明显高于二维彩色多普勒(2%)。椎动脉扭曲分为横突间扭曲和横突牵拉所致的扭曲。椎动脉扭曲呈多方向性。椎动脉扭曲好发部位于C3~C5段,以C4~C5为甚,占78%。统计分析显示椎动脉扭曲点与直行段比较,扭曲点PSV增高,内径减小,差异显著。3DUS诊断椎动脉扭曲优于二维彩色多普勒。结论三维透明成像能多方位显示椎动脉空间走行,有利于发现不同方向的椎动脉扭曲,提高椎动脉扭曲诊断的准确性,可成为诊断椎动脉扭曲的首选手段。