彩色多普勒超声对腹直肌鞘内子宫内膜异位症的诊断价值

目的 研究探讨剖宫产术后腹直肌鞘内子宫内膜异位症的彩色多普勒超声表现.方法 应用彩色多普勒超声对12例经手术和病理证实的腹直肌鞘内子宫内膜异位症的超声结果进行分析.结果 12例肿物均位于腹直肌鞘内,最大直径7.0～4.0 cm,无包膜,形态不规则,边缘不光滑,内部为低回声,部分呈无回声表现.彩色多普勒显示包块内部可见点状或条状血流信号,为低速高阻的动脉性血流频谱.结论 结合病史及临床表现,彩色多普勒超声是诊断腹直肌鞘内子宫内膜异位症的一种有价值的方法.     

彩色多普勒超声对剖宫产术后腹壁子宫内膜异位症的诊断价值

目的探讨剖宫产术后腹壁子宫内膜异位症(简称内膜异位症)的彩色多普勒超声表现。方法对8例经手术和病理证实的腹壁内膜异位症的彩色多普勒超声结果进行分析。结果8例肿物均位于皮下脂肪层,最大直径为1.6~3.7cm;形态不规则,边缘不光滑,常呈毛刺状侵及腹直肌前筋膜;内部呈不均匀的低回声,可见一个或数个小的液性暗区;彩色多普勒显示肿物内部均可见点状和/或条状血流信号,为低速高阻的动脉血流。结论与临床资料相结合,彩色多普勒超声是诊断腹壁内膜异位症的一种有价值的方法。     

腹壁子宫内膜异位症的彩色多普勒超声表现和诊断价值

目的：探讨腹壁子宫内膜异位症的彩色多普勒超声表现和临床价值。方法：对2003年1月~2010年8月我院23例经手术和病理证实的腹壁内膜异位症的彩色多普勒超声图像表现进行回顾性分析。结果：二维声像图表现为腹壁切口处探及边界欠清晰、形态不规则、内部不均质的低回声肿块,无包膜回声,边缘类似“伪足状”浸润。肿块有经前期增大,回声减弱;经期增大相对明显,回声呈不均匀增强或可见不规则小液性暗区;经期后缩小,回声略增强的特点。彩色多普勒表现为19例肿块内无明显血流信号,4例内部可见少许星点状血流信号,但周边均显示点状血流信号。脉冲多普勒可见动脉频谱,呈低速高阻型,但不易采集到连续、完整的理想频谱。结论：密切结合病史及临床表现,彩色多普勒超声能够对腹壁子宫内膜异位症作出明确诊断,从而对临床病灶的彻底清除具有重要的指导价值;而且具有诊断迅速、可靠、无创伤、操作简便、可重复性强等优势,因此彩色多普勒超声已成为临床首选的最佳检查方法。     

高频超声对腹壁切口子宫内膜异位症的诊断价值

目的探讨高频超声对腹壁切口子宫内膜异位症的诊断价值。方法对25例临床怀疑为腹壁切口子宫内膜异位症患者(剖宫产术后24例,附件巧克力囊肿切除术后1例)进行高频超声检查,并分析其声像图特征。结果 25例患者均经手术或穿刺活检病理证实为腹壁子宫内膜异位症。声像图表现为腹壁切口处探及边界不清、形态不规则、内部不均匀的低回声,彩色多普勒血流显像(CDFI)示21例包块周边见点状、条索状血流信号而内部无明显血流信号,2例包块周边见半环状血流信号而内部见少许星点状血流信号,2例包块内部及周边均未见明显血流信号;脉冲多普勒(PW)表现为低速高阻动脉频谱:峰速流值5.4～19.2 cm/s,阻力指数0.71～0.85。结论结合临床资料,高频超声诊断腹壁切口子宫内膜异位症准确率高,具有很重要的临床应用价值。     

彩色多普勒超声对腹壁瘢痕子宫内膜异位症的诊断价值

目的探讨腹壁瘢痕子宫内膜异位症的二维及彩色多普勒超声特征.方法对7例经手术及病理证实的腹壁瘢痕子宫内膜异位症的超声图像进行回顾性分析.结果腹壁瘢痕处探及边界不清、形态不规则、内部不均质的低回声肿块,彩色多普勒血流显示肿块周边部血流信号丰富,多普勒频谱表现为低速高阻的特点,PSV 6.5～19 cm/s,RI 0.71～0.85.结论彩色多普勒超声有助于对腹壁瘢痕子宫内膜异位症的诊断与鉴别诊断.     

高频超声对腹壁子宫内膜异位症的诊断价值

目的探讨高频超声对腹壁子宫内膜异位症诊断价值。方法经手术及病理确诊的腹壁子宫内膜异位症病人13例,术前行高频超声检查,对其声像图表现进行回顾性分析。结果 13例腹壁子宫内膜异位症病人高频超声声像图呈不均质低回声包块,边界尚清,形态不规则,无包膜,有的呈＂蟹足＂状向周围软组织及肌层浸润,内回声以低回声为主,可见小的不规则无回声区及稍强回声光斑。结论根据高频超声表现诊断腹壁子宫内膜异位症是可行的。     

超声对子宫内膜异位症的诊断价值

目的探讨超声与彩色多普勒血流显像CDFI对子宫内膜异位症的诊断价值。方法对108例经手术及病理证实的子宫内膜异位症的声像图进行回顾性分析。结果显示盆腔肿块者102例，腹壁切口处探及边界不清、形态不规则、无包膜、内部回声不均质的中低回声肿块4例，会阴侧切口处探及类似肿块1例，1例位于膀胱内不均质肿块。结论彩超对子宫内膜异位症进行诊断，具有重要的临床价值。     

腹壁子宫内膜异位症的超声诊断

目的探讨腹壁子宫内膜异位症声像图表现和临床价值。方法对12例手术和病理证实的腹壁子宫内膜异位症的声像图表现进行回顾性分析。结果8例肿块位于皮下脂肪层至筋膜层,4例侵及肌层,大小为1．4～3．2cm。形态不规则,边界欠清晰,未见包膜回声,内部呈不均匀低回声区,部分内见少量散在分布的液性无回声区,加彩后显示7例包块周边见点状、短棒状血流信号,5例未见血流信号。3例合并卵巢巧克力囊肿。结论结合病史及临床表现,超声检查有助于腹壁子宫内膜异位症的术前诊断,从而对术中病灶的彻底清除具有指导意义。     

超声对腹壁切口处及会阴部皮下子宫内膜异位症的诊断价值

目的探讨高频超声与彩色多普勒血流显像(CDFI)对腹壁切口处及会阴部侧切口处皮下子宫内膜异位症的诊断价值。方法对13例经手术、病理证实的腹壁切口处及会阴部侧切口处皮下子宫内膜异位症的声像图特征进行回顾性分析。结果腹壁切口处及会阴部侧切口处探及边界不清，形态不规则，无包膜，内部回声不均质的中低回声肿块，全部肿块内都见斑片状液性暗区间弱回声光点及条带状低回声区，CDFI显示肿块内有点状、短棒状和线状血流信号，脉冲多普勒(PW)表现为低速高阻的特点，Vs5．6～18cm／s，R10．66～0．82。结论高频超声结合CDFI和PW能对腹壁切口处及会阴部侧切口处皮下子宫内膜异位症进行诊断，具有重要的临床应用价值。     

腹壁子宫内膜异位症的超声特征分析

目的 回顾性分析腹壁子宫内膜异位症(AWE)的声像图特征和临床表现.方法 行腹壁肿物切除术且术后病理证实为AWE的105例患者共119个病灶为研究对象,分别评价每个病灶的声像图特征.将病灶按最大直径分为＜3 cm组和≥3 cm组,比较两组声像图特征的差异.结果 AWE的声像图特征为形态不规则的低回声,边界不清晰,内可有小的无回声区,周边可有强回声晕,彩色多普勒常表现为外周及内部少许血流信号.与≥3 cm组病灶相比,＜3 cm组病灶潜伏期较短,位置较浅,多位于皮下脂肪或浅肌层,病灶呈圆形或卵圆形,周边强回声晕,无或少许血流信号更为常见;≥3 cm组病灶则潜伏期较长,呈不规则形,位置较深,丰富血流信号更为常见.结论 使用高频灰阶及彩色多普勒超声,根据超声特征结合病史可对AWE作出定性诊断,并可判断病灶大小、范围及浸润深度,可为术前提供更多信息.     

Nodular endometriosis: dynamic MR imaging

Purpose In this study we aimed to investigate the value of contrast enhanced dynamic MR imaging (DMI) in the diagnosis of nodular abdominal endometriosis. Subjects and methods Fourteen patients with surgically and pathologically proven endometriosis were examined with DMI. The patients were 22–54 years old (mean age 30.8 years). The dynamic MR studies of these patients were retrospectively reviewed by two radiologists who were aware of the clinical data. Nodular masses showing enhancement were evaluated for size, margins, and signal intensity on T1- and T2-weighted MR sequences. The protocol was tailored to selectively determine the diagnostic utility of signal intensity time course analysis for the behavior of nodular endometriosis and endometrial tissue, in DMI. Contrast-enhanced DMI was performed and the time–intensity curves of the lesions and the uterine endometrial tissue of each patient were compared. Mean enhancement values were calculated. Each DMI was evaluated for signal intensity value. Results In 8 (57%) of 14 patients, we found endometriosis in the abdominal wall. All patients with abdominal wall endometriosis had pelvic surgical operation history. Diameter of nodular endometriosis determined in the abdominus muscle ranged between 3 and 40 mm. Of eight cases, five had only one lesion and three had multiple lesions. Remaining 6 (43%) cases had deep pelvic endometriosis located in the uterosacral ligaments (n = 3), rectosigmoid (n = 2), and rectovaginal septum (n = 1). Diameter of pelvic endometriosis ranged between 9 and 53 mm. Noncontrast mean signal intensity of endometriosis and endometrial tissue were 280 ± 73 and 216 ± 20, respectively. The mean values of both endometriosis and normal endometrial tissue were calculated for each patient examined with five-slice DMI. All of the curves showed significant correlation. The lesion showed significant enhancement in the course of time similar to the endometrial tissue in all patients. Conclusion Our study was inspired from the fact that endometriosis is the ectopic endometrial tissue and we thought that endometrial tissue and endometriomas should have similar vascularity. In this way imaging with MR, getting the time–intensity curves and experiencing the correlation between the endometriosis and endometrial tissue may support the diagnosis in the cases with suspected endometriosis. This first study shows that the ectopic nodular endometriosis can easily be identified with dynamic MRI. It may be used to differentiate nodular endometriosis from the other pathologic conditions of abdominal wall and pelvis.     

腹膜腔囊性病灶的CT诊断及临床意义

目的探讨腹膜腔囊性病灶的CT诊断及应用价值。方法对照分析20例腹膜腔囊性病灶的CT表现和手术、病理结果。结果3例腹膜腔单纯性浆液或黏液性的囊肿,CT均表现为边界清晰的囊性包块,4例囊腺瘤或囊腺癌可见增厚的囊壁和结节,3例肠系膜上的囊性肿瘤呈蔓藤飘浮状。3例腹膜腔假性黏液瘤在肝脏前、后间隙和结肠下间隙见多个有分隔状囊性肿块。2例腹膜腔囊性间皮瘤局限于下腹腔,壁稍厚,有强化。5例腹膜腔血肿均有外伤史,表现为上腹部器管间隙内边缘清晰的囊性包块。结论CT能清晰地显示腹膜腔囊性病灶的部位、形态、范围,对临床诊断和治疗有重要价值。     

Abdominal wall endometriosis: differentiation from other masses using CT features

Abdominal Radiology - To assess the utility of morphologic and quantitative CT features in differentiating abdominal wall endometriosis (AWE) from other masses of the abdominal wall. Retrospective...     

Endorectal color and duplex imaging of the normal rectal wall and rectal masses.

This study investigates the ability of endorectal ultrasonography aided by color flow and pulse wave Doppler techniques to identify submucosal arterial plexuses of the normal rectal wall and to detect vessels supplying rectal wall masses. Color flow and pulsed wave Doppler analysis of 62 normal submucosal arterial plexuses and vessels feeding rectal wall masses (one rectal endometriosis and seven rectal cancers) was performed. The color signals from normal submucosal arterial plexuses and the one case of rectal endometriosis were judged to be sparse or decreased in comparison to color signals from rectal cancers. The median and mean P1 values for normal submucosal arterial plexuses were significantly greater than those for the central feeding vessels or small peripheral vessels within rectal masses. Our experience with color and duplex endorectal ultrasonography suggests that different vascular structures exist in normal persons compared to those in rectal wall masses. Pathologically, rectal cancers possess vessels with and without a smooth muscle layer, which may produce the high and low resistance signals identified by pulse Doppler.     

卵泡膜细胞瘤的超声诊断

复习２６例卵泡膜瘤的临床及声像图表现，临床症状为腹部包块８０．７％，腹水６１．５％，腹痛、腹胀４２．３％，阴道不规则出血１１．５％，腹水合并右侧胸水３．８％。阴道不规则出血多发生在绝经期后。声像图呈实性肿物占６１．５％，囊、实性肿物占３８．５％。实性肿物中有１５．４％由于胶原纤维成分多，有坚实的包膜，从而表现为肿物前部呈强回声带，后方明显衰减，以至后壁不能显示，为较具有特征性的声像图表现。卵泡膜细     

剖宫产术后腹壁切口子宫内膜异位症20例临床分析

目的：探讨剖宫产术后腹壁切口子宫内膜异位症临床表现、治疗方法及预防。方法：对2006年3月—2011年8月收治的20例剖宫产术后腹壁切口子宫内膜异位症的患者的临床资料进行回顾性分析。结果：20例子宫内膜异位症患者均经手术治疗,术后随访1年均未复发。结论：剖宫产术是子宫内膜异位症最主要的医源性因素,手术时应用纱布垫保护子宫周围术野,缝合子宫壁时避免缝针穿过子宫内膜层,关腹后冲洗腹壁切口,降低剖宫产术后腹壁切口子宫内膜异位症的发生率。     

剖宫产术后腹壁切口子宫内膜异位症的超声诊断

目的总结分析剖宫产术后腹壁切口内子宫内膜异位症的声像图特征,提高对该病的认识和诊断准确性。方法对16例经手术和病理诊断证实的剖宫产术后腹壁切口内子宫内膜异位症的声像图进行回顾性分析,总结出其声像图特征,进行诊断和鉴别诊断。结果剖宫产术后腹壁切口内子宫内膜异位症声像图表现为腹壁皮下脂肪层或肌肉层内实性不均质、不规则、低回声、无明显包膜包块。有剖宫产史及明显的周期性下腹疼痛。结论根据声像图特征,再密切结合典型临床表现,剖宫产术后腹壁切口子宫内膜异位症可以得到正确诊断。     

腹壁瘢痕子宫内膜异位症的超声诊断

目的探讨腹壁瘢痕子宫内膜异位症的声像图特征。方法对12例经手术病理证实的腹壁瘢痕子宫内膜异位症的超声图像进行回顾性分析。结果12例腹壁子宫内膜异位症均探及具有周期性变化的边界不清、形态不规则、回声不均匀的包块。结论超声有助于诊断和鉴别诊断腹壁子宫内膜异位症。     

高频超声在腹外疝类型鉴别中的应用

目的探讨高频超声在腹外疝类型鉴别中的价值；方法用高频超声探测站立住至仰卧位时腹股沟肿块情况，了解肿块的形态、走行情况以及与腹股沟管或腹股沟韧带的关系、体位改变时的变化及腹壁下动脉的位置结果高频超声诊断腹外疝69例；均经手术证实，其中52例为斜疝，15例直疝，2例股疝结论高频超声能明确鉴别斜疝、直疝、股疝，可作为腹外疝外科手术前的首选鉴别方法。