Accuracy of transvaginal ultrasonography for detection of hematosalpinx in ectopic pregnancy.

The transvaginal approach has significantly improved the accuracy of ultrasonography for the detection of ectopic pregnancy. However, there has been limited emphasis given to determining the sensitivity of ultrasonography when a hematosalpinx was used as a specific finding to identify an ectopic pregnancy. The sensitivity of transvaginal ultrasonography was evaluated for the detection of a hematosalpinx defined as an "echogenic homogeneous or inhomogeneous, rounded or elongated structure" in a group of patients with surgically proven ectopic pregnancy. Retrospectively, transvaginal ultrasonography showed a hematosalpinx in 16 out of 18 (88.8%) tubal pregnancies. In 6/6 (100%) patients with a ruptured tube and 10/12 (83.3%) patients with an unruptured tube, a hematosalpinx was detected sonographically. A gestational sac with a live embryo was seen in 26.3% of these patients. The significance of identifying a hematosalpinx, predictability of rupture and implication in the treatment of ectopic pregnancy are discussed.     

First trimester selective reduction in multiple pregnancy guided by transvaginal sonography

Transvaginal ultrasonography-guided fetal reduction was performed in 11 patients presenting with multiple pregnancies. Embryonic aspiration was carried out in 7 women at 7 to 8 weeks and in 4 patients fetal intrathoracic injection was performed at 9 to 11 weeks, menstrual age. Seven patients delivered healthy babies at greater than 35 weeks, 3 have delivered prematurely 15 to 17 weeks after the procedure with subsequent neonatal death of all sets of twins. We believe that our method overcomes the technical difficulties related to the transabdominal or transcervical approach and should be the method of choice for early selective abortion.     

经阴道超声在宫外孕诊断及疗效监测中的价值

目的探讨各类宫外孕的声像图表现及在保守治疗宫外孕疗效中的监测价值,方法对经超声诊断并经手术病理证实的1938例宫外孕声像图进行回顾性分析并总结了731例保守治疗宫外孕超声表现及血中β—HCG水平变化关系。结果宫外孕声像图分五种类型,经阴道彩色超声监测保守治疗宫外孕混合性包块变化,回声由逐渐增强转化为边界模糊701例,且与HCG异常升高直接相关。结论宫外孕的声像图具有特征性表现,经阴道彩色超声为宫外孕非手术治疗提供了精确的疗效评估。     

经阴道超声诊断输卵管妊娠的临床价值与药物治疗的观察

目的 探讨经阴道超声检查，对输卵管妊娠早期诊断的检测价值，以及对药物治疗的分析。方法 对60例早期输卵管妊娠患进行阴道超声检查，对未破裂型输卵管妊娠给予静脉点滴MTX(氨甲喋啶)保守治疗，连续动态观察异位妊娠组织及混合性包块的形态。发展和转归。结果 本60例早期输卵管妊娠阴道超声检查的准确率100％。对于未破裂型及早期流产型早期输卵管妊娠．经血β-HCG确认后给药物保守治疗显效率81％，有效率12％，无效率7％。药物治疗成功34例，手术治疗26例。结论 阴道超声检查是目前诊断输卵管妊娠较有价值的检测手段，对于指导临床采取有效治疗措施具重要意义。     

阴道超声检查对宫颈癌诊断价值的Meta分析

目的 系统评价阴道超声诊断女性宫颈癌的临床价值。方法 检索CNKI、VIP、WangFang、PubMed、Web of Science等数据库和人工检索相关中文期刊,收集阴道超声与金标准(病理活检)比较诊断宫颈癌的诊断性试验。根据制定的纳入和排除标准对文献进行筛选和提取数据,对纳入的文献使用QUADAS工具评价方法学的质量;采用Meta-DiSc 1.4软件对敏感性(SEN)、特异性(SPE)、阳性似然比(+LR)、阴性似然比(-LR)、诊断比值比(DOR)进行异质性检验和数据合并分析,并绘制受试者曲线(SROC)和计算曲线下面积(AUC)。结果 最终纳入25篇文献,2333例研究对象,Meta分析结果：合并SEN=0.90,[95%CI (0.88,0.91)];合并SPE=0.95,[95%CI (0.93,0.96)];合并+LR=10.88,[95%CI (5.47,21.63)];合并-LR 0.13,[95%CI (0.09,0.18)];合并DOR= 105.99,[95%CI (44.07,254.89)];合并AUC为0.9590;Q_^*指数为0.9031。结论 阴道超声对宫颈癌的临床诊断有较高的敏感性(90%)和特异性(95%),对常规筛查和临床诊断具有重要的价值。由于研究的样本量和质量的限制,本研究结论尚需进行大样本量和高质量的研究加以客观验证。     

阴道超声在早期宫颈癌及宫颈癌前病变诊断中的应用价值

目的 探讨阴道超声在早期宫颈癌及癌前病变诊断中的临床价值.方法 对临床疑诊的早期宫颈癌和宫颈癌前病变患者分别经阴道超声检查及液基细胞学病理检查和组织活检,再对超声声像图作回顾性分析.结果 对早期宫颈癌、宫颈癌前病变,经阴道超声灵敏度分别为90.9%和83.3%,特异度70.6%和60.O%,漏诊率9.1%和16.7%.结论 阴道超声在早期宫颈癌诊断中起重要辅助作用.     

Umbilical artery velocity waveforms in early pregnancy: a transvaginal color Doppler study.

In a cross-sectional study, umbilical artery velocity waveforms were recorded in 214 low-risk pregnancies at 7 weeks to 16 weeks, menstrual age, by means of transvaginal color and pulsed Doppler ultrasonography. In all the cases studied, end diastolic velocities were absent until the 10th week. From this age onward end diastolic velocities were present in a percentage of pregnancies, progressively increasing with gestation and reaching 100% at 15 weeks. Similarly, the percentage of cardiac cycles in which end diastolic velocities were absent progressively decreased with advancing menstrual age. The normal range for the pulsatility index was constructed and a quadratic function was found to optimally fit its fall during gestation. No differences in pulsatility index values were found at these menstrual ages in 12 pregnancies that later developed intrauterine growth retardation and/or pregnancy-induced hypertension, suggesting that placental alterations causing abnormalities in umbilical velocity waveforms occur later in gestation.     

宫腔声学造影对子宫内膜病变鉴别诊断的意义

目的 应用宫腔声学造影经阴道检查鉴别诊断子宫内膜病变。方法 应用美国HP8500多商业区协彩色诊断仪和国产子宫造影导管Q/GHXL37双腔管,在实时扫查下向导管内注入生理盐水使宫腔逐渐扩张,以显示子宫内膜和病灶。结果 受检32例均为月经不规则和绝经后阴道流血的就诊患,检查结果仅3例患子宫内膜正常,其余29例均属异常病人,子宫病变检出率为90.6%。结论 宫腔声学造影术对子宫内膜病变的鉴别诊断很有价值。     

阴道超声和宫腔镜在诊断绝经后子宫出血中的应用

目的 比较阴道超声和宫腔镜检查在诊断绝经后子宫出血中的应用。方法 回顾性分析2030年1月至2003年12月来我院行阴道超声和宫腔镜检查的绝经后阴道出血妇女63例。全部在宫腔镜检查后刮取子宫内膜送病理检查。结果 组织取样不足2例(3.1％)；萎缩子宫内膜18例(28.57％)；正常子宫内膜4例(14.29％)；子宫内膜炎1例(1.59％)；子宫内膜息肉11例(17.46％)；子宫粘膜下肌瘤9例(14.29％)；子宫内膜单纯增生3例(4.76％)；子宫内膜非典型增生2例(3.17％)；子宫内膜癌13例(20.63％)。阴道超声诊断子宫内膜癌的敏感性为69.23％，特异性为88％，阳性预测值为60％，阴性预测值为91.67％；宫腔镜诊断子宫内膜癌的敏感性为76.92％，特异性为98％，阳性预测值为90.91％，阴性预测值为94.23％；二者联合诊断子宫内膜癌的敏感性为100％，特异性为89.7％，阳性预测值为92.3％，阴性预测值为100％。阴道超声诊断子宫内膜病变的敏感性为94.29％，特异性为39.28％，阳性预测值为66％，阴性预测值为84.62％；官腔镜诊断子宫内膜病变的敏感性为94.29％，特异性为92.86％，阳性预测值为94.29％，阴性预测值为92.86％；二者联合诊断子宫内膜病变的敏感性为96.5％，特异性为93.4％，阳性预测值为91.86％，阴性预测值为95.62％。结论 绝经后子宫出血是子宫内膜癌的一个危险信号。子宫内膜厚度大于4mm，宫腔镜直视下活检或诊断性刮宫，是最佳诊断手段。     

宫颈机能不全的经阴道超声诊断价值评价

目的:评价经阴道超声检查对宫颈机能不全的诊断价值。方法:分析25例宫颈机能不全患者非孕期及孕16~18周宫颈长度并与同时期健康孕妇相对照。结果:CIC患者非孕期宫颈长度及孕1~18周的宫颈长度低于均健康对照组。结论:经阴道超声检查宫颈长度对评估CIC具有一定价值。     

The assessment of normal early pregnancy by transvaginal color Doppler ultrasonography

Transvaginal color Doppler was performed in 198 volunteer pregnant women whose menstrual age ranged from the fifth to the twelfth week. In all patients an attempt was made to obtain signals from both uterine arteries, peritrophoblastic/retroplacental vessels, umbilical arteries, fetal aorta, intracranial vessels, and corpus luteum flow. With the combination of color and pulsed Doppler transvaginal sonography, detection of vascular structures was greatly facilitated and the amount of time for examination significantly reduced. Flow velocity waveforms were measured and results were analyzed by calculation of the Resistance Index. During the early stage of pregnancy, we were able to locate both uterine arteries in all cases and continuous diastolic shift signal was found. Flow in the peritrophoblastic/retroplacental area was observed with an overall success rate of 94%. Blood flow in the umbilical artery and fetal aorta was visualized by color Doppler starting from the seventh week. Intracranial blood flow could be visualized starting from the tenth week in some cases. Diastolic flow in these vessels was detectable starting from the twelfth week. Corpus luteum flow was found in 148 cases (75%) and the Resistance Index decreased as pregnancy progressed © 1993 by John Wiley & Sons, Inc.     

经阴道超声对子宫内膜息肉的诊断及漏误诊的分析

目的探讨经阴道超声对子宫内膜息肉的诊断价值及声像图特征。方法回顾性分析73例经手术和病理证实的子宫内膜息肉的经阴道超声声像图的特征。结果经阴道超声检出的子宫内膜息肉57例,检出率78．1％,误诊9例,误诊率12．3％;漏诊7例,漏诊率9．6％。结论经阴道超声能清晰地反映子宫内膜息肉超声特征,而且操作方便、易行,可作首选方法。     

经阴道超声筛查子宫内膜良性病变的价值探讨

目的以宫腔镜联合病理检查结果（H＆B）为金标准,探讨经阴道超声（TVS）筛查子宫内膜良性病变的价值。方法回顾性分析我院150例子宫内膜良性病变患者的TVS检查结果,与同期的H＆B进行对比。结果TVS诊断子宫内膜良性病变的敏感性为97．9％,特异性为80．0％,阳性预测值为96．6％,阴性预测值为72．7％。结论TVS检查可作为诊断子宫内膜良性病变经济、实用、敏感的检查手段,与H＆B高度一致。     

经阴道超声进行妇科普查的临床价值

目的分析经阴道超声检查在妇科普查中的临床价值。方法回顾性分析2008年至2010年期间10230例的年龄在28岁至65岁的妇女进行阴道超声妇科普查的情况。结果 10230例妇女中检出妇科疾病的共有2530例,5例早孕。结论在妇科普查中应用阴道超声检出妇科疾病是有效可行的。     

经阴道超声检测子宫内膜病变的诊断价值

目的探讨经阴道彩色多普勒超声诊断子宫内膜病变的价值。方法对78例子宫内膜病变患者进行经阴道超声检查,其结果与病理对照,并进行分析。结果 78例患者中,子宫内膜增生诊断符合率92.5%,子宫内膜息肉诊断符合率91.7%,子宫黏膜下肌瘤诊断符合率90.9%,3例可疑子宫内膜癌经病理证实。结论经阴道彩色多普勒超声检查因其无创伤性,且超声图像特征显示清晰,是诊断子宫内膜疾病的有效手段。     

经阴道超声检查在异位妊娠诊断中的应用价值

目的探讨经阴道超声检查在异位妊娠诊断中的应用价值。方法经阴道纵、横方向扫查,检查子宫大小形态,子宫内膜厚度,有无分离及假孕囊;附件区包块的位置,大小,形态、边界,内部回声及与周边器官的关系;腹盆腔有无积液,测量积液深度。结果124例异位妊娠中经手术病理确诊异位妊娠114例,保守治疗治愈6例,误诊2例,漏诊2例。124例病例中,输卵管妊娠116例,宫角妊娠4例。结论经阴道超声分辨力高,图像清晰,是诊断异位妊娠的首选辅助检查。     

子宫黏膜下肌瘤与子宫内膜息肉的经阴道超声检查

目的探讨经阴道超声检查对子宫黏膜下肌瘤、子宫内膜息肉的诊断价值。方法回顾性分析96例经手术病理证实的子宫黏膜下肌瘤、子宫内膜息肉的经阴道超声检查的声像图表现及诊断的符合情况。结果子宫黏膜下肌瘤诊断符合率为90．6％,子宫内膜息肉诊断符合率为84．37％。结论经阴道超声检查对子宫黏膜下肌瘤、子宫内膜息肉的诊断及二者间的鉴别诊断均有较高的实用价值。     

Transvaginal sonographic measurement of fetal kidneys in the first trimester of pregnancy

Fetal renal size late in the first trimester of pregnancy was evaluated by transvaginal ultrasonography in 50 patients not at risk for congenital kidney disease and whose pregnancies resulted in a normal outcome. Both kidneys were reliably identified in all patients scanned at 12 weeks, 13 weeks, and 14 weeks, menstrual age. Kidney diameter measurements obtained in this study are presented for reference in evaluating patients in late first trimester whose fetuses are at risk for kidney abnormalities.     

经阴道彩色多谱勒超声对宫颈疾病的诊断价值

目的通过分析各类宫颈疾病经阴道彩色多普勒超声声像特征,探讨经阴道彩色多谱勒超声对宫颈疾病的诊断价值。方法总结2003年至2006年本院诊治的各类宫颈疾病的病例,分析其经阴道彩色多普勒超声的声像特征,追踪手术及病理结果。结果共70例,其中宫颈囊肿38例(宫颈纳氏囊肿35例,宫颈子宫内膜异位囊肿3例),宫颈息肉5例,宫颈肌瘤5例,宫颈带蒂黏膜下子宫肌瘤2例,宫颈妊娠2例,宫颈机能不全3例,宫颈恶性肿瘤15例,全部病例经手术(48例)、宫腔镜检(22例)或宫颈刮片(4例)处理,超声与病理诊断符合率97%。结论经阴道彩色多谱勒超声对诊断宫颈疾病方便、有效,可作为诊断宫颈疾病的首选检查方法。     

经阴道彩色多普勒血流显像在盆腔静脉淤血症中的应用

目的评价经阴道彩色多普勒血流显像在盆腔静脉淤血症中的应用价值。方法通过经阴道扫查的二维超声显像、彩色多普勒血流显像,比较了30例正常组和40例盆腔静脉淤血症患者的声像图特征。结果盆腔静脉淤血症患者子宫多呈均匀增大,盆腔内可见走行各异呈蜂窝状的无回声区及“彩球”样彩色血流信号,正常组未见上述改变。结论彩色多普勒血流显像可作为一种简单、方便、无痛苦而又可靠的方法用于盆腔静脉淤血症的诊断。