妇科急腹症超声诊断及鉴别诊断

目的探讨超声检查在妇科急腹症诊断及鉴别诊断中的临床应用价值。方法回顾性分析我院收治的345例妇科急腹症的超声结果,并与病理结果进行对照分析。结果与术后病理结果对照,345例急腹症患者中超声准确诊断331例,总体符合率为95.94%,其中异位妊娠的诊断符合率为98.47%(257/261),不全流产的诊断符合率为86.05%(37/43),盆腔炎症的诊断符合率为94.74%(18/19),卵巢肿瘤破裂的诊断符合率为85.71%(12/14),卵巢肿瘤蒂扭转的诊断符合率为7/8。结论经阴道联合经腹部超声可简便、快速诊断与鉴别诊断妇科急腹症,尤其是对异位妊娠、不全流产的诊断符合率高。     

高低频超声配以逐级加压手法诊断急性阑尾炎80例分析

目的：探讨普通凸阵探头与高频线阵探头联合应用配以加压手法对急性阑尾炎的诊断价值。方法：回顾分析80例急性阑尾炎患者的超声图像。结果：高低频超声探头联合应用配以加压手法,对急性阑尾炎的诊断符合率、阑尾腔内粪石检出率明显高于单独用某一探头时的检出率。结论：高低频超声探头联合配以加压手法对诊断急性阑尾炎有重要价值。     

阑尾炎高频超声探头缓慢加压诊断符合率分析

目的：探讨高频超声探头缓慢加压对减少阑尾炎误诊的应用价值。方法：用低频超声探头3.5MH z检测阑尾区后,再改用高频超声探头7.5 MH z缓慢加压反复扫查阑尾区。结果：60例阑尾炎患者,单用低频超声探头诊断符合率为40%,而联合应用高频超声探头缓慢加压检测符合率为86.6%。结论：高频超声探头缓慢加压能较好的检测各型阑尾炎病变,减少误诊率,具有重要的临床应用价值。     

超声高低频探头联合应用诊断急性阑尾炎461例

目的:探讨超声高低频探头联合应用在诊断急性阑尾炎中的作用,总结不同类型急性阑尾炎的声像图特点,提高阑尾炎的超声诊断水平。材料与方法:对461例手术及病理证实的急性阑尾炎患者的超声诊断及其声像图进行回顾性分析,所有病例均联合使用高低频探头进行超声检查,统计其诊断符合率。结果:461例患者术前联合应用高低频探头超声诊断445例,诊断符合率96%,其中单纯性阑尾炎130例,化脓性阑尾炎197例,坏疽性阑尾炎(包括阑尾周围脓肿)118例。结论:联合使用高低频探头可以提高阑尾炎诊断符合率,提高诊断水平。     

研究超声在妇科急腹症的诊断价值

目的：分析超声检查妇科急腹症的诊断效果及价值。方法：经阴道、腹部对我院妇科106例急腹症患者进行超声诊断,对超声检查急腹症的诊断价值进行研究。结果：超声诊断急腹症的总符合率为92.5%,检查急性盆腔炎、卵巢囊肿蒂扭转、黄体破裂、异位妊娠的诊断符合率分别为92.3%、90.9%、90.0%、94.7%。结论：超声检查妇科急腹症疾病具有较高价值,可作为临床诊断妇科急腹症的首选方法。     

B型超声检查对妇科急腹症诊断及鉴别诊断的价值

目的 探讨B超对妇科急腹症的诊断及鉴别诊断价值。方法 总结101例各类妇科急腹症的声像图表现，对手术证实的79例进行分析总结，对非手术治疗的22例进行追踪观察，了解其保守治疗效果。对B超腹部探头及阴道探头进行比较。结果 经手术证实的79例各类妇科急腹症中，宫外孕38例占48%，卵巢囊肿蒂扭转25例，占31%，黄体破裂6例，占7%，处女膜闭锁及阴道畸形4例，占5%，非手术治疗的急腹症22例，盆腔炎17例，占77%，卵巢子宫内膜异位症5例，占23%；阴道探头在诊断清晰度上明显优于腹部探头且无需充盈膀胱；急腹症的声像图表现各有特点，鉴别诊断需密切结合临床，非手术治疗对盆腔炎性包块效果较好，对卵巢巧克力囊肿则效果不明显。结论 B超对妇科急腹症有重要的诊断价值。     

经腹部联合经阴道超声诊断妇产科急腹症的应用价值

目的探讨经腹部联合经阴道超声检查在妇产科急腹症诊断中的应用价值。方法选取经临床及病理确诊的妇产科急腹症患者110例,均行经腹部联合经阴道超声检查,比较超声检查结果与病理结果的诊断符合率。结果经腹部联合经阴道超声检查妇产科急腹症的诊断符合率97.27%(107/110),其中异位妊娠的诊断符合率96.77%(30/31);宫内孕流产的诊断符合率94.44%(17/18);卵巢囊肿破裂的诊断符合率93.33%(14/15);急性盆腔炎、卵巢肿瘤蒂扭转、子宫内膜异位症及胎盘早剥的诊断符合率分别为100%、10/10、8/8及5/5。结论经腹部联合经阴道超声检查在诊断妇产科急腹症中具有较好的临床应用价值。     

超声在可疑阑尾炎诊断中的应用146例分析

目的探讨临床可疑急性阑尾炎患者超声诊断的临床价值。方法对所有可疑的急性阑尾炎患者采用高、低频探头联合应用及加压手法,重点在右下腹患者压痛处寻找阑尾,同时行盆腔检查以排除其他急腹症。结果可疑的急性阑尾炎146例,超声确诊并证实急性阑尾炎136例(77.94%),确诊其他急腹症:妇科疾病5例,泌尿系疾病2例和肠道肿瘤1例,误诊2例。结论超声检查在可疑急性阑尾炎的诊断及鉴别诊断上具有较高的临床价值。     

超声诊断在妇科急腹症中的应用价值

对325例妇科急腹症患者的临床资料进行回顾性分析,分析其声像图特征及超声诊断对妇科急腹症的诊断价值。结果 325例患者中,超声诊断与临床诊断相比较,总的诊断符合率为95.69%。其中异位妊娠218例,诊断符合率98.62%;卵巢黄体破裂22例,诊断符合率90.91%;卵巢巧克力囊肿破裂9例,诊断符合率77.78%;卵巢囊肿蒂扭转15例,诊断符合率66.67%;急性盆腔炎32例,诊断符合率93.75%;宫腔积血29例,诊断符合率100%。超声诊断准确率高,有易操作、可重复等优点,在妇科急腹症诊断与鉴别诊断中具有较高的价值,为临床治疗提供了可靠的依据。     

高低频超声联合应用诊断急性阑尾炎52例分析

目的探讨联合应用高低频超声对急性阑尾炎诊断的价值。方法对52例临床拟诊为急性阑尾炎的患者应用常规腹部探头和高频探头进行右下腹检查,详细记录检查情况。结果超声诊断符合率为84．6％。结论高低频超声联合扫查能明显提高肿大阑尾的显示率,对急性阑尾炎的诊断有重要价值。     

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。     

Transvaginal sonography in the diagnosis of acute appendicitis.

OBJECTIVES: To evaluate transvaginal sonography with power Doppler capacity in the diagnosis of acute appendicitis and in discriminating appendicitis from pelvic inflammatory disease. PATIENTS AND METHODS: We describe transvaginal sonographic findings of six women with acute appendicitis selected from 31 women seen in an emergency room setting for clinically suspected pelvic inflammatory disease. The study population underwent gray-scale transvaginal sonography, and specific sonographic landmark findings for acute appendicitis and pelvic inflammatory disease were used. Hyperemia of any infectious complex was identified by power Doppler. Laparoscopy was performed after transvaginal sonography and was used as the gold standard. RESULTS: Laparoscopy showed acute appendicitis in six (19%) of the 31 patients. A thick walled non-compressible gas-containing tubular structure with a diameter exceeding 6 mm was seen by transvaginal sonography in four of the six cases, consistent with uncomplicated appendicitis. A heterogeneous complex with surrounding hyperechogenic soft tissue was seen in two cases with gangrenous appendicitis. Power Doppler detected hyperemia in all six cases. Normal adnexal structures were imaged next to the inflamed appendix. The sonographic criteria consistent with acute appendicitis were clearly different from those of acute pelvic inflammatory disease. CONCLUSIONS: Transvaginal sonography provides an opportunity to distinguish between appendicitis and acute pelvic inflammatory disease. Prospective trials are needed in order to evaluate the impact of transvaginal sonography in the diagnosis of acute appendicitis.     

The contribution of transvaginal ultrasound in the diagnosis of acute appendicitis: an observational study.

OBJECTIVE: To assess the contribution of transvaginal and transabdominal sonography in the diagnosis of acute appendicitis. METHODS: The study group included female patients in whom acute appendicitis was diagnosed preoperatively by ultrasound and confirmed by histology. Each patient was examined by transabdominal (TAS) and transvaginal (TVS) sonography. The contribution of both approaches to the diagnosis of acute appendicitis was assessed. RESULTS: Acute appendicitis was diagnosed sonographically in 38 women. In all of them the diagnosis was confirmed histologically. All patients had both TAS and TVS. In 16 (42%) patients the inflamed appendix was detected by both approaches, in 13 (34%) only by the transabdominal route and in nine (24%) only transvaginally. Thus, TAS detected only 76% of the cases and TVS added 24%. CONCLUSION: The use of TVS in conjunction with TAS seems to improve the detection rate of acute appendicitis.     

Imaging of acute appendicitis in children

Acute appendicitis is the most common acute abdominal condition that results in surgical intervention in childhood. The clinical diagnosis of acute appendicitis in children can be challenging. Approximately one-third of children with the condition have atypical clinical findings and are initially managed nonoperatively. Complications associated with delayed diagnosis of this condition include perforation, abscess formation, peritonitis, sepsis, bowel obstruction, infertility, and death. The use of cross sectional imaging has proven useful for the evaluation of suspected acute appendicitis in children. Both graded compression sonography and CT have been widely utilized in the imaging assessment of the condition. The principal advantages of sonography are its lower cost, lack of ionizing radiation, and ability to assess ovarian pathology that can often mimic acute appendicitis in female patients. The principal advantages of CT include less operator dependency than sonography as reflected by a higher diagnostic accuracy, and enhanced delineation of disease extent in perforated appendicitis.     

Sonography of acute appendicitis: a critical review

In 20% of the cases of acute appendicitis, especially in children, the elderly, and ovulating women, the findings are atypical. The radiographic procedures used to aid in the diagnosis have not been proven reliable. Sonography has often been used to diagnose or rule out appendiceal abscesses, or diseases that can mimic acute appendicitis, such as gynecologic, obstetric, or biliary abnormalities. Recently, high-resolution sonography with graded compression has been shown to be very helpful in the diagnosis of acute appendicitis in several studies. High-resolution 5- to 7.5-MHz transducers are used to compress the bowels, displace the interfering gas in the right lower quadrant, and directly visualize the inflamed appendix with a sensitivity that varies from 80 to 95%, a specificity of 95 to 100%, and an accuracy of 91 to 95%. It is also possible to differentiate acute appendicitis from the gangrenous and perforated appendix. High-resolution sonography is currently the diagnostic method of choice for appendicitis, particularly in patients with equivocal clinical findings. The technique, normal and pathologic anatomy values, and limitations of sonography are discussed.     

高低频探头联合使用在急性阑尾炎中的诊断价值

目的探讨联合使用高低频探头在急性阑尾炎中的诊断价值。方法回顾性分析了122例急性阑尾炎的临床资料,对比超声诊断与手术病理结果。结果 122例中,超声诊断阑尾炎110例,漏诊8例,误诊4例,诊断符合率90.16%(110/122);术前超声诊断分型与术后病理分型对比,122例中作了分型的110例中有95例与病理分型一致,诊断符合率为86.4%(95/110)。结论高低频探头联合应用提高了阑尾炎诊断符合率,且在阑尾炎病理分型中有重要应用价值。     

超声在急性阑尾炎临床诊断和分型中的临床意义

目的 探讨超声在急性阑尾炎诊断及病理分型中的作用和意义.方法 回顾2010年4月～2011 年11月急诊就诊的急腹症患者168例,均进行手术治疗,比较术前超声检查诊断结果 与术后病理检查结果 的差异.结果 单纯性阑尾炎超声诊断准确率为97.1%,化脓性阑尾炎准确率为95.2%,坏疽性阑尾炎准确率为100%,超声总的诊断准确率为97.1%;阑尾炎组的阑尾超声结果 显示其阑尾直径、长度、管壁厚度均高于非阑尾炎急腹症患者(P＜0.01).结论 超声检查对急性阑尾炎诊断准确率很高,具有重要的诊断价值,应作为首选辅助诊断方法.     

高频与低频超声联合诊断急性阑尾炎价值

目的比较高频超声及高频与低频超声联合应用诊断急性阑尾炎的价值。方法回顾性分析经手术组织病理证实的183例急性阑尾炎患者的超声声像资料,其中急性单纯性阑尾炎48例,急性化脓性阑尾炎75例,急性坏疽性阑尾炎39例,阑尾周围脓肿21例,比较高频超声、高频与低频超声联合术前诊断急性阑尾炎的准确性。结果急性单纯性阑尾炎、急性化脓性阑尾炎、急性坏疽性阑尾炎、阑尾周围脓肿高频超声诊断符合率分别为52．1％、80．0％、71．8％、81．0％,高频与低频超声联合诊断符合率分别为91．7％、96．0％、94．9％、100．0％,2种方法比较差异均有统计学意义（P〈0．05）。结论高频与低频超声联合应用可提高急性阑尾炎的诊断准确率。     

Improved sonographic visualization of the appendix with a saline enema in children with suspected appendicitis.

OBJECTIVE: To determine whether abdominal sonography after a saline enema can identify the appendix that is not visualized at graded compression sonography in children with suspected appendicitis. METHODS: High-frequency compression sonography was prospectively performed in 120 consecutive children with suspected appendicitis; the appendix was not identified in 27 of these patients. Among the 27 patients with a nonvisualized appendix, abdominal sonography after a saline enema was performed in 12 to identify the appendix. RESULTS: Abdominal sonography after the saline enema revealed the appendix in all 12 children in whom the appendix was not visualized at graded compression sonography. A normal appendix was found in 11 children, and acute appendicitis confined to the appendiceal tip was found in 1. The appendix was located in the pelvis (n = 5), posterior to the cecum (n = 4), posterior to the ileum (n = 2), and anterior to the ileum (n = 1). The appendix could be identified by using a window of the saline-filled sigmoid colon (n = 5), saline-filled cecum (n = 4), and saline-filled terminal ileum (n = 2). CONCLUSIONS: Abdominal sonography after a saline enema is a helpful technique for depiction of the appendix that is not visible at graded compression sonography in children with suspected appendicitis. Key words: appendix, sonography; appendicitis; children, gastrointestinal tract.     

低频与高频探头超声对急性阑尾炎诊断的比较

目的比较低频与高频探头超声对急性阑尾炎的诊断价值。方法对2010年1月-2011年6月120例急性阑尾炎的手术病理结果与超声检查结果进行回顾性分析,比较低、高频探头超声对急性阑尾炎的诊断价值。结果 120例急性阑尾炎中,通过低频探头超声检出67例(55.8%),通过高频探头超声检出105例(87.5%);单纯性阑尾炎以及化脓性和坏疽性阑尾炎高频探头超声检出例数明显大于低频探头超声,差异有统计学意义(P<0.05);阑尾周围脓肿低、高频探头超声均全部检出。结论高频探头超声对急性阑尾炎的检出率高于低频探头超声,但二者各有所长,在临床中联合应用能有效提高急性阑尾炎的超声诊断符合率。