The accreditation of ultrasound practices: impact on compliance with minimum performance guidelines.

OBJECTIVE: To determine the effectiveness of the American Institute of Ultrasound in Medicine (AIUM) accreditation program in improving compliance with standards and guidelines for the performance of obstetric and gynecologic ultrasound examinations. METHODS: Scores of case studies of accreditation applications were compared with their respective scores at the time of reaccreditation 3 years later. To account for the element of time, scores of applications that recently completed first-time accreditation were also compared as a control group. RESULTS: Individual obstetric case studies, as well as the average of all obstetric and gynecologic case studies, showed highly significant improvement with the reaccreditation application when compared with the initial accreditation application 3 years earlier (all P <.001). The proportion of practices successfully meeting obstetric and gynecologic AIUM accreditation requirements improved significantly with reaccreditation (obstetric, 57.3% for accreditation compared with 86.6% for reaccreditation; gynecologic, 60% for accreditation compared with 91.9% for reaccreditation; P <.001). Furthermore, reaccreditation scores were significantly higher than scores of recent first-time applications for obstetric case studies as well as scores of the average of obstetric and gynecologic case studies (all P <.05). CONCLUSIONS: Our study confirms that practices that sought and received ultrasound accreditation were able to improve the scores of case studies and compliance with published minimum standards and guidelines for the performance of obstetric and gynecologic ultrasound examinations when reevaluated 3 years after the initial application scores. This improvement should translate into an enhancement of the quality of ultrasound practice.     

产前超声检出胎儿胸膜肺母细胞瘤1例

孕妇33岁,于孕32周经产前超声检查发现胎儿肺部多个低回声结节(图1 A );孕38周超声示胎儿肺部结节较前增多、增大,周围肺组织回声增强,CDFI均未见明显血流信号(图1B).孕妇既往体健,孕2产1,与其丈夫均无家族及遗传病史;孕期胎儿发育无明显异常.孕38周胎儿MRI:双肺见数枚类圆形 T1稍高信号、T 2低信号结...     

Detailed ultrasound screening in the second trimester: pictorial essay of normal fetal anatomy

Today, ultrasound is the main diagnostic tool in the prenatal detection of congenital abnormalities. Therefore, ultrasound examination should be offered to all pregnant women. A detailed sonographic examination of the fetus is usually performed between 18 and 22 weeks of pregnancy. The accurate recognition of normal fetal anatomy is very important for the detection of both minor and major defects. The purpose of this pictorial essay is to show fetal anatomic structures, which have to be examined between the 18(th) and 22(nd) weeks of pregnancy, and present their standard measurements systematically and thoroughly in accordance with sonographically obtained ideal sections.     

亚临床型甲状腺功能减退伴高反应性黄素化超声表现1例

亚临床型甲状腺功能减退伴高反应性黄素化超声表现1例     

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。     

Three-dimensional ultrasound: Display modalities in obstetrics

Three-dimensional ultrasound (3DUS) has recently been introduced into clinical practice. Various techniques are available for display of the volume data. We review the importance of selecting the proper display option and rendering mode depending on the specific diagnostic question. Current display options include (1) arbitrary planar images similar to conventional two-dimensional US images, (2) surface rendering with emphasis on soft tissues or skeletal detail, (3) stereo viewing using liquid crystal glasses or red/blue glasses, and (4) cine review of gated studies. Rotation of volume data also is important in understanding/comprehending patient anatomy. The range of rotation angles varies depending on the clinical setting. Also data storage requirements increase as the number of views increases. © 1997 John Wiley & Sons, Inc. J Clin Ultrasound 25:157–167, 1997     

超声断层显像技术诊断胎儿主动脉弓畸形

目的 探讨时空影像关联（STIC）技术结合超声断层显像（TUI）诊断胎儿主动脉弓异常的价值。方法 回顾性分析45胎主动脉弓畸形胎儿的产前超声资料。以二维超声心动图（2DE）于三血管-气管切面判断主动脉弓相对于气管的位置,寻找异常头臂动脉。以STIC技术采集容积数据后,分别在横断面及冠状面行TUI重建,于横断面TUI切面判断弓的位置;于冠状面TUI切面寻找迷走左、右锁骨下动脉及双侧主动脉弓汇合处。结果 45胎中,5胎双主动脉弓,9胎左位主动脉弓合并右锁骨下动脉迷走,31胎右位主动脉弓。STIC-TUI法及2DE对胎儿主动脉弓畸形的诊断率分别为97.78%（44/45）及71.11%（32/45）,差异有统计学意义（P<0.01）。结论 STIC-TUI法可准确诊断胎儿主动脉弓畸形;标准化容积数据后处理方法使临床推广成为可能。     

产前超声诊断胎儿开放性脊柱裂合并18-三体综合征1例报告

临床实践中，超声查见开放性脊柱裂的胎儿常直接引产，忽视对胎儿是否合并染色体非整倍体的筛查与产前诊断，尤其是超声表现较为隐蔽，难以查见的情况下（如本例所示）。本病例提示，产前超声检查发现胎儿存在开放性脊柱裂等相关的声像表现时不应局限于神经管缺陷等疾病的诊断，同时务必要注意胎儿是否合并有18-三体综合征的可能性，进一步建议孕妇进行染色体异常相关的产前诊断以减少漏诊，为孕妇再生育咨询提供重要价值。     

Prenatal diagnosis with ultrasound of anomalous course of the umbilical vein and its relationship to fetal outcome

Diagnosis of three types of anomalous course of the umbilical vein (UV) was made in 10 cases using antenatal ultrasound (US). Pulsed wave (PW) Doppler ultrasound was used to evaluate the UV in all cases. In one case, the UV was directly joining the superior vena cava (SVC) without forming subcutaneous collaterals, an abnormal course of UV not yet reported previously. Of these ten fetuses, six had various associated anomalies, including three fetuses with central nervous system (CNS) abnormalities. © 1996 John Wiley & Sons, Inc.     

Prenatal ultrasound diagnosis of chordee without hypospadias

Chordee without hypospadias (CWH) is an extremely rare condition. Here, we describe a case of CWH diagnosed accurately on prenatal ultrasound at 25 weeks' gestation. Physical examination of the newborn confirmed the sonographic findings. To the best of our knowledge, prenatal ultrasound diagnosis of CWH has not been reported in the literature. We emphasize the importance of observing fetal micturition to rule out the possibility of CWH before the diagnosis of hypospadias is made on prenatal ultrasound.     

Prenatal sonographic diagnosis of mature renal teratoma: A case report

Renal teratoma is an extremely rare condition found in adolescents and young adults. Here, we report a case in which renal teratoma was diagnosed by fetal ultrasound examination. To our knowledge, this is the first report to describe the imaging manifestation of renal teratoma in prenatal diagnosis.© 2012 Wiley Periodicals, Inc. J Clin Ultrasound, 2013     

超声造影的创新性应用

随着在超声造影技术的发展和在临床应用中的不断探索,超声造影在胃肠、肝脏、心脏、甲状腺、乳腺、儿科、腹腔瘘管等领域的创新性应用为临床精准诊断与靶向治疗提供了重要依据。本文主要从超声造影在人体不同器官诊疗中的应用方面,对其创新性应用进行分析和展望。     

Evaluation of focal hepatic lesions with ultrasound contrast agents

Ultrasound contrast agents have gained wide acceptance for the detection and characterization of focal liver lesions. This pictorial essay reviews the growing body of evidence that supports the use of modern ultrasound contrast agents and illustrates the enhancement characteristics of commonly encountered focal liver lesions. Pathologies discussed include metastases, hepatocellular carcinomas, focal nodular hyperplasia, hepatocellular adenomas, hemangiomas, abscesses, complex cysts, and focal fatty deposition.     

经腹和经阴道彩超联合技术对重型α-地中海贫血胎儿的产前早期诊断

目的探讨经腹和经阴道彩超联合技术对重型α-地中海贫血胎儿的早期产前诊断的效果。方法选取我院妇产科门诊2014年12月~2017年12月收治的产检的孕12~26周孕妇153例,采用经腹羊水穿刺术或绒毛膜穿刺术对胎儿进行α-地中海贫血诊断,同时采用腹部联合阴道彩色超声技术对其进行检查,对比两次诊断结果。结果经腹部和阴道彩色超声联合技术对重型α-地中海贫血胎儿检测灵敏度为98.96%（95/96）,假阳性率为1.04%（1/96）,特异度为92.98%（53/57）,假阴性率为7.02%（4/57）。在超声图像中可清楚的看到患病胎儿浆膜腔积液、心脏增大、心胸比增大的现象,并且有颈部透明层增厚,肠管回声增强,胎盘增厚等现象。结论将经腹和经阴道彩超联合技术运用于早期产前诊断,能较准确的诊断出重型α-地中海贫血胎儿,值得临床的推广应用。     

产前经腹联合经阴道超声诊断前置胎盘并胎盘植入

目的 观察产前经腹联合经阴道超声检查对前置胎盘并胎盘植入的诊断效能.方法 回顾性分76例前置胎盘并胎盘植入孕妇产前超声资料,其中39例接受单纯经腹超声检查(经腹检查组)、37例接受经腹联合经阴道超声检查(联合检查组);比较2组诊断胎盘植入准确率,分析联合检查组胎盘植入分型准确率.结果 联合检查组产前诊断胎盘植入准确率9...     

产前超声提示脐带羊膜分离1例

孕妇32岁,孕30+2周超声检出脐带与羊膜分离(图1A),孕33+5周分离程度加重、脐动脉内径变窄;孕34+1周无明显诱因出现下腹部阵痛,伴少量淡黄色、清亮、稀薄阴道流液,门诊以"先兆早产、胎膜早破"收治入院.既往孕3产0;无羊膜腔穿刺及脐带血穿刺史,孕期血压正常.     

超声观察妊娠期母胎循环及胎盘植入血流变化

胎盘损伤是围产期母婴发病和死亡的主要原因。随着胎盘植入发生率增加，术中出血及子宫切除率明显上升。产前超声显示血流明显优于MRI。本文围绕超声观察正常母胎循环及胎盘植入血流改变研究进展进行综述。     

产前超声在前脑无裂畸形诊断中的临床价值分析

目的：探讨分析产前超声在前脑无裂畸形诊断中的临床价值。方法选取2010年1月至2013年1月接受产前胎儿系统超声检查的15000例孕妇资料进行回顾性分析。结果15000例接受产前胎儿系统超声检查的孕妇中共有11例胎儿被检出存在前脑无裂畸形的现象。其中5例为无叶全前脑畸形,3例胎儿的超声图片显示为半叶前脑无裂畸形,3例胎儿的超声图片信息显示为叶状前脑无裂畸形。合并畸形的情况为3例胎儿为唇腭裂畸形,1例胎儿为无鼻畸形,1例胎儿为眼距畸形,2例胎儿为dandy-w alker综合征。此外还有2例胎儿为羊水多,1例为多囊肾。11例胎儿经过尸检后证实为前脑无裂畸形。结论产前超声检查在前脑无裂畸形诊断中的准确率较高,临床价值较高,值得推广。