盆腔积液的超声观察分析

目的 探讨如何区别女性盆腔积液的性质及积液与疾病的关系.方法 对本院141例女性盆腔积液的声像图特征进行观察,并结合其临床资料及妇科检查进行分析.结果 本组141例盆腔积液中,宫外孕破裂54例,黄体破裂8例,炎性渗出48例,结核性包裹性积液6例,盆腔脓肿17例,巧克力囊肿2例,正常排卵6例.结论 根据声像图特征、紧密结合临床资料分析,并与妇产科及时配合穿刺送检,方能提高超声诊断准确率,为临床提高可靠依据.     

经阴道彩超用于宫外孕破裂及卵巢黄体破裂鉴别诊断的临床价值

目的：探讨经阴道彩超对宫外孕破裂及卵巢黄体破裂的鉴别诊断价值。方法：回顾性分析2020年9月至2021年8月在医院收治的25例宫外孕破裂患者（宫外孕组）和20例卵巢黄体破裂患者（卵巢黄体组）的临床资料进行研究。两组均行经阴道彩超检查,评价并比较经阴道彩超的诊断准确率、血流特征、血流动力学指标、肿块直径、卵巢体积、液性暗区深度、异常回声区直径及二维超声表现。结果：宫外孕组、卵巢黄体组的经阴道彩超诊断准确率分别为96.00%、95.00%(P>0.05)。与宫外孕组比较,卵巢黄体组的血流表现及频谱情况差异较大（P<0.05）,盆腔积液发生率比较,差异无统计学意义（P>0.05）。宫外孕组PI、RI指数均高于卵巢黄体组,PSV慢于卵巢黄体组（P<0.05）。宫外孕组的卵巢体积、液性暗区深度及异常回声区直径均小于卵巢黄体组,肿块直径大于卵巢黄体组（P<0.05）。结论：经阴道彩超在宫外孕破裂及卵巢黄体破裂鉴别诊断中,具有重要的临床意义。     

经阴道彩色多普勒超声诊断卵巢黄体囊肿破裂36例分析

目的:探讨经阴道彩色多普勒超声在卵巢黄体囊肿破裂的诊断价值.方法:回顾性分析36例卵巢黄体囊肿破裂经阴道彩色多普勒超声表现,检查结果与手术病理结果进行对照.结果:超声显示患侧卵巢增大,内见囊性结构,中等回声团包裹卵巢,伴不同程度的腹盆腔积液;彩色多普勒黄体囊肿周边见特征性环状血流信号.结论:经阴道彩色多普勒超声能明显提高卵巢黄体囊肿破裂的诊断率,为卵巢黄体囊肿破裂与异位妊娠的鉴别诊断提供有价值的信息.     

阴道超声、彩色多普勒及肿瘤标记物在盆腔囊实混合性肿块鉴别诊断中的应用

目的探讨阴道超声、彩色多普勒及血清肿瘤标记物对女性盆腔囊实混合性肿块的鉴别诊断价值。方法68例盆腔囊实混合性肿块患者，经阴道超声检查并评分，彩色多普勒检测阻力指数（RI），测定血清CAl25、CEA、AFP。结果对比三组间超声声像图上病灶内正常卵巢组织、盆腔带状结构、血流阻力指数（RI）、血清CAl25、CEA、AFP，差异有显著性。结论病灶内正常卵巢结构、盆腔带状结构是盆腔炎性肿块与卵巢肿瘤的重要声像图鉴别点。阴道超声、彩色多普勒、肿瘤标记物联合检查是鉴别盆腔囊实性混合肿块，良恶性较好的方法。     

经阴道彩色多普勒超声对宫外孕破裂与卵巢黄体破裂的鉴别诊断价值

目的探讨阴道彩色多普勒超声对宫外孕破裂与卵巢黄体破裂的鉴别诊断价值。方法选取42例宫外孕破裂和42例卵巢黄体破裂患者,分别给予阴道彩色多普勒超声和二维超声检查。结果二维超声检查对宫外孕破裂和卵巢黄体破裂鉴别诊断无明显意义,阴道彩色多普勒超声检查可对二者作出明确诊断。2组患者经阴道彩色多普勒超声检查显示血流表现、血流频谱和血流参数各项指标均存在显著差异(P0.05)。结论应用阴道彩色多普勒超声对宫外孕破裂与卵巢黄体破裂进行检查可进行明确诊断。     

胸腔肿块形包裹性积液的超声诊断

目的探讨肿块形包裹性积液的超声表现。方法采用Aloka-SSD1400实时超声诊断仪。探头频率3.5MHz,对19例肿块形包裹性积液行超声检查。结果B超检查的19例患者,结合其它检查,17例确诊为包裹性积液。其中心功能不全导致的4例,结核性11例,癌性2例。结论超声检查可较全面地显示肿块形包裹性积液的范围,了解胸水的性状,应作为临床诊断包裹性积液的常规方法。     

盆腔包裹性积液15例治疗分析

盆腔包裹性积液亦称盆腔炎性包裹性囊肿或盆腔腹膜囊肿，多继发于盆腔手术或盆腔炎症。大多采用中西医结合治疗或手术治疗，但疗效不十分满意，且易复发。作对15例手术后盆腔包裹性积液患采用B型超声介导下经阴道穿刺抽液注药并中药灌肠综合治疗，效果满意，现报道如下。     

宫外孕破裂的多普勒超声声像图和血流频谱特征及临床鉴别诊断

目的:探讨宫外孕破裂的多普勒超声声像图和血流频谱特征以及超声在临床鉴别诊断中的价值。方法:收集经手术病理证实的宫外孕破裂患者(62例)和卵巢黄体破裂患者(50例),分别记为宫外孕破裂组与卵巢黄体破裂组。比较2组阴道超声检查情况,总结宫外孕破裂的超声声像图和血流频谱特征,观察阴道超声对宫外孕破裂的鉴别诊断价值。结果:宫外孕破裂组附件区包块形态、边界、回声和液性暗区等表现与卵巢黄体破裂组相似,但前者可见胎芽、原始心动和假性妊娠囊,有助于鉴别诊断。多普勒超声检查显示宫外孕破裂组血流表现以"点状"和"条状"为主,血流频谱类型多样化,卵巢黄体破裂组血流表现以"半环状/环状"为主,血流频谱以极低/低阻力型为主,2组比较差异有统计学意义(P0.05),宫外孕破裂组血流参数、卵巢体积和液性暗区深度均低于卵巢黄体破裂组,差异有统计学意义(P0.05)。结论:经阴道多普勒超声检查能提供较丰富的宫外孕破裂声像图表现和血流频谱特征,为临床鉴别诊断宫外孕破裂提供重要依据。     

经阴道超声引导盆腔包裹性积液的穿刺治疗

目的探讨对盆腔包裹性积液经阴道超声引导穿刺抽液及注入硬化剂治疗的价值。方法对42例盆腔内包裹性积液,随机分成2组,穿刺组:在阴道超声引导下经后穹隆穿刺治疗,对照组:行腹腔镜手术治疗。结果经阴道超声引导盆腔包裹性积液穿刺22例,穿刺成功率100%,治愈20例,治愈率达90.91%(20/22);20例行腹腔镜手术者,治愈18例,治愈率90%(18/20),经统计学分析无显著性差异。结论经阴道超声引导盆腔包裹性积液穿刺治疗,是一种快速简便、经济、有效的治疗方法,可重复进行,是盆腔包裹性积液的首选治疗方法。     

盆腔包裹性积液治疗方法探讨

盆腔包裹性积液亦称盆腔炎性包裹性囊肿或盆腔腹膜囊肿，多继发于盆腹部手术或盆腔炎症。除妇科检查发现盆腔肿块外，超声检查是盆腔包裹性积液最佳诊断方法。目前随着妇女盆腔炎的急剧上升及妇科外科手术的进一步增加，本病有逐年增加的趋势。该病具有病程迁延难愈、治愈难度大的特点。现将本院2003年1月至2005年1月于B超引导穿刺下治疗21例，行剖腹手术或腹腔镜手术治疗33例，和中药保守治疗30例的疗效分析报告如下。[第一段]     

Comparison of tubal ring and corpus luteum echogenicities: a useful differentiating characteristic.

The purpose of this report is to compare the echogenicity of the tubal ring of an ectopic pregnancy and the corpus luteum with that of the ovary for improved detection of early ectopic pregnancy. In patients with ectopic pregnancy diagnosed at sonography on the basis of the presence of an adnexal tubal ring, echogenicity of the ring was compared with the echogenicity of the ovarian parenchyma. Twenty-six patients with tubal rings containing either a yolk sac or cardiac activity were included. Twenty-three (88%) of the 26 tubal rings had echogenicity equal to or greater than that of ovarian parenchyma. In 13 patients with ectopic pregnancy diagnosed on the basis of an empty tubal ring, 10 rings (77%) were more echogenic than the ovary. In 45 control patients with intrauterine pregnancy, the corpus luteum was more echogenic than the ovary in only 3 (7%). The tubal ring of an ectopic pregnancy is usually more echogenic than ovarian parenchyma, and the corpus luteum is usually equal to or less echogenic than the ovary. Echogenicity of an adnexal mass may help distinguish the tubal ring of an ectopic pregnancy from a corpus luteum.     

Corpus luteum blood flow in normal and abnormal early pregnancy: evaluation with transvaginal color and pulsed Doppler sonography.

One hundred and thirteen (66.5%) women in this study had a normal intrauterine pregnancy with ages ranging 6 to 12 weeks of gestation. Fifty-seven (33.5%) patients were admitted to the hospital owing to clinically suspected abnormal early pregnancy. Dilatation and curettage were done on all women and tissue sample sent to the pathologist for a final diagnostic. Diagnosis of ectopic pregnancy was made on laparoscopy. Both ovaries were examined carefully by color Doppler in sonography in all patients. Color flow was used as a guide for pulsed Doppler exploration. Corpus luteum blood flow was defined as random, usually semilunar in appearance, dispersed vessels with very low impedance to blood flow. The resistive index and pulsatility index were calculated. Overall detection rate of corpus luteum blood flow in normal pregnancies was higher for the left ovary (62.6%) than for the right ovary (37.4%) (P < 0.01). The mean resistive and pulsatility indices from corpus luteum blood flow were not influenced by gestational age in normal pregnancy. The overall mean value for for resistive index was 0.452 +/- 0.04 and for pulsatility index 0.636 +/- 0.09. The overall detection rate of corpus luteum in abnormal pregnancies also was higher for the left ovary (56.7%) than for the right ovary (43.4%) (P < 0.01). The mean resistive indices from corpus luteum blood flow in patients with missed abortion was higher than in women with normal pregnancy (P < 0.01). Both resistive and pulsatility indices were higher in patients with incomplete or threatened abortion in comparison with normal pregnancy (P < 0.01). No statistically significant difference was seen in the case of anembryonic, molar, or ectopic pregnancy.     

卵巢黄体囊肿破裂75 例临床分析

目的：探讨卵巢黄体囊肿破裂的临床特征和治疗方案。方法：对75例卵巢黄体囊肿破裂临床资料进行回顾性分析。结果：75例均发生于卵巢功能旺盛时期,均以突发性下腹痛为主要症状,5l例以右下腹痛为主,43例伴阴道流血,后穹隆穿刺或腹腔穿刺均抽出不凝血液。入院诊断为黄体囊肿破裂65例,腹痛原因待查10例。73例经手术病理证实为黄体囊肿破裂;2例经临床分析诊断为卵巢黄体囊肿破裂,保守治疗而愈。结论：卵巢黄体囊肿破裂既可发生于月经黄体,又发生于妊娠黄体,以右侧卵巢多见,临床应注意与阑尾炎、异位妊娠破裂及卵巢肿瘤蒂扭转鉴别。     

经阴道超声诊断卵巢妊娠价值的初步探讨

目的评价经阴道超声对卵巢妊娠的诊断价值。方法回顾性分析21例卵巢妊娠的超声图像特征，并与手术及病理结果进行对照分析。结果所有病例经阴道超声检查均诊断为宫外孕，9例未破裂型卵巢妊娠中，经阴道超声检查进一步提示部位在卵巢者3例，在卵巢表面者3例，部位不清者1例，误诊为输卵管妊娠2例，定位符合率66．7％；12例破裂型卵巢妊娠中，经阴道超声检查均未进一步提示病灶部位。其声像图特征为：子宫正常或略大，宫腔内未见胚囊；卵巢内部或表面见完整的胚囊结构或不均质强回声；或附件区见杂乱不均质回声，其内可测及或未测及完整的胚囊结构，盆腹腔常见多量游离液体。结论经阴道超声对未破裂型卵巢妊娠的术前诊断有一定价值。     

Criteria for transvaginal sonographic diagnosis of ectopic pregnancy

Transvaginal ultrasonography was performed in 1150 patients suspected of having an ectopic gestation. The criteria for transvaginal sonographic diagnosis of ectopic pregnancy were established by targeted scanning of the pelvic organs and spaces. Sonographic assessment of tubal pregnancy and its differential diagnosis were based on six criteria: (1) the presence or absence of gestational structures within the fallopian tube, (2) the presence or absence of amorphous material in a dilated fallopian tube, (3) the presence or absence of indirect signs of ectopic pregnancy within the pelvis, (4) the echogenicity of a suspected finding relative to the ovary, (5) the presence or absence of flow (of lacunar origin) within the suspected sonographic finding, and (6) the relationship of a suspected sonographic sign to an intentionally displaced ovary. The latter 3 criteria help differentiate between tubal gestation and a corpus luteum. We believe these diagnostic criteria should be applied when performing transvaginal sonographic scanning of patients suspected of having an ectopic gestation.     

Various sonographic appearances of the hemorrhagic corpus luteum cyst

Although hemorrhagic corpus luteum cysts are frequently seen during sonography of the female pelvis, their diagnosis is often challenging as a result of variations in size, thickness of the cyst wall, and internal echo pattern depending on the formation and lysis of the clot. There are cases in which hemoperitoneum is the most obvious finding. The differential diagnosis is extensive and includes ectopic pregnancy, adnexal torsion, neoplasm, and pelvic inflammatory disease. This review describes and illustrates the diverse appearances of the hemorrhagic corpus luteum, as well as other etiologies of adnexal pathology that can mimic the appearance of a hemorrhagic corpus luteum sonographically.     

彩色多普勒超声在异位妊娠和妊娠黄体中的诊断价值

目的探讨异位妊娠与妊娠黄体的经阴道超声表现,以提高其诊断符合率。方法回顾分析115例经手术及病理证实的异位妊娠患者和97例宫内早孕者妊娠黄体的经阴道超声表现。结果异位妊娠声像图表现为宫旁不均质包块,妊娠黄体声像图表现为卵巢内部或表面突出的不均质包块;彩色多普勒血流成像示115例异位妊娠患者血流呈环状者占1.74%(2/115),半环状者占26.96%(31/115),点/线状者占47.83%(55/115),未见血流信号者占23.48%(27/115);97例宫内早孕者妊娠黄体血流呈环状者占93.81%(91/97),半环状者占4.12%(4/97),点/线状者占2.07%(2/97)。异位妊娠患者较宫内早孕者妊娠黄体收缩期峰值流速低,阻力指数高,差异有统计学意义(P﹤0.05)。结论经阴道超声在异位妊娠与妊娠黄体的鉴别诊断中有重要价值。     

阴道三维能量多普勒超声检测妊娠黄体血流对异位妊娠的诊断价值

目的 应用阴道三维能量多普勒超声对异位妊娠黄体和宫内妊娠黄体进行对比分析.方法 临床拟诊宫外孕患者30例,手术前行阴道超声检查.使用三维能量多普勒超声观察异位妊娠黄体血流分布,并对同期31例宫内妊娠黄体进行观察.采集三维能量多普勒血流图并测量相应的血管参数:血管形成指数(VI)、血流指数(FI)、血管形成-血流指数(VFI).比较异位妊娠黄体与宫内妊娠黄体血流分布及血管参数差异,评价其在异位妊娠鉴别诊断中的意义.结果 异位妊娠黄体血流信号低于宫内妊娠黄体,异位妊娠黄体血管参数VI、VFI值低于宫内妊娠黄体,差异均有统计学意义(P<0.05),异位妊娠黄体FI值低于宫内妊娠黄体,但无统计学差异.结论 阴道三维能量多普勒超声检测妊娠黄体血流信息,可为异位妊娠的诊断提供有价值信息.     

Ectopic pregnancy versus corpus luteum cyst revisited: best Doppler predictors.

OBJECTIVE: To determine the best Doppler values for differentiating ectopic pregnancy from a corpus luteum cyst of pregnancy. METHODS: This was a prospective study of 80 consecutive patients with the diagnosis of ectopic pregnancy. All ectopic pregnancies were diagnosed on the basis of the presence of an extra-ovarian adnexal mass on sonography and were confirmed surgically. The last menstrual period ranged from 4 to 11 weeks (mean, 6.3 weeks), and the maximal ectopic pregnancy diameter ranged from 0.7 to 5.5 cm (mean, 2.5 cm). Seventy-six ectopic pregnancies showed color vascularity, and 40 showed corpus luteum cysts with vascular walls. The highest peak systolic velocity and the lowest resistive index of the vascular ectopic pregnancies were compared with the corresponding values in the vascular corpus luteum cysts. RESULTS: The mean peak systolic velocity of the ectopic pregnancies was 35.4 cm/s compared with 28.4 cm/s in corpus luteum cysts, with no significant statistical difference (P = .1). The resistive index of the ectopic pregnancies ranged from 0.15 to 1.6 (mean +/- SD, 0.61 +/- 0.24) compared with 0.39 to 0.7 (mean, 0.52 +/- 0.10) in corpus luteum cysts, with a significant statistical difference (P = .003). In this cohort, a resistive index of less than 0.39 had a specificity of 100% and a positive predictive value of 100% for diagnosing ectopic pregnancy but was present in only 15% (confidence interval, 7%-23%) of ectopic pregnancies. A resistive index of greater than 0.7 had a specificity of 100% and a positive predictive value of 100% for diagnosing ectopic pregnancy and was present in 31% (confidence interval, 21%-41%) of ectopic pregnancies. CONCLUSIONS: Both low and high resistive indices discriminate ectopic pregnancy from a corpus luteum cyst.