宫腔超声造影术对宫腔内病变的诊断价值

子宫内膜息肉、子宫粘膜下肌瘤、子宫内膜增生过长及子宫内膜癌等宫腔内病变是妇科常见病.目前经腹部超声(TAS)和经阴道超声(TVS)是宫腔内病变诊断的首选方法,但子宫腔通常处于闭合状态,有些宫内病变经TVS难以辨认其确切病变类型, 仅能显示子宫内膜增厚,不能辨别病变的细节,不能为治疗提供准确的指导.而宫腔超声造影术(SHG)是指向宫腔内注入造影剂使宫腔扩张,内膜分离后,再在TVS下观察子宫内病变情况,能清晰显示宫腔内病变为弥漫性或局灶性,病变的位置和特征,其敏感性和特异性很高.为此作者应用SHG经TVS检查宫腔内病变,并作鉴别诊断,取得了很好的效果,现报道如下.     

宫腔超声造影术在内膜良性病变中的应用价值

目的：探讨宫腔超声造影术对宫腔良性病变的诊断价值。方法：应用经阴道超声（TVS）条件下插管并注入超声造影剂,观察子宫内膜、宫腔内和肌层病变。结果：21例患者中,黏膜下肌瘤10例、内膜息肉8例、子宫内膜增生过长1例、妊娠残留物1例和子宫不完全纵隔1例等,其中3例误诊,准确率为85.7%。结论：经阴道超声宫腔造影术（SHG）是一项安全有效的宫腔内病变的影像学检查方法。     

经阴道超声宫腔造影术在诊断子宫疾病中的应用

目的探讨经阴道超声宫腔造影术(SHG)在诊断子宫疾病中的价值.方法应用经阴道超声宫腔造影术对40例子宫疾病的声像图特点进行了观察,并与手术及诊刮结果对比.结果 40例病例中子宫体肥大、子宫肌腺症合并结节5例,宫腔粘连5例,子宫内膜息肉8例、子宫内膜增厚4例、子宫内膜增厚伴囊样改变2例、子宫内膜息肉样增生1例、子宫粘膜下肌瘤10例、子宫内膜异常回声(怀疑内膜癌)2例、不全纵隔子宫1例、节育环移位嵌顿2例,粘膜下肌瘤与内膜息肉诊断与手术对比均准确.结论 SHG的操作简单易行,患者无痛苦、易接受,诊断效果明确.是一种诊断宫腔内疾病的良好方法.     

宫腔超声造影的临床应用及进展

宫腔超声造影技术是指向子宫腔内注入造影剂使宫腔扩张、内膜分离后,在经阴道超声下观察子宫内膜及宫腔内病变情况,该技术能清晰显示宫腔内病变为弥漫性或局灶性以及局灶性病变的位置和特征,具有很高的临床应用价值。本文综述宫腔超声造影的发展和操作过程及技术要领,重点讨论宫腔超声造影诊断宫腔内病变的临床应用价值,并介绍该技术临床应用的最新进展。     

经阴道超声宫腔造影对宫腔内病变的诊断价值

目的探讨经阴道超声宫腔造影对宫腔内病变的诊断价值。方法常规经腹或经阴道超声检查，发现子宫内膜增厚或宫腔内异常团块而难以明确诊断的25例患者，由妇科医师协助进行经阴道超声宫腔造影，造影剂采用无菌生理盐水。结果25例中检出子宫内膜息肉12例，子宫黏膜下肌瘤4例，子宫内膜增生过长6例，子宫内膜癌2例，另1例失败，均经宫腔镜或刮诊、手术证实。结论经阴道超声宫腔造影是一项操作简便易行、准确率高、疼痛少的诊断与鉴别诊断宫腔内病变的有效可行的方法。     

子宫腔内超声扫描的初步临床应用和研究

目的：探讨宫腔内超声扫描对子宫病变的诊断价值。资料与方法：对１３４例患者进行了宫腔内超声扫描检查,并将其结果与经腹或经阴道超声做了对照。结果：发现宫腔内超声扫描对子宫体的细致病变的敏感性高于其它扫描方式。结论：做为一种新的超声扫描技术,宫腔内超声扫描对子宫体病变的诊断有较高的应用价值。     

三维超声宫腔造影诊断子宫内膜病变

目的：评价经阴道三维超声宫腔造影对子宫内膜病变诊断价值。方法：应用阴道方式三维超声对子宫不规则出血30例患者进行宫腔内生理盐水灌注后扫查，并与宫腔镜检查及病理结果对照。结果：18例诊断子宫内膜息肉，7例诊断粘膜下肌瘤，3例子宫内膜增生，2例子宫内膜癌。宫腔造影敏感度100％，特异度93％。结论：经阴道三维超声宫腔内灌注显影方法简便、易行，准确度高，是诊断子宫内膜病变的可行方法。     

经阴道超声宫腔造影诊断子宫内膜息肉的价值

随着经阴道超声(TVS)的开展,子宫内膜息肉的诊断准确率逐步提高,但由于子宫腔通常处于闭合状态,有些宫内病变TVS检查难以辨认其确切病变的类型.经阴道超声宫腔造影技术(SHG)能清晰地显示宫腔轮廓及病灶形态,从而提高子宫内膜息肉诊断准确率.本研究回顾性分析了102例TVS检查拟诊子宫内膜息肉患者行SHG、宫腔镜及病理组织学检查结果,探讨SHG对内膜息肉的诊断价值,现报告如下.     

经阴道超声诊断宫腔粘连的价值

目的:探讨经阴道超声诊断宫腔粘连的价值.方法:对82例临床怀疑宫腔粘连的的患者进行阴道彩超检查,观察其子宫内膜及宫腔的改变并与宫腔镜手术后病理结果进行比较.结果:经阴道超声诊断宫腔粘连的敏感度为78.6％(55/70)、特异度为83.3％ (10/12)、准确性为69.5％(57/82).结论:经阴道起声对宫腔粘连诊断有重要价值,可作为宫腔粘连病变的常规筛查方法.     

超声造影在子宫宫腔病变诊断中的初步应用

目的 探讨超声造影在子宫宫腔病变诊断中的应用价值.方法 回顾性分析经手术病理或临床证实的子宫宫腔病变54例,分析其常规彩超和超声造影表现,比较常规彩超和超声造影对各种宫腔病变的诊断符合率.结果 子宫内膜癌及宫腔内血块超声造影检查诊断符合率明显增高,并有统计学显著差异(P<0.05);子宫黏膜下肌瘤、宫腔息肉、宫腔内残留诊断符合率提高,但无统计学显著差异(P>0.05).结论 超声造影能显示子宫宫腔病变微小血管的血流灌注,结合常规彩超能进一步提高子宫宫腔病变的诊断和鉴别诊断.     

Diagnostic Value of Sonohysterography in the Determination of Fallopian Tube Patency as an Initial Step of Routine Infertility Assessment

Objectives. Infertility is defined as the failure to conceive after 1 year of regular unprotected intercourse. It affects 10% to 15% of couples. Sonohysterography (SHG) is an accurate method for the assessment of fallopian tube patency, reflected in its high positive predictive value compared with hysterosalpingography (HSG) and laparoscopy with chromopertubation. In this study, our goal was to determine the diagnostic value of SHG for the diagnosis of bilateral tubal obstruction by comparison of SHG with HSG and laparoscopic results. Methods. This study was based on the evaluation of tubal patency by SHG and by the combination of HSG and laparoscopy in 40 patients. All patients underwent HSG as a routine infertility workup, and all patients with bilateral proximal tubal obstruction diagnosed by HSG subsequently underwent SHG. Results. Among 1024 infertile women referred to an infertility clinic, 117 (11.4%) had a diagnosis of a tubal factor as the cause of their infertility. Forty-two patients with HSG findings of bilateral proximal tubal obstruction were enrolled. Forty patients underwent SHG. In 32 patients (80%), at least 1 fallopian tube was patent, and 8 patients (20%) were reported to have bilateral tubal obstruction. Those 8 patients with SHG evidence of bilateral tubal obstruction underwent laparoscopy. Eventually, 6 of those were laparoscopically confirmed to have bilateral tubal obstruction. Conclusions. Sonohysterography is an accurate method for the determination of fallopian tube patency. It is a simple, safe, and well-tolerated technique with a low risk of adverse effects and severe complications.     

经腹及经阴道超声、宫腔超声造影和宫腔镜诊断宫内病变

目的 评价经腹、经阴道超声及官腔超声造影、官腔镜对宫内病变的诊断价值。方法 常规经腹部、经阴道超声及生理盐水灌注官腔后经阴道超声观察宫内病变，官腔镜检查治疗宫内病变。结果 88例经腹超声，45例经阴道超声，39例官腔超声造影，23例行官腔镜检查治疗，数种方法结果比较：官腔超声造影和官腔镜的敏感性、准确性和阳性预测值最高，分别为94．29％、90．24％、94．29％和95、65％、91、67％、95．65％，两者差异无显著性意义。结论 经阴道超声、官腔超声造影是诊断官腔内病变的一种简便、经济、无痛苦无损伤、诊断率高的方法。     

Optical delineation of human malignant melanoma using second harmonic imaging of collagen

Skin cancer incidence has increased exponentially over the last three decades. In 2008 skin cancer caused 2280 deaths in the UK, with 2067 due to malignant melanoma. Early diagnosis can prevent mortality, however, conventional treatment requires multiple procedures and increasing treatment times. Second harmonic generation (SHG) imaging could offer diagnosis and demarcation of melanoma borders non-invasively at presentation thereby short-cutting the excision biopsy stage. To test the efficacy and accuracy of SHG imaging of collagen in skin and to delineate the borders of skin cancers, unstained human melanoma biopsy sections were imaged using SHG microscopy. Comparisons with sister sections, stained with H&E or Melan-A were made for correlation of invasion borders. Fresh ex vivo normal human and rat skin was imaged through its whole thickness using SHG to demonstrate this technique is transferable to in vivo tissues. SHG imaging demonstrated detailed collagen distribution in normal skin, with total absence of SHG signal (fibrillar collagen) within the melanoma-invaded tissue. The presence or absence of signal changes dramatically at the borders of the melanoma, accurately demarcating the edges that strongly correlated with H&E and Melan-A defined borders (p<0.002). SHG imaging of ex vivo human and rat skin demonstrated collagen architecture could be imaged through the full thickness of the skin. We propose that SHG imaging could be used for diagnosis and accurate demarcation of melanoma borders on presentation and therefore potentially reduce mortality rates.     

宫腔声学造影在诊断及处理宫内节育器嵌顿中的价值

目的 评价宫腔声学造影（SHG）在诊断及处理宫内节育器（IUD）嵌顿中的价值。方法 应用SHG对18例疑IUD嵌顿的带器患者进行检查，并根据SHG检查结果予以相应处理。结果 SHG显示IUD浅嵌顿10例、深嵌顿4例、IUD下移1例及双器1例。除1例放弃取器外，17例病人经适当手术方法取出IUD。结论 宫腔声学造影是诊断IUD嵌顿的一种简便、有效的新方法，其结果有助于临床处理中取器方法的选择。     

乳腺病变3646例冷冻切片诊断分析

目的 为提高乳腺病变冷冻切片诊断的正确性提供有参考价值的资料。方法 就我科１９９１年￣１９９５年间３６４６例乳腺病变的冷冻切片进行回顾性分析。结果 发现乳腺病变的冷冻切片占冷切片总数的４９．７８％，居首位。对３６４６例乳腺病变的冷冻切片一石蜡切片对照比较，得出确诊率为９９．２３％，（其中完全符合９８．６５％，基本符合１．３５％），未确诊率０．７４％，误诊率０．０２７％。３６４６例病列中，良恶性病变     

Imaging-assisted percutaneous biopsy of the thoracic spine

Confirmation of tissue pathologic changes often is necessary before appropriate therapy can be instituted for lesions of the thoracic spine. Plain film roentgenography and computed tomography provide the key information needed for the percutaneous biopsy procedure. The location and type of bone involvement (lytic or sclerotic) and the presence or absence of a soft tissue mass determine the imaging technique and the choice of needle to use for safe and accurate performance of the procedure. In 26 patients with thoracic spinal or paraspinal lesions (or both), biopsy was done with use of fluoroscopic or computed tomographic guidance. The overall accuracy was 90%. Pneumothorax occurred in two patients. Percutaneous biopsy is a rapid, safe technique for diagnosis of lesions of the thoracic spine.     

Sonographically guided core needle biopsy of bone and soft tissue tumors.

OBJECTIVE: To determine the value of sonographically guided core needle biopsies of musculoskeletal tumors as a reliable alternative to fluoroscopy and computed tomography. METHODS: A prospective study was performed in 74 patients referred for image-guided needle biopsy of primary or recurrent musculoskeletal neoplasms and suspected solitary metastasis. Imaging studies performed before biopsy established the feasibility of sonographic guidance in 65 lesions, of which 38 were soft tissue tumors and 27 were bone lesions with extraosseous masses. The lesions were located mainly in the appendicular skeleton. Tissue samples were obtained with a 14-gauge cutting needle coupled to an automated biopsy device under local anesthesia and sonographic guidance. Statistical analysis was based on 48 biopsies confirmed by successful clinical treatment (10 cases) or surgical resection (38 cases). RESULTS: An accurate diagnosis was obtained in 47 (97%) of 48 biopsies; sensitivity was 96%, and specificity was 100%. The method did not yield sufficient tissue to establish a diagnosis in 1 case. Considering all 65 biopsies, high-quality specimens were obtained in 96%. The procedure was carried out expeditiously, and there were no complications. CONCLUSIONS: Sonographically guided core needle biopsy is accurate and safe, obviating open biopsy in most soft tissue masses and bone tumors with extraosseous masses in the appendicular skeleton. In such patients, the sonographically guided procedure is the most prompt and effective method for obtaining tissue samples.     

Sonohysterography: technique, endometrial findings, and clinical applications.

Transvaginal ultrasound-guided saline infusion sonohysterography (SHG) is a relatively new technique for evaluation of the uterine cavity. As new studies declare the clinical usefulness of this technique, SHG may quickly become part of the routine ultrasound evaluation of the female pelvis. In this article, the SHG procedure is described and normal findings are discussed. Common endometrial pathological findings such as atrophy, polyps, fibroids, hyperplasia, and carcinoma are reviewed. The newly touted roles of SHG for screening patients on long-term tamoxifen therapy and for evaluating patients with infertility are introduced. Finally, we present a practical ultrasound-based flow chart for the workup of menopausal and perimenopausal patients with abnormal uterine bleeding.     

Endoscopic ultrasound-guided fine-needle aspiration biopsy - Recent topics and technical tips

Endoscopic ultrasound-guided fine-needle aspiration biopsy (EUS-FNA) is a useful procedure that enables reliable pathological diagnoses of pancreatobiliary diseases, subepithelial lesions, and swollen lymph nodes. In recent years, a pathological diagnosis based on EUS-FNA has made it possible to provide accurate treatment methods not only in these fields, but also in respiratory organs and otorhinolaryngology. This review discusses the latest topics pertaining to EUS-FNA as well as procedural tips.