彩色多普勒超声在子宫腺肌症诊断中的应用

目的提高经腹彩色多普勒血流显像（2D-CDFI）对子宫腺肌症的诊断率。方法对经术后病理证实的30例子宫腺肌症彩超图像特征进行分析。结果30例子宫腺肌症患中，有3例误诊为子宫肌瘤，误诊率为10%（3/30），诊断符合率为90%（27/30）。子宫腺肌症可分为弥漫型10例，局灶型15例，混合型4例。结论2D-CDFI能清晰显示子宫腺肌症的超声特征，从超声特征上看子宫腺肌症与子宫肌瘤均有各自独特的声像学表现，轻易鉴别。     

经阴道彩色多普勒超声诊断子宫肌瘤和子宫肌腺病

目的 探讨经阴道彩色多普勒超声(TVCDU)对子宫肌瘤和子宫肌腺病的诊断价值.方法 应用经阴道彩色超声诊断仪,对45例子宫肌瘤和28例子宫肌腺病患者行术前检查,包括灰阶图像和彩色血流成像;术后均经病理证实.结果 超声检查诊断子宫肌瘤共42例,子宫肌腺病34例.与病理结果对照:3例子宫肌瘤被误诊为子宫肌腺病,6例子宫肌腺病被误诊为子宫肌瘤,子宫肌瘤的诊断符合率为92.8%,子宫肌腺病符合率为82.5%.二维灰阶超声:子宫肌瘤和子宫肌腺病各有特点,子宫肌瘤内部血流丰富,而子宫肌腺病只有星点样血流;子宫肌瘤随着体积的增大,彩色血流的丰富程度也随之增加,而子宫肌腺病不具备上述特征.结论 应用TVCDU二维灰阶成像可鉴别子宫肌瘤和子宫肌腺病,二者的诊断正确率均较高;联合应用灰阶图像及彩色图像,有利于提高诊断的正确率.     

经阴道彩色多普勒超声诊断子宫肌瘤和子宫腺肌症及腺肌瘤的临床分析

目的:本文探讨经阴道二维及彩色多普勒超声诊断子宫肌瘤、子宫腺肌症及腺肌瘤的临床应用价值。方法:我院1998年11月1日~2002年1月1日经手术病理证实子宫肌瘤、子宫腺肌症及腺肌瘤共92例,经阴道超声分析二维及彩色多普勒血流显像(CDFI)特征。结果:二维图像上均呈特征性改变;CDFI示子宫肌瘤周边血流丰富,动脉血流阻力指数RI为0.58±0.16,子宫腺肌瘤周边血流信号稀少,RI为0.74±0.07;经阴道彩色多普勒超声诊断子宫肌瘤、腺肌症符合率分别是93.1%,76.4%。结论:经阴道彩色多普勒超声为子宫肌瘤、子宫腺肌症及腺肌瘤的鉴别诊断提供有价值信息。     

超声诊断乳腺小肿块的应用价值

目的探讨彩色多普勒超声对乳腺小肿块（直径≤20mm）良、恶性病变鉴别诊断中的应用价值。方法应用彩色多普勒超声常规检查67例共91个乳腺小肿块对良、恶性肿块的二维超声图像与彩色多普勒血流（CDFI）特点进行总结。并将超声与病理结果相对照。结果良性乳腺小肿块超声诊断与病理诊断符合率为92．6％（50／54），恶性乳腺小肿块超声诊断与病理诊断符合率为89．2％（33／37），良、恶性乳腺小肿块纵/横径比、后方回声、肿块内血流信号丰富程度及血流动力学参数等存在差异。结论二维超声与彩色多普勒结合能进一步提高乳腺小肿块的鉴别诊断能力。     

子宫小叶样分割性平滑肌瘤的超声特征分析

目的总结子宫小叶样分割性平滑肌瘤（CDL）的超声影像学特征及鉴别诊断要点。 方法分析2011年1月至2016年12月在首都医科大学附属北京妇产医院超声检查并经手术及病理证实为CDL患者的超声影像学特征,总结CDL超声鉴别诊断要点。 结果6例CDL术前超声显示肿物局限于子宫肌层5例,表现为子宫肌层内边界不规则、内部回声不均匀的实性肿物;彩色多普勒血流成像（CDFI）示肿物内部血流信号丰富;1例肿物突破子宫浆膜层,宫外部分表现为胎盘小叶样分格状的低回声肿物,彩色多普勒示肿物内部血流信号丰富。术前超声诊断为子宫肌瘤3例,误诊为子宫平滑肌肉瘤1例,子宫内膜间质肉瘤1例,子宫腺肌瘤1例。 结论因子宫CDL有分割性生长方式及宫外扩张性生长的特点,术前超声易误诊为子宫恶性肿瘤,需仔细辨识。术前超声正确诊断有利于手术方式的选择,避免过度治疗。     

经阴道彩色多普勒超声对子宫肌瘤诊断的临床价值分析

目的：探讨经阴道彩色多普勒超声对子宫肌瘤的诊断及指导治疗的价值.材料与方法：将我院经阴道彩色多普勒超声诊断的30例子宫肌瘤患者作为研究对象,患者均阴道彩色多普勒超声确诊后接受手术治疗,将阴道彩色多普勒超声诊断结果与术后病理诊断结果进行比较观察.结果：30例患者术后病检子宫肌瘤28例,子宫腺肌瘤2例,B超诊断符合率为93.3％;超声特点（1）显示病灶为低回声结节型、光点增强增粗型、等回声及半囊半实质型;（2）病灶位于子宫浆膜下、子宫肌层、子宫黏膜下及子宫壁肌间（3）病灶边界尚清晰,周围有比较清晰的环状血流或半环状血流包绕,频谱的阻力指数为低阻血流频谱RI0.58±0.04.经手术治疗后均痊愈,治愈率为100％.结论：采用经阴道彩色多普勒超声诊断子宫肌瘤具有较高准确率,同时在经阴道彩色多普勒超声确诊后对选择治疗方法,有重要参考价值,有效促进患者康复.     

彩色多普勒超声在胆囊腺肌瘤症与原发性胆囊癌鉴别诊断中的价值

目的探讨彩色多普勒超声（CDFI）在胆囊腺肌瘤症与胆囊癌鉴别诊断中的价值。 方法采用CDFI检测20例胆囊腺肌瘤症与32例胆囊癌患者，全部病例均经手术病理证实，观察胆囊壁厚度与回声情况，浆膜层的完整性，囊腔回声情况，行CDFI检测增厚病变内的血流分布情况与血流丰富程度，并分别进行比较。 结果20例胆囊腺肌瘤症中35．0％（7／20）合并胆囊腔内结石，80．0％（16／20）合并壁内结石；胆囊浆膜层均显示完整（20／20）；CDFI于95％（19／20）胆囊腺肌瘤症增厚囊壁内未测及明显血流信号，仅1例测及少量星点状血流信号。32例胆囊癌中40．6％（13／32）合并腔内结石，无1例合并壁内结石；胆囊浆膜层53．1％（17／32）显示不完整；CDFI于81．2％（26／32）胆囊癌肿块内测及丰富血流信号，形态呈“网篮样”改变。 结论彩色多普勒超声在胆囊腺肌瘤症与胆囊癌鉴别诊断中具有重要的临床意义。     

阴道彩色多普勒超声在常见妇科疾病诊断中的应用

目的：探讨阴道彩色多普勒超声在诊断子宫肌瘤、子宫肌腺病、滋养叶细胞瘤中的临床价值。方法：回顾性分析健康妇女及子宫肌瘤、子宫肌腺病、滋养叶细胞瘤的患者血流阻力指数（RI）。结果：子宫肌瘤、子宫肌腺病、滋养叶细胞瘤组RI均低于正常对照组。滋养叶细胞瘤血流表现特征性低阻力。结论：阴道彩色多普勒具有高分辨率特征，对子宫肌瘤、子宫肌腺病鉴别以及滋养叶细胞瘤的良恶性诊断具有一定的临床价值。     

子宫腺肌症与子宫肌瘤彩色多普勒超声诊断鉴别

通过对34例子宫腺肌病及40例子宫肌瘤患者的超声图像与手术病理结果作分析，探讨彩色多普勒超声对子宫腺肌病和子宫肌瘤的鉴别诊断价值。     

经阴道彩色多普勒超声在子宫腺肌瘤诊断中的应用

目的：探讨经阴道彩色多普勒超声技术对子宫腺肌瘤的诊断与鉴别诊断的应用。方法：对46例患者进行术前经腹和经阴道彩色多普勒超声检查，并与术后病理结果对比分析。结果：例术前经阴道彩色多普勒超声与术后对照，超声诊断符合率。超声特点子宫腺肌瘤无包膜，内部回声多呈粗大颗粒状，后方常伴有放射状细淡声影，其内多见星点闪烁状彩色血流信号，频谱显示低速高阻动脉或静脉低速血流。结论：经阴道彩色多普勒超声能清晰地反映子宫腺肌瘤的超声特征，在同子宫肌瘤的鉴别上有较好的可比性。     

子宫腺肌病与子宫肌瘤超声鉴别诊断探讨

目的探讨2D超声、CDFI对子宫腺肌病和子宫肌瘤的鉴别诊断价值。方法将34例子宫腺肌病及40例子宫肌瘤患者的超声表现与手术病理结果作对照分析。结果子宫腺肌病超声诊断符合率为82．4％(28／34),误诊率17．6％(6／34),其中弥散性分布的子宫腺肌病全部确诊,而局限性及合并有子宫肌瘤者容易误诊为子宫肌瘤。结论少数病例子宫腺肌病和子宫肌瘤超声表现相似。确定团块边界是否清晰及团块周边有无包绕的血流信号对于鉴别病灶腺肌病和子宫肌瘤有重要价值。     

子宫腺肌病87例诊治分析

目的：分析近年来子宫腺肌痛的发病情况、临床表现、诊断和治疗。方法：回顾性分析2000年1月-2002年12月本院收治的87例子宫腺肌痛患者的临床资料。结果：87例子宫腺肌痛患者占我院同期妇科住院人数的9．6％、妇科子宫切除手术的21．3％。术前痛经者58例(66．7％)，月经过多者35例(40．2％)，人流后急性腹疼3例(3．4％)。术前诊断为子宫腺肌病51例，诊断符合率为58．6％，B超诊断符合率为49．4％，血CA125测定阳性率为69．2％。除3例行腺肌瘤剔除术外，其余均行全子宫切除术，其中32例术前曾使用内美通、丹那唑、米非司酮、避孕1号等治疗达3个月以上，76．0％痛经明显缓解，但73．7％患者停药后第1个月经周期痛经即复发。结论：子宫腺肌病目前仍以手术治疗为主，治疗子宫内膜异位症的常用药物对子宫腺肌病痛经均有效，但停药后易复发。     

Sonography as a predictor of human immunodeficiency virus-associated nephropathy.

OBJECTIVE: To determine whether renal sonography can be used to predict the pathologic diagnosis of human immunodeficiency virus-associated nephropathy. METHODS: This cross-sectional study evaluated 87 human immunodeficiency virus-positive patients who underwent both kidney biopsy and renal sonography after referral to the Johns Hopkins Renal Clinic from January 1995 to July 2002. Using a standardized measure of echogenicity, an independent blinded radiologist reviewed the original sonographic images. Sensitivity, specificity, positive and negative predictive values, receiver operating characteristic curves, and likelihood ratios were determined with the use of the biopsy pathologic report as the criterion standard. RESULTS: Thirty-four patients (39%) had biopsy-proved human immunodeficiency virus-associated nephropathy. A higher serum creatinine level, greater proteinuria, and black race were associated with human immunodeficiency virus-associated nephropathy, whereas age, sex, hypertension, and diabetes were not. Sensitivity and specificity for the highest 2 levels of echogenicity were 96% and 51%, respectively Sensitivity and specificity for the highest level of echogenicity were 40% and 95%. The likelihood ratio for the diagnosis of human immunodeficiency virus-associated nephropathy on the basis of the highest echogenicity score was 7.4 (95% confidence interval, 1.3-73.0; P = .006). The likelihood ratio for the lowest 2 echogenicity scores was 0.08 (95% confidence interval, 0.002-0.57; P = 0.003). Kidney size was not associated with human immunodeficiency virus-associated nephropathy status. CONCLUSIONS: This study provides evidence that, among patients with human immunodeficiency virus and kidney disease, the highest and lowest levels of sonographic echogenicity have diagnostic value in respectively establishing or excluding human immunodeficiency virus-associated nephropathy.     

Heterogeneous Echogenicity of the Thyroid Parenchyma Does Not Influence the Detection of Multi-focality in Papillary Thyroid Carcinoma on Preoperative Ultrasound Staging

Heterogeneous echogenicity and micro-nodulations of diffuse thyroid disease on ultrasonography (US) might influence the diagnostic performance of pre-operative US staging, especially the detection of multi-focality. This study was designed to determine whether heterogeneous echogenicity of the thyroid parenchyma influences the diagnostic performance of US in the detection of multi-focality in papillary thyroid carcinoma. Between December 2010 and April 2011, 811 patients underwent pre-operative staging US for papillary thyroid carcinoma and surgery. Twelve radiologists performed the pre-operative US for T and N staging. Underlying parenchymal echogenicity and unilateral and bilateral multi-focality of the thyroid nodules were also evaluated. Patients were divided into two groups on the basis of the underlying echogenicity of the thyroid gland. To evaluate the diagnostic accuracy of US with respect to underlying echogenicity, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy were calculated and compared between the two groups. Among the 811 patients included, US revealed underlying heterogeneous echogenicity of the thyroid parenchyma in 204 (25.2%) and underlying homogeneous echogenicity of the thyroid parenchyma in 607 (74.8%). There were no significant differences between the two groups in the diagnostic performance of pre-operative staging US in predicting unilateral multi-focality and bilaterality. Underlying heterogeneous echogenicity in a thyroid gland with Hashimoto's thyroiditis does not significantly influence the detection of multi-focality in papillary thyroid cancer on pre-operative US staging.     

Transvaginal sonography in the diagnosis of adenomyosis: which findings are most accurate?

OBJECTIVES: To evaluate the accuracy of various transvaginal sonographic findings in adenomyosis by comparing them with histopathological results and to determine the most valuable sonographic feature in the diagnosis of adenomyosis. METHODS: In this prospective study, 70 consecutive patients scheduled for hysterectomy underwent preoperative transvaginal sonography. If at least one of the following sonographic features was present, a diagnosis of adenomyosis was made: heterogeneous myometrial echotexture, globular-appearing uterus, asymmetrical thickness of the anteroposterior wall of the myometrium, subendometrial myometrial cysts, subendometrial echogenic linear striations or poor definition of the endometrial-myometrial junction. The sonographic features were compared with the histopathological results. RESULTS: The prevalence of adenomyosis was 37.1% (26/70 patients). The sensitivity, specificity, positive (PPV) and negative (NPV) predictive values and accuracy of transvaginal ultrasound for the diagnosis of adenomyosis were 80.8%, 61.4%, 55.3%, 84.4% and 68.6%, respectively. We found that a regularly enlarged uterus with a globular appearance, subendometrial echogenic linear striations and myometrial cysts had the highest accuracy for the diagnosis of adenomyosis. Of all findings evaluated, heterogeneous myometrium was the most common in patients with adenomyosis (21/26 patients), but it had a poor specificity. The presence of subendometrial linear striations was the most specific sonographic feature (95.5%) and it had the highest PPV (80.0%) for the diagnosis of adenomyosis. CONCLUSIONS: The presence of subendometrial echogenic linear striations, a globular configuration and myometrial cysts on transvaginal ultrasound supports the diagnosis of adenomyosis. Among the transvaginal ultrasound diagnostic findings of adenomyosis, subendometrial linear striations have the highest diagnostic accuracy.     

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.     

子宫腺肌病与子宫肌瘤患者的血清CA125测定

目的　探讨血清CA12 5测定对子宫腺肌病及子宫肌瘤的诊断价值。方法　采用放射免疫方法 (IRMA)对 10 1例子宫腺肌病 (腺肌病组 ) ,374例子宫肌瘤 (肌瘤组 ) ,32例子宫肌瘤合并腺肌病 (合并组 )的患者血清CA12 5进行测定。结果　三组血清CA12 5阳性率分别为 88.12 % ,12 .30 % ,87.5 0 % ,均值分别为 118.37± 78.2 1kU /L ,17.45± 14 .36kU/L ,10 6 .49± 6 3.91kU /L ,肌瘤组血清CA12 5均值及阳性率均明显低于另两组 ,差异有显著性 (P <0 .0 5 ) ,腺肌病组、合并组间的血清CA12 5均值及阳性率差异无显著性 (P >0 .0 5 )。结论　血清CA12 5测定对子宫腺肌病有辅助诊断价值 ,对子宫腺肌病与子宫肌瘤有一定的鉴别诊断价值。     

选择性子宫动脉栓塞术在子宫腺肌病治疗中的价值

目的　探讨选择性子宫动脉栓塞术 (UAE)治疗子宫腺肌病的价值。方法　采用Seldinger’s技术行选择性子宫动脉栓塞 ,治疗 2 6例子宫腺肌病患者。结果　UAE治疗 12个月后子宫体积平均缩小 3 3 .6% (P <0 .0 1) ;患者月经量减少46.3 % (P <0 .0 1) ;痛经缓解率达 88.5 % ,疼痛强度降低、活动能力明显好转 (P <0 .0 1)。结论　选择性子宫动脉栓塞术治疗子宫腺肌病是有效的     

Ultrasonography of the thyroid during pregnancy

To discover whether pregnancy causes ultrasonically detectable changes in the thyroid, an ultrasound examination of the thyroid was performed repeatedly in 21 pregnant women with no history of thyroid disease. Seven patients were examined three times and 14 twice during the course of pregnancy. The size of the thyroid was estimated and the echogenicity assessed with respect to homogenicity and degree by comparison with the echogenicity of adjacent muscles. The results were compared with the results of a control group of healthy female volunteers. The mean volume of the thyroid increased slightly during the course of pregnancy. No changes in the echogenicity or echostructure were noted.