Ultrasonographic appearance of cervical pregnancy following successful treatment with methotrexate.

We report a case of cervical ectopic pregnancy successfully treated with systemic methotrexate. Conservative management with single-dose methotrexate was undertaken, but owing to the failure of human chorionic gonadotropin (hCG) levels to fall by 15% by day 7 and the persistence of fetal cardiac activity, two further doses of methotrexate were required. The patient's hCG levels were monitored, and repeat transvaginal ultrasonography was performed until complete resolution of the pregnancy by spontaneous miscarriage. We describe the ultrasonographic findings, which showed that the sac size increased despite treatment.     

Ultrasonographic differentiation of hepatocellular carcinoma from metastatic liver cancer

Ultrasonographic features of tumor nodules in 64 patients with hepatocellular carcinoma and 87 with metastatic liver cancer were analyzed for differential diagnosis. Sonographic characteristics of hepatocellular carcinoma were the mosaic, posterior echo enhancement, and lateral shadow patterns, which were rarely observed in metastatic liver cancers. Small hepatocellular carcinomas, less than 3 cm in diameter, showed a hypoechoic pattern. Metastatic liver cancers originating from the gastrointestinal tract were frequently hyperechoic irrespective of their size and the bull's-eye-like pattern was specific for metastases from the lung. These results indicate that ultrasonography is useful for the differential diagnosis of hepatocellular carcinoma and metastatic liver cancer.     

腹腔妊娠的超声诊断

腹腔妊娠极少见，国内报道认为腹腔妊娠发病率在1：15000～1：30000次分娩．国外报道约占异位妊娠的1％。腹腔妊娠分为原发性和继发性腹腔妊娠两类，一般以继发性多见，此病易漏诊或误诊为宫内妊娠。     

颈部动脉夹层的超声影像特征分析

目的总结颈部动脉夹层的超声影像特征,以期提高超声对其的诊断准确率。方法选取18例经DSA、CTA或MRI证实的颈动脉夹层患者,回顾性分析其超声影像资料,总结其超声影像特征。结果 18例颈部动脉夹层患者共21根血管,超声准确诊断13例共15根血管,准确率71%。13例患者15根血管超声表现为"双腔征"(真腔和假腔),血管腔内见膜带状回声;3例患者4根血管超声表现为锥形不规则狭窄,疑为动脉夹层;2例患者2根血管超声表现为动脉管腔远端充满低回声,未见血流充盈,诊断为闭塞。结论颈部动脉夹层的超声特征具有一定特异性,超声可作为其首选检查方法。     

包块型子宫角妊娠超声诊断分析

目的总结包块型子宫角妊娠超声声像图特征及定位、定性诊断要点。方法对23例于2011年1月至2013年1月在北京协和医院超声检查并经手术及病理检查证实为包块型子宫角妊娠患者的超声声像图特征进行总结分析。结果 23例包块型子宫角妊娠患者（18例经阴道超声检查,5例经腹部超声检查）超声声像图均表现为位于一侧子宫角处向外突出的混合回声包块,其中20例包块边界清晰或较清晰,经腹部超声显示3例包块边界不清晰;15例可见间质线征,8例因包块与子宫内膜紧邻未显示间质线征;包块周边子宫肌层厚度为0.1-0.3 cm。23例中3例血清β-hCG检测值较高（〉20 000 IU/L）的患者超声可观察到子宫角包块中典型的中高回声绒毛结构;彩色多普勒血流成像示22例包块周边可见丰富环绕血流信号（其中9例伴内部较丰富血流信号）,1例包块周边示少许条状血流信号,动脉频谱均为低阻改变。23例包块型子宫角妊娠患者中,7例因包块呈蜂窝状混合回声、血流丰富及低阻动脉频谱误诊为滋养细胞肿瘤（5例经腹部超声检查,2例经阴道超声检查）,16例术前超声与手术病理诊断一致,声像图特征：包块均位于子宫角内膜延长线上;包块边界清晰、血流分布以周边环绕为主;血清β-hCG检测值较高的患者声像图中或可观察到典型的中高回声绒毛结构。结论超声诊断包块型子宫角妊娠应根据包块位置、边界、血流分布、有无绒毛结构并结合病史及血清β-hCG检测值与滋养细胞肿瘤相鉴别。经阴道超声检查在包块型子宫角妊娠定位、定性及鉴别诊断中有重要价值。     

颈部淋巴结结核的超声特征分析

<正>淋巴结结核是由结核杆菌引起的结核性肉芽肿,好发于颈部,是青少年中相对多见的良性病变。由于该病在不同的病理阶段超声表现多样,致使一些不典型病例诊断时较为困难。本组分析了32例经手术病理证实为淋巴结结核的声像图特征及血流分布情况,旨在提高超声诊断的准确率。资料与方法一、临床资料选取2011年4月至2014年4月在我院就诊的经手术或穿刺后病理证实的淋巴结结核患者32例,男14例,女18例,年龄     

Ultrasonographic differentiation of benign from malignant neck lymphadenopathy in thyroid cancer.

OBJECTIVE: The aim of this study was to determine whether ultrasonography itself was able to distinguish benign from malignant lymphadenopathy in patients with thyroid cancer. METHODS: We evaluated lymph nodes in a group of patients with thyroid cancer. Nodes were detected and measured by ultrasonography, and their shape, echogenicity, size, and location were noted. Ultrasonographically guided fine-needle aspiration biopsy (FNAB) was performed, and smears were analyzed cytologically. RESULTS: Ultrasonographically guided FNAB was performed in 578 neck nodes in a group of 631 patients with thyroid cancer. In most cases, metastases had a round shape and various echo structures, with a predomination of hypoechoic nodes without a hilum. There were statistical differences in size between metastatic and benign nodes in terms of maximum diameter, minimum diameter, and volume. Among these, minimum diameter and the shape of the nodes seemed to be the most reliable in suggesting malignancy. A round shape with a longitudinal/transverse ratio of less than 2 of hypoechoic nodes indicated the presence of metastases, and we then performed FNAB. The absence of an echogenic hilum and the presence of cystic portions and calcifications were significantly greater in malignancies than in benign lesions (P<.001). In most cases, metastatic nodules were situated in the lower third of the neck. Reactively enlarged nodes occurred more frequently in the upper part of the neck. CONCLUSIONS: Ultrasonography itself cannot distinguish benign from malignant lesions, but an echographic appearance suggests malignancy and helps in the selection of the node to aspirate with ultrasonographically guided FNAB, which is crucial for a final diagnosis.     

胎盘早剥的声像图表现及妊娠结局分析

目的 探讨胎盘早剥声像图特征及妊娠结局。方法 收集132例经产后诊断为胎盘早剥孕妇的产前超声检查资料,分析其声像图表现及妊娠并发症。结果 超声检出胎盘早剥48例,检出率36.36%（48/132）,漏诊率63.64%（84/132）。胎盘早剥声像图表现为胎盘增厚29例、胎盘实质回声异常16例、胎盘后方回声异常9例、胎盘边缘回声异常6例、胎盘胎儿面回声异常4例、宫壁与胎膜间回声异常2例以及羊水池内回声异常7例;主要并发症为剖宫产、子宫胎盘卒中、弥漫性血管内凝血、产后出血、早产、新生儿重度窒息及围生儿死亡,经超声检出胎盘早剥者以上并发症发生率均高于超声未检出者（P均<0.05）。结论 胎盘早剥产前超声检出率低;超声检出胎盘早剥者妊娠结局较差。     

B超诊断子宫肌壁间妊娠1例

患者女,30岁,孕2产1,因停经49天,外院B超示"宫内早孕",到我院行人工流产术,术中未刮出绒毛及蜕膜组织,后行药物流产术,未见任何组织排出;再行清宫术,仍未刮出绒毛组织及蜕膜组织.     

妊娠合并单纯卵巢扭转的超声诊断价值

1资料与方法 1．1．一般资料1996年10月-2006年11月在我院手术治疗的妊娠合并卵巢扭转7例．年龄22～34岁．平均26岁，孕期40天至39周．早孕3例．中晚妊各2例．因不同程度腹痛就诊（3例伴恶心呕吐），就诊时间1～48h。全部病例下腹部压痛征阳性，6例血白细胞总数和/或中性粒细胞数升高．1例血常规正常。     

异位妊娠的超声诊断及鉴别诊断

探讨了不同类型异位妊娠(EP)的超声表现和鉴别诊断,其中着重讨论了卵巢黄体囊肿与异位妊娠孕囊的鉴别诊断;宫腔及内膜超声表现预测异位妊娠的价值。探讨了各种超声新技术的比较优势,结果经阴道超声(TVS)结合彩色多普勒能量图(CDPI)被认为是诊断异位妊娠特异且敏感的方法,三维、四维超声及超声造影技术则更多应用于罕见部位的妊娠诊断,被认为较传统的二维超声更具优势。     

Heterotopic pregnancy: discovery of ectopic pregnancy after elective abortion

We report a case of combined intrauterine and tubal pregnancy in a 23-year-old woman. The patient came to the emergency department complaining of lower abdominal pain after having had an elective abortion 2 weeks earlier. Her physician had done pelvic ultrasonography, noting an intrauterine pregnancy before the abortion. Our working diagnosis in the emergency department was retained products of conception versus postabortion endometritis. Pelvic ultrasonography in the emergency department revealed an ectopic pregnancy without evidence of retained products of conception, and the patient had a right salpingotomy with removal of the ectopic fetus without complications.     

超声分级诊断评估颈部肿大淋巴结恶性风险

目的 建立评估颈部肿大淋巴结（LN）恶性风险的常规超声分级诊断标准。方法 回顾性分析882个颈部肿大LN的4项常规超声声像图指标，包括门髓质回声、内部回声、血流类型及长短径比（L/S）值，据以对每个LN进行评分并按照分值分组，根据各组中恶性LN比例差异提出分级诊断标准。结果 颈部肿大LN的声像图总评分值范围0~7分，恶性LN比例随分值提高而升高（P<0.05），LN恶性风险OR值亦随之升高。颈部肿大LN常规超声分级诊断标准：1级（0分），极低度恶性风险，恶性比例<3.70%；2级（1~2分），低度恶性风险，恶性比例（14.91±4.63）%；3级（3~4分），中度恶性风险，恶性比例（43.89±0.64）%；4级（5~7分），高度恶性风险，恶性比例（77.84±9.15）%。以"4级"为标准判定颈部恶性肿大LN的敏感度78.97%，特异度72.54%，约登指数0.515，准确率76.08%，AUC为0.791。结论 以常规超声声像图评分为基础建立的颈部肿大LN分级诊断标准鉴别良恶性LN的能力较好，并能预测其恶性风险。     

梗阻性子宫颈发育异常的超声特征及其诊断价值

目的探讨梗阻性子宫颈发育异常的超声特征及诊断价值。 方法回顾2014年1月至2021年12月于四川大学华西第二医院诊治,并经手术和病理证实为梗阻性子宫颈发育异常的患者12例,总结其超声图像特点,分析超声诊断价值及相关合并症的诊断。 结果梗阻性子宫颈发育异常：以术后诊断为标准,本组病例中,超声正确诊断梗阻性子宫颈发育异常8例,误诊4例,诊断率为66.7%（8/12）,误诊病例包括1例子宫颈未发育、2例子宫颈外口闭塞和1例子宫颈残迹。阴道闭锁：根据术中所见,共有11例患者合并阴道闭锁,其中阴道完全闭锁9例,阴道上段闭锁2例。术前超声正确诊断阴道闭锁8例,漏诊3例,诊断率为72.7%（8/11）。其他：以术后诊断为标准,超声正确诊断单侧或双侧输卵管积血5例,漏诊3例,误诊1例;超声诊断卵巢子宫内膜异位囊肿5例,误诊1例。 结论超声可显示宫颈形态、合并的子宫畸形、是否存在阴道闭锁及附件情况,是梗阻性子宫颈发育异常的首选检查方法。     

异位妊娠的超声诊断362例分析

目的探讨异位妊娠的超声图像特征、漏误诊原因及其鉴别诊断。方法对我院自2005年1月至2008年3月收治的362例异位妊娠的超声图像特点进行回顾性分析,并与手术及病理结果对照,总结其声像图特征。结果362倒异位妊娠中输卵管妊娠316例,占87．3％;子宫角妊娠14例,占3．8％;腹腔妊娠2例,占0．6％;宫颈妊娠4例,占1．1％;卵巢妊娠5例,占1．4％。超声确诊341例,占94．2％;漏误诊21例,占5,8％。结论经腹和经阴道途径联合超声检查,可提高对异位妊娠的诊断准确率,为临床选择治疗方案和确定手术时机提供可靠依据,是异位妊娠诊断的首选方法。