Transvaginal sonographic assessment of cervical length changes during triplet gestation

The current study aimed to evaluate the contribution of transvaginal sonography (TVS) for monitoring cervical changes during the second half of triplet gestation. Forty-five pregnant women with triplets pregnancies were prospectively scanned by TVS from approximately 26 weeks gestation and were longitudinally followed-up until delivery. Based on a receiver-operating curve it was found that a cervical length of 25 mm is the most accurate parameter (94% sensitivity and 45% specificity) for predicting premature delivery < or =33 gestational weeks. Thus, a single cervical length measurement of < or =25 mm at 26 weeks gestation correlated well with premature delivery at < or =33 weeks (chi(2); P = 0.002). Using the linear regression model, a mathematical equation [(Week of delivery = 27.4 + 1.6 x cervical length; R(2) = 0.46; P = 0.01)] for predicting the gestational age of delivery (dependent variable) was determined based on mid-gestation cervical measurements (predictors). In parturient women with triplet gestation, TVS assessment of the uterine cervix offers insight into the cervical status and provides valuable information for prenatal care. This includes both monitoring the cervical changes throughout third trimester as well as predicting the likelihood of premature delivery.     

阑尾粘液囊肿的超声诊断

目的　探讨阑尾粘液囊肿 (AMC)的声像图表现 ,评价其临床意义 ;方法　回顾性分析了 7例AMC的声像图表现及超声与病理诊断的符合情况 ;结果　 6例诊断正确 ,1例误诊 ,符合率 85 7% ,本组病理声像图的主要表现有①圆形或卵圆形边界清楚的超声暗区 ;②AMC最小 37mm× 30mm ,最大 5 8mm× 6 5mm ;③位于右下腹相当于阑尾的解剖部位 ;结论　作者初步经验表明超声检查为发现AMC的一种敏感和可靠的方法 ,有助于对是否需行手术治疗作出正确的判断     

Transvaginal sonography and rectal endoscopic sonography for the assessment of pelvic endometriosis: a preliminary comparison

BACKGROUND: Endometriosis and possible rectal involvement are difficult to assess by physical examination. Previous studies have shown the diagnostic value of magnetic resonance imaging and rectal endoscopic sonography (RES) in this setting, but not that of transvaginal sonography (TVS). The aims of this study were to compare the accuracy of TVS and RES for the diagnosis of pelvic endometriosis, and to compare the results with histological findings. PATIENTS AND METHODS: In a prospective study, 30 consecutive patients referred with clinical signs of endometriosis underwent TVS and RES; the images were interpreted blindly with regard to physical findings. RESULTS: Endometriosis was confirmed histologically in 28 (93%) of the 30 patients. Endometriomas were also present in 67% of cases. For the diagnosis of uterosacral endometriosis, the sensitivity, specificity, and positive and negative predictive values of TVS and RES were 75 and 75%, 83 and 67, 95 and 90%, and 45 and 40% respectively. For the diagnosis of rectosigmoid endometriosis, the sensitivity, specificity, and positive and negative predictive values of TVS and RES were 95 and 82%, 100 and 88%, 100 and 95%, and 89 and 64% respectively. CONCLUSION: Despite the large proportion of our patients who had intestinal endometriosis, representing a possible source of bias, our results suggest that TVS is as efficient as RES for detecting posterior pelvic endometriosis and should therefore be used as the first-line examination.     

癫癎患者脑血流速度改变与癫癎灶定侧的关系

目的 :探讨癫发作间期脑血流变化对癫灶定侧的价值。方法 :4 7例癫病人发作间期行经颅多普勒超声脑血流速度测定 ,并与临床、脑电图定位和MRI/CT病灶对比分析。结果 :根据临床症状确定病灶侧的 19例病人中 ,病灶侧脑血流速度改变 (升高和降低 )的比率显著高于双侧脑血流速度对称者 ;在脑电图确定病灶侧的 2 4例病人中 ,病灶侧脑血流速度升高比率显著高于脑血流速度降低和双侧脑血流速度对称者 ;在MRI确定病灶侧的 13例病人中 ,病灶侧脑血流速度增快 7例 ,减慢 2例 ,双侧血流速度对称 4例。结论 :癫病人一侧脑血流速度增高 ,高度提示癫病灶侧。     

经阴道彩色多普勒超声对子宫腺肌瘤的诊断价值

目的：探讨经阴道彩色多普勒超声对子宫腺肌瘤的诊断价值。方法：选取许昌中医院2020年1月至2022年1月期间收治的80例子宫腺肌瘤患者为研究对象,对上述患者实施经阴道彩色多普勒超声诊断,获得对应的诊断结果,随后将该结果和术后病理分析结果进行比较,最终得出诊断效果。结果：本研究80例子宫腺肌瘤患者中,经阴道彩色多普勒超声检出75例,漏诊或误诊5例,诊断准确率为93.75%;经阴道彩色多普勒检查诊断为子宫腺肌瘤的75例患者中,按照发病部位划分,有10例(13.33%)子宫腺肌瘤出现在子宫前壁区域,65例(86.67%)出现在子宫后壁部位;按照病情特点划分,有63例(84.00%)为单发子宫腺肌瘤,12例(16.00%)为子宫腺肌瘤合并子宫肌瘤。此外,75例患者中有3例患者并发卵巢内膜异位症。75例患者的子宫动脉血流阻力指数为0.75±0.05、搏动指数为1.37±0.04、舒张期峰值速度为(5.83±0.14)cm·s^-1、收缩期峰值速度为(71.74±0.25)cm·s^-1。结论：经阴道彩色多普勒超声可通过超声特征、血流分布、多普勒频谱特点,准...     

Reporting and grading of complications after mid-urethral sling surgeries: Could the “Clavien-Dindo Classification” be adopted?

Background:To construct a modified model for reporting and grading of postoperative complications after the mid-urethral sling (MUS) procedure based on the Clavien-Dindo classification. In addition, complications of three different types of MUS were compared.Materials and methods:A PubMed search for postoperative complication after MUS was carried out for the period between January 1990 and July 2018. Reported complications were stratified in a plate form designed in accordance with grades of the Clavien-Dindo classification. Then, the proposed model was applied on reported complications in 160 females who underwent three different procedures of MUS (transvaginal tape [TVT], transobturator tape [TOT], and autologous fascial sling) with a minimum follow-up of 24 months.Results:The mean ± SD age at time of surgery was 46 ± 7 years. TVT was carried out in 75 (47%) patients, TOT in 40 (25%), and fascial sling in 45 (28%). The total number of complications was 62 in 43 (26.8%) patients. The vast majority of complications were Grade I and Grade II 19 (12%) and 21 (13%) out of 160 patients, respectively. Transient postoperative voiding difficulty (Grade II) and de novo urgency (Grade II) were the most prevalent complications in the fascial sling method (15.4% for each), whereas transient thigh pain (Grade II) was the most frequently reported complication after TOT (10%). Life-threatening vascular injury (Grade IV-a) was a serious complication in TVT cases.Conclusions:Postoperative complications of the MUS could be graded according to Clavien''s classification. The vast majority of complications were Graded I or II. TVT can cause serious life-threatening complications.     

经阴道超声在早孕期流产后宫腔残留物诊断中的应用价值

目的探讨经阴道超声在早孕期流产后宫腔残留物诊断中的应用价值。方法选取2018年1月至2020年1月医院收治的早孕期人工流产、自然流产及药物流产后行宫腔残留物诊断的患者80例,均采用经阴道超声检查,以病理结果为金标准,分析经阴道超声的诊断效能。结果以病理结果为金标准,经阴道超声对早孕期流产后宫腔残留物的诊断灵敏度为97.22%,特异度为62.50%,准确度为93.75%。结论经阴道超声应用于早孕期流产后宫腔残留物诊断中,具有较高的诊断灵敏度、准确度,可为临床治疗提供依据。     

应用经阴道彩色多普勒对健康育龄妇女子宫卵巢动脉血流状况的研究

目的 研究育龄妇女子宫、卵巢动脉血流变化规律。方法 应用经阴道彩色多普勒对４６０例妇女子宫、卵巢动脉血流在不同月经周期进行搏动指数（ＰＩ）、阻力指数（ＲＩ）检测。结果 血流参数在四个周期间有非常显著性差异（Ｐ〈０．０１）,同时功能侧子宫动脉与卵巢动脉阻抗参数也有差异（Ｐ〈０．０５）。结论 通过检测子宫、卵巢动脉血流有助于对妇科疾患的诊断提供帮助。     

羊水过少的B超诊断性试验分析

目的 探讨产前Ｂ超测定羊水平段诊断羊水过少的最佳界值。方法 对妊娠≥３６周的孕妇进行Ｂ超测定羊水最大平段,剖宫产时实际测定羊水量,确定２．０ｃｍ、２．３ｃｍ、２．６ｃｍ、３．０ｃｍ、３．３ｃｍ、３．８ｃｍ等７个界点,分别计算其敏感性、特异性、阳性预测值和阴性预测值,对各界点的敏感性和（１－特异性）作受试者工作特性曲线。结果 当Ｂ超测定羊水平段界点为３．３ｃｍ,可获得较高的诊断敏感性和特异性,其值为８０．５６％和７８．７９％。结论 Ｂ超测定羊水平段界点值为３．３ｃｍ时,可产前诊断为羊水过少。     

Transcranial Doppler sonography in craniosynostosis

In the management of craniosynostosis, there is a need for quantitative assessment of treatment methods and outcome. Radiology and pressure studies are well documented, but so far little attention has been given to cerebral blood flow changes and their possible relevance. This paper reports our initial experience using transcranial Doppler sonography to calculate the cerebrovascular resistance and cerebral blood velocities in the major basal vessels before and after surgery for craniosynostosis. Ten patients were studied using the Scimed 2-MHz probe through the temporal and frontal windows of the skull. Measurements were taken under standard physiological conditions before, during and after surgery. Preliminary results suggest that this non-invasive technique may be helpful in predicting and assessing the outcome following surgery for craniosynostosis.