经阴道彩超在宫颈癌诊断中的应用

目的 探讨阴道彩超诊断宫颈癌的临床应用价值及宫颈癌的声像图特征。方法 本对120例经手术与病理证实的宫颈癌患的二维声像图和CDFI表现进行了回顾性分析。结果 中晚期宫颈癌的阴道彩超声像图表现具有特征性，可分宫颈增大、宫颈部肿块、宫颈部边界呈虫蚀状的液暗区，合并宫腔内积液，宫颈外浸润性肿块等图像改变，宫颈处血流信号丰富，呈“火球样”改变；而早期宫颈癌宫颈无明显增大，仅见宫颈管内强光斑，血流信号增多。宫颈部动脉阻力指数最人为0．61，最小0．27，平均0．39。结论 经阴道彩超对宫颈癌术前判断病变范围、侵犯范围、鉴别诊断都有较大的价值，可作为宫颈癌治疗前常规的辅助检查方法。     

Model‐Predicted Performance of Second‐Trimester Down Syndrome Screening With Sonographic Prenasal Thickness

Objective. The purpose of this study was to estimate the Down syndrome detection and false‐positive rates for second‐trimester sonographic prenasal thickness (PT) measurement alone and in combination with other markers. Methods. Multivariate log Gaussian modeling was performed using numerical integration. Parameters for the PT distribution, in multiples of the normal gestation‐specific median (MoM), were derived from 105 Down syndrome and 1385 unaffected pregnancies scanned at 14 to 27 weeks. The data included a new series of 25 cases and 535 controls combined with 4 previously published series. The means were estimated by the median and the SDs by the 10th to 90th range divided by 2.563. Parameters for other markers were obtained from the literature. Results. A log Gaussian model fitted the distribution of PT values well in Down syndrome and unaffected pregnancies. The distribution parameters were as follows: Down syndrome, mean, 1.334 MoM; log₁₀ SD, 0.0772; unaffected pregnancies, 0.995 and 0.0752, respectively. The model‐predicted detection rates for 1%, 3%, and 5% false‐positive rates for PT alone were 35%, 51%, and 60%, respectively. The addition of PT to a 4–serum marker protocol increased detection by 14% to 18% compared with serum alone. The simultaneous sonographic measurement of PT and nasal bone length increased detection by 19% to 26%, and with a third sonographic marker, nuchal skin fold, performance was comparable with first‐trimester protocols. Conclusions. Second‐trimester screening with sonographic PT and serum markers is predicted to have a high detection rate, and further sonographic markers could perform comparably with first‐trimester screening protocols.     

Brenner tumors of the ovary: sonographic and computed tomographic imaging features.

OBJECTIVE: The purpose of this study was to describe the sonographic appearance of ovarian Brenner tumors with computed tomographic (CT) correlation. METHODS: Twenty-two female patients (age range, 32-78 years; mean, 58 years) with 25 ovarian Brenner tumors were identified from pathologic records from 1990 to 2005. Corresponding pathologic reports and images (17 sonographic and 14 CT) were reviewed independently. RESULTS: Tumors ranged in size from 0.3 to 12 cm (mean, 2.5 cm); all were benign. Sixteen (64%) of 25 were found incidentally. Eight (36%) of 22 patients had a total of 12 associated benign ovarian neoplasms (1 was contralateral); 3 patients had bilateral Brenner tumors. Eight (47%) of 17 tumors were not seen on sonography, and 5 (36%) of 14 were not seen on CT. Of the tumors seen on imaging, most were solid (67% on sonography and 78% on CT). Four tumors appeared at least partially cystic, of which 3 had coexistent cystic ovarian lesions. CONCLUSIONS: Brenner tumors are most often solid neoplasms found incidentally and frequently seen in association with other benign ovarian epithelial neoplasms.     

腹阴联合超声在带环异位妊娠中的诊断价值

目的探讨腹阴联合超声在带环异位妊娠中的诊断价值,旨在提高早期异位妊娠的诊断水平。方法 65例经手术病理证实为带环异位妊娠的患者,术前均进行经腹部及经阴道超声检查,比较两种检查方法的诊断符合率及联合应用的诊断效果。结果经阴道超声检查及经腹超声检查诊断符合率为分别为92.3%、61.5%,两者联合应用诊断符合率为100%。结论腹阴联合超声检查与单独应用经阴道超声检查或经腹超声检查相比有明显优势,可提高带环异位妊娠诊断符合率,具有重要的临床价值。     

结直肠肿瘤经自然腔道取标本手术专家共识（2019版）

近年来,结直肠肿瘤经自然腔道取标本手术（NOSES）在我国发展迅速。我国《结直肠肿瘤经自然腔道取标本手术专家共识（2017版）》及国际《结直肠肿瘤经自然腔道取标本手术专家共识》相继发布,这些共识对我国乃至国际NOSES手术规范化开展起到了重要作用。然而,随着对NOSES理念技术的更新,目前结直肠肿瘤NOSES又得到进一步发展。基于此,在2017版共识基础上,再版修订并发布了新版《结直肠肿瘤经自然腔道取标本手术专家共识（2019版）》,新版共识对结直肠肿瘤NOSES理论技术体系进行了补充、更新和完善,以便更好指导临床实践。