Can nuchal cord cause transient increased nuchal translucency thickness?

When detected in a first trimester scan, an increased thickness of nuchal translucency (NT) may be associated with chromosomal, cardiac or genetic disorders. However, less attention has been devoted to the outcome of those fetuses who have confirmed normal anatomies and karyotyping, but have abnormal first trimester scans. Thus, a challenging new issue is how to counsel such cases of transient increased NT in which the translucency rapidly vanishes with no evidence of other underlying abnormalities. Two cases of transient increased thickness of NT are reported. In both, a nuchal cord was ultrasonographically demonstrated and a thorough work-up revealed chromosomally and anatomically normal fetuses. The pathophysiological theories behind these observations and their significance are discussed. Based on these observations, we suggest that transvaginal sonography combined with Doppler flow studies should be utilized for the presize detection of cord patterns to accomplish the work-up in cases of increased NT.     

Cerebral reperfusion in brain death of a newborn. Case report

A case of sudden infant death after 15 minutes of successful resusciation of cardiovascular function is presented. While apnoic cranial nerve areflexia and electrocerebral silence persisted, angiography and transcranial Doppler sonography demonstrated nearly normal cerebral perfusion, which even increased day by day inspite of the persistence of other signs of brain death. The phenomenon cerebral reperfusion is concluded to be compatible with the diagnosis of brain death.     

Choroid plexus dysmorphism detected by transvaginal sonography: the earliest sign of fetal hydrocephalus.

Fetal intracranial pathology detected in the early second trimester during 1237 transvaginal sonographic scans is presented. In a sharp contrast to simple choroid cysts, which disappear at the end of the second trimester as part of a benign course, gross distortion of the choroid plexus was found to be related to the later diagnosis of hydrocephalus. Three patterns of this abnormality are early absence of the plexus, hypoplasia and shrinkage, and "Swiss cheese" appearance. Ventriculomegaly in hydropic fetuses does not distort the normal architecture of the choroid plexus. Certain abnormal features of the choroid plexus, observed as early as the 14th week, menstrual age, are landmarks of developing hydrocephalus, currently detectable only later in pregnancy.     

未破裂型输卵管妊娠136例阴道超声声像分析

目的 探讨未破裂型输卵管妊娠阴道超声声像特征及误诊原因。方法 回顾性分析经临床和病理对比的136例未破裂型输卵管妊娠病例的F)1道超声声像特征。结果 宫外胚囊声像35例，卵巢旁小包块58例，盆腔一侧橄榄形或管状包块43例，误诊5例。结论 未破裂型输卵管妊娠阴道超声声像有一定特征，其共性为卵巢旁境界清晰，形态规则不均质包块。     

Diagnosis of ectopic pregnancy after in vitro fertilization and embryo transfer

Objective: The combination of transvaginal sonography and serum hCG measurement is reliable in the diagnosis of ectopic pregnancy (EP) in spontaneous pregnancies. In patients who became pregnant through IVF-ET, transfer of multiple embryos after IVF could be responsible for the different performance of these tests. We evaluated the discriminative capacity of transvaginal sonography in combination with hCG measurement in the diagnosis of EP after IVF-ET.

Design: Prospective cohort study.

Setting and Patient(s): Consecutive patients, pregnant through IVF-ET, who presented with clinically suspected EP.

Intervention(s): Transvaginal sonography, serum hCG measurement at 6, 9, and 15 days after ET and after a negative transvaginal sonography.

Main Outcome Measure(s): Ectopic pregnancy confirmed at laparoscopy.

Result(s): Between September 1993 and May 1996, 86 women were included in the study, of whom 24 had an EP. Transvaginal sonography identified 46 intrauterine pregnancies and 5 EPs, but serum hCG could not diagnose EPs in patients in whom transvaginal sonography did not show a gestational sac. Serum hCG measurement 9 days after ET could identify pregnancy failure with 100% specificity at a cut-off value of 18 IU/L, but it could not identify patients with EP with enough certainty to justify immediate treatment.

Conclusion(s): We recommend single serum hCG measurement 9 days after ET to discriminate between viable and nonviable pregnancies. Transvaginal sonography can be postponed until 5 weeks after ET, except for patients with abdominal pain and/or vaginal bleeding, or patients with a serum hCG level of <18 IU/L.     

彩色多普勒超声对门静脉高压食道胃底静脉曲张破裂出血的判断

目的　探讨应用彩色多普勒超声对门静脉高压食道胃底静脉曲张破裂出血的判断价值。方法　根据门静脉高压食道胃底静脉曲张患者有无出血分为出血组 (2 5例 )、未出血组 (2 5例 )与健康对照组 (15例 )进行对比分析。结果　出血组、未出血组与健康对照组门脉充血分数分别为 :0 .12 6± 0 .0 5 6、0 .0 6 0± 0 .0 2 0、0 .0 34± 0 .0 15 ,出血组与未出血组比较有显著差异 (P <0 .0 0 1) ;胃左静脉内径分别为 :(0 .89± 0 .2 6 )cm、(0 .70± 0 .2 4 )cm、(0 .31± 0 .0 7)cm ,出血组与未出血组比较有显著差异 (P <0 .0 5 ) ;出血组与未出血组食道曲张静脉内径分别为 :(0 .4 9± 0 .12 )cm、(0 .34± 0 .11)cm ,两者比较有显著差异 (P <0 .0 1) ;食道曲张静脉内血流速度分别为 (17.9± 7.4 )cm s、(11.1± 6 .0 )cm s,两者比较有显著差异 (P <0 .0 1)。当门脉充血分数截定为 0 .0 7时 ,对出血预测敏感性 96 % ,特异性 76 %。结论　门脉充血分数、胃左静脉内径、食道曲张静脉内径及其血流速度对判断出血具有重要作用。     

阴道超声对诊断治疗卵巢子宫内膜异位囊肿及子宫腺肌病的价值

目的探讨阴道超声及血清CA125测定对诊断治疗卵巢子宫内膜异位囊肿及子宫腺肌病的价值。方法对卵巢子宫内膜异位囊肿及子宫腺肌病患者631例进行回顾性分析，术前均经阴道超声检查，部分患者进行了血清CA125测定。结果阴道超声检查卵巢子宫内膜异位囊肿符合率98．7％；子宫腺肌病符合率91．7％；卵巢子宫内膜异位囊肿合并子宫腺肌病符合率95．1％。血清CA125检查卵巢子宫内膜异位囊肿，阳性率39．4％；子宫腺肌病阳性率52．2％；卵巢子宫内膜异位囊肿合并子宫腺肌病阳性率59．2％。结论阴道超声可做为较准确诊断卵巢子宫内膜异位囊肿及子宫腺肌病的首选方法。阴道超声下囊肿穿刺是治疗卵巢子宫内膜异位囊肿的简便、有效的方法之一。血清CA125测定可做为卵巢子宫内膜异位囊肿及子宫腺肌病的协助诊断方法，应进一步完善对照组的研究。     

Assessment of fetal behavior and general movements by four-dimensional sonography

The aim of this paper was to review the clinical applications of four-dimensional ultrasonography in the assessment of fetal behavior. With the use of a computerized database, articles on three-dimensional ultrasonography were reviewed. Several applications of dynamic three-dimensional ultrasonography have been reported, including imaging of fetal movements, facial expression and fetal hand movements. The importance of the assessment of fetal behavior by four-dimensional sonography is stressed. Four-dimensional sonography seems to be a useful imaging tool for clinical problem solving in perinatology, especially in observing the development of the central nervous system in utero.     

超声引导下自凝刀射频治疗子宫肌瘤58例分析

目的:探讨自凝刀射频治疗子宫肌瘤的临床价值。方法:2004年2月~2005年6月选择自愿接受自凝刀射频治疗子宫肌瘤的患者58例,肌瘤68个,瘤体直径1.5~5.5 cm,在B超监视和引导下将自凝刀经阴道宫颈置入肌瘤进行射频治疗。结果:治疗后随访3个月58例、6个月50例(59个肌瘤),治疗有效率、治愈率分别为100%(58/58)、51.72%(30/58)。结论:自凝刀射频治疗子宫肌瘤是1种能保留子宫的微创技术,可重复治疗,疗效确切,操作简单,易推广应用。     

MR动态增强扫描在前列腺癌诊断及鉴别诊断中的应用价值(英文)

目的通过绘制时间信号强度曲线,探讨 MRI 快速序列动态增强在前列腺癌诊断及鉴别诊断中的价值。方法对5例无泌尿系症状健康对照者、13例经病理证实的前列腺癌及36例前列腺增生行 MR 平扫、动态增强及延迟扫描,测量并计算病灶和正常组织的相对信号强度值,并绘制正常周围带、前列腺癌与增生三者的时间信号强度曲线。结果正常周围带轻度强化,并缓慢上升至晚期达峰值;36例前列腺增生早期明显强化并逐渐上升至中晚期达峰值后缓慢下降;13例前列腺癌中9例早期明显强化,并快速下降,4例 T_2WI 像上弥漫性病灶呈现中晚期强化。结论正常周围带、前列腺癌及前列腺增生的动态强化方式明显不同,应用动态增强扫描可对前列腺癌的诊断与鉴别诊断起积极作用。