婦產(chǎn)科疾病的超聲診斷ENGLISH課件

婦產(chǎn)科疾病的超聲診斷-ENGLISH2023/7/3婦產(chǎn)科疾病的超聲診斷ENGLISHSangreal--------uterusTHEDAWINCICODE婦產(chǎn)科疾病的超聲診斷ENGLISHPelvicCavityPosterior:Occupiedbyrectum,colon,andileumAnterior:bladder,ureters,ovaries,fallopiantubes,uterus,andvaginaNORMALANATOMY婦產(chǎn)科疾病的超聲診斷ENGLISHPre-inspection:Moderatebladderfilling

婦產(chǎn)科疾病的超聲診斷ENGLISHUterusHollow,pear-shapedorganDividedintofundus,body,andcervixUsuallyanteflexedandantevertedCoveredwithperitoneumexceptanteriorlybelowtheoswhereperitoneumisreflectedontobladderSupportedbylevatoranimusclesandpelvicfasciaRoundligamentkeepsuterusinposition婦產(chǎn)科疾病的超聲診斷ENGLISHUterinesizePrepubertal:3cmlongby0.5to1.0cmwideMenarcheal:8cmlongby4cmwidePostmenopausal:3.5to5.5cmlongby1to2cmwideNormalsize:2~3(thick)×4~5(width)×7~8cm(length)婦產(chǎn)科疾病的超聲診斷ENGLISHUterinelongitudinaldiameter

Uterinewidediameter

UterusbeforeandaftertheTrail

婦產(chǎn)科疾病的超聲診斷ENGLISHlength7~8cmbeforeandaftertheTrail

2~3cmwidth4~5cm婦產(chǎn)科疾病的超聲診斷ENGLISHUterinePositionMidlineanteversion:mostcommon;degreeofanteversionisbladderdistentiondependentRightorleft:normalvariantinabsenceofpelvicmassesRetroverted:entireorgandisplacedposteriorlyRetroflexed:bodydisplacedwithrespecttocervix婦產(chǎn)科疾病的超聲診斷ENGLISHUltrasonographyofnormaluterusUterineserosalayer:Linearhigh-echo;clear,smooth;

Myometrium:Homogeneousmiddle-echo;Endometria:Themiddlelineofhighecho,aroundtheweakecho.Itiswellknownthattheendometriumchangesdynamicallyinresponsetocyclichormonalflux.婦產(chǎn)科疾病的超聲診斷ENGLISHUterineserosalayer

Myometrium

Endometria

Normaluterustransabdominalultrasonography婦產(chǎn)科疾病的超聲診斷ENGLISHTransvaginalsagittalviewoftheuterus.Theroundedfundusisshowntowardtheleftoftheimagewiththeendometrialstriperummingthroughthemiddleoftheuterinecavity.MyometriumEndometriaUterineserosalayer婦產(chǎn)科疾病的超聲診斷ENGLISHFallopianTube（輸卵管）Infundibulum:funnel-shapedlateraltubethatprojectsbeyondthebroadligamenttooverlietheovariesAmpulla:sidestpartofthetubewherefertilizationoccursIsthmus:hardestpart;liesjustlateraltotheuterusLength:12cm;suppliedbyovarionarteriesandveins婦產(chǎn)科疾病的超聲診斷ENGLISHOvary（卵巢）AlmondshapedAttachedtobackofthebroadligamentbymesovarium;sometimescalledsuspensoryligamentoftheovaryLiesinovarianfossaFossaisboundedbyexternaliliacvessels,ureter,andobturatornerveReceivesbloodfromovarianarteryBlooddrainedbyovarianveinintoinferiorvenacavaonright;onleftbyovarianveinintolertrenalvein婦產(chǎn)科疾病的超聲診斷ENGLISHSonographyofthenormalovaryAnovoidhomogeneousechodensity;follicularcystsareoftenpresent.Thebestsonographicmarkerfortheovaryisidentificationofafollicularcyst,whichhastheclassicappearanceofbeingthinwalledandanechoicwiththrough-transmissionposteriorly.婦產(chǎn)科疾病的超聲診斷ENGLISHTransabdominalsagittalimageshowstheleftovaryposteriortotheurinarybladder婦產(chǎn)科疾病的超聲診斷ENGLISHTransvaginalsagittalimageoftheovaryovarianfollicle婦產(chǎn)科疾病的超聲診斷ENGLISHFollicularwallflow婦產(chǎn)科疾病的超聲診斷ENGLISHCommonDiseasesofObstetricsandGynecologyGynecology：Leiomyoma；Carcinoma;；OvarianTumors;Inflammatorymass;etc.Obstetrics：

Naturalpregnancy；Abnormalpregnancy;etc.婦產(chǎn)科疾病的超聲診斷ENGLISHTheuterusLeiomyoma/Hysteromyoma婦產(chǎn)科疾病的超聲診斷ENGLISHCharacteristicsofLeiomyomasMostcommonpelvictumorSmoothmusclecellcompositionFibrosisoccursafteratrophicofdegenerativechangesDegenerationoccurswhenfibroidsoutstriptheirbloodsupply;calcificationMaybepedunculatedClinical:enlargeduterus,profuseandprolongedbleeding,pain婦產(chǎn)科疾病的超聲診斷ENGLISHUterineLocationsofleiomyomasSubmucosalErodeintoendomertialcavity–heavybleeding;infertilityIntramuralMayenlargetocausepressureonadjacentorgans;infertilitySubserosalMayenlargetocausepressureonadjacentorgans婦產(chǎn)科疾病的超聲診斷ENGLISHSubserousmyomaBroadligamentmyomaCervicalmyomaintramurousmyomaSubmucousmyoma婦產(chǎn)科疾病的超聲診斷ENGLISHUltrasonicperformanceTwo-dimensional：①IncreaseduterinebodyorFormdisorders；②Sphericalhypoechoicareaintheuterinebody，Rearechoattenuation；③WithcalcificationorCysticchange,etc；④Signsofoppression；ColorDoppler：Tumoraroundwiththebloodflowsignalintheshapeofringorsemi-circularring；Dopplerspectrum：Mediumresistanceindex，RI0.6±0.1。婦產(chǎn)科疾病的超聲診斷ENGLISHintramurousmyoma婦產(chǎn)科疾病的超聲診斷ENGLISHSubserousmyomaintramurousmyoma婦產(chǎn)科疾病的超聲診斷ENGLISHSubserousmyoma婦產(chǎn)科疾病的超聲診斷ENGLISHCervicalmyoma婦產(chǎn)科疾病的超聲診斷ENGLISHAbundanttumorbloodflowMUT婦產(chǎn)科疾病的超聲診斷ENGLISHRI0.61婦產(chǎn)科疾病的超聲診斷ENGLISHSubmucousmyomawithcalcification婦產(chǎn)科疾病的超聲診斷ENGLISHTeratoma

DermoidTummors

（卵巢良性囊性畸胎瘤/皮樣囊腫)Pathology：derivesfromgermcell，themostcommonovarianneoplasm,constituting20%ofovariantumors.upto20%arebilateral.About80%occurinwomenofchildbearingage.婦產(chǎn)科疾病的超聲診斷ENGLISHSizerangesfromsmallto40cmUnliateral,roundtoovalmassContainsfaty,sebaceousmaterial,hair,cartilage,bone,teethClinical:asymptomatictoabdominalpain,enlargementandpressure;pedunculated,subjecttotorsionSonography:Cystic/complex/solidmass,echogeniccomponents;acousticshadowing婦產(chǎn)科疾病的超聲診斷ENGLISHSpecialUltrasoundFindings:1.Acysticmass:

withanechogenicmuralnodule2.Apastesign：particulateliptinite3.Afluffofhairsign4.Afat-fluidlevelsign：withfluidlevelinthecyst,fatabove,fluidbelow.5.Acomplexmass婦產(chǎn)科疾病的超聲診斷ENGLISHcysticteratomaofovaryAcysticmassPastesignFluffofhairsign婦產(chǎn)科疾病的超聲診斷ENGLISHPastesignFat-fluidlevelsignAcomplexmass婦產(chǎn)科疾病的超聲診斷ENGLISHA8yearsoldgirl,cuttingoffathreekilogramsbenignteratoma婦產(chǎn)科疾病的超聲診斷ENGLISHTheroleofUltrasoundinObstetrics婦產(chǎn)科疾病的超聲診斷ENGLISHTRIMESTERSFirsttrimester=0to12weeksofgestationSecondtrimester=13to26weeksofgestationThirdtrimester=27to42weeksofgetsationPosttermpregnancy=>42weeksofgestation婦產(chǎn)科疾病的超聲診斷ENGLISHIndicationsforFirst-TrimesterSonographyConfirmpresenceofintrauterinepregnancyEvaluateforsuspectedectopicpregnancyDefinecauseofvaginalbleedingDeterminegestationalageConfirmsuspectedmultiplegestationsAidininvasiveproceduresEvaluatepelvicmassesDetectuterineabnormalities婦產(chǎn)科疾病的超聲診斷ENGLISHNaturalpregnancy婦產(chǎn)科疾病的超聲診斷ENGLISHNonagepregnancy

(First-Trimester)Definition：Pregnancybefore12weekend.婦產(chǎn)科疾病的超聲診斷ENGLISH5weekspregnant—Gestationalsac；6-7weekspregnant—Germ;7-8Weeks—Primitivehearttubepulse；8-11weeks—Yolksac;9weeks—Embryonic,placenta.TheNormalFirstTrimester婦產(chǎn)科疾病的超聲診斷ENGLISHSonographicFeaturesofaNormalGestationalSacShape:roundofovalPosition:fundalormiddleportionofuterus;acenterpositionrelativetoendometriumContour:smoothWall:echogenic;3mmofmoreinthickness婦產(chǎn)科疾病的超聲診斷ENGLISHInternallandmarks:yalksacpresentwhengestationalsacislargerthan10mm;embryopresentwhengestationalsacislargerthan18mmGrowth:1mmperday(range:0.7mmto1.5mmperday)婦產(chǎn)科疾病的超聲診斷ENGLISH4-5weekspregnantInthegestationalsacwecanseeaembryopoint,theearliestembryo.婦產(chǎn)科疾病的超聲診斷ENGLISH7weekspregnant

Fetuswasabout4mm，wecanseeapparentheartthrob,andsmalllimbbud.婦產(chǎn)科疾病的超聲診斷ENGLISH8weekspregnant

Three-dimensionalultrasoundshowitsbeginningoftheshapeofahuman.婦產(chǎn)科疾病的超聲診斷ENGLISHUmbilicalbordEmbryonicheadEmbryonicabdomen婦產(chǎn)科疾病的超聲診斷ENGLISHYolksacEmbronicheadAmnioticsac婦產(chǎn)科疾病的超聲診斷ENGLISH9weekspregnant

Knownasafetal，Developmentofthevariouspartsofthefetus,tendstoimprove.婦產(chǎn)科疾病的超聲診斷ENGLISH12weekspregnantThespineisidentifiable,asthetwobead-likehighecho.Ears,limbs,bonescanbeshownandmeasurement.婦產(chǎn)科疾病的超聲診斷ENGLISHUltrasoundoftheSecondandThirdTrimesters婦產(chǎn)科疾病的超聲診斷ENGLISHIndicationsforSecond-and

Third-TrimesterEstimategestationalageforpatientswithuncertaindatesEvaluateuterinesizeandclinicaldatediscrepanciesEvaluatefetalgrowthEstimatefetalweightDeterminefetalpresentationEvaluatefetallife婦產(chǎn)科疾病的超聲診斷ENGLISHprovideadjuncttoamniocentesis,percutaneousumbilicalbloodsamplingprocedure,orcerclageplacementEvaluateuterineabnormalityEvaluateabnoumalmaternalserumalpha-fetoproteinvaluesEvaluateabnormalamnioticfluidEvaluateplacentaEtc.婦產(chǎn)科疾病的超聲診斷ENGLISHTheSecond-and

Third-Trimester

(Metaphaseandterminalprengancy)Mid-pregnancy:13-27weekspregnancy.Late-pregnancy:Morethan28weeksofpregnancy.婦產(chǎn)科疾病的超聲診斷ENGLISHScanningTechniquesSurveyuterusObservecardiacactivityDeterminepositionandnumberofthefetusandplacentaAssessamnioticfluidLookforuterineofplacentalmassesandfetalanomalies婦產(chǎn)科疾病的超聲診斷ENGLISHCheckcontents1、Fetalhead：BPD

biparietaldiameter;2、Fetalabdomen:ACabdomencircumference;3、Fetallimb：FLfemurlength;4、Others：Placenta,Fetalheartrate,Amnioticfluid,etc.婦產(chǎn)科疾病的超聲診斷ENGLISH1、FetalheadMeasuringtheBiparietalDiameter(BPD)Obitainbiparietaldiameterofthefetalheadatthetransverselevelofthemidbrain:falx,cavumseptipellucidi,andthalamicnucleiMakesuretheheadissymmetricandovalMeasurefromoutertoinnermarginsoftheskullInthethirdtrimester,theBPDisnotasaccurateinpredictingfetalage婦產(chǎn)科疾病的超聲診斷ENGLISHFetalhead,after12weekendpregnant婦產(chǎn)科疾病的超聲診斷ENGLISHFetalsideprofile,wecanobserveitsforehead,nose,lip,andchin,etc.婦產(chǎn)科疾病的超聲診斷ENGLISH2、FetalabdomenThehepatobiliarysystem:liver,portvenoussysterm,hepaticveinsandarteries,gallbladder,andbileductsThegastrointestinalsystem:theesophagus,stomach,smallandlargeintestines(colon)婦產(chǎn)科疾病的超聲診斷ENGLISHTheurinarysystem:kidneys,adrenalglands,ureters,bladder.Thefetalabdomencircumference（AC)

isthemostwidelymeasured婦產(chǎn)科疾病的超聲診斷ENGLISHMeasuringtheAbdominalCircumference(AC)TheACshouldbetakenfromaroundtransverseimagewiththeumbilicalportionoftheleftportalveinmidlinewithintheliverTheoutermarginoftheabdominalwallshouldbemeasuredTheabdominalwallmeasurementistheleastaccurate婦產(chǎn)科疾病的超聲診斷ENGLISHThefetallivergallbladderstomachportvenousspinegallbladderstomach婦產(chǎn)科疾病的超聲診斷ENGLISH3、FetallimbsTheupperlimbs:theulnatheradiusthehumerusThelowerlimbs:thefemur/thethighbonethefibulathetibiaThefemuristhemostwidelymeasuredlongbone（FLfemurlength）婦產(chǎn)科疾病的超聲診斷ENGLISHFemurmeasurementHyperechoniclinearstructurerepresentstheossifiedportionofthefemoualdiaphysisandcorrespondstofemorallengthmeasurementfromthegreatertrochantertothefemoralcondylesThemormalfemurhasastraightlaeralborderandacurvedmedialborderFemurlengthmaybeusedwiththesameaccuracyasBPDtopredictgestationalageFemurl