妇产科疾病的超声诊断ENGLISH课件.ppt

1、2023-1-21妇产科疾病的超声诊断ENGLISH妇产科疾病的超声诊断妇产科疾病的超声诊断-ENGLISH妇产科疾病的超声诊断ENGLISH妇产科疾病的超声诊断ENGLISH Pelvic CavitylPosterior:Occupied by rectum,colon,and ileumlAnterior:bladder,ureters,ovaries,fallopian tubes,uterus,and vagina妇产科疾病的超声诊断ENGLISHModerate bladder filling 妇产科疾病的超声诊断ENGLISHlHollow,pear-shaped organlD

2、ivided into fundus,body,and cervixlUsually anteflexed and antevertedlCovered with peritoneum except anteriorly below the os where peritoneum is reflected onto bladderlSupported by levator ani muscles and pelvic fascialRound ligament keeps uterus in position妇产科疾病的超声诊断ENGLISHlPrepubertal:3 cm long by

3、0.5 to 1.0 cm widelMenarcheal:8 cm long by 4 cm widelPostmenopausal:3.5 to 5.5 cm long by 1 to 2 cm wideNormal size:23(thick)45(width)78 cm(length)妇产科疾病的超声诊断ENGLISHUterine longitudinal diameter Uterine wide diameter Uterus before and after the Trail 妇产科疾病的超声诊断ENGLISHlength 78cmbefore and after the T

4、rail 23cmwidth 45cm妇产科疾病的超声诊断ENGLISHlMidline anteversion:most common;degree of anteversion is bladder distention dependentlRight or left:normal variant in absence of pelvic masseslRetroverted:entire organ displaced posteriorlylRetroflexed:body displaced with respect to cervix妇产科疾病的超声诊断ENGLISHlUterin

5、e serosa layer:Linear high-echo;clear,smooth;l Myometrium:Homogeneous middle-echo;lEndometria:The middle line of high echo,around the weak echo.It is well known that the endometrium changes dynamically in response to cyclic hormonal flux.妇产科疾病的超声诊断ENGLISHUterine serosa layer Myometrium Endometria 妇产

6、科疾病的超声诊断ENGLISHMyometriumEndometriaUterine serosa layer妇产科疾病的超声诊断ENGLISHlInfundibulum:funnel-shaped lateral tube that projects beyond the broad ligament to overlie the ovarieslAmpulla:sidest part of the tube where fertilization occurslIsthmus:hardest part;lies just lateral to the uteruslLength:12 cm

7、;supplied by ovarion arteries and veins妇产科疾病的超声诊断ENGLISHl Almond shapedlAttached to back of the broad ligament by mesovarium;sometimes called suspensory ligament of the ovarylLies in ovarian fossalFossa is bounded by external iliac vessels,ureter,and obturator nervelReceives blood from ovarian arter

8、ylBlood drained by ovarian vein into inferior vena cava on right;on left by ovarian vein into lert renal vein妇产科疾病的超声诊断ENGLISHlAn ovoid homogeneous echodensity;follicular cysts are often present.lThe best sonographic marker for the ovary is identification of a follicular cyst,which has the classic a

9、ppearance of being thin walled and anechoic with through-transmission posteriorly.妇产科疾病的超声诊断ENGLISH妇产科疾病的超声诊断ENGLISHovarian follicle妇产科疾病的超声诊断ENGLISH妇产科疾病的超声诊断ENGLISHGynecology：Leiomyoma；Carcinoma;；Ovarian Tumors;Inflammatory mass;etc.Obstetrics：NaturalNatural pregnancy；Abnormal pregnancy;etc.妇产科疾病的

10、超声诊断ENGLISH妇产科疾病的超声诊断ENGLISHlMost common pelvic tumorlSmooth muscle cell compositionlFibrosis occurs after atrophic of degenerative changeslDegeneration occurs when fibroids outstrip their blood supply;calcificationlMay be pedunculatedlClinical:enlarged uterus,profuse and prolonged bleeding,pain妇产科疾

11、病的超声诊断ENGLISHSubmucosal Erode into endomertial cavity heavy bleeding;infertilityIntramuralMay enlarge to cause pressure on adjacent organs;infertilitySubserosalMay enlarge to cause pressure on adjacent organs 妇产科疾病的超声诊断ENGLISHSubserous myomaBroad ligamentmyomaCervical myomaintramurous myomaSubmucous

12、 myoma妇产科疾病的超声诊断ENGLISHlTwo-dimensional：Increased uterine body or Form disorders；Spherical hypoechoic area in the uterine body，Rear echo attenuation；With calcification or Cystic change,etc；Signs of oppression；lColor Doppler：Tumor around with the blood flow signal in the shape of ring or semi-circula

13、r ring；lDoppler spectrum：Medium resistance index，RI 0.60.1。妇产科疾病的超声诊断ENGLISHintramurous myoma妇产科疾病的超声诊断ENGLISHSubserous myomaintramurous myoma妇产科疾病的超声诊断ENGLISHSubserous myoma妇产科疾病的超声诊断ENGLISHCervical myoma妇产科疾病的超声诊断ENGLISHM妇产科疾病的超声诊断ENGLISH妇产科疾病的超声诊断ENGLISHSubmucous myoma with calcification妇产科疾病的超声诊

14、断ENGLISHlPathology：derives from germ cell，the most common ovarian neoplasm,constituting 20%of ovarian tumors.up to 20%are bilateral.About 80%occur in women of childbearing age.妇产科疾病的超声诊断ENGLISHlSize ranges from small to 40 cmlUnliateral,round to oval masslContains faty,sebaceous material,hair,cartil

15、age,bone,teethlClinical:asymptomatic to abdominal pain,enlargement and pressure;pedunculated,subject to torsionlSonography:Cystic/complex/solid mass,echogenic components;acoustic shadowing妇产科疾病的超声诊断ENGLISH1.A cystic mass:with an echogenic mural nodule2.A paste sign：particulate liptinite3.A fluff of

16、hair sign4.A fat-fluid level sign：with fluid level in the cyst,fat above,fluid below.5.A complex mass妇产科疾病的超声诊断ENGLISHA cystic massPaste signFluff of hair sign妇产科疾病的超声诊断ENGLISHPaste signFat-fluid level signA complex mass妇产科疾病的超声诊断ENGLISH妇产科疾病的超声诊断ENGLISH妇产科疾病的超声诊断ENGLISHlFirst trimester =0 to 12 wee

17、ks of gestationlSecond trimester =13 to 26 weeks of gestationlThird trimester =27 to 42 weeks of getsationlPostterm pregnancy=42 weeks of gestation妇产科疾病的超声诊断ENGLISHlConfirm presence of intrauterine pregnancylEvaluate for suspected ectopic pregnancylDefine cause of vaginal bleedinglDetermine gestatio

18、nal agelConfirm suspected multiple gestationslAid in invasive procedureslEvaluate pelvic masseslDetect uterine abnormalities妇产科疾病的超声诊断ENGLISH妇产科疾病的超声诊断ENGLISHDefinition：Pregnancy before 12 weekend.妇产科疾病的超声诊断ENGLISH5 weeks pregnant Gestational sac；6-7 weeks pregnant Germ;7-8 Weeks Primitive heart tub

19、e pulse；8-11 weeks Yolk sac;9 weeks Embryonic,placenta.妇产科疾病的超声诊断ENGLISHlShape:round of ovallPosition:fundal or middle portion of uterus;a center position relative to endometriumlContour:smoothlWall:echogenic;3 mm of more in thickness妇产科疾病的超声诊断ENGLISHlInternal landmarks:yalk sac present when gestati

20、onal sac is larger than 10 mm;embryo present when gestational sac is larger than 18 mmlGrowth:1 mm per day(range:0.7 mm to 1.5 mm per day)妇产科疾病的超声诊断ENGLISH妇产科疾病的超声诊断ENGLISH妇产科疾病的超声诊断ENGLISH妇产科疾病的超声诊断ENGLISHUmbilical bordEmbryonic headEmbryonic abdomen妇产科疾病的超声诊断ENGLISHYolk sacEmbronic headAmniotic sa

21、c妇产科疾病的超声诊断ENGLISH妇产科疾病的超声诊断ENGLISH妇产科疾病的超声诊断ENGLISH妇产科疾病的超声诊断ENGLISHl Estimate gestational age for patients with uncertain dateslEvaluate uterine size and clinical date discrepancieslEvaluate fetal growthlEstimate fetal weightlDetermine fetal presentationlEvaluate fetal life妇产科疾病的超声诊断ENGLISHl provi

22、de adjunct to amniocentesis,percutaneous umbilical blood sampling procedure,or cerclage placementlEvaluate uterine abnormalitylEvaluate abnoumal maternal serum alpha-fetoprotein valueslEvaluate abnormal amniotic fluidlEvaluate placenta Etc.妇产科疾病的超声诊断ENGLISH妇产科疾病的超声诊断ENGLISHlSurvey uterus lObserve ca

23、rdiac activitylDetermine position and number of the fetus and placentalAssess amniotic fluidlLook for uterine of placental masses and fetal anomalies妇产科疾病的超声诊断ENGLISHl1、Fetal head：BPD biparietal diameter;l2、Fetal abdomen:AC abdomen circumference;l3、Fetal limb：FL femur length;l4、Others：Placenta,Fetal

24、 heart rate,Amniotic fluid,etc.妇产科疾病的超声诊断ENGLISHMeasuring the Biparietal Diameter(BPD)lObitain biparietal diameter of the fetal head at the transverse level of the midbrain:falx,cavum septi pellucidi,and thalamic nucleilMake sure the head is symmetric and ovallMeasure from outer to inner margins of

25、the skulllIn the third trimester,the BPD is not as accurate in predicting fetal age 妇产科疾病的超声诊断ENGLISH妇产科疾病的超声诊断ENGLISH妇产科疾病的超声诊断ENGLISHlThe hepatobiliary system:liver,port venous systerm,hepatic veins and arteries,gallbladder,and bile ductslThe gastrointestinal system:the esophagus,stomach,small and

26、 large intestines(colon)妇产科疾病的超声诊断ENGLISHlThe urinary system:kidneys,adrenal glands,ureters,bladder.The fetal abdomen circumference（AC)is the most widely measured 妇产科疾病的超声诊断ENGLISHlThe AC should be taken from a round transverse image with the umbilical portion of the left portal vein midline within

27、the liverlThe outer margin of the abdominal wall should be measuredlThe abdominal wall measurement is the least accurate妇产科疾病的超声诊断ENGLISHgallbladderstomachport venousspinegallbladderstomach妇产科疾病的超声诊断ENGLISHlThe upper limbs:the ulna the radius the humeruslThe lower limbs:the femur/the thigh bone the

28、fibula the tibia lThe femur is the most widely measured long bone（FL femur length ）妇产科疾病的超声诊断ENGLISHlHyperechonic linear structure represents the ossified portion of the femoual diaphysis and corresponds to femoral length measurement from the greater trochanter to the femoral condyleslThe mormal fem

29、ur has a straight laeral border and a curved medial borderlFemur length may be used with the same accuracy as BPD to predict gestational agelFemur length may indicate skeletal dysplasias or intrauterine growth restriction妇产科疾病的超声诊断ENGLISHThe radiusThe ulnaThe humerus 妇产科疾病的超声诊断ENGLISHFemur/thigh bon

30、eFibula/perone Tibia/shin bone 妇产科疾病的超声诊断ENGLISHlThe major fole of the placenta is to permit the exchange of oxygenated maternal blood(rich in oxgen and nutrients)with deoxygenated fetal blood.lThe thickness of the placenta varies with gestational age,with a minimum diameter of 15 mm in fetuses grea

31、ter than 23 weeks.The size of the placenta rarely exceeds 50 mm in the normal fetus.妇产科疾病的超声诊断ENGLISHThe placentaUmbilical bordAmniotic fluidThe fetal妇产科疾病的超声诊断ENGLISHcalcification 妇产科疾病的超声诊断ENGLISH妇产科疾病的超声诊断ENGLISH妇产科疾病的超声诊断ENGLISH妇产科疾病的超声诊断ENGLISH妇产科疾病的超声诊断ENGLISH妇产科疾病的超声诊断ENGLISH妇产科疾病的超声诊断ENGLISH2023-1-21妇产科疾病的超声诊断ENGLISH