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-ENGLISH2023/8/6婦產(chǎn)科疾病的超聲診斷ENGLISH婦產(chǎn)科疾病的超聲診斷-ENGLISH2023/7/27婦產(chǎn)科1Sangreal--------uterusTHEDAWINCICODE婦產(chǎn)科疾病的超聲診斷ENGLISHSangreal--------uterusTHEDAWI2PelvicCavityPosterior:Occupiedbyrectum,colon,andileumAnterior:bladder,ureters,ovaries,fallopiantubes,uterus,andvaginaNORMALANATOMY婦產(chǎn)科疾病的超聲診斷ENGLISHPelvicCavityNORMALANATOMY婦3Pre-inspection:Moderatebladderfilling

婦產(chǎn)科疾病的超聲診斷ENGLISHPre-inspection:Moderatebladd4UterusHollow,pear-shapedorganDividedintofundus,body,andcervixUsuallyanteflexedandantevertedCoveredwithperitoneumexceptanteriorlybelowtheoswhereperitoneumisreflectedontobladderSupportedbylevatoranimusclesandpelvicfasciaRoundligamentkeepsuterusinposition婦產(chǎn)科疾病的超聲診斷ENGLISHUterusHollow,pear-shapedorga5UterinesizePrepubertal: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ENGLISHUterinesizePrepubertal:3cm6Uterinelongitudinaldiameter

Uterinewidediameter

UterusbeforeandaftertheTrail

婦產(chǎn)科疾病的超聲診斷ENGLISHUterinelongitudinaldiameter7length7~8cmbeforeandaftertheTrail

2~3cmwidth4~5cm婦產(chǎn)科疾病的超聲診斷ENGLISHlength7~8cmbeforeandaftert8UterinePositionMidlineanteversion:mostcommon;degreeofanteversionisbladderdistentiondependentRightorleft:normalvariantinabsenceofpelvicmassesRetroverted:entireorgandisplacedposteriorlyRetroflexed:bodydisplacedwithrespecttocervix婦產(chǎn)科疾病的超聲診斷ENGLISHUterinePositionMidlineanteve9UltrasonographyofnormaluterusUterineserosalayer:Linearhigh-echo;clear,smooth;

Myometrium:Homogeneousmiddle-echo;Endometria:Themiddlelineofhighecho,aroundtheweakecho.Itiswellknownthattheendometriumchangesdynamicallyinresponsetocyclichormonalflux.婦產(chǎn)科疾病的超聲診斷ENGLISHUltrasonographyofnormaluter10Uterineserosalayer

Myometrium

Endometria

Normaluterustransabdominalultrasonography婦產(chǎn)科疾病的超聲診斷ENGLISHUterineserosalayerMyometriu11Transvaginalsagittalviewoftheuterus.Theroundedfundusisshowntowardtheleftoftheimagewiththeendometrialstriperummingthroughthemiddleoftheuterinecavity.MyometriumEndometriaUterineserosalayer婦產(chǎn)科疾病的超聲診斷ENGLISHTransvaginalsagittalviewof12FallopianTube（輸卵管）Infundibulum:funnel-shapedlateraltubethatprojectsbeyondthebroadligamenttooverlietheovariesAmpulla:sidestpartofthetubewherefertilizationoccursIsthmus:hardestpart;liesjustlateraltotheuterusLength:12cm;suppliedbyovarionarteriesandveins婦產(chǎn)科疾病的超聲診斷ENGLISHFallopianTube（輸卵管）Infundibulu13Ovary（卵巢）AlmondshapedAttachedtobackofthebroadligamentbymesovarium;sometimescalledsuspensoryligamentoftheovaryLiesinovarianfossaFossaisboundedbyexternaliliacvessels,ureter,andobturatornerveReceivesbloodfromovarianarteryBlooddrainedbyovarianveinintoinferiorvenacavaonright;onleftbyovarianveinintolertrenalvein婦產(chǎn)科疾病的超聲診斷ENGLISHOvary（卵巢）Almondshaped婦產(chǎn)科疾病的14SonographyofthenormalovaryAnovoidhomogeneousechodensity;follicularcystsareoftenpresent.Thebestsonographicmarkerfortheovaryisidentificationofafollicularcyst,whichhastheclassicappearanceofbeingthinwalledandanechoicwiththrough-transmissionposteriorly.婦產(chǎn)科疾病的超聲診斷ENGLISHSonographyofthenormalovary15Transabdominalsagittalimageshowstheleftovaryposteriortotheurinarybladder婦產(chǎn)科疾病的超聲診斷ENGLISHTransabdominalsagittalimage16Transvaginalsagittalimageoftheovaryovarianfollicle婦產(chǎn)科疾病的超聲診斷ENGLISHTransvaginalsagittalimageof17Follicularwallflow婦產(chǎn)科疾病的超聲診斷ENGLISHFollicularwallflow婦產(chǎn)科疾病的超聲診斷18CommonDiseasesofObstetricsandGynecologyGynecology：Leiomyoma；Carcinoma;；OvarianTumors;Inflammatorymass;etc.Obstetrics：

Naturalpregnancy；Abnormalpregnancy;etc.婦產(chǎn)科疾病的超聲診斷ENGLISHCommonDiseasesofObstetrics19TheuterusLeiomyoma/Hysteromyoma婦產(chǎn)科疾病的超聲診斷ENGLISHTheuterusLeiomyoma/Hystero20CharacteristicsofLeiomyomasMostcommonpelvictumorSmoothmusclecellcompositionFibrosisoccursafteratrophicofdegenerativechangesDegenerationoccurswhenfibroidsoutstriptheirbloodsupply;calcificationMaybepedunculatedClinical:enlargeduterus,profuseandprolongedbleeding,pain婦產(chǎn)科疾病的超聲診斷ENGLISHCharacteristicsofLeiomyomasM21UterineLocationsofleiomyomasSubmucosalErodeintoendomertialcavity–heavybleeding;infertilityIntramuralMayenlargetocausepressureonadjacentorgans;infertilitySubserosalMayenlargetocausepressureonadjacentorgans婦產(chǎn)科疾病的超聲診斷ENGLISHUterineLocationsofleiomyoma22SubserousmyomaBroadligamentmyomaCervicalmyomaintramurousmyomaSubmucousmyoma婦產(chǎn)科疾病的超聲診斷ENGLISHSubserousBroadligamentCervic23UltrasonicperformanceTwo-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ENGLISHUltrasonicperformanceTwo-dime24intramurousmyoma婦產(chǎn)科疾病的超聲診斷ENGLISHintramurousmyoma婦產(chǎn)科疾病的超聲診斷ENG25Subserousmyomaintramurousmyoma婦產(chǎn)科疾病的超聲診斷ENGLISHSubserousmyomaintramurousmyo26Subserousmyoma婦產(chǎn)科疾病的超聲診斷ENGLISHSubserousmyoma婦產(chǎn)科疾病的超聲診斷ENGLI27Cervicalmyoma婦產(chǎn)科疾病的超聲診斷ENGLISHCervicalmyoma婦產(chǎn)科疾病的超聲診斷ENGLIS28AbundanttumorbloodflowMUT婦產(chǎn)科疾病的超聲診斷ENGLISHAbundanttumorbloodflowMUT婦產(chǎn)29RI0.61婦產(chǎn)科疾病的超聲診斷ENGLISHRI0.61婦產(chǎn)科疾病的超聲診斷ENGLISH30Submucousmyomawithcalcification婦產(chǎn)科疾病的超聲診斷ENGLISHSubmucous婦產(chǎn)科疾病的超聲診斷ENGLISH31Teratoma

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ENGLISHTeratoma

DermoidTummors

（卵巢32Sizerangesfromsmallto40cmUnliateral,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ENGLISHSizerangesfromsmallto40c33SpecialUltrasoundFindings:1.Acysticmass:

withanechogenicmuralnodule2.Apastesign：particulateliptinite3.Afluffofhairsign4.Afat-fluidlevelsign：withfluidlevelinthecyst,fatabove,fluidbelow.5.Acomplexmass婦產(chǎn)科疾病的超聲診斷ENGLISHSpecialUltrasoundFindings:1.34cysticteratomaofovaryAcysticmassPastesignFluffofhairsign婦產(chǎn)科疾病的超聲診斷ENGLISHcysticteratomaAcysticmassP35PastesignFat-fluidlevelsignAcomplexmass婦產(chǎn)科疾病的超聲診斷ENGLISHPastesignFat-fluidlevelsign36A8yearsoldgirl,cuttingoffathreekilogramsbenignteratoma婦產(chǎn)科疾病的超聲診斷ENGLISHA8yearsoldgirl,cuttingof37TheroleofUltrasoundinObstetrics婦產(chǎn)科疾病的超聲診斷ENGLISHTheroleofUltrasoundinObst38TRIMESTERSFirsttrimester=0to12weeksofgestationSecondtrimester=13to26weeksofgestationThirdtrimester=27to42weeksofgetsationPosttermpregnancy=>42weeksofgestation婦產(chǎn)科疾病的超聲診斷ENGLISHTRIMESTERSFirsttrimester39IndicationsforFirst-TrimesterSonographyConfirmpresenceofintrauterinepregnancyEvaluateforsuspectedectopicpregnancyDefinecauseofvaginalbleedingDeterminegestationalageConfirmsuspectedmultiplegestationsAidininvasiveproceduresEvaluatepelvicmassesDetectuterineabnormalities婦產(chǎn)科疾病的超聲診斷ENGLISHIndicationsforFirst-Trimeste40Naturalpregnancy婦產(chǎn)科疾病的超聲診斷ENGLISHNaturalpregnancy婦產(chǎn)科疾病的超聲診斷ENG41Nonagepregnancy

(First-Trimester)Definition：Pregnancybefore12weekend.婦產(chǎn)科疾病的超聲診斷ENGLISHNonagepregnancy

(First-Trime425weekspregnant—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ENGLISH5weekspregnant—TheNormalF43SonographicFeaturesofaNormalGestationalSacShape:roundofovalPosition:fundalormiddleportionofuterus;acenterpositionrelativetoendometriumContour:smoothWall:echogenic;3mmofmoreinthickness婦產(chǎn)科疾病的超聲診斷ENGLISHSonographicFeaturesofaNorm44Internallandmarks:yalksacpresentwhengestationalsacislargerthan10mm;embryopresentwhengestationalsacislargerthan18mmGrowth:1mmperday(range:0.7mmto1.5mmperday)婦產(chǎn)科疾病的超聲診斷ENGLISHInternallandmarks:yalksacp454-5weekspregnantInthegestationalsacwecanseeaembryopoint,theearliestembryo.婦產(chǎn)科疾病的超聲診斷ENGLISH4-5weekspregnant婦產(chǎn)科疾病的超聲診斷EN467weekspregnant

Fetuswasabout4mm，wecanseeapparentheartthrob,andsmalllimbbud.婦產(chǎn)科疾病的超聲診斷ENGLISH7weekspregnant婦產(chǎn)科疾病的超聲診斷ENGL478weekspregnant

Three-dimensionalultrasoundshowitsbeginningoftheshapeofahuman.婦產(chǎn)科疾病的超聲診斷ENGLISH8weekspregnant婦產(chǎn)科疾病的超聲診斷ENGL48UmbilicalbordEmbryonicheadEmbryonicabdomen婦產(chǎn)科疾病的超聲診斷ENGLISHUmbilicalbordEmbryonicheadEm49YolksacEmbronicheadAmnioticsac婦產(chǎn)科疾病的超聲診斷ENGLISHYolksacEmbronicheadAmniotic509weekspregnant

Knownasafetal，Developmentofthevariouspartsofthefetus,tendstoimprove.婦產(chǎn)科疾病的超聲診斷ENGLISH9weekspregnant婦產(chǎn)科疾病的超聲診斷ENGL5112weekspregnantThespineisidentifiable,asthetwobead-likehighecho.Ears,limbs,bonescanbeshownandmeasurement.婦產(chǎn)科疾病的超聲診斷ENGLISH12weekspregnant婦產(chǎn)科疾病的超聲診斷ENG52UltrasoundoftheSecondandThirdTrimesters婦產(chǎn)科疾病的超聲診斷ENGLISHUltrasoundoftheSecondandT53IndicationsforSecond-and

Third-TrimesterEstimategestationalageforpatientswithuncertaindatesEvaluateuterinesizeandclinicaldatediscrepanciesEvaluatefetalgrowthEstimatefetalweightDeterminefetalpresentationEvaluatefetallife婦產(chǎn)科疾病的超聲診斷ENGLISHIndicationsforSecond-and

T54provideadjuncttoamniocentesis,percutaneousumbilicalbloodsamplingprocedure,orcerclageplacementEvaluateuterineabnormalityEvaluateabnoumalmaternalserumalpha-fetoproteinvaluesEvaluateabnormalamnioticfluidEvaluateplacentaEtc.婦產(chǎn)科疾病的超聲診斷ENGLISHprovideadjuncttoamniocente55TheSecond-and

Third-Trimester

(Metaphaseandterminalprengancy)Mid-pregnancy:13-27weekspregnancy.Late-pregnancy:Morethan28weeksofpregnancy.婦產(chǎn)科疾病的超聲診斷ENGLISHTheSecond-and

Third-Trimest56ScanningTechniquesSurveyuterusObservecardiacactivityDeterminepositionandnumberofthefetusandplacentaAssessamnioticfluidLookforuterineofplacentalmassesandfetalanomalies婦產(chǎn)科疾病的超聲診斷ENGLISHScanningTechniquesSurveyuter57Checkcontents1、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ENGLISHCheckcontents婦產(chǎn)科疾病的超聲診斷ENGLIS581、FetalheadMeasuringtheBiparietalDiameter(BPD)Obitainbiparietaldiameterofthefetalheadatthetransverselevelofthemidbrain:falx,cavumseptipellucidi,andthalamicnucleiMakesuretheheadissymmetricandovalMeasurefromoutertoinnermarginsoftheskullInthethirdtrimester,theBPDisnotasaccurateinpredictingfetalage婦產(chǎn)科疾病的超聲診斷ENGLISH1、FetalheadMeasuringtheBi59Fetalhead,after12weekendpregnant婦產(chǎn)科疾病的超聲診斷ENGLISHFetalhead,after12we60Fetalsideprofile,wecanobserveitsforehead,nose,lip,andchin,etc.婦產(chǎn)科疾病的超聲診斷ENGLISHFetalsideprofile,we612、FetalabdomenThehepatobiliarysystem:liver,portvenoussysterm,hepaticveinsandarteries,gallbladder,andbileductsThegastrointestinalsystem:theesophagus,stomach,smallandlargeintestines(colon)婦產(chǎn)科疾病的超聲診斷ENGLISH2、FetalabdomenThehepatobilia62Theurinarysystem:kidneys,adrenalglands,ureters,bladder.Thefetalabdomencircumference（AC)

isthemostwidelymeasured婦產(chǎn)科疾病的超聲診斷ENGLISHTheurinarysystem:kidneys,63MeasuringtheAbdominalCircumference(AC)TheACshouldbetakenfromaroundtransverseimagewiththeumbilicalportionoftheleftportalveinmidlinewithintheliverTheoutermarginoftheabdominalwallshouldbemeasuredTheabdominalwallmeasurementistheleastaccurate婦產(chǎn)科疾病的超聲診斷ENGLISHMeasuringtheAbdominalCircum64Thefetallivergallbladderstomachportvenousspinegallbladderstomach婦產(chǎn)科疾病的超聲診斷ENGLISHThefetallivergallbladderstom653、FetallimbsTheupperlimbs:theulnatheradiusthehumerusThelowerlimbs:thefemur/thethighbonethefibulathetibiaThefemuristhemostwidelymeasuredlongbone（FLfemurlength）婦產(chǎn)科疾病的超聲診斷ENGLISH3、FetallimbsTheupperlimbs:66FemurmeasurementHyperechoniclinearstructurerepresentstheossifiedportionofthefemoualdiaphysisandcorrespondstofemorallengthmeasurementfromthegreatertrochantertothefemoralcondylesThemormalfemurhasastraightlaeralborderandacurvedmedialborderFemurlengthmaybeusedwiththesameaccuracyasBPDtopredictgestationalageFemurlengthmayindicateskeletaldysplasiasorintrauterinegrowthrestriction婦產(chǎn)科疾病的超聲診斷ENGLISHFemurmeasurementHyperechonic67LongsectionoftheupperlimbsTheradiusTheulnaThehumerus

婦產(chǎn)科疾病的超聲診斷