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第一章 超声诊断物理基础 Physical Basis of Ultrasonic Diagnosis1

一、超声诊断的物理原理 Physical principles of ultrasonic diagnosis1

(一)超声的基本概念 Fundamental concepts of ultrasound1

(二)超声的物理量 Pysical capacity of ultrasound1

(三)超声波的产生与接收 Producing and receiving of ultrasound2

(四)超声波的传播 Spreading of ultrasound3

二、超声显像原理及超声诊断仪 Imaging Principle of ultrasound and diagnostic in strument4

(一)脉冲回声式 Pulse echo type4

(二)差频回声式 Aniso-frequency echo type5

三、超声诊断常用术语 Common terms of ultrasonic diagnos6

(一)回声形态的描述 Describing echo pattem6

(二)回声强度的描述 Describing echo intensity6

(三)回声分布的描述 Describing echo distribution6

(四)病灶内部回声的描述 Describing internal echo lesion6

(五)病灶边缘的描述 Describing echo of lesion edge7

(六)病灶后方回声的描述 Describing echo of lesson posteriority7

(七)某些特殊征象的描述 Describing certain special signs7

(一)滑行探查 Sliping examination8

(二)纵切面探查 Vertical-section examination8

二、探查手法 Examinaterical technique8

(三)横切面探查 Transverse-section examination8

(四)斜切面探查 Obique-section examination8

(一)直接探查法 Direct examinaterial methods8

一、探查方法 Examinaterical methods8

第二章 超声检查方法与诊断步骤 Examinaterical Methods and Diagnostic Stepes of US8

(二)间接探查法 Indirect examinaterial methods8

(五)定点探查 Spotting examination9

(六)双侧对照探查 Bilateral contrast examination9

三、诊断步骤 Diagnostic steps9

(一)了解临床资料 Understanding clinical data9

(二)全面细致探查 Overall and careful examination9

(二)膀胱充盈的适应证 Indications of urocyst-filling10

(三)膀胱充盈的方法 Methods of urocyst-filling10

(四)膀胱充盈度对盆腔脏器的影响 Effects of urocyst-filling to pelvic organs10

(一)膀胱充盈的目的 Prupose of urocyst-flling10

四、检查前的准备工作 Preparations before examination10

(三)综合分析诊断 Syntretical analyse10

五、妇科检查范围及适应证 Scan coverage and indication of gynaecology14

六、产科检查范围及适应证 Scan coverage and indications of obstetrics14

七、超声诊断报告的书写方法 Methods to write US diagnostic reports14

(一)B超诊断报告的书写的基本要求 B-mode US diagnostic report fundimental requires14

(三)妇科诊断报告内容及报告列举 Contents and examples of gynaecologic diagnostic reports15

(二)B超诊断报告的书写的基本内容 B-mode US diagnostic report fundimental contents15

(四)产科诊断报告内容及报告列举 Contents and examples of obstetricte diagnostic reports22

第三章 盆腔脏器解剖及其正常的超声图像 Anatomy and Normal Sonography of Pelvic Organs26

一、盆腔内的结构 Structures un pelvis26

二、妇性内生殖器 Female internal genitals27

(一)阴道 Vagina27

(二)子宫 Uterus27

(三)输卵管 Uterine tube28

(四)卵巢 Ovary28

(一)正常子宫声像图 Sonography of normal vagina29

(五)子宫及附件的血液供应 Blood supply of uterus and appendix29

三、正常内生殖器超声诊断 Ultrasonic diagnosis of normal internal genitals29

(二)正常子宫内膜周期性变化的声像图 Sonography of normal untrine edometrium with eycle35

(三)正常阴道声像图 Sonography of normal vagina36

(四)正常卵巢及输卵管声像图 Sonography of normal ovary and uterine tube37

四、各期卵巢卵泡发育的声像图 Sonography of follicular development38

五、卵泡发育的监测与意义 Examining of growing follicle and its significance38

(一)成熟卵泡的特点 Feature of mature follicle39

(二)已经排卵的声像图特征 Sonographic feature of ovulaged ovary39

(三)卵泡的增长速度 Growing speed of follicle39

第四章 生殖器发育异常 Congentital Anomalies of Genitals41

一、先天性无子宫的超声诊断 Ultrasonic diagnosis of congenieal anuterus41

三、幼稚子宫的超声诊断 Untrasonic dignosis of infantile uterus42

二、始基子宫的超声诊断 Ultrasonic diagnosis of blastemic uterus42

四、残角子宫的超声诊断 Untrasonic dignosis of rudinentary horn uterus43

五、双角子宫的超声诊断 Untrasonic dignosis of bicornis uterus44

六、纵隔子宫的超声诊断 Untrasonic dignosis of spartus uterus44

七、双子宫的超声诊断 Untrasonic dignosis of uterus didelphies45

八、先天性无阴道的超声诊断 Untrasonic dignosis of congenital absence of vagina48

九、处女膜闭锁的超声诊断 Untrasonic dignosis of imperforate hymen48

第五章 妇科疾病的超声诊断 Ultrasonic Diagnosis of Female Diseases50

一、宫颈息肉的超声诊断 Ultrasonic diagnosis of cervical polyp50

二、宫颈纳氏囊肿的超声诊断 Ultrasonic diagnosis of Nabothian cyst50

三、宫颈肥大的超声诊断 Ultrasonic diagnosis of cervial hypertrophy51

四、子宫内膜异位症的超声诊断 Ultrasonic diagnosis of endometriosis52

六、子宫内膜增殖症的超声诊断 Ultrasonic diagnosis of endometrial hyperplasia57

五、子宫内膜息肉的超声诊断 Ultrasonic diagnosis of endometrial polyp57

七、宫腔积液的超声诊断 Ultrasonic diagnosis of effusionmetra58

八、子宫穿孔、破裂的超声诊断 Ultrasonic diagnosis of uterine perforation and rupture59

九、子宫内膜炎、子宫肌炎的超声诊断 Ultrasonic diagnosis of endometritis and myometritis60

十、输卵管积水、输卵管炎、输卵管卵巢炎的超声诊断 Ultrasonic diagnosis of hydrosalping,salpingitis and salpingooophoritis60

十一、盆腔包裹性积液、血肿、脓肿的超声诊断 Ultrasonic diagnosis of pelvic cystic effusion,hematoma and abscess62

十二、子宫全切除及次全切除后的图像 Ultrasonographic image of post total and subtotal hysterectomy64

十三、子宫增大鉴别诊断表 Differential diagnostic tablet of uterus enlargement66

第六章 子宫、阴道及胎盘肿瘤的超声诊断 Ultrasonic Diagnosis of Uterine,Vaginal and Placental Tumors68

一、子宫肌瘤的超声诊断 Ultrasonic diagnosis of uterine myoma68

二、子宫海绵状血管瘤的超声诊断 Ultrasonic diagnosis ofuterine cavernous hemangioma79

四、子宫内膜癌的超声诊断 Ultrasonic diagnosis of endomtrial carcinoma80

五、子中颈癌的超声诊断 Ultrasonic diagnosis of cervical carcinoma82

六、阴道肿瘤的超声诊断 Ultrasonic diagnosis of vaginal tumors84

七、绒毛膜上皮癌的的超声诊断 Ultrasonic diagnosis of chorioepithelioma84

八、胎盘绒毛膜血管瘤的的超声诊断 Ultrasonic diagnosis of placental chorioangioma85

九、胎盘畸胎瘤的超声诊断 Ultrasonic diagnosis of placental teratoma85

十、胎盘囊肿的的超声诊断 Ultrasonic diagnosis of placental cyst85

第七章 卵巢及输卵管肿瘤的的超声诊断 Untrasonic Diagnosis of Ovarian and Tubal Tumors87

一、卵巢非肿瘤性囊肿的的超声诊断 Ultrasonic diagnosis of Nontumorous voarian cysts88

(一)滤泡囊肿 Follicular cyst88

(二)黄体囊肿 Corpus Iuteum cyst88

(三)黄素囊肿 Theca letein cyst90

(四)多囊卵巢综合征 Poiycystic ovary syudrome90

(五)卵巢血肿 Ovarian hematoma91

(一)粘液性囊腺瘤的超声诊断 Ultrasonic diagnosis of mucous cystadenoma95

二、良性卵巢肿瘤的超声诊断 Ultrasonic diagnosis of benign ovarian tumors95

(二)浆液性囊腺瘤的超声诊断 Ultrasonic diagnosis of serous cystadenoma97

(三)勃勒纳氏瘤的超声诊断 Ultrasonic diagnosis of brenner tumors98

(四)卵巢良性纤维瘤的超声诊断 Ultrasonic diagnosis of benign ovarian fibroma98

三、卵巢恶性肿瘤的超声诊断 Ultrasonic diagnosis of malignant ovarian tumors99

(一)浆液性囊腺癌的超声诊断 Ultrasonic diagnosis of serous cystadenocarcinoma101

(二)粘液性囊腺癌的超声诊断 Ultrasonic diagnosis of mucous systadenocarcinoma102

(三)子宫内膜样癌的超声诊断 Ultrasonic diagnosis of endometrioid carcinoma104

(四)恶生纤维瘤的超声诊断 Ultrasonic diagnosis of malignant fibroma104

(五)无性细胞瘤的超声诊断 Ultrasonic diagnosis of dysgerminoma104

(七)粒层细胞瘤的超声诊断 Ultrasonic diagnosis of granulosa cell tumor105

(八)恶生卵泡膜细胞瘤的超声诊断 Ultrasonic diagnosis of malignant thecoma105

(六)内胚窦瘤的超声诊断 Ultrasonic diagnosis of endodrmal sinus tumor105

(九)透明细胞癌的超声诊断 Ultrasonic diagnosis of clear cell carcinoma106

(十)转移癌的超声诊断 Ultrasonic diagnosis of metastatic carcinoma106

四、输卵管的超声诊断 Ultrasonic diagnosis of salpingian carcinoma106

五、卵巢畸胎瘤的超声诊断 Ultrasonic diagnosis of ovarian teratoma107

(一)良性卵巢畸胎瘤的超声诊断 Ultrasonic diagnosis of benign ovarian teratoma107

(二)恶生卵巢畸胎瘤的超声诊断 Ultrasonic diagnosis of malignant ovarian teratoma111

六、常见卵巢肿瘤的超声图像鉴别诊断及意义 Differential diagnosis and its significance of sonography in common ovarian tumors111

第八章 正常胎儿的发育解剖和生理 Growth Anatomy and Physiology of Normal Fetus113

一、精精卵的发育和着床 Growth and implantation of fertilized ovum113

二、胚胎期 Embryo period114

三、胎儿期 Fetus period114

四、胎盘形成、脐带组成 Formation of placenta and component of umbilical cord118

六、妊娠各周宫底高度 Uterinc fundus of pregnancy period120

五、羊膜腔及羊水 Amniotic cavity and amniotic fluid120

七、正常早期妊娠的超声特征 Ultrasonographic characteristics of normal early pregnancy121

八、早期妊娠检查注意点 Attentions to early pregnancy examination124

九、中、晚期妊娠超声特征 Ultrasonographic characteristics of middle and late pregnancy124

十、超声检测估计胎龄的方法 Methods for estimating gestational age by ultrasonography135

十一、多胎妊娠的超声诊断 Ultrasonic diagnosis of multiple Pregnancy139

十二、产后盆腔的超声诊断 Ultrasonic diagnosis of postpartum pelvis141

第九章 病理妊娠的超声诊断 Ultrasonic Diagnosis of Pathological Pregnancy143

一、流产的超声诊断 Ultrasonic diagnosis of abortion143

二、葡萄胎的超声诊断 Ultrasonic diagnosis of hydatidiform mole149

三、宫外孕的超声诊断 Ultrasonic diagnosis of extraut erine pregnancy154

四、胚胎停止发育的超声诊断 Ultrasonic diagnosis of embryonal development stoppage161

五、死胎的超声诊断 Ultrasonic diagnosis of fetal death162

六、前置胎盘的超声诊断 Ultrasonic diagnosis of placental previa163

七、胎盘早期剥离的超声诊断 Ultrasonic diagnosis of placental early abruption166

八、子宫肌瘤合并妊娠的超声诊断 Ultrasonic diagnosis of unerine myoma combined with pregnancy167

九、卵巢肿瘤合并妊娠的超声诊断 Ultrasonic diagnosis of ovarian tumors combined with pregnancy168

十、畸形子宫合并妊娠的超声诊断 Ultrasonic diagnosis of uterus malformation combined with pregnancy171

(一)双子宫合并妊娠 Double uterus combined with pregnancy171

(二)残角子宫合并妊娠 Uterus unicornis combined with pregnancy171

十一、子宫颈功能不全的超声诊断 Ultrasonic diagnosis of incompetent cervix173

十二、胎儿宫内生长迟缓的超声诊断 Ultrasonic diagnosis of fetal intrauterine growth retardation173

第十章 先天性胎儿畸形的超声诊断 Untrasonic Diagnosis of Fetal Congenital Malformations175

一、神经系统畸形的超声诊断 Ultrasonic diagnosis of neural system malformations175

(一)无脑儿 Anencephalus175

(二)脑积水 Hydrocephalap175

(四)脑脊膜膨出 Meningocephaocele178

(三)脊柱裂 Spina bifida178

(一)食管闭锁 Atresia of esophagus180

(二)肠管狭窄或闭锁及胃幽门梗阻 Intestinal stenosis or atresia and pylorus obstrustion180

(三)横膈膜疝 Diaphragmatic hermia180

二、消化系统畸形或异常的超声诊断 Ultrasonic diagnosis of digestive system malformations180

(四)腹壁缺陷 Omphalocele(periton desect)181

三、泌尿系统畸形的超声诊断 Ultrasonic diagnosis of urinary system malformations181

(一)肾发育不全或缺如 Hypoplasia of the kidney or anephrogenesis181

(五)尿道闭锁 Urethral atresia182

四、骨骼系统异常的超声诊断 Ultrasonic diagnosis of skeletal system abnormalities182

五、胎儿先天性心脏缺陷和某些心脏疾患的声像 Untrasonic diagnosis of fetal congenital heart diseases182

(四)肾积水 Hydronephrosis182

(三)多囊性肾发育不全 Hypoplasia of the polycystic kidney182

(二)多囊肾 Polycystic kidney182

六、胎儿水肿的超声诊断 Untrasonic diagnosis of hydrops fetalis183

七、胎儿淋巴系统异常的超声诊断 Untrasonic diagnosis of fetal lymphatic system abnormalities185

八、胎儿颈部血管瘤的超声诊断 Untrasonic diagnosis of fetal neck hemangioma185

九、胎儿肝囊肿、肺囊肿的超声诊断 Untrasonic diagnosis of feta liver and lung cyst185

十、胎儿卵巢囊肿的超声诊断 Untrasonic diagnosis of fetal ovarian cyst185

十一、双胎畸形的超声诊断 Untrasonic diagnosis of twin malformation186

十二、羊膜粘连带综合征 Amniotic adhesive band syndrome186

十三、超声检查胎儿异常的注意点 Attentions to fetal abnormalities examination with ultrasonography186

第十一章 计划生育 Fiamily Planning187

一、宫内节育器的超声诊断 Ultrasonic diagnosis of intrauterine device187

二、节育器的超声定位诊断 Localization of intrauterine device with ultrasonography189

三、节育器移位的超声诊断 Ultrasonic diagnosis of intrauterine device translocation189

五、子宫穿孔的超声诊断 Ultrasonic diagnosis of uterine perforation192

四、宫内节育器合并妊娠的超声诊断 Ultrasonic diagnosis of intrauterine device combined with pregnancy192

六、宫内节育器合并子宫肌瘤的超声诊断 Ultrasonic diagnosis of intrauterine device with uterine myoma194

第十二章 彩色多普勒血流显像在妇产科的应用 Application of Color Doppler Blood Flow Imaging in Gynaecology and Obstetrics196

一、正常盆腔脏器的彩色多普勒超声诊断* Color Doppler ultrasonographic appearance of normal pelvice organs196

(一)子宫动脉 Uterine artery196

(二)卵巢动脉 Ovarian artery196

二、妇科疾病的彩色多普勒超声诊断 Color Doppler ultrasonography in diagnosis of gynaecologic diseases196

(一)子宫肌瘤 Myoma of uterus196

(二)子宫内膜癌 Carcinoma of endometrium196

(一)早期妊娠 The early pregnance197

(一)胎儿宫内生长迟缓的彩色多普勒超声诊断 Color Doppler ultrasonographic appearance of fetal interuterine growth retardation197

四、异常妊娠的彩色多普勒超声诊断 Color Doppler ultrasonography in diagnosis of abnormal pregnancy197

(二)中、晚期妊娠 The middle and lately pregnancy197

三、正常妊娠的彩色多普勒超声诊断* Color Doppler ultrasonographic appearance of normal pregnancy197

(四)不孕症 Infertility197

(三)卵巢癌 Ovarian carcinoma197

(二)胎儿脐带绕颈的彩色多普勒超声诊断* Color Doppler ultrasonography in diagnosis of umbilical cord around neck198

(三)宫外孕的彩色多普勒超声诊断 Color Doppler ultrasonography in diagnosis of extrauterine pregnancy198

(四)滋养细胞肿瘤的彩色多普勒超声诊断 Color Doppler ultrasonography in diagnosis of trophoblastic tumors198

第十三章 介入性超声在妇产科的应用 Application of Interventional Ultrasonography in Gynaecology and Obstetrics199

一、超声引导下取环或放环 Ultrasonically guided removal or insertion of intrauterine device199

二、超声监护下刮宫 Ultrasonically monitored induction of labor199

三、超声引导下卵泡囊肿穿刺 Ultrasonically guided puncture of follicular cyst199

四、超声引导下穿刺盆腔囊性肿块 Ultrasonically guided puncture of pelvic cyst mass199

五、胎儿宫内穿刺诊断 Ultrasonic diagnosis of fetal by transuterine puncture biopsy200

参考文献201