第一章 超声诊断物理基础 Physical Basis of Ultrasonic Diagnosis 1
一、超声诊断的物理原理 Physical principles of ultrasonic diagnosis 1
(一)超声的基本概念 Fundamental concepts of ultrasound 1
(二)超声的物理量 Pysical capacity of ultrasound 1
(三)超声波的产生与接收 Producing and receiving of ultrasound 2
(四)超声波的传播 Spreading of ultrasound 3
二、超声显像原理及超声诊断仪 Imaging Principle of ultrasound and diagnostic in strument 4
(一)脉冲回声式 Pulse echo type 4
(二)差频回声式 Aniso-frequency echo type 5
三、超声诊断常用术语 Common terms of ultrasonic diagnos 6
(一)回声形态的描述 Describing echo pattem 6
(二)回声强度的描述 Describing echo intensity 6
(三)回声分布的描述 Describing echo distribution 6
(四)病灶内部回声的描述 Describing internal echo lesion 6
(五)病灶边缘的描述 Describing echo of lesion edge 7
(六)病灶后方回声的描述 Describing echo of lesson posteriority 7
(七)某些特殊征象的描述 Describing certain special signs 7
(一)滑行探查 Sliping examination 8
(二)纵切面探查 Vertical-section examination 8
二、探查手法 Examinaterical technique 8
(三)横切面探查 Transverse-section examination 8
(四)斜切面探查 Obique-section examination 8
(一)直接探查法 Direct examinaterial methods 8
一、探查方法 Examinaterical methods 8
第二章 超声检查方法与诊断步骤 Examinaterical Methods and Diagnostic Stepes of US 8
(二)间接探查法 Indirect examinaterial methods 8
(五)定点探查 Spotting examination 9
(六)双侧对照探查 Bilateral contrast examination 9
三、诊断步骤 Diagnostic steps 9
(一)了解临床资料 Understanding clinical data 9
(二)全面细致探查 Overall and careful examination 9
(二)膀胱充盈的适应证 Indications of urocyst-filling 10
(三)膀胱充盈的方法 Methods of urocyst-filling 10
(四)膀胱充盈度对盆腔脏器的影响 Effects of urocyst-filling to pelvic organs 10
(一)膀胱充盈的目的 Prupose of urocyst-flling 10
四、检查前的准备工作 Preparations before examination 10
(三)综合分析诊断 Syntretical analyse 10
五、妇科检查范围及适应证 Scan coverage and indication of gynaecology 14
六、产科检查范围及适应证 Scan coverage and indications of obstetrics 14
七、超声诊断报告的书写方法 Methods to write US diagnostic reports 14
(一)B超诊断报告的书写的基本要求 B-mode US diagnostic report fundimental requires 14
(三)妇科诊断报告内容及报告列举 Contents and examples of gynaecologic diagnostic reports 15
(二)B超诊断报告的书写的基本内容 B-mode US diagnostic report fundimental contents 15
(四)产科诊断报告内容及报告列举 Contents and examples of obstetricte diagnostic reports 22
第三章 盆腔脏器解剖及其正常的超声图像 Anatomy and Normal Sonography of Pelvic Organs 26
一、盆腔内的结构 Structures un pelvis 26
二、妇性内生殖器 Female internal genitals 27
(一)阴道 Vagina 27
(二)子宫 Uterus 27
(三)输卵管 Uterine tube 28
(四)卵巢 Ovary 28
(一)正常子宫声像图 Sonography of normal vagina 29
(五)子宫及附件的血液供应 Blood supply of uterus and appendix 29
三、正常内生殖器超声诊断 Ultrasonic diagnosis of normal internal genitals 29
(二)正常子宫内膜周期性变化的声像图 Sonography of normal untrine edometrium with eycle 35
(三)正常阴道声像图 Sonography of normal vagina 36
(四)正常卵巢及输卵管声像图 Sonography of normal ovary and uterine tube 37
四、各期卵巢卵泡发育的声像图 Sonography of follicular development 38
五、卵泡发育的监测与意义 Examining of growing follicle and its significance 38
(一)成熟卵泡的特点 Feature of mature follicle 39
(二)已经排卵的声像图特征 Sonographic feature of ovulaged ovary 39
(三)卵泡的增长速度 Growing speed of follicle 39
第四章 生殖器发育异常 Congentital Anomalies of Genitals 41
一、先天性无子宫的超声诊断 Ultrasonic diagnosis of congenieal anuterus 41
三、幼稚子宫的超声诊断 Untrasonic dignosis of infantile uterus 42
二、始基子宫的超声诊断 Ultrasonic diagnosis of blastemic uterus 42
四、残角子宫的超声诊断 Untrasonic dignosis of rudinentary horn uterus 43
五、双角子宫的超声诊断 Untrasonic dignosis of bicornis uterus 44
六、纵隔子宫的超声诊断 Untrasonic dignosis of spartus uterus 44
七、双子宫的超声诊断 Untrasonic dignosis of uterus didelphies 45
八、先天性无阴道的超声诊断 Untrasonic dignosis of congenital absence of vagina 48
九、处女膜闭锁的超声诊断 Untrasonic dignosis of imperforate hymen 48
第五章 妇科疾病的超声诊断 Ultrasonic Diagnosis of Female Diseases 50
一、宫颈息肉的超声诊断 Ultrasonic diagnosis of cervical polyp 50
二、宫颈纳氏囊肿的超声诊断 Ultrasonic diagnosis of Nabothian cyst 50
三、宫颈肥大的超声诊断 Ultrasonic diagnosis of cervial hypertrophy 51
四、子宫内膜异位症的超声诊断 Ultrasonic diagnosis of endometriosis 52
六、子宫内膜增殖症的超声诊断 Ultrasonic diagnosis of endometrial hyperplasia 57
五、子宫内膜息肉的超声诊断 Ultrasonic diagnosis of endometrial polyp 57
七、宫腔积液的超声诊断 Ultrasonic diagnosis of effusionmetra 58
八、子宫穿孔、破裂的超声诊断 Ultrasonic diagnosis of uterine perforation and rupture 59
九、子宫内膜炎、子宫肌炎的超声诊断 Ultrasonic diagnosis of endometritis and myometritis 60
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 salpingooophoritis 60
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 abscess 62
十二、子宫全切除及次全切除后的图像 Ultrasonographic image of post total and subtotal hysterectomy 64
十三、子宫增大鉴别诊断表 Differential diagnostic tablet of uterus enlargement 66
第六章 子宫、阴道及胎盘肿瘤的超声诊断 Ultrasonic Diagnosis of Uterine,Vaginal and Placental Tumors 68
一、子宫肌瘤的超声诊断 Ultrasonic diagnosis of uterine myoma 68
二、子宫海绵状血管瘤的超声诊断 Ultrasonic diagnosis ofuterine cavernous hemangioma 79
四、子宫内膜癌的超声诊断 Ultrasonic diagnosis of endomtrial carcinoma 80
五、子中颈癌的超声诊断 Ultrasonic diagnosis of cervical carcinoma 82
六、阴道肿瘤的超声诊断 Ultrasonic diagnosis of vaginal tumors 84
七、绒毛膜上皮癌的的超声诊断 Ultrasonic diagnosis of chorioepithelioma 84
八、胎盘绒毛膜血管瘤的的超声诊断 Ultrasonic diagnosis of placental chorioangioma 85
九、胎盘畸胎瘤的超声诊断 Ultrasonic diagnosis of placental teratoma 85
十、胎盘囊肿的的超声诊断 Ultrasonic diagnosis of placental cyst 85
第七章 卵巢及输卵管肿瘤的的超声诊断 Untrasonic Diagnosis of Ovarian and Tubal Tumors 87
一、卵巢非肿瘤性囊肿的的超声诊断 Ultrasonic diagnosis of Nontumorous voarian cysts 88
(一)滤泡囊肿 Follicular cyst 88
(二)黄体囊肿 Corpus Iuteum cyst 88
(三)黄素囊肿 Theca letein cyst 90
(四)多囊卵巢综合征 Poiycystic ovary syudrome 90
(五)卵巢血肿 Ovarian hematoma 91
(一)粘液性囊腺瘤的超声诊断 Ultrasonic diagnosis of mucous cystadenoma 95
二、良性卵巢肿瘤的超声诊断 Ultrasonic diagnosis of benign ovarian tumors 95
(二)浆液性囊腺瘤的超声诊断 Ultrasonic diagnosis of serous cystadenoma 97
(三)勃勒纳氏瘤的超声诊断 Ultrasonic diagnosis of brenner tumors 98
(四)卵巢良性纤维瘤的超声诊断 Ultrasonic diagnosis of benign ovarian fibroma 98
三、卵巢恶性肿瘤的超声诊断 Ultrasonic diagnosis of malignant ovarian tumors 99
(一)浆液性囊腺癌的超声诊断 Ultrasonic diagnosis of serous cystadenocarcinoma 101
(二)粘液性囊腺癌的超声诊断 Ultrasonic diagnosis of mucous systadenocarcinoma 102
(三)子宫内膜样癌的超声诊断 Ultrasonic diagnosis of endometrioid carcinoma 104
(四)恶生纤维瘤的超声诊断 Ultrasonic diagnosis of malignant fibroma 104
(五)无性细胞瘤的超声诊断 Ultrasonic diagnosis of dysgerminoma 104
(七)粒层细胞瘤的超声诊断 Ultrasonic diagnosis of granulosa cell tumor 105
(八)恶生卵泡膜细胞瘤的超声诊断 Ultrasonic diagnosis of malignant thecoma 105
(六)内胚窦瘤的超声诊断 Ultrasonic diagnosis of endodrmal sinus tumor 105
(九)透明细胞癌的超声诊断 Ultrasonic diagnosis of clear cell carcinoma 106
(十)转移癌的超声诊断 Ultrasonic diagnosis of metastatic carcinoma 106
四、输卵管的超声诊断 Ultrasonic diagnosis of salpingian carcinoma 106
五、卵巢畸胎瘤的超声诊断 Ultrasonic diagnosis of ovarian teratoma 107
(一)良性卵巢畸胎瘤的超声诊断 Ultrasonic diagnosis of benign ovarian teratoma 107
(二)恶生卵巢畸胎瘤的超声诊断 Ultrasonic diagnosis of malignant ovarian teratoma 111
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 tumors 111
第八章 正常胎儿的发育解剖和生理 Growth Anatomy and Physiology of Normal Fetus 113
一、精精卵的发育和着床 Growth and implantation of fertilized ovum 113
二、胚胎期 Embryo period 114
三、胎儿期 Fetus period 114
四、胎盘形成、脐带组成 Formation of placenta and component of umbilical cord 118
六、妊娠各周宫底高度 Uterinc fundus of pregnancy period 120
五、羊膜腔及羊水 Amniotic cavity and amniotic fluid 120
七、正常早期妊娠的超声特征 Ultrasonographic characteristics of normal early pregnancy 121
八、早期妊娠检查注意点 Attentions to early pregnancy examination 124
九、中、晚期妊娠超声特征 Ultrasonographic characteristics of middle and late pregnancy 124
十、超声检测估计胎龄的方法 Methods for estimating gestational age by ultrasonography 135
十一、多胎妊娠的超声诊断 Ultrasonic diagnosis of multiple Pregnancy 139
十二、产后盆腔的超声诊断 Ultrasonic diagnosis of postpartum pelvis 141
第九章 病理妊娠的超声诊断 Ultrasonic Diagnosis of Pathological Pregnancy 143
一、流产的超声诊断 Ultrasonic diagnosis of abortion 143
二、葡萄胎的超声诊断 Ultrasonic diagnosis of hydatidiform mole 149
三、宫外孕的超声诊断 Ultrasonic diagnosis of extraut erine pregnancy 154
四、胚胎停止发育的超声诊断 Ultrasonic diagnosis of embryonal development stoppage 161
五、死胎的超声诊断 Ultrasonic diagnosis of fetal death 162
六、前置胎盘的超声诊断 Ultrasonic diagnosis of placental previa 163
七、胎盘早期剥离的超声诊断 Ultrasonic diagnosis of placental early abruption 166
八、子宫肌瘤合并妊娠的超声诊断 Ultrasonic diagnosis of unerine myoma combined with pregnancy 167
九、卵巢肿瘤合并妊娠的超声诊断 Ultrasonic diagnosis of ovarian tumors combined with pregnancy 168
十、畸形子宫合并妊娠的超声诊断 Ultrasonic diagnosis of uterus malformation combined with pregnancy 171
(一)双子宫合并妊娠 Double uterus combined with pregnancy 171
(二)残角子宫合并妊娠 Uterus unicornis combined with pregnancy 171
十一、子宫颈功能不全的超声诊断 Ultrasonic diagnosis of incompetent cervix 173
十二、胎儿宫内生长迟缓的超声诊断 Ultrasonic diagnosis of fetal intrauterine growth retardation 173
第十章 先天性胎儿畸形的超声诊断 Untrasonic Diagnosis of Fetal Congenital Malformations 175
一、神经系统畸形的超声诊断 Ultrasonic diagnosis of neural system malformations 175
(一)无脑儿 Anencephalus 175
(二)脑积水 Hydrocephalap 175
(四)脑脊膜膨出 Meningocephaocele 178
(三)脊柱裂 Spina bifida 178
(一)食管闭锁 Atresia of esophagus 180
(二)肠管狭窄或闭锁及胃幽门梗阻 Intestinal stenosis or atresia and pylorus obstrustion 180
(三)横膈膜疝 Diaphragmatic hermia 180
二、消化系统畸形或异常的超声诊断 Ultrasonic diagnosis of digestive system malformations 180
(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 malformations 181
(一)肾发育不全或缺如 Hypoplasia of the kidney or anephrogenesis 181
(五)尿道闭锁 Urethral atresia 182
四、骨骼系统异常的超声诊断 Ultrasonic diagnosis of skeletal system abnormalities 182
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 diseases 182
(四)肾积水 Hydronephrosis 182
(三)多囊性肾发育不全 Hypoplasia of the polycystic kidney 182
(二)多囊肾 Polycystic kidney 182
六、胎儿水肿的超声诊断 Untrasonic diagnosis of hydrops fetalis 183
七、胎儿淋巴系统异常的超声诊断 Untrasonic diagnosis of fetal lymphatic system abnormalities 185
八、胎儿颈部血管瘤的超声诊断 Untrasonic diagnosis of fetal neck hemangioma 185
九、胎儿肝囊肿、肺囊肿的超声诊断 Untrasonic diagnosis of feta liver and lung cyst 185
十、胎儿卵巢囊肿的超声诊断 Untrasonic diagnosis of fetal ovarian cyst 185
十一、双胎畸形的超声诊断 Untrasonic diagnosis of twin malformation 186
十二、羊膜粘连带综合征 Amniotic adhesive band syndrome 186
十三、超声检查胎儿异常的注意点 Attentions to fetal abnormalities examination with ultrasonography 186
第十一章 计划生育 Fiamily Planning 187
一、宫内节育器的超声诊断 Ultrasonic diagnosis of intrauterine device 187
二、节育器的超声定位诊断 Localization of intrauterine device with ultrasonography 189
三、节育器移位的超声诊断 Ultrasonic diagnosis of intrauterine device translocation 189
五、子宫穿孔的超声诊断 Ultrasonic diagnosis of uterine perforation 192
四、宫内节育器合并妊娠的超声诊断 Ultrasonic diagnosis of intrauterine device combined with pregnancy 192
六、宫内节育器合并子宫肌瘤的超声诊断 Ultrasonic diagnosis of intrauterine device with uterine myoma 194
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 Obstetrics 196
一、正常盆腔脏器的彩色多普勒超声诊断* Color Doppler ultrasonographic appearance of normal pelvice organs 196
(一)子宫动脉 Uterine artery 196
(二)卵巢动脉 Ovarian artery 196
二、妇科疾病的彩色多普勒超声诊断 Color Doppler ultrasonography in diagnosis of gynaecologic diseases 196
(一)子宫肌瘤 Myoma of uterus 196
(二)子宫内膜癌 Carcinoma of endometrium 196
(一)早期妊娠 The early pregnance 197
(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 retardation 197
四、异常妊娠的彩色多普勒超声诊断 Color Doppler ultrasonography in diagnosis of abnormal pregnancy 197
(二)中、晚期妊娠 The middle and lately pregnancy 197
三、正常妊娠的彩色多普勒超声诊断* Color Doppler ultrasonographic appearance of normal pregnancy 197
(四)不孕症 Infertility 197
(三)卵巢癌 Ovarian carcinoma 197
(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 neck 198
(三)宫外孕的彩色多普勒超声诊断 Color Doppler ultrasonography in diagnosis of extrauterine pregnancy 198
(四)滋养细胞肿瘤的彩色多普勒超声诊断 Color Doppler ultrasonography in diagnosis of trophoblastic tumors 198
第十三章 介入性超声在妇产科的应用 Application of Interventional Ultrasonography in Gynaecology and Obstetrics 199
一、超声引导下取环或放环 Ultrasonically guided removal or insertion of intrauterine device 199
二、超声监护下刮宫 Ultrasonically monitored induction of labor 199
三、超声引导下卵泡囊肿穿刺 Ultrasonically guided puncture of follicular cyst 199
四、超声引导下穿刺盆腔囊性肿块 Ultrasonically guided puncture of pelvic cyst mass 199
五、胎儿宫内穿刺诊断 Ultrasonic diagnosis of fetal by transuterine puncture biopsy 200
参考文献 201