超声在妇科应用进展(英文)课件

progress

on

the

applicationof

ultrasound

ingynecology

progress

on

the

applicationo超声在妇科应用进展(英文)课件超声在妇科应用进展(英文)课件endo-luminalultrasound（腔内超声）Real-TimeTissueElastography(弹性成像)Contrastenhancedultrasound（超声造影）Three-dimensionalUltrasonography（3D三维超声）endo-luminalultrasound（腔内超声）uterine

cavityultrasonographyIndicationscontraindicationuterine

cavityultrasonographyTransvaginalUltrasounduterine

cavityultrasonographypathologyIA022IB256IC143ambiguity800TransvaginalUltrasounduterineacoustic

penetrationdepth

isinverselyproportionaltotheprobefrequency。Resolution

isproportionaltotheprobe

frequencyacoustic

penetrationdepth

isAdvantagesandlimitationsHigh-frequency,highresolution,clearimageSmallscanningradiusAdvantagesandlimitationsHigh妇科腔内超声适应症和禁忌症适应症禁忌症：1）未婚无性生活史；2）阴道出血；3）阴道炎；4）老年性或放射性阴道萎缩；4）先天性阴道闭锁。相对禁忌症：1）患者不同意阴道超声检查；2）超出阴道探头探查范围的盆腔肿块；3）中、晚期妊娠有阴道出血原因不明者。---临床技术操作规范超声医学分册妇科腔内超声适应症和禁忌症适应症

2、实时组织弹性成像

（Real-TimeTissueElastography）

2、实时组织弹性成像

（Real-Ti[Elastography]

The

hardnessoforganizationis

closerelativetohistopathology

.

Grayscaleorcolorcodedimagingsoftsofthardexternalforcesofthard[Elastography]

ThehardnessElastographyElastography

1points：deformation,green；

2points：largelydeformation,Greenandbluemosaic；

3points：Boundarydeformation－green,centerpartundeformed,blue

4points：tumorundeformed－blue；

5points：tumorandperienchymaundeformed,

tumorandperienchyma－blue1points：deformation,greequantitativeanalysis－－qualitativeanalysis1pointsbenign2～3pointsBenignmaybe4pointsPayattentiontothedifferentialdiagnosis5pointsmalignancymaybequantitativeanalysis－－qualita

strainratio------quantitativeanalysissoftwarestrainratio(应变率)strainratio------quantitativStrainratio=B/A=FLR=tumor/fattytissue(referencevalue4.3）Strainratio=B/A=tumor/referencetissue

(referencevalue3.08）Strainratio=B/A=FLR=tumor/fa超声在妇科应用进展(英文)课件超声在妇科应用进展(英文)课件超声在妇科应用进展(英文)课件clinicalapplicationTheearlydiagnosisofcancer

・Benign,malignantjudgement

・Diffusionregion

・ToconfirmthetherapeuticeffecclinicalstagingofvenousthrombosisHepaticfibrosisThecorrespondingclinicalfield：Thyroid,breast,prostate,skin,liver,pancreas,uterus/ovary,lymphnode,vascular,rectum,testis……clinicalapplication3、Contrast-EnhancedUltrasoundTheshortageofconventionalultrasound

differentialdiagnosisofbenignandmalignantdiseasesLowspecificityLowsensitivityAdieasehasabroadspetrumofsonographicapperance，variousdieaseshavecommonsonographicapperance3、Contrast-EnhancedUltrasoundOvariancysticmassOvariancysticmassTheprincipleofconventionalultrasound

2D：acousticimpedanceacousticattenuation

CDFI：DopplershiftTheprincipleofconventionalIntravenousContrastUltrasoundDifferenceofmicrocirculationchangesincreasetheechogenicityofthebloodEnhancethedifferenceoftissueperfusionIntravenousContrastUltrasounWhatisulrasoundcontrastagent?Sizesufficientlysmall(lessthanredbloodcell)Strongsignals(morethanredbloodcell)PassthroughoutthebodyEliminateviatherespiratorysystemWhatisulrasoundcontrastageHowmicrobubbleswork?RapidlycontractingandexpandingtothepressurechangesofthesoundmakemicrobubblesseveralthousandtimesmorereflectivethannormalbodytissueThenon-linearoscillationofmicrobubblesgenerateharmonicTheacousticresultmicrobubblesburstHowmicrobubbleswork?Rapidly---定性：心脏、腹部、高频和腔内应用领域的实时造影技术

CnTI™-ContrastTunedImaging---定量：声学时间强度曲线分析

Wash-in/Wash-out™---创新：微血管灌注成像

CMI™-ContrastMicro-Imaging---定性：心脏、腹部、高频和腔内应用领域的实时造影技术Inertgas-filledmicrobubblescontrastagentSafetynon-toxicityUniformsize,lessthan10μmPassthroughthecapillariesGenerateharmonicGoodstabilityInertgas-filledmicrobubblesmicrobubblesBloodcirculationPassthroughthecapillariesthedifferenceoftissueperfusionReflectBloodsupplyoflesionsThedetectionrateofMicrovesselsincreasedTheechogenicofdifferenttissueweredifferentRealtimecontrastenhanceultrasoundmicrobubblesBloodcirculationPCEUSCEUS局灶性不典型增生FocalnodularhyperplasiaFNH局灶性不典型增生FocalnodularhyperplaTime-intensitycurves(OrdènetalRadiology2003;206:405-10)Time-intensitycurves(OrdènetPostoperative

CervicalcancerPostoperative

CervicalcancerBorderlineserouscystadenomaBorderlineserouscystadenomaMalignantmesotheliomaMalignantmesotheliomaDeepmyometrialinvasioninendomentrialcancerDeepmyometrialinvasioninenPelvicrecurrenceofendometrialcancerPelvicrecurrenceofendometri4、Three-dimensionalUltrasonography4、Three-dimensionalUltrasonoModernobstetricsandGynecologycategorygynaecologyobstetricsFemalepelvicmedicine；UrogynecologyfamilyplanningModernobstetricsandGynecoloThreedimensionalobstetrics

ultrasoundThreedimensionalgynaecologyultrasoundThreedimensionalobstetricsu3D,Anewfieldofvision3D,AnewfieldofvisionDynamicthree-dimensionalimaging，4DDynamicthree-dimensionalimagImagingmode：surfacemodetransparentmodecolordopplerflowimagingmodemultipleplanemodeNichemode超声在妇科应用进展(英文)课件surfacemodesurfacemodetransparentmodetransparentmodecolordopplerflowimagingmodecolordopplerflowmultipleplanemodemultipleplanemodeNichemodeNichemodeTwodimensionalultrasoundcannotget；Theimageiseasytounderstand；Makeacomprehensiveanalysisoftheinterestingzone。Closetotheactualanatomy,easyforcliniciansandnonmedicalstaffunderstanding,bettercommunicationbetweenultrasounddoctors，cliniciansandpatient超声在妇科应用进展(英文)课件indicationCongenitaluterineanomaliesIntrauterinedeviceintrauterinediseaseectopicpregnancyAdnexalmasses,follicledetection,ovarianvolumemeasurementindicationCongenitaluterineaAssessmentofovarianresponseThediagnosisofPCOSEvaluatetheuterinemorphologyandendometrialvolumePredicttheoutcomeofIVF-ETThreedimensionalultrasoundguidedpunctureAssessmentofovarianresponsetestingtimetestingtimeAFS(美国生殖协会)，1988yAFS(美国生殖协会)，1988y

classⅠ：Uterinehypoplasia/dysplasiaclassⅠ：UterinehypoplasiaclassⅡ：

unicornousuterus

(rudimentaryhornofuterus)classⅡ：

unicornousuterus(ru超声在妇科应用进展(英文)课件classⅢ：

didelphicuterusclassⅢ：

didelphicuterusdidelphicuterusdidelphicuterusclassⅣ：

bicornuateuterusclassⅣ：

bicornuateuterusIncompletebicornuateuterusIncompletebicornuateuteruscompletebicornuateuterus（doublecervix）

completebicornuateuterus（doucompletebicornuateuterus（doublecervix）completebicornuateuterus（dou

classⅤ

septateuterusclassⅤ

septateuterus超声在妇科应用进展(英文)课件Incompleteseptate

uterusSideintrauterinepregnancyIncompleteseptateuteruscompleteseptate

uteruscompleteseptateuterusclassⅥ

arcuateuterusclassⅥ

arcuateuterusclassⅦ：

diethystilbestrol（DES）exposureclassⅦ：

diethystilbestrol（DES

lengthdepthanglelength超声在妇科应用进展(英文)课件Incompleteseptate

uterus

Comparisonofpreoperativeandpostoperative

before

after

内膜Incompleteseptateuterus

Comp3D－PDA3D－PDAVOCALhistogramThreevascularindex：VI－VascularindexFI－flowindexVFI－VesselsflowindexVOCALhistogramThreevascular743D：Applicationinassistedreproductivetechnology1、Toobservethesituationofendometrial,ovarian,ovarianfollicle。2、Evaluationofendometrialreceptivity。3、Toevaluatethereactivityofovary。4、Toguidetheembryoimplantation。743D：Applicationinassistedr3DUltrasoundangiographyof

fallopiantubecoded

contrast

imaging

CCIThreedimensionalimagingfunctionstereoimageryoftubalmorphologyanddistribution3DUltrasoundangiographyof

fSonoAVC

AutomaticmeasurementvolumeoffolliclesandfolliclecounSonoAVC

AutomaticmeasurementdiagnosticcriteriaofPCOSdiagnosticcriteria1990NIH

2003Rotterdam

2006AndrogenExcessSocietyUltrasonicPCOcriteria:1990NIH

Theovarianperiphery≥10smallfollicles,andeachdiameter<1cm2003Rotterdamunilateralorbilateralovarianfolliclesmorethan12,1~9mmindiameter,andorovarianvolumegreaterthan10mldiagnosticcriteriaofPCOSdia78endometrialreceptivityEndometrialreceptivityisoneofthemainfactorsaffectingembryoimplantationAlthoughvariousendocrinefactorsmayinfluencetheendometrialreceptivity,butendometrialitselfenvironmentisaveryimportantreasonTVUScanbeusedtoevaluateendometrialthickness,echoandbloodflow,butmorethan10yearsofresearchshowsthelowsensitivity78endometrialreceptivityEndom793DandnormalendometriumNormalmenstrualcycleEndometrialvolume：Endometrialvascular：Somestudiesshowthatcomparedwiththeproliferativephase,secretoryphase(thelutealphase)vascularsurfacearea,diameter,capillarynumber

significantlyincreased793DandnormalendometriumNorThenewdisciplineofultrasoundUrogynecology;

pelvicfloorfunctionevaluationThenewdisciplineofultrasouThepelvicdiaphragmhiatus3Dimaging:Thepelvicdiaphragmhiatus3DPelvicfloormusclePelvicfloormuscle

urethrovaginalseptum

rectovaginalseptum超声在妇科应用进展(英文)课件22/49/6322/49/63超声在妇科应用进展(英文)课件超声在妇科应用进展(英文)课件超声在妇科应用进展(英文)课件超声在妇科应用进展(英文)课件thankyou！thankyou！

progress

on

the

applicationof

ultrasound

ingynecology

progress

on

the

applicationo超声在妇科应用进展(英文)课件超声在妇科应用进展(英文)课件endo-luminalultrasound（腔内超声）Real-TimeTissueElastography(弹性成像)Contrastenhancedultrasound（超声造影）Three-dimensionalUltrasonography（3D三维超声）endo-luminalultrasound（腔内超声）uterine

cavityultrasonographyIndicationscontraindicationuterine

cavityultrasonographyTransvaginalUltrasounduterine

cavityultrasonographypathologyIA022IB256IC143ambiguity800TransvaginalUltrasounduterineacoustic

penetrationdepth

isinverselyproportionaltotheprobefrequency。Resolution

isproportionaltotheprobe

frequencyacoustic

penetrationdepth

isAdvantagesandlimitationsHigh-frequency,highresolution,clearimageSmallscanningradiusAdvantagesandlimitationsHigh妇科腔内超声适应症和禁忌症适应症禁忌症：1）未婚无性生活史；2）阴道出血；3）阴道炎；4）老年性或放射性阴道萎缩；4）先天性阴道闭锁。相对禁忌症：1）患者不同意阴道超声检查；2）超出阴道探头探查范围的盆腔肿块；3）中、晚期妊娠有阴道出血原因不明者。---临床技术操作规范超声医学分册妇科腔内超声适应症和禁忌症适应症

2、实时组织弹性成像

（Real-TimeTissueElastography）

2、实时组织弹性成像

（Real-Ti[Elastography]

The

hardnessoforganizationis

closerelativetohistopathology

.

Grayscaleorcolorcodedimagingsoftsofthardexternalforcesofthard[Elastography]

ThehardnessElastographyElastography

1points：deformation,green；

2points：largelydeformation,Greenandbluemosaic；

3points：Boundarydeformation－green,centerpartundeformed,blue

4points：tumorundeformed－blue；

5points：tumorandperienchymaundeformed,

tumorandperienchyma－blue1points：deformation,greequantitativeanalysis－－qualitativeanalysis1pointsbenign2～3pointsBenignmaybe4pointsPayattentiontothedifferentialdiagnosis5pointsmalignancymaybequantitativeanalysis－－qualita

strainratio------quantitativeanalysissoftwarestrainratio(应变率)strainratio------quantitativStrainratio=B/A=FLR=tumor/fattytissue(referencevalue4.3）Strainratio=B/A=tumor/referencetissue

(referencevalue3.08）Strainratio=B/A=FLR=tumor/fa超声在妇科应用进展(英文)课件超声在妇科应用进展(英文)课件超声在妇科应用进展(英文)课件clinicalapplicationTheearlydiagnosisofcancer

・Benign,malignantjudgement

・Diffusionregion

・ToconfirmthetherapeuticeffecclinicalstagingofvenousthrombosisHepaticfibrosisThecorrespondingclinicalfield：Thyroid,breast,prostate,skin,liver,pancreas,uterus/ovary,lymphnode,vascular,rectum,testis……clinicalapplication3、Contrast-EnhancedUltrasoundTheshortageofconventionalultrasound

differentialdiagnosisofbenignandmalignantdiseasesLowspecificityLowsensitivityAdieasehasabroadspetrumofsonographicapperance，variousdieaseshavecommonsonographicapperance3、Contrast-EnhancedUltrasoundOvariancysticmassOvariancysticmassTheprincipleofconventionalultrasound

2D：acousticimpedanceacousticattenuation

CDFI：DopplershiftTheprincipleofconventionalIntravenousContrastUltrasoundDifferenceofmicrocirculationchangesincreasetheechogenicityofthebloodEnhancethedifferenceoftissueperfusionIntravenousContrastUltrasounWhatisulrasoundcontrastagent?Sizesufficientlysmall(lessthanredbloodcell)Strongsignals(morethanredbloodcell)PassthroughoutthebodyEliminateviatherespiratorysystemWhatisulrasoundcontrastageHowmicrobubbleswork?RapidlycontractingandexpandingtothepressurechangesofthesoundmakemicrobubblesseveralthousandtimesmorereflectivethannormalbodytissueThenon-linearoscillationofmicrobubblesgenerateharmonicTheacousticresultmicrobubblesburstHowmicrobubbleswork?Rapidly---定性：心脏、腹部、高频和腔内应用领域的实时造影技术

CnTI™-ContrastTunedImaging---定量：声学时间强度曲线分析

Wash-in/Wash-out™---创新：微血管灌注成像

CMI™-ContrastMicro-Imaging---定性：心脏、腹部、高频和腔内应用领域的实时造影技术Inertgas-filledmicrobubblescontrastagentSafetynon-toxicityUniformsize,lessthan10μmPassthroughthecapillariesGenerateharmonicGoodstabilityInertgas-filledmicrobubblesmicrobubblesBloodcirculationPassthroughthecapillariesthedifferenceoftissueperfusionReflectBloodsupplyoflesionsThedetectionrateofMicrovesselsincreasedTheechogenicofdifferenttissueweredifferentRealtimecontrastenhanceultrasoundmicrobubblesBloodcirculationPCEUSCEUS局灶性不典型增生FocalnodularhyperplasiaFNH局灶性不典型增生FocalnodularhyperplaTime-intensitycurves(OrdènetalRadiology2003;206:405-10)Time-intensitycurves(OrdènetPostoperative

CervicalcancerPostoperative

CervicalcancerBorderlineserouscystadenomaBorderlineserouscystadenomaMalignantmesotheliomaMalignantmesotheliomaDeepmyometrialinvasioninendomentrialcancerDeepmyometrialinvasioninenPelvicrecurrenceofendometrialcancerPelvicrecurrenceofendometri4、Three-dimensionalUltrasonography4、Three-dimensionalUltrasonoModernobstetricsandGynecologycategorygynaecologyobstetricsFemalepelvicmedicine；UrogynecologyfamilyplanningModernobstetricsandGynecoloThreedimensionalobstetrics

ultrasoundThreedimensionalgynaecologyultrasoundThreedimensionalobstetricsu3D,Anewfieldofvision3D,AnewfieldofvisionDynamicthree-dimensionalimaging，4DDynamicthree-dimensionalimagImagingmode：surfacemodetransparentmodecolordopplerflowimagingmodemultipleplanemodeNichemode超声在妇科应用进展(英文)课件surfacemodesurfacemodetransparentmodetransparentmodecolordopplerflowimagingmodecolordopplerflowmultipleplanemodemultipleplanemodeNichemodeNichemodeTwodimensionalultrasoundcannotget；Theimageiseasytounderstand；Makeacomprehensiveanalysisoftheinterestingzone。Closetotheactualanatomy,easyforcliniciansandnonmedicalstaffunderstanding,bettercommunicationbetweenultrasounddoctors，cliniciansandpatient超声在妇科应用进展(英文)课件indicationCongenitaluterineanomaliesIntrauterinedeviceintrauterinediseaseectopicpregnancyAdnexalmasses,follicledetection,ovarianvolumemeasurementindicationCongenitaluterineaAssessmentofovarianresponseThediagnosisofPCOSEvaluatetheuterinemorphologyandendometrialvolumePredicttheoutcomeofIVF-ETThreedimensionalultrasoundguidedpunctureAssessmentofovarianresponsetestingtimetestingtimeAFS(美国生殖协会)，1988yAFS(美国生殖协会)，1988y

classⅠ：Uterinehypoplasia/dysplasiaclassⅠ：UterinehypoplasiaclassⅡ：

unicornousuterus

(rudimentaryhornofuterus)classⅡ：

unicornousuterus(ru超声在妇科应用进展(英文)课件classⅢ：

didelphicuterusclassⅢ：

didelphicuterusdidelphicuterusdidelphicuterusclassⅣ：

bicornuateuterusclassⅣ：

bicornuateuterusIncompletebicornuateuterusIncompletebicornuateuteruscompletebicornuateuterus（doublecervix）

completebicornuateuterus（doucompletebicornuateuterus（doublecervix）completebicornuateuterus（dou

classⅤ

septateuterusclassⅤ

septateuterus超声在妇科应用进展(英文)课件Incompleteseptate

uterusSideintrauterinepregnancyIncompleteseptateuteruscompleteseptate

uteruscompleteseptateuterusclassⅥ

arcuateuterusclassⅥ

arcuateuterusclassⅦ：

diethystilbestrol（DES）exposureclassⅦ：

diethystilbestrol（DES

lengthdepthanglelength超声在妇科应用进展(英文)课件Incompleteseptate

uterus

Comparisonofpreoperativeandpostoperative

before

after

内膜Incompleteseptateuterus

Comp3D－PDA3D－PDAVOCALhistogramThreevascularindex：VI－VascularindexFI－flowindexVFI－VesselsflowindexVOCALhistogramThreevascular1633D：Applicationinassistedreproductivetechnology1、Toobservethesituationofendometr