初級婦產科超音波判讀

婦產科 陳郁菁 醫師

原理

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婦科超音波之應用

Normal uterus

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 Thickened endometrium

1. Reproductive age female, the thickness of EM >1.0cm during D4-9 of

MC cycle
2. Postmenopausal women
• Without HRT, EM>0.6cm
• With cyclic HRTÆ 1.; with continuous E+P therapy for 3 months
Æ 2.

Endometrial polyp

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Submucosal myoma

Subserosa myoma

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 Features of myoma

z Discrete, well-defined mass

with hypoechoic periphray
z They may be hypo-, iso-, or
hyperogenic
z Cystic areas of degeneration
are uncommon in fibroids
although they certainly do
occur

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 Adenomyosis

•Poor-defined area
•Mottled heterogeneous appearing myometrium
•A globular asymmetric uterus
•Small myometrial lucent areas,
•An indistinct endometrial stripe

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Adnexa mass

Hydrosalpinx

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 Pyosalpinx

Polycystic ovary

Pearl necklace sign

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 Ovarian follicle

Multiple follicles after ovulation

induction

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Endometrioma

z Homogeneous hypoechogenic
z ground-glass appearance

Dermoid cyst

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Papillary serous cystadenocarcinoma

Complex ovarian cyst

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 Findings suggestive of malignancy
(Complex cyst)

•Solid component within ovarian mass

•Thick septations >2-3 mm
•Color Doppler ultrasound shows blood flow within
mass (RI<0.4, PI<1.0)
•Thick cyst wall >2-3 mm
•Also seen in benign conditions
•Hemorrhagic ovarian cyst
•Endometrioma
•Cyst size does not distinguish benign from
malignant
•However size may risk stratify postmenopausal
cysts

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Ectopic pregnancy with internal bleeding

Cervical pregnancy

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IUD displacement

產科超音波之應用

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 Early pregnancy

Gestational sac

Crown-rump length

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Nuchal translucency

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 Brain

Fetal face

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Heart

Spine

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Abdomen

Limbs

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Placenta previa totalis

Umbilical cord

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 Doppler sonography of umbilical
circulation

Cervical incompetence

bladder

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 Retained placenta

3D Obstetric ultrasound

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The end!!

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