Objective To analyze the fetal cardiac size by the two-dimensional speckle tracking technique(fetal-HQ package)and to explore the quantification of cardiac size remodeling in the small for gestational age(SGA)fetu-ses.Methods Prospective collection of singleton pregnancies at 28 to 39+6 weeks of gestation.The length,width and area of the four-chamber view and two ventricles were measured and calculated using fetalHQ in 453 low-risk and 210 SGA fetuses.Results After normalization for estimated fetal weight,the four-chamber view and right ventricular(RV)width and area were greater in SGA fetuses with normal umbilical arteries(UA)than in low-risk fetuses,P＜0.05.The top three ratios of cardiac size parameters＞95th％in SGA fetuses with normal UA were at least one seg-ment of RV width(35.0％),the mid segment of RV width(22.9％),and four-chamber view width(19.7％),which were greater than those of low-risk fetuses(all P＜0.05).Conclusions 1/3 of SGA fetuses present with an abnormal enlargement of the RV width(predominantly in the mid)earlier than the UA.

目的:探讨不同程度胎儿腹腔囊性占位的妊娠结局和预后.方法:研究对象为复旦大学附属妇产科医院2015年1月-2017年12月共135例因产前超声诊断为胎儿腹部囊性占位行多科会诊的病例.结果:共发现胎儿腹部囊性占位135例,其中失访及产后未明确诊断17例.其余118例均经引产后、生后手术或影像学的随访结果证实.胎儿腹部囊性包块根据解剖位置主要分为肝胆来源16例(14％);消化道来源24例(20％);肾脏肾上腺来源27例(23％);泌尿系梗阻38例(32％);生殖系统来源13例(11％).出现7例误诊,总符合率93.8％.结论:产前超声可发现胎儿腹部囊性占位,对预测与评估胎儿发育、妊娠结局及生后治疗有重要作用,可为临床处理及治疗提供参考.

目的 探讨子宫内膜间质肉瘤(endometrial stromal sarcoma,ESS)的临床和病理特点及对超声结果进行分析,以提高对ESS的超声检出率.方法 回顾性分析复旦大学附属妇产科医院2010年1月至2016年12月78例经手术病理检查证实为ESS患者的临床和病理特点及超声结果分析.结果 78例患者平均年龄为(44.3±10.9)岁.主要临床表现:46例(59.0％)因体检发现异常占位就诊,28例(35.9％)因异常阴道流血就诊,4例(5.1％)因腹痛就诊.术前超声正确诊断4例(5.1％),误诊为子宫肌瘤伴变性24例(30.8％),子宫肌瘤22例(28.2％),子宫腺肌症10例(12.8％),宫腔息肉5例(6.4％),肌瘤影响宫腔5例(6.4％),卵巢肿瘤4例(5.1％),肌瘤伴腺肌症3例(3.8％),子宫内膜癌1例(1.4％).ESS的超声表现:病灶多为单发,位置各异,可位于肌壁间或宫腔,较大时宫腔及肌壁间均可累及,也可位于盆腔.病灶回声多呈中低回声或内部回声不均质,CDFI示病灶大多为条索状血流信号(44例)、星点状血流信号(21例),彩色血流不明显(13例).术后病理检查均证实为ESS,72例(92％)低级别子宫内膜间质肉瘤(low-grade endometrial stromal sarcoma,LGESS),其中6例LGESS伴性索样分化、7例LGESS伴平滑肌分化,4例为高级别子宫内膜间质肉瘤(high-grade endometrial stromal sarcoma,HGESS),2例为未分化子宫肉瘤(undifferentiated uterine sarcoma,UUS),其中1例USS伴性索样分化.结论 ESS临床及超声表现无特异性,需要病理诊断确诊.当超声发现肌壁内病灶边界不清,内部回声不均质,弥漫性子宫肌层增厚,内部回声伴有结节性,从宫腔延伸至子宫肌层的息肉样结构等情况时,检查者应充分考虑ESS的可能性,并在术前予以提示,帮助临床在术前做好充分的准备,降低二次手术的发生率.

目的:探讨经阴道彩色多普勒超声对子宫内膜息肉的诊断价值及误诊分析.方法:回顾性分析281例经阴道彩色多普勒超声诊断为子宫内膜息肉患者的宫腔内二维灰阶及彩色多普勒超声声像图表现,并与宫腔镜检查及病理结果对照,探讨子宫内膜息肉的超声声像图特征及误诊分析.结果:281例经阴道彩色多普勒超卢诊断为子宫内膜息肉并经宫腔镜及病理确诊的患者中,符合223例,占79.4％;误诊58例,误诊率为20.6％.其中内膜增生34例、宫腔粘连12例、子宫黏膜下肌瘤9例、子宫内膜癌2例、子宫腺纤维瘤1例.结论:经阴道彩色多普勒超声作为无创性、可重复性检查,对子宫内膜息肉诊断具有较高的临床价值,但需与内膜增生、宫腔粘连、黏膜下肌瘤及子宫内膜癌鉴别.

Objective To explore the value of real-time ultrasonic elastosonography in the qualitative diagnosis of hysteromyoma.Methods One hundred and seventeen hysteromyomas in 113 cases were scanned with regular ultrasonic examination and elastosonography,from which the strain ratios were derived,and the results of elastosonography were compared with post-operative pathological results.Results Hysteromyomas had peculiar ultrasonic images with elastosonography.The mean strain ratio of 98 regular hysteromyomas was 1.71±0.29,which was significantly different from 0.95±0.36,the value of 19 abnormal hysteromyomas(P0.05).The resistance index(RI) and the strain ratio of hysteromyomas had positive correlation(r=0.485,P0.05),so did that of abnormal hysteromyomas(r=0.494,P0.05).Conclusions Ultrasonic elastosonography can offer the information of stiffness and blood flow of hysteromyomas,and is helpful in the diagnosis of hysteromyomas.