ABSTRACT
Objective To explore the prenatal ultrasonic types ,sonographic features of malformation , ultrasonic diagnosis and prognosis of fetuses with adrenal area space‐occupying lesions . Methods Forty‐four fetuses with adrenal area space‐occupying lesions were retrospectively analyzed . Compared with postpartum neonatal special inspection results or the anatomical and pathological examination results of the corpses after induced labor ,the ultrasound types ,sonographic feature ,the key points of differential diagnosis were summarized . The newborns were followed up to 6 months after birth ,tracking the prognosis . Results Totally 44 fetuses among 166 471 fetuses(166 471 pregnant women) were detected with adrenal area space‐occupying lesions , 41 cases after delivery , including 24 cases adrenal hematoma ( 2 cases prenataly misdiagnosed as neuroblastoma) ,14 cases adrenal cyst and 3 cases neuroblastoma ,were accurately diagnosed through color Doppler or MRI or CT or pathological examination results . Three cases after induced labor , including 1 case adrenal neuroblastoma ,1 case mullerian duct cyst and 1 case adrenal hematoma( prenataly misdiagnosed as neuroblastoma ) were confirmed through the anatomical and pathological examination results of the corpses . So the conformity rate of adrenal area space‐occupying lesions was 90 .9% (40/44) . The postnatal ultrasound showed that the tumor disappeared in twenty‐four cases of adrenal hematoma without surgery ,and the longest time of the tumor disappearance was 1 year . The size of 14 cases adrenal cyst had no obvious change . One case of adrenal neuroblastoma was operated at 2 months ,2 cases were operated at 2 years of age . Conclusions Ultrasound can be used as qualitative diagnosis and differential diagnosis for fetal adrenal area space‐occupying lesions . The majority of the children with adrenal area space‐occupying lesions have a good prognosis .
ABSTRACT
ObjectiveTo summarize the ultrasonic features of endometrial carcinoma in transvaginal color Doppler sonography (TVCDS), and to analyze the supplementary function of serum CA125and CA199in diagnosing endometrial carcinoma.MethodsFrom January 2006 to October 2012, fourteen thousand and twenty-seven women underwent TVCDS in GZ Women & Children Medical Centre, serum CA125 and CA199 were determined by chemiluminescence immunoassay. The ultrasound characteristics of 131 cases of endometrial carcinoma (including 64 cases of early-stage and 67 cases of advanced endometrial carcinoma) who were accurately diagnosed by pathology and the value of serum CA125 and CA199 were analyzed.ResultsIn groups 131 patients were accurately conifrmed by pathology, including 64 cases early-stage and 67 cases advanced carcinoma. The diagnositic coincidence of ultrasound and ultrasound combined with serum tumor markers was 56.3% (36/64) and 78.1% (50/64) respectively. On ultrasonography, 64 patients with early stage endometrial carcinoma showed uterine enlargement in 38 cases and endometrial thickening in 53 cases. In 9 cases, endometrial lesions were heterogeneously hypoechoic. In 55 cases, the halo between endometrium and muscle was interrupted and disappeared. In 56 cases, endometrial lesions had muscular layer inifltration. In 13 cases, endometrial lesions had cervical inifltration. In 61 cases, sparse punctuate or reticular flow signals were detected within lesions. In 3 cases, there was no blood flow signal in lesions. All these patients had not lymph node metastasis. Sixty-seven cases with advanced endometrial carcinoma showed more obviously uterine enlargement and significant endometrial thickening. In 61 patients, tumor spread outside the uterus. Reticular or dendritic flow signals were detected in 67 cases lesions. There were hypoechoic lymph node mestastasis in 53 cases. In 31 cases of early stage endometrial carcinoma, preoperative CA125 increased. In 27 cases of early stage endometrial carcinoma, preoperative CA199 increased. In 24 cases CA125 and CA199 increased meanwhile. In 61 cases of advanced endometrial carcinoma, preoperative CA125 increased. In 59 cases of advanced endometrial carcinoma, preoperative CA199 increased. In 56 cases CA125 and CA199 increased meanwhile. Sixty-four cases of early-stage endometrial carcinoma were diagnosed by TVCDS assisted with CA125 and CA199 and were confirmed by pathology. The detective rate was 78.1% (50/64). To compared with TVCDS, the difference was statistical signiifcance (χ2=6.95,P=0.01).ConclusionsThe ultrasonic features of early-stage endometrial carcinoma in TVCDS were uterine enlargement, endometrial thickening, heterogeneous hypoechoic endometrial lesions, interrupted or disappeared hypoechoic halo between endometrium and musclar layer, and sparse punctuate or reticular flow signals within lesions. Serum CA125 and CA199 may be helpful in improving diagnosis coincidence rate when early-stage endometrial cancer is ifnd or suspected on ultrasonography.
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Objective To investigate the application value of color Doppler ultrasonography in the diagnosis and treatment of uterine scar pregnancy. Methods The sonographic characteristics of 34 patients of uterine scar pregnancy were analyzed. The changes of blood flow and the resistance index (RI) were compared before and after conservative treatment. Meanwhile, the therapeutic effect was evaluated referencing to the changes of β-hCG in blood. Results Uterine scar pregnancies were classfied into three subtypes according to ultrasonic characteristics: Type Ⅰ: embryo sac (n=16 cases);Type Ⅱ: asymmetrical mass (n=14);Type Ⅲ: mixed type (embryo sac+asymmetrical mass, n=4). Peri-myometrium of the gastrula and the mass had abundant blood flow and lower RI before treatment, while rare blood flow and middle RI were found 4 weeks after treatment. There was statistical significance in the change of RI between before and four weeks, after treatment. Conclusion Uterine scar pregnancy has characteristic ultrasonogram. Color Doppler ultrasound may precise diagnose and localize uterine scar pregnancy, playing an important role in guiding the conservative treatment schedule, evaluating the therapeutic effect and following-up of these patients.