妇产科四疾病的超声诊断2011english.pptVIP

Sangreal--------uterus NORMAL ANATOMY Pelvic Cavity Posterior : Occupied by rectum, colon, and ileum Anterior: bladder, ureters, ovaries, fallopian tubes, uterus, and vagina Pre-inspection : Moderate bladder filling Uterus Hollow, pear-shaped organ Divided into fundus, body, and cervix Usually anteflexed and anteverted Covered with peritoneum except anteriorly below the os where peritoneum is reflected onto bladder Supported by levator ani muscles and pelvic fascia Round ligament keeps uterus in position Uterine size Prepubertal : 3 cm long by 0.5 to 1.0 cm wide Menarcheal: 8 cm long by 4 cm wide Postmenopausal: 3.5 to 5.5 cm long by 1 to 2 cm wide Normal size : 2~3(thick)×4~5(width)×7~8 cm(length) Uterine Position Midline anteversion: most common; degree of anteversion is bladder distention dependent Right or left: normal variant in absence of pelvic masses Retroverted: entire organ displaced posteriorly Retroflexed: body displaced with respect to cervix Ultrasonography of normal uterus Uterine serosa layer: Linear high-echo ;clear, smooth; Myometrium: Homogeneous middle-echo ; Endometria: The middle line of high echo , around the weak echo . It is well known that the endometrium changes dynamically in response to cyclic hormonal flux. Fallopian Tube（输卵管） Infundibulum: funnel-shaped lateral tube that projects beyond the broad ligament to overlie the ovaries Ampulla: sidest part of the tube where fertilization occurs Isthmus: hardest part; lies just lateral to the uterus Length: 12 cm; supplied by ovarion arteries and veins Ovary（卵 巢） Almond shaped Attached to back of the broad ligament by mesovarium; sometimes called suspensory ligament of the ovary Lies in ovarian fossa Fossa is bounded by external iliac vessels, ureter, and obturator nerve Receives blood from ovarian artery Blood drained by ovarian vein into inferior vena cava on right; on left by ovarian vein into lert renal vein Sonography of the normal ovary An ovoid homogeneous echodensity; follicular