Diagnostic value of color doppler ultrasonography for the endometriosis in the scar abdominal wall after caesarean section
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Abstract:
Objectives:To study the value of high-frequency ultrasonic and CDFI for the diagnosis of the endometriosis in the scar abdominal wall after caesarean section.Methods:26 patients who had been authenticated with the endometriosis in the scar abdominal wall by pathological examination were investigated via ultrasonography.Results:An intermediate frequency echo or low frequency echo conglomeration had been found in the scar abdominal wall,and the border was blurry,the shape was erose,the envelope was not found,and flecky liquid dark areas with low frequency echo photic points and zonary low frequency echo could be found in the conglomeration.CDFI: punctate and short club-shape or zonary blood stream signal could be found in the conglomeration.PW showed low speed and high resistance characteristic,Vs 5.0~20 cm/s,RI 0.65~8.2.Conclusion:Using high frequency ultrasonography combined with CDFI and PW,the exact diagnosis can be given to the endometriosis in the scar abdominal wall,thus good advise is provided for the clinical diagnosis.Keywords:
Color doppler
Abdominal ultrasonography
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Objective To discuss the two-dimensional and colored Doppler supersonic characteristics of abdominal wall scar endometriosis.Methods The supersonic images of 15 cases with abdominal wall scar endometriosis,which confirmed by surgery and pathology were analyzed retrospectively.Results The region of abdominal wall scar present as low level echo lump shade,with obscure boundary,irregular shape and uneven interior.The colored Doppler flow imaging demonstrated that the periphery blood stream signal was rich.Doppler frequency characterized as low speed high-resistance.PSV 6.5~19 cm/s,RI 0.71~0.85.Conclusions Colored Doppler ultrasound is helpful to the diagnosis and differential diagnosis of the abdominal wall scar endometriosis.
Color doppler
Doppler ultrasound
Doppler imaging
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Objective: To explore the application value of transvaginal color doppler ultrasound in the diagnosis of scarred uterus pregnancy.Method: From Jun.2010 to Jun.2012,admitted 73 cases early in the late scar pregnancy.The patients had abdominal color doppler ultrasound examination and vaginal doppler ultrasound at the same time.Result: After the abdominal color doppler ultrasound examination,49 cases of a clear diagnosis,diagnostic coincidence rate was 67.12%,and misdiagnosis rate was 12.33%;Check transvaginal doppler ultrasonography to confirm the diagnosis of 69 cases,the diagnostic rate was 94.52% and missed diagnosis rate was 1.37%.Vaginal doppler ultrasonography diagnosis rate was higher than that of abdominal ultrasonography(P 0.05),while the rate of misdiagnosis was significantly lower than abdominal ultrasonography(P0.05).The sonographic features,including 69 patients with clear diagnosis of the gestational sac in 21 cases,the mixed mass in 33 cases,15 cases of cellular type.Conclusion: The transvaginal ultrasound can have a close observation of the lesion and surrounding blood relations,provide a strong basis for clinical diagnosis and treatment,can be used as the preferred method of examination of scar pregnancy,it is worth widely used in clinical.
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Objective To explore the diagnosing value of high-frequency ultrasound and color Doppler flow imaging(CDFI) for the abdominal wall and perineal incision scar endometriosis.Methods 46 patients with surgery and pathology identified abdominal or perineal incision scar endometriosis whose sonographic features were analyzed retrospectively.Results 46 patients all have cesarean section or episiotomy history.The color Doppler performance:In the original side wall or perineal incision mass,mixed hyperechoic mass is visible,the border is not clear,shape is irregular.CDFI:flow signal is visible,in perineal area blood flow signals were more abundant than the lesion in the abdominal wall,PW:low speed and high resistent arterial flow spectrum is explored.Conclusion Combined with clinical data,color Doppler ultrasound in the early diagnosis of abdominal wall and perineal endometriosis is a valuable way.
Color doppler
Episiotomy
Abdominal ultrasound
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Objective To describe the features on two-dimensional and color Doppler ultrasonography of abdominal wall scar endometriosis.Methods Ultrasonographic appearances of endometriosis in abdominal wall scar confirmed by pathology in 7 patients were retrospective analyzed.Results Their ultrasonographic features were mass-like structure with ill-defined and irregular contour,heterogeneous and hypoechoic internal echoes in the abdominal wall scar. There were masses with peripheral hypervascularity on color Doppler flow imaging. Spectral Doppler revealed low speed (PSV 6.5-19 cm/s) and high resistance (RI 0.71-0.85).Conclusion Ultrasonography is helpful to the diagnosis and differential diagnosis of abdominal wall scar endometriosis.
Hypervascularity
Color doppler
Duplex ultrasonography
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Objective
To investigate the diagnostic value of ultrasonography examination for endometriosis in abdominal wall scar after cesarean section.
Methods
A total of 100 patients with endometriosis in abdominal wall after cesarean section were selected, and all patients underwent the ultrasonography examination. Then, the features and diagnostic value of ultrasonography examination were observed.
Results
The ultrasonography examination showed that 97 patients were diagnosed with endometriosis of abdominal wall scar, the accuracy of diagnosis was 97%, and there was no significant difference between ultrasonography examination results and pathological findings (P>0.05); the ultrasonography examination showed that the lesion had irregular shape, unclear edge and inhomogeneous echo in the interior. Color Doppler flow imaging (CDFI) showed that there was small amount of bar blood flow signal and blood flow defect in lesion.
Conclusions
The ultrasonography examination is a safe and reliable method for the diagnosis of endometriosis in abdominal wall after cesarean section, which can provide an effective basis for clinical diagnosis and treatment.
Key words:
Cesarean section; Abdominal wall scar; Endometriosis; Ultrasonography; Diagnostic value
Abdominal ultrasonography
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To describe the sonographic and clinical features of abdominal wall endometriosis (AWE), a frequently misdiagnosed condition.This was a retrospective study of 21 consecutive women with pathologically proven endometriosis of the abdominal wall. Ultrasonographic and Doppler examinations were performed, before surgery, with a high-frequency linear transducer. The clinical data and the results of the sonographic examinations were reviewed and described.At ultrasound, all the nodules appeared as discrete solid masses that were less echogenic than the surrounding hyperechoic fat. The nodules had a median diameter of 20 (range, 5-50) mm and in 18/21 (86%) cases the nodules had a round/oval shape. In eight of 21 (38%) women the AWE was located at the umbilicus, in six of 21 (29%) it was between the transverse suprapubic line and the umbilicus, in five of 21 (24%) it was found along the scar of a previous Cesarean section and in two of 21 (9%) it was in the right inguinal canal. The content was homogeneously hypoechoic in 12/21 (57%) women and inhomogeneous in the other nine (43%). The outer borders were invariably ill defined. Scarce blood vessels were found by power Doppler. Cyclic or continuous spontaneous pain at the level of the AWE was present in 19/21 (91%) cases, and two (9%) patients were asymptomatic.Hypoechoic round/oval nodules with ill-defined borders and a hyperechoic rim should raise the suspicion of abdominal wall endometriosis, even in patients with no history of endometriosis or previous laparotomic surgery. Pressing the ultrasound probe against the nodule should reinforce a suspected diagnosis because of the pain it induces.
Echogenicity
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Objective:Analysis two-dimensional ultrasonography and the performance of color Doppler ultrasound from 25 patients who were diagnosed abdominal wall endometriosis by operation and abdominal wall nodules puncture.Methods: 24 patients were found nodules or swellings in different layers of abdominal wall. Results:The deepest nodules can reach the intraperitoneal omentum. One of the nodules from the patient about 20 mm from the top of the cut,the size of the swelling between 9～51 mm, it is irregular, and burr-like edges or pseudopodium-like, there are not homogeneous echo inside, honeycomb-like structure appears in menstrual period, most of them has attenuation. According to the showing of color Doppler ultrasound, there are spotted or short strips biood-leaving signals beyond or inside the nodules in 19 cases, artery spectrum showed high resistance to low speed. There is ovarian endometrioma in five cases. Conclusion:Color Doppler ultrasound can find out if the symptom of abdominal wall endometriosis has had the characteristic changes, it has very important clinical value to diagnose this disease by combining the history and clinical manifestations, it can also help cure the clinical lesions.
Color doppler
Nodule (geology)
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Objective To assess the value of high-frequency ultrasonography in identifying endometriosis of abdominal wall.Methods Thirteen patients with abdominal wall endometriosis confirmed by surgery and pathology were enrolled in this study,their preoperative sonographic appearance was analyzed retrospectively.Results All the ultrasonograms showed an inhomogenous low-echo level mass without envelope,with a clear border and irregular form.Some of them appeared as crab feet infiltrating surrounding soft tissue and muscle,the echo was mainly low-echo level,in which,small and irregular echo-free zones and slightly high-echo light spots could be seen.Conclusion It is feasible to identify abdominal wall endometriosis based on its high-frequency sonographic manifestations.
Echo (communications protocol)
Abdominal ultrasonography
High frequency ultrasound
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Objective To describe the sonographic and color Doppler features of abdominal wall endo-metriomas near cesarean delivery scars.Methods Ultrasonographic appearances of abdominal wall endometriomas of 8 patients confirmed by pathology and operation were analyzed retrospectively. Results Sonography disclosed that all nodules were located at subcutaneous tissue.The nodules size was 1.6-3.7cm. The sonographic features were irregular shape and irregular margins, often speculated, infiltrating the muscularis fascia; a hypoechoic in homogeneous echo texture with internal anechoic lacunae.Color Doppler examination showed that the color signal pattern was dot-like and/or linear with low-velocity and high-resistance arterial flow in all the patients.Conclusion Color Doppler ultrasound,when properly combined with clinical data,may be a valuable method for diagnosing abdominal wall endometriomas.
Color doppler
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Abdominal ultrasonography
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