From the Department of Radiology and Imaging Sciences, University of Utah, 30 North 1900 East, #1A71, Salt Lake City, UT 84132 (A.M.S., M.R., J.D.O., A.M.K.); Department of Radiology, University of Missouri Health Care, Columbia, Mo (A.H.G.); Department of Diagnostic Radiology, Oregon Health & Science University, Portland, Ore (B.R.F.); Department of Radiology, Mayo Clinic, Scottsdale, Ariz (C.O.M.); and Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, Houston, Tex (K.M.E.).
Radiographics. 2017 Nov-Dec;37(7):2045-2062. doi: 10.1148/rg.2017170083.
Ultrasonography (US) is frequently the first imaging modality used to examine women with symptoms involving the pelvis. It is widely available and involves no exposure to ionizing radiation. Images can be acquired with a transabdominal, endovaginal, or translabial approach, and the use of video clips and three-dimensional reconstructions can be helpful. US is excellent for assessment of the uterus, ovaries, and adnexa. Occasionally, nongynecologic pelvic diseases arising from the gastrointestinal, genitourinary, and musculoskeletal systems and the pelvic peritoneal and extraperitoneal spaces may be detected and can be a source of diagnostic dilemma. US can be helpful not only in the detection but also occasionally in the characterization of such entities. Computed tomography and magnetic resonance imaging are useful in complicated cases. In this article, the normal US appearance of the bowel and US signs of bowel disease and specific entities, including appendicitis, diverticular disease, bowel obstruction, appendiceal mucocele, and intestinal tumors, are reviewed. The lower urinary tract is included in the field of view in every pelvic US examination; commonly encountered entities related to the urinary bladder, distal ureter, and urethra are illustrated. In addition to arising in the gastrointestinal and genitourinary tracts, pathologic conditions in the pelvis can arise in the peritoneal or extraperitoneal space. Although conditions of the pelvic peritoneal and extraperitoneal spaces are rare, it is important to recognize these entities and distinguish them from the more common gynecologic diseases. Owing to the implications for diagnosis and management, radiologists and other physicians who perform pelvic US should be aware of the spectrum of nongynecologic pathologic entities that can be detected. RSNA, 2017.
超声检查(US)常用于检查盆腔症状的女性患者,是最常使用的影像学方法之一。它广泛可用,不会接触到电离辐射。可通过经腹部、经阴道或经会阴途径获取图像,使用视频片段和三维重建有助于检查。US 非常适合评估子宫、卵巢和附件。偶尔,源自胃肠道、泌尿生殖系统和肌肉骨骼系统以及盆腔腹膜和腹膜外间隙的非妇科盆腔疾病可能被检测到,并可能成为诊断难题的来源。US 不仅有助于检测,而且偶尔有助于此类疾病的特征描述。计算机断层扫描和磁共振成像在复杂病例中很有用。本文回顾了肠道的正常 US 表现和肠道疾病的 US 征象以及特定疾病,包括阑尾炎、憩室病、肠梗阻、阑尾黏液囊肿和肠道肿瘤。在每次盆腔 US 检查中,下尿路都在视野范围内;图示了与膀胱、远端输尿管和尿道相关的常见疾病。除了胃肠道和泌尿生殖系统的疾病外,盆腔腹膜或腹膜外间隙也可能发生病理情况。尽管盆腔腹膜和腹膜外间隙的疾病很少见,但重要的是要识别这些疾病,并将其与更常见的妇科疾病区分开来。由于对诊断和治疗的影响,进行盆腔 US 的放射科医生和其他医生应了解可检测到的非妇科病理实体的范围。RSNA,2017 年。