婦科超音波

婦科超音波
Gynecologic ultrasonography
婦科超音波; Gynecologic ultrasonography
	婦科超音波中檢查到的輸卵管積水（英语：hydrosalpinx）
別稱	Gynecologic sonography
ICD-9-CM	88.76, 88.79
OPS-301（英语：OPS-301）	3-05d

婦科超音波（Gynecologic ultrasonography）是指對於女性骨盆腔器官所進行的医学超声检查，主要是針對子宫、卵巢、输卵管，也會針對膀胱、子宫附件及直腸子宮陷凹（英语：recto-uterine pouch）。這個檢查可能會發現骨盆腔中的情形，後續也會有其他的檢查。

事实速览 婦科超音波 Gynecologic ultrasonography, 別稱 ...

关闭

此檢查可以透過經腹部超音波進行，檢查前會讓受檢者喝水，讓膀胱充飽尿液，作為聲學窗（acoustic window），在檢查骨盆器官時，有更好的成像效果，也可以用經陰道超音波（英语：Transvaginal ultrasonography）進行，會使用特製的陰道換能器。經陰道超音波影像會利用高頻的影像，對卵巢、子宫及子宮內膜的解析度較好（一般情形看不到輸卵管，只有在特別擴張的情形才看得到），不過影像穿透能力有限，較大，較靠近腹部的部份比較適合用經腹部超音波來檢查。在進行腹部超音波時，充飽尿液的膀胱的檢查也有幫助，因為超音波在其中比較不會衰減，比較可以檢查到在膀胱後面的卵巢、子宫。婦科超音波若是用經陰道超音波的方式進行，依定義來看是侵入性醫療。檢查會由超音波檢查師（英语：sonographer）進行，或是受過超音波訓練的婦科醫師進行。

以下是會使用婦科超音波的一些情形：

評估骨盆器官
診斷闌尾炎^[1]
診斷及處理婦科疾病，例如子宮內膜異位症、平滑肌瘤（英语：leiomyoma）、子宫腺肌病、卵巢囊腫和病變
識別子宮附件的硬塊，包括異位妊娠,
診斷婦科癌症
在不孕症治療上，追蹤卵泡對生育藥物（英语：fertility medication）（例如普格鈉（英语：Pergonal））的反應。不過常常會低估卵巢的大小^[2]。

透過經陰道超音波，可以取得卵巢囊腫，此技術也可用在經陰道卵母細胞取得（英语：transvaginal oocyte retrieval）中，透過經陰道超音波直接的穿刺卵泡，以取得卵母细胞，在後續的體外人工受精中使用。

若使用婦科超音波，針對沒有卵巢癌風險的女性進行卵巢癌篩檢，有可能是醫療過度使用^[3]。目前的醫學共識認為，若卵巢癌的風險沒有特別高，不應用婦科超音波進行卵巢癌的篩檢^[3]。

宮腔聲學造影（Sonohysterography）是將液體（多半是生理食鹽水）注入子宮腔中，同時進行的婦科超音波，因此也稱為鹽水注人超音波影像（saline infusion sonography），或簡稱SIS。2015年回顧研究的結論是，宮腔聲學造影在檢查女性不孕症的子宮內異常時，其靈敏度比子宮鏡檢查要高。在診斷子宫内膜息肉、膜下子宮肌瘤、子宫畸形、子宮內粘連（英语：intrauterine adhesions）（Asherman綜合症（英语：Asherman's syndrome）的一部份）時，宮腔聲學造影有高度的靈敏度和特異度，可以在進行體外人工受精前，篩檢較不容易生育的女性^[4]

產科超音波（英语：Obstetric ultrasonography）
陰道超音波（英语：Vaginal ultrasonography）

[1]
Caspi, B.; Zbar, AP.; Mavor, E.; Hagay, Z.; Appelman, Z. The contribution of transvaginal ultrasound in the diagnosis of acute appendicitis: an observational study.. Ultrasound Obstet Gynecol. Mar 2003, 21 (3): 273–6. PMID 12666223. doi:10.1002/uog.72.
[2]
Rosendahl M, Ernst E, Rasmussen PE, Yding Andersen C. True ovarian volume is underestimated by two-dimensional transvaginal ultrasound measurement. Fertil. Steril. December 2008, 93 (3): 995–998. PMID 19108822. doi:10.1016/j.fertnstert.2008.10.055.
[3]
American Congress of Obstetricians and Gynecologists, Five Things Physicians and Patients Should Question, Choosing Wisely: an initiative of the ABIM Foundation (American Congress of Obstetricians and Gynecologists), [August 1, 2013], （原始内容存档于2013-09-01）, which cites
- U.S. Preventive Services Task Force. Screening for Ovarian Cancer: Recommendation Statement. The Annals of Family Medicine. 2004, 2 (3): 260–262. PMC 1466669 . PMID 15209204. doi:10.1370/afm.200.
- Lin, Kenneth; Barton, Mary B., Screening for Ovarian Cancer - Evidence Update for the U.S. Preventive Services Task Force Reaffirmation Recommendation Statement, AHRQ Publication No. 12-05165-EF-3 (United States Preventive Services Task Force), April 2012 [30 August 2013], （原始内容存档于2014-11-01）
- Partridge, E.; Greenlee, A. R.; Xu, R. T.; Kreimer, C.; Williams, J. L.; Riley, T. R.; Reding, B.; Church, C. C.; Kessel, J. L.; Johnson, C.; Hill, G. L.; Fouad, S.; Buys, L. R.; Isaacs, S. S.; Andriole, T.; Ogden, S.; Chia, D.; Ragard, L. R.; Prorok, P. C.; Gohagan, J. K.; Berg, C. D. Results from four rounds of ovarian cancer screening in a randomized trial. Obstetrics and Gynecology. 2009, 113 (4): 775–782. PMC 2728067 . PMID 19305319. doi:10.1097/AOG.0b013e31819cda77.
- American College of Obstetricians; Gynecologists Committee on Gynecologic Practice. Committee Opinion No. 477: The Role of the Obstetrician–Gynecologist in the Early Detection of Epithelial Ovarian Cancer. Obstetrics & Gynecology. 2011, 117 (3): 742–746. PMID 21343791. doi:10.1097/AOG.0b013e31821477db.
[4]
Seshadri, S.; El-Toukhy, T.; Douiri, A.; Jayaprakasan, K.; Khalaf, Y. Diagnostic accuracy of saline infusion sonography in the evaluation of uterine cavity abnormalities prior to assisted reproductive techniques: a systematic review and meta-analyses. Human Reproduction Update. 2014, 21 (2): 262–274. ISSN 1355-4786. PMID 25505226. doi:10.1093/humupd/dmu057 .

Information about Sonography （页面存档备份，存于互联网档案馆）

[1] [1]
Caspi, B.; Zbar, AP.; Mavor, E.; Hagay, Z.; Appelman, Z. The contribution of transvaginal ultrasound in the diagnosis of acute appendicitis: an observational study.. Ultrasound Obstet Gynecol. Mar 2003, 21 (3): 273–6. PMID 12666223. doi:10.1002/uog.72.

[2] [2]
Rosendahl M, Ernst E, Rasmussen PE, Yding Andersen C. True ovarian volume is underestimated by two-dimensional transvaginal ultrasound measurement. Fertil. Steril. December 2008, 93 (3): 995–998. PMID 19108822. doi:10.1016/j.fertnstert.2008.10.055.

[ACOGfive-3] [3]
American Congress of Obstetricians and Gynecologists, Five Things Physicians and Patients Should Question, Choosing Wisely: an initiative of the ABIM Foundation (American Congress of Obstetricians and Gynecologists), [August 1, 2013], （原始内容存档于2013-09-01）, which cites
U.S. Preventive Services Task Force. Screening for Ovarian Cancer: Recommendation Statement. The Annals of Family Medicine. 2004, 2 (3): 260–262. PMC 1466669 . PMID 15209204. doi:10.1370/afm.200.

Lin, Kenneth; Barton, Mary B., Screening for Ovarian Cancer - Evidence Update for the U.S. Preventive Services Task Force Reaffirmation Recommendation Statement, AHRQ Publication No. 12-05165-EF-3 (United States Preventive Services Task Force), April 2012 [30 August 2013], （原始内容存档于2014-11-01）

Partridge, E.; Greenlee, A. R.; Xu, R. T.; Kreimer, C.; Williams, J. L.; Riley, T. R.; Reding, B.; Church, C. C.; Kessel, J. L.; Johnson, C.; Hill, G. L.; Fouad, S.; Buys, L. R.; Isaacs, S. S.; Andriole, T.; Ogden, S.; Chia, D.; Ragard, L. R.; Prorok, P. C.; Gohagan, J. K.; Berg, C. D. Results from four rounds of ovarian cancer screening in a randomized trial. Obstetrics and Gynecology. 2009, 113 (4): 775–782. PMC 2728067 . PMID 19305319. doi:10.1097/AOG.0b013e31819cda77.

American College of Obstetricians; Gynecologists Committee on Gynecologic Practice. Committee Opinion No. 477: The Role of the Obstetrician–Gynecologist in the Early Detection of Epithelial Ovarian Cancer. Obstetrics & Gynecology. 2011, 117 (3): 742–746. PMID 21343791. doi:10.1097/AOG.0b013e31821477db.

[4] U.S. Preventive Services Task Force. Screening for Ovarian Cancer: Recommendation Statement. The Annals of Family Medicine. 2004, 2 (3): 260–262. PMC 1466669 . PMID 15209204. doi:10.1370/afm.200.

[5] Lin, Kenneth; Barton, Mary B., Screening for Ovarian Cancer - Evidence Update for the U.S. Preventive Services Task Force Reaffirmation Recommendation Statement, AHRQ Publication No. 12-05165-EF-3 (United States Preventive Services Task Force), April 2012 [30 August 2013], （原始内容存档于2014-11-01）

[6] Partridge, E.; Greenlee, A. R.; Xu, R. T.; Kreimer, C.; Williams, J. L.; Riley, T. R.; Reding, B.; Church, C. C.; Kessel, J. L.; Johnson, C.; Hill, G. L.; Fouad, S.; Buys, L. R.; Isaacs, S. S.; Andriole, T.; Ogden, S.; Chia, D.; Ragard, L. R.; Prorok, P. C.; Gohagan, J. K.; Berg, C. D. Results from four rounds of ovarian cancer screening in a randomized trial. Obstetrics and Gynecology. 2009, 113 (4): 775–782. PMC 2728067 . PMID 19305319. doi:10.1097/AOG.0b013e31819cda77.

[7] American College of Obstetricians; Gynecologists Committee on Gynecologic Practice. Committee Opinion No. 477: The Role of the Obstetrician–Gynecologist in the Early Detection of Epithelial Ovarian Cancer. Obstetrics & Gynecology. 2011, 117 (3): 742–746. PMID 21343791. doi:10.1097/AOG.0b013e31821477db.

[SeshadriEl-Toukhy2014-4] [4]
Seshadri, S.; El-Toukhy, T.; Douiri, A.; Jayaprakasan, K.; Khalaf, Y. Diagnostic accuracy of saline infusion sonography in the evaluation of uterine cavity abnormalities prior to assisted reproductive techniques: a systematic review and meta-analyses. Human Reproduction Update. 2014, 21 (2): 262–274. ISSN 1355-4786. PMID 25505226. doi:10.1093/humupd/dmu057 .

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