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第三节 检查方法
(一)扫查方法
探头在颌面部及颈部依次作横、纵、斜切面连续扫查,或沿脏器的体表投影行长、短轴扫查,并与对侧作对比扫查。
1.甲状腺扫查
患者仰卧平躺,肩部垫枕,头后仰。探头置于颈前甲状腺水平。横切扫查甲状腺,上下移动探头并调整声束角度获得最大甲状腺横切图(图3-3-1A),然后获得甲状腺横切彩色多普勒血流图(图3-3-1B);自颏下-舌骨水平-甲状腺-胸骨上窝动态扫查,获得甲状腺横切动态图,除外异位甲状腺;旋转探头90°并移向颈前右侧,获得右侧叶纵切图(图3-3-1C)和右侧叶纵切彩色多普勒血流图(图3-3-1D);自外向内摆动获得右侧叶纵切动态图。相同方法完成甲状腺左叶扫查。
![](https://epubservercos.yuewen.com/F07E37/15859872205032906/epubprivate/OEBPS/Images/P39_0360_1133.jpg?sign=1739532444-Ty0ITCGKoWRTFuDRXkpDwr9Jw1vY57HX-0-cb1998df30dd58777a84c5c2fca132e6)
![](https://epubservercos.yuewen.com/F07E37/15859872205032906/epubprivate/OEBPS/Images/P39_0362_1137.jpg?sign=1739532444-SypZWgR3tnVs66GYfx71ATYWXXWOrvKV-0-430ee9b048a4532ecf8af9d16e16799a)
![](https://epubservercos.yuewen.com/F07E37/15859872205032906/epubprivate/OEBPS/Images/P39_0364_1140.jpg?sign=1739532444-OQ7oTxXypO58bUeM84AeoKABvMdiNlgS-0-44639d63ddb45a91c9f10b467fe7af79)
![](https://epubservercos.yuewen.com/F07E37/15859872205032906/epubprivate/OEBPS/Images/P3-3-1_1144.jpg?sign=1739532444-V1c2IGLv9CYmsBu5HXh3ccQCjRs2Ee6q-0-6657c1f07c48126a13dd38e6a82a36d5)
图3-3-1 正常甲状腺声像图
A.甲状腺横切图;B.甲状腺横切彩色血流图;C.甲状腺右侧叶纵切图;D.右侧叶纵切彩色血流图
2.颌下腺扫查
患者仰卧平躺,肩部垫枕,头转向一侧,探头置于一侧颌下,摆动探头调整声束角度获得最大颌下腺斜切图(图3-3-2A);获得颌下腺斜切彩色多普勒血流图(图3-3-2B);上下摆动探头,获得颌下斜切动态图。旋转探头90°获得颌下腺纵切图(图3-3-2C)及彩色多普勒血流图(图3-3-2D);左右摆动探头,获得颌下腺纵切动态图。对侧以相同的方法扫查。
![](https://epubservercos.yuewen.com/F07E37/15859872205032906/epubprivate/OEBPS/Images/P40_0373_1158.jpg?sign=1739532444-vOEaD69K0s0JWblLxgOAxHCsFtzJKdjI-0-ee72d9c5479ed9fb707a2091442c46c6)
![](https://epubservercos.yuewen.com/F07E37/15859872205032906/epubprivate/OEBPS/Images/P40_0375_1162.jpg?sign=1739532444-1UdoBdWMnTelh9iBbzEFfI5hTiTnRO77-0-3f9d3dbc85c6752ef73a60980f9ca459)
![](https://epubservercos.yuewen.com/F07E37/15859872205032906/epubprivate/OEBPS/Images/P40_0377_1165.jpg?sign=1739532444-tQoESXvPvPErgoDfPLDpgpIZI2RBuO5o-0-63a7314dec033a33b25292b25032ccd5)
![](https://epubservercos.yuewen.com/F07E37/15859872205032906/epubprivate/OEBPS/Images/P3-3-2_1169.jpg?sign=1739532444-zPGUPnoaRAbJ3AvjxTJ0oWIHbrucGgz2-0-673939721f3b19f4ca749d4eee3d2be3)
图3-3-2 正常颌下腺声像图
A.颌下腺斜切图;B.颌下腺斜切彩色血流图;C.颌下腺纵切图;D.颌下腺纵切彩色血流图
3.腮腺扫查
患者仰卧平躺,肩部垫枕,头转向一侧,冠状扫查,获得腮腺纵切图(图3-3-3A)及腮腺纵切彩色多普勒血流图(图3-3-3B);旋转探头90°,获得腮腺横切图(图3-3-3C)及其彩色多普勒血流图(图3-3-3D);上下移动探头获得腮腺动态图。对侧以相同的方法扫查。
![](https://epubservercos.yuewen.com/F07E37/15859872205032906/epubprivate/OEBPS/Images/P40_0381_1174.jpg?sign=1739532444-Z50pXhun0SAxvfkSofmSWtB2Ey8vtHBZ-0-6ad25b1c01237d343a113ae2a59f89b6)
![](https://epubservercos.yuewen.com/F07E37/15859872205032906/epubprivate/OEBPS/Images/P40_0383_1178.jpg?sign=1739532444-nJbtlzHZwVc7oq5Ghrzx5qRlc9Ulo8lt-0-0608e4ef7c94b0bac9862b5525b74da1)
![](https://epubservercos.yuewen.com/F07E37/15859872205032906/epubprivate/OEBPS/Images/P41_0394_1188.jpg?sign=1739532444-w4cMTOMv5U1qtNlZHNPesMh3Eyn4cyS7-0-18a02ebaa34d9cde12f6ea91d27c7c3b)
![](https://epubservercos.yuewen.com/F07E37/15859872205032906/epubprivate/OEBPS/Images/P3-3-3_1192.jpg?sign=1739532444-pce8vHT83EyJ9V31uET5V6DoHmF6cIYr-0-7af6d753649d6afbdd7a645bb9f024a6)
图3-3-3 正常腮腺声像图
A.腮腺纵切图;B.腮腺纵切彩色血流图;C.腮腺横切图;D.腮腺横切彩色血流图
(二)注意事项
1.仪器选择适当的检查条件,如浅表、甲状腺等;彩色多普勒Scale 10~15cm/s。
2.注意双侧对比检查,对比双侧腺体的大小、回声及血流情况。
3.颈部包块注意观察描述与周围腺体的比邻关系,有无沟通。