부인과초음파-2판

초음파는 이제 어느덧 산부인과의 전문 진단 영역으로 독보적인 자리를 잡았습니다. 산부인과 초음파 검사 중 산모 및 태아에 대
한 산과 초음파뿐 아니라 부인과 환자를 대상으로 하는 부인과 초음파 또한 산부인과 의사에게 이제는 청진기와 마찬가지로 진료
에 없어서는 안 될 검사가 되었습니다. 더욱이 나날이 발전하는 초음파 영상 기술의 발달은 이제 폭넓은 수준에서 다양한 부인
과 영역의 진단을 가능하게 해주고 있으며, 이에 산부인과 의사들의 부인과 초음파 검사 술기 및 판독에 대한 배움의 열의 또한
높아지고 있습니다.

이에 대한산부인과초음파학회에서는 회원 여러분의 진료와 연구활동에 도움이 되고자 2007년 ‘부인과학 초음파’를 발간하였
고, 다시 발간 10주년을 맞아 내용을 더욱 충실히 갖추어 2017년에 ‘부인과 초음파’ 개정 2판을 발간하게 되었습니다.

2판에서는 각 장기별 초음파 지식을 자궁, 난소, 나팔관으로 세분하여 자세하게 다루었고, 비정상적자궁출혈, 골반통 등의 증상
중심의 접근법에 대한 단원도 추가하였습니다. 아울러 초음파 검사와 함께 CT, MRI 소견을 같이 다룸으로써 산부인과 영상 전체
에 대한 이해를 도울 수 있도록 하였습니다. 또한, 산부인과 의사로서 알아야 할 유방 및 충수돌기 초음파뿐 아니라 갑상선, 탈
장 초음파를 추가하여 폭넓은 지식을 습득할 수 있도록 하였습니다.

이 책이 산부인과 초음파 공부를 위한 대표적인 저서로 자리 잡을 수 있게 초석을 세워주신 초판 집필진, 이번에 아낌없는 노력
으로 내용을 더욱 풍부하게 구성해주신 2판 집필진 그리고 개정판의 기획부터 출간까지 주관해주신 ‘부인과 초음파’ 편찬위원
회 박미혜 위원장과 위원들 및 무엇보다 학회의 출간 사업을 믿고 적극적으로 지원해주신 회원 여러분들께 진심으로 깊은 감사
의 말씀을 드립니다.

이 ‘부인과 초음파’ 책이 어려운 진료 환경에서도 최적의 부인과 진료를 위해 애쓰시는 회원 여러분들께 큰 도움이 되기를 기
원합니다.



2017년 10월

대한산부인과초음파학회장 박 중 신



01 초음파의 이해

1. 초음파의 물리적 성질 ······················ 3

2. 초음파진단기의 신호처리 및 해상도 ·········· 5

3. 초음파장비 조작 ··························· 8

4. 3차원 초음파 ····························· 9

5. 초음파검사의 생물학적 작용 및 안정성 ······ 17



02 여성골반의 초음파

1. 골반 초음파 검사 ························· 21

2. 적응증 및 금기증 ························ 21

3. 검사방법 ································ 22

4. 자궁 ···································· 23

5. 난소 ···································· 26



03 부인과 영역의 도플러 초음파

I. 도플러 초음파의 기본 원리

1. 도플러 효과 ······························ 33

2. 도플러 초음파 기기의 종류 ················· 34

3. 도플러 측정의 실제 ······················· 35



II. 부인과 질환에서 도플러 초음파의 응용

1. 자궁 ···································· 38

2. 난소 ··································· 43

3. 기타 부인과 질환 ························· 49



04 부인과영역의 3차원 초음파

1. 3차원 초음파의 역사 ····················· 57

2. 부인과 영역 ······························ 57



05 정상변이와 허상

1. 자궁의 정상변이와 허상 ··················· 89

2. 자궁부속기의 정상변이와 허상 ············· 93



06 자궁 질환의 초음파

I. 체부 : 자궁의 양성질환

1. 자궁근종 ······························· 101

2. 자궁선근증 ···························· 104



II. 체부 : 자궁의 악성질환

1. 자궁육종 ······························ 107



III. 자궁내막

1. 자궁내막증식증 ························· 109

2. 자궁내막암 ····························· 111

3. 자궁강내 공간을 차지하는 병변 ··········· 114

4. 자궁혈종/자궁축농증 ···················· 119

5. 자궁강내 유착 ·························· 122



07 난소 질환의 초음파

I. 악성

1. 난소암 ································· 131

2. 악성 상피세포 종양의 개요와 초음파 검사에

의한 감별 · · · · · · · · · · · · · · · · · · ·· · · · 132

3. 경계성 상피세포암 ······················· 134

4. 악성 상피세포 종양 ······················ 136

5. 악성 종자세포종양 ······················· 141

6. 악성 성끈기질종양 ······················· 145

7. 전이성 난소암 ··························· 148

8. 림프종, 악성중배엽성혼합종양 및 육종 ····· 149



II. 양성

1. 기능성낭 ······························· 151

2. 자궁내막종 ····························· 153

3. 난관난소농양 ··························· 155

4. 양성신생물 ····························· 156



08 나팔관 질환의 초음파

1. 자궁관 ································· 165

2. 자궁관의 소통검사 ······················ 166

3. 골반 염증성 질환 ························ 169

4. 자궁관암 ······························· 172

5. 부난소낭종 ····························· 172



09 비정상적 자궁출혈의 부인과 초음파

I. 악성

1. 자궁내막증식증 ························· 177

2. 자궁내막암 ····························· 179

3. 자궁경부암 ····························· 182

4. 임신성 융모막 질환 ······················ 185



II. 양성

1. 서 론 ·································· 187

2. 평가 ··································· 189

3. 구조적 이상 ···························· 194

4. 기능적 이상 ···························· 199



10 골반통의 부인과 초음파

1. 급성 골반통 ····························· 205

2. 만성 골반통 ····························· 207



11 자궁외임신

1. 역학 ··································· 217

2. 위험인자 ······························· 217

3. 자궁외임신의 종류 ······················· 218





12 불임 영역의 초음파

1. 난포의 감시 ····························· 231

2. 자궁내막의 평가 ························· 236

3. 초음파 유도하 난자 채취 ················· 240

4. 초음파 유도하 배아 이식 ················· 241

5. 난소과자극증후군 ······················· 242

6. 초음파자궁조영술 ······················· 243

7. 자궁난관조영초음파 ······················ 252



13 비뇨부인과 영역의 초음파

1. 요실금 ································· 259

2. 골반장기탈출증 ························· 264



14 소아와 청소년의 골반 초음파

1. 개요 ·································· 273

2. 초음파 검사 방법 ······················· 273

3. 소아와 청소년의 정상 골반 초음파 소견 ···· 274

4. 소아청소년기 난소 종괴 ·················· 277

5. 소아청소년기 자궁 이상 ·················· 285

6. 기타 질환 ······························ 294



15 중재적 시술 영역의 초음파

1. 농양배액술 ····························· 301

2. 경화요법 ······························· 306

3. 자궁 동맥 색전술 ························ 314

4. 고강도집속초음파치료 ···················· 324



16 유방 및 갑상선 초음파

I. 유방초음파

1. 유방 초음파 진단의 임상 적용 ············· 341

2. 유방 초음파 해부학 ······················ 348

3. 유방 초음파의 판독 ······················ 355

4. 양성과 악성 병변의 구분 ················· 365



II. 갑상선 초음파

1 갑상선 초음파 검사 방법 ·················· 368

2. 정상 갑상선의 초음파 소견 ················ 368

3. 갑상선 결절의 초음파 소견 ················ 368

4. 비결절성 갑상선 질환의 초음파 소견 ······· 375

5. 갑상선암의 수술전 및 수술후 평가 ········· 378



17 충수돌기와 샅굴탈장 초음파

1. 급성 충수염 ···························· 389

2. 샅고랑부위 탈장 ························· 396







18 부인과 질환의 CT와 MRI

I. CT와 MRI 영상의 비교 401



II. 난소의 낭성종괴 402

1. 신생물질환 ····························· 402

2. 비신생물질환 ··························· 402

III. 난소의 고형종괴 406

1. 신생물질환 ····························· 406

2. 염증성질환 ····························· 408

IV. 난소종괴의 염전 409

V. 자궁내막과 근육층에서 자란 종양 409

1. 자궁내막종괴 ··························· 409

2. 자궁근육등에서 기원한 종괴 ·············· 410

3. 악성혼합성뮬러씨종양과 자궁내막간질육종 411



** 찾아보기·Index 413