超声弹性成像对干燥综合征不同腺体病变的诊断价值

目的 探讨超声弹性成像对干燥综合征（SS）不同腺体病变的诊断价值。方法 选取我院就诊的75例疑似SS患者，根据欧美专家共识诊断标准（2002年版）将其分为SS患者35例（研究组）和非SS患者40例（对照组），应用超声弹性成像测量两组腮腺和颌下腺剪切波速度（SWV）值，取其平均值为唾液腺SWV值，分析两组间及各组左右侧SWV值的差异。绘制受试者工作特征（ROC）曲线分析超声弹性成像对SS不同腺体病变的诊断效能。结果 研究组腮腺、颌下腺、唾液腺SWV值均高于对照组，差异均有统计学意义（均P<0.05）。对照组和研究组内左右侧腮腺、颌下腺、唾液腺SWV值比较差异均无统计学意义。ROC曲线分析显示，当SWV值为1.94 m/s时，超声弹性成像诊断SS颌下腺病变的曲线下面积（AUC）为0.897，灵敏度为86.4%，特异度为83.0%；当SWV值为2.15 m/s时，超声弹性成像诊断SS腮腺病变的AUC为0.936，灵敏度为93.5%，特异度为86.4%；当SWV值为2.03时，超声弹性成像诊断SS唾液腺病变的AUC为0.959，灵敏度为96.3%，特异度为87.8%。结论 超声弹性成像对...     

慢性颌下腺炎的超声表现

目的探讨超声诊断慢性颌下腺炎的价值。方法结石型颌下腺炎组患者25例,非结石型颌下腺炎组患者11例,共39处病变;超声观察颌下腺的大小、形态、边界、腺体回声及血流分布特征,腺管有无扩张,腺管内有无结石,周围软组织、颌下区淋巴结和邻近唾液腺有无累及。结果结石型颌下腺炎组均为单侧发病;19例颌下腺形态饱满,18例颌下腺导管扩张伴结石,7例腺体内结石,3例腺体内及颌下腺导管内结石并存。非结石型颌下腺炎组,8例单侧病变,6例双侧病变;11例颌下腺形态饱满,腺体回声偏低、不均匀,呈"结节样"改变,"结节"大小3~15 mm。其中,6例颌下腺"结节"相互融合形成低回声"肿块"。腺体内血流丰富,但血管走行正常。病变颌下腺不伴导管扩张或结石。结论超声检查对于慢性颌下腺炎的诊断和治疗具有重要的参考意义,是一种有效的检查方法。     

87例急性阑尾炎在超声诊断中的价值

目的：探讨阑尾病变的超声图像特征及超声对阑尾病变的诊断价值。方法：应用低频超声(简称低频)及高频超声(简称高频)对35例可疑阑尾病变进行检查并诊断，全部经手术与病理证实。结果：阑尾病变的超声诊断符合率：低频为42．3％，高频为94．1％。结论：高频对阑尾病变的显示率明显高于低频，其对阑尾病变的直观显示可为临床提供客观的诊断依据。     

高频超声观察干燥综合征患者泪腺、涎腺的临床价值

目的:探讨高频超声观察干燥综合症患者泪腺、腮腺、颌下腺的临床价值。方法:对11例确诊为干燥综合征及可疑干燥综合征的患者,利用高频超声观察其腮腺、颌下腺、泪腺的超声声像图特征并进行总结。结果:7例确诊为干燥综合征患者的腺体均有不同程度的超声改变,2例可疑为干燥综合征患者的腺体亦有不同程度的超声表现。结论:干燥综合征患者的腮腺、颌下腺、泪腺均有不同程度的超声改变,高频超声对于干燥综合征患者的辅助诊断有一定的临床价值。     

涎腺良性肿物的彩色多普勒超声诊断分析

本组病例主要分析39例腮腺及颌下腺常见良性肿物的声像图特征及彩色多普勒血流显像,总结规律,评价高频彩色多普勒超声检查对涎腺良性肿物的诊断价值.     

高频超声对乳腺病变的诊断价值

目的探讨高频超声诊断乳腺；病变的价值。方法回顾性分析93例经手术及病理证实的乳腺肿块的高频超声声像图表现。结果本组93例中，超声诊断乳腺癌15例，良性病变78例；术后病理诊断乳腺癌16例（诊断符合率93％），良性病变77例（诊断符合率98．7％），1例乳腺癌误诊为纤维瘤伴乳腺增生病。结论乳腺病变有典型的声像图特征，高频超声诊断率高，为乳腺疾病提供了可靠的诊断依据。     

颌下腺肿瘤超声诊断的临床应用

目的探讨超声在颌下腺肿瘤诊断中的临床应用价值。方法单侧颌下腺实质性占位性病变病例66例采用超声进行诊断。结果超声诊断颌下腺肿瘤符合率为93.9%(62/66)。结论超声诊断颌下腺肿瘤具有临床应用价值。     

超声对颌下颏下区包块的诊断价值

目的：探讨颌下颏下区包块超声鉴别的诊断要点。方法：运用高频彩色多普勒对50例颌下颏下区包块进行超声诊断，并与手术病理结果比较。结果：彩色多普勒超声对病灶的囊性或实性物理特性的诊断正确率为98％；对囊性病变病理定性诊断正确率为94．12％；对实性病变病理定性诊断正确率为57．58％。结论：高频超声及彩色多普勒检查，对颌下颏下区的囊性病变定性诊断的正确率高，对颌下腺及淋巴结病变的定性诊断有一定价值。     

B超诊断胆囊息肉样病变与病理对照分析

目的：本通过对胆囊息肉样病变的超声诊断与病理结果分析，以探讨不同类型胆囊息肉样病变的声像图特征，为早期分类诊断提供依据。方法：对75例胆囊息肉样病变患的超声图像与手术后病理诊断进行对照分析。结果：胆固醇性息肉64例，腺瘤并局部不典型增生及癌变4例，单纯性腺瘤2例，粘膜息肉样变1例，慢性胆囊炎4例。在病理诊断为胆囊息肉样病变中合并慢性胆囊炎61例，合并胆囊结石3例。超声与病理诊断符合率为94．67％。结论：应用超声图像分析，可以提高对胆囊息肉样病变的良性病变与恶性病变及病理分型的诊断率，特别是对胆囊癌前病变及早期胆囊癌的预防和早期诊断有重要价值。     

彩超鉴别胃病变良恶性的临床价值

目的：评价彩色多普勒超声对胃良恶性病变的鉴别诊断价值。方法：对78例患行胃彩色多普勒超声检查，其中27例胃有病变，观察其病灶大小、形态、回声特征及血供情况，测定病变内动脉阻力指数(RI)。结果：胃癌组病灶内血流丰富，显示率100％，RI平均0．55；良性病灶组病灶内几乎无血流信号，显示率(1／15)6．6％。结论：彩色多普勒超声对胃良恶性病变有鉴别诊断价值。     

高频超声在诊断腮腺和颌下腺良性疾病中的应用

目的　探讨高频超声对腮腺和颌下腺良性病变的诊断价值。方法　２１ 例腮腺、颌下腺疾病用二维和彩色血流显像检查,１７ 例有手术病理证实。结果　高频超声对囊性、囊实性病变确诊率高,对颌下腺导管结石显示直观。结论　高频超声能确定腺体内是否有占位性病变或为炎症性改变。对选择治疗方式有指导意义。     

彩超对涎腺结石的诊断价值

目的 观察涎腺结石彩超诊断价值。方法应用彩超高分辨率探头对患者涎腺多切面扫查，观察腺体及导管形态结构。结果共检出颌下腺结石58例，腮腺结石9例，5例颌下腺及腮腺合并结石。结石声像图多为强回声，部分为中等回声，强回声者后方声影明显。最大结石12mm，位于颌下腺导管内。其中70例与手术相符，两例误诊，正确率97％。结论彩超是诊断涎腺结石的首选方法。     

实时灰阶谐波超声造影诊断血管疾病的初步研究

目的：评价实时灰阶谐波超声造影对血管疾病的诊断价值。方法：各类血管疾病患者73例，均接受常规彩色多普勒超声与灰阶谐波造影检查，两种方法的检查结果分为：①不能得到诊断结果；②可疑诊断；③诊断明确。所有结果均经过DSA、CT及MRI检查证实。结果：常规彩色多普勒超声诊断明确的有50．7％（37／73），可疑诊断占38．4％（28／73），不能得到诊断结果的有10．9％（8／73）。结合灰阶谐波造影检查后明确诊断的有89．0％（65／73），可疑诊断有8．2％（6／73），不能得到诊断结果的有2．8％（2／73）。常规彩色多普勒超声诊断的敏感性95．7％（45／47），特异性27．8％（5／18），准确性76．9％（50／65）；谐波造影诊断的敏感性98．0％（50／51），特异性95．0％（19／20），准确性97．2％（69／71）。结论：应用实时灰阶谐波超声造影能够比较直观地反映血管流道及管壁的变化，没有角度依赖性，不存在溢出等伪像，有助于对血管疾病的诊断。     

唾液腺显像诊断干燥综合征

目的 探讨唾液腺显像诊断干燥综合征的价值。方法 回顾性分析44例临床怀疑干燥综合征（SS）患者的唾液腺显像资料,在双侧腮腺、颌下腺勾画ROI获得时间-放射性曲线（TAC）,对曲线进行定量分析获得唾液腺摄取指数（UI）和排泌分数（EF）,分析UI和EF与唾液腺显像定性分级诊断结果的相关性,并比较其诊断SS的效能。结果 与非SS患者相比较,SS患者唾液腺UI和EF均明显减低（P均<0.05）。定性诊断评价唾液腺功能受损程度分为0~3级,双侧颌下腺、腮腺UI与定性诊断分级呈负相关（P均<0.001）;除右侧颌下腺EF与唾液腺显像定性分级呈负相关外（r=-0.312,P=0.039）,其余腺体EF与定性诊断分级无相关性（P均>0.05）。UI的综合诊断效能均高于定性诊断,但是其ROC曲线下面积与定性诊断比较差异无统计学意义（P均>0.05）。结论 唾液腺显像定量分析可准确评价唾液腺功能,对诊断SS具有重要价值。     

86例上颈部占位病变的临床病理分析

【目的】探讨上颈部占位病变的临床病理类型及特点。【方法】回顾性分析86例上颈部占位病例的临床病理资料。【结果]86例患者中,颌下腺来源42例,其中肿瘤性病变27例（24例良性肿瘤和3例恶性肿瘤）,涎石症15例。囊性病变共25例,包括11例甲状舌骨囊肿,7例鳃裂囊肿,4例（表）皮样囊肿,1例囊性水瘤,1例舌下腺囊肿及1例颈淋巴脓肿。另有7例颈淋巴结转移癌,5例恶性淋巴瘤,脂肪瘤4例以及血管瘤、神经鞘瘤、淋巴组织反应性增生各1例。【结论】上颈部占位病变临床病理类型多样,良恶性病变各占一定的比例,结合临床病史、体检、辅助检查（B超,CT,MRI等）及针吸活检一般可确诊,少数病例需切取或切除活检以明确诊断。     

FURTHER STUDIES CONCERNING THE FILTRABLE VIRUS PRESENT IN THE SUBMAXILLARY GLANDS OF GUINEA PIGS

1. It has been shown that the guinea pig virus localizes in the submaxillary glands of young guinea pigs following subcutaneous, intraperitoneal, or intravenous injection of active material, and that the specific lesion is demonstrable in the glands in 12 to 15 days. When an active infection of the gland has been produced in this way, the guinea pigs are refractory to intracerebral inoculation of the virus. 2. No lesion develops in the submaxillary glands of young guinea pigs injected subcutaneously with guinea pig virus which has been inactivated by heat. Young guinea pigs which have received injections of heat-killed virus do not become refractory to intracerebral inoculation of the virus. 3. When young guinea pigs from which both submaxillary glands have been removed are injected subcutaneously with active virus, the virus localizes in the parotid gland, and the animals become refractory to intracerebral inoculation. 4. It has been impossible to demonstrate virucidal properties in the sera of adult guinea pigs which have become spontaneously infected with the virus, or in the sera of young guinea pigs which have been artificially rendered refractory to intracerebral inoculation. 5. It has been possible to transmit the virus from guinea pig to guinea pig continuously in series through seven animals by direct inoculation from submaxillary gland to submaxillary gland. 6. The fact that the virus regularly localizes in the submaxillary glands following subcutaneous inoculation has been utilized in passing the virus from guinea pig to guinea pig. 2 weeks after the subcutaneous inoculation of the virus into young guinea pigs, the active agent was present in the submaxillary glands. Emulsions of the submaxillary glands of these animals were then used for the subcutaneous injection of another group of young guinea pigs. In this way the virus was transmitted continuously from skin to submaxillary gland through a series of seven animals.     

Is color Doppler a reliable method for the diagnosis of malrotation?

Purpose

The gold standard for the diagnosis of malrotation is barium contrast study of the upper gastrointestinal system (UGCS), while color Doppler ultrasonography (CDUS) is another method used in the diagnosis. We investigated the value of CDUS for the diagnosis of malrotation in this study.

Methods

UGCS images, CDUS images, plain abdominal images, demographic data, and symptoms of 82 patients who were investigated for presumed malrotation during a 7-year period were evaluated, retrospectively.

Results

All patients underwent CDUS, and 18% of these patients were diagnosed with malrotation as the superior mesenteric vein was seen to be on the left of the superior mesenteric artery. We found that 16% of the 75 patients who underwent UGCS were diagnosed with malrotation. The sensitivity and specificity of CDUS in the diagnosis of malrotation was found to be 93.8 and 100%, respectively. The respective values for UGCS were 91.7 and 98.4%.

Conclusion

Current data in the literature and our results underline that UGCS may yield false-positive and false-negative results. Although CDUS was found to be a reliable method for the diagnosis of malrotation in our study, the limitations of UGCS are also recognized for CDUS. Prospective studies are needed to determine the more valuable method.

     

Differential effects of hypoxia on the turnover of norepinephrine and epinephrine in the heart, adrenal gland, submaxillary gland and stomach

The authors examined the effects of hypoxia (8% O2 in N2) on the turnover rates of norepinephrine (NE) and epinephrine (E) in the heart, adrenal gland, submaxillary gland and stomach. The turnover rates were estimated by measuring the decrease in the content of NE and E after an i.p. injection of alpha-methyl-p-tyrosine (250 mg/kg), an inhibitor of tyrosine hydroxylase. After a 4-h exposure to hypoxia, the turnover rate of NE in the heart and those of NE and E in the adrenal gland were increased, whereas that of NE in the submaxillary gland was decreased. The turnover rate of NE in the stomach was unchanged. Pretreatment with hexamethonium, a ganglionic nicotinic receptor blocker, abolished the hypoxia-induced changes in the turnover rate of NE or E in the heart, adrenal gland and submaxillary gland. Furthermore, transection of the spinal cord at the level of C5-6 abolished hypoxia-induced alterations in the turnover rate of NE and E in the adrenal gland and submaxillary gland. In contrast, the hypoxia-induced changes seen in the heart persisted, although at a lower level, even after transection. These results show that the effects of hypoxia on the activities of the sympathoadrenal system differ depending on the organs; activities are increased in the heart and adrenal gland, decreased in the submaxillary gland and unchanged in the stomach. Furthermore, the present data suggest that hypoxia-induced alterations in the activities of cardiac sympathetic nerves originate in both the brain and spinal cord, including preganglionic neurons, whereas changes in the activities of the sympathetic nerves to the adrenal gland and submaxillary gland originate mainly in the brain.     

Sympathetic and parasympathetic nerves regulate postsynaptic alpha-2 adrenoceptor in salivary glands

The effects of sympathetic denervation or parasympathetic decentralization on the inhibitory effects of postsynaptic alpha-2 adrenoceptors were studied in the submaxillary and the sublingual gland of the rat. Chronic sympathetic denervation enhanced by a factor of 10 the potency of clonidine to inhibit the secretory responses of the submaxillary gland to either norepinephrine or methacholine. In denervated glands, clonidine (1 microgram/kg), reduced markedly the response to norepinephrine, but potentiated this response in control glands. Blockade of postsynaptic alpha-2 adrenoceptors with idazoxan (3 micrograms/kg) enhanced the secretory responses of denervated glands to norepinephrine. Parasympathetic decentralization also potentiated the inhibitory effects of the alpha-2 agonists. In the submaxillary gland the potency of guanabenz to decrease the secretory response to methacholine was increased by a factor of 30. Supersensitivity to the inhibitory effects of clonidine was also observed in parasympathetically decentralized sublingual glands. Parasympathetic decentralization increased the maximum binding site of [3H]clonidine binding by about 50% in both the submaxillary and sublingual glands. No changes in KD were detected. This surgical procedure also increased the maximum binding site of [3H]prazosin binding in submaxillary glands. The present findings show clearly that interruption of either branch of the autonomic nervous system induces supersensitivity of the inhibitory response mediated through postsynaptic alpha-2 adrenoceptors. The enhanced inhibitory activity could mask alpha-1 adrenoceptor supersensitivity after postganglionic sympathetic denervation.     

Intrarenal color duplex ultrasonography: a window to vascular complications of renal transplants.

OBJECTIVE: We analyze and discuss the importance of intrarenal color duplex ultrasonography (CDUS) in the diagnosis and differential diagnosis of vascular complications in renal transplants. METHODS: We retrospectively reviewed results of CDUS, especially intrarenal CDUS, in 102 consecutive inpatients with vascular complications of renal transplants from January 1, 2000, to December 31, 2006. Correlations between CDUS and magnetic resonance angiography, digital subtraction angiography, surgical findings, and clinical diagnoses were studied. RESULTS: Abnormal findings on intrarenal CDUS clearly represent vascular complications primarily located at the main renal vessels and intrarenal vessels. In our study, there were 5 cases of false-negative intrarenal arteriovenous fistulas, 1 case of false-positive transplant renal vein thrombosis, and 2 cases of false-negative transplant renal artery stenosis. The accuracy of detecting vascular complications of renal transplants with CDUS was 92% (94/102). CONCLUSIONS: Intrarenal CDUS is a noninvasive, accurate diagnostic tool that can be administrated portably and is easily repeatable, thereby making it not only a highly valuable imaging technique but also the method of choice in screening and diagnosing vascular complications of renal transplants.