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1.
目的分析超声造影中不同胆囊良恶性病变的征象,并对良恶性病变鉴别诊断进行分析总结。方法收集75例不同胆囊占位性病变患者超声造影的征象,并对比良恶性病变的超声造影征象的差异。结果胆囊良恶性病变超声造影征象在晚期增强水平、增强模式、胆囊壁连续性及病变内部血管形态方面有统计学差异(P0.05);胆囊良性病变达峰时间及峰值强度小于恶性病变,消退时间及平均渡越时间大于恶性病变,差异均有统计学意义(P0.05)。结论超声造影可显示胆囊良恶性病变血流灌注特征和胆囊壁的连续性情况,对辅助鉴别病变性质具有较高的临床应用价值。  相似文献   

2.
超声造影鉴别诊断胆囊良恶性病变的价值   总被引:1,自引:0,他引:1  
目的 探讨超声造影在鉴别诊断胆囊良恶性疾病中的价值.方法 回顾分析应用对比脉冲序列成像技术和SonoVue超声造影检查117例胆囊病变的特征,比较胆囊良恶性病变常规超声和超声造影的诊断符合率.结果 除胆泥无造影剂进入外,胆囊良恶性病灶在达峰时多表现为高增强、富血供;消退时胆囊癌为低增强,良性病灶多为等增强.对于胆囊癌,常规超声的诊断符合率为65.38%,超声造影为92.31%;胆囊良性病灶,常规超声的诊断符合率为82.41%,超声造影为93.41%.结论 超声造影可提高超声诊断胆囊疾病的准确率,可鉴别胆泥沉积与胆囊癌,了解胆囊癌侵犯胆囊壁的程度及肝内转移情况,但对于腺瘤和单发息肉以及直径小的胆囊癌鉴别较困难.  相似文献   

3.
胆囊隆起性病变超声造影增强模式的探讨   总被引:5,自引:1,他引:4  
目的 探讨胆囊隆起性病变超声造影的血流灌注过程及其增强模式,评价其应用价值.方法 对47例胆囊隆起性病变进行彩色多普勒超声和造影超声检查,观察胆囊壁及病变的增强时间和增强模式.结果 经手术病理证实的47例中良性病变35例,恶性病变12例.彩色多普勒超声检出病变内血流信号19例(40%,19/47);超声造影增强病例38例(81%,38/47),P<0.005.胆囊壁平均始增时间为(16.2±1.9)s,良性病变平均始增时间(16.3±2.8)s,恶性病变平均始增时间(16.2±3.2)s,未见明显统计学差异(P=0.92).47例胆囊隆起性病变增强模式分为4类:Ⅰ类:无增强;Ⅱ类:动脉相均匀增强;Ⅲ类:动脉相蜂窝状不均匀增强;Ⅳ类:动脉相血管呈杂乱树枝状高增强.所有良性病变造影模式分别表现为Ⅰ类到Ⅲ类,11例(92%,11/12)恶性病变表现为Ⅳ类,1例表现为Ⅲ类.11例恶性病例动脉相胆囊壁局部连续性显示中断.结论 超声造影可显示胆囊隆起性病变的血流灌注过程.特征性的增强模式,可以提高鉴别诊断能力.动脉相胆囊壁显示是否完整连续对鉴别良恶性有意义.  相似文献   

4.
超声造影诊断乳腺肿瘤的价值   总被引:1,自引:0,他引:1  
目的 探讨实时超声造影增强模式对乳腺良恶性肿瘤的鉴别诊断价值.方法 108个乳腺病灶(恶性52个、良性56个)行常规超声及超声造影检查,重点观察病灶的造影增强模式,并从以下5方面进行评估:(1)增强程度;(2)是否边缘增强;(3)是否均匀增强;(4)增强时病灶边界是否清晰;(5)增强时病灶形态是否规则.对乳腺良恶性肿瘤的增强模式进行研究.结果 良、恶性肿瘤的5项增强模式差异均有显著性(P<0.05),边缘增强诊断恶性病灶的特异度最高,为91.07%;明显增强诊断恶性病灶的敏感度最高,为82.69%.结论 实时超声造影增强模式有助于乳腺肿块的良恶性评估.  相似文献   

5.
目的 探讨乳腺良,恶性肿块典型超声造影模式特征.方法 观察66个乳腺良、恶性肿块超声造影特征性表现,并对其进行造影时间-强度曲线分析.结果 超声造影乳腺良、恶性肿块增强均以高增强为主.良性组多呈均匀增强,边缘多平滑,而恶性组多呈不均匀增强,边缘多不光滑呈放射状增强,差异有统计学意义(P<0.05).时间-强度曲线参数分析中,乳腺恶性肿块的达峰时间、上升支及下降支斜率均大于良性肿块,差异有统计学意义(P<0.05).结论 乳腺良、恶性肿块超声造影模式均表现一定的特征性,有助于乳腺肿块良、恶性鉴别诊断.  相似文献   

6.
目的 探讨超声造影(CEUS)增强模式对甲状腺实性结节良恶性鉴别诊断的价值.方法 回顾性分析39个甲状腺实性结节的常规超声声像图特点及超声造影过程,观察病灶超声造影增强模式和造影前后结节大小的变化.结果 甲状腺良恶性结节增强模式间存在显著性差异(P<0.05),甲状腺恶性结节造影增强模式多为不均匀增强,占85.71% (18/21),利用不均匀增强诊断甲状腺恶性结节,敏感度85.71%,特异度88.89%;而良性结节多为周边环状增强,占77.78% (14/18),利用结节周边环状增强诊断甲状腺良性结节,敏感度77.78%,特异度95.24%.结论 超声造影增强模式分析对甲状腺实性结节良恶性鉴别诊断具有重要的价值.  相似文献   

7.
目的探讨实时超声造影对腹部良恶性占位病变的鉴别诊断价值。方法对250例腹腔脏器占位性病变进行实时超声造影研究,其中包括肝脏良恶性肿瘤196例,胆囊癌及胆囊良性病变39例,胰腺良恶性病变15例,所有病例均经过手术或其他影像学检查方法证实。结果造影剂Sono Vue2.4ml静脉注射后,肝癌动脉相表现为整体快速增强,并在门脉相快速消退,在实质相显示为低回声;血管瘤呈周围向心性环状或结节状增强,门脉相及实质相进一步增强,持续较长时间;局灶性结节增生表现为中央扩散型快速整体增强,部分病例显示为车轮状;肝硬化增生结节的造影增强特征与肝实质一致;胆囊癌快速不均匀增强,胆囊壁连续性中断,胆囊良性病变及慢性胆囊炎胆囊壁连续;胰腺癌造影剂快速进入,消退时间早于胰腺实质,胰腺炎性肿块造影后回声与胰腺一致,或造影剂不进入。结论实时超声造影能显示肿瘤内微小血管的血流灌注情况,对腹部良恶性占位病变的定性诊断具有重要的意义。  相似文献   

8.
目的 观察乳腺肿块实时灰阶超声造影增强模式,探讨其在乳腺良恶性病灶鉴别诊断中的价值.方法 50个乳腺肿块,恶性病灶23个,良性病灶27个,观察其超声造影增强的增强程度、增强模式,病灶边界是否清晰、消退模式,比较良恶性病变血流灌注特征.结果 50个乳腺病灶均有不同程度增强,恶性病灶表现为3级以上明显增强17个,占73.9%,呈结节状不均匀增强16个,占69.6%,增强时边界不清晰不规则,呈放射状18个,占78.3%.良性病灶27个,增强程度为3级的占40.7%(11/27),呈整体较均匀增强20个,占74.1%,部分增强7个,占25.9%,表现为点线状、结节状或团块状增强.良恶性病灶造影增强特点的差异有统计学意义(P〈0.05).结论 超声造影可以动态观察乳腺病灶内微血管血流灌注,提高其良恶性的鉴别诊断能力.  相似文献   

9.
目的探讨实时超声造影(CEUS)增强模式对胆囊癌的鉴别诊断价值。方法 20例胆囊癌和37例胆囊良性病变患者行常规超声及CEUS检查,重点观察病灶的造影增强模式。结果胆囊癌CEUS表现为病灶与胆囊壁同时显影,肝动脉期以增强明显为主,肝门静脉期以低增强为主。在CEUS增强早期呈高增强或等增强并在造影剂注射后35 s内变低增强者在胆囊癌中占95.0%(19/20);良性病变中占16.2%(6/37)(P=0.000)。病变表现为不均匀增强者在胆囊癌中占80.0%(16/20),良性病变中占23.3%(7/30)(P=0.000)。病变处胆囊壁完整性破坏者在胆囊癌中占85.0%(17/20),良性病变中占0.0%(0/37)(P=0.000)。超声检查诊断胆囊良恶性病灶的准确性92.98%、敏感性95.00%和特异性91.83%。结论 CEUS可提高超声诊断胆囊癌的准确率,能显著改善对胆囊疾病良恶性鉴别诊断能力,值得临床应用推广。  相似文献   

10.
目的 :探讨超声造影增强模式在低位胆道梗阻病灶良恶性鉴别诊断中的应用价值。 方法:回顾性分析低位胆道梗阻住院患者53例的超声造影诊断结果及其增强模式,并与病理结果比较,探讨超声造影对低位胆道梗阻定性诊断的符合率及增强模式对良恶性鉴别诊断的特异性及敏感性。结果: 以增强早期呈现高增强或等增强并在增强晚期有消退表现作为诊断恶性病变的指标时,良恶性组间差异有统计学意义( P<0.05) ,本组恶性病例的诊断敏感性、特异性分别为92.3%、96.3%,阳性预测值及阴性预测值分别为96%、92.9%。患者的性别、年龄及病灶的二维灰阶表现在良恶性组间差异无统计学意义( P >0. 05)。结论:超声造影增强表现模式对低位胆道梗阻的定性诊断具有一定的应用价值,增强早期呈现高增强或等增强并在增强晚期有减退表现有助于低位胆道梗阻病灶良恶性的鉴别诊断。  相似文献   

11.
We asked in this study if the quantitative sonographic analysis could diagnose effectively the benign and malignant tumors of the parotid gland. Sonographic analyses using mean grey values and SDs of echo levels were performed on the 21 benign tumors and 22 malignant tumors of the parotid glands. Both the mean grey level and the SD of the echo levels were significantly and characteristically different among the different parotid tumor groups. Discrimination analysis showed that, compared with single uses, a combined use of these two criteria improved diagnostic accuracy to 81% (carcinoma vs. pleomorphic adenomas), 93% (malignant lymphomas vs. pleomorphic adenomas), 91% (carcinomas vs. malignant lymphomas), 100% (pleomorphic adenomas vs. Warthin's tumors), 100% (carcinomas vs. Warthin's tumors) and 100% (malignant lymphomas vs. Warthin's tumors). These findings suggest that quantitative sonographic analysis is effective in differentiating benign and malignant tumors of the parotid gland.  相似文献   

12.
In a demographic and histologic study of 200 intraoral minor salivary gland tumors seen in Japan (Nagasaki and Miyagi prefectures), 127 cases (63.5%) were classified as benign, comprising 124 pleomorphic adenomas and 3 monomorphic adenomas. The other 73 cases (36.5%) were malignant tumors, represented by 33 adenoid cystic carcinomas, 16 mucoepidermoid carcinomas, 10 carcinoma in pleomorphic adenomas, 6 acinic cell carcinomas, 5 adenocarcinomas, one polymorphous low-grade adenocarcinoma, one undifferentiated carcinoma and one clear cell carcinoma. There was an overall female preponderance (1.78/1). The mean age for females was 47.2 years and for males was 50.6 years. The mean age for patients with malignant tumors was 10 years greater than for patients with benign tumors and was statistically significant. The palate was the most common site for intraoral minor salivary gland tumors followed by the lip and buccal mucosa. These three sites accounted for 83% of all cases. Tumors arising in these three sites were predominantly benign. In contrast, those located in the gingiva, floor of the mouth and tongue were predominantly malignant. The results of this study were compared with other recent studies.  相似文献   

13.
The literature states that most thyroid nodules found on physical examination are benign adenomas, but each nodule must be regarded with suspicion until proven benign or malignant. This diagnostic protocol provides a step by step process of evaluating subjective data, objective data and diagnostic tests relating to the work-up of the patient with a thyroid nodule.  相似文献   

14.
目的 探讨DWI鉴别诊断实质性肝脏良性与恶性肿瘤的价值。 方法 回顾性分析经病理证实的7例肝腺瘤、14例肝局灶性增生(FNH)及32例肝脏恶性肿瘤患者(25例肝癌和7例转移瘤)的DWI定量分析结果,比较肝脏FNH和腺瘤与肝脏恶性肿瘤ADC值的差异。 结果 7例肝腺瘤9个病灶的平均ADC值为(1.05±0.28)×10-3 mm2/s,14例FNH 18个病灶的平均ADC值为(1.13±0.46)×10-3 mm2/s,32例肝脏恶性肿瘤49个病灶的平均ADC值为(0.96±0.29)×10-3 mm2/s(b=800 s/mm2)。FNH、肝腺瘤与肝脏恶性肿瘤的平均ADC值之间差异无统计学意义(P均>0.05)。 结论 ADC值对实质性肝脏良性肿瘤(FNH和肝腺瘤)与肝脏恶性肿瘤的鉴别无帮助。  相似文献   

15.
The objective of this study was to evaluate the usefulness of a galactose-based ultrasonographic contrast agent, Levovist (Schering AG, Berlin, Germany), in differentiating benign from malignant thyroid nodules by analysis of the time-intensity curves correlating the variation of the intensity signal value during the contrast transit time. Fifty-four patients scheduled for surgical removal of a nodule or the thyroid gland or both after cytologic examination were enrolled in this study; all of the nodules underwent a baseline color and power Doppler evaluation and then to a color Doppler examination after an intravenous bolus injection of Levovist. The time-intensity curves were analyzed with respect to the histologic results. Carcinomas showed a significantly earlier arrival time of Levovist than nodular hyperplastic benign nodules and adenomas (8.1 +/- 1.41 versus 19.6 +/- 2.2 and 16.1 +/- 2.8 seconds; P < .0001), although no significant difference occurred between hyperplastic benign nodules and adenomas; carcinomas and adenomas showed an earlier time to peak than hyperplastic benign nodules (14.6 +/- 1.2 and 23.1 +/- 3.8 versus 33.0 +/- 3.0 seconds; P < .0001). No significant difference was found in baseline, peak, final intensity signal, and percent variation of intensity signal among hyperplastic benign nodules, adenomas, and carcinomas. Although cytologic examination still remains the standard of reference for the presurgical diagnosis of thyroid nodules, the preliminary data of this pilot study demonstrate that the analysis of time-intensity curves after Levovist injection might provide useful, complementary, and quantitative information to differentiate benign from malignant thyroid nodules.  相似文献   

16.
目的 探讨常见腮腺肿瘤的高频彩色多普勒超声声像图特点.方法 应用高频彩色多普勒超声观察54例腮腺肿块,并将声像图与手术、病理结果对照.结果 腮腺良性肿瘤42例,恶性肿瘤12例.良性病变常表现为形态规则边界清楚的肿块,以混合瘤居多,其次为腺淋巴瘤;恶性病变常表现为形态不规则,边界不清晰的肿块,以黏液表皮样癌居多.结论 腮腺肿瘤高频彩色多普勒血流显像(CDFI)表现呈多样性,但亦具有一定的差异性,对于同时伴有颈部淋巴结肿大的病变可以做出进一步提示,但最终诊断仍依赖于活检或手术.  相似文献   

17.
Gallbladder polyps are protuberances of the gallbladder wall projecting into the lumen. They are usually incidentally found during abdominal sonography or diagnosed on histopathology of a surgery specimen, with an estimated prevalence of up to 9.5% of patients. Gallbladder polyps are not mobile and do not demonstrate posterior acoustic shadowing; they may be sessile or pedunculated. Gallbladder polyps may be divided into pseudopolyps and true polyps. Pseudopolyps are benign and include cholesterolosis, cholesterinic polyps, inflammatory polyps, and localised adenomyomatosis. True gallbladder polyps can be benign or malignant. Benign polyps are most commonly adenomas, while malignant polyps are adenocarcinomas and metastases. There are also rare types of benign and malignant true gallbladder polyps, including mesenchymal tumours and lymphomas. Ultrasound is the first-choice imaging method for the diagnosis of gallbladder polyps, representing an indispensable tool for ensuring appropriate management. It enables limitation of secondary level investigations and avoidance of unnecessary cholecystectomies.  相似文献   

18.
超声诊断甲状腺良恶性结节的病理基础及鉴别诊断的价值   总被引:15,自引:0,他引:15  
目的结合甲状腺良、恶性结节的病理基础,分析其声像图特点,探讨超声对甲状腺良、恶性结节鉴别诊断的临床应用价值。方法对89例甲状腺结节的患者术前行超声检查,术后根据病理结果对其超声征象进行良、恶性对照研究。结果89例甲状腺结节患者中,良性者76例共199个结节,恶性者13例共18个结节,甲状腺结节超声诊断与手术病理结果符合率为81.6%,其中结节性甲状腺肿的诊断符合率为85.2%,甲状腺腺瘤的诊断符合率为83.3%,甲状腺癌的诊断符合率为62.2%。结论超声对甲状腺良恶性结节的鉴别诊断有明确的临床应用价值,综合分析甲状腺良恶性结节的病理基础与超声征象可提高对其鉴别诊断的准确率。  相似文献   

19.
The nonspecificity of the thyroid halo sign   总被引:1,自引:0,他引:1  
In a series of 28 patients with solitary solid thyroid masses, 10 of the patients had a mass surrounded by a rim of decreased echoes or by an echo-free rim, previously termed the halo sign. Eight of these lesions were benign, being either adenomas or benign nodules; however, two halos were also demonstrated surrounding proven carcinomas. The presence of the halo in both benign and malignant disease is illustrated, and the possibility of pericapsular inflammatory infiltrate as its underlying anatomic correlate is suggested.  相似文献   

20.
目的探讨大肠侧向发育型肿瘤Bcl-2和Caspase9的基因表达改变,及其与大肠腺癌的关系。方法应用免疫组化SP法测定大肠腺癌、大肠腺瘤、大肠侧向发育型肿瘤的Bcl-2和Caspase9的表达。结果正常粘膜中Bcl-2表面上皮表达阴性,在腺癌组明显低于腺瘤组和LST良性组(P0.05),而LST良性组与腺瘤组相比没有统计学差别。正常粘膜中Caspase9广泛表达于胞浆中,在腺癌组明显低于腺瘤组和LST良性组(P0.05),而LST良性组与腺瘤组相比没有统计学差别。结论 LST良性组与大肠腺瘤组在Bcl-2、Caspase9等基因的改变上没有统计学差异,同样是癌前病变,Caspase-9和bcl-2同样参与细胞凋亡的调节,在大肠肿瘤的恶变中发挥作用。  相似文献   

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