多普勒超声收缩期峰值与阻力指数在鉴别诊断乳腺肿瘤中的应用价值

目的 探讨多普勒超声收缩期峰值血流速度(PSV)与阻力指数(RI)在乳腺良恶性肿瘤鉴别诊断中的价值.方法 回顾分析经手术证实的120例乳腺肿瘤患者(良性46例,恶性74例)的血流参数PSV、RI,比较两者在鉴别诊断乳腺良恶性肿瘤中的敏感性、特异性和准确性.结果 乳腺恶性肿瘤RI较良性肿瘤明显增高,两者差异有统计学意义,而PSV差异无统计学意义.以PSV>20 cm/s,RI>0.7作为乳腺恶性肿块的判定标准,PSV与RI的诊断准确性分别为55.8%、77.5%;敏感性为50.0%、77.0%;特异度为65.2%、78.3%.联合PSV与RI两项指标其鉴别准确率为79.4%.结论 彩色多普勒血流参数PSV、RI有助于乳腺良恶性肿瘤的鉴别诊断;RI的鉴别诊断价值明显优于PSV;联合两者判定可提高诊断准确性,但与单独使用RI并无明显差别.     

Propagation velocity and attenuation of a shear wave pulse measured by ultrasound detection in agarose and polyacrylamide gels

The aim of our research was to measure and analyze phase velocity and pulse attenuation of a shear wave in two media: well-known agarose-gelatin gel and seldom-used polyacrylamide gel. These quantities were determined at three temperatures by the method of transmission sonoelastography described by Catheline et al. (1999). The shear wave was generated with a shaker stimulated by an electric pulse, with a length of one sinusoidal period with a preset frequency. The calculation method is based on a cross-correlation algorithm used for consecutive A-scans of signals of backwards scattered ultrasonic pulses. It allows determination of the local displacement of scattering elements in the medium, caused by a propagating shear wave, and determination of viscoelastic properties of gels. The results of the measurements of shear wave phase velocity and attenuation, obtained for agarose-gelatin and polyacrylamide gels that simulate biological systems depending on frequency and amplitude of vibrations, are presented. The comparison of the measured characteristic properties of gels has revealed that polyacrylamide gel is more useful in viscoelastic investigations of tissue-like phantoms.     

定量组织速度成像评价慢性心力衰竭患者左室壁收缩的非同步性

目的　探讨定量组织速度成像 (QTVI)评价慢性充血性心力衰竭 (慢性心衰 )患者左室壁收缩的非同步性。方法　应用 QTVI分析 16例慢性心衰患者和 2 0例正常人的左室壁运动速度曲线 ,并对其中 4例右室双灶起搏和 1例双心室起搏患者起搏前、后进行对比分析。结果　慢性心衰患者的室间隔和左室侧壁基底段的收缩期速度峰均明显减低 (P<0 .0 0 1) ,两节段的收缩期速度峰延迟明显 (P<0 .0 0 1)。5例患者起搏后室间隔和左室侧壁基底部收缩期速度峰均较起搏前稍增大 ,两节段的收缩期速度峰延迟较起搏前明显缩短。结论　 QTVI能够评价左室壁收缩的非同步性 ,并能够评估起搏治疗再同步化的效果。     

Orbital blood flow velocities in patients with rheumatoid arthritis

PURPOSE: To assess orbital blood flow changes in patients with rheumatoid arthritis using Doppler sonography. PATIENTS AND METHODS: The study comprised 35 patients who were diagnosed with RA and were treated at the Department of Physical Therapy and Rehabilitation at Duzce Medical School. A control group consisted of 35 healthy volunteers. Color Doppler imaging was used to measure peak systolic velocity (PSV) and end diastolic velocity (EDV), from which the resistance index (RI) was calculated in the ophthalmic artery (OA), central retinal artery (CRA), and posterior ciliary arteries (PCAs). RESULTS: In the OA, PSV, EDV, and RI were, respectively, 36.7 +/- 0.6 cm/sec, 9.7 +/- 0.2 cm/sec, and 0.73 in the control group versus 34.7 +/- 3.0 cm/sec, 9.1 +/- 1.1 cm/sec, and 0.74 in the patient group. In the CRA, they were, respectively, 11.8 +/- 1.7 cm/sec, 3.6 +/- 0.7 cm/sec, and 0.66 in the control group versus 11.1 +/- 1.7 cm/sec, 3.4 +/- 0.7 cm/sec, and 0.68 in the patient group. In the PCAs, they were, respectively, 13.2 +/- 1.2 cm/sec, 4.7 +/- 0.6 cm/sec, and 0.65 in the control group versus 12.4 +/- 1.2 cm/sec, 4.2 +/- 0.6 cm/sec, and 0.66 in the PCAs. PSV, EDV, and RI of the PCAs and OA and RI of the CRA were significantly different between patients and controls, whereas there was no difference in the serum levels of glucose, triglyceride, low-density lipoprotein cholesterol, and total cholesterol. In the patient group, there was a significant correlation between orbital blood flow and duration of disease. CONCLUSION: Ocular blood flow appears to be slightly lower in RA patients than in healthy controls, suggesting that RA is a systemic inflammatory disease that may also involve ocular vessels.     

Hemodynamic evaluation of the female pelvic vessels using a high-frequency transvaginal image-directed Doppler system

Perfusion characteristics of the female pelvic vessels were studied by a high-frequency transvaginal image-directed Doppler system. A 5-MHz Doppler transducer was coupled to a 6.5-MHz probe especially designed for intravaginal use. Distinct patterns of flow velocity waveforms were obtained from the ascending branch of the uterine artery, before and during pregnancy. A gradual increase in diastolic flow throughout gestation was observed, consistent with a decrease in vessel resistance. Flow velocity profiles in the ovarian artery were sampled from the infundibulo-pelvic ligament. Only limited diastolic flow could be detected in either ovary during the follicular phase of the cycle. In the luteal phase there was a marked increase in this flow but only in the ovary containing the corpus luteum. In early pregnancy the high diastolic flow was maintained or even increased, consistent with a low arterial resistance. High image resolution and a higher frequency Doppler transducer increase the usefulness of this technique in the hemodynamic evaluation of the female pelvic vessels.     

α-Glucosidase inhibitors in diabetes: lessons from animal studies

Two rat models for non-insulin-dependent diabetes mellitus (NIDDM) have been used in our laboratory to study the effects of α-glucosidase inhibitors. These models become hyperglycaemic and have other characteristics which make them good models for NIDDM, and both prevention and reversal studies have been carried out; the prevention experiments were started before the animal became diabetic while the reversal groups were treated after diabetes had fully developed. In both models blood glucose was significantly lowered toward control levels using a dose of 40 mg per 100 g of diet while there was a less dramatic, but still significant, correction with half that dose. Treatment increased the weight gain of the more diabetic model (ZDF) while there was no effect of treatment on the weight of the Wistar diabetic fatty (WDF) rat. Other parameters such as glycated haemoglobins, nerve conduction velocity and nerve sugar content are also reversed with effective treatment of the hyperglycaemic condition.     

超声心动图观察雄激素替代治疗改善慢性心力衰竭雄性大鼠左室收缩功能

目的自身对照研究雄激素替代治疗前后大鼠的心功能状况.方法二维超声结合定量组织速度成像(QT-VI)技术检测四种不同处理(对照组、阿霉素组、睾丸切除 阿霉素组和睾丸切除 阿霉素 雄激素组)大鼠的心脏,测量常用心功能参数,脱机分析后室间隔和左室侧壁二尖瓣环处的速度曲线,记录收缩期峰值速度Vs.结果睾丸切除 阿霉素 雄激素组左室短轴缩短率和二尖瓣环平均峰值速度比睾丸切除 阿霉素组增高,差异有显著性意义.结论雄激素补充治疗能够改善激素水平低下的充血性心力衰竭大鼠的左室收缩功能.定量组织速度成像技术是评价大鼠心血管疾病模型心功能的一个新方法.     

定量组织速度成像技术评价急性心肌梗死后左室重构的左室功能

目的应用定量组织速度成像技术对心肌梗死后左室重构的左心功能进行评价,以探讨其应用价值.方法用定量组织速度成像技术测定22例健康者及临床确诊的29例心肌梗死后左室重构的冠心病患者的左室壁各节段的收缩期峰值速度(VS),舒张早期速度(VE),舒张晚期速度(VA)和VE/VA比值.测定二尖瓣口血流频谱的快速充盈速度(E),左房收缩充盈速度(A)和E/A值.容积法测左室射血分数,左室舒张末期容积指数(LVEDVI),左室收缩末期容积指数(LVESVI)及球形指数,并与正常组比较.结果心脏左室长轴方向上心梗组前壁,侧壁,下壁各节段,后间隔心尖段Vs明显下降(P＜0.01),后间隔基底段和中间段Vs无明显差异(P＞0.05);心梗组几乎各节段VE、VA、VE/VA与正常组相比有显著差异(P＜0.05).各节段平均VS与左室射血分数,球形指数等呈线性相关(r值分别为0.79,0.68,P＜0.01),舒张期功能参数平均VE/VA与二尖瓣E/A比值之间存在高度相关性(r=0.62,P＜0.01).心梗组LVEDVI和LVESVI明显增大(P＜0.01).结论定量组织速度成像可客观定位定量的反映心肌梗死局部心肌组织的收缩及舒张功能,又能体现心肌梗死后左室重构的整体功能,为心肌梗死后左室重构的心功能的评价提供了客观依据.     

彩色多普勒超声观测动脉滤器对猪颈动脉血流的影响

目的应用彩色多普勒超声观察动脉滤器对活体猪颈动脉血流的影响。方法选择7只中华小型猪，在猪右侧颈动脉内置入滤器，应用彩色多普勒超声在置入滤器前后分别测量颈动脉血流频谱并进行分析。结果动脉滤器置入前后颈动脉频谱形态相似，RI、PI升高，差异没有统计学意义（P值分别为0．334，0．425），平均血流速度降低40．3％（P=0．034）。1例滤器置入后远端血流频谱呈静脉样，造影可见血管完全阻塞，取出的动脉滤器内可见大量血栓。结论动脉滤器置入可引起颈动脉平均血流速度降低，彩色多普勒超声可以量化评价由滤器引起的颈动脉血流参数的变化，是目前监测实验动脉血流参数最佳方法。     

组织速度成像检测糖尿病患者早期心脏功能的改变

目的评价组织速度成像技术在检测糖尿病患者早期心脏功能改变的应用价值。方法选取无高血压、冠心病及其他心脏病变的糖尿病患者36例，健康人32例（正常对照组），比较两组间的常规超声指标EF值、E／A；组织速度指标VS、VE、VA以及VE／VA，分析EF与VS的相关性以及E／A与VE／VA的一致性。结果糖尿病组与健康组比较，EF值、VS、VA差别无显著性（P〈0．05），而糖尿病组VE绝对值、VE／VA较正常对照组显著降低（P〈0．05）。结论二尖瓣口血流E／A以及室间隔组织速度成像VE／VA可反映糖尿病患者早期心脏舒张功能的改变。