兔肝炎性假瘤的超声显像及其病理基础

目的探讨兔肝炎性假瘤声像图特征及其病理基础。 方法10只肝内接种炎性假瘤的实验兔,应用超声显像观察兔肝炎性假瘤的二维声像图特点、彩色多普勒血流显像,并与病理结果相对照。 结果15个炎性假瘤结节在B超上均表现为等回声或不均匀高回声区,边界尚清晰,其后方无明显增强或衰减表现,个别有弱声晕。彩色多普勒检查,9个结节周边可见点状血流信号,4个结节周围有较明显血流信号并测及静脉频谱,2个结节周边和内部均未见明显血流信号。这些表现均与其病理显示相吻合。 结论超声显像仅可作为肝炎性假瘤提示诊断的初步手段,确诊只能依靠病理检查。     

超声造影评价兔肝炎性假瘤及VX2肝癌血流灌注的实验对照研究

目的 应用实时超声造影成像技术及时间-强度曲线,观察兔肝炎性假瘤和转移性VX2肝癌的血流灌注方式.方法 荷炎性假瘤和荷VX2肝癌实验兔各10只,经耳缘静脉团注法注射超声造影剂SonoVue后,应用CnTI低机械指数实时灰阶成像技术和定量时间-强度曲线(Wash in-Wash out Curve)软件,观察分析各时相肿瘤结节及周围正常肝组织的动态增强过程.结果 与正常肝实质相比较,炎性假瘤造影增强与肝实质同步,二者造影始增时间、峰值时间、增强时间、始消时间无显著性差别(P>0.05).VX2肝癌强化呈典型的"快进快出"型,早期动脉相快速增强,门脉相与延迟相肿瘤结节内造影剂迅速廓清,表现为负性显影,VX2肝癌始增时间、峰值时间、增强时间、始消时间显著早于正常肝实质(P<0.05).VX2肝癌与炎性假瘤比较,VX2肝癌造影始增时间、峰值时间、始消时间显著早于炎性假瘤(P<0.05).结论 低机械指数实时超声造影成像,可提供肝脏局灶性结节的动态血流灌注信息,结合时间-强度曲线定量分析,对肝肿瘤的诊断和鉴别诊断具有较佳的实用价值.     

局限性胰腺炎的彩色多普勒超声诊断及误诊分析

目的：评价彩色多普勒超声对局限性胰腺炎和胰腺癌的鉴别诊断价值。方法：对8例经手术病理证实的局限性胰腺炎的超声声像图及其误诊原因进行回顾性分析。结果：局限性胰腺炎与胰腺癌在超声图像上有许多相似之处,如发病部位、病灶形态、内部回声、均质程度及邻近血管变化等,但局限性胰腺炎也有其特征性的声像图表现,如内部强回声斑块、胰管和胆总管的阻塞形态、彩色多普勒血流显像等方面与胰腺癌有明显差别。结论：彩色多普勒超声对局限性胰腺炎与胰腺癌有一定的鉴别诊断价值。     

乳腺良恶性肿瘤的超声诊断价值

目的探索乳腺良、恶性肿瘤的二维和彩色多普勒超声的特征性改变,提高乳腺肿瘤的超声诊断符合率。方法回顾总结125例经手术病理诊断证实的乳腺肿瘤患者的声像图特点。结果乳腺良性肿瘤形态规则,边界光滑、整齐,有完整包膜;乳腺恶性肿瘤形态不规则,边界呈毛刺状、蟹足样或锐角样改变,包膜不完整或无包膜,后方回声衰减,特别是病灶内微小钙化点与穿支血管的检出率分别为83%(50/60)和78%(47/60),明显高于良性肿瘤(P<0.01)。结论超声检查乳腺肿瘤方法简便、无创、重复性强,值得临床推广,可早期发现乳腺病变。     

超声斑点追踪技术对系统性红斑狼疮患者局部心肌收缩功能的评价

目的 应用超声斑点追踪技术(STI)评价系统性红斑狼疮(SLE)患者局部心肌收缩功能.方法 ①SLE组36例,健康对照组24名,分别记录并存储每位被检者心尖位左心室3个长轴切面高帧频二维动态图像,应用自动功能成像软件(AFI)检测左心室壁18节段收缩期峰值应变(S),记录并比较各参数测值.②在对照组中随机取20名被检者,双盲条件下,由同一观察者不同时间及2名观察者分别测量每位被检查者心肌收缩期峰值应变值,2组问计量资料比较采用非配对t检验,并利用Pearson相关分析法分析其相关性.结果 对照组左心室各壁S值自基底段向心尖段逐渐增加,心尖段与基底段、中间段差异有统计学意义(P＜0.05),不同室壁对应节段间差异无统计学意义(P＞0.05);同一室壁各节段心肌收缩期峰值应变达峰时间基本一致.SLE组除前间隔和前壁外各室壁S值自基底段向心尖段逐渐增加[(-18.7+4.2)%,(-16.3±9.4)%,(-18.1±10.5)%与(-19.0±9.0)%,(-18.6±7.9)%,(-17.7±1.4)%],心尖段与基底段、中间段差异均无统计学意义(P＞0.05);SLE组各室壁各节段S值明显低于对照组,差异均有统计学意义(P＜0.05);SLE组同一室壁各节段心肌收缩期峰值应变达峰时间一致性差.同一观察者不同时间及2名观察者问对心肌收缩期峰值应变值的测量相关性良好(P＜0.01).结论 STI技术发现SLE患者与健康对照组差异有统计学意义,SLE患者心肌损害表现为左室局部心肌收缩期峰值应变减低.

Abstract：

Objective To assess the vaIue of speckle tracking imaging (STI) in quantifying the regional myocardial strain in systemic lupus erythematosus (SLE) group.Methods ① Sixty subjects were divided into SLE group and normal group.High frame rate two-dimensional images were recorded from the apical two-chamber view,long-axis view and four-chamber view of the left ventricle (LV).Peak systolic strain of each view of 18 segments were measured by automated functional imaging (AFI) software of 2-DSE.All parameters were compared between the two groups.② Twenty cases were randomly taken from the normal group.The same observer at different times and two observers measure the strain of left ventricular respectively.The results of the measurement between the two groups were compared with unpaired t test and its relevance was analyzed using Pearson's correlation analysis.ResultsLeft ventricular two-dimensional longitudinal strain gradually increased from the base to apex in the normal group.There were statistically differences between the apical segments and the basal,middle segments of every left ventricular wall (P＜0.05).The same wall segment time to peak myocardial systolic peak strain was consistent.Left ventricular two-dimensional longitudinal strain gradually increased from the base to apex in the SLE group,except for the anterio-septal and anterior wall [ (-18.7±4.2)％,(-16.3±9.4)％,(-18.1±10.5)％ vs (-19.0±9.0)％,(-18.6±7.9)％,(-17.7±1.4)％ ].There was no statistically significant difference between the apical segments and the basal,middle segments of every left ventricular wall(P＞0.05).All parameters of S were significantly higher in the normal group than those of the SLE group.The difference was statistically signoficant (P＜0.05).The time to peak systolic peak strain of every segments was not consistent.The results from the same observer at different times and peak systolic myocardial strain measurements by the two observers were correlated well(P＜0.01).Conclusion The myocardial function assessment by STI technology in the SLE patients is significantly different from that of the normal control:SLE patients with left ventricular myocardial damage can be manifested as reduced regional myocardial systolic peak strain.     

“三切面法”筛查胎儿心脏畸形的价值分析

目的探讨胎儿心脏四腔心切面加左右心室流出道切面(三切面)在产前筛查胎儿先天性心脏病的临床应用价值。方法对150例高危孕妇行胎儿心脏三切面的扫查,对异常者行详细的胎儿超声心动图检查,并与产后尸解或产后超声心动图的检查结果进行比较。结果心脏四腔切面与左右心室流出道切面检出异常12例,尸解证实7例,产后超声心动图证实5例。结论胎儿心脏四腔切面及左右心室流出道切面探测方法简单,易于掌握,对产前筛查胎儿心脏病具有重要的临床应用价值。     

超声造影在膀胱占位性病变诊断中的应用

目的:探讨超声造影在膀胱占位性病变诊断中的临床应用价值.方法:对25例膀胱占位性病变行实时超声造影, 观察并分析病灶的超声造影表现,总结超声造影灌注时相的动态变化规律,并与病理结果相对照.结果:超声造影提示膀胱恶性肿瘤17例(26个病灶),经手术病理证实膀胱移行细胞癌18例.超声造影诊断膀胱癌的敏感性为94.4%(17/18),特异性为100%(7/7),准确性为96.0%(24/25).结论:超声造影能够实时观察膀胱占位性病变的血流灌注情况,对占位性病变的诊断和鉴别诊断具有较高的临床应用价值.     

经颅多普勒超声与磁共振血管造影比较评估大脑中动脉狭窄分界的最佳诊断值研究

随着经颅多普勒超声(TCD)在临床的广泛应用[1]和深入实践,它已被确认为一种诊断颅内外血管和闭塞疾病的有效检测技术。但由于缺乏统一量化的TCD诊断标准,而影响了其诊断的准确性和一致性,很大程度上影响了科研和交流。本研究利用TCD和磁共振血管造影(MRA),通过无创性地探查颅内     

运用彩色多普勒超声监测经颈静脉肝内门体分流术

运用彩色多普勒超声监测经颈静脉肝内门体分流术山西医学院第二附属医院（０３０００１）雷成功，李慧敏经颈静脉肝内门一体静脉支撑架分流术（Ｔｒａｎ－ｓｊｕｇｕｌａｒＩｎｔｒａｈｅｐａｔｉｃＰｏｔｏｓｙｓｔｅｍｉｃＳｔｅｎｔＳｈｕｎｔＴＩＰＳＳ）是近几年来应...     

Ⅱ型糖尿病患者肾内动脉血流变化与肾功能之间关系的探讨

Ⅱ型糖尿病患者肾内动脉血流变化与肾功能之间关系的探讨山西医学院第二附属医院李慧敏，雷成功，刘望彭邮政编码０３０００１糖尿病（ＤＭ）是一种常见病，肾脏极易受累并最终发展为糖尿病肾病（ＤＮ）。本文应用ＣＤＦＩ超声技术检测ＤＭ－Ⅱ型患者５８例及４０名同年龄...