应变弹性成像在甲状腺结节良恶性鉴别中的应用价值分析

目的：评估应变弹性成像技术在甲状腺结节良恶性鉴别诊断中的应用价值。方法：对收入我院进行检查的31例患者31个甲状腺结节进行常规超声及弹性成像检查,分析弹性评分法及SR比值法对甲状腺良恶性结节的检出率情况,并分别计算三种方法在甲状腺良恶性结节鉴别诊断中的灵敏度、特异度、阳性预测值、阴性预测值。结果：31个甲状腺结节,经病理检查良性结节15个,恶性结节16个。弹性评分法及SR比值法阳性检出率均高于常规超声;弹性评分法及SR比值法的灵敏度、特异度、阳性预测值、阴性预测值均高于常规超声。结论：弹性成像技术有助于鉴别诊断甲状腺结节的良恶性。     

探讨健康体检中超声弹性成像应变比值鉴别甲状腺结节良恶性的价值

目的：探索超声弹性成像应变比值（SR）与常规超声在健康体检中鉴别甲状腺（ACR TI-RADS 4类及以上）结节良恶性的价值。方法：回顾性分析2020年1月1日—2022年12月31日本院健康体检的甲状腺结节（ACR TI-RADS 4类及以上）患者,针对经术后或穿刺病理证实的79个甲状腺结节同时进行常规超声检查（拟定ACR TI-RADS评分5分及以上考虑恶性）和超声弹性成像SR检查,阈值为2.73,以病理结果为金标准,构建受试者工作特征ROC曲线,分析曲线下面积（AUC）,评价两种方法在健康体检中鉴别诊断甲状腺结节良恶性的价值。结果：经病理证实79个结节（恶性52个,良性27个）。超声弹性成像SR和常规超声鉴别诊断甲状腺（ACR TI-RADS 4类及以上）结节良恶性的灵敏度、特异度、准确性、阳性预测值、阴性预测值分别为：92.31%、88.89%、91.14%、94.12%、85.71%;67.30%、62.96%、65.82%、77.78%、50.0%。超声弹性成像SR组和常规超声组曲线下AUC分别为0.906和0.651,两种方法测值比较,差异具有统计学意义（P<0.0...     

经直肠超声联合成像技术在前列腺良恶性结节诊断中的价值

目的探讨经直肠超声联合成像技术在诊断前列腺良恶性结节中的价值。方法选择临床资料完整的疑似前列腺癌患者170例,穿刺前均行经直肠超声检查(TRUS),以病理结果为金标准,比较经直肠能量多普勒超声(PDI)、经直肠实时组织弹性成像(TRTE)及PDI联合TRTE对前列腺结节良恶性诊断的准确度、特异性、敏感性、阳性预测值、阴性预测值。结果PDI对前列腺癌诊断的敏感度、特异度、阳性预测值、阴性预测值及准确度分别为72.9%、74.3%、78.7%、67.9%和73.5%,TRTE分别为73.9%、78.4%、81.6%、69.9%和75.9%,差异无统计学意义(P0.05);PDI联合TRTE可显著提高对前列腺结节诊断的敏感度(94.8%)、阴性预测值(90.9%)及准确度(82.9%)(P0.05)。结论经直肠PDI和TRTE均可作为判断前列腺结节良恶性的单独指标,二者结合判断可以提高敏感度、阴性预测值及准确度。     

声触诊组织成像与定量技术及实时弹性成像技术在甲状腺影像报告与数据系统4类结节的应用价值

目的比较声触诊组织成像与定量技术及实时弹性成像（VTIQ）技术在甲状腺影像报告与数据系统（TI-RADS）4类结节良恶性鉴别诊断中的应用价值。 方法选取2015年11月至2016年3月在浙江大学附属第一医院与浙江金华市中心医院就诊的110例患者（共117个结节）,常规超声检查为TI-RADS 4类甲状腺结节的实时弹性技术成像与声触诊组织成像与定量及VTIQ技术图像特征,实时弹性技术采用测定结节的应变比值（SR）评估结节硬度,VTIQ技术采用测定结节的剪切波速度（SWV）评估结节硬度。以术后病理结果为"金标准",分别计算2种方法单独以及联合应用的敏感度、特异度、准确性、阳性预测值、阴性预测值并绘制受试者工作特征（ROC）曲线,获得曲线下面积（AUC）及最佳临界值。 结果117个甲状腺结节中良性结节43个,恶性结节74个。声触诊组织成像与定量、实时弹性成像技术单独以及联合应用诊断甲状腺癌的敏感度、特异度、准确度、阳性预测值、阴性预测值、ROC曲线下面积分别为80.3% vs 86.7% vs 83.7%,72.5% vs 82.3% vs 84.2%,76.1% vs 84.6% vs 87.5%,73.3% vs 83.4% vs 84.5%,79.7% vs 85.5% vs 88.7%,0.786 vs 0.869 vs 0.881;根据ROC曲线SR的最佳诊断界值为3.3,VTIQ的最佳诊断界值为3.03 m/s。声触诊组织成像与定量与实时弹性成像方法单独以及两者联合应用不同组间曲线面积比较,差异均无统计学意义（Z=1.95、1.83、1.03,P值均>0.05）。 结论声触诊组织成像与定量及VTIQ技术单独或联合应用对诊断甲状腺TI-RADS 4类结节的良恶性均有一定价值,3种方式的诊断价值相当。     

超声弹性成像与常规超声诊断甲状腺良恶性结节的效果观察及敏感性影响评价

目的:探讨超声弹性成像与常规超声诊断甲状腺良恶性结节的效果观察及敏感性影响。方法:选取本院2017年12月至2018年12月收治的140例甲状腺结节患者(175个结节)作为研究样本,其中恶性结节74个,良性占位101个,均接受常规超声诊断(常规超声组)与超声弹性成像技术诊断(超声弹性成像组),比较两组患者的良恶性结节诊断结果、诊断符合率、灵敏度、特异度、阳性预测值、阴性预测值等。结果:超声弹性成像组的诊断符合率89.71%高于常规超声组的66.29%、灵敏度87.19%高于常规超声组的58.12%,特异度90.10%高于常规超声组的72.28%,阳性预测值86.84%高于常规超声组的60.56%、阴性预测值91.92%高于常规超声组的70.19%,组间差异有统计学意义(P<0.05)。结论:甲状腺良恶性结节应用超声弹性成像诊断较常规超声诊断准确性相对更高,且具有较高的灵敏度和特异度,值得推广与应用。     

常规超声与超声弹性成像对乳腺实性结节的诊断价值分析

目的分析常规超声与超声弹性成像对乳腺实性结节的诊断价值。方法选取2015年12月~2017年2月我院收治的乳腺实性结节患者93例。所有患者均进行常规超声(常规超声组)与超声弹性成像(超声弹性成像组),将常规超声联合超声弹性成像作为观察组,并以实性结节切除术后病理诊断为参考标准,将其作为对照组。观察并比较敏感度、特异度、准确度、阳性及阴性预测值。结果常规超声组敏感度、特异度、准确度、阳性及阴性预测值与超声弹性成像组比较,差异无统计学意义(P0.05);观察组敏感度为93.41%,与常规超声组的79.57%、超声弹性成像组的78.49%比较,差异有统计学意义(P0.05)。结论在乳腺实性结节的诊断过程中,常规超声与超声弹性成像均有一定的诊断价值,两者联合应用能够更好地提高该疾病诊断的敏感性。     

桥本甲状腺炎背景下甲状腺结节的超声弹性成像分析

目的探究应用超声弹性成像技术评价桥本病(HT)背景下甲状腺结节良恶性诊断效果。方法回顾性分析我院收治的46例桥本病患者,共54个甲状腺结节常规超声及超声弹性评分结果,并对其应用甲状腺次全切除术或甲状腺全切术。比较常规超声和超声弹性成像技术对其良恶性诊断价值的差异。结果术后病理显示,46例患者共有54个病灶,其中恶性结节33个,平均直径为(1.59±0.94)cm;良性结节21个,平均直径为(1.68±0.63)cm,良恶性结节直径比较,差异无统计学意义(P0.05)。33个恶性结节中,常规超声诊断恶性27个,良性6个;超声弹性成像诊断恶性32个,良性1个。21个良性结节中,常规超声诊断恶性4个,良性17个;超声弹性成像诊断恶性3个,良性18个。常规超声灵敏度为81.82%、特异度为80.95%、阳性预测值87.10%、阴性预测值73.91%、符合率为81.48%。超声弹性成像灵敏度为96.97%、特异度为85.71%、阳性预测值为91.43%、阴性预测值为94.74%、符合率为92.59%。超声弹性成像的灵敏度、阴性预测值均显著高于常规超声,且差异具有统计学意义(P0.05),而两者的特异度和阳性预测值则无显著差异(P0.05)。结论 HT背景下甲状腺结节的诊断应用超声弹性成像具有较高的灵敏度,但特异度无显著优势,需临床上结合二维超声共同进行诊断。     

超声结合弹性成像在鉴别非哺乳期乳腺良恶性病变的价值分析

目的对比超声结合弹性成像与常规超声、超声弹性成像评分(UE)的诊断差异,寻找更灵敏的鉴别非哺乳期乳腺良恶性病变的检测方法。方法选择接受治疗的264例非哺乳期患者(312个乳腺病灶,恶性97个,良性215个)进行常规超声和UE检测,检测结果与组织病理学检测结果比较,对比三种方法的准确度、灵敏度以及特异度。结果超声诊断检测结果良性病灶166个,检测正确149个,恶性病灶146个,检测正确80个,准确度、灵敏度、特异度、阳性预测值和阴性预测值分别为73.39%、82.47%、69.30%、54.79%、89.76%;超声弹性成像评分结果为≤3分(良性)189个,检测正确176个,≥4分(恶性)123个,检测正确83个,准确度、灵敏度、特异度、阳性预测值和阴性预测值分别为83.01%、83.51%、81.86%、65.85%、93.12%;超声结合弹性成像结果为良性病灶207个,检测正确197个,恶性病灶105个,检测正确90个,准确度、灵敏度、特异度、阳性预测值和阴性预测值分别为93.35%、92.78%、91.63%、85.71%、95.17%。三组准确度、特异度比较差异有统计学意义(P0.05),常规超声与弹性成像的灵敏度、阳性预测值和阴性预测值比较差异未见统计学意义(P0.05),而与超声合并弹性成像组比较差异有统计学意义(P0.05)。结论超声结合弹性成像在诊断非哺乳期乳腺良恶性病变时,灵敏度高,特异度好,具有重要临床检测价值,值得推广。     

UE技术联合常规超声检查在桥本甲状腺炎背景下甲状腺结节定性诊断中的应用价值

目的：探讨超声弹性成像（UE）技术联合常规超声检查在桥本甲状腺炎（HT）背景下甲状腺结节（TN）定性诊断中的应用价值。方法：选取2018年5月~2020年5月收治的HT背景下TN患者73例，TN 92个，患者均行常规超声、UE技术及病理检查，以病理检查为“金标准”，比较常规超声、UE技术及常规超声+UE技术检查诊断HT背景下TN良恶性准确度、灵敏度、特异度、阳性预测值及阴性预测值。结果：常规超声+UE技术检查的准确度92.39%、灵敏度96.49%、阴性预测值93.75%均高于常规超声检查的73.91%、64.91%、60.78%和UE技术检查的76.09%、66.67%、62.75%（P＜0.05）；常规超声+UE技术检查HT背景下TN良恶性特异度85.71%、阳性预测值91.67%与常规超声检查88.57%、90.24%和UE技术检查91.43%、92.68%比较，差异无统计学意义（P＞0.05）。结论：常规超声联合UE技术检查对HT背景下TN良恶性具有一定诊断价值，可为临床提供有效筛查方法。     

超声弹性成像对腱鞘巨细胞瘤的辅助诊断价值

目的探讨超声弹性成像技术对腱鞘巨细胞瘤的辅助诊断价值。方法选择因手部肿物于我科检查的102例患者。全部病例均经病理证实。采用弹性成像技术测量弹性适配器与手部肿物的应变比值(SR),应用受试者工作特性曲线评价超声弹性成像对腱鞘巨细胞瘤的诊断价值。结果 (1)传统二维超声诊断腱鞘巨细胞瘤的灵敏度、特异度、准确性、阳性预测值及阴性预测值分别为82.2%、68.4%、74.5%、67.3%、83.0%。(2)应用ROC曲线评价SR诊断腱鞘巨细胞瘤的曲线下面积为0.928,取SR诊断阈值为10.15。(3)利用常规二维超声与超声弹性成像进行联合诊断腱鞘巨细胞瘤时,诊断的灵敏度、特异度、准确性、阳性预测值及阴性预测值分别为91.1%、93.0%、92.2%、91.1%、93.0%。结论超声弹性参数SR对腱鞘巨细胞的诊断有较好的应用价值,常规二维超声与超声弹性成像联合诊断可显著提高诊断效能。     

Ultrasound: State of the art

Ultrasound has become an accepted diagnostic modality since the late 1950s. Since its introduction as a soft-tissue imaging method, ultrasound has broadened and assumed many research and clinical roles in medicine. Yet, despite the growing enthusiasm for ultrasound, there has been little written about its growth that brings together the latest areas of clinical utilization and research. To gather this data, we personally researched 32 leading medical centers in the United States. This paper shows where ultrasound stands now and where it is likely to go in the near future.     

超声波与声学造影剂在溶栓中的作用

血栓形成是导致心肌梗塞、缺血性卒中等疾病和死亡的重要原因。超声波和声学造影剂（微泡）可通过空化效应、机械作用等多种生物学效应直接溶栓和增强溶栓药物作用。在微泡的介导下,其潜在的携药载体作用和靶向结合能力为进一步提高溶栓效率提供了可能,该方法有着广阔的临床应用前景。     

Bedside US imaging in multiple trauma patients. Part 1: US findings and techniques

Objectives

The aim of this review article is to present the current views and visions of the role of ultrasound (US) in the management of patients with multiple trauma. The article is divided into two parts. Part 1 (US findings and techniques) will mainly deal with the technical aspects of US imaging in trauma patients and is written also for educational purposes. Part 2 (pathophysiology and US imaging in trauma patients) will deal with integration of US in the clinical and pathophysiological management of multiple trauma patients.

Methods

A non-systematic review of the literature through PubMed search (restricted to the last 10 years) of original articles and review articles.

Results

80 publications were selected for Part 1. Of these 80 articles, the author selected 50 according to personal criteria on the basis of their innovative or original contents (48 original articles and 2 literature review articles); 19 articles were furthermore extracted from the references of the selected publications. The information extracted from these 69 publications was organized into sections dealing with different fields of applications of US imaging in multiple trauma patients.

Conclusions

US imaging in trauma has evolved from the initial use, i.e., early diagnosis of peritoneal effusion (focused abdominal sonography for trauma), to a wider use known as resuscitative ultrasonography, and is today considered as an extension of physical examination to implement a more effective approach to clinical problems and increase the timeliness and safety of interventions.     

Ultrasound evaluation of the posthysterectomy pelvis

Ultrasound findings in pelvic examinations of 80 patients with a previous hysterectomy are evaluated. Ovaries were located low in the pelvis close to the superior end of the vagina in a large number of patients. An enlarged ovary contiguous with the superior end of the vagina may simulate the appearance of the uterus. Occasionally, the superior end of the vagina or cervical remnant (in patients with a supracervical hysterectomy) may be prominent and should not be mistaken for a pathologic mass.     

Sonographic examination of the adult brain

Phased-array real-time transcranial ultrasound with a 2.5-MHz transducer was used to examine 23 normal adult volunteers and patients, and 8 selected patients with abnormalities proven by computed tomography. Normal cerebral landmarks were consistently seen and pulsed Doppler signals were often obtainable from central cerebral arteries. Dilated lateral ventricles, subdural hygromas, or cerebral masses were identified in 6 of the 8 patients. In the 2 others abnormal cases, known suprasellar aneurysms were missed. While current technology will not provide accurate screening for cerebral abnormalities, ultrasound imaging may often be adequate for follow-up examinations and for midline evaluation, and may provide simplified preoperative localization of some brain lesions. Doppler ultrasound examinations may be used for intracranial vessel hemodynamic evaluation.     

Echogenic forms of hydatid cysts: sonographic diagnosis

Of 167 patients with abdominal hydatidosis, 29 showed a total of 36 hydatid cysts in which ultrasound demonstrated an overall echogenic appearance. The following ultrasound characteristics of an abdominal mass suggest the diagnosis of hydatid cyst: round or oval shape, well-defined borders, partial wall calcification, peripheral cystic structures, internal echogenic linear formations, snow storm and/or hyperechogenic internal echo pattern, and posterior acoustic enhancement. A comparative study with computed tomography has also been carried out in 10 of these cysts. Pathologic correlation in most cases allows us to postulate that this appearance represents an overly mature, probably ruptured, hydatid cyst.     

Ultrasound breast imaging—the method of choice for examining the young patient

It is shown in this paper that relatively simple ultrasound techniques, in combination with specific scanning protocols, can provide a more accurate diagnosis for pathologies in the breast of young subjects than does X-ray mammography. Static, B-mode ultrasound instrumentation with close-interval scanning and transducers designed for the specific examination regime, was used to examine 116 symptomatic breast patients under 30 yr of age. Approximately 50% of the patients were diagnosed by ultrasound as fibroadenoma cases; biopsy of 22% of these cases indicated 100% diagnostic accuracy for the ultrasound technique. Thirty-one percent of the cases diagnosed as fibroadenoma by ultrasound were also examined by X-ray mammography; in 80% of these cases, X-ray mammography did not adequately image the mass.     

A preliminary analysis of the ultrasound imaging characteristics of malignant breast masses as compared with X-ray mammographic appearances and the gross and microscopic pathology

Thirty correctly diagnosed carcinomas were chosen for retrospective analysis of their ultrasound and X-ray imaging characteristics, and correlated with pathologic examination. It was determined that the ultrasound image correlated well with that revealed by radiographic techniques. The posterior attenuation shadow and the jagged wall were the prime indicators of malignancy in this study, occurring in 90 and 87% of the cases, respectively. However, in about 67% of these masses, attenuation shadowing was revealed only by close-interval (1 mm) stepwise scanning. A non-homogeneous internal echo pattern was found in 73% of the cases. Thirteen of the 30 masses showed disturbed architecture away from the overt lesion when imaged by ultrasound techniques. Seventy per cent of these showed histological abnormalities in remote regions. Finally, it was shown that the attenuation shadowing exhibited by malignant breast masses is related to the collagen content of the lesion, expressed as fibrosis.     

Evaluation of a point of care ultrasound curriculum for Indonesian physicians taught by first-year medical students

BACKGROUND: The purpose of this study was to assess the short-term efficacy of a 4-week ultrasound curriculum taught by American first-year medical students to general practitioners working in public health care clinics, or puskesmas, in Bandung, Indonesia.