容积造影成像C平面对纵隔子宫畸形的诊断价值

纵隔子宫畸形是引起不孕、习惯性流产及早产的常见原因.二维超声因不能显示子宫冠状面常造成误诊.容积造影成像C平面(volume contrast imaging c plane,VCI-C)可弥补二维超声的不足,本研究将其应用于纵隔子宫的诊断,并分析VCI-C对纵隔子宫的临床价值.     

经阴道实时三维超声VCI-C成像对先天性子宫畸形的诊断价值

目的 评价经阴道实时三维超声VCI-C成像对子宫畸形的诊断价值.方法 对26例可疑先天性子宫畸形的患者分别行经阴道二维及实时三维超声扫查,并与宫腔镜和/或腹腔镜、子宫输卵管碘油造影、手术等结果进行对照.结果 26例患者中,双子宫4例,双角子宫6例,完全纵隔子宫3例,不全纵隔子宫10例,单角子宫3例.结论 经阴道实时三维超声VCI-C成像可直观、准确地显示子宫冠状面及宫腔内膜形态,是一种较便捷诊断子宫畸形的方法.     

三维超声容积对比成像-C平面对纵隔子宫诊断的价值研究

目的探讨三维超声容积对比成像联合C平面技术(VIC-C)对纵膈子宫的诊断价值。方法回顾性分析2017年3月-2018年6月在我院经检查提示或临床可疑纵膈子宫畸形的患者84例,均行二维超声及三维超声VIC-C扫查,对比两种检查方法与宫腔镜、输卵管造影或手术结果(金标准)进行对比。结果 84例患者均获取满意二维及三维超声图像,三维超声VCI-C诊断与金标准完全相符,诊断准确度为100%,对各型子宫畸形诊断敏感性、特异性均为100%。二维超声无法诊断出弓形子宫与双角子宫,对完全纵膈、不典型完全纵膈、不完全纵膈诊断的敏感性、特异性分别为100%和93.33%、66.67%和100%、100%和72.73%。结论三维超声VCI-C技术能够获取清晰子宫冠状面图像,对纵膈子宫诊断有重要价值。     

三维超声成像对先天性子宫畸形的诊断价值

目的 探讨三维超声成像对先天性子宫畸形的诊断价值.方法 对50例疑为先天性子宫畸形患者行二维超声和三维超声检查,结果进行对比分析.结果50例患者中,双子宫6例,不完全型纵隔子宫20例,完全型纵隔子宫8例,双角子宫10例,弓形子宫4例,单角子宫2例,三维超声诊断准确率为100％,二维超声诊断准确率为84％.双子宫三维超声表现为2个独立子宫;纵隔子宫宫底外形基本正常,不完全型纵隔子宫者内膜呈“Y”形,完全型纵隔子宫者内膜呈“V”形;双角子宫宫底中央凹陷,内膜呈“Y”形,但夹角较大;弓形子宫外形正常,宫底部内膜轻微内凹;单角子宫外形呈梭形,内膜呈单角状.结论三维超声冠状面成像能直观、清晰显示子宫宫腔形态结构及宫底外观轮廓,在对先天性子宫畸形的诊断中明显优于二维超声,是一种简便、易行、准确的子宫畸形的诊断方法.     

经阴道三维超声诊断子宫畸形的临床价值

目的探讨应用经阴道三维超声成像诊断子宫畸形的临床价值。方法收集我院经宫腔镜或/和腹腔镜确诊的子宫畸形患者56例,回顾性分析其术前经阴道二维超声及三维超声特点,比较经阴道二维超声和三维超声对子宫畸形的诊断价值。结果术前经阴道二维超声诊断子宫畸形43例,诊断准确率76.8%(43/56);经阴道三维超声成像诊断子宫畸形51例,诊断准确率91.1%(51/56),二者比较差异有统计学意义(P=0.040)。结论经阴道三维超声的容积后处理模式可多角度观察子宫轮廓及内部结构,特别是子宫底部及内膜情况,可在术前辅助诊断子宫畸形,为临床手术提供更多参考信息。     

经阴道三维容积超声成像在纵隔子宫诊断中的价值

目的探讨经阴道二维及三维容积超声成像对单纯性和非单纯性纵隔子宫诊断的价值。方法对32例经宫腔镜与腹腔镜联合检查(31例)或全子宫切除术(5例)后确诊的单纯性和非单纯性纵隔子宫患者﹙合并子宫肿瘤和宫内早孕,宫内有节育器)的经阴道二维及三维容积超声图像进行分析比较。结果宫腔镜与腹腔镜联合检查及全子宫切除术后病理诊断证实的32例纵隔子宫患者中,术前超声检出单纯性纵隔子宫21例(不全纵隔子宫17例,完全纵隔子宫4例);非单纯性纵隔子宫11例(完全纵隔子宫1例,不全纵隔子宫10例;7例合并子宫肌瘤,1例宫内早孕,4例放置宫内节育器)。其中经阴道二维超声诊断单纯性纵隔子宫15例(15/21),非单纯性纵膈子宫4例(4/11);经阴道三维容积超声诊断单纯性纵膈子宫21例(21/21),非单纯性纵隔子宫10例(10/11)。结论经阴道二维超声不能显示子宫外部轮廓,而经阴道三维容积超声冠状面可清晰显示其轮廓,并可显示膈膜的长度和宫底部隔膜中心点的角度;对正确诊断纵隔子宫及显示异常子宫形态方面均优于经阴道二维超声,可作为纵隔子宫诊断首选的检查方法。     

经阴道二维超声与三维超声诊断与鉴别诊断纵隔子宫的对比研究

目的 探讨经阴道二维超声与三维超声诊断与鉴别诊断纵隔子宫的价值.方法 回顾性分析62例经手术、宫腔镜、碘油造影证实的纵隔子宫的二维、三维超声图像并对其诊断符合率进行对比分析.结果 经阴道三维超声诊断纵隔子宫符合率98.4％ (61/62),经阴道二维超声诊断纵隔子宫符合率85.5％ (53/62).结论 经阴道三维超声冠状切面成像,可以清晰显示宫腔内膜形态,可以得到纵隔子宫畸形的准确信息,对于临床少见复杂的、疑难的子宫纵隔能够准确诊断,可为临床选择处理方式提供有价值的信息,经阴道三维超声较二维超声有无可比拟的优越性及显著的临床意义.     

不全纵隔子宫和弓形子宫三维超声成像及妊娠结局的追踪分析

目的探讨三维超声诊断不全纵隔子宫和弓形子宫的特点,以及畸形子宫对妊娠结局的影响。方法经宫腔镜证实的72例不全纵隔子宫和43例弓形子宫患者,分析其二维及三维超声特点,同时追踪分析妊娠结局。结果不全纵隔子宫二维和三维超声诊断符合率分别为86.1%(62/72)和97.2%(70/72),后者高于前者(P<0.05)。弓形子宫二维和三维超声诊断符合率分别为79.1%(34/43)和97.6%(42/43),后者高于前者(P<0.05)。不全纵隔子宫患者123次妊娠,弓形子宫患者64次妊娠,不全纵隔子宫患者自然流产率高于弓形子宫患者,足月分娩率低于弓形子宫患者(P<0.05)。结论三维超声可清晰显示子宫腔结构和外观形态,准确测量不全纵隔子宫和弓形子宫内膜中央部下陷深度及内膜夹角,较二维超声更具优势;明确诊断畸形子宫对不孕和早期妊娠流产的预测意义较大。     

超声不同成像方法诊断子宫畸形的比较研究

目的探讨二维超声与三维超声（Render模式与Omni view模式）两种成像模式诊断子宫畸形的准确性,筛选出更适用于临床诊断的超声检查方法与成像模式。 方法对2011年9月至2013年1月复旦大学附属妇产科医院临床检查拟诊为子宫畸形的159例患者行二维及三维超声检查,在Render及Omniview两种成像模式下分别对患者子宫三维容积图像进行子宫冠状面的重建,并作出定性和分型诊断。与宫腔（腹腔）镜、磁共振成像或子宫输卵管造影检查结果对照,对子宫畸形患者二维及三维超声（Render模式与Omni view模式）诊断准确性进行分析比较。 结果与宫腔（腹腔）镜、磁共振成像或子宫输卵管造影检查结果对照,三维超声Render模式（78.6%,125/159）和Omni view成像模式（81.8%,130/159）诊断子宫畸形的符合率均高于二维超声（52.8%,84/159）,差异均有统计学意义（Render模式：χ²=23.465,P<0.01;Omni view模式：χ²=30.234,P<0.01）。 结论三维超声两种成像模式对子宫畸形的诊断准确率均高于二维超声,两种成像模式均可用于子宫畸形的诊断。     

阴道三维超声成像对子宫畸形的诊断分析

目的:探究阴道三维超声成像对子宫畸形的诊断效果。方法:选取2015年1月至2018年3月在我院进行治疗的56例先天性子宫畸形患者,分别对其进行阴道二维超声检查及阴道三维超声成像检查,比较其诊断准确率。结果:三维超声诊断对56例患者诊断率准确率为98.21%,误诊率为1.79%,漏诊率为0.00%,均显著优于二维超声诊断结果(P0.05),且三维超声诊断患者平均用时为(15.92±2.06)min,二维超声诊断患者平均用时为(23.61±3.42)min,两组间差异显著(P0.05)。结论:采用阴道三维超声成像技术能够较为准确的对子宫进行进行诊断,对该类患者的早发现、早诊断及早治疗具有重要意义。     

容积对比超声造影成像对兔闭合性肾外伤的初步研究

目的 初步探索容积对比超声造影(VCI-CEUS)成像对诊断闭合性肾外伤(BRT)的价值.方法 健康新西兰兔9只,雄性4只,雌性5只,随机平均分为3组.采用SMS型撞击器3种不同撞击力度,建立BRT动物模型.撞击前及撞击后10 min内,分别依次完成灰阶超声、彩色多普勒(CDFI)和实时三维超声造影(又称四维超声造影,4D-CEUS)采集原始数据,存于仪器硬盘.采用VCI软件处理相关图像.检查结束后,处死实验动物,通过大体病理验证检查结果.结果 9只兔均发生损伤,撞击力度越大,损伤级别越高.CEUS显示损伤病灶表现为充盈缺损.VCI-CEUS显示病灶在不同观察面、层厚及深浅,病灶图像各异:A平面多表现为以肾门向外的放射性扇形;B平面主要表现为楔形;C平面多表现为锯齿状.层厚薄,图像光点较粗,适合于显示小病灶,层厚较厚,图像细腻、整体感好,适合于较大范围病灶.通过调节深浅,可以表现不同病灶不同深度的分布范围和形态.不同的层厚,图像表现也有差别;VCI-CEUS结果和病理检查一致性好.结论 VCI-CEUS可以从不同角度和深度观察BRT损伤病灶分布的范围及形态,而且通过调节层厚,可以提高图像质量,其检查结果与大体病理具有较高的一致性.     

Fast,Low-Frequency Plane-Wave Imaging for Ultrasound Contrast Imaging

Plane-wave ultrasound contrast imaging offers a faster, less destructive means for imaging microbubbles compared with traditional ultrasound imaging. Even though many of the most acoustically responsive microbubbles have resonant frequencies in the lower-megahertz range, higher frequencies (>3 MHz) have typically been employed to achieve high spatial resolution. In this work we implement and optimize low-frequency (1.5-4 MHz) plane-wave pulse inversion imaging on a commercial, phased-array imaging transducer in vitro and illustrate its use in vivo by imaging a mouse xenograft model. We found that the 1.8-MHz contrast signal was about four times that acquired at 3.1 MHz on matched probes and nine times greater than echoes received on a higher-frequency probe. Low-frequency imaging was also much more resilient to motion. In vivo, we could identify sub-millimeter vasculature inside a xenograft tumor model and easily assess microbubble half-life. Our results indicate that low-frequency imaging can provide better signal-to-noise because it generates stronger non-linear responses. Combined with high-speed plane-wave imaging, this method could open the door to super-resolution imaging at depth, while high power pulses could be used for image-guided therapeutics.     

VCI-C平面及三维超声重建对胎儿显性脊柱裂诊断价值的探讨

目的 探讨容积对比成像(Volume Contrast Imaging，VCI)-C平面及三维超声重建对胎儿显性脊柱裂的临床应用价值。方法对6例患显性脊柱裂的胎儿进行二维超声普通切面、VCI-C平面及三维超声重建，并对相关图像进行了分析。结果 本组6例胎儿显性脊柱裂二维超声普通切面声像图特征明显，定性诊断率高．达100％，但其声像图由于本身的技术特点而存在一定的不足，如图像空间立体感不强，逼真度差；VCI-C平面能显示与普通二维超声声束相垂直的声像图特征，其显像深度可在一定范围内任意调节，能从另一视角观察胎儿显性脊柱裂的声像图表现，声像图较逼真；三维超声重建在对胎儿显性脊柱裂的应用中优点为图像形象逼真，空间立体感强，缺点在于受二维超声声像图质量等多因素影响大；VCI-C平面超声成像结合三维超声重建信息量大，可以进行任意角度的图像后处理，获得了大量的超声信息。结论 VCI-C平面超声成像能在普通二维图像的基础上从另一视角观察胎儿显性脊柱裂的声像图，且图像形象逼真，空间立体感强，VCI-C平面超声成像与三维超声重建能在普通二维超声诊断胎儿显性脊柱裂的基础上提供更多的诊断信息。     

Ultrafast Imaging of Ultrasound Contrast Agents

The disappearance of ultrasound contrast agents after disruption can provide useful information on their environment. However, in vivo acoustical imaging of this transient phenomenon, which has a duration on the order of milliseconds, requires high frame rates that are unattainable by conventional ultrasound scanners. In this article, ultrafast imaging is applied to microbubble tracking using a 128-element linear array and an elastography scanner. Contrast agents flowing in a wall-less tissue phantom are insonified with a high-intensity disruption pulse followed by a series of plane waves emitted at a 5 kHz PRF. A collection of compounded images depicting the evolution of microbubbles is obtained after the echoes are beamformed in silico. The backscattering of the microbubbles appears to increase in the first image after disruption (4 ms) and decrease following an exponential decay in the next hundred milliseconds. This microbubble dynamic depends on the length and amplitude of the high-intensity pulse. Furthermore, confined microbubbles are found to differ significantly from their free-flowing counterparts in their dissolution curves. The high temporal resolution provided by ultrafast imaging could help distinguish targeted microbubbles during molecular imaging. (E-mail: olicou@gmail.com)     

光声成像分子造影剂

光声成像是利用光声效应成像的新型影像技术, 具有光学成像高对比度和超声成像高穿透力的优势。光声成像分子包括内源性生色团和外源性造影剂, 其中外源性分子造影剂的应用, 使分子光声成像成为可能, 因而具有广阔的生物医学应用前景及重要的研究意义。本文对光声成像外源性分子造影剂的物理化学性质及合成方式进行综述, 重点介绍小分子有机染料、贵金属纳米颗粒、碳纳米材料、有机纳米多聚物、基因编码的生色团、铜铁化合物、半导体多聚物纳米颗粒等光声信号复合物及常见的配体分子, 如小分子、肽类、亲和小体、适体和抗体等, 并对未来本领域的相关研究进行展望。     

Imaging Methods for Ultrasound Contrast Agents

Microbubble contrast agents were introduced more than 25 years ago with the objective of enhancing blood echoes and enabling diagnostic ultrasound to image the microcirculation. Cardiology and oncology waited anxiously for the fulfillment of that objective with one clinical application each: myocardial perfusion, tumor perfusion and angiogenesis imaging. What was necessary though at first was the scientific understanding of microbubble behavior in vivo and the development of imaging technology to deliver the original objective. And indeed, for more than 25 years bubble science and imaging technology have evolved methodically to deliver contrast-enhanced ultrasound. Realization of the basic bubbles properties, non-linear response and ultrasound-induced destruction, has led to a plethora of methods; algorithms and techniques for contrast-enhanced ultrasound (CEUS) and imaging modes such as harmonic imaging, harmonic power Doppler, pulse inversion, amplitude modulation, maximum intensity projection and many others were invented, developed and validated. Today, CEUS is used everywhere in the world with clinical indications both in cardiology and in radiology, and it continues to mature and evolve and has become a basic clinical tool that transforms diagnostic ultrasound into a functional imaging modality. In this review article, we present and explain in detail bubble imaging methods and associated artifacts, perfusion quantification approaches, and implementation considerations and regulatory aspects.