超声造影定量分析在精索静脉曲张诊断中的应用价值

摘 要 目的 探讨超声造影（CEUS）定量分析在精索静脉曲张（VC）诊断中的应用价值。方法 选取我院左侧VC患者27例为研究组,同期健康男性志愿者27例为对照组,所有受检者均行CEUS检查双侧精索静脉,获得CEUS定量参数：精索动静脉渡越时间（TT）、精索静脉到达时间（ATV）、静脉达峰所需时间（TTPV）、静脉达峰时间（PTV）、静脉峰值减半时间（WOT50%）、静脉半衰期（HTV）,比较两组上述参数的差异。结果 研究组左侧与右侧精索静脉TT、ATV、TTPV、PTV、WOT50%、HTV比较差异均有统计学意义（均P＜0.05）;对照组左侧与右侧精索静脉各CEUS定量参数比较差异均无统计学意义。研究组与对照组左侧精索静脉TT、ATV、TTPV、PTV、WOT50%、HTV比较差异均有统计学意义（均P＜0.05）;右侧精索静脉各CEUS定量参数比较差异均无统计学意义。结论 CEUS定量参数能够反映精索静脉血流动力学情况,在VC诊断中有一定的应用价值。     

Qualitative and quantitative gait phase analysis by continuous monitoring of inter-ankle distance

A new device is presented that is able to provide a temporal recording of gait as well as a continuous qualitative monitoring of gait events. It can be used with motor-point electromyography to perform walking electromyography, with an electrogoniometer to record joint position, or with other measuring devices to record events relative to phase of gait. The major advantages of this system as compared with available systems are ease of use, decreased patient encumbrance, potential for portability, greatly reduced expense, and the potential for digitizing the signal for computer compatibility. Preliminary data are comparable to available accepted norms.     

Accuracy of quantitative MR vessel wall imaging applying a semi-automated gradient detection algorithm--a validation study.

Magnetic resonance imaging (MRI) is uniquely suited to study the pathophysiology of arteriosclerosis. So far, magnetic resonance (MR) measurements of vessel dimensions have mainly been done by manual tracing of vessel wall contours. However, such data postprocessing is very time-consuming and has limited accuracy due to difficulties in precise tracing of the thin vessel wall. PURPOSE: To assess the accuracy and reproducibility of quantitative vascular MR imaging applying a data analysis method based on (1) vessel wall unwrapping, followed by (2) a gradient detection algorithm for MR data postprocessing. Vascular MR imaging studies were done both in vessel phantoms and in healthy volunteers (n=29) on a clinical 1.5 T MR scanner. A dark blood double-inversion turbo spin echo sequence with fat suppression was applied, with proton-density-weighted and breath-hold acquisition for aortic imaging and T2-weighted acquisition for carotid imaging. Intraobserver and interobserver variability were systematically evaluated by two independent observers. A repeat study within 10 days of the first MRI was performed in 10 of these subjects for assessment of interstudy reproducibility. RESULTS: The semiautomated edge detection software revealed a clear view of the inner and outer vessel wall boundaries both in the phantoms and in the volunteers studied. There was close agreement between MR-derived measurements and phantom dimensions (mean difference of 1.1+/-16.9 mm2, 8.0+/-19.9 mm2, 9.0+/-12.1 mm2 for vessel wall cross-sectional area, inner vessel area, and total vessel area, respectively). Quantification of vessel dimensions was feasible in all 29 healthy volunteers studied. Semiautomated quantification of cross-sectional vessel wall area (mean+/-SD, 253.6+/-208.4 mm2) revealed close correlation for repeated measurements by one or two observers (r=0.99 each). Both intraobserver and interobserver variability of vessel wall area MR measurements were low (mean difference 7.5+/-16.7 mm2 and 14.4+/-24.6 mm2 , respectively). In the repeat study of 10 volunteers, MRI with semiautomated postprocessing quantitation revealed a high correlation and agreement of vessel dimensions between the two scans (r=0.994, mean difference 2.6+/-25.1 mm2). CONCLUSION: Semiautomated analysis methods can provide approaches that benefit from the human understanding of the image and the computer's ability to measure precisely and rapidly. Thus, by combining the latest MRI methods and semiautomated image analysis methods, we are now able to reproducibly determine the geometric parameters of blood vessels.     

小通道腹腔镜下精索内血管集束高位结扎术治疗精索静脉曲张

目的 探讨腹腔镜下治疗精索静脉曲张的新方法 .方法 回顾性分析50例精索静脉曲张患者实施小通道腹腔镜下精索内血管集束高位结扎术的情况,包括手术时间、术后恢复情况等.结果 全部患者均顺利完成手术,用时25～60min,平均35 min,无严重并发症.总住院时间3、4 d,平均3.3 d.46例术后随访3～12个月均无复发.结论 小通道腹腔镜下精索内血管集束术治疗精索静脉曲张,手术时间短,创伤小,恢复快,疗效满意,值得推广应用.     

Qualitative and quantitative abnormalities of argininosuccinate synthetase in citrullinemia

Enzymological and immunochemical analyses of the liver were preformed in seven Japanese patients with citrullinemia. Among the urea cycle enzymes in the liver, only the activity of argininosuccinate synthetase was specifically decreased to 2 to 50% of normal controls. Liver argininosuccinate synthetase of patients was indistinguishable from that of controls when tested immunochemically by Ouchterlony's double immunodiffusion technique with anti-rat argininosuccinate synthetase antiserum. Immunochemical analysis by means of the single radial immunodiffusion revealed that the decrease in the activity of liver argininosuccinate synthetase was explainable by a decrease in the amount of the enzyme protein in five patients, while the decrease in the activity in the other two patients was not accompanied by a decrease of enzyme protein. The Km values for the substrates of liver argininosuccinate synthetase of the former five were similar to those of the control, while the kinetic properties of the latter two were quite different in terms of higher Km values and negative cooperativity. From these results, we consider that citrullinemia may consist of more than one type including qualitative or quantitative abnormalities of argininosuccinate synthetase caused by some defects in certain genes or in the epigenetic processes in the liver.     

CEUS定性及定量诊断甲状腺结节

目的 探讨CEUS目测定性法与时间-强度曲线(TIC)定量法诊断甲状腺结节良恶性的临床价值。方法 对81例94个取得病理诊断结果的甲状腺实性结节术前行CEUS,分别采用定性法、定量法观察各指标,进行单因素分析后采用Logistics回归行多因素分析;采用ROC曲线比较定性法及定量法。结果 定性法中动脉期增强程度、增强时相、实质期增强程度及环形强化诊断甲状腺良恶性结节差异有统计学意义(P<0.05);定量法中,始增时间、相对始增时间(rRT)、峰值强度(IMAX%)、峰值时间、相对峰值时间诊断甲状腺良恶性结节差异有统计学意义。定性法动脉期增强程度对鉴别良恶性结节差异有统计学意义(P<0.001)。定量法中,IMAX%(P=0.006)和rRT(P=0.004)对鉴别结节良恶性差异有统计学意义。定性法及定量法诊断甲状腺恶性结节准确率分别为73.40%(69/94)和79.79%(75/94)。定性法和定量法ROC曲线下面积分别为0.756和0.868(P=0.002)。结论 甲状腺结节CEUS TIC定量法诊断能力优于定性法。定量法中甲状腺结节增强IMAX%减低和rRT增加对诊断恶性结节最有意义。