类风湿关节炎跖趾关节病变的超声表现

目的 了解类风湿关节炎(RA)患者跖趾关节病变的超声表现.方法 RA患者65例,健康志愿者20例,分别利用高频超声检查跖趾关节,观察二维声像图及彩色多普勒血流显像情况.结果 RA患者跖趾关节病变的超声表现主要为:滑膜炎,部分可见血流信号;关节腔积液;骨质破坏;肌腱病变.结论 超声检查可以观察到RA患者跖趾关节的病理改变,且有明确的声像图表现,在判断病情变化和随访中有较高的应用价值.     

腹膜间皮瘤的超声诊断价值

目的：分析腹膜间皮瘤的超声声像图特征，探讨超声对腹膜间皮瘤的诊断价值。方法：对23例腹膜间皮瘤的超声声像图及其中9例的彩色多普勒检查结果进行分析和总结，并将其声像图表现与手术及病理诊断相对照。结果：腹膜间皮瘤的超声声像图表现为：18例探及腹腔或盆腔肿块，回声不均匀，部分肿块内可见不规则暗区；腹膜弥漫性层状或结节状增厚11例(其中6例合并腹腔肿块)，腹水17例。彩色多普勒显像示肿块内较丰富的血流信号。结论：超声检查结合临床对本病可做出初步诊断。     

彩色多普勒及二维超声显像诊断胆囊癌与手术病理对照分析

目的：总结彩色多普勒及二维超声显像诊断胆囊癌的声像特点与分型。方法：通过对经手术后病理证实的43例胆囊癌患者的术前彩色多普勒及二维超声显像进行对照分析。结果：依二维超声显像将胆囊癌分为五型：实块型,蕈伞型,厚壁型,息肉型和混合型。彩色多普勒血流超声检查可以在病变内或周边探及异常的血流回声,并可应用频谱多普勒识别其为动脉或静脉。结论：二维超声显像诊断胆囊癌,彩色多普勒血流检查亦是超声诊断胆囊癌的重要内涵和依据。     

腺性膀胱炎的超声诊断与分型

目的： 研究腺性膀胱炎的声像图特点、病理基础、诊断价值及其临床意义。方法： 回顾性分析１４ 例经手术病理证实的腺性膀胱炎的声像图资料, 就其病理与超声显像的关系及超声鉴别诊断进行了分析。结果： 本组超声诊断符合率为７９％ （１１／１４ 例）。根据超声所见并结合手术后病理结果, 将其声像图表现分为四型： Ⅰ型： 乳头增生型２ 例; Ⅱ型： 结节增生型 ２ 例; Ⅲ型： 弥漫增生肥厚型４ 例; Ⅳ型： 混合增生型 ６ 例。结论： 超声对腺性膀胱炎的定位和定性具有重要的诊断价值, 结合病史和临床表现可减少误诊。     

超声显像在桥本病诊断中的应用

目的:评价超声显像技术对桥本病的诊断价值。方法:通过对53例经病理组织学确诊的桥本病声像图分析,总结该病的声像特征及诊断正确率。结果:桥本病声像图弥漫回声减低者88.7％(47/53),局限回声减低者11.3(6/53);结构呈粗网样者71.2％(38/53),呈细网样者22.6％(12/53),回声不均匀或伴结节者5.6％(3/53);双侧叶宽径、厚径,峡部厚径,双侧甲状腺上动脉峰值速度均高于对照组(P<0.01)。超声诊断符合率92-4％(49/53)。结论:桥本病声像改变特征性明显,超声显像技术是该病的一种良好诊断方法。     

超声检查偏子宫角部位妊娠的诊断价值

目的：探讨超声检查对偏子宫角部位妊娠（NCP）的诊断价值。方法：回顾分析70例（40例为NCP,30例为子宫角妊娠（CP））患者术前超声声像图特点、临床表现和彩色多普勒血流显像（CDFI）。结果：NCP的发生率为1.46‰。NCP术前超声声像图均为孕囊型。CP术前超声声像图分2型：孕囊型（Ⅰ型）10例（33.3%）,混合回声型（Ⅱ型）20例（66.7%）。NCP和CP术前超声诊断符合率分别为100%和60%。超声监护下吸刮宫术中NCP和CP1次性手术成功率分别为100%和69%。结论：超声检查NCP的诊断价值较高;孕早期经超声检查,有助于鉴别NCP及CP;超声监护行下吸刮宫术,可提高手术成功率,减少手术并发症。     

高应超声及彩色多普勒血流显像在诊断浅表软组织肿物中的应用

目的：探讨高频超声及彩色多普勒血流显像（CDFI）在诊断浅表软组织肿物中的应用。方法：对84例经手术、病理证实的浅表软组织肿物的二维声像图及彩色多普勒血流显像进行分析。结果：82例为良性,2例为恶性。82例良性肿物中,12例可探及血流信号,均为血管瘤和炎性肿块。囊性肿物的超声诊断符合率为100％。结论：高频超声及彩色多普勒血流显像对浅表软组织肿物的诊断及鉴别诊断具有一定的临床价值。     

超声检查在卵巢畸胎瘤诊断中的价值

目的 探查超声对卵巢畸胎瘤的诊断价值。方法对经手术和病理证实的57例成熟畸胎瘤的声像图特征进行分析。结果57例经超声诊断52例，符合率为91．2％。其中单侧50例，双侧7例，共有瘤体64个。声像图分三种类型：囊肿型，类实性型，混合型。成熟畸胎瘤彩色多普勒检查，肿块内或边缘几乎未见血流信号。结论经腹及经阴道超声检查，结合彩色多普勒显像，可以提高畸胎瘤的诊断率及鉴别诊断。     

新生儿颅脑疾病的超声诊断分析

目的评价新生儿颅脑疾病经超声检查的价值。方法应用实时超声显像仪,测量各脑室的大小,观察脑中线有无偏移,双侧大脑半球和整个脑实质回声结构的比较。结果未成熟儿脑声像36例,脑室轻度扩张31例,中度扩张5例,重度扩张2例,缺氧缺血性脑病16例,颅内出血2例。结论头颅超声提供了一种快速、重复性好、无创的方法,只要严格掌握头颅超声诊断标准,可大大提高诊断符合率。     

超声显像对先天性巨输尿管症的诊断价值

目的 探讨先天性巨输尿管症（下称巨输尿管症）的病理生理学改变与声像图表现的关系。方法 对16例（20例）经静脉肾盂造影、手术和病理证实的巨输尿管症的超声显像结果进行分析。结果 16例（20侧）巨输尿管症输尿管内径最小2.0cm，最大4.7cm。超声显像诊断符合率95％（19／20）。根据16例（20例）巨输尿管症的病变累计范围和声像图不同，大致将其声像图表现分为三种类型：（1）圆柱型8例（10侧），输尿管全程均呈圆柱状显著扩张，其中6例（8侧）伴有迂曲；（2）纺锤型6例（8侧），以输尿管下段扩张为主，功能性狭窄段输尿管外形呈纺锤状；（3）鼠尾型2例(2侧），输尿管中下段扩张，张力输低的输尿管末端呈鼠尾状。结论 巨输尿管症的声像图表现与其病理生理学改变关系较密切，超声显像及该病有重要诊断价值。     

Cricoid cartilage on sonography in pediatric patients mimics a thyroid mass.

OBJECTIVE: The purpose of this study was to describe the sonographic appearance of the uncalcified cricoid cartilage in pediatric patients and illustrate how this can be easily confused with a thyroid mass or residual thyroid tissue after thyroidectomy. METHODS: We retrospectively reviewed the sonographic and computed tomographic examinations performed on 4 adolescent patients. Two patients had either thyroid cancer or thyroid nodules, and 2 healthy patients were reviewed to show normal anatomy. Results were compared with the clinical and surgical findings in each patient. RESULTS: Computed tomographic and sonographic examinations showed the normal anatomic relationships and imaging appearance of the cricoid cartilage. Findings from a follow-up sonographic examination on a patient with treated thyroid cancer were initially interpreted as residual thyroid tissue, but another examination revealed that this tissue was actually uncalcified cricoid cartilage. Another patient who had intraoperative sonography verified these findings. CONCLUSIONS: Uncalcified cricoid cartilage in a pediatric patient appears on sagittal sonography as a round or ovoid structure with variable echogenicity, located posteromedial to the thyroid gland. Awareness of this structure's sonographic appearance should prevent unnecessary biopsy or surgery.     

Use of Sonography for Airway Assessment

Objective. The purpose of this study was to evaluate the feasibility of sonography in identifying the anatomic structures of the upper airway and to describe their appearance on sonography. Methods. We enrolled 24 healthy volunteers, placed them supine with their head extended and neck flexed (the “sniffing” position), and performed a systematic sonographic examination of their upper airway from the floor of the mouth to the suprasternal notch. Results. We were able to visualize all relevant anatomic structures in all of the participants using either a linear or curved transducer oriented in 1 of 3 planes: sagittal, parasagittal, and transverse. Bony structures (eg, the mandible and hyoid) were brightly hyperechoic with an underlying hypoechoic acoustic shadow. Cartilaginous structures (eg, the epiglottis, thyroid cartilage, cricoid cartilage, and tracheal rings) were hypoechoic, and their intraluminal surface was outlined by a bright air‐mucosa interface. The vocal cords were readily visualized through the thyroid cartilage. However, the posterior pharynx, posterior commissure, and posterior wall of the trachea could not be visualized because of artifacts created by an intraluminal air column. Conclusions. Sonography of the upper airway is capable of providing detailed anatomic information and has numerous potential clinical applications.     

Assessing the force generated with application of cricoid pressure

The application of cricoid pressure is a common technique used to decrease the risk of aspiration during anesthetic induction. Research recommends that 3 to 4 kg of cricoid force be applied to achieve effective esophageal occlusion. The purpose of this study was to assess perioperative nurses' knowledge regarding the recommended amount of cricoid force that should be applied to the cricoid cartilage and to assess the amount of force generated when cricoid pressure was applied to a scale-mounted model. A convenience sample of 102 perioperative nurses participated in the study. Five percent of participants identified the correct amount of force necessary. Applied force was significantly less than the recommended amount. Findings of this study suggest perioperative nurses lack both knowledge and clinical skill for generating effective amounts of cricoid force.     

摔跤运动员耳的超声表现

目的 探讨摔跤运动员耳的超声特征.方法 摔跤和柔道运动员共12例为病例组,健康志愿者15例为对照组,对双侧耳廓行超声检查.结果 病例组的超声表现为耳廓增厚,积液,血流信号增加,软骨破坏.病例组耳廓厚度为(0.95±0.41)cm,对照组耳廓厚度为(0.41±0.07)cm,二者比较差异有统计学意义(t=7.06,P＜0.01).结论 摔跤运动员耳具有特征性的超声表现,超声在其诊断和治疗中有一定的应用价值.     

Cricoid pressure--safety necessity or unnecessary risk?

Cricoid pressure is a simple and effective measure to prevent regurgitation of gastric juice and content. This procedure, which prevents a possible reflux by compression of the oesophagus between the cricoid cartilage and the cervical vertebral bodies, is generally acknowledged in clinical practice, although there is lack of scientific evidence regarding its effect on the outcome of patients at risk of aspiration. However, there is only a rare incidence of complications as long as cricoid pressure is used with exact indication, considering the contraindications and correct performance. Especially important are the optimal force applied on the cricoid and the duration of application. However, there is a lot of evidence in the literature that the knowledge of anaesthetists about the method and technique of cricoid pressure is rather unsatisfactory. Thus, the starting point for improving the efficiency and safety of cricoid pressure seems to be better teaching and training.     

Sonoanatomy of the Achilles tendon insertion in children

PURPOSE: The aim of this study was to describe typical age-related sonographic features of the Achilles tendon and calcaneal apophysis in children, providing a reference for the assessment of heel pathologies during the growth period. METHODS: The calcaneal apophysis and Achilles tendon insertion of 100 children 2 months to 18 years old were examined by high-frequency gray-scale and color Doppler sonography along both the longitudinal and transverse planes. The thicknesses of the apophyseal cartilage at the calcaneal tuberosity and of the Achilles tendon were measured. Also, the sonographic appearance of the bone-cartilage interface was studied. RESULTS: In children 2 months to 3 years old, the cartilage of the calcaneal tuberosity apophysis was anechoic, with small scattered echoes. In 19 of these 25 children (76%), the echogenic areas contained at least 1 small vessel, visualized on color Doppler sonography. In 15 of 25 children (60%) 4-6 years old, a wavy interface was noted at the junction of the calcaneus and the apophyseal cartilage. CONCLUSIONS: High-frequency sonography can yield reliable information about the bone-cartilage interface and the Achilles tendon insertion site at the calcaneal tuberosity in children. The sonographic features of the normal heel described here may contribute to improved assessment of pathologies in this anatomic region.     

Isolated cricoid fracture associated with blunt neck trauma

A 32-year-old woman without a remarkable history presented at the emergency department with strangulation of the neck. CT scans of the neck revealed a displaced cricoid fracture. Six days after admission to hospital, hoarseness and dyspnoea disappeared. On the 10th day, the patient was discharged without complications. The traditional treatment guidelines for laryngeal trauma have recommended an early surgical intervention after immediate tracheotomy in cases of displaced fractures of the cricoid cartilage. The patient could be treated successfully through continuous monitoring of airway obstruction without surgical management.     

肋骨、肋软骨骨折X线与超声诊断的对比研究

目的：探讨肋骨及肋软骨骨折的超声诊断价值。方法：对31例肋骨、7例肋软骨骨折的X线及B型超声特点进行回顾性分析。结果：X线诊断肋骨骨折26例,阳性率83.87%,肋软骨未显像;超声诊断肋骨骨折31例,肋软骨骨折7例,阳性率100%。结论：超声对肋骨、肋软骨骨折,特别是线形骨折的诊断明显优于X线,二者结合分析,可提高诊断率。     

Use of the anterior cricoid split operation in infants with acquired subglottic stenosis

Ten infants with acquired subglottic stenosis were treated successfully using the anterior cricoid split operation. Eight had been preterm infants who required endotracheal intubation and assisted ventilation for the respiratory distress syndrome. Two had been born at term; 1 required mechanical ventilation for aspiration of meconium and the other intubation for obstructive apnea. All had been extubated successfully in less than 2 wk and were discharged home with no signs of subglottic stenosis. These infants were referred at 2 to 13 months of age for evaluation of upper airway obstruction. By bronchoscopy, we confirmed severe subglottic stenosis in each of the infants. The anterior cricoid split procedure requires a single midline vertical incision through the anterior cartilaginous ring of the cricoid cartilage and the upper 2 tracheal rings. Our postoperative management included 7 to 10 days of endotracheal intubation, mechanical ventilation, neuromuscular blockade, sedation, and total parenteral nutrition. All were extubated at the end of this period without evidence of stridor or obstructive apnea. One patient developed a subglottic granuloma at the level of the cricoid cartilage 4 months after the operation; this was successfully excised with the carbon dioxide laser. The other 9 patients remain asymptomatic 1 month to 1 yr after the surgical repair.     

Sonography of the nasal cartilage: technique and normal anatomy

The cartilagineous parts of the nose may be involved in a wide range of pathologies ranging from trauma and infection to malignancy. If pathology is suspected on examination, an easy-to-use imaging modality would be helpful in everyday clinical work. Until now, sonography of the nasal cartilage has not been described. This short letter describes the technique and normal anatomy of the nasal cartilage on sonography. Sonography may evolve into a powerful imaging tool in imaging of the nasal cartilage.