超声弹性成像对乳腺癌的早期诊断价值

乳腺癌是严重威胁女性健康的一类疾病,乳腺超声检查是早期检出乳腺癌的重要方法之一。超声弹性成像是应用于传统乳腺二维超声检查技术基础上的新兴辅助检查技术,能够利用恶性病变与良性病变组织弹性差别,对传统二维超声检查难以辨别的不典型病变,尤其是较小的和不可触及的病灶提供更多的鉴别诊断证据,能够提高诊断乳腺良恶性病变的准确性。     

超声弹性成像诊断乳腺癌的临床价值

目的分析超声弹性成像对乳腺癌的影像学表现,探讨超声弹性成像在乳腺癌诊断的价值。方法回顾性分析37例经病理证实的乳腺癌患者,超声弹性成像的诊断符合率。结果超声弹性成像诊断乳腺癌敏感性87.50%,特异性76.92%,准确性83.78%。结论超声弹性成像诊断乳腺癌有较高的临床价值。     

常规超声联合超声弹性成像诊断甲状腺癌

目的探讨常规超声及弹性成像二者联合应用对甲状腺癌的诊断价值。方法我院行甲状腺癌手术的患者52例,共93个结节,所有患者术前均行常规及弹性成像超声检查,术后经病理证实。诊断甲状腺癌常规超声和弹性成像的准确性、特异性及敏感性。结果常规超声诊断甲状腺癌的敏感性75.86%,特异性84.38%,准确性81.72%;而超声弹性成像诊断甲状腺癌的敏感性89.66%、特异性85.94%、准确性87.10%;常规超声联合超声弹性成像诊断甲状腺癌的敏感性93.10%、特异性90.62%、准确性91.40%。同常规超声诊断相比,二者联合应用对甲状腺良、恶性结节诊断的差异有统计学意义,P〈0.01。结论常规超声联合超声弹性成像应用可提高诊断甲状腺癌的准确性,可为临床诊断提供重要信息。     

超声弹性成像应用于评价肝纤维化程度上的研究现状

超声弹性成像(ultrasonic elastography)是一种全新的成像模式,能直接反映组织的弹性信息。自1991年Ophir[1]等提出这一概念以来,超声弹性成像得到了广泛关注并迅猛发展。作为一种全新的成像方式,弹性成像已经成为医学超声     

超声弹性成像参数诊断慢性乙型肝炎肝纤维化临床分析

目的 探讨超声弹性成像(RTE)参数在慢性乙肝肝纤维化中诊断价值.方法 选取我院慢性乙肝肝纤维化患者79例设为观察组,另选取同期健康体检者79例设为对照组.两组均实施RTE检查,并给予观察组对应治疗措施.对比观察组及对照组、观察组不同疾病分期患者RTE参数[峰度(KURT)、偏度(SKEW)、复杂度(COMP)、对比度...     

超声弹性成像诊断甲状腺恶性肿块的价值

目的探讨超声弹性成像(ultrasonic elastography,UE)诊断甲状腺恶性肿块的临床价值。方法回顾性分析我院住院患者40例,42个甲状腺恶性肿块,术后不同超声类型检查结果分别与病理结果对照分析。结果常规超声诊断甲状腺恶性肿块的敏感性常规超声灵敏性78.6%,特异性71.4%,准确性76.2%;超声弹性成像技术灵敏性81.5%,特异性80.0%,准确性80.9%;联合二者灵敏性85.7%,特异性87.5%,准确性90.5%。常规超声与弹性成像技术诊断准确性的比较无统计学意义,两种技术联合的诊断准确性分别与其中一种技术相比,具有统计学意义。结论常规超声和弹性成像技术联合运用,能够提高甲状腺恶性肿块的诊断准确性。     

超声弹性成像及灰阶超声在肝纤维化诊断中的对比研究

目的:比较超声弹性成像(ultrasound elastosonography UE)及灰阶超声在肝纤维化诊断中的应用价值。方法:对120例慢性乙型肝炎患者的肝脏在进行超声引导下穿刺活检前进行超声弹性成像和灰阶超声检查,以病理结果为诊断金标准,分析超声弹性成像和灰阶超声评价肝纤维化的准确度。结果:超声弹性成像诊断肝纤维化的敏感度、特异度、准确度分别为92.5%、85.0%、90.0%。灰阶超声诊断肝纤维化的敏感度、特异度、准确度分别为42.5%、97.5%、60.8%。超声弹性成像联合灰阶超声诊断肝纤维化的敏感度、特异度、准确度分别为:93.7%、95.0%、94.2%。UE诊断准确度高于灰阶超声2=32.59(P<0.05)。UE诊断肝纤维化的受试者特征(ROC)曲线下面积为0.874(95%CI,0.798～0.950)。结论:超声弹性成像在评价肝纤维化较灰阶超声更有价值。     

超声弹性成像应变率比值法在微波消融治疗甲状腺良性结节中应用

目的探讨超声弹性成像应变率比值法在微波消融(MA)治疗甲状腺良性结节中的应用价值。方法选取2017年8—12月于北部战区总医院行超声引导下MA治疗的19例甲状腺良性结节患者为研究对象。本组患者共41枚病灶,其中,结节性甲状腺肿38例、甲状腺腺瘤3例,于消融前、消融后1、3、6个月分别接受超声弹性成像应变率比值法(SR)诊断。观察消融效果,比较结节性甲状腺肿与甲状腺腺瘤病灶消融前后的甲状腺结节体积变化及SR值变化情况。结果 41枚甲状腺结节治疗后1、3、6个月治疗有效率分别为61. 0%(25/41)、90. 2%(37/41)及97. 6%(40/41),随着恢复时间的延长,治疗有效率显著增高,差异有统计学意义(P <0. 05)。术后1、3、6个月,结节性甲状腺肿及甲状腺腺瘤的体积缩小率逐渐增加,甲状腺腺瘤的结节体积逐渐减小,但差异无统计学意义(P> 0. 05);结节性甲状腺肿与甲状腺腺瘤体积缩小率比较,差异均无统计学意义(P> 0. 05)。在消融后1、3、6个月,结节性甲状腺肿与甲状腺腺瘤的SR值比较,差异无统计学意义(P>0. 05)。结论超声弹性成像SR技术可识别坏死后消融灶与周围正常组织的硬度差异,可评价甲状腺良性结节MA治疗后恢复的效果,对促进微波消融手术的发展具有一定意义。     

超声弹性成像诊断甲状腺结节的价值

目的: 探讨超声弹性成像诊断甲状腺结节性疾病的价值.材料和方法: 分析68例共116个甲状腺结节的纵、横切面超声弹性图,按弹性硬度将其分为5级,以0～II级作为判断甲状腺良性结节的诊断标准,III～IV级作为判断甲状腺恶性结节的诊断标准,并与病理结果对照.结果: 超声弹性图纵切面的诊断敏感性为100%,特异性为73.3%,准确性为76.8%;横切面的诊断敏感性为100%,特异性为72.3%,准确性为75.9%.纵、横切面鉴别甲状腺良、恶性结节的差异无统计学意义(P＞0.05).结论: 超声弹性成像对甲状腺结节的诊断有较大的应用价值,综合常规超声表现有助于提高诊断的信心.     

超声弹性成像与常规超声联合应用在乳腺病灶良恶性鉴别上的价值

目的：探讨超声弹性成像在鉴别乳腺病变良恶性上的价值。材料和方法：对随机来我院检查的400例患者共433个乳腺病灶分别进行常规超声及弹性超声检查，结果与病理对照。结果：常规超声成像和弹性成像在鉴别乳腺病灶良恶性上价值相当（灵敏度、特异度及正确率分别为84．8％、82．8％及83．6％和83．6％、78．2％及80．4％，P〉0．05），但联合应用2种技术灵敏度提高至93．0％，比常规超声检查显著提高（P≤0．01）。结论：超声弹性成像对乳腺恶性病变较敏感，能帮助诊断常规超声较难鉴别的良恶性病变，两者联合应用可进一步提高超声技术的鉴别诊断能力。     

血管内超声评估肾动脉狭窄临界病变的初步应用

目的:探讨血管内超声(IVUS)在肾动脉狭窄评估中的临床价值。材料和方法:对7例疑似肾动脉狭窄的患者行肾动脉造影和IVUS检查,比较二者测定的管腔狭窄程度,通过IVUS引导行肾动脉扩张或支架植入,并用IVUS评价治疗效果。结果:IVUS可清晰显示血管壁的形态结构、斑块的性质,管腔截面积。结论:肾动脉血管内超声检查在判定肾动脉斑块性质、明确狭窄程度、测量管腔直径及指导支架植入有重要临床价值。     

血管内多普勒超声对Budd—Chiari综合征介入治疗前后血流动力学变化的评价

目的 :检测Budd Chiari综合征 (BCS)患者血流动力学的变化及对BCS患者PTA术后即刻的效果进行评价。材料和方法 :使用血管内多普勒导丝对 2 7例BCS患者下腔静脉 /肝静脉 (IVC/HV)介入治疗 (PTA)前后血流速度、血流量和压力的变化进行测定及比较。结果 :IVC和HV病变远心端PTA后较PTA前的平均峰值流速、最大峰值流速及血流量显著增加 ,而压力显著下降。结论 :PTA有利于BCS患者IVC/HV血流动力学的恢复 ;血流动力学指标可作为BCS在PTA后IVC/HV再通的依据之一。血流速度的变化可以作为判定PTA治疗终点的可靠指标之一。     

Staging of Hepatic Fibrosis: Comparison of Magnetic Resonance Elastography and Shear Wave Elastography in the Same Individuals

Objective

To cross-validate liver stiffness (LS) measured on shear wave elastography (SWE) and on magnetic resonance elastography (MRE) in the same individuals.

Materials and Methods

We included 94 liver transplantation (LT) recipients and 114 liver donors who underwent either MRE or SWE before surgery or biopsy. We determined the technical success rates and the incidence of unreliable LS measurements (LSM) of SWE and MRE. Among the 69 patients who underwent both MRE and SWE, the median and coefficient of variation (CV) of the LSM from each examination were compared and correlated. Areas under the receiver operating characteristic curve in both examinations were calculated in order to exclude the presence of hepatic fibrosis (HF).

Results

The technical success rates of MRE and SWE were 96.4% and 92.2%, respectively (p = 0.17), and all of the technical failures occurred in LT recipients. SWE showed 13.1% unreliable LSM, whereas MRE showed no such case (p < 0.05). There was moderate correlation in the LSM in both examinations (r = 0.67). SWE showed a significantly larger median LSM and CV than MRE. Both examinations showed similar diagnostic performance for excluding HF (Az; 0.989, 1.000, respectively).

Conclusion

MRE and SWE show moderate correlation in their LSMs, although SWE shows higher incidence of unreliable LSMs in cirrhotic liver.     

先天性心脏病患儿肺动脉内超声成像与右心导管检查的对比研究

目的:探讨在先心病合并重度肺动脉高压(PH)时,肺动脉血管内超声(IVUS)的临床应用价值。材料和方法:对12例合并PH的先心病患儿行右心导管检查的同时进行肺动脉IVUS成像。右心导管测定mPAP、TPR、Qp/Qs,IVUS观测肺动脉管腔大小、内膜和中层的厚度,计算肺动脉管壁厚度比(WTR)以及血管的搏动性。结果:吸入纯氧后mPAP及TPR明显降低,Qp/Qs则明显增高;高阻力组与低阻力组间,肺动脉搏动性在吸氧前后未见显著性差异;在吸氧前后,WTR与TPR具有直线相关。结论:IVUS可以应用于临床,其监测结果与右心导管监测的肺动脉血流动力学变化情况呈高度相关。     

Acute decrease in the stiffness of resting muscle belly due to static stretching

The purpose of the study was to examine the acute effect of static stretching exercise on the resting stiffness of gastrocnemius muscle belly. Ten healthy young adults performed standing wall stretching in dorsiflexion for 1 min at a time and repeated five times. Before and after stretching, the shear modulus was measured in medial and lateral heads of the resting gastrocnemius muscle with ultrasound shear‐wave elastography. After the stretching, dorsiflexion range of motion (ROM) of the ankle joint increased (P < 0.01) by 3.9° and returned in 20 min. Immediately after stretching, shear modulus decreased (P < 0.01) by 14%, compared with before stretching across muscle heads. The decrease in shear modulus returned in 20 min after stretching. In the comparison group of 10 additional subjects, the standing intervention without stretching had no influence on these measures. There was a negative correlation between dorsiflexion ROM and shear modulus in either head before and after stretching. The results demonstrate the transient decreases in the stiffness of the resting gastrocnemius muscle belly and indicate that joint flexibility is greater in individuals with lower resting stiffness of the muscle belly.     

Non-uniform distribution of passive muscle stiffness within hamstring

Limited information is available on whether stiffness is different within and between the constituents of the hamstring, that is, the biceps femoris long head (BFlh), semitendinosus (ST), and semimembranosus (SM). Therefore, understanding of hamstring injuries and stretching effect on hamstring stiffness is difficult. The present study primarily aimed to identify whether passive muscle stiffness differs between the BFlh, ST, and SM and between the proximal, middle, and distal sites within each muscle. Secondly, the effect of stretching exercise on the heterogeneity in passive muscle stiffness was examined. In the lengthened hamstring positions by extending the knee joint or flexing the hip joint, passive muscle shear modulus (a measure of stiffness) at the proximal, middle, and distal sites of the BFlh, ST, and SM was measured by using ultrasound shear wave elastography. Furthermore, before and after five repetitions of 90-seconds static stretching for the hamstring, passive muscle shear modulus at the proximal and distal sites of the SM was measured. The shear modulus was significantly higher in the SM than in the BFlh and ST and higher at the distal site than the proximal site in all muscles. After the stretching, the higher shear modulus at the distal site of the SM compared to the proximal site was still observed (pre-stretching: +80%, post-stretching: +81%). These findings indicate that passive muscle stiffness varies within the hamstring regardless of performing stretching exercise and that passive muscle stiffness is not highest at the proximal site of the SM where a stretching-type hamstring strain typically occurs.     

Elasticity reconstructive imaging by means of stimulated echo MRI

A method is introduced to measure internal mechanical displacement and strain by means of MRI. Such measurements are needed to reconstruct an image of the elastic Young's modulus. A stimulated echo acquisition sequence with additional gradient pulses encodes internal displacements in response to an externally applied differential deformation. The sequence provides an accurate measure of static displacement by limiting the mechanical transitions to the mixing period of the simulated echo. Elasticity reconstruction involves definition of a region of interest having uniform Young's modulus along its boundary and subsequent solution of the discretized elasticity equilibrium equations. Data acquisition and reconstruction were performed on a urethane rubber phantom of known elastic properties and an ex vivo canine kidney phantom using <2% differential deformation. Regional elastic properties are well represented on Young's modulus images. The long-term objective of this work is to provide a means for remote palpation and elasticity quantitation in deep tissues otherwise inaccessible to manual palpation.     

离体肺动脉内超声成像与造影结果的对比研究

目的探索血管内超声在肺动脉内检查的可行性,并对离体肺动脉血管内超声检查与肺动脉造影结果进行比较,同时为临床应用作准备.材料和方法取13例意外死亡尸体的52段肺动脉分别进行了血管内超声检查和血管造影,测量其管腔直径和面积.结果二者呈高度相关(r=0.98和r=0.93).结论血管内超声能够对肺动脉进行检查,而且其结果与血管造影检查结果有高度相关性.     

Intravascular Ultrasound Guidance for Transjugular Intrahepatic Portosystemic Shunt Procedure in a Swine Model

A new method is described for guiding hepato-portal venous puncture using a longitudinal side-view intravascular ultrasound (L-IVUS) transducer to assist in the performance of transjugular intrahepatic portosystemic shunt (TIPS) in three Australian swine. Simultaneous L-IVUS with an AcuNav® 5–10 MHz 10 Fr transducer (Acuson Corporation, Mountain View, CA, USA) and fluoroscopy guidance was used to image and monitor the hepatic to portal venous puncture, dilatation of the tract, and deployment of the TIPS stent. Flow through the shunt could be demonstrated with both L-IVUS and angiography. TIPS was successful in all swine. The time for portal vein puncture once the target portal vein was identified was reduced at each attempt. The number of portal vein puncture attempts was 2, 1, and 1. No post-procedural complication was evident. L-IVUS-guided TIPS is practical and has the potential to improve safety by permitting simultaneous ultrasound and fluoroscopic imaging of the needle and target vascular structures. This technique allows for a more streamlined approach to TIPS, decreasing the fluoroscopic time (hence, decreasing the radiation exposure to the staff and patient) and anesthetic time. In addition, there are improved safety benefits obviating the need for wedged portography, facilitating avoidance of bile duct and hepatic arterial puncture, and minimizing hepatic injury by decreasing liver capsular puncture and the attendant risks.