应用超声与磁共振诊断胎儿肝脏血管内皮细胞瘤的价值

目的：探讨应用超声（ US）与磁共振（ MR）诊断胎儿肝脏血管内皮细胞瘤的价值。方法：6例孕妇,孕龄27-34周产前行US与MR检查,US检查后24-48h内行MR检查,两种检查方法均行胎儿腹部冠状面、矢状面及横断面扫描,将产前US检查结果及MR检查结果与手术病理结果对照。结果：6例胎儿肝脏血管内皮细胞瘤US表现为肝脏内边界清晰的单发、低回声或稍强回声肿块。MR表现为肝脏内边界清晰的单个肿块,单次激发快速自旋回波（ SSTSE）序列上表现为不均匀高信号肿块,T1加权选择性水激发（ T1 W-WATS）序列上表现为不均匀低信号肿块。结论：产前US筛查可发现胎儿肝脏血管内皮细胞瘤,MR能进一步提供诊断胎儿肝脏血管内皮细胞瘤的有价值信息,是产前影像诊断又一重要手段,两者结合可以大大提高少见的胎儿肝脏血管内皮细胞瘤的诊断。     

高频超声与X线诊断乳腺肿瘤的价值比较及漏误诊原因分析

目的:探讨高频超声与X线对乳腺肿瘤的诊断价值及漏误诊原因。方法:对45例46个肿块经手术病理证实的乳腺肿瘤患者术前超声与X线摄片结果与病理结果进行对照分析。结果:高频超声与X线的诊断符合率分别为82.6%(38/46)、78.3%(36/46),两者比较,无明显差异(P>0.05);两者相结合诊断符合率为95.7%(44/46),分别与单种诊断符合率比较,均有较明显差异(均P<0.05)。结论:单纯应用高频超声或X线诊断乳腺肿瘤,两者的病理诊断符合率相似,两者结合可提高诊断符合率。对可疑病例,一种检查未发现病灶的,有必要进行另一种检查作为补充。     

胰腺体尾部肿瘤超声诊断的临床观察

目的：探讨超声对胰腺体尾部肿瘤的诊断价值。方法：回顾性分析21例经常规超声或术中超声检查诊断为胰腺体尾部肿瘤的图像特点,并与手术及病理结果相对照。图像分析的主要内容有肿瘤回声、境界、形态以及毗邻关系等。结果：21例患者中,术前超声诊断：（1）基本符合11例（52．4％）;（2）漏诊3例（14．3％）,为2例胰岛细胞瘤及1例胰体尾癌;（3）误诊7例（33．3％）,其中3例胃间质肿瘤、1例炎性包块误诊为胰腺癌,1例全胰癌误诊为胰体尾癌,另2例将胰腺肿瘤与腹腔或腹膜后肿瘤相混淆。结论：超声具有安全、无创、简便的优势,是胰腺体尾部肿瘤首选的诊断方法,在临床上有着重要的应用价值,结合CT和磁共振等检查,町提高诊断准确率。     

超声弹性成像在乳腺良恶性肿块中的诊断价值

目的:探讨超声弹性成像在乳腺良恶性肿块诊断中的价值。方法:对40例患者共43个乳腺病灶进行了超声弹性成像检查,以手术后病理结果为金标准,对超声弹性成像结果、病理结果进行比较分析。结果:43个乳腺病灶,其中恶性肿块17个,良性肿块24个,交界性肿块2个,恶性肿块弹性评分结果:5分9例,4分7例,3分1例;良性肿块弹性评分结果:5分1例,4分1例,3分7例,2分10例,1分5例;交界性肿块弹性评分结果:4分2例,弹性成像诊断正确38例,误诊5例,诊断灵敏度80%,特异度95.7%。结论:正确掌握超声弹性成像原理及疾病的病理特征,对结果进行充分分析,有助于提高超声弹性成像诊断乳腺肿瘤的准确性。     

高频超声对42例甲状旁腺肿瘤诊断的回顾性分析

目的:探讨高频超声对甲状旁腺肿瘤的诊断价值及漏或误诊原因,以提高超声对甲状旁腺肿瘤的诊断水平。方法:回顾性分析经手术及病理证实的甲状旁腺肿瘤患者42例,其中良性肿瘤40例,恶性肿瘤2例。分析其超声特征表现并与术后病理对比,比较不同部位及长径的甲状旁腺肿瘤对超声诊断的影响,总结超声诊断符合率和定位准确率,并分析漏误诊原因。结果:42例甲状旁腺肿瘤患者共87个病灶,超声正确诊断35例,符合率83.3%,检出病灶与手术对比准确定位率88.4%。误诊5例,漏诊2例,7例中5例为异位病灶,占71.4%。结论:高频彩色多普勒超声可在术前对甲状旁腺肿瘤做出较准确的影像学诊断和术前定位,但需加强对异位甲状旁腺肿瘤的临床和影像学认识,多方面综合分析,避免漏误诊。     

超声引导下经皮肺部肿瘤穿刺细胞学诊断价值探讨

目的探讨肺部肿瘤超声引导经皮穿刺细胞学检查的准确性、适应征及应用价值.方法应用超声引导对148例患者进行穿刺细胞学检查,12例经手术病理证实.结果阳性108例(70.3%),可疑阳性7例(4.7%),阴性30例(20.9%),穿刺失败3例(2.3%).结论超声引导下经皮肺部穿刺细胞学对肺部肿瘤的诊断准确率高,值得广泛应用.     

恶性滋养层细胞肿瘤的病理与声像图对照——探讨其声像图分型及诊断价值

本文分析了32例恶性滋养层细胞肿瘤的病理及超声诊断资料,根据恶性滋养层细胞肿瘤的病理学特点,结合声像图所见分为3型:灶性强回声型;强弱混合回声型;弥漫浸润型。经病理证实,超声对恶性滋养层细胞肿瘤的诊断符合率为90.6％(29/32),并对恶性滋养层细胞肿瘤的超声诊断价值进行了讨论。     

终端输尿管癌超声诊断与病理分析

目的 提高超声对终端输尿管癌的诊断准确率并能为手术方式提供可靠的依据.方法 18例患者均行超声检查、手术后作病理检查.部分患者行CT、X线造影及膀胱镜检查.结果 14例观察到肿瘤的直接征象,声像图表现为结节型、团块型、狭窄型.2例超声诊断终端梗阻,不排除肿瘤或炎症;2例诊断为先天性狭窄.手术后病理检查均为移行上皮癌,超声诊断检出率88.8%,诊断符合率77.7%.结论 超声检查应作为输尿管肿瘤诊断的首选影像学手段,并可为临床分期提供依据.     

经阴道超声在宫颈癌闭孔淋巴结转移的诊断价值

目的探讨经阴道超声检查在宫颈癌闭孔淋巴结转移诊断中的价值。方法选择32例行广泛性子宫切除+盆腔淋巴清扫术的宫颈癌患者,术前采用经阴道超声检查闭孔淋巴结情况,记录淋巴结部位、数量及大小,与术中分离出的淋巴结及病理结果进行对照分析。结果 32例患者中,有27例经超声检查结果与手术病理相符,准确性为84.1%(27/32);存在闭孔淋巴结转移21例,超声诊断17例,漏诊4例,假阳性0例;无转移患者11例,超声诊断13例,误诊2例。超声诊断的特异性为84.6%(11/13),敏感性为100%。结论经阴道超声检查可以诊断宫颈癌闭孔淋巴结转移,对肿瘤临床分期及治疗方案的选择有应用价值。     

彩色多普勒超声对乳腺肿块的诊断价值

目的 探讨高频超声对良、恶性乳腺肿瘤的诊断及鉴别诊断价值.方法 将138例行乳腺肿块切除术患者的术前超声诊断与术后病理结果进行对照分析.结果 103例恶性肿块中,超声诊断96例,超声诊断符合率为93.2%;误诊7例.35例良性肿块,超声诊断32例,超声诊断符合率为91.4%;误诊3例.结论 彩色多普勒超声是诊断和鉴别诊断乳腺良、恶性肿瘤的首选方法,具有较高的临床应用价值.     

睾丸恶性肿瘤的超声诊断价值

回顾性分析60例睾丸恶性肿瘤患者的临床病理资料，对照分析了二维超声图像与病理结果。术后病理诊断精原细胞瘤34例、胚胎性癌8例、畸胎瘤12例、淋巴肉瘤4例和混合性癌2例。睾丸的各种恶性肿瘤均有不同的二维超声图像特征，超声诊断符合率达96．7％；对腹股沟、腹膜后及锁骨上等区域的淋巴结转移诊断符合率高；同时由于其方便、经济及没有辐射忧虑，可作为睾丸恶性肿瘤首选的影像诊断方法。     

乳腺占位性病变的超声图像特点

目的：分析乳腺占位性病变的超声图像特点，探讨高频黑白超声对乳腺占位性病变诊断的价值。方法：对我院2001年～2003年住院收治的230例乳腺占位性病变患者使用高频超声检查的结果进行回顾性分析，并与病理结果对比研究。结果：184例乳腺良性占位性病变与46例恶性占位性病变的B超诊断与术后病理结论符合率分别为94．5％、91．3％。结论：普通高频超声对乳腺良恶性占位性病变的诊断和鉴别诊断具有重要价值，而且经济实惠、对人体无创伤。诊断的准确率取决于检查者的技术、经验及责任心。超声检查可以作为乳腺占位性病变诊断的手段之一。不同性质的乳腺占位性病变具有不同的超声图象特点。     

Management of colorectal neoplasia during pregnancy and in the postpartum period

AIM: To report our experience on management of colorectal neoplasia during pregnancy and in the postpartum period. METHODS: Patients who were diagnosed with colorectal cancer during pregnancy or in the postpartum period (< 6 mo), between 8/1997 and 4/2013, in our department were reviewed. Patient characteristics, operations, fetal health and follow-up during pregnancy, type of delivery and oncologic outcomes were analyzed. RESULTS: Eight patients met our study criteria. Median age at the time of diagnosis of colorectal cancer was 31 years. Median follow-up after surgery was 36 mo. Median duration of symptoms before diagnosis was 16 wk. Three patients were diagnosed with colorectal cancer during pregnancy and underwent surgery prior to delivery. None of the patients received adjuvant treatment during pregnancy. Five patients were diagnosed with colorectal cancer within a median of 2.1 mo after delivery and underwent surgery. No adverse neonatal outcomes were noted. All deliveries were at term (2 cesarean sections) except for one preterm delivery following low anterior resection on the 34^th week of pregnancy. CONCLUSION: There has been a significant delay in the diagnosis of colorectal cancer which is probably due to overlap of symptoms and signs between these tumors and a normal pregnancy. Surgery for colorectal cancer during pregnancy can be performed safely without compromising maternal and fetal outcomes.     

乳腺浸润性导管癌的超声表现与钼靶X线摄影对比研究

目的探讨超声对乳腺浸润性导管癌的诊断价值.方法对55例经病理证实的乳腺浸润性导管癌患者,分析其超声表现,并与钼靶X线比较.结果超声显示肿块阴影54例(98.2％),形态不规则,无包膜,边缘蟹足状36例(占65.4％),内部回声不均匀41例(74.5％),后方伴声衰减9例(16％),钙化影4例(7.3％),35例血流丰富(63.6％).超声诊断准确率89.1％,误诊率10.9％,钼靶摄影诊断准确率94.5％,误诊率5.5％.结论超声对乳腺导管癌诊断有很大价值,且与钼靶X线结合应用,可提高乳腺浸润性导管癌的诊断准确率.     

原发性心脏恶性肿瘤的外科治疗回顾

目的 :探讨原发性心脏恶性肿瘤的诊断和治疗方法。方法 :回顾分析 1986年 1月～ 1997年 12月 ,上海市胸科医院及上海市第六人民医院心外科 10例原发性心脏恶性肿瘤的诊断及手术治疗。结果 :7例成功切除肿瘤 ,3例因肿瘤广泛侵犯心脏周围组织仅作局部活检。 1例术后第 2天因急性肾功能衰竭死亡 ,其余顺利出院。结论 :原发性心脏恶性肿瘤较为罕见 ,一旦诊断成立应尽快手术 ,其积极意义是确定无疑的     

广州市非缺失型α-地贫基因诊断和产前诊断结果分析

目的: 分析广州市非缺失型α-地中海贫血(α-地贫)的临床特征、基因突变类型及构成比,为临床遗传咨询提供依据。方法: 259例受检者均进行血液常规和高效液相色谱分析(HPLC),筛查阳性者采用跨越断裂点PCR(Gap-PCR)和PCR结合反向杂交(PCR-RDB)技术进行α-地贫基因分析。夫妇为同型α-地贫携带者进一步行胎儿α-地贫基因诊断,产后随防。结果: 259例受检者中,αα^QS/αα 170例、αα^WS/αα 43例、αα^CS/αα 34例、——^SEA/αα^QS 6例、——^SEA/αα^CS 4例、-α^3.7/αα^QS 1例、-α^4.2/αα^QS 1例。同性别的患者3种非缺失型α-地贫红细胞平均体积(MCV)、红细胞平均血红蛋白量(MCH)比较差异有统计学意义(P<0.05),而血红蛋白(HGB)比较差异无统计学意义(P>0.05)。经产前基因诊断检出非缺失型HbH(——^SEA/αα^T)病胎儿5例,胎儿引产后留脐血进行复核,均与产前基因诊断结果一致。结论: 广州市非缺失型α-地贫发生率高,以αα^QS/αα最常见,对疑似非缺失型α-地贫携带者进行基因检测,可显著降低非缺失型HbH病患儿的发生率。     

Neoplasms in young dogs after perinatal irradiation

For a study of the life-time effects of irradiation during development, 1,680 beagles were given single, whole-body exposures to 60Co gamma-radiation at one of three prenatal (preimplantation, embryonic, and fetal) or at one of three postnatal (neonatal, juvenile, and young adult) ages. Mean doses were 0, 0.16, or 0.83 Gy. For comparison with data on childhood cancer after prenatal irradiation, examination was made of tumors occurring in young dogs in this life-span experiment. Up to 4 years of age, 18 dogs had neoplasms diagnosed, 2 of these being in controls. Four dogs that were irradiated in the perinatal (late fetal or neonatal) period died of cancers prior to 2 years of age. This risk was of significant increase compared to the risks for other experimental groups and for the canine population in general. Overall, 71% (5 of 7) of all cancers and 56% (10 of 18) of all benign and malignant neoplasms seen in the first 4 years of life occurred in 29% (480 of 1,680) of the dogs irradiated in the perinatal period. These data suggest an increased risk for neoplasia after perinatal irradiation in dogs.     

Ultrasonographic Diagnosis of Malignant Hepatic Tumors

Forty-two patients with liver malignancies were examined withthe U.I. Octoson ultrasonographic scanner. The cases were dividedinto four groups according to the ultrasonographic patterns.About 71% (5/7) of the metastatic tumors of colonic cancer and91% (10/11) of those of gastric cancer were of the homogeneoushyperechoic pattern (Group A), while all cases of hepato-cellularcarcinoma were of the hypoechoic pattern with nodular echogenicity(Group B) or hypoechoic pattern with granular and reticularechogenicity (Group C). These results indicate that ultrasonography is useful methodfor differentiating hepatocellular carcinoma from metastatictumors to the liver, especially those of adenocarcinomas ofthe stomach and colon.