加用直肠水囊超声扫查女性盆腔疾患的对比研究

目的探讨在直肠内加用水囊法结合超声显像扫查某些盆腔脏器疾患的临床实用价值。方法行腹部超声(简称腹超)或阴道超声(简称阴超)检查的同时,在直肠内加入水囊,使子宫卵巢及肿物显像清晰。结果102例患者加用直肠水囊后扫查、诊断符合率达98%。结论应用超声显像附加直肠水囊法对未婚女性、某些膀胱难以充盈又伴有阴道病变不能行阴道超声检查者,应用超声显像附加直肠水囊法将起到良好的辅诊作用,为一种简便实用的好方法。     

经腹超声联合直肠水囊诊断女性盆腔疾病83例的护理配合

目的探讨加用直肠水囊法结合超声检查女性盆腔疾病时的护理要点。方法对83例女性盆腔疾病患者,针对性的进行术前心理、术中规范护理及术后护理关怀,配合超声医师顺利完成检查操作。结果对83例患者加用直肠水囊后检查及诊断符合率达99%。结论通过针对性的护理,应用超声显像加用直肠水囊法对未婚女性,膀胱难以充盈及伴有阴道疾病不能行阴道超声检查者,起到了良好的辅助作用。     

螺旋CT直肠内置水囊结合二维重建技术对诊断直肠癌的应用价值

目的:探讨螺旋CT采用直肠内置水囊结合图像重建技术对直肠癌的诊断价值。材料与方法:将48例拟诊直肠癌患者行直肠内置入水囊行螺旋CT扫描,采用薄层增强扫描加以矢状位及冠状位重建,分析其CT表现与手术病理结果相对照,探讨本方法对直肠癌诊断的应用价值。结果:直肠内置水囊扫描能满意扩张肠腔,肿瘤病灶显示率为95.8%(46/48),辅以矢状位及冠状位重建判断侵犯浆膜外组织及器官敏感性为97%(33/34);特异性为85.7%(12/14),测量病变离肛口的距离准确率100%(46/46)。结论:螺旋CT直肠内水囊法扫描加以图像二维重建技术在诊断直肠癌时有很高的应用价值,对临床手术起重要指导作用。     

经腹、经直肠超声联合应用在诊断妇科疾病中的价值

[目的]探讨经腹、经直肠超声联合应用对妇科疾病诊断的价值.[方法]对734例患者同时经腹、经直肠超声诊断妇科疾病,超声结果均与手术及病理诊断作对照.[结果]所有病例均有满意的超声显像,经腹超声符合率82.3%,经腹、经直肠联合超声诊断符合率为97.9%,后者超声诊断符合率明显高于前者.[结论]对妇科病变的诊断,经腹与经直肠超声结合是一种较理想的检查方法,值得推广应用.     

肾上腺皮质肿瘤的超声显像诊断与鉴别诊断价值

目的：评估超声显像对肾上腺皮质肿瘤定位与定性及其鉴别诊断价值。方法：应用超声显像诊断81例肾上腺皮质肿瘤，经手术与病理证实为柯兴氏症腺瘤33全,腺癌4例，醛固酮症腺瘤31例，性征异常症皮质腺癌7例，无功能性腺瘤6例。结果：超声显像诊断结果与手术和病理诊断结果对比，超声定位诊断符合率占95．1％（77／81）；定性诊断符合率占90．1％（73／81）。结论：超声显像对肾上腺皮质肿瘤的定位与定性诊断价值较大。但由于不同病理性质肾上腺皮质肿瘤的声像图表现缺乏特异性，因此熟练掌握其超声显像技术、诊断与鉴别诊断方法十分重要。     

超声显像对卵巢良恶性肿瘤的诊断及鉴别诊断价值

目的探讨超声显像对卵巢良恶性肿瘤的诊断及鉴别诊断的价值.方法应用超声显像诊断卵巢肿瘤并与手术病理作对照.结果超声诊断卵巢囊肿65例,67个肿瘤,与手术病理诊断符合率为95.4%（62/65）,卵巢囊腺瘤47例,52个肿瘤超声诊断符合率为93.6%（44/47）,卵巢畸胎瘤91例,101个肿瘤超声诊断符合率为92.3%（84/91）,卵巢实质性肿瘤17例,19个肿瘤,其中良性9例,恶性8例,超声诊断符合率为58.8%（10/17）.结论超声显像对卵巢囊性肿瘤具有重要的诊断价值,但对实质性肿瘤鉴别诊断尚有困难.     

经直肠超声诊断直肠肿瘤与病理对照分析

目的探讨经直肠超声诊断直肠肿瘤的临床意义。方法以经直肠超声二维声像图为基础，结合彩色多普勒血流特征，将108例直肠肿瘤的超声诊断结果分成三组与病理学结果进行回顾性对照分析。结果直肠癌与病理符合率89．7％，直肠息肉与病理符合率75％，直肠平滑肌瘤与病理符合率66．7％。结论经直肠超声声像图及彩色多普勒血流特征对诊断和鉴别诊断直肠良恶性肿瘤有一定的临床价值，将超声诊断与病理学对照分析，能对直肠肿瘤良恶性特征有进一步认识。     

超声对肾盂输尿管连接部梗阻的定位及病因分析

目的评价超声对肾盂输尿管连接部梗阻的诊断价值。方法采用空腹饮水膀胱充盈法对68例肾盂输尿管连接部梗阻进行超声检查。结果最后确诊为肾盂输尿管连接部结石37例、狭窄19例、肿瘤5例、因周围肿瘤压迫3例、结核和肾门部囊肿压迫各2例。超声显像诊断肾盂输尿管连接部梗阻位置的符合率为97·1%,诊断梗阻病因的符合率为91·2%。结论超声显像对肾盂输尿管连接部的诊断具有重要价值。     

小探头超声在食管黏膜下肿瘤诊断中的应用

目的探讨超声微探头在提高食管黏膜下肿瘤诊断率中的价值。方法利用超声微探头和自制水囊,对经常规内镜诊断为食管黏膜下肿瘤的73例患者进行超声内镜检查。结果微型超声探头检查并经病理证实的33例,术后病理诊断与超声内镜诊断符合率93．9％。结论超声微探头和自制水囊检查能清楚显示食管壁各层判断肿瘤起源及浸润层次,对食管黏膜下肿瘤的诊断有较高的临床价值。     

肾脏实质性肿瘤的超声诊断和鉴别

目的 探讨肾脏肿瘤的声像图表现，以提高肾脏肿瘤的诊断水平。方法 回顾性分析术前作过超声检查的肾脏实质性肿瘤47例。结果 超声显像诊断结果与手术和病理对照，超声定位诊断符合率占95．7％，定性诊断符合率占91．9％。结论 超声显像可动态观察肾脏肿瘤的声像图变化，及时为临床正确选择治疗方案提供参考依据。     

水灌肠18F-FDG PET/CT鉴别诊断良恶性结直肠病变

目的 探讨水灌肠PET/CT鉴别结直肠良恶性病变的价值。方法 对常规PET/CT检查发现的45例直肠及乙状结肠局灶性或弥漫性FDG浓聚患者行水灌肠PET/CT显像,与肠镜或术后病理结果进行对照。结果 水灌肠PET/CT扫描后诊断生理性摄取准确率为100%（15/15）;诊断恶性肿瘤的敏感度为100%（18/18）,特异度为92.59%（25/27）,准确率为95.56%（43/45）,阳性预测值为90.00%（18/20）,阴性预测值为100%（27/27）。结论 水灌肠PET/CT可有效排除结直肠生理性摄取¹⁸F-FDG,准确鉴别常规PET/CT难以诊断的良恶性结直肠病变。     

超声内镜对结直肠黏膜下病变的诊断价值

目的探讨超声内镜(EUS)在结直肠黏膜下病变诊断和治疗中的作用。方法对结直肠黏膜下病变进行EUS检查。根据黏膜下病灶的起源层次,部分患者接受深挖活检、超声内镜引导下细针穿刺吸取活检术(EUS-FNA)、内镜下治疗或外科手术。回顾性分析EUS诊断结果与临床病理的相关性。结果 EUS检查的74例患者中,诊断神经内分泌肿瘤28例(均位于直肠);脂肪瘤15例(其中位于回盲部4例、横结肠1例、升结肠8例、乙状结肠2例);直肠间质瘤2例(固有肌层和黏膜肌层各1例);外压性改变14例(卵巢肿瘤9例,淋巴结2例,盆腔肿瘤3例);囊肿5例(横结肠4例、升结肠1例);气囊肿1例;乙状结肠子宫内膜异位3例;直肠周边恶性肿瘤侵犯4例;肠道淋巴瘤2例。所有病灶均接受深挖活检、EUS-FNA、内镜下治疗或外科手术。最终病理和EUS诊断符合率为68/74(91.9%),其中2例EUS考虑直肠类癌最后病理确诊为黏膜肌层来源的平滑肌瘤。1例考虑脂肪瘤最终确诊为肠道淋巴瘤。2例考虑直肠周边恶性肿瘤最终为炎性包块,1例考虑子宫内膜异位症最终诊断为直肠癌。结论 EUS能清晰地显示消化道各层结构,能清楚显示结直肠黏膜下病变的大小、起源及其与相邻结构的关系,并且能较精确地判断各种病变的性质,进而指导结直肠黏膜下病变的治疗。     

Colitis cystica profunda of the rectum: An unexpected operative finding

Colitis cystic profunda is a rare entity benign condition of the colon and rectum that can mimic suspicious polyps or malignancy. The commonest sites of affectation are the rectum and the sigmoid colon but it can be unusually widely distributed in the colon. The aetiology of this condition is not fully elucidated and confident diagnosis can only be made on histological features. We hereby describe a patient who presented with significant rectal symptoms and an unexpected finding of a submucosal mucous cyst mimicking a suspicious rectal polyp and highlighted its significance and the review of the literature.     

超声造影在肾肿瘤诊断和鉴别诊断中的价值

目的探讨超声造影技术在肾肿瘤诊断和鉴别诊断中的初步应用价值。方法对30例经常规彩色多普勒超声检查诊断为肾占位的患者进行实时超声造影。观察造影剂在病灶内时相变化的规律及造影剂在肿瘤内分布的特点,并与病理结果进行对照。结果30例患者中23例为恶性病变,7例患者为良性病变,彩色多普勒超声诊断准确率86.7%（26/30）,敏感性95.7%（22/23）,特异性57.1%（4/7）;使用超声造影检查后准确率、敏感性和特异性均提高,分别为96.7%（29/30）,100%（23/23）,85.7%（6/7）。使用超声造影检查后均检出肿瘤内局灶性坏死。结论超声造影技术为肾脏占位性病灶的检出提供了更为丰富的信息,对肾脏肿瘤的诊断及鉴别诊断具有重要价值。     

Transabdominal Ultrasound Colonography for Detection of Colorectal Neoplasms: Initial Clinical Experience

We investigated the feasibility of using ultrasound colonography (USC) to visualize the healthy colon and rectum and detect colorectal polyps. Eight healthy volunteers underwent USC after standard bowel preparation. The feasibility and image quality of USC in different segments were evaluated. Then, USC was conducted on eight patients with known colonic neoplasms using colonoscopy as the reference standard. For volunteers, USC examinations were successfully performed on four (50.0%) ascending, three (37.5%) transverse and eight (100%) descending colons, as well as all sigmoid colons and rectums. One of four (25.0%) ascending, two of eight (25.0%) descending and all sigmoid colons and rectums were well visualized and free of artifacts. For patients, colonoscopy revealed that eight patients had 17 neoplasms in the distal sigmoid colon and rectum, which included 3 lesions ≤5 mm, 3 lesions 6–9 mm and 11 lesions ≥10 mm. USC visualized 12 of 17 (70.6%) neoplasms. Lesion detection by USC was 0% (0/3), 33.3% (1/3) and 100% (11/11) for neoplasms ≤5, 6–9 mm and ≥10 mm in size. USC can visualize the sigmoid colon and rectum well and detect distal sigmoid and rectal neoplasms ≥10 mm in diameter.     

Water intubation of the sigmoid colon: water instillation speeds up left-sided colonoscopy.

BACKGROUND AND STUDY AIMS: Rapid passage through the sigmoid and descending colon is important during flexible colonoscopy, and colonoscopists have developed several techniques and tricks for achieving this. The present study was designed to explore the effect of instilling 200 ml of water into the first bend of the sigmoid on the speed of passage of the endoscope from the rectum to the left colonic (splenic) flexure. PATIENTS AND METHODS: A prospective study of 100 successive single-handed colonoscopies was carried out, using randomly either the water intubation technique (50 patients) or the traditional method (50 controls) to compare the time needed to pass the endoscope from the rectum to the left colonic flexure. RESULTS: The results indicate that water intubation allowed the endoscope to be advanced through the sigmoid and descending colon in a median time (fiftieth percentile) of 154.5 seconds, compared to 223.5 seconds using the traditional technique. Water intubation speeds up the insertion time by 31%. This difference was highly significant statistically (P<0.0001). The difference remained significant when the data for men and women were analyzed separately. There was no statistically significant difference in the formation of N loops, or in incidentally formed alpha loops between the two study groups. CONCLUSION: The water intubation technique is more efficient than the traditional method, particularly in difficult left-sided colonoscopies, but it is equally safe.     

Localized colitis cystica profunda of the sigmoid colon

Localized colitis cystica profunda (CCP) is a rare condition found in the rectum. Localized CCP of 70-year-old man was found in the sigmoid colon, it was accompanied by a cancer in the ascending colon and an adenomatous polyp with focal malignancy in the sigmoid colon. Colonoscopically, the tumor appeared like a submucosal tumor.     

16层螺旋CT三维重建技术在结直肠癌外科治疗中的应用

目的探讨16层螺旋CT三维重建在中晚期结肠癌外科治疗中的应用价值。方法回顾分析43例经过手术证实的结肠癌病例,术前均进行平扫和三期扫描,所有病例均进行三维重建。结果浆膜层浸润准确率95%（35/37）,淋巴结转移准确率77%（10/13）,远处脏器转移准确率62%（8/13）,显示肿块准确率100%（43/43）,显示供血血管准确率100%（24/24）。结论16层螺旋CT三维重建可以更好的显示病灶及病灶与周围脏器的关系,为外科手术治疗提供独特的信息。     

慢性腹泻诊断方法的临床分析

目的　探讨慢性腹泻诊断的最经济有效的检查手段。方法　收集近 6年来全结肠镜检查 5 0 14例 ,分成三组 ,结合病史 ,分析其病因及病变分布范围。结果　慢性腹泻组的患者 1987例中 5 7 3%为正常肠粘膜相 ,4 2 7%有内镜下异常 ,其前三位病因是非特异性炎症 (73 9% )、肠息肉 (13 3% )及溃疡性结肠炎(11 1% ) ,而结直肠癌仅占 0 9% (在慢性腹泻中的检出率仅为 0 4 % )。异常者病变范围为横结肠以远病变占 72 2 % (6 2 1/ 84 8) ,全结肠一致性病变占 2 5 4 % (2 15 / 84 8) ,右半结肠仅占 1 4 % (12 / 84 8) (无一例癌症 ) ,加上正常粘膜相的病例 ,左半结肠镜检查的诊断率可达 99 4 %。结论　慢性腹泻患者的诊断以行左半结肠镜检查为最佳首选方案     

Evaluation and analysis of colonoscopy in the diagnosis of 186 cases of ulcerative colitis patients

The objective of this study was to evaluate the diagnostic value of colonoscopy plus biopsy in patients with ulcerative colitis (UC). Retrospective analysis was performed on clinical data in 186 cases. Erosions, or ulcers, together with mucosal hyperemia and oedema were the most common manifestations of colonoscopy in 87% of patients. In about 56.4% of 186 cases, such manifestations occurred in the rectum and the sigmoid colon. Nearly 65.6% of the patients had a chronic intermittent clinical course. One case developed colon cancer, and another case had toxic megacolon; each case represents 0.05% of the total 186 patients. Therefore, prevalence of both malignancy and complication is low. Colonoscopy plus biopsy is considered to be the major means of the diagnosis of UC, demonstrating its value in differential diagnosis.