Wrist and hand ultrasound

With adequate equipment, training, and expertise, ultrasound (US) should be regarded as the first-line imaging modality for the assessment of a wide range of pathological conditions affecting the soft tissues around the wrist and hand. With high-resolution transducers, US allows detection of foreign bodies and a reliable identification of a variety of traumatic lesions affecting tendons, retinacula and annular pulleys, ligaments, vessels, and nerves. In addition, inflammatory arthropathies, infectious disorders, overuse tendinopathies, and degenerative conditions can be diagnosed with this technique. In the wrist, US is able to identify the entrapment of the median, ulnar, and radial nerves. In patients with localized soft tissue swelling, US is able to assess the presence of a space-occupying lesion and to characterize its nature in many cases.     

彩色多普勒超声和二维超声诊断肾血管平滑肌脂肪瘤

目的:评价彩色多普勒超声和二维超声在诊断肾血管平滑肌脂肪瘤(RAL)中的应用价值。方法:应用二维超声、彩色多普勒血流图(CDFI),检测26例肾血管平滑肌脂肪瘤。结果:二维超声显示26例肾血管平滑肌脂肪瘤,分四型,高回声型,低回声型,无回声型,混合回声型,20个肿瘤彩色多普勒血流图其内可显示血流信号,6个肿瘤其内未显示血流信号。结论:彩色多普勒超声有助于对RAL的诊断。     

超声弹性成像与常规超声检查甲状腺结节的临床价值分析

目的：探讨超声弹性成像对常规超声可疑恶性甲状腺结节的鉴别诊断作用。方法对常规超声与超声弹性成像对可疑恶性甲状腺结节的鉴别诊断。结果本组32例患者均经手术病理证实,其中甲状腺乳头状癌21例,甲状腺腺瘤9例,甲状腺滤泡癌2例。32例患者均为单发实性低回声病灶,其中13例患者的病灶内可见点状钙化,1例患者伴有粗大钙化,10例患者的二维超声显示边缘不规则,11例周边存在声晕;彩色能量多普勒超声显示血流丰富程度为：血流Ⅱ型21例,Ⅲ型11例。以低回声、点状钙化、存在声晕、C PD血流丰富作为恶性提示指标,研究结果显示常规二维和C PD检查为恶性21例,其中与手术病理诊断一致17例;经统计,常规二维和C PD联合检查的灵敏性为73．91％,特异性为55．56％,准确性为68．75％。结论超声弹性成像是一种无创评价组织弹性的显像方式,对经常规超声检查可疑恶性的甲状腺单发实性小结节的进一步鉴别诊断有很大的帮助。     

携紫杉醇和Herceptin高分子造影剂联合超声体外寻靶及显影效果研究

目的 探讨携紫杉醇(Pac)和注射用曲妥珠单克隆抗体(Herceptin)高分子造影剂(Pac-PLGA-HER)联合超声体外寻靶能力及显影效果.方法 通过双乳化法和碳二亚胺法制备载Pac靶向高分子造影剂.将MCF-7细胞种植于12个培养皿中,培养24 h,分为4组,每组3个:非靶向造影剂组(Pac-PLGA组)、靶向造影剂组(Pac-PLGA-HER组)、靶向造影剂+超声组(Pac-PLGA-HER+超声组)和抗体封闭组.在激光共聚焦显微镜下对比观察高分子造影剂与细胞的结合能力.观察体外显影效果,并用DFY型定量仪进行定量,采用独立样本t检验进行统计学分析.结果 靶向载Pac高分子造影剂平均粒径为(596±12) nm,体外寻靶能力实验显示靶向载Pac高分子造影剂可与MCF-7细胞大量结合.体外显影实验示靶向与非靶向载Pac高分子造影剂平均声强分别为(134.50±10.19)和(135.11±11.49) dB,平均灰阶分别为147.83±11.12和148.50±12.63,两者比较差异均无统计学意义(t均为-0.097,P均＞0.05).结论 携Pac和Herceptin的高分子造影剂对高表达HER2的人乳腺癌MCF-7有较强的结合能力,在体外显影实验中有较好的显影效果.     

Echo enhancers and ultrasound imaging

The quality of diagnostic ultrasound images is sometimes limited by excessive acoustic attenuation within the organs and tissues. Ultrasound echo-enhancers help to overcome that limitation by increasing the intensity of the reflected signal. Acoustic principles dictate that the most effective enhancers are gas-filled microbubbles. The problem of producing a microbubble suspension stable enough for routine clinical use has been overcome in several ways. Newer developments are leading to enhancers with an active acoustic response and that have affinities for specific organs and tissues     

Intravascular ultrasound

The recent development and rapid expansion of new percutaneous vascular interventional devices designed to remove or remodel atherosclerotic plaque has been accompanied by equally strong interest in imaging modalities guidance systems to more accurately evaluate disease and better facilitate vascular interventions than traditional angiography. Although contrast angiography remains the standard for diagnostic evaluation of coronary and peripheral arteries, intravascular ultrasound has the potential to offer more precise information about vascular anatomy and disease. Intravascular ultrasonography has been able to provide specific information regarding vessel lumen and wall. Such information is not available by traditional diagnostic methods and may become essential in the future diagnosis, staging, and treatment of atherosclerosis.     

Carotid ultrasound

This article provides an overview of basic diagnostic carotid ultrasound applications, and emphasizes practical aspects of this examination. Areas currently being investigated include carotid plaque characterization and applications relative to IMT measurements. Contrast-enhanced ultrasound imaging also offers promise to improve plaque characterization, which in turn may link these evaluations to outcome studies.     

Interventional ultrasound

Modern cross-sectional imaging methods of computed tomography, sonography and lately MRI have contributed greatly to non-invasive studies of different parenchymal organs and permit the evaluation of pathological changes in different areas of the body. Although these techniques have reached a very high level of refinement, it is often not possible to define whether a focal lesion is benign or malignant. Ultrasound-guided fine-needle aspiration biopsy (FNA) or core-needle biopsy (including high-speed- and vacuum-assisted techniques) are essential to find out the character of the disease in these cases. Experience of more than 10,000 interventions of different organs are presented. Technique, results, problems, as well as risks are discussed. Moreover, it is shown how the results of percutaneous biopsies often change the treatment of a patient. This is especially of interest in those suffering from lymphomas, pancreatic carcinomas, and breast cancers, as well as relapsing tumors.     

Intraoperative ultrasound

Intraoperative ultrasound is an exciting arena for real-time depiction and evaluation of relevant anatomy and pathology. The information provided by this technique often is pivotal to the surgeon, and not infrequently impacts the nature and extent of the surgical procedure. As more radiologists develop an interest and become facile with IOUS, and as more surgeons appreciate the benefits of this modality, the numbers and applications for this technique will continue to expand. This, coupled with continued commercial and technical improvements, and increasing demand for minimally invasive surgery, ensures that the future of IOUS will be a bright one.     

Hip ultrasound

In newborns, US has an established role in the detection and management of developmental dysplasia of the hip. Later in childhood, when the limping child is a major diagnostic dilemma, US is extremely helpful in the identification of the varied disease processes underlying this condition, as transient synovitis, septic arthritis, Perthes disease and slipped femoral capital epiphysis. In adolescent practicing sporting activities, US is an excellent means to identify apophyseal injures about the pelvic ring, especially when avulsions are undisplaced and difficult-to-see radiographically. Later on, in the adulthood, US is an effective modality to diagnose tendon and muscle injuries about the hip and pelvis, identify effusion or synovitis within the hip joint or its adjacent bursae and guide the treatment of these findings. The aim of this article is to provide a comprehensive review of the most common pathologic conditions about the hip, in which the contribution of US is relevant for the diagnostic work-up.