高频线阵探头Sonazoid超声造影在肝脏浅表病变检出及诊断中的应用

目的 探讨高频线阵探头Sonazoid超声造影在肝脏浅表病变检出及诊断中的应用。资料与方法 回顾性纳入2019年10月—2020年12月北京医院肝脏浅表病变患者53例（63个病变），分别使用凸阵探头和线阵探头行Sonazoid超声造影检查，比较二者对病灶检出率、病灶检出可靠性以及对不同性质病灶增强特征的显示。结果 线阵探头Sonazoid超声造影对肝脏浅表病变检出率[100%(63/63)比79.4%(50/63),P=0.000]和病灶检出可靠性评分均较凸阵探头高。二者对直径≤1 cm病灶的检出率差异有统计学意义[100%(14/14)比14.3%(2/14),P=0.000]，对直径>1 cm病灶的检出率差异无统计学意义（P>0.05）。线阵探头对肝转移瘤[100%(30/30)比66.7%(20/30),P=0.003]和肝细胞癌[100%(21/21)比90.5%(19/21),P=0.488]的检出率高于凸阵探头。线阵探头对不同病变的增强方式及灌注细节显示更好。结论 使用凸阵探头行Sonazoid超声造影时，联合使用高频线阵探头有利于肝脏浅表病变尤其是直径≤1 c...     

呼吸时相及探测深度对肝弹性测量值的影响

目的评价探测深度及呼吸时相对Supersonic剪切波弹性成像技术(SSI)测量肝弹性值的影响。资料与方法121例男性志愿者均使用SupersonicImagine公司AixPlore型实时定量剪切波超声弹性成像超声诊断仪,1～6MHz凸阵探头。嘱受检者深呼吸,分别在吸气末和呼气末于肝右叶2～4cm、6～8cm深度测量肝弹性模量值并进行比较。结果深度为2～4cm处测量,呼气末肝弹性模量值为6.026±1.482kPa,吸气末肝弹性模量值为6.097±1.628kPa;深度为6～8cm处测量,呼气末肝弹性模量值为6.758±2.035kPa,吸气末肝弹性模量值为6.976±2.142kPa。呼气末与吸气末肝弹性模量值比较,差异无统计学意义P>0.05;2～4cm深度与6～8cm深度肝弹性模量值比较,差异有统计学意义P<0.05。结论运用SSI测量肝弹性模量值时,受检者呼吸时相对肝弹性模量值测量无影响;测量深度影响肝弹性模量值的测量,随着深度的增加,肝弹性模模量有所增加。     

超声横波在健康人群与GNE相关肌病病人骨骼肌对比中意义的初步研究

正摘要目的明确正常的骨骼肌与受到GNE肌病影响的骨骼肌之间横波速度(SWV)是否存在定量差异。同时,在健康对照组检测肌肉特异性、检查深度及轴向前负荷对SWV的影响。材料与方法本研究经伦理委员会批准,符合HIPAA。所有参与研究的志愿者均签署了知情同意书。疾病对照组纳入8例病人(男4例,女4例,年龄30~50岁),均经遗传和组织学证实患有GNE相关肌病,正常对照组共5名健康志愿者(男2名,女3名,年龄27~33岁)。使用9 MHz线阵探头,经过SWV成像。评估GNE相关肌病病人的腓肠肌,     

多探头联合应用在颈部血管超声检查中的价值

目的 探讨高频线阵探头（HFLP）、低频凸阵探头（LFCP）联合应用在颈部血管检查中的价值,比较高频、低频探头在二维及彩色多普勒超声检查中的显示情况.方法 对100例受检者行颈部血管超声检查,采用随机分组对照方法,试验组创新性采用高、低频探头联合扫查,观察55例,对照组常规高频线阵探头扫查,观察45例,分别记录颈动脉内中膜厚度、斑块形成、血管流速等情况.结果 不考虑受检者在年龄、性别、身高、体重等方面的差异,试验组中颈动脉内中膜增厚显示率为56.4%,对照组为34.6%;试验组中颈动脉斑块形成检出率为75.9%,对照组为56.8%,试验组与对照组比较,有显著性差异﹙P＜0.05﹚,具有统计学意义.结论 联合应用高频线阵探头及低频凸阵探头检测颈部血管,局部动脉内中膜显示率及硬化斑块检出率明显增高,局部血管狭窄漏诊情况明显减少.     

腔内凸阵探头在急性阑尾炎诊断中的临床价值

目的:探讨腔内凸阵探头在急性阑尾炎诊断中的临床价值。方法:分别用腹部低频凸阵探头、高频线阵探头、腔内凸阵探头对54例临床可疑急性阑尾炎患者进行检查,首先判断阑尾及其位置,再根据阑尾管径及长径、管壁回声及腔内回声、肠系膜淋巴结有无肿大、阑尾周围有无积液等改变诊断阑尾炎,并将检查结果与手术病理结果对比。结果:经腹部低频凸阵探头诊断急性阑尾炎28例,漏诊20例,诊断符合率为58.3%,排除急性阑尾炎4例;高频线阵探头诊断急性阑尾炎43例,漏诊5例,诊断符合率为89.6%;腔内凸阵探头诊断急性阑尾炎42例,漏诊6例,诊断符合率为87.5%,排除急性阑尾炎3例。结论:腔内凸阵探头既可定位诊断阑尾的位置,了解阑尾与周围脏器的关系及病变情况,减少误诊、漏诊率,也可定性诊断阑尾的严重程度,对诊断急性阑尾炎有较高的临床价值。     

超声诊断胎儿多处畸形1例

患者女，26岁。妊娠26周无明显不适，来我院常规检查，孕2产0，以往曾有孕3个月不原因流产史。采用百胜Mylab 90彩超诊断议，凸阵探头3．5MHz，患者仰卧位，探头置腹部检查。超声所见：胎儿颅骨光环完整，颅内结构未见明显异常，双顶径5．4cm，脊柱排列规则，股骨长4．3cm，羊水最大深度6．6cm，颜面部多切面扫查，正常鼻唇结构消失，上唇连续中断0．6cm并向上延续，与鼻分界不清（图1）；     

彩色多普勒超声诊断输尿管囊肿1例

1　临床资料患者男 ,7岁 ,缘于 1年前开始出现小便时排尿中断 ,时有尿频、尿急、尿痛 ,来我院门诊就诊。超声检查使用Acuson SEQUOIA5 12超声诊断仪 ,采用 2 5～ 4 0MHz凸阵探头进行扫查显示 :左肾大小为 7 7cm× 4 2cm ,肾盂分离宽约 1 2cm ,左侧输尿管上段宽 0 6cm ,下段宽 1 1cm ;右肾大小为7 6cm× 4 4cm ,肾盂分离宽约 0 9cm ,右侧输尿管上段宽 0 7cm ,下段宽 1 2cm。然后患者取仰卧位 ,探头置于耻骨联合上方扫查 ,斜冠状切面显示膀胱内三角区处类圆形的液性暗区 ,呈“眼镜状”(图 1) ,左右大小分别为 1 8cm× 1 6cm、2 0…     

声触诊组织量化技术对肝纤维化的诊断价值

目的 评估声触诊组织量化（VTQ）技术对肝纤维化的诊断价值.方法 选取2011年6月~2012年12月来我院就诊的慢性肝炎患者（慢性肝炎组）60例、肝硬化患者（肝硬化组）45例及健康体检者（健康对照组）25例,利用VTQ技术测定右肝感兴趣区肝脏横向剪切波速度（SWV）;慢性肝炎患者同期行肝穿刺活检病理检查,分析SWV与肝纤维化程度的相关性,采用受试者工作特征（ROC）曲线,评价VTQ技术诊断肝纤维化的准确性.结果 健康对照组、慢性肝炎组及肝硬化组肝脏SWV分别为（2.0±0.2）m/s、（2.3±0.4）m/s 和（3.1±0.5）m/s,3者间具有显著性差异（P＜0.05）.随着肝纤维化程度加深,肝脏SWV增高,SWV值与肝纤维化分期呈正相关,相关系数为0.73（P〈0.05）;诊断≥S2及≥S3的ROC曲线下面积为0.94、0.92,诊断的临界值为1.36m/s、1.69m/s,灵敏性、特异性分别为0.88、0.88,0.92、0.76.结论 VTQ技术对肝纤维化具有较高的诊断价值.     

CT机内外定位线距离变化的规律

目的：研究 CT 机内外定位线距离变化的规律。方法：5种型号 CT 机为 GE 双排,GE 宝石,飞利浦64层,东芝64层以及西门子20层 CT 机,内、外定位线距离不同,但在机架角度0°时为一固定值。实验方法取 CT 机架角度为0°、10°、15°和20°4种状态,内外定位线投影在扫描床上,用标尺测量内外定位线之间的实际距离,并记录其变化;公式 T＝R/Cosθ＋M 计算5种型号 CT 机架角度为0°、10°、15°和20°4种状态下的内外定位线距离值,并与实验测量值进行比较。结果：实验方法显示5种型号 CT 机架角度为0°、10°、15°和20°时的内外定位线之间的距离变化与公式 T＝R/Cosθ＋M 的计算结果完全一致。结论：公式 T＝R/Cosθ＋M 揭示 CT 机架倾斜角为0°～20°时,内外定位线距离变化的规律,从而为医生赢得宝贵的诊治时间,为患者减少辐射剂量,具有非常重要的临床意义。     

可视化瞬时弹性成像评估健康成人肝脏硬度测值的影响因素

目的 探讨可视化瞬时弹性成像（Vi TE）测量健康成人肝脏硬度值的影响因素。资料与方法 前瞻性连续收集2020年6月17日—11月20日四川大学华西医院超声科59例健康成人志愿者,在空腹状态及不同影响因素下（包括采集次数、取样框、检测深度、呼吸时相等）采用Vi TE行肝脏硬度检测（LSM）,分析其可能影响LSM值的因素及稳定性。结果 (1)采集次数：相同取样框下,采集5次和10次的LSM值差异无统计学意义（P均>0.05）;箱线图显示,测量10次时LSM值更集中,变异度更低。(2)取样框：不同取样框（35 mm×8 mm、40 mm×10 mm、50 mm×10 mm和60 mm×10 mm）的LSM值分别为（5.69±1.15）k Pa、（5.75±1.20）kPa、（5.75±1.43）k Pa、（5.99±1.52）kPa,差异无统计学意义（F=0.57,P=0.633）;箱线图显示当取样框为35 mm×8 mm及40 mm×10 mm时LSM值更集中,变异度更低。(3)检测深度：取样框中心距肝包膜3 cm和5 cm,检测有效率分别为100%和98.31%(58/59),差...     

Knee injury and Osteoarthritis Outcome Score (KOOS) - validation of a Swedish version

The Knee injury and Osteoarthritis Outcome Score (KOOS) is a self-administered instrument measuring outcome after knee injury at impairment, disability, and handicap level in five subscales. Reliability, validity, and responsiveness of a Swedish version was assessed in 142 patients who underwent arthroscopy because of injury to the menisci, anterior cruciate ligament, or cartilage of the knee. The clinimetric properties were found to be good and comparable to the American version of the KOOS. Comparison to the Short Form-36 and the Lysholm knee scoring scale revealed expected correlations and construct validity. Item by item, symptoms and functional limitations were compared between diagnostic groups. High responsiveness was found three months after arthroscopic partial meniscectomy for all subscales but Activities of Daily Living.     

The acutely limping child

Acute limping may be the result of multiple pathologies in children. The differential diagnosis varies based on the age of the child. Irrespective of age, the initial imaging work-up includes AP and frog leg radiographs of the pelvis and ultrasound; MRI may sometimes be helpful. In children less than 3 years, infections and trauma are most frequent. MRI is the imaging modality of choice when osteomyelitis is clinically suspected. Between the ages of 3 and 10 years, transient synovitis of the hip and Legg-Calvé-Perthes disease are main considerations but infection, inflammation and focal bony lesions are also considered. In children over 10 years, slipped capital femoral epiphysis also is considered.     

Do Balance Board Training Programs Reduce the Risk of Ankle Sprains in Athletes?

Introduction Ankle sprains are the most common musculo-skeletal injury that occurs in athletes,particularly in sports that require jumping and landing on one foot such as soccer,and basketball(1-4).These injuries often result in significant time loss from participation,long-term disability,and have a major impact on health care costs and resources(5-8).     

High Intensity Interval Training:New Insights

KEY POINTS ·High-intensity interval training(HIT)is characterized by repeated sessions of relatively brief，intermittent exercise.often performed with an“a11 out”effort or at an intensity close to that which elicits peak oxygen uptake(i.e.，≥90%of VO2 peak).     

Endovascular management of carotid-cavernous fistulas

Objective To investigate endovascular treatment of traumatic direct carotid-cavernous fistulas （CCF） and their complications such as pseudoaneurysms. Methods： Over a five-year period, 22 patients with traumatic direct CCFs were treated endovascularly in our institution. Thirteen patients were treated once with the result of CCF occluded, 8 twice and 1 three times. Treatment modalities included balloon occlusion of the CCF, sacrifice of the ipsilateral internal carotid artery with detachable balloon, coll embolization of the cavernous sinus and secondary pseudoaneurysms, and covered-stem management of the pseudoaneurysms. Results All the direct CCFs were successfully managed endovascularly. Four patients developed a pseudoaneurysm after the occlusion of the CCF with an incidence of pseudoaneurysm formation of 18.2% （4/22）. A total number of 8 patients experienced permanent occlusion of the ICA with a rate of ICA occlusion reaching 36.4% （8/22）. Followed up through telephone consultation from 6 months to 5 years, all did well with no recurrence of CCF symptoms and signs. Conclusion Traumatic direct CCFs can be successfully managed with endovascular means. The pseudoaneurysms secondary to the occlusion of the CCFs can be occluded with stent-assisted coiling and implantation of covered stents.     

Developmental validation of the PowerPlex(®) ESI 16 and PowerPlex(®) ESI 17 Systems: STR multiplexes for the new European standard

In response to the ENFSI and EDNAP groups’ call for new STR multiplexes for Europe, Promega^® developed a suite of four new DNA profiling kits. This paper describes the developmental validation study performed on the PowerPlex^® ESI 16 (European Standard Investigator 16) and the PowerPlex^® ESI 17 Systems. The PowerPlex^® ESI 16 System combines the 11 loci compatible with the UK National DNA Database^®, contained within the AmpFlSTR^® SGM Plus^® PCR Amplification Kit, with five additional loci: D2S441, D10S1248, D22S1045, D1S1656 and D12S391. The multiplex was designed to reduce the amplicon size of the loci found in the AmpFlSTR^® SGM Plus^® kit. This design facilitates increased robustness and amplification success for the loci used in the national DNA databases created in many countries, when analyzing degraded DNA samples. The PowerPlex^® ESI 17 System amplifies the same loci as the PowerPlex^® ESI 16 System, but with the addition of a primer pair for the SE33 locus. Tests were designed to address the developmental validation guidelines issued by the Scientific Working Group on DNA Analysis Methods (SWGDAM), and those of the DNA Advisory Board (DAB). Samples processed include DNA mixtures, PCR reactions spiked with inhibitors, a sensitivity series, and 306 United Kingdom donor samples to determine concordance with data generated with the AmpFlSTR^® SGM Plus^® kit. Allele frequencies from 242 white Caucasian samples collected in the United Kingdom are also presented. The PowerPlex^® ESI 16 and ESI 17 Systems are robust and sensitive tools, suitable for the analysis of forensic DNA samples. Full profiles were routinely observed with 62.5 pg of a fully heterozygous single source DNA template. This high level of sensitivity was found to impact on mixture analyses, where 54–86% of unique minor contributor alleles were routinely observed in a 1:19 mixture ratio. Improved sensitivity combined with the robustness afforded by smaller amplicons has substantially improved the quantity of data obtained from degraded samples, and the improved chemistry confers exceptional tolerance to high levels of laboratory prepared inhibitors.     

Prevalence and severity of hip and groin pain in sub‐elite male football: a cross‐sectional cohort study of 695 players

The purpose of this study was twofold: (a) to investigate the prevalence of hip and groin pain in sub‐elite male adult football in Denmark and (b) to explore the association between prevalence and duration of hip and groin pain in the previous season with the Copenhagen Hip and Groin Outcome Score (HAGOS) in the beginning of the new season. In total 695 respondents from 40 teams (Division 1–4) were included. Players completed in the beginning of the new season (July–Sept 2011) a self‐reported paper questionnaire on hip and/or groin pain during the previous season and HAGOS. In total 49% (95% CI: 45–52%) reported hip and/or groin pain during the previous season. Of these, 31% (95% CI: 26–36%) reported pain for >6 weeks. Players with the longest duration of pain during the previous season had the lowest HAGOS scores, when assessed at the beginning of the new season, P < 0.001. This study documents that half of sub‐elite male adult football players report pain in the hip and/or groin during a football season. The football players with the longest duration of pain in previous season displayed the lowest HAGOS scores in the beginning of the new season.     

Bronchial stump fistula :treatment with covered retrievable hinged metallic stents-preliminary clinical experience

Objective To evaluate the preliminaily clinical efficacy and retrievability of a retrievable hinged covered metallic stent in the treatment of the bronchial stump fistula （BSF）. Methods Between April 2003 and March 2005, 8 patients with bronchial stump fistula after pneumonectomy or lobectomy were treated with two types （A and B） of retrievable hinged covered metallic stents. Type A stent was placed in 6 patients and type B in 2 under fluoroscopic guidance. The stent was removed with a retrieval set when BSF was healed or complications occurred. Results Stent placement in the bronchial tree was technically successful in all patients, without procedure-related complications. Immediate closure of the BSF was achieved in all patients after the procedure. Stents were removed from all patients but one. Removal of the stents was difficult in two patients due to tissue hyperplasia. Patients were followed up for 6 - 21 months. Placement of the stents remained stable in all patients except one due to severe cough. Permanent closure of BSF was achieved in 7 （87.5%） of 8 patients. Conclusion Use of a retrievable hinged covered expandable metallic stent is a simple, safe, and effective procedure for closure of the BSF. Retrieval of the stent seems to be feasible. （J Intervent Radiol, 2007, 16： 253-257）