彩色多普勒超声造影诊断肝脏肿瘤

目的:研究彩色多普勒超声造影(ECDFI)对肝肿瘤内血流的检测能力和诊断准确性。方法:对75个肝内病灶(良性18个,恶性57个)进行ECDFI检查,结果与CT双期增强扫描和病理检查结果(金标准)比较。结果:ECDFI瘤内血流显示率良性组和恶性组分别为78％和96％,CT动脉期增强分别为83％和98％。ECDFI诊断符合率93％。增强CT87％。结论:ECDFI对于提高肝肿瘤血流显示率和诊断符合率有重要意义,其敏感性、特异性与CT较为一致。     

肝癌的多普勒超声与微血管密度关系的相关性观察

新生肿瘤血管是肝癌生长和转移的关键因素，肿瘤血管化程度在肝癌的诊断、治疗和预后中占重要地位。本资料采用免疫组化方法计数微血管密度（MVD），并与肝癌的多普勒检测肿瘤血管进行对照研究，评价其检测肝癌血流与肿瘤血管增生的关系。     

彩色多普勒超声在小肝癌鉴别诊断中的价值

对肝硬化增生结节和小肝癌的鉴别 ,肝血管瘤与小肝癌的鉴别仍是二维超声的难题。本文旨在探讨彩色多普勒超声对小肝癌的鉴别诊断价值。1　对象和方法1.1　对象　本组肝病 16 9例 ,共 2 5 9个病灶 ,肿瘤大小为 8～91mm。男 97例 ,女 72例 ;年龄 2 3～ 75岁 ,平均 (5 9.1± 13.8)岁。其中原发性肝癌 5 9例 ,共 6 8个病灶 ,其中 ,4 1例经手术和 /或病理证实 ,18例经超声引导下细针经皮肝穿刺病理证实。转移性肝癌 36例 ,共 86个病灶 ,各有 11例经手术和超声引导下细针经皮肝穿刺病理证实 ,另外 12例基于原发肿瘤病理诊断和 CT检查。肝血管瘤 7…     

肝脏肿瘤的能量和常规彩色多普勒超声评价

肝脏肿瘤的能量和常规彩色多普勒超声评价马玉香①蔡立卿②侯家声①１资料和方法经证实的肝血管瘤（ＨＡ）１２例、肝细胞癌（ＨＣＣ）１１例、肝转移癌（ＭＬ）９例。ＨＡ年龄为３０～６５（平均４８．６）岁，ＨＣＣ为３６～６８（平均５３．３）岁，ＭＬ为５２～６７（...     

彩色多普勒超声对集束电极射频治疗肝癌的疗效观察

目的　利用彩色多普勒超声评价肝癌集束电极射频 (RFA)治疗的效果。方法　对 12例肝癌患者射频治疗术前后 1周肿块的大小及血流动力学的变化进行观察。结果　射频治疗术后 1周 ,12例患者 2 3个肿块中 ,14个肿块体积缩小 ,6个肿块大小变化不明显 ,3个肿块较术前增大。低回声肿块变成高回声 ,强回声肿块不变或变成不均质强回声。术前18个肿块可测及血流信号 ,术后 8个肿块血流信号减少 ,6个肿块血流信号完全消失 ,4个无明显变化。结论　彩色多普勒超声对肝癌射频治疗前后肿块大小及血流变化的观察可以为预后判断和重复治疗提供依据     

超声造影非典型肝癌的血流动力学表现及病理特征分析

目的：探讨超声造影表现不典型的原发性肝癌的血流动力学基础。方法：分析造影表现不符合原发性肝癌诊断标准的123例原发性肝恶性肿瘤的血流动力学表现及与病理特征阃的关系。结果：从超声造影增强方式分析，病灶呈斑片状或环状增强者81例，不同肿瘤组中出现不典型增强方式的比例以胆管细胞性肝癌和少见类型肿瘤组以及肿瘤直径大于3cm组多见，且差异有统计学意义（P〈0．01）；造影增强时相不典型方面，肿瘤开始增强与肝实质同步或晚于肝实质、门脉期未减退者42例，与肝癌的分化程度密切相关。结论：原发性肝癌中因病理类型和分化程度不同而出现相应的造影表现，分析造影增强特征有助于特殊类型的原发性肝癌的诊断。     

彩色多普勒超声对肠系膜上动脉粥样斑块血液动力学评价

目的：研究肠系膜上动脉（SMA）粥样斑块血液动力学变化情况及临床意义。方法：选取21例SMA粥样斑块患者作为观察组，正常对照组10例。采用彩色多普勒超声测定SMA血流动力学各项参数。结果：动脉粥样硬化患者SMA内径较正常对照组显著减小（P＜0．01）；当SMA狭窄＞50％时，实验组与对照组血液动力学参数存在显著差异（P＜0．01）。结论：SMA粥样斑块使SMA血流量减少，对老年性急腹症有重要的诊断意义。     

超声造影对肝癌射频微创治疗的应用价值

目的：评价超声造影对肝癌射频微创治疗的价值。方法：98例肝癌患者126个病灶在超声引导下射频消融治疗,其中原发性肝癌51例60个病灶,转移性肝癌47例66个病灶。治疗前及治疗后行超声造影检查,并与同期增强CT比较,治疗中51例69个病灶使用了超声造影引导消融。结果：126个病灶治疗1个月后超声造影判定89.7%（113/126）的病灶达到完全消融,10.3%（13/126）的病灶消融不全;增强CT判定88.9%（112/126）的病灶达到完全消融,11.1%（14/126）的病灶消融不全,两者比较差异无显著性,P＞0.01。结论：超声造影在肝癌射频微创治疗中不但起着定位肿瘤、引导穿刺、监测治疗过程的作用,而且是评价肝癌射频消融疗效的有效方法。     

腹腔镜超声在肝脏肿瘤手术中的应用

目的：探讨腹腔镜超声在肝脏肿瘤手术中的应用.方法：对60例肝脏肿瘤患者行腹腔镜超声引导下手术治疗,腹腔镜超声探查结果分别与术前常规超声检查结果、CT检查结果比较,并根据术中探查结果相应调整手术方案.结果：术前术中共发现106枚病灶,其中腹腔镜超声发现98枚（检出率92％）,常规超声检查发现81枚（检出率76％）,CT检查发现87枚（检出率82％）,另腹腔镜超声发现7例患者已发生腹腔淋巴结转移,腹腔镜超声检出率高于常规超声检查（P=0.002）及CT检查（P=0.038）,差异有统计学意义.术中根据腹腔镜超声探查结果,26例改变原手术方案,34例继续原手术方案.术后所有患者均未出现严重并发症,术后6～12月5例患者出现复发.结论：腹腔镜超声对肝脏肿瘤不仅具有较高检出率,可发现术前影像学检查遗漏的病灶,且在术者选择手术方案方面提供精确的病灶信息,指导手术彻底、安全及合理实施.     

彩色多普勒超声评价颈内动脉支架置入后的血液动力学状态

本研究应用彩色多普勒血流成像（CDFI）观察颈内动脉支架置入后血流变化情况，旨在了解支架置入后颁内动脉血流动力学状态。为临床评价治疗效果、早期发现再狭窄等并发症提供简捷方便的检查手段。     

应用二维及多普勒超声对射频治疗肝癌疗效的随访观察

目的：评价应用自然组织谐波显像（NTHI）、彩色及能量多普勒（CDFI及CDE）随访观察集束电极射频治疗肝癌6－18个月的疗效。方法：NTHI、CDFI和CDE观察射频治疗前及治疗后6月的68例73个肿块、12月的40例55个肿块和18月的15例17个肿块的大小、回声和血流动力学情况。随访射频术后6月、12月、18月的患者,计算其生存率。结果：射频治疗后6月、12月、18月肿块缩小,回声增强,肿块缩小率分别为57.5%,51.8%,47.1%;肿块血流信号消失或明显减少,血流信号消失率分别为72．6％,55．1％,48．7％;肝动脉的血流速度及阻力指数降低。患者的生存率分别为100％,93．3％和85．2％。结论：应用NTHI、CDFI、CDE对肝癌患者射频治疗前后肿块的观察方法简便、无创,在疗效判断及随访中具有重要临床意义。     

彩色多普勒超声对高度近视眼血流动力学研究

目的:研究高度近视眼血流动力学及其在近视眼病理改变机制中的作用。方法:应用ATL超9型彩色多普勒诊断仪对26例高度近视眼、17例轻中度近视眼及26例正常对照眼的眼动脉(OA)、视网膜中央动脉(CRA)、睫状后动脉(PCA)进行检测。结果:高度近视组、轻中度近视组与正常对照组血流参数比较:OA血流参数无显著性差异(P>0.05)。CRA、PCA的收缩期(PSV)、舒张期(EDV)、平均血流速度(AV)流速均减低, CRA的阻力指数(RI)升高(P<0.05)。轻中度近视组与对照组比较,无显著性差异(P>0.05)。结论:高度近视眼患者CRA、PCA血流速度减低,表明视网膜及睫状血管系统血液灌注不足,可能是引起其病理性眼底改变的因素之一。彩色多普勒超声用于研究眼底血管、高度近视眼血流动力学变化具有临床意义。     

肝肿瘤超声造影前后血流平均密度对比研究

目的:探讨定量指标血流平均密度(MFD)在评价肝肿瘤超声造影前后血供情况的临床应用价值。方法:造影前对35个肝肿瘤病灶(原发性肝癌11个,转移性肝癌9个,血管瘤15个)行能量多普勒成像(CPA),计测病灶内MFD,经肘静脉注射造影剂SonoVue,对病灶行超声造影反向脉冲谐波(PIH)检查,计测造影后病灶内MFD,并分别与造影前对比、统计分析。结果:各组造影前与造影后MFD比较差异有统计学意义(P<0.05),造影后原发性肝癌组MFD(0.303±0.179),明显高于血管瘤组(0.093±0.064),两组间比较差异有统计学意义(P<0.05)。造影后转移性肝癌组分别与原发性肝癌组和血管瘤组比较,差异均无统计学意义(P>0.05)。结论:超声造影能提高不同性质肝肿瘤的血流信号,血流定量指标MFD能对肝癌与肝血管瘤的鉴别诊断提供有价值的信息。     

肺癌恶性肿瘤多弹头射频治疗CT评价

目的：用CT评价肺部恶性肿瘤多弹头射频治疗的近期疗效。方法：CT引导下经皮肺穿刺插入多弹头射频电极行射频热凝固治疗40例共58个病灶,治疗即时及3或6个月后CT扫描评价治疗效果。结果：治疗后即时CT扫描显示病灶周边渗出,38个病灶减低,31个病灶内出现的小气泡影,3或6个月后CT复查3个病灶完全消失,36个缩小,10个增大,9个基本无改变。37例有肺部相关症状及体征在治疗后消失或好转。结论：多弹头射频治疗肺部恶性肿瘤近期疗效确切,CT可准确上导射频针的插入及显示肺癌治疗后的病理改变。     

彩色多普勒超声对乳头溢液的病因诊断与鉴别

目的:探讨彩色多普勒超声对乳头溢液的病因诊断及鉴别诊断价值。方法:术前应用彩色多普勒超声对72例乳头溢液患者进行检查,并将超声检查结果与手术及病理诊断结果对比。结果:本组72例乳头溢液包括:导管内乳头状瘤38例(52.8%),乳腺囊性增生23例(31.9%),导管内乳头状癌6例(8.3%)及浆细胞性乳腺炎5例(7.0%)。彩色多普勒超声检出乳腺病变最小直径0.2cm,最大直径2.4cm,经与手术及病理诊断结果对比,超声对病变检出率为90.3%(65/72),超声诊断符合率达81.9%(59/72)。结论:彩色多普勒超声对乳头溢液患者病变定位及定性诊断价值较大,可作为临床诊断本病的首选检查方法。     

直肠癌的腔内高频彩超声像图表现

目的 探讨直肠癌的腔内高频彩超声像图特点。方法 经直肠高频彩起检查25例直肠癌并与手术病理结果进行对照分析;测定20例正常人直肠粘膜层动脉流速曲线。结果 直肠癌直肠粘膜层回声连续性中断,呈低回声肿块,边界不清,无包膜,可伴有微钙化。腔内高频超声可检测直肠癌肠壁内外浸润程度。恶性肿块内部动脉血流丰富,BIO.71±0.08,正常直肠粘膜层RI0.83±0.08(P<0.01)。结论 直肠癌的二维声像图表现,如肿块的边界,内部回声,钙化均有一定特点;腔内高频超声对直肠癌浸润度检测有极高的临床价值。     

Vascularity of gastric carcinoma: evaluation using color Doppler ultrasonography

Purpose The purpose of this study was to investigate the vascularity of primary gastric cancer lesions using color Doppler ultrasonography.Methods We used color Doppler ultrasonography to study 78 patients with gastric cancer detected on B-mode ultrasonographic examination and 14 patients without gastric tumors but with a slightly thickened gastric wall that was also detected on B-mode ultrasound. The color Doppler signals of the gastric lesions were graded as (–), no color signals; (+), slight increase in number of color signals; and (++), an obvious increase in number of color signals. The vessel area outside the tumor area in the microscopic pathological specimens was also calculated.Results The color signals of 13 (18%) of the 71 gastric cancer patients were graded (–); those of 14 (20%) patients were graded (+); and those of 44 (62%) patients were graded (++). The color signals for 9 (65%) of 14 patients without gastric tumors were graded (–); those of 4 (28%) patients were graded (+), and those of 1 patient (7%) were graded (++). These differences were significant (P = 0.0002). The vessel count ratio in the microscopic pathologic specimens was also significantly higher in patients with an increased number of color signals than in those without an increased number of color signals (P = 0.002).Conclusion Color Doppler ultrasound showed increased vascularity in the gastric cancers in most of the subjects (82%, 58/71). Furthermore, color Doppler ultrasound also showed no increase in vascularity in most subjects (65%, 9/14) whose B-mode ultrasonograms showed thickened gastric walls but who did not have gastric cancer. Thus, color Doppler imaging may prove useful as a screening modality for gastric cancer.     

Assessment of therapeutic response in hepatocellular carcinoma treated with percutaneous radio frequency ablation: comparison of multiphase helical computed tomography and power Doppler ultrasonography with a microbubble contrast agent.

OBJECTIVE: To compare the results of multiphase helical computed tomography and power Doppler ultrasonography with a microbubble contrast agent in the assessment of the therapeutic response to radio frequency ablation in hepatocellular carcinoma. METHODS: In 66 patients with 73 nodular hepatocellular carcinomas ranging from 1.0 to 4.0 cm (mean, 2.6 cm) in diameter, contrast-enhanced power Doppler ultrasonography was performed after intravenous bolus injection of a galactose-based microbubble contrast agent before and after radio frequency ablation. The results of the studies were compared with the findings of follow-up 3-phase helical computed tomography. All patients were regularly followed up with computed tomography for more than 1 year (range, 13-19 months). RESULTS: In 8 (11%) of 73 hepatocellular carcinomas, immediate follow-up computed tomography obtained within 2 hours after radio frequency ablation showed focal enhancing portions within the treated lesions, suggesting residual non-necrotic tumors. All 8 of these tumors had intratumoral flow signals on contrast-enhanced power Doppler ultrasonography. The diagnostic agreement between computed tomography and contrast-enhanced power Doppler ultrasonography was achieved in 100%. Among the remaining 65 hepatocellular carcinomas with the absence of residual tumors at both immediate follow-up computed tomography and contrast-enhanced power Doppler ultrasonography, subsequent follow-up computed tomography showed local regrowth at the margins of 10 lesions (15%). CONCLUSIONS: The results of contrast-enhanced power Doppler ultrasonography closely correlated with those of immediate follow-up computed tomography for detecting residual tumors in hepatocellular carcinomas treated with radio frequency ablation. Both techniques, however, showed a limitation in detecting small or microscopic residual tumors and in predicting local regrowth in the treated lesions.     

Transitional cell carcinoma involving the distal ureter: assessment with transrectal and color Doppler ultrasonography.

OBJECTIVE: The purpose of this study was to compare the feasibility of transrectal ultrasonography (TRUS) and color Doppler ultrasonography (CDUS) with transabdominal ultrasonography (TAUS) for the diagnosis of transitional cell carcinoma (TCC) involving the distal ureter. METHODS: Our study group consisted of 12 patients having TCC involving the distal ureter who had undergone TAUS and TRUS. Verification of the TCC involving the distal ureter was made by surgery (n = 9) or urine cytologic examination combined with the imaging findings (n = 3). The gray scale images of TAUS and TRUS were retrospectively evaluated to determine whether the ureteral mass was visualized. The CDUS findings were compared with the T stage, the histopathologic grade, and the mean microvessel density of histopathologically proved distal ureteral TCCs (n = 8). RESULTS: Transabdominal ultrasonography showed hypoechoic ureteral dilatation in 6 patients, a ureteral mass in 5, and anechoic ureteral dilatation in 1. Transrectal ultrasonography showed a ureteral mass in all 12 patients. Color Doppler ultrasonography could show blood flow in the ureteral mass in all patients. The tumor vascularity on CDUS showed no statistically significant relationship with the T stage, the histopathologic grade, and the mean microvessel density. CONCLUSIONS: Compared with TAUS, TRUS seems to improve the ability to detect TCC involving the distal ureter. In conjunction with TRUS, CDUS shows blood flow in the ureteral mass, and this may be helpful for the diagnosis of TCC involving the distal ureter.