睾丸网腺癌1例报道并文献复习

目的：报告1例睾丸网腺癌并探讨其临床病理特点。方法：取我院收治的1例睾丸网腺癌进行常规病理检查并结合组织化学和免疫组织化学技术。进行病理学研究并收集复习文献中报告的病例。结果：诊断睾丸网腺癌，系原发于睾丸纵隔的恶性肿瘤。结论：睾丸网腺癌是原发于睾丸网纵隔的恶性肿瘤，极为罕见，世界文献报道仅60余例，预后差，5年生存率仅13％，平均发病年龄54．4岁。     

Unusual combination of bilateral testicular microlithiasis and tubular ectasia of the rete testis with left intra- and extratesticular varicocele in a 17-year-old boy

We describe the rare combination of testicular microlithiasis, unilateral intra/extratesticular varicocele, and tubular ectasia of the rete testis in a 17-year-old boy who presented with testicular pain following a trauma. He had a prior history of undescended testis and orchiopexy in childhood. His workup included a normal abdominal ultrasound and a sperm analysis demonstrating a low sperm count with sperm dysmotility. A follow-up ultrasound was unchanged, and he has been managed conservatively. This combined set of findings has not been previously reported.     

超声在发育性髋关节异常诊断中的应用

超声检查是发育性髋关节异常早期筛选、早期诊断和追踪随访的重要方法.本文就超声诊断发育性髋关节异常的优势、方法、新生儿超声筛查情况及目前应用中存在的问题作一综述.     

超声造影应用Bosniak分级诊断肾囊性病灶的价值

目的 探讨CEUS应用Bosniak分级诊断肾囊性病灶的价值,并与增强CT比较。方法 收集同期接受CEUS和增强CT检查的52例患者共68个肾囊性病灶,观察病灶的形态、边壁、分隔、实性结节及血流灌注情况,评价2种方法分级诊断肾囊性病灶的价值。结果 良性组中,25个病灶(25/31,80.65%)CEUS和增强CT均表现为单房或多房囊性病灶,内无分隔或伴纤细分隔,分隔无强化或轻度强化,仅3个病灶(3/31,9.68%)表现为多房囊性病灶伴多个实性结节,2个病灶(2/31,6.45%)表现为花瓣样增强,分隔不规则增厚,1个病灶(1/31,3.23%)表现为网状增强;恶性组中,32个病灶(32/37,86.49%)CEUS和增强CT均表现为多房囊性病灶伴多个实性结节或不规则实性增强区,4个病灶(4/37,10.81%)表现为分隔较厚的多房性囊性病灶,1个病灶(1/37,2.70%)表现为边壁不规则增厚的单房囊性病灶;以Ⅳ级为诊断标准,CEUS和增强CT诊断囊性肾癌的敏感度、特异度、准确率分别为67.57%和70.27%,93.55%和96.77%,79.41%和82.35%。以Ⅲ级及以上为诊断标准,CEUS和增强CT诊断囊性肾癌的敏感度、特异度、准确率分别为97.30%和100%,74.19%和 80.65%,86.76% 和91.18%。分隔数目≥3条及分隔厚度≥1.75 mm可作为诊断肾囊性病灶良恶性的最佳诊断界值。结论 CEUS结合Bosniak标准鉴别诊断肾囊性病灶的良恶性具有较高的价值。     

Torsion of an undescended testis located in the inguinal canal

Background

Torsion of undescended testis located within the inguinal canal is a rare finding in the emergency department (ED). This diagnosis can present as undifferentiated abdominal or groin pain, and a full genitourinary examination is essential to making this diagnosis.

Objectives

We present this case to increase awareness among emergency physicians regarding torsion of undescended testis.

Case Report

A 5-year-old boy presented to the ED with abdominal pain and a mass in his right groin. Physical examination and Doppler ultrasound were used to diagnose torsion of undescended testis.

Conclusions

In a patient with undescended testis, torsion must be considered as a cause of abdominal or groin pain. Full genitourinary examination is essential to making this diagnosis.     

Graf法超声对婴幼儿发育性髋关节发育不良的早期应用价值

目的 探讨Graf法超声检查在婴幼儿发育性髋关节发育不良(DDH)早期诊断及随访中的价值,为今后将髋关节超声检查作为0～6个月婴幼儿DDH早期普查或高危新生儿筛查的首选项目提供理论依据。方法 选取2021年3月至2021年8月南京市江北新区妇幼保健所儿童保健门诊健康查体的408例0～6个月婴幼儿作为研究对象进行Graf法超声DDH筛查,并对DDH婴幼儿早期随访,对筛查和随访结果进行统计分析。结果 408例婴幼儿816个髋关节中,DDH 45例,共53个髋关节,总检出率6.50%(53/816);生理性不成熟35例,需要干预治疗10例;DDH以单侧较常见,左侧较右侧多见(P=0.016),且Ⅱb型、Ⅱc型及D型主要见于左侧;女性DDH发病率高于男性(P=0.004);随访的48个DDH髋关节中38个生理性不成熟髋关节自然发育成熟的比率为94.74%(36/38);自然转归率为77.08%(37/48),临床干预治疗率为22.92%(11/48)。结论 Graf法超声无创、方便、可重复性高,在0～6个月婴幼儿DDH的早期筛查和治疗随访中具有重要的应用价值。     

The role of ultrasonography in the assessment of peri-prosthetic hip complications

Purpose

Total hip arthroplasty (THA) is a widespread option for treating hip osteoarthritis. Peri-prosthetic complications after THA represent a common event influencing patient outcome and costs. The purpose of this paper is to report the use of ultrasonography (US) to detect peri-prosthetic complications in symptomatic patients who underwent THA.

Methods

We retrospectively reviewed the records of patients with THA who underwent imaging evaluation between January 2009 and December 2012 at two different institutions. We evaluated the presence/absence of superficial and/or deep peri-prosthetic collections as well as the presence/absence of a cutaneous sinus tract. For patients who underwent both MRI and US, a concordance correlation analysis between US and MR findings was performed.

Results

In the reference period, 532 symptomatic patients (mean age ± standard deviation 74 ± 12 years) underwent X-ray and MRI examinations for suspected peri-prosthetic complications. Among them, 111 (20.9 %) underwent also US. Overall, 108 patients underwent both US and MRI. US findings included 67 superficial collections, 48 subcutaneous fistulas, 74 deep peri-prosthetic collections. Twenty-four patients had solid, mass-like peri-prosthetic collections. In 11 patients, no peri-prosthetic complications were seen. MRI findings included 68 superficial collections, 49 subcutaneous fistulas, 79 deep peri-prosthetic collections. Twenty-four patients had solid, mass-like peri-prosthetic collections. In four patients, no peri-prosthetic complications were seen. Concordance analysis between US and MRI findings showed almost perfect agreement (k ≥ 0.89).

Conclusion

US is an efficient and practical imaging modality to evaluate peri-prosthetic complications in patients with THA, being almost comparable to MRI in detecting and characterizing these complications.     

The effect of ultrasound exposure in utero on the development of the fetal mouse testis: Adult consequences

The effects of exposure in utero to 1 MHz, continuous-wave ultrasound on adult growth and testicular development in the mouse was investigated. The spatial peak temporal average intensity (I ) employed ranged from 1 to 10 W/cm², with exposure durations (t) of 200 s to 20 s. Exposures were made on days 9, 12 or 15 of gestation. Results showed an increase in postpartum deaths, an increase in the number of stillbirths, and a decrease in litter size when I²t ≥ 1125 W² s/cm⁴, such that there was significant loss of pups. Birthweights of pups from nearly all dosage groups was significantly lower than that of the sham or cage control groups. Results also showed that males exposed to ultrasound in utero had decreased testis size and decreased daily sperm production ranging from 9% to 30%. This study showed that ultrasound exposure in utero is capable of disrupting fetal development and having potential subsequent effects on fertility in the adult male.     

Focal fatty sparing of the pancreatic head in cystic fibrosis: CT findings

The most common imaging appearance of the pancreas in cystic fibrosis is diffuse, complete fatty replacement. We present a case of complete fatty replacement of the pancreatic body and tail with total sparing of the pancreatic head. To our knowledge, this pattern of fatty sparing and its associated computed tomographic appearance have not been previously reported in cystic fibrosis.     

Ectopic ureter,renal dysplasia,and recurrent epididymitis in an infant: case report and review of the literature

The most common etiologies of acute scrotum in boys <1 year of age are torsion of the testis or an appendix, urogenital anomalies, and epididymitis. We report an infant with recurrent epididymitis associated with single‐system ectopic ureter opening into the seminal vesicle and dysplastic right kidney. Treatment included nephroureterectomy.     

阴道三维超声测量丘脑间粘合在胎儿中脑导水管梗阻性脑积水诊断中的作用

目的 探讨阴道三维超声测量丘脑间粘合在胎儿中脑导水管梗阻性脑积水诊断中的作用。方法 选取2021年1月-2022年4月我院收治的60例存在胎儿侧脑室扩张的孕妇,选择同期体检的健康孕妇43例作为对照组。比较两组超声指标的差异。根据经腹彩超结果将侧脑室扩张胎儿分为侧脑室扩张轻度组（n=42）及侧脑室扩张重度组（n=18）。比较两组不同程度侧脑室扩张胎儿超声指标。采用Pearson相关性分析法分析侧脑室扩张与胎儿超声指标的相关性。结果 侧脑室扩张组胎儿C、CD、WA明显高于健康对照组胎儿（P<0.05）,APD、ITAD、ITAD/WA明显低于健康对照组胎儿（P<0.05）;侧脑室扩张重度组胎儿C、CD、WA明显高于侧脑室扩张轻度组（P<0.05）,APD、ITAD、ITAD/WA明显低于侧脑室扩张轻度组（P<0.05）;Pearson相关性分析结果显示,侧脑室扩张与胎儿C、CD、WA呈正相关（P<0.05）,侧脑室扩张与胎儿APD、ITAD、ITAD/WA呈负相关（P<0.05）。结论 阴道三维超声可诊断丘脑间粘合在胎儿中脑导水管梗阻性脑积水。     

Whole-body ultrasound in the intensive care unit: A new role for an aged technique

Management of critically ill patients requires rapid and safe diagnostic techniques. Ultrasonography has become an indispensable tool that supplements physical examination in the intensive care unit. It enables early recognition of neurological emergencies, assists the diagnosis of abdominal and lung pathologies, and provides real-time information on the cardiac performance of critically ill patients. Furthermore, it detects possible infectious sites and renders therapeutic invasive procedures more convenient and less complicated. Whole-body ultrasound in the hands of adequately trained intensivists has the ability to reinvigorate the physical examination, without subjecting the patient to excessive irradiation and the risks of transport.     

Clinical‐radiological approach for the diagnosis of cleidocranial dysplasia in adults: A familial cases series

Cleidocranial dysplasia is a rare disease with an autosomal‐dominant inheritance that mainly affects the bones of the axial skeleton. In this report, we discuss the clinical and radiological signs of a case series comprising three sisters and the son of one of the sisters, all with suspected bone dysplasia.     

Seeing past the appendix: the role of ultrasound in right iliac fossa pain

Acute right iliac fossa pain is a common surgical presentation. The presentation is often non-specific and encompasses a wide differential, which creates a diagnostic challenge. Ultrasound is commonly the initial cross-sectional imaging modality and can be used as a tool to triage patients appropriately; assessing for appendicitis and other salient findings, which may indicate an alternative condition. Additionally, the dynamic nature of this imaging modality enables patient interaction. Following a systematic assessment of the abdomen and pelvis, a more focused interrogation of the right iliac fossa is performed. In this pictorial review, we illustrate the sonographic features of appendicitis and other conditions that can mimic appendicitis in its presentation. This highlights that through a systematic approach, it is possible to distinguish between these different pathologies, enabling clinicians to optimally manage the patient.     

Contrast-enhanced dynamic ultrasonography of the liver: optimization of hepatic arterial phase in normal volunteers

Background: To optimize hepatic arterial phase timing in contrast-enhanced dynamic ultrasonography (US) of the liver.Methods: Dynamic US was performed by using a microbubble-specific mode in 22 healthy volunteers after bolus injection of SH U 508A. Images were analyzed to determine whether hepatic arterial and portal venous phases could be temporally discriminated. Delay times to contrast enhancement at the hepatic artery (A_ini) and portal vein (P_ini) and the delay time until the signals between both vessels became inseparable (A_end) were determined.Results: The hepatic arterial and portal venous phases could be temporally discriminated in all subjects. A_ini, P_ini, and A_end (mean ± standard deviation) were 11.0 ± 2.0, 14.8 ± 3.6, and 22.6 ± 5.1 s, respectively.Conclusion: In hepatic contrast-enhanced dynamic US, hepatic arterial phase scanning should be commenced earlier than 11 s and terminated after 23 s postinjection.     

Rehabilitation of ectodermal dysplasia patient with a telescopic denture in the maxilla and mandibular implant assisted overdenture: A case report

Hypohidrotic ectodermal dysplasia is a heritable disease, characterized by hypodontia, hypotrichosis, and anhidrosis. This clinical report demonstrates prosthetic rehabilitation of a patient complaining of impaired mastication and the odd appearance of her jaws. Maxillary telescopic overdenture and implant‐supported mandibular prostheses were fabricated to improve mastication, speech, and esthetics of the patient.