超声检查在甲状腺疾病诊断中的价值

随着超声医学的发展，超声检查在临床应用日益广泛，尤其在浅表器官的疾病检查中，它不仅能观察病变组织形态、结构、边缘、内部回声等二维表现，而且可了解病变部位的血流分布情况并得到血流频谱参数及测值，通过超声造影新技术反应局部组织血流灌注状态。由于超声检查具有非侵入性、无辐射、可反复检查等优点，它已成为甲状腺疾病诊断中的不可或缺的手段，在甲状腺疾病的诊断和鉴别诊断方面发挥着十分重要的作用。现就超声检查在甲状腺疾病中的诊断价值简述如下。     

超声检查早期诊断体外受精-胚胎移植术后复合妊娠

目的探讨超声检查早期诊断体外受精-胚胎移植术(IVF-ET)后复合妊娠(HP)的价值。方法回顾性分析81例IVF-ET后临床确诊为复合妊娠患者的超声和手术情况,并随访宫内妊娠结局。结果超声诊断HP的时间为IVFET后20~49天,平均(29.08±5.74)天。81例中,术前超声诊断为宫内合并输卵管妊娠70例,宫内合并宫角妊娠8例,宫内合并宫颈妊娠、宫内合并肌壁间妊娠、单侧输卵管妊娠各1例;术前超声误诊3例,漏诊1例;超声诊断符合率为95.06%(77/81)。对77例宫内妊娠情况进行随访,其中60例已分娩或继续妊娠,6例术后宫内胚胎停育而接受清宫术,1例因21-三体高风险而接受引产,10例失访。结论超声检查可早期诊断IVF-ET后HP,指导临床及时治疗。     

超声早期诊断类风湿关节炎

类风湿关节炎是一种以慢性破坏性关节病变为特征的自身免疫性疾病,临床、实验室检查与放射学检查对早期诊断的作用有限。高频灰阶超声软组织分辨力较高,能够区分渗出性和增殖性滑膜病变;能量多普勒超声有助于区分活动性和非活动性关节病变;CEUS可提高检出滑膜增厚、滑膜血管增生等病变的敏感性。超声检出骨侵蚀的能力优于放射学检查,还可随访和监测治疗效果。     

超声诊断妊娠合并葡萄胎的研究进展

妊娠合并葡萄胎是一种复杂的异常妊娠,其临床发生率极低,诊断困难,常伴随严重的母婴并发症。妊娠合并葡萄胎的早期症状易被忽视,主要通过超声及实验室检查进行诊断,但最终确诊需依靠超声检查结合病理结果。本文旨在对妊娠合并葡萄胎的超声影像学特点、鉴别诊断、超声在妊娠合并葡萄胎发生发展预后中的作用及妊娠合并葡萄胎的病因、发生机制,可能出现的母婴并发症等进行综述。     

常规彩色多普勒超声与弹性成像技术在诊断乳腺肿块中的价值

目的 探讨联合应用常规彩色多普勒超声与弹性成像技术在诊断乳腺肿块中的价值。方法 对超声检查发现91例患者的98个乳腺肿块进行超声弹性成像与常规彩色多普勒超声检查,以术后病理结果作为金标准,对常规超声诊断,弹性成像诊断及两者联合诊断对乳腺肿块的鉴别价值分别采用SPASS18.0统计软件进行分析,率的比较采用χ2检验,P<0.05为差异有统计学意义。结果 诊断乳腺肿块的敏感性、特异性及准确率比较:常规彩色多普勒超声分别为83.9%、68.7%及73.5%;超声弹性成像分别为:83.9%、59.7%及67.3%;而联合应用超声弹性成像与彩色多普勒超声检查诊断乳腺肿块优于前2种,分别为90.3%、91.0%及90.8%,三种检查方式在乳腺良恶性肿块的鉴别诊断中,差异均有统计学意义P<0.01。结论 在运用超声诊断乳腺肿块时,联合应用常规彩色多普勒超声与弹性成像技术明显提高了准确率。     

高频超声诊断女婴腹股沟斜疝内容物为卵巢1例

目的探讨高频超声在诊断女婴腹股沟斜疝,内容物为卵巢的临床应用价值。方法回顾性分析我院收治并手术确诊的1例腹股沟斜疝,内容物为卵巢的女婴的超声声像图特点及临床资料。结果超声检查诊断此例女婴腹股沟斜疝,疝内容物为卵巢,与手术结果相符。结论高频超声可作为女婴腹股沟斜疝,疝内容物为卵巢的首选检查方法,为早期临床诊断治疗提供可靠依据。     

超声检查在活体肝移植受体术后胆道并发症诊断中的应用

目的探讨超声检查在活体肝移植术后胆道并发症诊断中的临床应用。方法对21例成人右半肝活体移植受体术后进行超声检查,观察移植肝及其胆道声像图表现,与经皮经肝穿刺胆道造影引流(PTCD)等影像学结果相对比。结果 21例病例经PTCD及临床随访证实为胆管吻合口狭窄5例,胆泥1例,胆漏1例。超声检查能够诊断并与之相符5例,为4例吻合口狭窄及1例胆泥,胆漏病例可见肝周积液。其中4例胆管吻合口狭窄病例超声诊断时间均明显早于临床出现黄疸或血清胆红素升高的时间。结论在活体肝移植术后胆道并发症的诊断中,超声检查操作简便、无创、可重复性强、准确性较高,可早期诊断胆管并发症,具有重要的临床应用价值。     

膝骨性关节炎早期诊断的研究进展

膝骨性关节炎是常见的关节病之一,临床上典型患者的临床分期属于中晚期,因此提高对早期膝骨性关节炎的诊断尤为重要。目前临床上最常应用于诊断膝骨性关节炎的方法为磁共振检查,且随着磁共振不同序列的发展,针对关节软骨早期病变的序列正应用于临床。在膝骨性关节炎的早期诊断中,超声检查等简单实用的方法正成为一种趋势,而特异性生物标志物将成为一项热门研究。     

超声研究胎儿胰腺发育的现状

胰腺异常属罕见先天性畸形,环状胰腺胎儿常伴发多种畸形,病死率高且预后差,产前超声早期诊断对降低围生期死亡率具有重要意义。由于胎儿胰腺位置隐蔽且体积小,在产前超声检查中常易被忽视。近年来,随着产前超声检查技术不断进步及产科检查需求更加全面、细致,利用产前超声观察胎儿胰腺大小、形态及回声越来越受到关注。本文主要对胰腺的胚胎发育、胎儿胰腺的解剖学基础及超声检查研究等进展进行综述。     

超声心动图评价肥厚型心肌病的研究进展

肥厚型心肌病(HCM)是一种常见的遗传性心血管疾病,早期诊断和准确评估对于HCM的治疗和预后至关重要.本文对国内外关于HCM的超声心动图研究现状、各种新技术的临床应用及研究进展进行综述.     

Diagnostic ultrasound of the small joints of the hands and feet: current status and role of ultrasound in early arthritis

The small joints of the hands and feet play a central role in the diagnosis and classification of arthropathy. Ultrasound can be used to assess involvement in areas that are clinically occult. The aim of this article was to review the current status of ultrasound imaging of patients with rheumatological disorders of the hands and feet. There is increasing evidence that ultrasound detects synovitis that is silent to clinical examination. Detection and classification of synovitis and the early detection of bone erosions are important in clinical decision making. Ultrasound has many advantages over other imaging techniques with which it is compared, particularly magnetic resonance. The ability to carry out a rapid assessment of many widely spacedjoints, coupled with clinical correlation, the ability to move and stress musculoskeletal structures and the use of ultrasound to guide therapy accurately are principal amongst these. The use of colour flow Doppler studies provides a measure of neovascularisation within the synovial lining of joints and tendons, and within tendons themselves, that is not available with other imaging techniques. Disadvantages compared to MRI include small field of view, poor image presentation, and difficulty in demonstrating cartilage and deep joints in their entirety.     

A new surgical technique for treatment of preauricular sinus

BACKGROUND: The objectives of this paper are to describe the shortcomings of current techniques for treatment of preauricular sinus (PAS) and to introduce a new surgical technique. PAS is a common congenital abnormality. Usually these lesions are asymptomatic. However, some patients complain of discharge and/or (recurrent) infections, and require excision. Surgical treatment of PAS is characterized by high recurrence rates. This paper describes a single institution's experience with the operative management of PAS and introduces a new technique. METHODS: Data on PAS procedures were collected from a retrospective review of patients' charts and interviews by questionnaire of all patients treated operatively for PAS in the Leiden University Medical Centre from 1984 to 2003. RESULTS: Thirty-nine patients (21 male, 18 female) with PAS underwent 40 procedures for PAS. These procedures included 17 classic operations (in 16 patients) and the "inside-out technique" in 23 patients. In the patient group treated "classically," 2 patients developed a recurrence; one underwent successful reoperation; the other patient has been lost to follow-up. Another patient developed wound breakdown postoperatively, resulting in an ugly scar. Two patients had postoperative infections requiring treatment. Neither recurrences nor complications requiring treatment occurred in the group who underwent the inside-out technique. CONCLUSIONS: The inside-out technique provides an easy solution for patients with PAS. However, further study on a larger patient group is necessary.     

胎盘植入性疾病分子机制和病理诊断研究进展

胎盘植入性疾病(placenta accreta spectrum disorders,PAS)是胎盘绒毛不同程度侵入子宫肌层的一组疾病.PAS是产科的高危并发症之一,在临床上可导致严重产后出血、休克、子宫切除,甚至产妇死亡.病理诊断是PAS诊断的"金标准",但目前仍存在争议.本文主要就PAS的分子机制和病理诊断两个方...     

Use of Quantitative Ultrasound Densitometry (QUS) in Male Osteoporosis

Bone densitometry is a key factor in the early diagnosis of osteoporotic bone disorders. Cut-off values for WHO classification for male osteoporosis and all densitometry techniques such as dual x-ray absorptiometry (DXA), quantitative ultrasound (QUS), and quantitative computed tomography (QCT) need to be developed. Hereby, QCT, DXA, and QUS are equivalent methods in the prospective assessment of fracture risk. Where men and women have similar BMD values, they also have similar fracture probability. QUS has several advantages compared to the radiological devices. The QUS systems, which are commercially available at present, are non-invasive methods, which are safe, simple, free of radiation, portable, and relatively inexpensive. QUS can be measured at the calcaneus and phalanges or with multi-site systems. Phalangeal ultrasound is especially useful as being easily accessible.     

超声新技术评估化学治疗乳腺癌致左心室功能损伤研究进展

化学治疗(简称化疗)是乳腺癌常规治疗手段之一,在有效抑制肿瘤的同时亦会导致心脏损伤。化疗所致心脏损伤的最直接表现是左心室收缩功能减低。目前临床评价左心室功能最常用方法为超声测量左心室射血分数(LVEF),而LVEF只有在心肌严重损伤情况下才会明显下降,此时多已错过最佳干预时机。随着超声技术的进步,一系列超声新技术已用于检测心功能,并能早期发现心肌损伤。本文对超声新技术评估乳腺癌化疗致左心室功能损伤研究进展进行综述。     

New developments in ultrasonography for the detection of prostate cancer

The introduction of contrast agents has changed the diagnostic role of ultrasonography dramatically. Advanced ultrasound techniques, although currently largely unexplored, especially for prostate applications, were introduced to improve, for example, differential diagnosis. Also, new technologies became available using the interaction of the angioemboli with the transmitted ultrasound waves, and sensitive methods to detect microbubbles were developed. As the traveling of microbubbles through the vascular system is a dynamic process, new information becomes available: when the concentration of the contrast agent can be determined as a function of time, a measure for the actual blood flow can be obtained that provides quantitative information. Initially developed to enhance the ultrasound examinations in cardiac applications, contrast agents can currently be found in radiologic applications as well. The first reports of enhanced Doppler examinations of prostatic blood flow have been published, and the results indicate that contrast agents are a promising addition to the conventional ultrasound examination. In this paper, we present a short overview of the status of transrectal ultrasound imaging in prostate cancer, background information on contrast agents and imaging modalities, and early results of enhanced Doppler studies of the prostate to identify cancer. The early results suggest the feasibility of using angioemboli to enhance ultrasound imaging of prostate diseases, and although many issues remain to be solved, angioemboli in combination with a dedicated imaging modality have the potential to improve the diagnostic application of ultrasound in evaluating the prostate for disease.     

超声技术在糖尿病肾病诊断中的应用现状

糖尿病肾病是糖尿病患者重要的并发症之一,也是终末期肾衰竭主要致病原因之一。超声一直是糖尿病肾病的主要诊断方法,发展至今,临床上常见的糖尿病肾病超声诊断方法包括二维超声、超声背向散射积分、彩色多普勒血流成像、彩色多普勒能量图、三维超声等技术,这些超声诊断技术用于糖尿病肾病的诊断均有一定价值。本文列出了各类主要超声技术用于诊断糖尿病肾病的应用现状,并阐明其机制,由此探讨超声诊断技术在糖尿病肾病早期评估与诊断中的应用价值。     

Current role of imaging in diagnosing aortic graft infections

Vascular prosthetic graft infection is a rare but serious complication after aortic graft replacement, with high morbidity and mortality rates. Therefore, adequate diagnostics are needed to detect and treat these infections as early as possible. Several imaging modalities provide different diagnostic values for detecting prosthetic graft infection. Previous studies reported on the diagnostic value of ultrasound, computed tomography imaging, magnetic resonance imaging, fluorodeoxyglucose-positron emission tomography, and single-photon emission computed tomography. In addition, adjunctive studies on new and promising techniques to detect prosthetic graft infection (eg, bio-optical imaging and target imaging with nuclear techniques) have also been investigated. This review provides a summary of noninvasive imaging modalities and their diagnostic values in order to evaluate and treat possible vascular graft infections as early as possible.     

Diagnosis and monitoring in arterial surgery: the use of ultrasound and related techniques.

Recent advances in ultrasound techniques have led to new pathophysiological measurements for patients with arterial diseases. They have identified arterial wall stiffening in early atherosclerosis and have shown an exaggerated vascular response to the inhalation of cigarette smoke. Femoral artery Doppler signals have been used to assess the haemodynamic effects of incomplete stenoses of the iliac arteries. Ultrasound imaging has been used to predict non-invasively atheroma at the carotid bifurcation as well as to identify changes in implanted grafts which are associated with late graft failure.