经阴道超声对女性尿道憩室的诊断价值

目的探讨经阴道超声检查女性尿道憩室的声像图表现及诊断价值。方法回顾性分析40例女性尿道憩室患者临床及超声资料,总结其声像图特点。结果 40例经阴道超声诊断为尿道憩室。其中38例为单发憩室,2例多发憩室。均位于尿道中段,背侧为主。环形11个,马鞍形25个,类圆形7个。复杂性憩室37个,单纯性憩室6个。憩室最大径0.9~6.2 cm(中位3.0 cm),其中复杂性憩室最大径1.5~6.2 cm(中位3.0 cm),单纯性憩室最大径0.9~2.2 cm(中位1.5 cm)。壁厚0.2~0.5 cm(中位0.3 cm)。32个憩室呈无回声,11个憩室为片絮状弱回声。34个憩室内多发分隔,9个憩室内无分隔。26个憩室内点片状强回声结石,17个无强回声。43个憩室内均未见实性肿瘤。29个憩室开口位置与术中所见相符,14个憩室开口与术中所见不相符或未得到手术证实。28个憩室壁或分隔可见少量低速高阻动脉血流信号。结论女性尿道憩室的声像图具有特征性,有助于术前诊断及鉴别诊断。     

浅表软组织肿块的超声检查评价

目的探讨二维高频超声及彩色多普勒超声对浅表软组织肿块的诊断价值.方法对121例浅表软组织肿块应用二维高频超声及彩色多普勒超声进行检查和分析.全部病例均经手术和病理学检查证实.结果良性肿块102例(其中脂肪瘤65例,腱鞘囊肿12例,神经鞘瘤7例,神经纤维瘤2例,血管瘤8例,结核脓肿5例,内膜移位1例).恶性肿块19例(其中恶性神经鞘瘤5例,恶性纤维组织细胞瘤4例,隆突性皮肤纤维肉瘤4例,脂肪肉瘤4例,恶性颗粒细胞瘤1例,横纹肌肉瘤1例).良性肿块中边界不清者40例(39%),圆度系数＞2.0者59例(57.8%),内部回声多半分布均匀,彩色血流检出率20.58%.恶性肿块边界清晰者10例(52.6%),圆度系数＜1.5者12例(63.1%),内部回声多半不均匀,彩色血流检出率100%.结论二维高频和彩色多普勒超声有助于确定浅表软组织肿块的形态、大小及深度,区分肿块的囊实性与血流特征,具有一定的临床应用价值.     

Imaging Features of Paratesticular Masses

In this pictorial essay, we review the sonographic and other imaging findings of paratesticular masses in correlation with the pathologic findings. The examples include benign and malignant tumors and also non‐neoplastic mass lesions of the paratesticular structures. Diagnostic sonographic findings of these mass lesions as well as correlative findings of other imaging methods are presented.     

Evaluation of 1294 Female Patients with Breast Pain: A Retrospective Study

Introduction

Mastalgia, or breast pain, is one of the most important complaints referred to outpatient clinics. The objective of this study was to evaluate the factors causing mastalgia. All patients who presented to our clinic with complaints of mastalgia were assessed along with their type of mastalgia symptoms, menopausal status, and radiology results.

Methods

A total of 3157 patients with mastalgia complaints visited our clinic between January 2015 and February 2018. Only 1294 of them were retrospectively screened. Age, sex, menopausal (premenopausal, postmenopausal) status, mastalgia type (cyclic, non-cyclic), and imaging findings of the patients were examined.

Results

The mean age was 43.8?±?11.8 (13–86) years, with 453 (35%) patients younger than 40 years and 841 (65%) older than 40. Cyclic mastalgia was found in 207 (16%) patients, and non-cyclic mastalgia was seen in 1087 (84%) patients. A total of 786 (60.7%) patients were premenopausal, and 508 (39.3%) were postmenopausal. Mammography was used in 545 (42.1%) patients; 1190 (92.0%) women had breast ultrasonography.

Conclusion

Although breast pain is a common symptom in women who are referred to breast outpatient clinics, we concluded that patients who complain of mastalgia should not be afraid of cancer. Despite this and for reassurance, clinical imaging may be necessary to alleviate these patients’ suspicions.

     

三维超声成像对乳腺肿块诊断价值的初步探讨

目的初步探讨三维超声成像技术在乳腺肿块中的诊断价值。方法对20例24个乳腺肿块术前进行二维彩色多普勒超声及三维超声检查，分析其血流情况及三维超声成像效果。结果三维超声成像可立体、直观地显示乳腺肿块的立体形态、与周边组织的关系以及内部细微结构特征。二维超声的诊断符合率为87．5％，三维超声的诊断符合率为95．8％。结论在原有二维及彩色多普勒的基础上结合三维超声，可进一步提高诊断水平，三维超声对乳腺肿块的良恶性有鉴别诊断作用。     

女性尿道综合征病人的护理

女性尿道综合征 (femaleurethralsyndrome ,FUS)又称无菌性尿频 -排尿不适综合征 ,是指仅有尿频、尿急和或尿痛的症状 ,而中段尿细菌定量培养阴性 ,并排除结核、真菌及厌氧菌尿路感染者[1] 。本症在女性中最常见 ,是泌尿系统的一种常见病 ,其机制尚不清楚。尿道解剖异常、免疫因素、心理因素以及尿道细菌感染是FUS的致病因素。国外近年趋向于采取生物反馈行为治疗、电刺激、盆底肌肉训练等方法重建下尿路功能[2 ] 。国内倾向于采取综合治疗。自 2 0 0 0年— 2 0 0 2年我科共收治住院FUS病人 60例 ,现将护理体会介绍如下。1　资料及方法1…     

女性非妇科盆腔肿物12例超声特征及误诊探析

目的探讨超声检查对女性非妇科盆腔肿物的诊断价值。方法回顾性分析2008年7月—2013年7月收入我院妇科手术的12例非妇科盆腔肿物的超声声像图特点及其他临床资料。结果术前超声检查12例共13个肿物,呈囊实性7例,实性5例,囊性1例;诊断卵巢肿瘤6例,子宫浆膜下肌瘤4例,盆腔肿物(性质待定)2例。12例均行手术探查,并经术后病理检查确诊。术后病理检查示12例中肿物来源于胃肠道6例(50.0%),腹膜后肿瘤4例(33.3%),其他部位肿瘤2例(16.7%);小肠间质瘤3例,腹膜后平滑肌瘤、腹膜后神经鞘瘤各2例,阑尾黏液腺癌、盆壁侵袭性血管黏液瘤、乙状结肠系膜畸胎瘤、非霍奇金B细胞淋巴瘤及肠系膜巨大囊肿各1例。结论女性非妇科盆腔肿物术前超声检查易误诊为卵巢肿瘤和子宫浆膜下肌瘤,超声科医师结合临床特征进行诊断及避免思维定式可减少误诊。     

Comparison of Ultrasonographic Findings of the Rotator Cuff Between Diabetic and Nondiabetic Patients with Chronic Shoulder Pain: A Retrospective Study

It is still unclear whether diabetic mellitus (DM) is associated with rotator cuff lesions. The object of this retrospective study was to compare the ultrasonographic (US) findings of rotator cuffs in diabetic patients with those of nondiabetic patients with chronic shoulder pain. In total, 419 patients (80 diabetic, 339 nondiabetic) who had chronic shoulder pain and had been referred to receive US examination between January 2005 and January 2008 in a medical center were included in this study. The US findings of rotator cuff lesions were classified into two main categories: rotator cuff tears (RCTs) and calcifying tendinopathy (CT). In total, 114 (25.2%) shoulders with CT of the rotator cuff and 160 (35.3%), 15 (3.3%) and 5 (1.1%) shoulders with supraspinatus, infraspinatus and subscapularis tears, respectively, were noted. No difference in the ratio of tears of RCTs was found on US examinations between two groups. The crude odds ratio (OR) for CT of diabetic patients was 1.85 (p = 0.014); however, the adjusted OR for CT in diabetic patients became insignificant after controlling for the other variables (OR = 1.59, p = 0.08). To our knowledge, this is the first study to explore US findings among diabetic and nondiabetic patients with chronic shoulder pain. Further study is advised to confirm our findings. (E-mail: csc@tmu.edu.tw)     

微小肝癌的声像图特征与病理组织学的对比分析

本文报告超声诊断3例4个微小肝癌。超声显示病灶形态多为圆形或卵圆形,边界清楚,内部显示无回声暗区,边缘高回声圈等。文中对微小肝癌声像图特征的病理基础进行了探讨。通过对比分析,得出如下结论:(1)显示暗区回声的微小肝癌结节在组织学上是高分化、无出血坏死或间质纤维化,缺乏汇管区的实质性肿瘤;(2)边缘出现高回声圈的微小肝癌结节在组织学上是厚包膜的肿瘤     

乳腺导管内乳头状瘤的高频超声表现特征

目的：通过分析乳腺导管内乳头状瘤的高频超声表现特征,提高超声医师对该病的认识.材料和方法：回顾性分析经手术病理证实的32例乳腺导管内乳头状瘤的高频超声声像图表现.结果：本组病例的声像图特征可分为5型：Ⅰ型为导管扩张伴管腔内乳头状实性回声或实性回声充填（46.9%）;Ⅱ型为囊实混合型团块（18.8%）;Ⅲ型为局限性导管扩张,远端导管壁不规则或中断（18.8%）;Ⅳ型为导管扩张伴远端中断处实性结节或团块回声（9.4%）;Ⅴ型为腺体内低回声结节,无导管扩张（6.3%）.32例中有23例的超声诊断与手术及病理相符,诊断符合率71.9%.结论：高频超声能显示乳腺导管内乳头状瘤乳管扩张及瘤体情况,对Ⅰ、Ⅱ型病变的诊断准确率最高,Ⅳ型次之.     

The Neurological Features of HIV-Positive Patients in Glasgow--A Retrospective Study of 90 Cases

A retrospective study of the neurological problems arising inHIV-I seropositive patients in a single defined geographicalarea was undertaken. Ninety patients were referred for a neurologicalopinion from a total known HIV-I seropositive population of436. Minor problems were frequently encountered early in thecourse of disease (20 at CDC stage II, 12 at CDC stage III),including seizures related to drug abuse in six. The most frequentneurological problem in those patients in CDC group IV (58 patients)were the AIDS dementia complex (14 patients), an axonal sensorimotorneuropathy (12), toxoplasmosis (nine) and cryptococcal meningitis(three). All patients with a structural lesion had appropriatefocal signs on examination. The value and role of CT cranialscanning in the diagnosis of toxoplasmosis is discussed andthe importance of recognizing potentially treatable causes ofboth intellectual impairment and cytomegalovirus-related neuropathiesis stressed. This is the First report of an unselected seriesof patients at all stages of HIV-I related neurological diseasefrom a single UK centre.     

女性抑郁症病人的心理特征及护理对策

为了解女性抑郁症病人的心理特征，采用应激量表及功能失调性态度问卷（DAS）对50例女性，30例男性抑郁症病人的心理状态进行测评。结果显示：生活事件应激评分和认知评分女性抑郁症病人明显高于男性（P＜0．05）。说明女性抑郁症病人存在较多的心理社会问题及不良认知，并针对女性抑郁症病人的心理特征提出了相应的心理护理对策。     

Advance Directives in Hospitalized Patients: A Retrospective Cohort Study

The purpose of this study was to examine processes for advance directives (ADs) in hospitalized patients to inform improvements in practice and policy. This was a retrospective study examining electronic records of 5,330 inpatients admitted over a 3-month period. During admission, 63.5% of patients were queried, with 37.2% of patients having ADs and only 14.4% available in the record. Older age and Medicare insurance were associated with having ADs. Opportunities exist for nurse practitioners to change structure and processes related to ADs improving completion and availability.     

腹膜后肿块超声诊断研究及临床意义

目的：研究不同病理性质腹膜后肿块的块像图特征,最终寻找出一些超声诊断规律。方法：应用超声检查经手术病理证实的腹膜后肿块83例,并对其超声图像进行综合分析。结果：表明（1）腹膜后肿块超声定位有八种声像图特征;（2）肿块内部回声特征与病理结构相关;（3）肿块好发部位与病理性质相关,本组与手术病理对照,超声诊断符合率83％（69／83）,结论这些超声定位特征对腹膜后肿块及时诊断以及与非腹膜后肿块鉴别诊断具有重要的临床价值,结合内部回声特征与好发部位还可有助于对肿块病理性质的诊断。     

The Value of High-Frequency Ultrasonographic Imaging for Quantifying Trigger Digits: A Correlative Study with Clinical Findings in Patients with Different Severity Grading

Trigger digit is recognized as thickening and constriction of the flexor tendon sheath at the base of digits. This study investigates the correlation between the severity grading of trigger digits and clinical findings from high-frequency ultrasonography. We measured and compared thicknesses, areas and pathological changes of the flexor digit tendons among total, contracture and noncontracture trigger digits and noninvolved contralateral digits. Forty-seven patients with 55 idiopathic trigger digits (36 contracture and 19 noncontracture) and 55 noninvolved contralateral digits were examined using high-frequency ultrasonography. The thickness of the flexor tendons was measured in a longitudinal plane at the A1 pulley: Inlet (metacarpal head–neck junction), Outlet (proximal phalangeal base–shaft junction) and Interpulley (middle of Inlet and Outlet). The cross-sectional and extratendinous tissue areas of the flexor tendons in a transverse plane at the point of Interpulley were measured. Pathological changes including irregular internal echotextures, fluid collection, dominant A1 pulley and abnormal metacarpophalangeal joint were analyzed. All thicknesses and areas of total and contracture trigger digits were significantly greater than those of noninvolved contralateral digits (p < 0.05), whereas no significant difference was observed in noncontracture trigger digits. The pathological changes were all significantly different from noninvolved contralateral digits in total, contracture and noncontracture trigger digits (p < 0.05). In contracture and noncontracture trigger digits, there were significant differences only in the thickness of the Inlet and the pathological change of the dominant A1 pulley (p < 0.05). In conclusion, the results of the ultrasonographic measurements and findings provided evidence of Notta's node and correlated with clinical findings and severity grades.