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。     

乙肝患者不同时期的肝脏三维超声显像

目的 探讨乙肝患不同时期的肝脏三维超声图像表现。方法 本对52例实验室检查乙肝三系为三大阳，空腹状态下进行二维超声，三维超声成像，描述了不同演变时期肝脏实质病变的三维图像特征。结果 三维超声成像显示肝脏实质病变的增粗颗粒、增生结节、肿块具有立体感强，形态直观；对肝癌肿块二维图像肿块边界尚清，有声晕，三维图像肿块边界不规则，凹凸不平。对肝硬化腹水患，肝脏包膜被液性暗区环绕时，三维成像硬化肝表面高低不平。结论 三维超声成像从多切面、多角度获得更多的信息，在一定程度上弥补了二维超声的不足，为疾病的诊断和鉴别诊断提供了可靠的形态学依据。     

三维超声成像在胰腺肿块诊断中的应用

目的：探讨三维超声重建在胰腺肿块中的应用价值。方法：对32例胰腺肿块进行三维超声重建并与二维进行对比，经手术及病理证实。结果：三维超声重建图像清晰、形态直观、立体感强，能够显示肿块内部结构特征，确定病变与相邻结构的空间关系。结论：三维超声成像从多切面、多角度获取更多的临床信息，在一定程度上弥补了二维超声的不足，为疾病的诊断和鉴别诊断提供了可靠的形态学依据。     

三维超声成像在附件实性及囊实混合性肿块中的应用

目的：评价三维超声在附件实性及囊实混合性肿块中的临床应用价值。方法：98例附件区肿块患者在常规二维超声检查后进行三维超声检查，并与二维超声图像对比，确定是否三维超声成像要优于二维超声。结果：三维超声对瘤体内小突起的显示要优于二维超声；三维超声可正确判断病变位置，术前细致地评价肿瘤与周围脏器的空间位置关系；三维能量多普勒超声的应用为卵巢肿瘤的定性诊断提供了一个新的参考指标。结论：三维超声可直接显示盆腔解剖，在术前能够提供较二维超声更丰富的信息，对明确诊断及确定治疗方案有重要意义。     

乳腺癌的二维超声与实时三维超声诊断的对比分析

目的探讨和对比二维彩色超声与实时三维超声成像技术在诊断乳腺癌中的价值。方法应用高频二维彩色超声及实时三维超声采集了51例乳腺癌的二维、三维灰阶图像、彩色血流图，所有图像储存在机器内，二维超声通过测量肿块的长、宽、高最大径，利用公式长×宽×高计算肿块的体积，而三维超声应用Vocal软件计算肿块三维体积，分析图像结果。所有病例被病理结果所证实。结果三维超声与二维超声技术相比，肿块的体积测量值小于二维测量值，结果更精确；彩色成像中，肿块内的血流丰富程度与二维超声相似，对穿入型血流可立体显示肿块内的血管树分布情况，更直观的反映出肿块内的血管数量，但对血流少肿块的血管立体构建不佳；冠状切面提供的肿块与周围腺体层交界处的组织关系即汇聚或毛刺征使诊断正确率提高11．8％。结论三维超声是对二维超声检查的一个补充，它为诊断乳腺肿块的良恶性多提供了一些观察的指标，尤其对那些在二维图像上不能明确诊断的小肿块，加用三维扫查，注重分析冠状切面特点，有助于提高诊断的正确率。     

三维超声鉴别诊断乳腺肿块良恶性的优势

目的 探讨三维超声鉴别诊断乳腺肿块良恶性的优势征象.方法 由5名超声医师独立评估109例女性患者中120个乳腺实性肿块的二维及三维超声图像(手术病理诊断69个恶性,51个良性).评估内容包括肿块的7项二维及10项三维声像特征,通过受试者工作特征曲线(ROC) 分析比较三维超声相对于二维超声鉴别诊断肿块良恶性的优势.结果 二维及三维声像图上良恶性肿块的声像特征间各自均显著不同(P<0.001);三维声像上恶性特征显示率高于二维声像,其中三维冠状面上"汇聚征"诊断恶性的敏感性为56.8%、特异性为93.7%,边缘不规则或毛刺征诊断恶性的敏感性为92.2%,特异性为51.8%;完整界面回声诊断良性的敏感性为77.6%,特异性为90.4%.ROC分析显示三维与二维的曲线下面积分别为0.948 3和0.908 6(P<0.05).结论 三维超声提供更多的影像评估特征,使乳腺肿块的良恶性鉴别比二维超声更可靠.三维超声的诊断价值高于二维超声.     

三维超声诊断乳腺肿瘤的一些特征及价值评估

目的探讨三维超声诊断乳腺疾病中在冠状面上的某些新发现,并通过对比二维超声评价三维超声诊断乳腺疾病的价值。方法通过实时三维超声检查,对171例乳腺肿块进行良恶性鉴别诊断,并与术后病理结果进行对照。结果对实时三维超声的冠状切面的乳腺癌二维图上,新发现的图像特征为"太阳征"实时三维超声对乳腺良恶性肿块鉴别诊断的准确度83.4%、敏感度83.3%和特异度83.9%。结论三维超声通过结合"太阳征",为诊断乳腺良恶性肿块提供了一个有价值的新方法     

妇科囊性肿块三维超声重建中的探讨

目的：探讨三维亏声重建对妇科囊性肿块临床应用价值。方法：对７８例附件囊性肿块三维超声成像并与二维超声进行对比,均经手术及病理证实。结果：三维超声重建图像清晰,形态直观,立体感强,可以确定病变的形态特征,各结构空间位置关系及内部的间隔,乳头状突起,炎症包块的观察,三维超声成像更显其优越性。结论：三维超声可以提供较二维更为直观、更为丰富的诊断信息,大大提高了术前诊断的准确性。     

在泌尿系统疾病中二维与三维超声图像对照观察与评价

1．目的 泌尿系统的疾病属于常见病多发病，通过对泌尿系统疾病的二维与三维超声图像对比，从中找出二者的不同点，在某些疾病中，确认三维超声比二维超声的优势及三维超声不及和不能取代二维超声的方面，提高对疾病的诊断和鉴别诊断水平，扩大诊断范围，评价三维超声在泌尿系统中的临床应用价值。     

三维超声在乳腺肿块术前诊断中的应用价值

目的探讨三维超声在乳腺肿块术前诊断中的应用价值。方法分别采用二维及三维超声检查方法对151个乳腺实性肿块的声像特征进行分析,评价其良恶性,并与手术病理结果进行对照分析。结果三维模式下,肿块的二维形态、边界轮廓,以及三维冠状面汇聚征、冠状面边界轮廓对三维超声诊断准确性的影响有显著作用(P0.05)。三维超声ROC曲线下面积为0.913,高于二维超声(0.817),两者比较差异有统计学意义(Z=2.284,P0.05)。结论三维超声可提供更多的影像特征,与二维超声相比,对乳腺肿块的术前诊断准确率更高,具有重要的临床应用价值。     

Comparison between Thin-Slice 3-D Volumetric Ultrasound and Conventional Ultrasound in the Differentiation of Benign and Malignant Thyroid Lesions

We explored the efficacy of thin-slice volumetric 3-D ultrasound (3-DUS) in distinguishing between benign and malignant thyroid nodules. A total of 103 thyroid nodules were evaluated prospectively using 3-D gray-scale ultrasonography. The shape, margin, halo and potential capsular invasion of the nodules were compared with the findings of conventional 2-D ultrasound (2-DUS). Of the 103 thyroid nodules, there were 50 pathologically confirmed benign lesions and 53 malignant lesions (51.5%). Shape irregularity, ill-defined margins and capsular invasion provided sensitivities of 90.0%, 47.2% and 39.6% and specificities of 88.0%, 84.0% and 100%, respectively, for the malignant lesions. The diagnosis of thyroid cancer was improved in 3-DUS compared with 2-DUS, with a sensitivity of 88.7%, specificity of 90.0%, positive predictive value of 90.4%, negative predictive value of 88.2% and accuracy of 89.3%. The sensitivity of detection for lesions with capsular invasion increased to 39.6% with 3-DUS, more than twice that of 2-DUS. Three-dimensional US is highly accurate in diagnosing thyroid nodules, particularly those with capsular invasion.     

子宫腔内病变的三维超声诊断

目的 探讨三维超声在子宫腔内病变诊断中的价值。方法 应用Voluson 730D三维超声诊断仪对36例子宫腔内病变进行三维重建成像，重建模式选用表面成像模式。结果 重建后的三维图像逼真，采用electronic scalpel（电子刀）技术，可以充分显示病变范围，空间位置及表面结构，与二维超声相比有较高的敏感性和特异性，以上病例经宫腔镜和病理证实。结论 结合“电子刀”技术，三维重建图像更有利于对病变性质的诊断及鉴别。     

三维超声在肾综合征出血热诊断中的应用

目的对肾综合征出血热(HFRS)伴有急性肾功能不全病程中肾锥体行三维立体成像，以评价其临床应用价值。方法采用三维动态成像检测45例经血清学证实HFRS抗体阳性患伴有急性肾功能衰竭及30例无肾功不全行双肾三维立体成像。结果无肾功不全肾锥体未能获得满意三维立体图像，而伴有急性肾功能衰竭的HFRS通过三维重建后，肾锥体扩大，清晰、可见，呈蜂窝样改变，并对肾皮质产生压迹。结论三维超声显像能直观形象地显示了扩大的肾锥体。     

二维及彩色多普勒超声对先天性肌斜颈的诊断价值

目的探讨先天性肌斜颈二维及彩色多普勒超声表现及诊断价值。方法总结分析46例胸锁乳突肌(SCM)肿块的超声检查资料,分析其大小、内部回声及多普勒血流信号。结果本组46例先天性肌斜颈患儿均可见一侧SCM肿块。结论二维及彩色多普勒超声检查对本病的诊断及鉴别诊断是一种有效的方法,肿块的大小及内部回声强度与临床转归有关。     

Three-dimensional ultrasound imaging

The objective of this article is to provide scientists, engineers and clinicians with an up-to–date overview on the current state of development in the area of three-dimensional ultrasound (3-DUS) and to serve as a reference for individuals who wish to learn more about 3-DUS imaging. The sections will review the state of the art with respect to 3-DUS imaging, methods of data acquisition, analysis and display approaches. Clinical sections summarize patient research study results to date with discussion of applications by organ system. The basic algorithms and approaches to visualization of 3-D and 4-D ultrasound data are reviewed, including issues related to interactivity and user interfaces. The implications of recent developments for future ultrasound imaging/visualization systems are considered. Ultimately, an improved understanding of ultrasound data offered by 3-DUS may make it easier for primary care physicians to understand complex patient anatomy. Tertiary care physicians specializing in ultrasound can further enhance the quality of patient care by using high-speed networks to review volume ultrasound data at specialization centers. Access to volume data and expertise at specialization centers affords more sophisticated analysis and review, further augmenting patient diagnosis and treatment.     

Abdominal Aortic Aneurysm Imaging with 3-D Ultrasound: 3-D-Based Maximum Diameter Measurement and Volume Quantification

The clinical reliability of 3-D ultrasound imaging (3-DUS) in quantification of abdominal aortic aneurysm (AAA) was evaluated. B-mode and 3-DUS images of AAAs were acquired for 42 patients. AAAs were segmented. A 3-D-based maximum diameter (Max3-D) and partial volume (Vol30) were defined and quantified. Comparisons between 2-D (Max2-D) and 3-D diameters and between orthogonal acquisitions were performed. Intra- and inter-observer reproducibility was evaluated. Intra- and inter-observer coefficients of repeatability (CRs) were less than 5.18 mm for Max3-D. Intra-observer and inter-observer CRs were respectively less than 6.16 and 8.71 mL for Vol30. The mean of normalized errors of Vol30 was around 7%. Correlation between Max2-D and Max3-D was 0.988 (p < 0.0001). Max3-D and Vol30 were not influenced by a probe rotation of 90°. Use of 3-DUS to quantify AAA is a new approach in clinical practice. The present study proposed and evaluated dedicated parameters. Their reproducibility makes the technique clinically reliable.     

三维超声成像对膀胱占位性病变的诊断价值

目的 探讨三维超声成像对膀胱内占位性病变的诊断价值.方法 应用二维超声对76例膀胱内占位性病变进行检查,并对其病变进行三维重建,观察其内部结构、肿块形态、边界以及肿块与膀胱壁之间的关系.结果 三维超声成像能清晰显示肿块的形态特征,特别是对膀胱壁上小的乳头结构的检出、肿块的整体观显示以及肿块与膀胱壁是否有浸润情况的判断.结论 三维超声成像较二维超声能更直观、立体地反映肿块结构,提高诊断率.     

Magnetic Resonance Imaging and Freehand 3-D Ultrasound Provide Similar Estimates of Free Achilles Tendon Shape and 3-D Geometry

The purpose of this study was to assess the similarity of free Achilles tendon shape and 3-D geometry between magnetic resonance imaging (MRI) and freehand 3-D ultrasound (3-DUS) imaging methods. Fourteen elite/sub-elite middle-distance runners participated in the study. MRI and 3-DUS scans of the Achilles tendon were acquired on two separate imaging sessions, and all 3-D reconstructions were performed using identical methods. Shape similarity of free Achilles tendon reconstructed from MRI and 3-DUS data was assessed using Jaccard index, Hausdorff distance and root mean square error (RMSE). The Jaccard index, Hausdorff distance and RMSE values were 0.76 ± 0.05, 2.70 ± 0.70 and 0.61 ± 0.10 mm, respectively. The level of agreement between MRI and 3-DUS for free Achilles tendon volume, length and average cross-sectional area (CSA) was assessed using Bland-Altman analysis. Compared to MRI, freehand 3-DUS overestimated volume, length and average CSA by 30.6 ± 15.8 mm³ (1.1% ± 0.6%), 0.3 ± 0.7 mm (0.6% ± 1.9%) and 0.3 ± 1.42 mm² (0.4% ± 2.0%), respectively. The upper and lower limits of agreement between MRI and 3-DUS for volume, length and average CSA were −0.4 to 61.7 mm³ (−0.2% to 2.3%), −1.0 to 1.5 mm (−3.2% to 4.5%) and −2.5 to 3.1 mm² (−3.5% to 4.3%), respectively. There were no significant differences between imaging methods in CSA along the length of the tendon. In conclusion, MRI and freehand 3-DUS may be considered equivalent methods for estimating shape and 3-D geometry of the free Achilles tendon. These findings, together with the practical benefits of being able to assess 3-D Achilles tendon shape and geometry in a laboratory environment and under isometric loading, make 3-DUS an attractive alternative to MRI for assessing 3-D free Achilles tendon macro-structure in future studies.     

三维超声在完全性葡萄胎诊断中的临床应用

目的探讨应用三维超声成像评价完全性葡萄胎的临床应用价值.方法采用Sequoia 512带有三维超声成像功能的彩色多普勒超声仪,对40例完全性葡萄胎患者进行三维图像重建.结果三维超声重建图像清晰,形态直观,立体感强,能够显示病变内部细微结构特征,确定病变与相邻结构的空间关系.结论三维超声成像可以提供较二维更为丰富的诊断信息.     

正常妊娠胎盘绒毛血管树的三维彩色多普勒超声成像

目的比较二维和三维彩色多普勒超声对正常妊娠胎盘内绒毛血管树的显示及评价三维彩超显示胎盘内远端绒毛血管树分支的功能。方法用二维和三维彩色多普勒超声显示20～38周36例正常单胎妊娠胎盘内绒毛血管树分支。结果三维彩超和二维彩超对胎盘内一级绒毛干血管的显示无差异;三维彩色多普勒超声对胎盘内远端血管分支的显示率明显优于二维;对近母体面的胎盘小叶血管,二维和三维彩色和能量多普勒超声均未能显示。结论彩色多普勒超声可以显示胎盘内绒毛血管树的结构,而且三维彩超明显优于二维,未来可用于对高危妊娠胎盘功能的评价。