计算机辅助诊断系统辅助超声诊断甲状腺弥漫性病变合并结节良恶性的应用价值

目的：探究计算机辅助诊断（computer-aided diagnosis,CAD）系统辅助超声医师诊断甲状腺弥漫性病变合并结节良恶性的效能。方法：收集2017年8月至2017年12月在我院就诊并行超声检查的甲状腺弥漫性病变合并结节患者342例（共533个结节）,以病理检查结果为金标准,比较按常规超声诊断方法（依据成人甲状腺结节与分化型甲状腺癌指南的标准）与CAD系统辅助下超声诊断判断甲状腺弥漫性病变合并结节良恶性的灵敏度、特异度、阳性预测值、阴性预测值及受试者操作特征曲线（receiver operator characteristic curve, ROC曲线）的曲线下面积（erea under the curve, AUC）。结果：常规超声诊断甲状腺弥漫性病变合并结节良恶性的灵敏度为96.6%,特异度为72.5%,AUC为0.846;在CAD系统辅助下超声诊断的灵敏度为96.6%,特异度为80.9%,AUC为0.888。在CAD系统辅助下的诊断特异度和AUC均较高（P均<0.01）。结论：对于甲状腺弥漫性病变合并结节的患者,采用超声联合CAD系统诊断甲状腺结节良恶性时,可在...     

人工智能超声辅助诊断系统联合超声造影对ACR TI-RADS 4类结节的诊断价值

目的 分析人工智能超声辅助诊断系统（AI-UADS）联合超声造影对ACR TI-RADS 4类结节的诊断价值。方法 选取我院经手术病理证实的甲状腺结节患者84例，共92个结节，均为ACR TI-RADS 4类，其中恶性结节17个，良性结节75个，比较AI-UADS与超声造影单独及联合对ACR TI-RADS 4类良恶性结节的诊断效能。结果 超声造影准确诊断恶性结节14个，良性结节61个，诊断甲状腺恶性结节的灵敏度、特异度、准确率、阳性预测值、阴性预测值分别为82.35%、81.33%、81.52%、50.00%、95.31%;AI-UADS准确诊断恶性结节15个，良性结节62个，诊断甲状腺恶性结节的灵敏度、特异度、准确率、阳性预测值、阴性预测值分别为88.24%、82.67%、83.70%、53.57%、96.88%；二者联合准确诊断恶性结节14个，良性结节70个，联合诊断甲状腺恶性结节的灵敏度、特异度、准确率、阳性预测值、阴性预测值分别为82.35%、93.33%、91.30%、73.68%、95.89%。AI-UADS联合超声造影诊断甲状腺恶性结节的特异度和阳性预测值均高于单独诊断...     

计算机辅助超声医师诊断甲状腺TI-RADS 3～4级占位病变的价值

目的评价甲状腺超声图像分析软件(AmCAD-UT Detection)辅助超声医师诊断甲状腺TI-RADS 3～4级占位病变性质的作用及可行性。方法本试验入组病例超声诊断为TI-RADS 3级50例,诊断为TI-RADS 4级174例占位病变;病理证实154例甲状腺恶性病灶及80例甲状腺良性病灶,将符合AmCAD-UT Detection分析系统读片要求的术前超声图像输入系统,该系统通过对甲状腺结节超声图像中表现的主要良、恶性鉴别特征进行处理、量化,并通过诊断系统进行诊断,同时术前超声诊断医师结合软件处理后图像及诊断结论重新进行诊断。对比同一医师在使用该软件前、结合软件后及软件本身独立诊断三者对甲状腺占位病例诊断的灵敏度、特异度及准确率差异。结果对比超声医师术前独立诊断、AmCAD-UT Detection软件读图诊断及超声医师结合软件后诊断三者对甲状腺占位性病变的灵敏度、特异度及准确率。医师术前独立诊断甲状腺占位病变准确率:CUT OFF值设定为TI-RADS 4a、4b及4c级分别为82.1%、54.6%、76.6%;甲状腺CAD诊断甲状腺占位病变准确率:CUT OFF值设定为TI-RADS 4a、4b及4c级分别为86.8%、89.3%、88%;超声医师结合甲状腺CAD诊断甲状腺占位病变准确率:CUT OFF值设定为TI-RADS 4a、4b及4c级分别为91.5%、91.0%、88%。ROC曲线下面积:超声医师、CAD及超声医师+CAD分别为82.3、93.1、96.3;比较三者诊断能力:医师结合CADCAD医师独立诊断,AmCAD-UT Detection辅助超声医师提高诊断甲状腺TI-RADS 3～4级占位病变性质的能力。结论 AmCAD-UT Detection可辅助超声医师提高诊断甲状腺TI-RADS 3～4级占位病变的诊断能力,提高超声医师诊断结节恶性或良性倾向性百分比,为临床医师下一步治疗方案提供更明确依据。     

超声引导下穿刺活检联合超声造影在甲状腺结节良恶性诊断中的价值

目的：分析超声引导下穿刺活检联合超声造影在甲状腺结节性质诊断中的意义。方法：回顾性选取2021年1月—2023年4月在徐州市肿瘤医院行甲状腺结节切除术的80例患者。所有患者在术前均行甲状腺超声引导下穿刺活检及超声造影检查,以术中快速病理切片诊断结果作为金标准,比较超声引导下穿刺活检、超声造影单一及联合检查的灵敏度、特异度、准确率;分析良恶性结节超声表现。结果：80例患者共计检出103个甲状腺结节,经过术中快速病理切片诊断证实28例患者为恶性（36个结节）,52例患者为良性（67个结节）;超声造影检查检出良性结节64个,恶性结节39个;超声引导下穿刺活检检出良性结节70个,恶性结节33个;联合诊断检出良性结节68个,恶性结节35个;联合检查灵敏度97.22、特异度100.00%、准确率99.03%均高于结节穿刺活检的91.67%、100.00%、97.09%及超声造影的83.33%、86.57%、85.44%,其中联合检查与结节穿刺活检的特异度、准确率明显高于超声造影（P <0.05）,联合检查与结节穿刺活检各指标差异无统计学意义（P> 0.05）;恶性结节组和良性结节组在增...     

中国超声甲状腺影像报告和数据系统与美国甲状腺协会超声模型对甲状腺结节诊断效能的比较研究

目的 比较中国超声甲状腺影像报告和数据系统(C-TIRADS)与美国甲状腺协会(ATA)超声模型对甲状腺结节良恶性的诊断价值。方法 回顾性分析经病理结果证实的245例甲状腺结节的常规超声声像图,分别使用C-TIRADS和ATA超声模型进行分类评价,比较两者对甲状腺结节良恶性的诊断效能。结果 C-TIRADS和ATA超声模型对甲状腺结节诊断的受试者工作特征(ROC)曲线下面积分别为0.750、0.625。C-TIRADS诊断甲状腺结节良恶性的灵敏度为97.7%,特异度为52.2%, ATA超声模型诊断甲状腺结节良恶性的灵敏度为99.2%,特异度为25.7%。结论 C-TIRADS较ATA超声模型诊断效能更高,特异度较高,可降低甲状腺良性结节的误诊率。     

二维超声与彩色多普勒超声在甲状腺良恶性结节诊断中的临床应用价值分析

目的:分析甲状腺良恶性结节诊断中应用二维超声与彩色多普勒超声的价值。方法:选择2019年1月-2020年10月期间我院收治的50例甲状腺结节患者,共65个结节。本组患者行二维超声与彩色多普勒超声诊断,以手术病理检查为金标准,分析两种诊断方法对甲状腺良恶性结节的诊断效果,对比诊断灵敏度、特异度、准确率。结果:二维超声诊断65个结节中,良性结节46个,恶性结节19个,诊断灵敏度为72.73%,特异度为79.63%,准确率为78.46%。彩色多普勒超声诊断65个结节中,良性结节44个,恶性结节21个,诊断灵敏度为63.64%,特异度为74.07%,准确率为72.31%。两者联合诊断65个结节中,良性结节54个,恶性结节11个,诊断灵敏度为81.82%,特异度为96.30%,准确率为93.85%,相较于彩色多普勒超声与二维超声单一诊断,两者联合诊断的灵敏度、特异度、准确率更高,数据差异具有统计学意义(P0.05)。结论:两者联合诊断相比彩色多普勒超声与二维超声单一诊断,可更为准确地鉴别甲状腺结节良恶性,指导临床制定合理且稳妥的治疗方案,值得推广。     

高频超声弹性成像及超声造影对甲状腺良恶性结节的诊断研究

目的:研究甲状腺良恶性结节应用高频超声弹性成像及超声造影的效果。方法:将我院在2017年4月—2019年4月期间收治的80例甲状腺良恶性结节诊断患者作为研究对象,在其他条件一致的情况下,为这80例甲状腺良恶性结节诊断患者分别实行手术病理检查、高频超声弹性成像诊断和超声造影诊断,将两种诊断方法的结果和病理诊断结果进行比较,记录每种诊断方法的准确率、特异度和灵敏度。结果:与病理诊断结果相比,高频超声弹性成像诊断准确率为86.3%,超声造影诊断准确率为92.5%,在灵敏度和特异度上,超声造影技术更优于高频超声弹性成像技术,两种诊断结果差异具有统计学意义(P<0.05)。结论:高频超声弹性成像和超声造影在甲状腺良恶性结节诊断上均有着一定的效果,但是超声造影技术的准确率更高,能够清楚的将患者结节形态、大小、数目、边界及回声情况呈现出来,但同时也存在一定的局限性,因此将两种诊断方法结合起来的准确率更高,是一项值得推广的应用。     

超声弹性成像联合超声TI-RADS分级鉴别诊断甲状腺结节良恶性的价值

目的 探讨甲状腺结节良恶性采用超声弹性成像（UE）联合超声甲状腺影像报告与数据系统（TI-RADS）分级鉴别诊断的价值。方法 选取2021年1月至2022年1月我院收治的甲状腺结节患者83例（95个结节）。所有患者均经手术治疗,且接受UE、TI-RADS分级检查,以术后病理诊断为“金标准”,分析UE联合TI-RADS分级鉴别诊断甲状腺结节良恶性的价值。结果 95个甲状腺结节,经病理检查结果显示恶性29个,占比30.53%(29/95),良性66个,占比69.47%(66/95);UE联合TI-RADS分级鉴别诊断甲状腺结节良恶性的准确性、灵敏度、特异度及阴性预测值均比单一UE及TI-RADS分级高,差异有统计学意义（P<0.05）;单一UE、TI-RADS分级及UE联合TI-RADS分级鉴别诊断甲状腺结节良恶性的阳性预测值比较,差异无统计学意义（P>0.05）。结论 UE联合鉴别诊断甲状腺结节良恶性有较高的灵敏度、特异度、准确性及阴性预测值,诊断价值满意。     

超声造影联合超声实时组织弹性成像在甲状腺良恶性结节诊断中的应用价值

目的：评价超声造影联合超声实时组织弹性成像（RTE ）在甲状腺良恶性结节诊断中的应用价值。方法分析85例甲状腺结节患者的超声造影和RTE的图像信息并与病理活组织检查（活检）相对比,评估单用两种方法及联合使用两种方法诊断的灵敏度、特异度、阳性预测值、阴性预测值及诊断符合率。结果85个甲状腺结节中,病理活检证实恶性病灶48个,良性病灶37个。恶性结节在注射造影剂后以不均匀低增强为主,早于周边甲状腺组织消退。良性结节则以弥散性等增强或高增强为主,晚于周围腺体廓清。超声造影的灵敏度、特异度、阳性预测值、阴性预测值及诊断符合率分别为91.67％、81.08％、91.67％、81.08％、87.06％;RTE 则分别为87.50％、83.78％、87.50％、83.78％、85.89％;两者联合诊断的灵敏度、特异度、阳性预测值、阴性预测值及诊断符合率分别为97.92％、86.49％、90.38％、96.97％、92.94％。超声造影联合 RTE 灵敏度、特异度、阴性预测值及诊断符合率比单用超声造影或RTE高（均P＜0.05）。结论超声造影联合RTE可提高甲状腺良恶性结节诊断的准确性。     

常规超声及超声造影在囊实性甲状腺结节良恶性鉴别诊断中的应用价值

目的：探讨囊实性甲状腺结节良恶性鉴别诊断中常规超声及超声造影的应用价值。方法：选取河池市人民医院2022年7月—12月收治的甲状腺结节患者40例（共计58个囊实性甲状腺结节）,患者均进行常规超声及超声造影检查,以病理检查结果为金标准,比较常规超声及超声造影检查的诊断效能,分析良恶性结节超声表现。结果：超声造影检查的灵敏度、特异度、准确率均高于常规超声检查,漏诊率、误诊率低于常规超声检查,但差异不显著（P> 0.05）;常规超声检查下甲状腺良、恶性结节表现、血流阻力指数的差异均有统计学意义（P <0.05）;超声造影检查下甲状腺良性结节均匀增强多于恶性结节,不均匀增强少于恶性结节,周边环状增强表现多于恶性结节,差异有统计学意义（P <0.05）,无增强表现占比差异无统计学意义（P> 0.05）;超声造影检查中良性结节和恶性结节的超声强化程度差异不显著（P>0.05）,恶性结节与良性结节超声造影峰值到达时间差异显著（P <0.01）。结论：囊实性甲状腺结节良恶性鉴别诊断中超声造影检查可更清晰观察甲状腺结节特征,提升诊断的准确性。     

A pilot study of comprehensive ultrasound education at the Wayne State University School of Medicine: a pioneer year review.

OBJECTIVE: Ultrasound is a versatile diagnostic modality used in a variety of medical fields. Wayne State University School of Medicine (WSUSOM) is one of the first medical schools in the United States to integrate an ultrasound curriculum through both basic science courses and clinical clerkships. METHODS: In 2006, 25 portable ultrasound units were donated to WSUSOM. First-year medical students were provided an ultrasound curriculum consisting of 6 organ-system sessions that addressed the basics of ultrasound techniques, anatomy, and procedural skills. After the last session, students were administered 2 anonymous and voluntary evaluations. The first assessed their overall experience with the ultrasound curriculum, and the second assessed their technical skills in applying ultrasound techniques. RESULTS: Eighty-three percent of students agreed or strongly agreed that their experience with ultrasound education was positive. On the summative evaluation, nearly 91% of students agreed or strongly agreed that they would benefit from continued ultrasound education throughout their 4 years of medical school. Student performance on the technical assessment was also very positive, with mean class performance of 87%. CONCLUSIONS: As residency programs adopt ultrasound training, medical school faculty should consider incorporating ultrasound education into their curriculum. Portable ultrasound has the potential to be used in many different settings, including rural practice sites and sporting events. The WSUSOM committee's pilot ultrasound curriculum will continue to use student feedback to enhance the ultrasound experience, helping students prepare for challenges that they will face in the future.     

Ultrasound Morphologic Features of Steatocystoma Multiplex With Clinical Correlation

The ultrasound features of 87 steatocytoma multiplex (SCM) lesions detected in 9 patients are reported. Steatocytoma multiplex is a hamartomatous condition derived from the pilosebaceous duct junction that generates multiple cutaneous cystic lesions. It appeared as clusters of well-defined hypoechoic nodules with mild posterior enhancement in 100% of cases, with both dermal and subcutaneous locations in 67%. No calcification foci were detected within or at the periphery of the lesions. Fifty-six percent of the cases showed signs of hypervascularity in the edge of the nodules, and 44% of the lesions were associated with another dermatologic condition, most frequent being hidradenitis suppurativa (75%), followed by vellus hair cysts (25%). Steatocytoma multiplex shows ultrasound features that allow discrimination from other common cutaneous entities.     

Three- and 4-dimensional ultrasound in obstetrics and gynecology: proceedings of the american institute of ultrasound in medicine consensus conference.

The American Institute of Ultrasound in Medicine convened a panel of physicians and scientists with interest and expertise in 3-dimensional (3D) ultrasound in obstetrics and gynecology to discuss the current diagnostic benefits and technical limitations in obstetrics and gynecology and consider the utility and role of this type of imaging in clinical practice now and in the future. This conference was held in Orlando, Florida, June 16 and 17, 2005. Discussions considered state-of-the-art applications of 3D ultrasound, specific clinical situations in which it has been found to be helpful, the role of 3D volume acquisition for improving diagnostic efficiency and patient throughput, and recommendations for future investigations related to the utility of volume sonography in obstetrics and gynecology.     

Sonography of Dermatologic Emergencies

Dermatologic conditions may be the subjects of potential emergency consultations, and the knowledge of their sonographic appearance can facilitate an early diagnosis and management. In this pictorial essay, the sonographic dermatologic anatomy, technique, and conditions that can be supported by a prompt sonographic diagnosis are reviewed. The sonographic signs that may help diagnose these entities are discussed with a practical approach.     

Ultrasound Transducer Selection in Clinical Imaging Practice

Many types of medical ultrasound transducers are used in clinical practice. They operate at different center frequencies, have different physical dimensions, footprints, and shapes, and provide different image formats. However, little information is available about which transducers are most appropriate for a given application, and the purpose of this article is to address this deficiency. Specifically, the relationship between the transducer, imaging format, and clinical applications is discussed, and systematic selection criteria that allow matching of transducers to specific clinical needs are presented. These criteria include access to and coverage of the region of interest, maximum scan depth, and coverage of essential diagnostic modes required to optimize a patient's diagnosis. Three comprehensive figures organize and summarize the imaging planes, scanning modes, and types of diagnostic transducers to facilitate their selection in clinical diagnosis.     

Overview of therapeutic ultrasound applications and safety considerations

Applications of ultrasound in medicine for therapeutic purposes have been accepted and beneficial uses of ultrasonic biological effects for many years. Low-power ultrasound of about 1 MHz has been widely applied since the 1950s for physical therapy in conditions such as tendinitis and bursitis. In the 1980s, high-pressure-amplitude shock waves came into use for mechanically resolving kidney stones, and "lithotripsy" rapidly replaced surgery as the most frequent treatment choice. The use of ultrasonic energy for therapy continues to expand, and approved applications now include uterine fibroid ablation, cataract removal (phacoemulsification), surgical tissue cutting and hemostasis, transdermal drug delivery, and bone fracture healing, among others. Undesirable bioeffects can occur, including burns from thermal-based therapies and severe hemorrhage from mechanical-based therapies (eg, lithotripsy). In all of these therapeutic applications of ultrasound bioeffects, standardization, ultrasound dosimetry, benefits assurance, and side-effect risk minimization must be carefully considered to ensure an optimal benefit to risk ratio for the patient. Therapeutic ultrasound typically has well-defined benefits and risks and therefore presents a manageable safety problem to the clinician. However, safety information can be scattered, confusing, or subject to commercial conflicts of interest. Of paramount importance for managing this problem is the communication of practical safety information by authoritative groups, such as the American Institute of Ultrasound in Medicine, to the medical ultrasound community. In this overview, the Bioeffects Committee of the American Institute of Ultrasound in Medicine outlines the wide range of therapeutic ultrasound methods, which are in clinical use or under study, and provides general guidance for ensuring therapeutic ultrasound safety.     

Two‐Dimensional and Three‐Dimensional Ultrasound of Artificial Skin

Wound healing may be a difficult problem, and variable types of artificial skin prototypes have been developed for supporting this process. Using ultrasound, we studied 4 cellulose‐derived artificial skin prototypes and assessed their two‐dimensional and three‐dimensional morphology. These prototypes were identified on ultrasound both on in vitro and in vivo studies. They allowed the sonographic observation of deeper layers on different types of surfaces of the body with good definition on the in vivo examinations performed on healthy skin and cutaneous ulcers. The ultrasound detection of these artificial biomaterials may potentially support the noninvasive monitoring of wound healing.     

Pre-hospital assessment with ultrasound in emergencies: implementation in the field

BACKGROUND: Point-of-care ultrasound (US) is a proven diagnostic imaging tool in the emergency department (ED). Modern US devices are now more compact, affordable and portable, which has led to increased usage in austere environments. However, studies supporting the use of US in the prehospital setting are limited. The primary outcome of this pilot study was to determine if paramedics could perform cardiac ultrasound in the field and obtain images that were adequate for interpretation. A secondary outcome was whether paramedics could correctly identify cardiac activity or the lack thereof in cardiac arrest patients.METHODS: We performed a prospective educational study using a convenience sample of professional paramedics without ultrasound experience. Eligible paramedics participated in a 3-hour session on point-of-care US. The paramedics then used US during emergency calls and saved the scans for possible cardiac complaints including: chest pain, dyspnea, loss of consciousness, trauma, or cardiac arrest.RESULTS: Four paramedics from two distinct fire stations enrolled a total of 19 unique patients, of whom 17 were deemed adequate for clinical decision making (89%, 95%CI 67%-99%). Paramedics accurately recorded 17 cases of cardiac activity (100%, 95%CI 84%-100%) and 2 cases of cardiac standstill (100%, 95%CI 22%-100%).CONCLUSION: Our pilot study suggests that with minimal training, paramedics can use US to obtain cardiac images that are adequate for interpretation and diagnose cardiac standstill. Further large-scale clinical trials are needed to determine if prehospital US can be used to guide care for patients with cardiac complaints.     

Nonmedical fetal ultrasound: knowledge and opinions of Maine obstetricians and radiologists.

OBJECTIVE: The purpose of this study was to evaluate knowledge and opinions regarding nonmedical fetal ultrasound (NMFU) in obstetricians (OB) and radiologists (R). METHODS: A questionnaire was sent to all Maine fellows of the American College of Obstetricians and Gynecologists practicing obstetrics and members of the Maine Society of Radiology in April 2005. RESULTS: Among OB, 52 (81.2%), 24 (37.5%), 45 (75.0%), and 56 (87.5%) did not know whether the American College of Radiology, American College of Obstetricians and Gynecologists, American Institute of Ultrasound in Medicine, or US Food and Drug Administration held positions on NMFU. Among R, 11 (37.9%), 27 (93.1%), 19 (65.5%), and 24 (82.7%) did not know whether the organizations held positions. More R than OB agreed that women might forego medical ultrasound after NMFU (62.1% versus 49.2%; P = .05), whereas more OB than R believed fetal anomalies would go undetected during NMFU (79.4% versus 62.1%; P = .04). OB and R had concerns for false-positive NMFU diagnoses (41.9% and 31.0%), false reassurance by NMFU (76.2% and 62.1%), poor imaging causing anxiety (39.7% and 51.7%), and lack of physician availability to review suspected abnormalities on NMFU (73.0% and 65.5%). Sizable minorities of OB and R believed NMFU providers should be disciplined by licensing boards (33.9% and 44.8%), excluded from society memberships (22.9% and 37.9%), or reported to the Food and Drug Administration (21.3% and 31.0%). CONCLUSIONS: Most Maine OB and R are aware of their own but not each other's professional or regulatory NMFU positions yet practice within these guidelines. Most respondents do not favor sanctioning colleagues performing NMFU.