彩超及B-FLOW技术引导下经外周静脉穿刺中心静脉置管的可行性研究

目的 探讨彩超及B-FLOW技术引导下经外周静脉穿刺中心静脉置管(PICC)的可行性.方法 将120例需行PICC的患者分为盲穿组、彩超组、结合组,分别行盲穿、彩超引导、彩超结合B-FLOW引导下置管,对置管一次成功率、局部组织损伤、术后血栓发生率进行比较.结果 3组一次置管成功率、局部组织损伤、术后血栓发生率比较,差异均有统计学意义,结合组一次置管成功率最高,局部组织损伤、术后血栓发生率最低.结论 彩超及B-FLOW引导下行PICC是一种实用、安全的置管方法,使普通彩超引导下置管变得更完美,对局部血管状况差的患者使用更能突显其优势.     

超声血流显像技术在儿童经外周静脉置入中心静脉导管中的应用

目的探讨超声血流显像技术在儿童经外周静脉置入中心静脉导管中的运用。方法将90例需要行PICC置管的患儿,分为对照组和试验组各45例,对照组采用传统的盲穿法,试验组在超声显像技术引导下置管,比较2组穿刺成功率、操作时间、局部组织损伤率。结果试验组的穿刺成功率、操作时间和局部组织损伤率明显优于对照组。结论超声血流显像技术引导下行PICC置管可提高穿刺成功率,缩短操作时间,降低局部组织损伤发生率,此方法安全、可靠、有效,具有可行性。     

二维彩超与视锐5超声引导仪在PICC置管术中应用的效果比较

目的 探讨具有二维血流显示功能的彩超与PICC置管专用超声引导仪器—视锐5(STTE～RITE5)在PICC置管中的应用效果.方法 将60例需要在超声导引下行PICC置管的患者分为对照组和实验组,分别使用SITE～RITE5引导仪和具有二维血流显示功能的彩超导引下进行PICC置管,对比2组的血管穿刺成功率、一次置管成功率以及对血管选择的准确率和局部组织损伤率.结果 实验组的血管选择准确率略高于对照组,一次血管穿刺准确率、一次置管成功率低于对照组,局部组织损伤率高于对照组,但差异无统计学意义.结论 对于暂时不能购置PICC置管专用超声引导仪的医院来讲,可以尝试利用现有的二维彩超仪进行PICC置管,以提高血管条件差的患者PICC置管成功率,使得该项技术得以发展.     

彩超引导下中心静脉导管术置管成功50例

目的:研究彩超引导下行外周静脉植进的中央静脉导管术(peripherally insened central catheter,PICC)操作方法及临床应用.方法:利用彩色多普勒引导技术行PICC穿刺患者50例为观察组,床边穿刺置管患者50例为对照组.结果:观察组穿刺成功率、皮肤穿刺点异化情况、感染发生率、静脉炎发生率、患者满意度、舒适度均优于对照组.结论:彩超引导下中心静脉置管术提高了穿刺的成功率,减少了穿刺针在组织间潜行对周围组织的损伤和局部刺激,降低置管并发症,提高患者的满意度.     

超声引导下PICC置管在乳腺癌术后化疗患者中的应用

目的：探讨乳腺癌术后化疗超声引导下PICC置管的应用。方法：将60例需行PICC置管的乳腺癌患者分为盲穿组和超声组，分别在盲穿和超声引导下置管，对两组置管成功率、局部组织损伤发生率进行比较。结果：超声组置管成功率高于盲穿组，局部组织损伤发生率低于盲穿组，差异有统计学意义（P〈0．05）。结论：超声技术有效克服了盲穿置管的局限性，提高了穿刺置管成功率．减少了局部组织损伤的发生。     

经彩色多普勒及导针架引导下肘部PICC置管的临床研究

目的:探讨经彩色多普勒及导针架引导下肘部PICC置管的临床效果。方法:将120例需要在超声引导下进行肘部PICC置管的患者随机分为对照组和观察组各60例,对照组在统一超声引导下未使用穿刺架,观察组使用穿刺架静脉穿刺置入PICC导管,比较两组患者一次穿刺成功率、一次置管成功率及局部组织损伤率。结果:观察组一次穿刺成功率、一次置管成功率均高于对照组(P0.05)。结论:与超声医师配合利用彩色多普勒及导针架运用改良塞丁格技术置入PICC导管,可以有效提高中小医院PICC置管的成功率,降低并发症发生率。     

定期血管彩超随访在降低PICC导管相关性血栓导致的非计划拔管率中的应用

目的探讨肿瘤患者行PICC置管术后,定期进行血管彩超随访对PICC导管相关性血栓导致的非计划拔管率的影响。方法将2013年7月-2014年12月241例于我院运用B超引导下塞丁格穿刺技术行PICC置管术的肿瘤患者,按随机数字法分为观察组121例和对照组120例。观察组对置管侧肢体行定期血管彩超随访,对照组在患者出现血栓症状时进行血管彩超检查,比较分析PICC置管后导管相关性血栓的发生情况、因PICC导管相关性血栓导致的非计划拔管率。结果实施定期血管彩超随访后,观察组的PICC导管相关性血栓发生率、PICC置管侧上肢深静脉完全性血栓发生率、导管相关性血栓导致的非计划拔管率均较对照组低,差异有统计学意义(P<0.05)。结论在PICC置管患者中运用血管彩超随访可以及时检测出导管相关性血栓,从而减少有症状上肢深静脉完全性血栓的发生率,减轻患者的焦虑与不适感,且能动态监测血栓的转归情况,最大限度减少因导管相关性血栓导致的非计划拔管。     

改良Seldinger技术应用于血管超声引导下上臂置入PICC的效果

目的探讨改良Seldinger技术应用于血管超声引导下上臂置入PICC的临床效果。方法将2009年7-12月行PICC的120例患者按置管穿刺时间分为对照组和试验组各60例,试验组采用改良Seldinger技术在血管引导下行上臂PICC置管,对照组采用常规的盲穿置管,比较两组患者PICC置管成功率、操作时间、置管后机械性静脉炎及静脉血栓的发生率。结果试验组的置管成功率、机械性静脉炎和静脉血栓的发生率分别为98.33%、0和0,对照组分别为86.67%、13.46%和11.54%,差异均有统计学意义（P〈0.05）。结论采用改良Seldinger技术在血管引导下上臂PICC置管的成功率高,置管后机械性静脉炎和血栓的发生率比较低,尽管操作时间有所延长,但仍有较高的临床应用价值。     

Site-Rite 5型超声导引下结合改良塞丁格技术置入PICC的应用效果评价

[目的]评价 Site-Rite 5型超声导引下结合改良塞丁格技术经外周置入中心静脉导管（PICC）的临床应用效果。[方法]将140例肿瘤病人肘部血管条件良好者作为对照组（85例）,差者为观察组（5 5例）,对照组采用常规盲穿式PICC置管法,观察组采用 Site-Rite 5型超声导引下结合改良塞丁格技术行 PICC 置管。比较两组一次性穿刺成功率、一次性置管成功率以及术后组织损伤、机械性静脉炎、血栓、误入动脉发生率。[结果]观察组一次性置管成功率高于对照组（P〈0.05）,组织损伤、机械性静脉炎发生率低于对照组（P〈0.05）,误入动脉发生率高于对照组（P〈0.05）。[结论]Site-Rite 5型超声导引下结合改良塞丁格技术置入PICC的置管成功率高、术后总体并发症低于常规盲穿式PICC置管法,但存在误穿动脉的风险。     

上臂隧道式经外周静脉置入中心静脉导管的临床应用

目的:探讨隧道技术应用于上臂经外周静脉置入中心静脉导管(PICC)的效果。方法:选取留置PICC病人162例为研究对象,按置管方式分为试验组80例和对照组82例;试验组采用建立皮下隧道方式置管,对照组采用传统赛丁格穿刺技术置管。比较两组病人一针穿刺成功率、操作疼痛评分、操作出血量评分、置管后24 h内渗血量、PICC管脱出、导管口感染、机械性静脉炎、导管相关性血液感染、血栓发生率。结果:两组病人置管过程的疼痛评分、操作出血量评分、置管后脱管、导管口感染、机械性静脉炎、导管相关性血液感染、血栓发生率比较,差异无统计意义(P>0.05);试验组一针穿刺成功率明显高于对照组(P=0.005);置管后24 h内渗血程度低于对照组(P<0.01)。结论:隧道式PICC置管操作简单、易学,能提高一针穿刺成功率,降低术后渗血程度。     

Shoulder MR imaging normal variants and imaging artifacts

The appearance of osseous, labral, hyaline cartilage, ligament, muscle, and tendon variants and pitfalls are discussed with attention to the keys to distinguishing each of the findings from pathologic lesions of the shoulder.     

Basic concepts of MR imaging, diffusion MR imaging, and diffusion tensor imaging

MR image contrast is based on intrinsic tissue properties and specific pulse sequences and parameter adjustments. A growing number of MRI imaging applications are based on diffusion properties of water. To better understand MRI diffusion-weighted imaging, a brief overview of MR physics is presented in this article followed by physics of the evolving techniques of diffusion MR imaging and diffusion tensor imaging.     

Fetal imaging

Presently, MRI is an adjunct to prenatal sonography. It provides information that can aid in the diagnosis of fetal anomalies, affect prenatal counseling and management of the pregnancy, and guide prenatal intervention and delivery planning. With further advances in technology, particularly shorter scan times and better image resolution, the applications for fetal imaging are likely to increase.     

Microglia imaging

Imaging of microglia cells using the radiolabeled ligand toward peripheral benzodiazepine receptor(PBR) is applied to brain injury and neurodegenerative diseases. A novel PBR radioligand other than [11C] PK11195 might be desirable to detailedly delineate this complicated phenomenon and a novel idea other than in vitro PBR binding ability is desirable to expect feasibility of a new candidate. Current status, problems and future prospects associated with indirect imaging of microglial activity with [11C] PK11195 will be discussed.     

Magneto-photo-acoustic imaging

Magneto-photo-acoustic imaging, a technique based on the synergy of magneto-motive ultrasound, photoacoustic and ultrasound imaging, is introduced. Hybrid nanoconstructs, liposomes encapsulating gold nanorods and iron oxide nanoparticles, were used as a dual-contrast agent for magneto-photo-acoustic imaging. Tissue-mimicking phantom and macrophage cells embedded in ex vivo porcine tissue were used to demonstrate that magneto-photo-acoustic imaging is capable of visualizing the location of cells or tissues labeled with dual-contrast nanoparticles with sufficient contrast, excellent contrast resolution and high spatial resolution in the context of the anatomical structure of the surrounding tissues. Therefore, magneto-photo-acoustic imaging is capable of identifying the nanoparticle-labeled pathological regions from the normal tissue, providing a promising platform to noninvasively diagnose and characterize pathologies.     

分子影像学报告基因显像的研究进展

报告基因显像技术是分子影像学中重要的显像技术,其可对多种不同的生物学和分子遗传学过程进行显像,有望更快地应用于临床.本文综述分子影像学中报告基因显像的一般原则、分类、相关影像学技术及潜在的临床应用.     

Diagnosis--radiologic imaging

One of the most important recent advances in imaging technology for the diagnosis of lung cancer is CT consisting of high-resolution and helical volumetric techniques. CT has made a detailed morphological analysis correlated with histopathology as well as the detection of small peripheral lung cancers possible. MRI still remains as a complementary role to CT, but MR angiography using fast gradient-echo technique has achieved a great progress. FDG-PET is the most encouraging development in nuclear medicine and is vigorously evaluated for its cost-effective clinical value in differentiating benign and malignant nodules as well as in staging of lung cancer. In chest radiography, the development of computer-aided diagnosis is underway and seems promising.