彩色多普勒超声在诊断新生儿缺氧缺血性脑病中的应用研究

目的　研究新生儿 (缺氧缺血性 )脑病 (HIE)头颅彩色多普勒脑血流动力学及颅内结构改变特征 ,评价其对新生儿 (HIE)脑损伤的应用价值。方法　应用彩色多普勒超声检查 37例新生儿缺氧缺血性脑病患儿和 30例正常新生儿出生后 2 4～ 72h大脑中动脉血流动力学参数变化、侧脑室及脑实质回声的变化。结果　①轻度HIE组和中度HIE组左侧大脑中动脉舒张末期流速 (Vd)均低于对照组 ,经统计学处理均有显著性差异 (P <0 .0 1) ;轻度HIE组以左中动脉 (单侧 )Vd减慢为主 ,中度HIE组双侧中动脉Vd均减慢 ;中度HIE组右中动脉Vs明显增快 ,与对照组及轻度HIE组比较有显著性差异 (P <0 .0 1) ;②轻度HIE组和中度HIE组双侧大脑中动脉PI及RI增高尤其明显 ,与对照组比较有显著性差异 (P <0 .0 1) ;中度HIE组右中动脉PI及RI较轻度HIE组增高明显 ,有显著性差异 (P <0 .0 1) ;③ 37例HIE中 ,大脑中动脉血流阻力及颅内结构异常 32例 :32 /37,其中大脑中动脉RI异常 2 8例 (占 75 % ) ;脑室增宽 14例 ;脑实质回声稍增强 8例 ;侧脑室脉络丛少量出血 4例 ;脑实质少量出血 3例 ;脑室内少量出血 2例 ;室管膜下少量出血 1例。结论　彩色多普勒对HIE脑损伤有较好的诊断敏感性 ,对临床医师指导治疗及评估预后具有一定的实用价值。     

超声弹性成像技术在乳腺病变诊断中的进展

超声弹性成像作为对传统超声的补充,它能够评估组织的固有弹性属性并提供有关组织相对硬度方面的信息,是一种全新的、可靠的非侵袭性技术。文章综述了超声弹性成像的原理、相关技术及评分标准。着重介绍了压迫式超声弹性成像技术在乳腺疾病中的应用、存在的局限性、影响因素及超声弹性成像技术发展前景。     

超声造影及超声弹性成像技术在睾丸疾病诊断中的应用进展

目的探讨超声造影及超声弹性成像技术在睾丸疾病诊断中的应用进展。方法查阅近年来超声造影及超声弹性成像技术应用于睾丸疾病诊断的相关文献,进行归纳总结。结果在二维高频灰阶超声、彩色多普勒超声检查基础上,超声造影可提高睾丸扭转、表皮样囊肿、梗死和脓肿等睾丸疾病诊断的敏感性和特异性。超声弹性成像能反映组织的相对软硬度,对良恶性病变具有一定的鉴别价值。结论超声造影及超声弹性成像技术可以提高睾丸疾病诊断的符合率,并能进一步提高睾丸良恶性病变诊断的准确性。     

超声弹性成像在乳腺疾病诊断中的应用进展

超声弹性成像(UE)技术可无创、定性、定量获得组织的硬度/弹性信息,现已广泛应用于肝脏、乳腺、甲状腺等疾病的诊断和治疗评估并取得可喜的进展。弹性成像对乳腺疾病的诊断具有重要意义,其不但可发现二维超声图像上模糊不清的肿块,还可对常规超声发现的肿块进一步评估,调整肿块的乳腺影像报告和数据系统(BI-RADS)评分,鉴别肿块的良恶性,提高乳腺癌诊断的特异度。另外,弹性成像还在预测乳腺癌的预后、病理分型及评估新辅助化学治疗效果等方面具有指导意义。文章主要对应用于乳腺的UE技术的基本情况及其研究进展作一综述。     

超声弹性成像技术研究现状

超声弹性成像(ultrasound elastography,UE)是以软组织的弹性参量为对象的一种新的成像技术,它弥补了传统超声成像技术不能提供生态学特性的不足,拓宽了超声图像在肿瘤探测及扩散疾病成像方面的应用,具有非常重要的临床应用价值。本文详细介绍了超声弹性成像技术的实现原理、研究现状以及常用的临床衡量指标,如对比度传输率、应变滤波器、时间延时等,并对其发展做出展望。     

经直肠超声弹性成像在前列腺癌中应用进展

早期前列腺癌预后较好,前列腺癌的早期诊断至关重要。超声弹性成像技术是应用于前列腺癌的筛查和诊断一种无创的新兴影像学检查技术。文章就弹性成像技术的基本原理、在前列腺癌诊断中的应用、在前列腺治疗中的应用和进展做一综述,展望弹性成像随着多模态成像技术的发展,在诊断鉴别前列腺良恶性病变、预测癌灶的病理分化程度、评估监测前列腺癌治疗中发挥诊治作用。     

声辐射力超声弹性成像技术在狼疮肾炎患者中的应用

目的:应用声辐射力超声弹性成像技术(acoustic radiation force ultrasound elastography,ARFI)测量狼疮肾炎(lupus nephritis,LN)患者肾实质的弹性,早期评估狼疮肾炎患者肾的损害.方法:对30例狼疮肾炎患者(患病组)及30例健康志愿者(健康组)的左右肾分别...     

超声弹性成像在乳腺疾病诊断中的仿真分析

乳腺疾病是当今女性的常见病,由于超声检查简单易行,已成为乳腺疾病中良恶性肿块鉴别的常用方法.本研究借助于MATLAB软件下的PDE工具箱,利用有限元分析方法,结合弹性力学理论计算得到良恶性乳腺肿块在不同情况下的应变分布图.仿真结果表明,对于弹性模量较大的肿块,其x方向应变和切应变图像在鉴别诊断上都具有较高的临床应用价值,但是对于一些硬度较大的良性病变和一些硬度较小的恶性病变,其准确性不是很高,为后续研究提供了依据.     

超声弹性成像的原理及理论分析

超声弹性成像能够获得常规的成像模态无法获取的组织弹性这种基本的信息，具有非常重要的临床价值。本文详细介绍了超声弹性成像的一般原理与改进，以及理论分析的方法。     

新生儿缺氧缺血性脑病的B超诊断价值

新生儿缺氧缺血性脑病 (HIE)是新生儿期最为严重的疾病之一 ,也是造成儿童期神经系统功能障碍的主要原因之一。我们对 14 5例HIE行头颅B超检查 ,报告如下。资料与方法一、一般资料 :　严格按照 1996年 10月中华医学会新生儿组在杭州制订的HIE诊断依据和临床分度收治的HIE患儿 14 5例 ,其中男 98例 ,女 4 7例 ;轻度 4 0例 ,中度 6 2例 ,重度 4 3例。胎龄 <37w18例 ,37～ 4 2w113例 ,>4 2w14例。全部病例均于生后 1～ 7d内行第一次头颅B超 ,异常者每隔3～ 5d复查一次至声像图正常。 89例患儿于第 7～ 14d再次复查头颅B超 ,32例患儿于第 …     

Acoustic radiation force impulse elastography in differentiating renal solid masses: a preliminary experience

New diagnostic methods are required to diagnose renal mass. Thus, we assessed virtual tissue quantification (VTQ) of acoustic radiation force impulse (ARFI) elastography in differentiation of renal solid masses. Forty-two patients with renal masses were assessed by VTQ in terms of measurement of the shear wave velocity (SWV). The masses were divided into three groups. They were clear cell carcinoma (CCC) angiomyolipoma (AML), and pseudotumor. The differences among the three groups in SWV, as well as between masses and its surrounding parenchyma, were investigated. Receiver operating characteristic (ROC) curve was plotted to evaluate the diagnostic performance. We found that the SWV among the three groups were significant different (F = 6.976, P = 0.003) and the SWV of pseudotumor (3.14 ± 0.75 m/s) was significantly higher than CCC (2.46 ± 0.45 m/s) and AML (2.49 ± 0.63 m/s) (P = 0.007 and 0.001 respectively). There were no significant difference between CCC and AML in SWV (P = 0.719). For each group, there was no significant difference between the mass and its surrounding parenchyma (P = 0.693, 0.892, and 0.714, respectively). Between pseudotumor and CCC, the optimal cut-off value of SWV for differential diagnoses was 3.07 m/s; and the area under the ROC curve (AUC) was 0.78 (95% CI: 0.560 to 0.924) (P = 0.004), the sensitivity and specificity were 100% and 58.3%, respectively. Between pseudotumor and AML, the optimal cut-off value of SWV for differential diagnoses was 3.03 m/s, thus AUC curve was 0.786 (95% CI: 0.591 to 0.918) (P = 0.002), the sensitivity and specificity were 100% and 58.3%, respectively. No significant difference was found between AML and CCC (P = 0.587) and the AUC was 0.562. To conclude, our results support that ARFI has potential value in differentiation between CCC and pseudotumor, or between AML and pseudotumor, however, it fails to make a distinction between CCC and AML.     

Ultrasound Evaluation of Liver Fibrosis

Early diagnosis of liver fibrosis is an important factor affecting the efficacy of chronic hepatitis treatment. In the past, the diagnosis of liver fibrosis was dependent on a liver biopsy which has several shortcomings as sampling error, intra- or inter-observation variations and possible procedure-related complications. Ultrasound-based elastography, tissue elastography (TE) and acoustic radiation force impulse (ARFI) have been developed to assess liver fibrosis. Current clinical evidence indicates that TE and ARFI had high sensitivities and specificities to diagnosis from significant fibrosis to liver cirrhosis. TE and ARFI can not only assess liver fibrosis but can also be used to predict prognosis.In practical, ARFI can also be used on a regular basis to evaluate the degree of liver fibrosis for chronic hepatitis B and C, nonalcoholic fatty liver disease, and alcoholic liver disease.     

Sonorheometry: A Noncontact Method for the Dynamic Assessment of Thrombosis

Inappropriate blood coagulation plays a central role in the onset of myocardial infarction, stroke, pulmonary embolism, and other thrombotic disorders. The ability to screen for an increased propensity to clot could prevent the onset of such events by appropriately identifying those at risk and enabling prophylactic treatment. Similarly, the ability to characterize the mechanical properties of clots in vivo might improve patient outcomes by better informing treatment strategies. We have developed a technique called sonorheometry. Unlike existing methods, sonorheometry is able to assess mechanical properties of coagulation with minimal disturbance to the delicate structure of a forming thrombus. Sonorheometry uses acoustic radiation force to produce small, localized displacements within the sample. Time delay estimation is performed on returned ultrasound echoes to determine sample deformation. Mechanical modeling and parametric fitting to experimental data yield maps of mechanical properties. Sonorheometry is well suited to both in vitro and in vivo applications. A control experiment was performed to verify that sonorheometry provides mechanical characterization in agreement with that from a conventional rheometer. We also examined thrombosis in blood samples taken from four subjects. This data suggests that sonorheometry may offer a novel and valuable method for assessing the thrombogenicity of blood samples.     

Quantitative Assessment of Tumor Responses after Radiation Therapy in a DLD-1 Colon Cancer Mouse Model Using Serial Dynamic Contrast-Enhanced Magnetic Resonance Imaging

Purpose

The purpose of this study was to investigate the predictability of pretreatment values including Dynamic Contrast-Enhanced Magnetic Resonance Imaging (DCE-MRI) derived parameters (K^trans, K_ep and V_e), early changes in parameters (K^trans, tumor volume), and heterogeneity (standard deviation of K^trans) for radiation therapy responses via a human colorectal cancer xenograft model.

Materials and Methods

A human colorectal cancer xenograft model with DLD-1 cancer cells was produced in the right hind limbs of five mice. Tumors were irradiated with 3 fractions of 3 Gy each for 3 weeks. Baseline and follow up DCE-MRI were performed. Quantitative parameters (K^trans, K_ep and V_e) were calculated based on the Tofts model. Early changes in K^trans, standard deviation (SD) of K^trans, and tumor volume were also calculated. Tumor responses were evaluated based on histology. With a cut-off value of 0.4 for necrotic factor, a comparison between good and poor responses was conducted.

Results

The good response group (mice #1 and 2) exhibited higher pretreatment K^trans than the poor response group (mice #3, 4, and 5). The good response group tended to show lower pretreatment K_ep, higher pretreatment V_e, and larger baseline tumor volume than the poor response group. All the mice in the good response group demonstrated marked reductions in K^trans and SD value after the first radiation. All tumors showed increased volume after the first radiation therapy.

Conclusion

The good response after radiation therapy group in the DLD-1 colon cancer xenograft nude mouse model exhibited a higher pretreatment K^trans and showed an early reduction in K^trans, demonstrating a more homogenous distribution.