常见眼内疾病的三维超声表现初探

目的探讨眼内常见疾病的三维超声图像特征表现。方法应用三维超声重建技术对常见眼内疾病进行三维超声成像并描述其成像特征。图像采集方式为无定位系统的自由臂扫查，扫查时间为3～5S。结果48只患眼中46只获得较为满意的三维图像，患眼内视网膜脱离、脉络膜脱离、玻璃体内机化物的立体形态及范围，晶状体脱离及玻璃体内异物的空间位置，球内肿瘤的立体结构、表面及内部的特征均清晰可见。结论三维超声不但具有采集时间短的优点，而且所重建图像形象、直观、立体感强、空间位置关系明确，同时可观察到病变的表面及内部的细微结构特征，弥补了二维超声的不足，为眼内疾病的诊断提供了更多的信息。     

不放液的巩膜外垫压术治疗孔源性视网膜脱离临床观察

孔源性视网膜脱离(RRD)是眼科常见疾病.以往外路手术治疗多采用冷凝、电凝或光凝封闭裂孔,环扎、外加压和放液是基本步骤.近年来,最小量的视网膜脱离手术[1]在临床广泛应用,简化手术步骤,避免了许多并发症,达到了封闭视网膜裂孔使视网膜复位的目的.回顾分析我院18例(18只眼)RRD患者采用不放液的巩膜外垫压术的临床效果,报告如下.     

实时三维超声评价胎儿颜面和肢体畸形

目的探讨实时三维超声在诊断胎儿颜面和肢体畸形中的应用价值.方法对24例常规二维超声检查正常的胎儿和9例疑有颜面或肢体畸形的孕中晚期胎儿行实时三维超声检查,仪器为GE Voluson 730 expert.实时三维成像方法应用经腹容积探头,采用表面成像法和透明成像法,将所采集图像存入硬盘,并对病变部位进行2～4次重复扫描.结果24例正常胎儿颜面部常规三维成像显示率83%(20/24),实时三维追踪显示率可达100%.上肢单肢显示率100%,双上肢显示率63%(15/24),下肢单肢显示率100%,双下肢显示率75%(18/24).实时三维捕捉到颜面或肢体动态图像,如单手拂面、握拳或手指伸展,吞咽或吐舌,蹬腿或伸足等.9例异常胎儿中唇裂3例,四肢短小(成骨发育不良)3例,下肢短小(软骨发育不良)2例,足内翻合并严重的全身水肿1例,均得到理想成像.结论实时三维超声成像有助于显示出颜面和肢体畸形的外貌特征,为胎儿颜面和肢体畸形的诊断提供了重要手段.     

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.     

转基因小鼠前列腺癌模型肿瘤三维超声成像与三维病理重建

目的:应用三维超声微成像检测转基因小鼠前列腺癌(TGMAP)模型并与三维病理图像比较.方法:通过三维微超声成像系统对TGMAP小鼠前列腺癌进行三维超声图像采集,对前列腺癌标本进行连续切片,扫描并存储图像,纵向排列所有的二维图像获得重建的三维数字化病理图像,对三维超声图像和三维病理图像进行比较.结果:通过定性比较前列腺癌的三维超声成像与连续组织学切片,证实了该超声系统可以准确显示活体小鼠肿瘤的大小和形状.结论:小鼠前列腺癌模型的三维超声微成像有望成为小鼠临床前期研究的新的微成像手段.     

二维及三维超声诊断胎儿面部畸形的价值

目的：探讨二维及三维超声在胎儿面部畸形中的应用价值。方法：对17例面部畸形胎儿进行二维超声普通切面及三维超声重建,并对相关图像进行分析。结果：17例面部畸形胎儿包括唇腭裂7例,单纯唇裂6例,面横裂1例,全前脑胎儿特征性的眼、鼻异常3例。二维超声对上述面部畸形的定性诊断率可达94.1%,图像特征明显,但图像的空间立体感不足,逼真性差。三维超声在诊断胎儿上述畸形时图像逼真,空间立体感强,可进行任意角度的旋转,从不同视角观察胎儿颜面部,并可应用不同成像模式,判断胎儿腭裂等骨性畸形,其定性诊断率可达100%。结论：三维超声在普通二维超声图像的基础上可以从更多的视角并应用不同的成像模式显示胎儿面部畸形。     

眼部疾病的实时三维超声成像研究

目的探讨实时三维(three dimensional,3-D)超声评价眼部疾患的应用价值.方法应用实时3-D技术对28只分别患视网膜脱离、眼内异物、眼外伤及玻璃体积血等疾病的患眼进行三维超声成像,并与二维(two dimensional,2-D)超声检查结果、手术所见进行对比分析.结果所有患眼均能获得清晰的3-D图像,患眼内视网膜脱离的空间形态及范围、玻璃体积血、眼内异物的位置和形态、泪道囊肿均清晰可见.2-D测量的视网膜脱离高度和3-D的比较差异有显著性意义(P＜0.05),3-D和术中所见视网膜脱离的起止点比较无差异(P＞0.05).结论 3-D超声可以明确快速地显示眼部病变的立体结构和空间分布,与2-D超声比较,3-D可为手术提供更明确的诊断信息和空间定位信息.     

三维超声成像诊断胎儿体表畸形的应用价值

目的探讨三维超声成像在诊断胎儿体表畸形中的临床应用价值.方法应用实时三维超声仪对974例孕妇、共990个胎儿进行产前二维及三维超声检查,统计并比较超声诊断与产后诊断的符合率.结果发现胎儿体表畸形22例51处,产前二维及三维超声对病变部位判断正确者分别为37处(72.5%)及47处(92.2%),能直观显示病变及对细节判断正确者分别为18处(35.3%)及46处(90.2%).结论三维超声图像立体、直观,为胎儿体表畸形的诊断提供了更丰富的信息,优于单纯使用二维超声,有较高的临床应用价值,是提高产前诊断水平的一个可靠的技术手段.     

倍频532nm激光治疗孔源性视网膜脱离临床观察

<正>孔源性视网膜脱离(RRD)发病迅速,给患者的视功能造成严重损害,而尽早封闭视网膜裂孔是治疗RRD、提高术后视功能的关键。采用巩膜外加压术或玻璃体手术治疗RRD损伤大、费用高,而倍频532激光封闭视网膜裂孔治疗,不扰乱玻璃体状态,眼部组织损伤较轻,费用低,可以重复治疗。本研究采用532 nm激光对部分RRD患者进行治疗,效果确切,报告如下。1资料与方法     

经阴道三维超声Render成像与Omniview成像技术对宫腔疾病的诊断成效对比

目的 探讨经阴道三维超声传统三维渲染成像(Render)与自由解剖成像(Omniview)技术在宫腔疾病诊断中的应用成效.方法 102例宫腔疾病患者术前行经阴道三维超声检查,并利用Render和Omniview技术重建图像.分析两种成像模式的诊断效能.结果 Render与Omniview成像对子宫内膜增生、子宫内膜息肉...     

三维灰阶超声与二维超声在甲状腺结节诊断中应用

目的研究三维灰阶超声在甲状腺结节诊断中的应用。方法对56例62个甲状腺结节在二维超声的基础上进行三维检查,并与手术、病理结果对照分析。结果三维灰阶超声能迅速提供肿物的三维重建冠状断面图像及与周围组织的关系。三维超声中良性实质结节有完整的高回声界面,88．9％有宽窄均匀的暗环;而69．2％恶性实质结节无完整的高回声界面,恶性实质结节表现为76．9％内部无暗环或暗环宽窄不一。4个结节向腺体外生长并侵犯颈动脉提示恶性肿物。甲状腺囊实性肿物以良性为多,占92．6%,三维超声中恶性囊实性结节表现为实质部分表面不规则,凹凸不平。结论甲状腺三维超声成像拓宽了超声检查的视野,提供直视的、立体的肿块形态学特点,为甲状腺疾病的一种新的成像方法。     

What Does 2‐Dimensional Imaging Add to 3‐ and 4‐Dimensional Obstetric Ultrasonography?

OBJECTIVE: The purpose of this study was to determine whether 2-dimensional (2D) ultrasonography adds diagnostic information to that provided by the examination of 3-dimensional/4-dimensional (3D/4D) volume data sets alone. METHODS: Ninety-nine fetuses were examined by 3D/4D volume ultrasonography. Volume data sets were evaluated by a blinded independent examiner who, after establishing an initial diagnostic impression by 3D/4D ultrasonography, performed a 2D ultrasonographic examination. The frequency of agreement and diagnostic accuracy of each modality to detect congenital anomalies were calculated and compared. RESULTS: Fifty-four fetuses with no abnormalities and 45 fetuses with 82 anomalies diagnosed by 2D ultrasonography were examined. Agreement between 3D/4D and 2D ultrasonography occurred for 90.4% of the findings (123/136; intraclass correlation coefficient, 0.834; 95% confidence interval, 0.774-0.879). Six anomalies were missed by 3D/4D ultrasonography when compared to 2D ultrasonography (ventricular septal defect [n = 2], interrupted inferior vena cava with azygous continuation [n = 1], tetralogy of Fallot [n = 1], horseshoe kidney [n = 1], and cystic adenomatoid malformation [n = 1]). There were 2 discordant diagnoses: transposition of the great arteries diagnosed as a double-outlet right ventricle and pulmonary atresia misinterpreted as tricuspid atresia on 3D/4D ultrasonography. One case of occult spinal dysraphism was suspected on 3D ultrasonography but not confirmed by 2D ultrasonography. When compared to diagnoses performed after delivery (n = 106), the sensitivity and specificity of 3D/4D ultrasonography (92.2% [47/51] and 76.4% [42/55], respectively) and 2D ultrasonography (96.1% [49/51] and 72.7% [40/55]) were not significantly different (P = .233). CONCLUSIONS: Information provided by 2D ultrasonography is consistent, in most cases, with information provided by the examination of 3D/4D volume data sets alone.     

中药辅助治疗孔源性视网膜脱离的临床研究

目的评价中药辅助治疗孔源性视网膜脱离（rhegmatogenous retinal detachment,RRD）的临床疗效。方法将52例（52眼）RRD患者按随机数字表法分为观察组和对照组,每组26例（26眼）。对照组采用单纯视网膜脱离复位术;观察组在视网膜脱离复位术基础上采用中药辨证论治治疗,对2组患者视网膜下液吸收的情况及术后视力恢复情况进行比较。结果①视网膜下积液吸收情况：观察组总有效率92.3%;对照组总有效率为61.5%,2组比较差异有统计学意义（P〈0.01）。②视力改善情况：观察组总有效率为73.1%。对照组总有效率为46.2%,2组较差异有统计学意义（P〈0.05）。结论中药能促进视网膜下积液的吸收及视功能的恢复,是辅助治疗RRD的一个重要举措。     

Three-dimensional ultrasonography of bone and soft tissue lesions.

BACKGROUND: The aim of this study was to investigate feasibility and potential applications of three-dimensional (3D) ultrasonography in the evaluation of musculoskeletal disorders. METHODS: 3D ultrasonography was performed in 83 patients with bone (n = 50) or soft tissue lesions (n = 33). Volume data were obtained using two volume probes (1-8.5 and 8.5-12 MHz) and a 3D ultrasound unit. The results of 3D ultrasonography were compared to two-dimensional ultrasound and radiological imaging. RESULTS: The system enabled acquisition of 3D ultrasound data in diagnostic quality. 3D image-processing permits to analyse ultrasound data interactively in three orthogonal planes (section mode) or in realistic 3D views (rendering mode). Compared to conventional ultrasonography 3D image analysis improved assessment of details, provided better spatial orientation and facilitated image interpretation in 23, 44 and 49 cases, respectively. Additional findings that had significant influence on patient management were obtained in 16 of 83 patients (19%). Multiplanar reformating provided additional scan planes and increased the comparability of follow up examinations by standardized display and measurement. 3D surface reconstructions were very helpful to understand the morphology of bone lesions e.g. tortuous fracture lines. CONCLUSION: Our preliminary experience shows that 3D ultrasonography of musculoskeletal disorders is feasible. The ability to assess previously unattainable scan planes and lifelike surface projections may be particularly valuable for imaging of bone lesions. Further studies will be required to assess the exact role of this new technique for the evaluation of musculoskeletal disorders.     

超声在产前诊断胎儿颅脑疾病中的应用

目的 探讨超声检查在产前诊断胎儿颅脑疾病中的应用价值.方法 对31例患胎儿颅脑疾病孕妇行二维超声、三维超声、磁共振检查,并与病理结果对照分析.结果 31例胎儿超声提示2例无脑儿,1例露脑,2例脑膨出,5例全前脑,2例蛛网膜囊肿,1例Galen静脉瘤,2例胼胝体发育不全,1例脑裂,3例Dandy-Walker畸形,7例侧脑室扩张,5例颅后窝池增宽,通过磁共振检查核对,三维超声诊断符合率100%,二维超声诊断符合率93.5%.结论 超声检查在胎儿颅脑疾病中有很高价值,三维超声比二维超声检查更直观.     

超声在产前诊断胎儿颅脑疾病中的应用

目的 探讨超声检查在产前诊断胎儿颅脑疾病中的应用价值.方法 对31例患胎儿颅脑疾病孕妇行二维超声、三维超声、磁共振检查,并与病理结果对照分析.结果 31例胎儿超声提示2例无脑儿,1例露脑,2例脑膨出,5例全前脑,2例蛛网膜囊肿,1例Galen静脉瘤,2例胼胝体发育不全,1例脑裂,3例Dandy-Walker畸形,7例侧脑室扩张,5例颅后窝池增宽,通过磁共振检查核对,三维超声诊断符合率100%,二维超声诊断符合率93.5%.结论 超声检查在胎儿颅脑疾病中有很高价值,三维超声比二维超声检查更直观.     

超声在产前诊断胎儿颅脑疾病中的应用

目的 探讨超声检查在产前诊断胎儿颅脑疾病中的应用价值.方法 对31例患胎儿颅脑疾病孕妇行二维超声、三维超声、磁共振检查,并与病理结果对照分析.结果 31例胎儿超声提示2例无脑儿,1例露脑,2例脑膨出,5例全前脑,2例蛛网膜囊肿,1例Galen静脉瘤,2例胼胝体发育不全,1例脑裂,3例Dandy-Walker畸形,7例侧脑室扩张,5例颅后窝池增宽,通过磁共振检查核对,三维超声诊断符合率100%,二维超声诊断符合率93.5%.结论 超声检查在胎儿颅脑疾病中有很高价值,三维超声比二维超声检查更直观.     

Three-dimensional ultrasound in the evaluation of fetal anomalies.

OBJECTIVES: To determine the additional information and clinical impact provided by three-dimensional ultrasound (3D US) imaging of fetal anomalies compared to conventional 2-dimensional ultrasound (2D US). MATERIALS AND METHODS: Sixty-three patients with 103 anomalies were scanned prospectively with both 2D and 3D US. Each anomaly was reviewed by one or more fetal imaging specialists to determine whether the 3D US data were advantageous, equivalent, or disadvantageous when compared with 2D US images. Clinical impact and pathologic or clinical outcome were determined in all cases. RESULTS: The 3D US images provided additional information in 53 anomalies (51%), were equivalent to 2D US images in 46 anomalies (45%), and were disadvantageous in four anomalies (4%). The 3D US was most helpful in evaluating fetuses with facial anomalies, hand and foot abnormalities and axial spine and neural tube defects. Planar images derived from 3D US volume data sets generally were more helpful for diagnostic purposes, whereas rendered 3D US images were more useful as a point of reference and were better appreciated by patients in understanding fetal abnormalities. Additional information provided by 3D US images impacted clinical management in 5% of patients. The 3D US images were disadvantageous in two fetuses with multiple anomalies and two with cardiac anomalies. CONCLUSION: The 3D US offered diagnostic advantages in about one-half of the selected cases studied and had effect on patient management in 5% of cases. This modality can be a powerful adjunctive tool to 2D US in providing a more comprehensible, 3D US impression of congenital anomalies. Thus, 3D US is currently most helpful as a targeted study complementing 2D US.