B超图像复杂性特征分析方法诊断脂肪肝

目的利用复杂性分析研究脂肪肝患者B超图像纹理改变,进而诊断脂肪肝。方法通过分析正常肝脏与脂肪肝B超图像的复杂度,近似熵和近远场灰度比特征,组成特征矢量,利用反向传播人工神经网络对脂肪肝进行计算机辅助诊断。结果用80例样本建立识别模型,用50例样本进行验证,对正常肝的识别率达到100%,脂肪肝识别率达到100%。结论复杂性分析能较好地描述脂肪肝超声图像的特征,对脂肪肝的识别有着较好的性能。     

Evaluation of the accuracy of articular cartilage thickness measurement by B-mode ultrasonography with conventional imaging and real-time spatial compound ultrasonography imaging

The present study aimed to quantify the thickness of articular cartilage (Tc) in vitro using both conventional and real-time spatial compound B-mode ultrasonography (US) with a clinically used transducer and to evaluate the accuracy of measurement by comparing the results with values obtained microscopically. Femoral condyle samples were obtained from a 6-month-old pig and a 3-year-old pig. B-mode US images with conventional imaging and real-time spatial compound imaging (RTSCI) of osteochondral blocks were acquired. Tc determined using US (Tc-US) was measured from line data parallel to US beam direction acquired from B-mode images with an objective method for determining cartilage surface and bone-cartilage interfaces at the peak brightness values. Tc was also determined under microscopy (Tc-optical) using the corresponding points from US measurement. Tc-US was compared with Tc-optical to assess accuracy. Tc-US correlated significantly with Tc in both conventional imaging and RTSCI (r = 0.961, 0.976, respectively). Bland-Altman plots showed mean differences between Tc-optical and Tc-US were -0.0073 mm and 0.0139 mm with standard deviations of 0.171 mm and 0.131 mm for conventional imaging and RTSCI, respectively. Our results show that Tc-US measurement using B-mode US allows accurate measurement of Tc. Considering correlation coefficients between Tc-US and Tc-optical, RTSCI US may offer higher accuracy for measuring Tc than conventional methods when an objective tissue border determination algorithm is used, even though both showed good accuracy in our study.     

Textural variations in B-mode ultrasonography: A stochastic model

Analysis of textural patterns in gray-scale ultrasonography is frequently the basis for clinical diagnosis. It has been found, however, that texture is shaped not only by tissue microstructure but by characteristics of the imaging system as well. This paper describes computer and analytic models which give insight into the role of the imager in texture formation. It is shown that spatial resolution and texture granularity are not simply related, and that axial and lateral texture are determined by unrelated phenomena. Experimental results are given which confirm the modeling.     

飞行人员B型超声检查新发现疾病调查

目的 调查分析年度疗养飞行人员B超检查新发现疾病特点,为尽早预防、治疗疾病提供依据.方法 分析2981例男性飞行人员B超检查及临床体检资料.结果 新发现B超异常病例136例,共有17个病种,以肝、胆、肾系统结石最为常见(占37.5%),其次是脂肪肝(占26.5%),肝、肾囊肿(占15.4%)及胆囊息内(占8.8%)等.新发现病例健康鉴定结论 合格131例(占96.3%),5例(占3.7%)病情较重定为飞行暂不合格(其中2例结石发生急性绞痛、1例输尿管结石并重度积水、1例肾脏透明细胞癌、1例早期肝硬化).结论 飞行人员超声检查新发病例多见,个别疾病受检者虽无自觉症状,但病变明显需及时治疗,应引起航卫工作者的高度重视.     

术前B超在腹腔镜胆囊切除术的应用价值

腹腔镜胆囊切除术(LC)作为微创外科新技术近年来发展较快。但因其特殊的手术环境及对设备的高度依赖性导致手术中出现一定的困难,术后也有一些并发症出现,因此术前认真选择适当的病例,预测术中手术的难易程度,对减少或避免并发症的发生及中转开腹尤为重要。为此我们对术前超声检查和手术资料进行了回顾性分析,以便预测术中困难和中转开腹的可能性。表3胆囊壁厚度与手术难易的关系胆囊壁厚度手术容易手术困难合计>3mm14585230≤3mm45243495合计597128725注:χ2=86.32,P<0.01,胆囊壁厚度与手术的难易有显著性差异。表4胆囊透声度与手术难易…     

石家庄地区乙肝病毒感染与肝、胆B超影像学分析

目的分析石家庄地区乙肝病毒感染者肝胆B超影像学检查结果,为该地区乙肝病毒感染患者肝胆疾病防治及诊断提供参考。方法选取石家庄地区三家医院的乙肝病毒感染患者500例作为研究对象,所有患者均完整保留了肝功能检查资料和肝胆B超检查资料,对其肝功能检测结果和肝胆B超影像学检测结果进行分析。结果 500例乙肝病毒感染患者中,丙氨酸氨基转移酶(ALT)升高率22.4%;腹部B超诊断出肝囊肿患者占5.4%,肝脓肿患者占2.2%,脂肪肝患者占8.4%,原发性肝癌患者占1.4%,继发性肝癌患者占1.2%,肝硬化患者占1.0%。结论 B超检测结果中,患有脂肪肝、肝硬化、肝脓肿的患者肝功能检测结果 ALT升高比例较高,提示在对乙肝病毒感染患者的肝功能检测中ALT升高者应重视B超检查,重点关注患者是否出现肝硬化、脂肪肝及肝脓肿。     

Measurement of articular cartilage thickness using a three-dimensional image reconstructed from B-mode ultrasonography mechanical scans feasibility study by comparison with MRI-derived data

The present study aimed to develop a method to measure three-dimensional (3-D) thickness of cartilage (Tc) at the femoral condyle using B-mode ultrasonography (US) and to clarify the feasibility of US in clinical evaluations of articular cartilage by comparing the results with 3-D measurement values using magnetic resonance imaging (MRI) and assessing repeatability. The medial surface of the right knees of two healthy male volunteers (age, 37 and 59 years) and the knees on affected side of three male patients with osteoarthritis (OA) (age, 73, 81 and 83 years) were scanned using B-mode US with the knee flexed at 120°. The range of the angle of probe rotation for the arm was 0-80° and B-mode images (total, 101 images) were acquired every 0.8°. MRI of the knees was also performed using the double echo steady-state sequence. Both US and MRI images were used to create 3-D models of medial femoral condyle articular cartilage. Tc was determined at points 1 mm apart from one another in the US model (Tc-US) and MRI model (Tc-MRI). Tc-US was compared with Tc-MRI and the repeatability of Tc-US was assessed by mean Tc in the specific region of interest of the femoral condyle. Tc-US correlated significantly with Tc-MRI both in volunteers and in OA patients (p < 0.0001 each) and coefficients of correlation were 0.976 and 0.964 for volunteers and OA patients, respectively. The coefficient of variance for mean Tc-US was 4.90%. Our results show that 3-D US measurements of femoral cartilage are reproducible and correlate strongly with MRI measurements.     

Extracranial carotid vascular disease: detection by real time B-mode ultrasonography

Real time B-mode ultrasonography is a currently popular technique used to screen patients with suspected carotid vascular disease and identify those who need cerebral angiography. From September 1981 through February 1983, 1,205 patients had carotid ultrasonography in the Vascular Laboratory at Erlanger Medical Center. Retrospective review of these patients identified 260 who also had cerebral angiography. In these 260 patients, 517 arteries were studied with ultrasound and then compared to angiographic results, using the angiograms as control. In this study, there was a technical success rate of 89% for all ultrasonic procedures done. With positive disease considered as stenosis of more than 40%, the overall accuracy was 79%, sensitivity was 81%, and specificity was 77%. The false-positive rate was 14% and the false-negative rate 7%. Carotid ultrasonography accurately detected total vessel occlusion in 91% of such cases. Ultrasonic studies were not consistently accurate in the detection of ulcerative plaques where compared to angiographic results.     

Osteogenesis by chondrocytes from growth cartilage of rat rib.

Chondrocytes were isolated from growth and resting cartilage of rat rib and cultivated in vitro. The cultivated chondrocytes were placed in Millipore diffusion chambers, which were then implanted into the abdominal cavities of rats for several weeks and prepared for histological analysis. The results indicate that growth cartilage cells have a remarkable osteogenic potential, even after cultivation in vitro, whereas resting cartilage cells show no osteogenic activity. However, growth cartilage cells alone do not form new bone but require the participation of certain host cells to initiate osteogenic differentiation.     

单纯性肥胖儿童颈动脉的超声研究

目的：应用二维及多普勒超声,定量单纯性肥胖儿童颈动脉的结构和血流及其临床意义。方法：对60例肥胖儿童（脂肪肝组30例,非脂肪肝组30例）和30名正常儿童进行二维超声测量颈总动脉（CCA）的内径（d）和内膜厚度（IMT）,以及颈内动脉（ICA）、颈外动脉（ECA）及椎动脉（VA）内径;多普勒超声测量峰值流速（Vs）、舒张期流速（Vd）、平均流速（Vm）、阻力指数（RI）和峰值流速与舒张末期流速的比值（S/D）。结果：①肥胖儿童的CCA IMT比对照组明显增高,差异有统计学意义（P＜0.05）。受检者IMT与体质量指数（BMI）呈线性正相关,r=0.60,P＜0.01。②肥胖儿童的血流速度（CCA-Vs、ICA-Vd、ECA-Vd）与正常对照组比较均明显减低（P＜0.05）,而血管阻力（ICA-RI、ECA-RI、ECA-S/D）明显增高（P＜0.05）,差异均有统计学意义;其中脂肪肝组部分颈动脉血流速度（CCA-Vm、ECA-Vs、ECA-Vm、VA-Vs）与正常对照组比较均明显减低,差异有统计学意义（P＜0.05）。结论：单纯性肥胖儿童存在颈动脉的结构及血流动力学变化,超声对定量检测血管功能的损伤有重要临床意义。     

Juvenile first rib fracture caused by morning stretching

Background

First rib fractures are very rare, being primarily associated with external blunt trauma. Related conditions, such as sudden contraction of the neck muscle, stress fractures, and fatigue fractures, have been reported sporadically. These fractures are mostly related to repetitive or explosive physical training. However, anatomical relationships and related injury mechanisms may cause first rib fractures without repetitive sports activity.

Objective

To present a case of juvenile first rib fracture caused by morning stretching without sports activity.

Case Report

We present a rare case report of juvenile atraumatic first rib fracture.

Conclusion

Physicians should be aware that even morning stretching with yawning can cause a first rib fracture in children. Awareness is important for early recognition, and proper management is critical for a pain-free return to normal life. An understanding of the mechanism of atraumatic first rib fracture is important.     

Antenatal measurement of fetal umbilical venous flow by pulsed Doppler and B-mode ultrasonography

In this study, 163 normal fetuses of between 25 and 41 weeks' gestational age were examined sonographically using B-mode and Doppler equipment to measure umbilical vein diameter, umbilical venous flow amount (UVFA) and velocity (UVFV), and abdominal area (AA). A total number of 230 examinations were performed. The relationships between gestational age and umbilical vein diameter, UVFA, UVFV, and the UVFA/AA ratio were analyzed. Throughout pregnancy, the umbilical venous blood flow velocity remained relatively constant, whereas the umbilical venous blood flow amount increased steadily with gestational age and was proportional to abdominal area.     

多排螺旋CT在肋骨和肋软骨骨折诊断中的应用

目的探讨64排螺旋CT图像后处理技术在肋骨及肋软骨骨折中的临床应用价值。方法回顾性分析30例55处肋骨及10处肋软骨骨折病例,采用VR、SSD、MIP和MPR(包括曲面重建)技术进行肋骨及肋软骨重建,并与X线胸片(CR/DR)和常规轴位CT图像对照。结果在64排螺旋CT重建后发现的55处肋骨及10处肋软骨骨折中,X线平片发现肋骨骨折38/55处(69.1%),肋软骨骨折0处;常规轴位CT发现肋骨骨折45/55处(81.8%),肋软骨骨折3/10处(30%);64排螺旋CT重建技术显示肋骨及肋软骨骨折与常规轴位CT和X线胸片间有明显统计学意义(P&lt;0.01)。结论64排螺旋CT图像后处理技术对肋骨及肋软骨骨折的显示明显优于X线胸片及常规胸部轴位CT扫描,尤其对肋软骨骨折的诊断将是一种较好的诊断方法。     

盆腔B超检查前膀胱充盈状况的研究

[目的]观察老年人盆腔B超检查前适量饮水后膀胱充盈与膀胱内尿量的关系,为做好检查前指导提供科学依据.[方法]随机选择行盆腔B超检查的95例住院老年人为受试对象,B超显示膀胱充盈度并测量膀胱容量;检查后立即排空膀胱并测量尿量;记录病人憋尿时的感受.[结果]膀胱充盈满意、基本满意、不满意者分别为63例、16例、16例;B超测膀胱容量及尿量分别为＞300mL、＞110 mL、＜100mL;膀胱充盈满意度与B超测膀胱容量、排出尿量密切相关;膀胱充盈满意者膀胱容量大、尿量多,较基本满意者、不满意者均有统计学差异;膀胱充盈满意者B超测膀胱容量及尿量均＞300 mL.憋尿时的感觉主要为烦躁出汗、小腹胀痛、急于解出小便及小量解出.不同膀胱充盈度者憋尿时的不适发生率无统计学差异,但膀胱充盈满意者中憋尿时的不适发生率较高.[结论]膀胱充盈度与膀胱内尿量密切相关,为使检查顺利进行,盆腔B超检查前应对饮水量给予指导,以保证膀胱内产生一定尿量;同时根据憋尿时的感受判断膀胱内充盈情况;急诊或不能耐受憋尿者可经导尿管注入150 mL～300 mL生理盐水以满足检查需要.     

In vivo study of Dacron aortic grafts through B-mode ultrasonography

Real-time B-mode ultrasonography was used to study in vivo the behavior of bifurcated aortic grafts (Dacron knitted) implanted over a period of 1 to 88 months previously in 67 patients, 28 of whom (42 per cent) were hypertensive. Most grafts showed an increase in size, when compared with the original one, which appeared to be closely related to arterial pressure (P less than 0.05). This increase was not dependent on the time elapsed from implant.     

经体表与胃充盈法彩超对肝硬化门脉高压侧支循环的检测

目的 探讨彩超对肝硬化门脉高压侧支循环的检测价值。方法 运用经体表与胃充盈法彩超检测一系列门脉侧支循环血管及血流动力学变化。结果 430例临床确诊的肝硬化患接受彩超检查，检出门脉侧支循环95例共11种．包括门脉内离肝血流、门静脉血流搏动化、脐旁静脉重新开放、胃底贲门区静脉曲张和胃左静脉扩张等。彩超显示扩张血管呈红或蓝色血流伴低速静脉流速曲线。结论 彩超能无创性检测门脉侧支循环血流方向、速度和性质，对肝硬化和门脉高压的诊断及手术方案的选择具有重要价值。     

Real-time B-mode ultrasonography for better specificity in the noninvasive diagnosis of deep venous thrombosis

In order to evaluate the usefulness of B-mode ultrasonography in the diagnosis of deep vein thrombosis, a prospective study was performed on 145 patients. Each patient was examined with occlusive venous plethysmography, continuous wave Doppler, real-time B-mode ultrasonography, and radiographic contrast phlebography. The diagnostic sensitivity and specificity versus phlebography were 91 and 82.1 per cent, respectively, for plethysmography, 92 and 86.6 per cent for Doppler, and 94 and 100 per cent for B-mode sonographic scanning. The combined noninvasive approach reached a 96 per cent sensitivity. B-mode ultrasonography demonstrated a mass in eight cases, and showed a superficial venous thrombosis in four cases, among the 45 patients without deep vein thrombosis. B-mode ultrasonography, therefore, appears to be very useful in obtaining a better specificity and differential diagnosis.