经阴道彩色多普勒超声诊断异位妊娠的价值

目的 探讨经阴道彩色多普勒超声对诊断异位妊娠的重要性.方法 51例临床怀疑异位妊娠的育龄妇女均接受了经阴道彩色多普勒超声检查,并对妊囊包块的血流成像与血流频谱进行了分析.结果 51例异位妊娠患者中,经阴道彩色多普勒超声正确诊断49例,包括输卵管妊娠47例,子宫角妊娠与卵巢妊娠各1例,诊断准确性为95%.2例输卵管妊娠患者由于妊娠包块不明显及腹胀肠气的干扰而漏诊.在声像图上,妊囊包块表现为胎囊型22例,流产破裂型27例,以及类实性光团型2例.在彩色多普勒血流显像上,妊囊包块表现为滋养层血流频谱或怪异频谱.结论 经阴道彩色多普勒超声对异位妊娠有很高的诊断准确性,而且其操作简单、无创,可作为诊断早期异位妊娠的首选方法.     

鼻咽癌肝转移超声诊断的价值

目的探讨二维及彩色多普勒超声诊断鼻咽癌肝转移的价值.材料与方法回顾性分析6例19个鼻咽癌肝转移病灶的二维及彩色多普勒声像图特征.结果鼻咽癌肝转移二维超声表现为以囊性为主的囊实混合性回声或囊肿样回声.囊壁多不规则增厚、囊内有分隔或囊壁上有乳头样结节样实性突起.5例为多发病灶.6例彩色多普勒均于瘤内或壁上引出动脉血流信号,其中5例为高速动脉血流(流速＞40cm/s)结论鼻咽癌肝转移表现以囊性为主的囊实混合性肿块或囊肿样回声,彩色多普勒在病灶内引出高速动脉血流信号为鼻咽癌肝转移与肝脏良性囊性病变的鉴别诊断提供了重要依据.     

彩色多普勒超声诊断小结节甲状腺癌的价值

目的:探讨彩色多普勒超声对小结节甲状腺癌的诊断价值.材料和方法:分析 60例经手术病理证实的小结节甲状腺癌(结节直径7～23mm,平均15.98±3.71mm),二维灰阶超声、彩色多普勒显像及频谱多普勒图像特点.结果:60例小结节甲状腺癌中,超声明确诊断45例(75%).声像图最多见的表现为结节内微钙化灶,占75%.与多发结节相比较,超声对单发结节的诊断更为准确(P＜0.05).54例(90%)彩色多普勒图像显示病灶内部血流信号增多,频谱呈高速高阻型.颈部淋巴结转移27例,其中24例转移淋巴结内含有微钙化.结论:灰阶超声结合彩色多普勒血流显像对小结节甲状腺癌具有重要的诊断价值.     

多房囊性肾癌的超声分析

目的分析多房囊性。肾癌的声像图表现,以提高对此病的认识及诊断率。方法13例多房囊性肾癌患者均行彩色多普勒血流显像（CDFI）和能量多普勒血流显像（PDI）检查,以及CT和（或）MRI动态增强扫描。结果多房囊性肾癌13例中,囊壁增厚或厚薄不均匀11例,囊壁菲薄均匀2例。其中伴壁结节或（和）隔结节10例,分隔厚薄不均匀8例、纤细均匀5例,分隔呈“车辐轮”状4例。3例病灶内可见囊壁和（或）分隔钙化。CDFI和（或）PDI在瘤体内检测到星点状或短条状血流信号10例,CT和（或）MRI增强扫描有不同程度增强11例。结论多房囊性肾癌多表现为多房囊性肿物,边界清楚,囊壁可有局部增厚,分隔粗细不均匀,附壁及分隔结节直径均小于6．0mm,CDFI和PDI能提高多房囊性肾癌的诊断率。本病需要与复杂性。肾囊肿及肾癌囊性变等鉴别诊断。     

胰腺实性-假乳头状瘤的超声和CT诊断及鉴别诊断

目的探讨超声和CT对胰腺实性-假乳头状瘤的诊断及鉴别诊断依据。方法回顾性分析经手术及病理证实的9例胰腺实性-假乳头状瘤的超声和CT影像表现。结果二维超声瘤体表现为囊、实混合性团块,其中以囊性结构为主5例,实性结构为主1例,囊、实结构比例相近3例。彩色多普勒血流显像(CDFI)4例检出血流信号,其中仅1例血流信号较丰富。CT平扫病灶呈类圆形低密度团块影;增强扫描显示实性部分明显强化,囊性部分各期均无强化。结论胰腺实性-假乳头状瘤超声和CT影像具有一定特征性,有利于诊断及鉴别诊断。     

含囊性成分肾细胞癌的彩色多普勒超声诊断分析

目的探讨含囊性成分肾细胞癌的彩色多普勒超声特征并与肾脏其他类似病变进行比较,总结其诊断和鉴别诊断特点。方法对49例含囊性成分的肾细胞癌和46例含囊性成分的肾脏良性病变的彩色多普勒超声特征进行回顾性分析,将其分为以囊性为主和以实性为主2种类型,对4组病变的声像图特征进行比较分析。结果与囊性为主型肾良性病变相比,囊性为主型肾细胞癌具有更不光滑的囊壁与分隔,实性部分回声以等回声或低回声为主,囊性结构更多表现为多囊性结构,囊壁发生结节更多,内部更常探及动脉血流信号,周边出现抱球样血流信号,分隔内探及更多的动脉血流。而与实性为主型肾良性病变相比,实性为主型的肾细胞癌则表现为实性部分回声以等回声或低回声为主,具有更多的囊性结构,内部可更多的探及动脉血流信号,周边大多都出现抱球样血流信号。与囊性为主型肾细胞癌相比,实性为主型肾细胞癌在各个超声特征方面均具有明显的差异。结论与同类型的良性病变相比,含囊性成分的肾细胞癌具有特征性的声像图表现,依据囊性成分比例的不同而应用不同的超声指标可更准确地对其进行定性诊断。     

甲状腺乳头状癌的超声特征

目的 :探讨甲状腺乳头状癌的声像图特征。材料和方法 :对 2 5例甲状腺乳头状癌结节用高频超声进行二维及彩色多普勒超声检查 ,术后与病理对照。结果 :甲状腺乳头状癌的声像图特征为实质不均质低回声为主伴有散在砂粒状强回声微钙化点。结节较小 ,约 0 .5～ 3 .0cm ,大多数无明显包膜但分界清楚 ,边缘毛糙。彩色多普勒血流显像 (CDFI) :肿瘤结节 10 0 %都能测到血流信号 ,结节较大者多血供 ,微小隐匿癌常为少血供。结论 :应用高频超声检查对甲状腺乳头状癌的声像图特征分析有助于本病与甲状腺良性结节的鉴别诊断。     

卵巢卵泡膜细胞瘤的超声表现分析

目的 :探讨卵巢卵泡膜细胞瘤的声像图表现 ,及与相应的病理改变和临床症状的关系 ,以提高术前诊断准确率。材料和方法 :2 6例患者术前行彩超检查 ,术后将手术及病理所见与超声表现进行对照分析。结果 :2 6个肿瘤中 2 3个呈实性、1个呈囊实性、1个呈囊性、1个含有机化的凝血块。实性肿瘤中有 19个呈低回声 ,其中 8个后方伴有声衰减。CVI仅于 1例肿瘤内探及少许血流信号 ,余均未见血流。 1例实性肿瘤被超声误判为囊肿。结论 :大多数卵巢卵泡膜细胞瘤的声像图表现是呈低回声实性包块 ,边界清晰 ,可伴有后方声衰减 ,内无或仅有少许血流信号 ;这些超声表现对提示卵巢卵泡膜细胞瘤的诊断有重要价值。     

2维及彩色多普勒超声对亚急性甲状腺炎的诊断

目的 探讨2维及彩色多普勒超声对亚急性甲状腺炎的诊断及鉴别诊断价值。方法 对临床确诊的18例亚急性甲状腺炎患者均行2维及彩超检查并对其甲状腺声像图特点及血流分布情况进行回顾性分析。结果 亚急性甲状腺炎的声像图特点主要表现为甲状腺双侧或单侧弥漫性或局灶性回声减低。彩色多普勒血流显像CDFI显示为病变内血流较丰富。脉冲多普勒(PW)测及动脉血流特点为低速低阻型。结论 2维及彩色多普勒超声可作为亚急性甲状腺炎的一个重要诊断手段，如能结合病史进行综合分析，将更有利于亚急性甲状腺炎的诊断及鉴别诊断。     

卵巢甲状腺肿超声与CT影像比较分析

目的探讨超声与CT对卵巢甲状腺肿的临床诊断价值。方法回顾性分析经手术和病理证实的11例卵巢甲状腺肿患者的超声与CT表现,并与病理检查结果行对照研究,对卵巢甲状腺肿的超声和CT诊断的准确率行统计学分析。结果 11例卵巢甲状腺肿病例中:1)发生于左侧卵巢者4例,发生于右侧卵巢者7例;2)单发囊性病灶1例,囊实性病灶10例;3)6例形态不规则,5例呈类圆形或椭圆形;4)超声显示单发囊性病灶回声均匀,囊实性病灶呈混杂回声,其中10例囊实性病灶均呈中高回声的不规则间隔及实性结节,7例呈多房、且各房回声不等,3例囊壁及间隔见强回声钙化,1例见高回声脂肪,4例彩色多普勒超声可探及实性成分及分隔的血流信号;5)CT显示单发囊性病灶密度高于水,10例囊实性病灶中7例呈多房、密度不等,7例囊壁及间隔见钙化,2例见脂肪密度,增强扫描9例实性成分明显强化,1例轻度强化,5例伴盆腔积液,1例伴胸腔积液。结论卵巢甲状腺肿的超声及CT表现具有一定特征性,认识其影像学特征对减少误诊具有重要意义。     

Cystic lesions of the breast: sonographic-pathologic correlation

PURPOSE: To understand the pathologic basis for sonographic features of cystic lesions of the breast and determine appropriate assessment and management recommendations for these lesions based on sonographic appearance. MATERIALS AND METHODS: From a database of 2,072 image-guided procedures performed from July 1995 through September 2001, 150 cystic lesions were identified. Diagnosis was established with fine-needle aspiration (n = 55), 14-gauge core-needle biopsy (n = 81), or both (n = 14). Excision was performed for all malignant (n = 18) and atypical (n = 2) lesions and for 11 benign lesions, which recurred or enlarged at follow-up. Imaging follow-up was available for 92 of 119 benign lesions. Targeted sonography was performed with high-frequency (10-MHz center frequency) transducers. Imaging and histopathologic, cytologic, and/or microbiologic findings were reviewed. Lesions were categorized as simple cysts, complicated cysts (imperceptible wall, acoustic enhancement, low-level echoes), clustered microcysts, cystic masses with a thick (perceptible) wall and/or thick (> or =0.5 mm) septations, intracystic or mixed cystic and solid masses (at least 50% cystic), or predominantly solid masses with eccentric cystic foci. RESULTS: Of 150 lesions, 16 were simple cysts aspirated for symptomatic relief. Of 38 lesions characterized as complicated cysts and one cyst with thin septations, none proved malignant, nor did any of 16 lesions characterized as clustered microcysts. Of 23 masses with thick indistinct walls or thick septations, seven proved malignant. Of 18 intracystic or mixed cystic and solid masses, four proved malignant. Of 38 predominantly solid masses with eccentric cystic foci, seven proved malignant. CONCLUSION: Symptomatic complicated cysts generally warrant aspiration. All clustered microcysts were benign, but further study is required. Cystic lesions with thick indistinct walls and/or thick septations (> or =0.5 mm), intracystic masses, and predominantly solid masses with eccentric cystic foci should be examined at biopsy; 18 of 79 of such complex cystic lesions proved malignant in this series.     

超声与CT对肾母细胞瘤诊断价值

目的:探讨肾母细胞瘤的超声和CT影像表现及诊断价值。方法:回顾性分析14例肾母细胞瘤的超声和CT表现,并与手术病理结果对照。结果:本组14例B超显示均为单侧病灶,瘤体形态呈圆形或类圆形,边界清楚,病灶呈实性者11例,囊实性者2例,囊性者1例,其中5例病灶内可见斑点状钙化,1例边缘呈环形钙化。CT平扫呈混杂密度,强化后瘤体呈不均匀强化;彩色多普勒血流显像(CDFI)均见数量不等的血流信号显示。结论:肾母细胞瘤的超声和CT影像表现具有一定的特征性,两者联合应用具有更高临床价值。     

卵巢颗粒细胞瘤的CT表现

目的：分析卵巢颗粒细胞瘤（OGCT）的CT征象,提高对本病的诊断水平。方法：回顾性分析19例经手术病理证实的卵巢颗粒细胞瘤的CT资料,其中11例为初发病例,8例为复发病例。结果：19例OGCT患者共有23个肿瘤,其中14个呈类圆形或圆形,9个呈不规则或分叶状,共有2个囊性肿块,15个囊实性肿块和6个实性肿块。囊性肿块在CT图像上以均匀低密度、无强化的囊性成分为主,囊壁、分隔或壁结节有强化;实性肿块CT表现为肿块大部分为实性,内有单发或多发灶性低密度坏死区;囊实性肿块CT表现为囊性与实性成分大致相等。所有病例增强扫描病灶实性部分呈轻度-中度强化。13例伴腹水,9例伴子宫内膜增厚,19例均无淋巴结肿大。结论：卵巢颗粒细胞瘤的CT表现有一定特征,结合临床和CT有助于对本病的诊断和鉴别诊断。     

Struma ovarii: MRI findings

We describe the MRI findings in three cases of struma ovarii. In all three cases, MRI showed a multilocular cystic mass with a variable signal intensity within loculi. Some loculi or small cysts within septations showed low signal intensity on T1 weighted images and very low signal intensity on T2 weighted images, corresponding pathologically to gelatinous colloid material in large follicles. In one case, with Gd-DTPA enhanced T1 weighted images, the thick septations and locally thickened wall showed marked enhancement, corresponding microscopically to thyroid tissue.     

Cystic struma ovarii: imaging findings

We report three cases of cystic struma ovarii not associated with any solid component. One case was a thin-walled unilocular mass, and the other two cases were multilocular cystic masses. An area of signal void on T2-weighted images and intermediate intensity on T1-weighted images was noted in the two multilocular cases. Preoperative diagnosis was difficult in each case, but struma ovarii should be included in differential diagnoses even in the case of a completely cystic ovarian mass.     

Cystic renal tumors: US and CT findings

Cystic renal tumors represent a variety of lesions in which both solid and liquid components coexist. These lesions may be either benign or malignant and include the multilocular cystic nephroma (MCN), the renal cell carcinoma (RCC), and the papillary adenocarcinoma (PAC). The MCN is a rare neoplasm formed of multiple loculated cystic masses divided by septa. The tumor is benign, although there are some rare reports of malignant cases. The RCC and the PAC may appear with cystic patterns. This is rather uncommon for the RCC, which inside has a unilocular or multilocular cystic appearance, if the necrotic component is large. PAC is an infrequent renal tumor, which has a greater tendency to appear as a large mass with a unilocular large cystic space. The ultrasonography (US) and computed tomographic (CT) features of 27 cystic tumors are presented. Both US and CT allowed the recognition of the cystic components, the septa, and the vegetations. The two imaging techniques made it possible to distinguish the tumors into "unilocular" and "multilocular" masses: the former correspond to RCC and PAC, the latter to MCN and RCC. CT added some information on calcified or partially calcified tumors. CT more than US enabled the differentiation between the malignant RCC and the benign MCN for which conservative surgery may be indicated. The two techniques did not allow the differentiation between RCC and PAC, which has different prognostic behavior.     

肝脏少见恶性肿瘤的CT表现

目的 分析5例不同组织类型的肝脏少见恶性肿瘤的CT表现，以提高对这些恶性肿瘤的识别能力。方法 经临床和病理证实的肝脏少见恶性肿瘤5例，均行CT检查，其中肝肉瘤3例(包括血管肉瘤1例，恶性间叶瘤1例，恶性纤维组织细胞瘤1例，类癌2例)。结果 上述肝脏恶性肿瘤表现多样化，恶性间叶瘤以儿童肝内巨大单发囊性为主病灶；肝血管肉瘤表现为肝内多发境界清楚的低密度灶，可合并坏死、囊变及新鲜出血，无肝硬化基础；恶性纤维组织细胞瘤为肝右叶单发巨块低密度病灶，可伴纤维分隔，免疫组织化学标记具有诊断价值；类癌CT特征为肝内单发或多发病灶，密度不均匀，呈单房或多房，增强表现实质部分强化，伴类癌综合征时更具有诊断价值。结论 本组分析的5例肝脏恶性肿瘤临床均较少见，各种病理类型的此类肿瘤有其相似和不同的CT征象，结合临床及实验室检查，应在临床诊断中考虑到上述肿瘤的可能，以免漏诊或误诊。     

卵巢卵黄囊瘤的CT表现

目的 探讨卵巢卵黄囊瘤的CT特点.资料与方法 分析23例经手术病理证实的卵巢卵黄囊瘤的CT表现.结果 23例均为单发.肿瘤最长径平均为16.5 cm.其中实性肿块7例、囊实性肿块12例、单房囊性肿块2例和多房囊性肿块2例.增强扫描病灶实性部分较明显强化,10例肿瘤内可见血管影.11例肿瘤显示有包膜,其中7例显示包膜破裂.13例伴有腹水,4例伴腹膜种植结节,3例伴盆壁淋巴结肿大.结论 卵黄囊瘤的CT表现有一定特征性.结合临床,CT有助于对本病的诊断和鉴别.     

卵巢囊性腺纤维瘤MR特征及病理分析

目的：探讨卵巢囊性腺纤维瘤的MRI表现特征及病理学基础,提高对该疾病的诊断准确性。方法收集并回顾性分析14例经手术病理证实的卵巢囊性腺纤维瘤患者MRI资料,所有患者术前均行MR平扫及增强扫描。重点对病变内部结构、信号特征及增强表现进行分析归纳,明确其具有诊断价值的图像特征。结果本组13例病灶为单侧发病,1例为双侧发病。病灶最大径为3．4-14．8cm,平均约8．15cm;8例呈囊性（多囊者6例,单囊者2例）,5例呈囊实性,1例呈实性。8例囊性病变于MRI-T2WI囊壁及分隔呈低信号;囊实性病灶实性成份主要表现为低信号,其中并见多发小囊样高信号灶,其中2例形成较典型的“黑色海绵征”。MR增强扫描所有病灶实性成份及囊壁均呈中度或明显强化效应。结论卵巢囊性腺纤维瘤多为单侧发病,主要呈多囊性表现;肿瘤中实性成份及囊壁T2WI呈低信号,增强扫描呈轻中度强化。“黑色海绵征”是其较典型的特征表现。