不同切面声速检测对乳腺肿物的诊断价值

目的 探讨不同切面上声速(SV)检测对乳腺肿物的诊断价值。方法 对手术病理证实的232例女性患者共248个乳腺肿物行声速匹配技术检查,获得病灶在横切面、纵切面及两切面中SV较大切面上的相应SV值,与病理诊断结果相对照,构建ROC曲线进行分析。结果 乳腺良恶性肿物在横切面、纵切面及SV较大切面的SV的差异均具有统计学意义(P均<0.05)。在横切面、纵切面及SV较大切面上测得的SV鉴别诊断乳腺肿物时ROC曲线下面积(AUC)分别为0.77、0.80、0.83,横切面及SV较大切面之间的差异具统计学意义(P<0.05);Youden指数分别为横切面0.48,纵切面0.55,SV较大切面0.60。应用SV较大切面,以1547 m/s作为SV临界点,鉴别诊断乳腺肿物良恶性的敏感度、特异度、准确率分别为73.08%(57/78)、87.06%(148/170)、82.66%(205/248)。结论 横切面、纵切面及SV较大切面上测得的SV对鉴别诊断乳腺肿物的良恶性均有一定价值,其中SV较大切面的诊断价值最高。     

超声造影和钼钯X线对乳腺肿物良恶性的诊断效能比较

目的 探讨乳腺CEUS和钼钯X线对乳腺肿物良恶性的诊断效能。方法 收集接受乳腺肿物切除的患者164例共176个病灶,患者于术前接受乳腺CEUS和钼钯X线检查,以病理结果为金标准,比较这两种方法鉴别乳腺肿物良恶性的诊断效能。结果 176个肿物中,良性63个,恶性113个。CEUS和钼钯X线鉴别乳腺肿物良恶性的ROC曲线下面积分别为0.91、0.71(Z=4.69,P<0.05)。CEUS和钼钯X线诊断乳腺恶性病变的准确率、敏感度、特异度分别为88.64%(156/176)、92.04%(104/113)、82.54%(52/63)和69.32%(122/176)、75.22%(85/113)、58.73%(37/63)。结论 CEUS鉴别乳腺肿物良恶性有较高的诊断效能。     

声速测算对乳腺肿物诊断价值的初探

目的 通过声速匹配技术测定乳腺肿物的声速(sound velocity,SV),探讨SV对乳腺病灶良恶性的诊断价值.方法 对75例女性患者共99个乳腺肿物进行声速匹配技术检查,获得相应的声速匹配值(zone speed index,ZSI),进而得到病灶的SV.以病理结果作为金标准,构建ROC曲线,判断SV对乳腺病灶的诊断价值.结果 乳腺肿物的SV在良恶性组之间的差异具有显著性意义(P=0.000 1).SV判断乳腺良恶性肿物的最佳临界点为1 561 m/s,ROC曲线下面积为0.842,其判断乳腺恶性病变的敏感性、特异性、准确性分别为81.5％、91.7％、88.9％.结论 SV测算对乳腺肿物良恶性判断有一定的诊断价值.     

乳腺可视化触诊成像系统鉴别诊断乳腺良恶性病变：与临床触诊、X线及超声对照

目的 探讨乳腺可视化触诊成像系统对乳腺病灶良恶性病变的鉴别诊断价值。方法 对169例乳腺病变患者（共195个病灶）行触诊成像、临床触诊和X线,对其中151例行超声检查。比较以上4种方法鉴别乳腺良恶性病变的敏感度、特异度,评估各方法对不同腺体类型乳腺病灶的诊断价值。结果 触诊成像对良恶性病灶的诊断敏感度为82.40%,特异度为80.00%,敏感度高于临床触诊（60/125,48.00%,P<0.001）但低于X线（117/125,93.60%,P=0.003）及超声（105/110,95.45%,P<0.001）,特异度高于X线（39/70,55.71%,P=0.002）及超声（38/61,62.29%,P=0.023）。对于不同腺体类型的乳腺,触诊成像鉴别良恶性病灶的敏感度和特异度变化不大。结论 触诊成像对于鉴别乳腺良恶性病灶具有较高的应用价值,有望成为现有乳腺检查技术的补充。     

超微血管成像技术检测乳腺良恶性肿物血流

目的 探讨超微血管成像(SMI)技术在鉴别乳腺肿物良恶性肿瘤中的应用价值。方法 选取超声检出并术后病理证实的乳腺肿瘤患者70例78个病灶,其中良性病灶40个,恶性病灶38个。按照Adler分级标准,采用CDFI和SMI技术分别观察同一肿瘤的血流情况,计算两种血流检测技术对于单个病灶检出血管条数的差值(SMI-CDFI)、单纯使用CDFI及SMI诊断恶性病变的最佳诊断阈值及相关诊断试验评价指标。结果 两种检测方法对所有肿瘤血流丰富程度的检测差异有统计学意义(P<0.05);对恶性肿瘤血流丰富程度的检测差异有统计学意义(P<0.01);而对良性肿瘤血流丰富程度的检测差异无统计学意义(P=0.14)。CDFI诊断恶性肿物最佳诊断阈值为血管条数≥2,敏感度71.12%,特异度62.50%;SMI诊断恶性肿物最佳诊断阈值为血管条数≥3,敏感度92.11%,特异度62.50%;SMI-CDFI诊断恶性肿物最佳诊断阈值为血管条数差值≥3,敏感度84.21%,特异度85.00%。结论 SMI 技术可检测乳腺恶性肿物潜在的微血管,可为鉴别乳腺肿瘤的良恶性提供可靠的参考依据,有广泛的临床应用前景。     

自动乳腺全容积扫查与增强磁共振成像诊断乳腺病灶对比研究

目的 比较自动乳腺全容积扫查(ABVS)与MRI诊断乳腺病灶的价值。方法 收集乳腺肿块患者70例,共77个病灶,均经手术后病理证实。分析其ABVS和MRI图像特征,并比较二者评估乳腺病灶大小和诊断病灶良恶性的效能,评估ABVS冠状面上的"汇聚征"对乳腺恶性肿块的诊断效能。结果 70例患者中,良性37例(共43个病灶),恶性33例(共34个病灶)。ABVS[(18.0±8.9)mm]和MRI[(17.0±9.0)mm]测得病灶最大值与病理测值[(17.8±9.2)mm]均呈正相关(r=0.96、0.95,P<0.01),但ABVS和MRI所测病灶最大值差异无统计学意义(P>0.05)。ABVS和MRI诊断乳腺肿块的敏感度、特异度、准确度、阳性预测值和阴性预测值分别为91.18%(31/34)和85.29%(29/34)、86.05%(37/43)和90.70%(39/43)、88.31%(68/77)和88.31%(68/77)、83.78%(31/37)和87.88%(29/33)、92.50%(37/40)和88.64%(39/44),ROC曲线下面积分别为0.96、0.95(P>0.05)。"汇聚征"阳性率为32.47%(25/77),在良、恶性病灶中分别占6.98%(3/43)和64.71%(22/34),差异有统计学意义(χ2=6.87,P<0.01)。ABVS重建冠状面"汇聚征"对乳腺肿瘤良恶性鉴别诊断的敏感度、特异度、准确度、阳性预测值和阴性预测值分别为64.70%(22/34)、93.02%(40/43)、80.52%(62/77)、88.00%(22/25)和76.92%(40/52)。结论 ABVS和MRI均能有效诊断乳腺肿块,但ABVS对乳腺肿块的诊断敏感度更高,其冠状面的"汇聚征"能有效鉴别乳腺肿块的良恶性。     

实时剪切波弹性成像定量评价乳腺良恶性病变

目的 应用剪切波弹性成像技术定量测定乳腺实性病灶的弹性模量值,评价该技术对乳腺实性病灶定性诊断的价值。方法 对108例女性患者(124个病灶)行实时剪切波弹性成像检查,以手术病理为诊断金标准,获得乳腺病灶的定量弹性模量值,并用ROC曲线得出不同性质病灶的弹性参考数值。结果 病理诊断良性87例(103个病灶),恶性21例(21个病灶)。恶性病灶表现的平均、最大弹性模量值分别为(47.92±32.54)kPa和(113.18±47.48)kPa;良性病灶表现的平均、最大弹性模量值分别为(25.87±12.50)kPa和(39.50±17.98)kPa,良恶性间的弹性最大值和平均值差异均有统计学意义(P＜0.01)。实时组织定量分析乳腺病灶弹性最大值与弹性平均值对诊断乳腺良恶性病灶的ROC曲线下面积分别为0.944和0.756(P＜0.05)。分别以乳腺病灶弹性模量值的最大值60.12 kPa和平均值42.08 kPa作为诊断界值时,诊断的敏感度、特异度为90.50%、88.30%和57.10%、92.20%。结论 根据病灶的弹性平均值与弹性最大值可定量评价肿物硬度,为判断乳腺病灶良恶性提供诊断依据。     

声速匹配技术在乳腺良恶性病灶鉴别诊断中的价值初探

目的初步探讨声速匹配技术在乳腺良恶性病灶鉴别诊断中的临床价值。方法 73例患者共76个病灶(良性58个,恶性18个)行声速匹配值测定,计算声速,并与病理诊断结果对照,采用受试者工作特征(ROC)曲线确定良恶性病灶声速的临界值。结果良恶性病灶声速比较差异有统计学意义(P﹤0.05),ROC曲线确定诊断良恶性病灶的声速临界值为1578.33 m/s,ROC曲线下面积0.866,约登指数0.82,声速鉴别良恶性病灶的敏感性为85.7%,特异性为97.0%,准确性为94.7%。结论声速匹配技术可为乳腺病灶的临床诊断提供客观定量依据,声速临界值为超声鉴别诊断乳腺病灶良恶性提供了一项新指标。     

超声造影鉴别诊断乳腺良恶性肿瘤

目的 探讨超声造影(CEUS)鉴别诊断乳腺良恶性肿瘤的应用价值。方法 纳入277例乳腺肿瘤患者,均行常规超声(BUS)及CEUS检查,并与病理结果进行对照,对BUS及CEUS各观察指标进行Logistic回归分析,比较BUS与CEUS鉴别诊断乳腺良恶性肿瘤的效能。结果 277例患者中,良性病变184例(良性组),恶性病变93例(恶性组)。Logistic回归分析显示,BUS诊断恶性肿瘤的危险指标为中等血供、非平行生长、血供丰富及边界模糊,相对危险度分别为5.17、4.84、3.39、3.04;CEUS为离心性增强、向心性增强、肿瘤形状不规则、造影剂分布不均、增强后范围增大,相对危险度分别为13.36、4.58、4.07、3.28、2.36。BUS诊断乳腺肿瘤的准确率为81.59%(226/277),CEUS为88.09%(244/277),二者差异有统计学意义(χ²=1.012, P<0.001)。结论 采用CEUS鉴别诊断乳腺良恶性肿瘤的准确率较高,其在乳腺局灶性病变的定性诊断中具有一定的应用价值。     

超声实时弹性成像整体应变率与局部应变率诊断乳腺病灶的比较

目的 比较超声实时弹性成像整体应变率(ESR)、局部应变率(LSR)对乳腺良恶性病灶的诊断价值。 方法 对113例患者共145个乳腺病灶(良性组:85个,恶性组:60个)分别行LSR、ESR两种应变率测量。以病理诊断为金标准,构建ROC曲线,分别获得两种方法鉴别乳腺病灶良恶性的最佳临界点,比较其诊断效率。 结果 构建ROC曲线后,ESR ROC曲线下面积(AUC)为0.90±0.03,最佳临界点为3.16,其敏感度、特异度、准确率分别为88.33%(53/60)、88.24%(75/85)、88.28%(128/145)。LSR的AUC为0.97±0.02,最佳临界点为31.15,其敏感度、特异度、准确率分别为96.67%(58/60)、94.12%(80/85)、95.17%(138/145)。LSR对乳腺病灶良恶性的诊断价值及准确率均优于ESR(P＜0.05)。 结论 ESR和LSR对乳腺病灶良恶性的鉴别诊断具有较大价值,LSR优于ESR。     

A new method of measuring in vivo sound speed in the reflection mode

This paper describes a new method for in vivo sound measurement in the reflection mode. The mean sound speed between the reflector and linear array transducer is measured using the following three parameters: time of flight, time of flight difference, and distance between two receiver elements. To detect time of flight, the system delay-line time compensator is adjusted to obtain the sharpest reflector image. This method was evaluated in vivo in human livers, specifically 26 normal, 27 cirrhotic, and 15 fatty livers. The mean sound speed between diaphragm and the transducer was obtained. The measured sound speed was significantly higher in cirrhotic livers and lower in fatty livers.     

声速匹配技术与传统超声扫查胎儿心脏成像质量的比较研究

目的 比较声速匹配技术(SSC)与传统超声成像在超重孕妇胎心扫查中的应用价值.方法 40例18～27孕周超重孕妇分别用SSC及传统超声(标准化声速1 540 m/s扫查成像)进行胎心扫查,获得9个标准切面,比较两种方法获得的图像合格率和一致性,并分析孕妇腹壁脂肪厚度与特定区域速度指数(ZSI)的相关性.结果 9个标准胎心切面中,SSC扫查图像合格率均高于传统超声,其中主动脉弓、动脉导管弓、腔静脉长轴切面差异有统计学意义(P＜0.05),合格率分别为80.0％、77.5％、85.0％;两种扫查技术所得的图像在四腔心、五腔心切面几乎一致,Kappa值为0.889、0.877,而在主动脉弓、动脉导管弓切面一致性不理想,Kappa值为0.388、0.392;孕妇腹壁脂肪厚度与ZSI呈负相关性(r=-0.872,R2 =0.761,P＜0.001).结论 声速匹配技术较传统超声成像更有助于超重孕妇胎心扫查.     

胃肠内容物声学特性测定及其对HIFU治疗深腹部肿瘤时的影响

目的：探索胃肠内容物的声学特性及超声波经过胃肠内容物的衰减规律。方法：以胃内食物团块,小肠乳糜及四种类型粪便各10份样本为介质,测定超声波通过介质产生的延迟及衰减,求得声速,声阻抗及衰减系数。结果：胃肠内容物对超声波的传导具有很大的影响,结论：在进行腹腔内肿瘤HIFU治疗前必须进行充分的清理胃肠内容物准备。     

Relationship between myocardial tissue density measured by microgravimetry and sound speed measured by acoustic microscopy

If myocardial tissue can be assumed to be fluid-like, myocardial tissue elasticity can be estimated by the sound speed of tissue based on the equation K=ρc², where K is the elastic bulk modulus, ρ is density, and c is the sound speed of tissue. However, little data exist regarding the relationship between the sound speed of tissue and tissue density. The purpose of the present study was to evaluate the relationship between the sound speed of tissue and tissue density of various diseased myocardia. Myocardial tissue specimens at autopsy were obtained from 10 control patients without cardiovascular disease, 8 patients with pressure overload left ventricular hypertrophy (POLVH), and 8 patients with cardiac amyloidosis (AMD). Myocardial tissue sound speed was measured using a scanning acoustic microscope operating in the frequency of 450 MHz, and tissue density was measured by microgravimetry. The sound speed in POLVH (1639 ± 17 m/s) was higher and that in AMD (1565 ± 11 m/s) was lower than that in control patients (1615 ± 15 m/s) (p < 0.001) at the temperature of 20–22°C. The density in POLVH (1.087 ± 0.004 g/cm³) was higher and that in AMD (1.072 ± 0.003 g/cm³) was lower than that in control patients (1.082 ± 0.003 g/cm³) (p < 0.001). Tissue density correlated with sound speed in all three groups (r = 0.96, p < 0.001). Therefore, myocardial tissue sound speed data obtained by acoustic microscopy enabled us to evaluate tissue elasticity without measuring tissue density directly.     

Influence of tissue preparation on the high-frequency acoustic properties of normal kidney tissue

The influence of various tissue preparations on the acoustic properties of normal kidney tissue at high frequencies was investigated. Eight surgically excised normal kidney tissue specimens were classified into three groups: (i) fresh, frozen section, (ii) formalin-fixed, frozen section and (iii) formalin-fixed, paraffin section. Scanning acoustic microscopy operating in the frequency range of 100–200 MHz was used to display the two-dimensional distribution of attenuation constant and sound speed. Our results indicate that (i) there is no significant variation in both acoustic parameters between the three tissue groups, (ii) fixation by 10% formalin produces no significant change in the acoustic parameters, (iii) in fat-free tissue regions, the acoustic parameters are independent of preparation method and (iv) frozen sections must be used to assess the acoustic parameters in fat-rich tissues.     

Finite amplitude measurements of the nonlinear parameter B/A for liquid mixtures spanning a range relevant to tissue harmonic mode

The objective of this investigation was to measure the nonlinear parameter B/A using an enhanced finite amplitude distortion technique, based on nonlinear propagation effects analogous to those associated with tissue harmonic imaging. These measurements validate an improved method for measuring the nonlinear parameter B/A, the small-signal speed of sound, and the attenuation coefficient from a single set of ultrasonic measurements. To test the method, measurements were performed on 11 different mixtures of isopropyl alcohol (isopropanol) and water that span the range of concentrations from 0% to 100% isopropanol. Results for B/A ranging from approximately five to 11 were found to be reproducible and in good agreement with previously published values obtained using a thermodynamic method.     

声触诊弹性成像、声触诊弹性测量联合血清糖类抗原153鉴别诊断BI-RADS 4类乳腺肿瘤的对比研究

目的 对比声触诊弹性成像（STE）联合血清糖类抗原153(CA153)与声触诊弹性测量（STQ）联合血清CA153鉴别诊断BI-RADS 4类、乳腺肿瘤良恶性的临床价值。方法 选取我院经手术病理确诊的乳腺肿瘤患者116例，均为BI-RADS 4类、单发病灶，其中恶性组45例和良性组71例，所有患者均于术前分别采用STE及STQ测量弹性模量值（以下简称STE、STQ测值），并检测血清CA153。比较STE及STQ测量成功率及不同操作者间的一致性；剔除STE或STQ测量失败的病例后，比较恶性组与良性组STE及STQ测值、血清CA153。绘制受试者工作特征（ROC）曲线分析STE测值、STQ测值、血清CA153单独及联合鉴别BI-RADS 4类乳腺肿瘤良恶性的诊断效能。结果 STE测量成功率为100%，明显高于STQ(89.66%)，差异有统计学意义（P<0.05）；不同操作者间STE测值的组间相关系数（ICC）高于STQ(0.932 vs.0.894)。剔除STQ测量失败的12例患者，剩余104例患者中恶性组39例，良性组65例；恶性组STE、STQ测值、血清CA153均高于良性组，...     

Ultrasonic Assessment of Thermal Therapy in Rat Liver

One way to assess the efficacy of thermal therapy is to quantify changes in tissue properties through ultrasonic interrogation, which requires knowledge of the acoustic properties of thermally treated tissues. In this study, estimates of ultrasonic attenuation, speed of sound, backscatter coefficient (BSC), and scattering property estimates were generated from rat liver samples submersed for 10 minutes in a saline bath that was heated to one of seven temperature values over a range of 37–70°C. The attenuation coefficient increased monotonically with exposure temperature, with a maximum increase of 90%. Speed of sound changed by <1% for the different treatment conditions. The BSC had close agreement for all thermal doses over the frequency range of 8–15 MHz. Above this frequency range, samples heated ≥55°C demonstrated an increased BSC slope, and the effective scatterer diameter and effective acoustic concentration were able to distinguish treated from nontreated cases. The findings suggest that attenuation and either BSCs or scatterer property estimates above 15 MHz were sensitive to tissue changes in excised liver caused by thermal therapy.     

Using Speed of Sound Imaging to Characterize Breast Density

A population of 165 women with negative mammographic screens also received an ultrasound tomography (UST) examination at the Karmanos Cancer Institute in Detroit, MI. Standard statistical techniques were employed to measure the associations between the various mammographic- and UST-related density measures and various participant characteristics such as age, weight and height. The mammographic percent density (MPD) was found to have similar strength associations with UST mean sound speed (Spearman coefficient, r_s = 0.722, p < 0.001) and UST median sound speed (r_s = 0.737, p < 0.001). Both were stronger than the associations between MPD with two separate measures of UST percent density, a k-means (r_s = 0.568, p < 0.001) or a threshold (r_s = 0.715, p < 0.001) measure. Segmentation of the UST sound speed images into dense and non-dense volumes showed weak to moderate associations with the mammographically equivalent measures. Relationships were found to be inversely and weakly associated between age and the UST mean sound speed (r_s = ?0.239, p = 0.002), UST median sound speed (r_s = ?0.226, p = 0.004) and MPD (r_s = ?0.204, p = 0.008). Relationships were found to be inversely and moderately associated between body mass index (BMI) and the UST mean sound speed (r_s = ?0.429, p < 0.001), UST median sound speed (r_s = ?0.447, p < 0.001) and MPD (r_s = ?0.489, p < 0.001). The results confirm and strengthen findings presented in previous work indicating that UST sound speed imaging yields viable markers of breast density in a manner consistent with mammography, the current clinical standard. These results lay the groundwork for further studies to assess the role of sound speed imaging in risk prediction.     

Analysis of the spectral envelope of sounds by the human brain

Spectral envelope is the shape of the power spectrum of sound. It is an important cue for the identification of sound sources such as voices or instruments, and particular classes of sounds such as vowels. In everyday life, sounds with similar spectral envelopes are perceived as similar: we recognize a voice or a vowel regardless of pitch and intensity variations, and we recognize the same vowel regardless of whether it is voiced (a spectral envelope applied to a harmonic series) or whispered (a spectral envelope applied to noise). In this functional magnetic resonance imaging (fMRI) experiment, we investigated the basis for analysis of spectral envelope by the human brain. Changing either the pitch or the spectral envelope of harmonic sounds produced similar activation within a bilateral network including Heschl's gyrus and adjacent cortical areas in the superior temporal lobe. Changing the spectral envelope of continuously alternating noise and harmonic sounds produced additional right-lateralized activation in superior temporal sulcus (STS). Our findings show that spectral shape is abstracted in superior temporal sulcus, suggesting that this region may have a generic role in the spectral analysis of sounds. These distinct levels of spectral analysis may represent early computational stages in a putative anteriorly directed stream for the categorization of sound.