经阴道彩色多普勒超声诊断子宫肌瘤和子宫腺肌症及腺肌瘤的临床效果分析

目的:探讨经阴道彩色多普勒超声诊断子宫肌瘤、子宫腺肌症、腺肌瘤的效果。方法:选取2021年1月—2022年12月在苏州明基医院诊治的150例子宫疾病患者作为研究对象,根据疾病不同病理类型分为子宫肌瘤组(70例)、子宫腺肌症组(51例)、腺肌瘤组(29例)三组。所有患者均行经腹部彩色多普勒超声诊断和经阴道多普勒超声诊断,比较不同检查方法对不同组患者的诊断准确情况和血流动力学特征。结果:经阴道多普勒彩色超声诊断子宫肌瘤、子宫腺肌症、腺肌瘤的准确率及总诊断准确率均高于经腹部多普勒彩色超声(P<0.05);子宫肌瘤组、子宫腺肌症组、腺肌瘤组患者收缩期峰值速度(Vs)、血流阻力指数(RI)依次升高(P <0.05);子宫肌瘤组、腺肌瘤组、子宫腺肌症组舒张期峰值速度(Vd)、血流搏动指数(PI)依次升高(P<0.05)。结论:经阴道彩色多普勒超声对子宫肌瘤、子宫腺肌症、腺肌瘤的诊断准确率高于经腹部超声,而且不同的病理类型的血流动力学指标存在着明显的差异,临床应用价值较高。     

TVCDFI技术在子宫肌瘤与子宫腺肌瘤鉴别诊断中的价值

目的探讨经阴道彩色多普勒血流显像技术(TVCDFI)对子宫肌瘤和子宫腺肌瘤的诊断和鉴别诊断意义。方法以手术病理诊断为标准,回顾性地分析子宫肌瘤和子宫腺肌瘤的TVCDFI特征,对照比较二者瘤体包膜回声、瘤体内部回声、彩色血流信号和RI值的差异。结果子宫肌瘤与子宫腺肌瘤声像图的鉴别以瘤体周边假包膜特征最为重要;彩色多普勒血流显示瘤体周边出现环状彩色血流,子宫肌瘤组占95.9%,子宫腺肌瘤组占30.8%,组间差异明显;子宫肌瘤和子宫腺肌瘤周边血流阻力指数(RI)分别是0.53±0.07和0.67±0.057,RI≥0.7分别是1.4%和38.5%,组间存在显著性差异(P<0.05)。结论结合瘤体包膜回声、彩色血流信号和RI等超声特征能提高TVCDFI对子宫肌瘤和子宫腺肌瘤的诊断和鉴别诊断率。     

经阴道及腹部彩色多普勒超声在子宫肌瘤与子宫腺肌瘤鉴别诊断中的应用

目的探讨子宫肌瘤和子宫腺肌瘤的二维图像及彩色血流分布特点,提高两种疾病的诊断率。方法对45例子宫肌瘤和38例子宫腺肌瘤患者行彩色多普勒超声(CDFI),分析其二维图像及彩色血流分布特点。随机选择40名健康妇女为正常对照组。结果子宫肌瘤组和子宫腺肌瘤组患者发病年龄及临床表现相近,但子宫腺肌瘤的痛经、子宫体触痛明显;二维图像上子宫肌瘤及子宫腺肌瘤均呈特征性改变。CDFI示子宫肌瘤及子宫腺肌瘤患者子宫动脉平均阻力指数(RI)低于正常对照组(P<0.05)。子宫肌瘤周围有环绕血流,浆膜下肌瘤及黏膜下肌瘤的蒂部显示丰富的血流;子宫腺肌瘤周边血流信号稀少,内部见丰富或星点状血流信号;频谱显示子宫腺肌瘤阻力指数高于子宫肌瘤周边及内部动脉RI。结论 经阴道及腹部超声对子宫肌瘤与子宫腺肌瘤的鉴别有重要价值,但必须结合临床表现才能提高二者诊断的准确率。     

经阴道彩色多普勒超声诊断子宫肌瘤与子宫腺肌症及腺肌瘤的临床价值

目的:探究经阴道彩色多普勒超声诊断子宫肌瘤、子宫腺肌症、子宫腺肌瘤的临床价值.方法:回顾性选取徐州市第六人民医院2020年1月—2021年12月期间收治的经手术病理确诊的31例子宫肌瘤患者、35例子宫腺肌症患者、28例子宫腺肌瘤患者为研究对象,所有患者均进行经阴道彩色多普勒超声和经腹部彩色多普勒超声诊断.比较经阴道及经...     

经阴道彩色多普勒超声诊断子宫肌瘤和子宫肌腺病

目的 探讨经阴道彩色多普勒超声(TVCDU)对子宫肌瘤和子宫肌腺病的诊断价值.方法 应用经阴道彩色超声诊断仪,对45例子宫肌瘤和28例子宫肌腺病患者行术前检查,包括灰阶图像和彩色血流成像;术后均经病理证实.结果 超声检查诊断子宫肌瘤共42例,子宫肌腺病34例.与病理结果对照:3例子宫肌瘤被误诊为子宫肌腺病,6例子宫肌腺病被误诊为子宫肌瘤,子宫肌瘤的诊断符合率为92.8%,子宫肌腺病符合率为82.5%.二维灰阶超声:子宫肌瘤和子宫肌腺病各有特点,子宫肌瘤内部血流丰富,而子宫肌腺病只有星点样血流;子宫肌瘤随着体积的增大,彩色血流的丰富程度也随之增加,而子宫肌腺病不具备上述特征.结论 应用TVCDU二维灰阶成像可鉴别子宫肌瘤和子宫肌腺病,二者的诊断正确率均较高;联合应用灰阶图像及彩色图像,有利于提高诊断的正确率.     

经阴道及腹部彩色多普勒超声在子宫肌瘤与子宫腺肌瘤鉴别诊断中的应用

目的:研究子宫肌瘤与子宫腺肌瘤患者经阴道及腹部彩色多普勒超声诊断的价值。方法:回顾分析我院妇科经病理学证实的40例子宫肌瘤患者、40例子宫腺肌瘤患者,均接受阴道及腹部彩色多普勒超声检查,比较分析诊断结果。结果:两种疾病患者比较舒张期血流峰值无差异;阴道超声与联合超声检查子宫肌瘤、子宫腺肌瘤无差异,P>0.05;与子宫腺肌瘤患者比,子宫肌瘤患者血流灌注指数高,阻力指数低;与阴道超声检查比,联合超声检查确诊率高,P<0.05。结论:经腹部+阴道彩色多普勒超声鉴别诊断子宫肌瘤、子宫腺肌瘤具可行性,为后期临床治疗提供参考数据。     

彩色多普勒超声对子宫肌瘤、子宫腺肌瘤的鉴别诊断价值

目的探讨彩色多普勒超声(CDFI)对子宫肌瘤、子宫腺肌瘤的鉴别诊断价值。方法收集2015年12月至2018年12月在我院经术后病理检查确诊的子宫肌瘤患者600例,子宫腺肌瘤患者180例,对两组患者联合经阴和经腹彩色多普勒超声检查结果进行分析,比较CDFI对这两种疾病的诊断准确率,以及病灶周围血流情况,血流阻力指数(RI)、搏动指数(PI)。结果联合经阴和经腹CDFI对子宫肌瘤和子宫腺肌瘤的诊断准确率比较,差异未见统计学意义(P0.05);子宫肌瘤CDFI多表现为边界清,均匀、低回声,肌瘤周围伴有声晕,子宫增大,多伴形态改变,肌瘤发生部位和数目不一,而子宫腺肌瘤CDFI多表现为边界不清,回声多不均,子宫弥漫性增大,多不伴形态改变;内膜多移位,病灶多发生于子宫后壁。子宫肌瘤组患者病灶周围环状血流检出率为73.67%(442/600),显著高于子宫腺肌瘤组[15.00%(27/180)],子宫肌瘤组RI、PI均显著低于子宫腺肌瘤组(P均0.05)。结论彩色多普勒超声对子宫肌瘤和子宫腺肌瘤具有较高的诊断准确率,且对二者有较高的鉴别诊断价值。     

经阴道彩色多普勒超声诊断子宫肌瘤和子宫腺肌病及腺肌瘤的临床价值

目的:探讨经阴道彩色多普勒超声诊断子宫肌瘤和子宫腺肌病及腺肌瘤的临床价值.方法:回顾性分析2020年1月—2021年8月在威海市立医院妇科治疗的135例子宫肌瘤和子宫腺肌病及腺肌瘤患者的临床资料,其中子宫肌瘤84例,单纯子宫腺肌病31例,子宫腺肌病合并腺肌瘤20例,患者均使用经腹和经阴道彩色多普勒超声检查,以手术病理结...     

三维彩色多普勒超声在子宫肌瘤及子宫腺肌症鉴别诊断中的应用

目的研究三维彩色多普勒超声在子宫肌瘤及子宫腺肌症鉴别诊断中的应用价值。方法回顾性分析2017年2月～2019年2月本院收治的子宫肌瘤患者50例(A组)和子宫腺肌症患者50例(B组)的临床资料。所有患者均行三维彩色多普勒超声检查,检查完毕后,均经手术病检。以手术病检结果为"金标准",评定三维彩色多普勒超声诊断子宫肌瘤与子宫腺肌症的符合率;对比分析两组病灶内部及周边血流检出率、动脉血流阻力指数(RI)。结果 A组的符合率为92.00%与B组的96.00%比较,差异无统计学意义(P>0.05);A组内部血流检出率(38.00%)明显低于B组(84.00%),周边血流检出率(92.00%)明显高于B组的(14.00%),差异有统计学意义(P<0.05);A组动脉血流RI明显低于B组,差异有统计学意义(P<0.05)。结论采用三维彩色多普勒超声检查子宫肌瘤及子宫腺肌症的符合率较高,具有良好的鉴别诊断价值。     

超声显像对子宫腺肌症诊断及鉴别诊断探讨

目的总结子宫腺肌症的超声图像（经腹部、阴道）、彩色多普勒技术（CDFI）特征，探讨其诊断、鉴别诊断。方法通过术前超声图像、彩色多普勒血流表现与手术病理结果对照来探讨子宫腺肌症的特性、鉴别要点。结果38例子宫腺肌症超声诊断符合率81．6％，误诊为子宫肌瘤占15．8％。结论子宫腺肌症弥漫型，结合病史，多能明确诊断；局限型偏低回声病例易误诊，误诊率10．5％。鉴别要点：综合分析团块的形态、回声、与周围组织界限是否清晰及彩色多普勒血流特点。     

Determination of creatine kinase isoenzyme MB activity in serum using immunological inhibition of creatine kinase M subunit activity. Activity kinetics and diagnostic significance in myocardial infarction.

This is a new method for the determination of creatine kinase isoenzyme MB activity in serum. The method uses direct activity measurement of creatine kinase B subunit activity after blocking of CK-M subunit activity by inhibiting antibodies. The test takes no longer than 15 min. The method yields an intra-serial C.V. of 2.0-12.9%, and a C.V. from day to day of 5.5%. The detection limit is 3.4 U/l creatine kinase MB. In the 95 cases with proven myocardial infarction several types of creatine kinase MB activity kinetics could be determined. The percentage of creatine kinase MB of peak CK-total is 6-25%, with a mean of 11.1%. The amount of creatine kinase MB with respect to total CK activity after reinfarction is higher than the amount after initial infarction.     

Dissociable correlates of two classes of retrieval processing in prefrontal cortex

Although substantial evidence suggests that the prefrontal cortex (PFC) implements processes that are critical for accurate episodic memory judgments, the specific roles of different PFC subregions remain unclear. Here, we used event-related functional magnetic resonance imaging to distinguish between prefrontal activity related to operations that (1) influence processing of retrieval cues based on current task demands, or (2) are involved in monitoring the outputs of retrieval. Fourteen participants studied auditory words spoken by a male or female speaker and completed memory tests in which the stimuli were unstudied foil words and studied words spoken by either the same speaker at study, or the alternate speaker. On "general" test trials, participants were to determine whether each word was studied, regardless of the voice of the speaker, whereas on "specific" test trials, participants were to additionally distinguish between studied words that were spoken in the same voice or a different voice at study. Thus, on specific test trials, participants were explicitly required to attend to voice information in order to evaluate each test item. Anterior (right BA 10), dorsolateral prefrontal (right BA 46), and inferior frontal (bilateral BA 47/12) regions were more active during specific than during general trials. Activation in anterior and dorsolateral PFC was enhanced during specific test trials even in response to unstudied items, suggesting that activation in these regions was related to the differential processing of retrieval cues in the two tasks. In contrast, differences between specific and general test trials in inferior frontal regions (bilateral BA 47/12) were seen only for studied items, suggesting a role for these regions in post-retrieval monitoring processes. Results from this study are consistent with the idea that different PFC subregions implement distinct, but complementary processes that collectively support accurate episodic memory judgments.     

俯卧位通气对高海拔地区肺复张治疗无效急性呼吸窘迫综合征患者氧合的影响

目的 探讨俯卧位通气对高海拔地区肺复张术(RM)治疗无效急性呼吸窘迫综合征(ARDS)患者的治疗作用.方法 从海拔2260m的地区医院筛选RM治疗无效的41例ARDS患者[平均氧合指数( PaO2/FiO2)较RM前升高＜20％视为RM无效],依不同病因分为肺内源性ARDS组(ARDSp组)和肺外源性ARDS组(ARDSexp组),每组再按信封法随机分为俯卧位组和仰卧位组,即ARDSp俯卧位组(11例)、ARDSp仰卧位组(9例)、ARDSexp俯卧位组(10例)、ARDSexp仰卧位组(11例).在通气前及通气1、2、3、4h监测动脉血氧分压( PaO2)、PaO2/FiO2、静态顺应性(Cst)、气道阻力(Raw)的变化.结果 通气lh时,ARDSexp俯卧位组PaO2/FiO2( mm Hg,l mm Hg=0.133 kPa)即较通气前显著升高(157.4±40.6比129.3±48.7,P＜0.05),并随通气时间延长呈持续增高趋势,4h达峰值(219.1 ±41.1);且ARDSexp俯卧位组通气3h内PaO2/FiO2较其他3组显著增高,另3组间则差异无统计学意义.ARDSp俯卧位组、ARDSexp俯卧位组通气4h时PaO2/FiO2均较相应仰卧位组显著增高(208.8±39.7比127.4±47.1,219.1±41.1比124.9±50.8,均P＜0.05).4组通气前后Cst无显著改变,各组间差异也无统计学意义.ARDSp俯卧位组通气4h时Raw(cmH2O·L-1·s-1)较通气前显著降低(6.8±1.7比10.7±1.8,P＜0.05),且明显低于其他3组;其他3组各时间点Raw组内及组间比较差异均无统计学意义.结论 俯卧位通气作为ARDS机械通气重要策略之一,可以改善RM无效高原ARDS患者的氧合,为抢救患者赢得宝贵的时间.     

Digital imaging among medical facilities

The Department of Veterans Affairs (VA) in the USA operates a network of 172 medical centres which all utilize a hospital information system (HIS) which has been developed and is currently maintained by the VA. During the past several years, an image management and communication module has been developed, installed and clinically utilized at the Washington DC and Maryland VA Medical Centres. This image management and communication system, referred to as the decentralized hospital computer program (DHCP) imaging system, is fully integrated with a commercial picture archiving and communication system (PACS). The system is utilized to capture, archive, and display all images generated within the hospital including radiology, nuclear medicine, pathology, endoscopy, bronchoscopy, and dermatology, intraoperative photographs, ECG data, and a limited number of paper documents. The ultimate goal of the project is to have all patient text and image data available at any clinical workstation to any authorized user anywhere within the network of medical centres. Clinical requirements for an imaging workstation include ease of use, rapid and reliable access to the complete set of patient information, and images which are of acceptable quality to meet the requirements of the user and the subspecialty. Patient confidentiality and data security must be safeguarded at all times. Integration of the images with the remainder of the patient's database was found to be critical to the success of the project. The experience at the Washington and Maryland facilities suggests that an imaging system that is successfully integrated with a hospital information system can provide substantial clinical and economic benefits both within and among medical centres. Clinical acceptance and utilization of the system has been excellent, particularly in diagnostic radiology where DHCP Imaging has been interfaced to a commercial PAC system. Based upon this initial experience, the VA has begun to deploy the system throughout its large network of medical centres.     

Myocardial elastography at both high temporal and spatial resolution for the detection of infarcts

Myocardial elastography is a novel method for noninvasively assessing regional myocardial function, with the advantages of high spatial and temporal resolution and high signal-to-noise ratio (SNR). In this paper, in-vivo experiments were performed in anesthetized normal and infarcted mice (one day after left anterior descending coronary artery [LAD] ligation) using a high-resolution (30 MHz) ultrasound system (Vevo 770, VisualSonics Inc., Toronto, ON, Canada). Radiofrequency (RF) signals of the left ventricle (LV) in longitudinal (long-axis) view and the associated electrocardiogram (ECG) were simultaneously acquired. Using a retrospective ECG gating technique, 2-D full field-of-view RF frames were acquired at an extremely high frame rate (8 kHz) that resulted in high-quality incremental displacement and strain estimation of the myocardium. The incremental results were further accumulated to obtain the cumulative displacements and strains. Two-dimensional and M-mode displacement images and strain images (elastograms), as well as displacement and strain profiles as a function of time, were compared between normal and infarcted mice. Incremental results clearly depicted cardiac events including LV contraction, LV relaxation and isovolumetric phases in both normal and infarcted mice, and also evidently indicated reduced motion and deformation in the infarcted myocardium. The elastograms indicated that the infarcted regions underwent thinning during systole rather than thickening, as in the normal case. The cumulative elastograms were found to have higher elastographic SNR (SNR(e)) than the incremental elastograms (e.g., 10.6 vs. 4.7 in a normal myocardium, and 6.0 vs. 2.4 in an infarcted myocardium). Finally, preliminary statistical results from nine normal (m = 9) and seven infarcted (n = 7) mice indicated the capability of the cumulative strain in differentiating infracted from normal myocardia. In conclusion, myocardial elastography could provide regional strain information at simultaneously high temporal (>/=0.125 ms) and spatial ( approximately 55 microm) resolution as well as high precision ( approximately 0.05 microm displacement). This technique was thus capable of accurately characterizing normal myocardial function throughout an entire cardiac cycle, at the same high resolution, and detecting and localizing myocardial infarction in vivo.     

手转胎头术失败的原因与分娩结局临床分析

目的 探讨手转胎头术失败的原因与分娩结局.方法 选择2008年1月至2010年12月于我院住院分娩的持续性枕横位、枕后位产妇198例,根据行手转胎头术后结果分为成功组126例、失败组72例.比较两组分娩结局,对比分析失败原因.结果 失败组胎儿体质量≥3500 g的发生率[76.4％(55/72)]明显高于成功组[31.7％(40/126)],差异有统计学意义(x2=30.177,P=0.001)、失败组宫缩乏力发生率[58.3％(42/72)]高于成功组[38.1％ (48/126)],差异有统计学意义(x2=7.569,P=0.006)、失败组骨盆临界或轻度狭窄发生率[38.9％ (28/72)]高于成功组[23.8％(30/126)],差异有统计学意义(x2 =5.030,P=0.002)、失败组手转胎头时机不当(宫口开大＜6 cm、胎头位于坐骨棘上及宫口开大8～10 cm、胎头位于坐骨棘下≥2 cm)发生率[61.1％(44/72)]高于成功组[38.9％(49/126)],差异有统计学意义(x2=9.084,P=0.003).失败组母儿并发症(产后出血、产褥病率、胎儿窘迫、新生儿窒息)发生率高于成功组(x2 =9.586,P=0.002、x2=9.334,P=0.002、x2=5.910,P=0.015、x2=5.240,P=0.022)、失败组剖宫产发生率[72.2％(52/72)]明显高于成功组[34.1 ％(43/126),x2=26.641,P=0.001)].结论 手转胎头术能使难产变顺产,降低剖宫产率,减少母儿并发症,但须积极预防、处理导致手转胎头术失败的原因,对矫正失败后继续矫正及试产应慎重.