三维超声汇聚征在乳腺肿块诊断及预后评估中的价值

目的探讨三维超声汇聚征在乳腺肿块诊断及预后评估中的价值。方法对165例乳腺肿块患者术前行三维超声检查,观察肿块冠状面汇聚征的表达情况,并与肿块直径、组织学分级、淋巴结状态以及雌激素受体(ER)、孕激素受体(PR)、人表皮生长因子-2(Cerb B-2)及Ki-67结果作比较,统计分析汇聚征与上述指标间关系。结果汇聚征诊断乳腺恶性肿块的灵敏度为67.7%,特异度为93.1%。汇聚征显示率在浸润性癌和非浸润性癌间差异有统计学意义(P0.01)。汇聚征显示率与直径、组织学分级以及ER、PR表达有关。与无汇聚征组相比,有汇聚征组的肿块直径多≤2 cm(P0.05),组织学分级多为Ⅱ级(P0.05),且ER、PR的阳性率较高(P0.05)。两组的淋巴结状态、Cerb B-2及Ki-67表达之间差异无统计学意义(P0.05)。结论三维超声汇聚征表达情况有助于乳腺癌预后评估,从而为临床治疗方案的制定提供更多有效影像学信息。     

高频超声及CDFI检查在乳腺肿块诊断中的应用

对32例乳腺肿块进行高频超声及彩色血流显像（CDFI）超声检查,并与术后病理检查结果做比较,结果高频超声及CDFI诊断32例肿块中,囊性7例,实质性22例,多发性囊性肿块3例,良性肿块23例、恶性肿块9例,与手术病理对照,肿块检出率100％,对肿块的囊性、实质性、混合性的检出率也是100％。良性肿块1例与手术病理不符,总符合率为96．9％（31／32）。高频CDFI超声对乳腺血管彩色血流的检出率（RI）为72％（24／32）。经手术证实,全部肿块均在超声定位象限内。认为高频超声及CDFI检查在乳腺肿块的诊断中具有较好的应用价值。     

超声对乳腺良恶性肿块诊断及定位分析

目的探讨超声对乳腺良恶性肿块诊断及定位的临床应用价值。方法对手术病理证实的39例乳腺良恶性肿块超声诊断及定位进行分析。结果超声诊断39例乳腺肿块中，良性肿块24例，恶性肿块15例。实质性15例，囊性19例，多发性囊肿5例。与手术对照良恶性肿块除4例与手术病理不符外，总符合率为89．7％，误诊率为10．3％。手术证实全部乳腺肿块均在超声定位象限内。结论超声检查对乳腺良恶性肿块有较高的诊断及定位价值。     

彩色多普勒超声在乳腺肿块诊断中的应用

1995年1月至2003年8月，我们对1420例乳腺肿块患者进行彩色多普勒超声检查，其结果分别与病理对照，分析、研究各种良恶性乳腺肿块的超声图像，提出超声诊断的声像图特征，评价其临床应用价值。     

数字化乳腺X线及超声诊断乳腺肿块类病变的对比

目的探讨数字化乳腺X线(乳腺DR)及超声对乳腺内肿块类病变的临床应用价值。方法收集145例乳腺肿块类疾病患者的数字化乳腺X线(乳腺DR)和超声的影像学资料,将其与病理诊断对照,进行统计学分析。结果单纯应用乳腺DR诊断的符合率为84.8%,单纯应用超声诊断的符合率为82.8%,乳腺DR及超声联合应用诊断的符合率为92.4%。结论乳腺DR及超声联合应用,能明显提高乳腺肿块类疾病的诊断符合率,具有确切的临床意义。     

超声造影在乳腺实性肿块良恶性诊断中的应用价值

女性乳腺疾病的发生率逐年增加,乳腺癌成为了我国女性发病率最高的恶性肿瘤,乳腺良恶性实性肿块的鉴别诊断一直是医学影像学研究的重点难点.超声造影使实性肿瘤中的低速低流量的微小血管得以显示,并进行实时动态评估,从而提高了诊断及鉴别乳腺良恶性肿块的准确率.该文就超声造影在乳腺实性肿块良恶性诊断中的应用价值进行综述.     

彩色多普勒超声检查在乳腺肿块鉴别诊断中的应用

1999年10月至2003年10月，我们将彩色多普勒超声检查用于乳腺肿块良、恶性的鉴别诊断。现报告如下。     

高频超声诊断乳腺肿块的应用性研究

目的探讨高频超声对乳腺肿块的诊断价值。方法收集行乳腺超声检查并经手术病理证实的住院乳腺肿块患者220例作为研究对象,与病理结果对比,分析超声诊断乳腺肿块的准确性。结果220例患者中,高频超声诊断乳腺肿块的敏感性为89．1％,特异性为78．3％,阳性预测值为85．1％,阴性预测值别为83．7％,准确性为84．5％。结论高频超声在乳腺疾病诊断中的价值是肯定的,对临床工作起着重要的辅助诊断作用。     

超声造影检查对乳腺肿块血管特性的诊断价值研究

目的：：探讨超声造影检查对乳腺肿块患者诊断及血管特性分析的价值。方法：随机选取84例乳腺肿块患者作为研究对象。其中42例作为对照组,行普通超声检查,另42例作为研究组,在对照组基础上再行超声造影检查。统计研究组造影前后血流分级的变化,分别记录乳腺肿块内时间强度曲线。所有患者均行穿刺活检以病理学检查结果作为最终确诊结果,比较种方式的诊断符合率。结果：①造影后,血流分级为Ⅲ级的患者比例大大增加,Ⅱ级和Ⅰ级、0级明显减少。②两组患者小于2cm的良性肿块的诊断符合率相差不大,其他肿块的诊断符合率均有显著性差异, P<0．05。③研究组恶性肿块与良性肿块参数比较,恶性肿块的平均强度差值、曲线下面积差值显著偏高,造影剂达峰值时间偏短;而其造影剂渡越时间远远常于对照组, P<0．05。此外良恶性肿块内部最大血流速度( Vmax)有显著性差异,利于鉴别;而肿块内部的阻力指数( RI)则无统计学意义。结论：超声造影检查技术对乳腺肿块的诊断和治疗具有重要价值,诊断符合率高,有助于患者及时诊断疾病及时治疗,值得临床推广应用。     

超声弹性成像对校正BI-RADS-US 3类及4类乳腺肿块的诊断价值

目的 分析超声弹性成像对校正乳腺超声影像报告数据系统(Breast Imaging and Reporting System Ultrasound,BI-RADS-US) 3类及4类乳腺肿块的诊断价值。方法 对常规BI-RADS-US分类法诊断为3类及4类的乳腺肿块用超声弹性成像进行校正,以病理结果为金标准,对比分析校正前后的BI-RADS-US分类法对乳腺肿块良恶性的鉴别诊断效能。结果 常规BI-RADS-US分类法诊断乳腺良恶性肿块的灵敏度、特异度、准确度分别为75. 6%、88. 1%、83. 8%,受试者工作特征(ROC)曲线下面积为0. 836。经超声弹性成像校正后BI-RADS-US分类法的诊断灵敏度、特异度、准确度分别为82. 9%、93. 1%、90. 8%,ROC曲线下面积为0. 918。校正前后ROC曲线下面积比较差异有统计学意义(P 0. 05)。结论 弹性成像有助于提高超声对BI-RADS-US3类及4类乳腺肿块良恶性的鉴别诊断效能。     

Plaque color analysis by the conventional yellow-color grading system and quantitative measurement using LCH color space

BACKGROUND: Yellow plaques of higher color grades are regarded as more vulnerable. We tried to elucidate the characteristics of yellow color that are regarded as the sign of vulnerable plaques by an objective and quantitative plaque color analysis. METHODS: The color of yellow plaques was quantitatively analyzed using LCH color space and was presented by the maximum values of lightness (Lmax), chroma (Cmax), and hue (Hmax). Effect of light intensity on these parameters was experimentally examined (five plaque models, six light intensities). Relation between conventional yellow-color grade and LCH parameters was examined (31 plaques). Color analysis with LCH color space was applied (1) to compare the culprit lesions of unstable angina (eight patients) and of stable effort angina (nine patients) and (2) to evaluate the regression of yellow plaque by 80-week statin treatment (four patients, 19 plaques). RESULTS: Cmax and Hmax were not influenced by light intensity so far as it was within appropriate range. Cmax (13 +/- 3, 25 +/- 5, and 28 +/- 4) became higher and Hmax (178 +/- 26, 134 +/- 10, and 91 +/- 16) became lower as the grade became higher (P < 0.0001). Culprit lesions of unstable angina had higher Cmax (22.8 +/- 7.9 vs 14.8 +/- 7.5, P = 0.04) and lower Hmax (73.3 +/- 19.7 vs 168.0 +/- 71.5, P = 0.002) than stable effort angina. Statin treatment reduced Cmax (21.3 +/- 9.6 vs 14.6 +/- 3.1, P = 0.004) and increased Hmax (82.6 +/- 25.8 vs 142.3 +/- 54.1, P = 0.0005). CONCLUSIONS: Plaque color was consistently and quantitatively measurable using LCH color space uninfluenced by light intensity of appropriate range. Vulnerable yellow color had high chroma and low hue, indicating vivid and reddish-yellow color.     

Percutaneous interventions in unprotected left main lesions: novel three-dimensional imaging and quantitative analysis before and after intervention

ObjectiveTo examine the potential yield of three-dimensional (3D) reconstruction of left main coronary lesions.MethodsA novel, previously validated, system for 3D reconstruction of the coronary vessels was used to evaluate 302 angiographic images, before and after stenting, from 62 consecutive patients (age 73.5±11.3 years) with unprotected left main lesions.ResultsThree-dimensional reconstructions significantly improved morphological analysis, especially for ostial and bifurcation lesions. In cases of bifurcation involvement, lesion length was significantly longer in the 3D reconstructions than in the 2D images (12.3±4.1 vs. 10.6±4.9 mm, P=.003). The 3D analysis showed that procedures performed in distal left main were associated with a decrease in the bifurcation angle after intervention (from 82±27° to 72±28°, P=.01). The mortality rate was 18% at 6 months. Elective intervention was associated with significantly lower mortality (5% vs. 39% at 6 months).ConclusionsThree-dimensional reconstruction adds insights on the morphology and lesion length of unprotected left main artery lesions, especially those involving the bifurcation, which may make it an important tool in planning interventional procedures and evaluating their results.     

The clinical value of histogram analysis of diffusion kurtosis imaging in prostate cancer and the correlation between histogram parameters and Gleason score

<正>Objective To explore the value of diffusion kurtosis imaging(DKI) histogram analysis for differential diagnosis of prostate cancer and noncancerous foci and the correlation between histogram parameters and Gleason score.Methods Twenty-one patients were retrospectively     

Usefulness of three-dimensional color Doppler sonography for the differential diagnosis of subpleural lesions]

The purpose of our investigation was to assess the usefulness of three-dimensional color Doppler sonography (velocity mode and power mode) for the differential diagnosis of subpleural lesions. Thirty lesions (11 pneumonias, 5 lung abscesses, 11 primary lung cancers, 3 metastatic lung cancers) were examined. Three-dimensional images were reconstructed by a maximum intensity projection method. Three-dimensional representations of intralesional blood flow became available for all lesions approximately 11 seconds after scanning. In every case, the entire vasculature of the tumor, the pneumonia, the abscess, or the inflamed region of the lung was appreciated more easily from three-dimensional images than from two-dimensional images. We classified the color flow pattern of subpleural lesions depicted by color flow imaging into seven groups. Color flow was depicted better by the three-dimensional color Doppler power mode than the velocity mode. Three-dimensional color flow patterns observed in power mode, patterns of the pneumonias and the lung cancers differed significantly. Our results suggest that the three-dimensional color Doppler power mode is useful for the differential diagnosis of subpleural lesions.     

A technique for quantitative three-dimensional analysis of microvascular structure

Research into angiogenesis and vascular microarchitecture has contributed to progress in a wide variety of biomedical fields, but increased understanding is limited, in part, by the available assays and imaging modalities. Techniques that allow quantitation of vascular microarchitecture are needed. A comprehensive method is presented that uses 6-microm-thick serial sections of frozen tissue samples, immunostaining for CD31, brightfield microscopy, automated alignment of two-dimensional serial sections, and volume rendering to produce high-resolution, three-dimensional, quantifiable images of microvascular structure. Application of the technique is shown by characterizing vascularization into a fibrin gel implanted against the skeletal muscle of rats and explanted after 7 days. Comparing measurements from automated and manually aligned MRI and fibrin samples verified quantitation. Automation removes concerns of observer bias or variation inherent in manual alignment and increases the speed of analysis. Analysis of the fibrin gel reveals a dense (4.3 +/- 1.1% endothelial cell density) network of tortuous (1.37 +/- 0.05 tortuosity) capillaries that replaces the gel as it degrades. There is a high level of void space (22.8 +/- 3.6%) in the gel, and average capillary length in the fibrovascular tissue was 93.0 +/- 7.4 microm. Data obtained from these automatically aligned images agreed with those obtained using manual analysis (no statistical difference), and the results are consistent with data from traditional methods.     

彩色多普勒超声对腹主动脉瘤破裂的诊断价值分析

目的 探讨彩色多普勒超声对腹主动脉瘤破裂的诊断价值.方法 回顾性分析13例腹主动脉瘤破裂患者的彩色多普勒超声检查资料,并与手术或计算机断层扫描血管成像(CTA)、核磁共振成像(MRI)检查结果进行对比分析.结果 超声诊断腹主动脉瘤破裂11例,准确率84.6％,误诊2例,误诊率15.4％.腹主动脉瘤体最大直径5.1～9.6 cm.超声可显示瘤体及破口、瘤腔内附壁血栓、撕裂内膜、腹腔积液、腹腔内和腹膜后血肿,显示率分别为92.31％、38.46％、46.15％、15.38％、76.92％、46.15％、53.85％.结论 彩色多普勒超声诊断腹主动脉瘤破裂方便、快捷、无创,诊断准确率高,具有较高的临床应用价值.     

实时荧光定量PCR技术检测肺炎衣原体的诊断价值

目的探讨实时荧光定量PCR技术检测肺炎衣原体的诊断价值。方法对呼吸道感染的186例患者的痰液分别采用实时荧光定量PCR技术和基因测序检测,以评价实时荧光定量PCR技术检测肺炎衣原体感染的准确性。结果实时荧光定量PCR检测肺炎衣原体的灵敏度为100.0%,特异度为93.1%,阳性预期值为80.8%,阴性预期值为100.0%,准确率为94.6%。结论实时荧光定量PCR技术检测肺炎衣原体具有较高的可靠性,适用于临床快速诊断肺炎衣原体感染的相关疾病。     

自动乳腺全容积成像冠状面图像特征在乳腺病变鉴别诊断中的应用价值

目的探讨自动乳腺全容积成像系统(ABVS)冠状面图像特征在乳腺病变鉴别诊断中的应用价值。方法选择2015-03~2018-01在该院超声科就诊的乳腺肿瘤患者103例(共130例病灶),分别应用二维超声和ABVS系统进行检查,以术后病理结果为金标准,比较两种诊断方法的诊断效能。结果 130例病灶中,恶性病变56例,良性病变74例。二维超声和ABVS系统诊断乳腺肿瘤的敏感性、特异性、准确性分别为69. 6%、79. 7%、75. 4%和87. 5%、94. 6%、91. 5%。ABVS冠状面特有的"汇聚征"征象在恶性结节中的出现率(75. 0%)显著高于良性结节(5. 4%),P 0. 05;并且团块最大直径≤2 cm的恶性结节的"汇聚征"的检出率(83. 9%)亦明显高于 2 cm的恶性结节(61. 5%),P 0. 05。结论 ABVS检查能够明显提高乳腺良恶性肿瘤鉴别诊断的准确性,特别是"汇聚征"对乳腺癌具有较高的诊断效能,可有效地提高早期小乳腺癌的检出率,具有较高的临床应用价值。