乳腺筛查病变分布及扫查时长对检出率影响的单因素分析

[摘要]目的：研究正常体检筛查情况下,乳腺病灶的年龄、部位的分布情况,同时对扫查时长对漏检影响进行了单因素分析。方法：随机将在我院超声科行乳腺体检筛查的受检者进行年龄分组,对受检者的乳腺病灶分为囊肿、导管扩张,乳腺结节,腋窝结节。扫查时长分为2分钟扫查组（平均每侧乳腺扫查1分钟,包含双侧腋窝）,4分钟扫查组（平均每侧乳腺扫查2分钟,包含双侧腋窝）及6分钟扫查组（平均每侧乳腺扫查3分钟,包含双侧腋窝）。扫查完成后分别记录超声发现病灶的情况。每组300人,共900人参与了本次研究。扫查时长对漏检的影响采用Logistic 回归分析。显著性检验水平采用P<0.05。结果：共900例体检者进入研究组,其中18-30岁年龄层右乳发现病变有26例,左乳发现病变有19例,双侧均发现病变的有48例;31-45岁年龄层,右乳发现病变有44例,左乳发现病变有57例,双侧均发现病变的有161例;46-55岁年龄层,右乳发现病变有24例,左乳发现病变有19例,双侧均发现病变的有53例：大于55岁年龄层,右乳发现病变有20例,左乳发现病变有17例,双侧均发现病变的有26例。根据Logistic回归分析4分钟和6分钟分别与2分钟比较阳性率均有差别,其中4分钟的OR值为1.65（P=0.003）,6分钟OR值为2.01（P=0.000）。单独比较4分钟、6分钟阳性率差别无统计学意义（P=0.239）结论：超声乳腺筛查是发现乳腺病变的重要工具,扫查时长影响乳腺病变的检出率。     

Ultrasound biomicroscopy for estimation of tumor thickness for conjunctival melanoma

We assessed the feasibility of using high-frequency ultrasound biomicroscopy (UBM) in estimating thickness of conjunctival melanomas preoperatively. Three patients underwent UBM prior to excision of conjunctival melanoma between February 2003 and March 2006. Conjunctival tumor thickness was estimated via UBM in each case and compared with the estimated histopathologic tumor thickness (Breslow thickness). Patient 1 had an estimated thickness of 1.99 mm via UBM versus a Breslow thickness measurement of 1.5 mm based on the surgical specimen. Patient 2 had a UBM thickness measurement of 2.4 mm and a Breslow thickness of 2.23 mm based on the surgical specimen. In patient 3, both UBM thickness and Breslow thickness were 2.3 mm. The use of high-frequency UBM is feasible for the estimation of tumor thickness for conjunctival melanomas. UBM may serve as an additional diagnostic tool for estimating tumor thickness before surgical resection of conjunctival melanoma.     

In Vitro Ultrasound Biomicroscopic Imaging of Colitis in Rats

Objective. The purpose of this study was to show the feasibility of 50‐MHz ultrasound biomicroscopy (UBM) to image the rat colon. Methods. B‐mode images were obtained from ex vivo colon samples (n = 4) collected from Rattus norvegicus (Berkenhout, 1769) rats, with 2,4,6‐trinitrobenzene sulfonic acid–induced colitis in 3 of them. Left colon rectangular fragments (5 × 5 mm) were obtained after necropsy, and UBM images were acquired with the samples immersed in saline at 37°C. All layers of the normal intestinal wall were analyzed according to their thickness and the presence of uneven bowel mucosa (ulcers). The folds and layers detected by UBM were correlated with histopathologic analysis. Results. The 4 layers of the normal colon were identified on the UBM images: the mucosa (hyperechoic), muscularis mucosae (hypoechoic), submucosa (hyperechoic), and muscularis externa (hypoechoic). On 2 UBM images, superficial ulcers were detected, approximately 0.5 mm in size, with intestinal involvement limited to the mucosa. The histopathologic analysis verified enlargement of submucosa layers due to an edema associated with sub‐mucosa leukocyte infiltration. On 1 UBM image, it was possible to detect a deep ulcer, which was confirmed by the light microscopic analysis. Conclusions. An ultrasound imaging system was scaled and optimized to visualize the rat colon. Ultrasound biomicroscopy provided axial and lateral resolutions close to 25 and 45 μm, respectively, and adequate penetration depth to visualize the whole thickness of an inflamed colon. The system identified the colon layers and was able to detect mural changes and superficial ulcers on the order of 500 μm.     

经直肠超声造影联合剪切波弹性成像诊断前列腺良恶性病变的价值

目的  分析经直肠超声造影(CETRUS)联合剪切波弹性成像鉴别诊断前列腺良恶性病变的价值。方法  选取2020年5月~2021年12月我院收治的102例前列腺疾病患者,以经直肠超声(TRUS)引导前列腺穿刺活检为金标准,将其分为前列腺癌组(n=37)和前列腺增生组(n=65),对所有患者进行经直肠超声造影联合剪切波弹性成像检查,比较两组患者的E_ration值和E_max值,比较不同方法的诊断准确度。结果  前列腺癌组患者E_ration、E_max值明显高于前列腺增生组患者,差异有统计学意义(P < 0.05);CETRUS联合剪切波弹性成像诊断前列腺良恶性病变的敏感度、特异性、准确率明显高于单一CETRUS检查,单一技术诊断(81.08%、80.00%、80.39% vs 56.76%、64.62%、61.76%,P < 0.05);CETRUS联合剪切波弹性成像的曲线下面积为0.748(95%CI：0.534~0.760),大于单一CETRUS曲线下面积0.685(95%CI：0.626~0.851)。结论  经直肠超声造影联合剪切波弹性成像可通过杨氏模量值来反应组织的硬度,进而对前列腺良恶性病变进行诊断,在临床上具有一定的应用价值。     

Simultaneous Bilateral Real-Time 3-D Transcranial Ultrasound Imaging at 1 MHz Through Poor Acoustic Windows

Ultrasound imaging has been proposed as a rapid, portable alternative imaging modality to examine stroke patients in pre-hospital or emergency room settings. However, in performing transcranial ultrasound examinations, 8%–29% of patients in a general population may present with window failure, in which case it is not possible to acquire clinically useful sonographic information through the temporal bone acoustic window. In this work, we describe the technical considerations, design and fabrication of low-frequency (1.2 MHz), large aperture (25.3 mm) sparse matrix array transducers for 3-D imaging in the event of window failure. These transducers are integrated into a system for real-time 3-D bilateral transcranial imaging—the ultrasound brain helmet—and color flow imaging capabilities at 1.2 MHz are directly compared with arrays operating at 1.8 MHz in a flow phantom with attenuation comparable to the in vivo case. Contrast-enhanced imaging allowed visualization of arteries of the Circle of Willis in 5 of 5 subjects and 8 of 10 sides of the head despite probe placement outside of the acoustic window. Results suggest that this type of transducer may allow acquisition of useful images either in individuals with poor windows or outside of the temporal acoustic window in the field.     

睫状体剥离的超声诊断特征

目的探讨睫状体剥离的形态学改变。方法分别应用超声生物显微镜（UBM）、彩色多普勒超声显像仪、眼科A／B型超声诊断仪、前房角镜对172例186只眼睫状体剥离的形态进行观察。结果186只患眼均经UBM、彩色多普勒超声显像仪、眼科A／B超声诊断仪、房角镜检查，睫状体剥离的诊断率分别为100％、88％、55％、35％。结论UBM应为睫状体剥离诊断金标准；彩色多普勒超声诊断仪诊断率较高，尤其适宜眼科临床推广；B超诊断率较低，但对条件有限的单位仍应列为一种检查手段；房角镜检查局限性较多，但为唯一的光学检查手段，定位准确，应与其他方法联合应用。     

高频超声对腮腺肿瘤的检测价值

目的 探讨应用高频超声对腮腺肿瘤的价值。方法 应用彩色多普勒超声诊断仪，探头频率7.5MHz，对163例腮腺肿瘤患进行检查，其中145例为良性肿瘤，18例为恶性肿瘤。结果 经手术、病理证实良性肿瘤超声诊断符合率为88％，恶性肿瘤超声诊断符合率为76％。结论 高频超声能清晰地显示腮腺肿瘤的形态，结构、大小和相邻关系，对腮腺肿瘤的诊断具有较高的价值，有助于对腮腺肿瘤的鉴别诊断。     

高频超声诊断异位甲状腺的临床价值

目的探讨高频超声诊断异位甲状腺的临床价值。方法对13例异位甲状腺的临床资料及超声特征进行回顾性分析。结果(1)异位甲状腺以女性多见(12/13),年龄段以10岁以下儿童(5/13)及30~40岁(5/13)较多见;(2)异位甲状腺以舌根部及颈前部最多见(11/13);(3)绝大多数(12/13)异位甲状腺正常部位未见甲状腺回声,异位甲状腺回声与正常甲状腺回声相似,合并异位甲状腺功能亢进或结节性甲状腺肿时有相应病变的超声表现;(4)6例手术病例中5例术前未能明确诊断,7例拟手术病例中6例术前超声检查提示异位甲状腺,避免了不必要的手术。结论高频超声对异位甲状腺的诊断具有重要临床价值。     

肿瘤性与非肿瘤性胆囊息肉样病变的超声鉴别诊断

目的探讨超声检查对胆囊肿瘤性与非肿瘤性息肉样病变的鉴别诊断价值。方法对所选患者胆囊进行多切面超声检查及病理检查,记录并分析胆囊息肉样病变的部位、大小、数目、形态及声像图特征。结果167例胆囊息肉样病变中,肿瘤性病变17例占10．18％,非肿瘤性病变150例占89．82％。结论实时超声显像有助于从胆囊息肉样病变中及早发现肿瘤性病变。对于5-10mm胆囊腺瘤恶性变和胆囊癌声像图缺乏特异性。     

超声诊断子宫内膜病变42例的临床分析

目的探讨超声诊断子宫内膜病变的价值。方法对超声诊断的子宫内膜病变结果进行对照分析。结果超声诊断子宫内膜病变42例中，全部经诊刮和病理检查证实的有内膜息肉15例，黏膜下肌瘤11例，内膜增生过长7例，内膜癌3例，正常6例，诊断符合率为85．72％。结论超声诊断可为子宫内膜病变的鉴别诊断提供重要依据，对临床制定治疗方案具有重要意义。     

彩超在诊断脾脏占位性病变中的应用价值

目的探讨彩色多普勒超声对脾脏占位性病变(SSOL)的诊断价值。方法对37例经病理和临床证实的脾脏占位性病变进行二维及彩色多普勒超声分析。结果二维和彩色多普勒超声可以显示脾脏占位性病变的结构特征及血供状态,具有检出率高等特点。结论二维和彩色多普勒超声为诊断脾脏占位性病变提供了丰富的影像学资料,具有重要的临床应用价值。     

应用多普勒超声对肝内占位性病变肝脏血流动力学的研究

目的：应用多普勒超声（Ｄ－ＵＳ）测定多普勒血流灌注指数（ＤＰＩ）、门脉充血指数（ＰＣＩ）及阻力比（ＲＲ）等血流参数,用以评价这些血流参数在肝内良、恶性占位病变中的鉴别诊断和早期诊断价值。方法：１８例正常对照组,１０例肝硬化增生结节（ＨＣＲＮ）,３０例原发性肝癌（ＰＨＣ）,１５例肝转移癌和１０例肝血管瘤（ＨＨ）患者在禁食１２小时后,应用Ｄ－ＵＳ测定ＤＰＩ、ＰＣＩ、ＲＲ等血流参数。结果：１．ＰＨＣ和肝     

Computed tomographic and ultrasonic appearances of primary carcinoma of the common bile duct

Two patients with obstructive jaundice due to surgically proved primary carcinoma of the common bile duct were examined by CT and ultrasound. The combination of the two modalities showed dilatation of the extrahepatic biliary system and the main pancreatic duct. The diagnosis of primary bile duct carcinoma is suggested by these findings in the presence of a normal pancreatic head, although similar findings may occur with a small pancreatic or ampullary carcinoma.     

肝硬化患者肝脏局灶性病变的超声造影分析

摘 要 目的 探讨肝硬化患者发现肝脏局灶性病变的超声造影特征。方法 回顾性分析经穿刺活检或手术病理证实的53例肝硬化背景下肝脏局灶性病变患者的超声造影表现,采用Fisher确切概率法比较不同分化程度（高分化和中-低分化）HCC的廓清时相和不同大小（≤3 cm、3~5 cm、≥5 cm）HCC的动脉相增强模式的差异。结果 10例肝硬化结节患者中7例与周围肝实质三期均呈等增强,2例动脉相呈低增强,门脉相和延迟相呈等增强,另1例动脉相和门脉相呈等增强,而延迟相呈低增强。1例胆管细胞癌动脉相出现周边不均匀增强,肿块中间增强不明显,门脉相开始廓清。不同分化程度的HCC在动脉相、门脉相、延迟相的廓清例数比较,差异有统计学意义（P＜0.05）。病灶直径≤3 cm与＞5 cm的HCC动脉相的增强模式比较,差异有统计学意义（P=0.01）。结论 不同分化程度的HCC廓清时相存在差异,不同大小的HCC动脉相的增强模式也存在差异,超声造影对于鉴别肝硬化背景下局灶性病变的良恶性具有较高特异性。