闭合性肾损伤的B型超声诊断(附36例分析)

本文通过对36例闭合性肾损伤超声检查结果与其部分放射线检查资料的对比分析,描述了肾挫伤、肾裂伤及肾粉碎伤的声像图特点;讨论了闭合性肾损伤的超声分型诊断问题:认为B超可能是闭合性肾损伤较为理想的间接病理分型方法。     

闭合性肾损伤的超声诊断

本文报告经手术病理证实的10例闭合性肾损伤超声诊断结果。10例中坠落伤5例,车祸4例,跌倒伤1例。其声像图表现:①肾挫伤,轻度者声像图可无异常变化。如肾实质内血肿形成,肾脏局部可肿大,肾实     

46例闭合性肾损伤的B型超声诊断与分析

通过对４６例闭合性肾损伤超声检查结果的总结分析，描述了肾挫伤、肾裂伤及肾粉碎伤的声像图特点。认为，Ｂ超对于闭合性外伤的诊断具有一定的可靠性。Ｂ超检查可以做为闭合性肾损伤形态学分类的较为理想的方法。     

闭合性肾损伤75例诊治分析

目的探讨闭合性肾损伤的诊断和治疗方法。方法对75例闭合性肾损伤的临床资料进行回顾性分析。结果本组75例闭合性肾损伤中，肾挫伤42例，肾裂伤27例，肾粉碎伤5例，肾蒂血管伤1例。复合伤15例。保守治疗46例，手术治疗27例，选择性肾动脉栓塞治疗2例，死亡2例，并发症6例。结论尿液检查和B超检查应作为诊断肾损伤的常规检查方法，CT是具有重要诊断价值的检查手段，治疗方法主要取决于肾脏损伤类型、伤情程度及复合伤情况。     

闭合性肾损伤的诊断与治疗

目的总结闭合性肾损伤诊断与治疗的经验。方法对135例闭合性肾损伤的临床资料进行回顾性分析。结果135例闭合性肾损伤中,肾挫伤92例,肾裂伤24例,肾粉碎伤19例,并发伤38例。血尿、腰部疼痛是主要临床症状。保守治疗97例,超选择性肾动脉栓塞术3例,手术治疗30例,死亡5例。结论B超和CT检查是诊断肾损伤的有效方法。其治疗主要取决于肾脏伤情,保守治疗是重要的治疗方法。     

闭合性肾损伤的诊断与治疗

目的 总结闭合性肾损伤的诊断与治疗。方法 对125例闭合性肾损伤患者的临床资料进行回顾性分析。结果 125例闭合性肾损伤患者中，肾挫伤75例、肾裂伤41例、肾粉碎伤9例，其中并发伤70例。血尿和腰部疼痛是主要的临床症状。保守治疗93例，手术治疗32例，无死亡病例。结论 B超和CT检查是诊断闭合性肾损伤安全有效的方法。对伤情作出快速而准确的评估。及时严格掌握手术时机是治疗闭合性肾损伤的关键。     

58例肾损伤的诊治分析

目的探讨肾损伤的诊断与治疗。方法对2007年9月至2010年3月对58例闭合性肾损伤临床资料进行回顾性分析,其中合并伤19例(32.7%),据CT和B超及手术证实:肾挫伤20例,肾挫裂伤34例,肾横断伤4例。保守治疗48例,手术治疗10例。结果肾损伤均有不同的外伤史,临床表现中休克发生率29.3%,血尿为86.4%,腰痛93.5%,CT阳性率为97.2%,B超阳性率92.1%,治愈率100%,平均住院时间21d。结论闭合性肾损伤诊断一般并不困难,受伤后有血尿及腰痛,CT检查不但能迅速、准确地确定诊断,而且能明确显示肾损伤的类型及范围。治疗关键取决于病情:肾挫伤、轻度撕裂伤一般可通过保守治疗治愈,对较严重的裂伤,尽量采用保守治疗,动态观察病情变化。肾碎裂伤应紧急手术探查。     

闭合性肾脏损伤59例诊治分析

目的：总结闭合性肾脏损伤的诊断和治疗。方法：59例闭合性肾脏损伤中，肾挫伤28例，肾裂伤23例，肾粉碎伤6例，合并有并发伤14例。保守治疗44例，手术治疗15例，死亡3例。结果：本组治愈56例，死亡4例，均为并发其他脏器损伤并顽固性休克者。结论：血尿、腰部疼痛是闭合性肾脏损伤的主要临床症状，CT和B超检查是诊断肾损伤的有效方法。以CT检查结果进行分类肾脏损伤可以有效地指导临床治疗。准确的病情判断、严格掌握手术时机是治疗闭合性肾脏损伤的关键。     

122例闭合性肾损伤的观察及护理

肾损伤病人视病情选择保守治疗或手术治疗,采取何种处理方法取决于对病人病情及时、准确的评估及诊断[1]。现对本院2008年7月—2011年9月收治的122例闭合性肾损伤病人的临床资料进行回顾分析。1临床资料1.1一般资料122例闭合性损伤病人中,肾挫伤86例,肾裂伤28例,肾粉碎伤8例;合并其他脏器或组织损伤63例;肉眼     

闭合性肾外伤的B型超声诊断

闭合性肾外伤的Ｂ型超声诊断邮政编码３６５１００福建省尤溪县医院Ｂ超室徐诚本文报告超声诊断闭合性肾外伤１２例，其中肾挫伤和肾部分小裂伤各２例均经超声定位在肾周穿刺抽出血性脓液；８例肾破裂伤均经手术证实。Ｂ型超声诊断闭合性肾外伤在声像图上具有一定的特征，...     

经腹彩色多普勒超声在宫颈浸润癌诊断中的临床应用

目的探讨经腹彩色多普勒超声(TA-CDUS)在宫颈浸润癌诊断中的临床应用价值。方法应用TA-CDUS对83例宫颈浸润癌进行诊断,观察癌组织有无侵犯周围脏器和侵犯周围脏器的范围及程度,并与手术病理、CT扫描、膀胱镜和结肠镜检查对照。结果83例宫颈浸润癌全部经病理证实。超声检出81例,检出率97.6%(81/83),未检出2例,占2.4%(2/83)。超声检出癌组织未侵犯周围脏器36例,占44.4%(36/81),术后符合35例,占97.2%(35/36);有癌组织侵犯周围脏器45例,占55.6%(45/81)。TA-CDUS具有典型的声像图特征。结论TA-CDUS能对宫颈浸润癌进行诊断,并能观察侵犯周围脏器的范围及程度,具有较高的临床应用价值。     

高、低频超声诊断肝包膜下小肿块的对比研究

目的探讨高、低频超声对肝包膜下小肿块的诊断价值。方法对23例24个直径0．9～2．2cm的肝包膜下小肿块进行高、低频超声的灰阶超声和彩色多普勒超声分析、诊断，病例均经螺旋CT、病理等证实。结果对肿块边界、包膜、内部回声的观察及血流检出方面高频超声明显优于低频超声，低频超声的诊断符合率58％，高频超声的诊断符合率92％。结论对肝包膜下小肿块的超声诊断，使用高频超声可明显提高诊断率。     

实时灰阶谐波超声造影诊断血管疾病的初步研究

目的：评价实时灰阶谐波超声造影对血管疾病的诊断价值。方法：各类血管疾病患者73例，均接受常规彩色多普勒超声与灰阶谐波造影检查，两种方法的检查结果分为：①不能得到诊断结果；②可疑诊断；③诊断明确。所有结果均经过DSA、CT及MRI检查证实。结果：常规彩色多普勒超声诊断明确的有50．7％（37／73），可疑诊断占38．4％（28／73），不能得到诊断结果的有10．9％（8／73）。结合灰阶谐波造影检查后明确诊断的有89．0％（65／73），可疑诊断有8．2％（6／73），不能得到诊断结果的有2．8％（2／73）。常规彩色多普勒超声诊断的敏感性95．7％（45／47），特异性27．8％（5／18），准确性76．9％（50／65）；谐波造影诊断的敏感性98．0％（50／51），特异性95．0％（19／20），准确性97．2％（69／71）。结论：应用实时灰阶谐波超声造影能够比较直观地反映血管流道及管壁的变化，没有角度依赖性，不存在溢出等伪像，有助于对血管疾病的诊断。     

Intrarenal color duplex ultrasonography: a window to vascular complications of renal transplants.

OBJECTIVE: We analyze and discuss the importance of intrarenal color duplex ultrasonography (CDUS) in the diagnosis and differential diagnosis of vascular complications in renal transplants. METHODS: We retrospectively reviewed results of CDUS, especially intrarenal CDUS, in 102 consecutive inpatients with vascular complications of renal transplants from January 1, 2000, to December 31, 2006. Correlations between CDUS and magnetic resonance angiography, digital subtraction angiography, surgical findings, and clinical diagnoses were studied. RESULTS: Abnormal findings on intrarenal CDUS clearly represent vascular complications primarily located at the main renal vessels and intrarenal vessels. In our study, there were 5 cases of false-negative intrarenal arteriovenous fistulas, 1 case of false-positive transplant renal vein thrombosis, and 2 cases of false-negative transplant renal artery stenosis. The accuracy of detecting vascular complications of renal transplants with CDUS was 92% (94/102). CONCLUSIONS: Intrarenal CDUS is a noninvasive, accurate diagnostic tool that can be administrated portably and is easily repeatable, thereby making it not only a highly valuable imaging technique but also the method of choice in screening and diagnosing vascular complications of renal transplants.     

闭合性肾损伤合并胸外伤79例临床诊治分析

目的探讨闭合性肾损伤合并胸外伤的致伤原因以及诊治特点。方法回顾性总结79例闭合性肾损伤合并胸外伤患者的临床诊断和抢救治疗措施。结果闭合性肾损伤合并胸外伤发生率较高,占同期闭合性肾损伤患者的39.9%(79/198)。且该类患者往往有相似的致伤原因。79例闭合性肾损伤合并胸外伤患者胸外伤的不同受伤方式与损伤类型的比较,差异有统计学意义(χ2=15.9488,P<0.05)。而CT对于胸外伤检出率分别与临床诊断比较(χ2=25.4432,P<0.01)、与X线比较(χ2=15.0176,P<0.01),差异均有极显著意义。79例中,闭合性肾损伤保守治疗75例,手术治疗4例;胸外伤中血气胸23例,行胸腔闭式引流术者12例。本组患者均有较好转归。结论闭合性肾损伤患者较常见合并胸外伤,绝大多数经CT检查可明确,需引起重视。早期发现和处理合并胸外伤,对于病情诊断、治疗抢救均有重要意义。     

肺实变的超声特征及其诊断价值

目的探讨肺实变的超声特征及其诊断价值。方法对125例实变肺的二维及彩色多普勒超声表现进行回顾性对比分析。结果含气或含液管状结构以及分支状血流信号是超声诊断肺实变的重要特征。彩色多普勒超声显示实变肺内血流信号有较高敏感性（92．7％），对含气或含液管状结构和肿块的检出率也高于灰阶超声，差异有显著性（P〈0．05）。超声在确定肺实变方面优于X-线检查（P〈0．005），与CT相比差异无显著性（P〉0．05）。结论彩色多普勒超声在肺实变的诊断中优于灰阶超声，是对X-线、CT等其他影像方法的一个很好补充。     

The renal resistive index as a predictor of acute hydronephrosis in patients with renal colic

IntroductionThe objective of this study was to determine whether the renal resistive index (RI) can predict hydronephrosis in patients with renal colic (RC) and whether or not its performance is time-dependent.Materials and methodsThe study population was composed of 54 patients admitted for unilateral RC. At the time of the first observation (time point I, tpI), each patient underwent routine examinations, abdominal ultrasonography, and renal color Doppler ultrasound (CDUS) with measurement of the RI. The two imaging studies were repeated 6, 12, 18, 24, 36, and 48 h later (tpII, tpIII, tpIV, tpV, tpVI, tpVII). In addition, each patient underwent non-contrast urinary tract CT 48–60 h after admission. A mean renal RI of >0.70 (mRI+) for the symptomatic kidney was considered indicative of obstruction. Patients were retrospectively divided into two groups: those who developed dilatation (group A) and those who did not (group B).ResultsA mRI+ on CDUS predicted the onset of hydronephrosis with 100% sensitivity, 84% specificity, 92.6% accuracy, PPV and NPV of 87.9% and 100%, and diagnostic efficiency of 84%. In group A, mRI+ were always observed before onset of hydronephrosis in a time-dependent manner. In group B, mRI+ were observed occasionally in 4/25 patients (16%) and all were recorded at tpII. In these cases, the RI had returned to normal by tpIII.ConclusionsIn our RC patients, renal RI obtained with CDUS predicted the onset of acute dilatation with higher sensitivity, specificity, accuracy, and diagnostic efficiency than ultrasonography, and it can be used routinely in the emergency department to supplement ultrasound findings.     

腹部创伤定点超声检查对急诊腹部闭合性创伤的临床诊断价值

[目的]探讨腹部创伤定点超声检查(FAST)对急诊腹部闭合性创伤的临床诊断价值.[方法]选择2015年6月至2016年8月经本院急诊科收治的200例腹部闭合性创伤患者的临床资料,所有患者先行FAST检查,待生命体征平稳后,再前往CT室行腹部CT检查.将两种诊断结果与临床实际手术结果进行对比,分析两种检查方法的诊断时间及检出率.[结果]FAST检查结果在肝破裂、肾损伤、脾破裂、腹膜出血检查符合率为86.49%、88.24%、85.92%、73.91%,FAST+CT联合检查符合率为97.30%、97.10%、97.10%、95.65%,FAST检查符合率与FAST+CT联合检查相比,在肾损伤及腹膜出血方面的诊断检查符合率差异具有统计学意义(P<0.05).FAST诊断所用时间为(4.12±0.85)min明显短于CT诊断(26.13±1.27)min,差异有统计学意义(P<0.05);FAST检查对腹部损伤诊断的检出率为85.00%(170/200),漏诊率为0,FAST+CT联合检查对腹部损伤诊断的检出率为96.00%(192/200),漏诊率为0,两种检查方法的检出率比较差异具有统计学意义(χ2=14.0739,P=0.0002<0.05).[结论]FAST超声检查其作为急诊科常见检查设备,诊断具有用时较短,且检出率高的优点,操作简单便于使用,在其基础上联合CT检查,可以进一步提高腹部创伤的检出情况,临床应用价值较高.     

Diagnosis of Gastric Varices and Evaluation of the Effectiveness of Treatment Using Transabdominal Color Doppler Ultrasonography

Objective. The aim of this study was to evaluate the hemodynamics of gastric varices using transabdominal color Doppler ultrasonography (CDUS). Methods. Using CDUS, we evaluated 41 consecutive patients with gastric varices. We examined color flow images and measured the velocity of gastric variceal blood flow using fast Fourier transform analysis. In addition, we compared detection rates of gastric varices and their outflow vessels using CDUS and computed tomography (CT). Results. Gastric varices were detected with CDUS in 41 of 41 patients (100%), and outflow vessels were detected in 34 (82.9%). Of these, 32 were gastrorenal shunts (GRSs), and 2 were GRSs and subphrenic veins. The velocity of the large and coil‐shaped varices (mean ± SD, 23.0 ± 5.8 cm/s; n = 13) was significantly higher than that of the enlarged and tortuous varices (14.1 ± 4.3 cm/s; n = 28; P < .001). With CT, gastric varices were detected in 41 of 41 patients (100%), and outflow vessels were detected in 38 (92.7%). Color Doppler ultrasonographic and CT findings were in complete agreement in 35 of 41 patients (85.4%). A total of 11 patients with a high risk of variceal rupture underwent balloon‐occluded retrograde transvenous obliteration, and CDUS and CT findings after treatments were consistent. Conclusions. Transabdominal CDUS is a useful noninvasive modality for the diagnosis of gastric variceal hemodynamics and for evaluation of the therapeutic effects of gastric variceal treatment.     

Accuracy of sonography for detecting renal stone: comparison with CT

PURPOSE: To determine the diagnostic accuracy values of sonography in the detection of renal stones using noncontrast CT as the gold standard. In addition, we correlated the accuracy of sonography with stone size, the kidney affected (right versus left), and body mass index (BMI). METHODS: Fifty patients underwent 2 separate sonographic examinations performed by 2 radiologists. CT scans were evaluated by another 2 radiologists, and the diagnosis was made by consensus. We compared the sonograms and CT scans and the sonographic detection of stones in the left and right kidneys. All sonographic findings were correlated with the BMI groups. RESULTS: The sensitivity of sonography for any stone in a patient was 52-57% for the right kidney (radiologist 1 and 2) and 32-39% for the left kidney (radiologist 1 and 2). The overall accuracy of sonography in detecting a stone in the right kidney by radiologists 1 and 2 was 67% and 77%, respectively. The corresponding accuracy values for the left kidney were 53% and 54%, respectively. CONCLUSION: Sonography is of limited value for detecting renal stones. The sonographic detection of a renal stone is dependent on the side of the kidney involved but is independent of BMI.