乳头状肾癌和嫌色细胞癌的超声造影表现

目的 探讨超声造影在乳头状肾癌和嫌色细胞癌中的表现.方法 对22例22个经手术病理证实为乳头状肾癌和嫌色细胞癌的常规超声及超声造影声像图进行回顾性分析.常规超声观察肾占位大小、回声、边界、有无彩色血流信号.超声造影观察病灶的增强方式和增强时相,包括起始时间、达峰值时间、消退时间及病灶内部结构的增强表现.结果 本组22个肾占位经手术和病理证实乳头状肾癌13个和嫌色细胞癌9个.22个肿块最大直径范围1.1～14.2 cm,常规超声显示实质性肿块17个,囊实性肿块5个;18个病灶内发现彩色血流信号,4个未显示彩色血流信号.超声造影显示22个病灶均见增强,同步增强13个,缓慢增强9个,其延迟时间2～4 s,达峰值和实质期增强程度始终低于肾皮质;实质期快速消退16个,同步消退6个,共11个肿块周边显示假包膜.结论 缓慢增强和全期低增强对诊断乳头状肾癌和嫌色细胞癌有较大的帮助.     

超声显像诊断肾细胞癌34例分析

目的分析肾细胞癌(RCC)的超声表现及特征,评价超声对其的诊断价值。方法对34例经手术病理证实的肾细胞癌患者的超声声像图进行回顾性分析。结果肾细胞癌超声表现多为边界较清晰的均匀低回声及等回声团块,小肾癌(直径≤3 cm)可表现为高回声或等回声,肿块周边及内部血流信号丰富,可测及低阻血流信号。结论超声对肾细胞癌有很高的诊断价值,是早期发现肾细胞癌的首选检查方法。     

肾细胞癌超声表现分析

目的 分析肾细胞癌（RCC）的超声表现及特征，评价超声对其的诊断价值。方法对2004年1月～11月经手术病理证实的25例肾细胞癌患者的超声声像图进行分析。结果肾细胞癌超声表现多为边界较清的均匀低回声及等回声团块，小肾癌（43cm）可表现为高回声或等高回声。肿块周边及内部血流信号多丰富，可测及低阻血流信号。结论随着超声新技术的应用，超声是早期发现肾细胞癌的较有效方法。     

超声造影在肾细胞癌亚型鉴别诊断中的价值

目的探讨超声造影在肾细胞癌亚型鉴别诊断中的应用价值。方法 2004年6月至2010年2月常规超声和超声造影检查343例肾细胞癌患者346个病灶,均经手术及病理证实。常规超声观察肿瘤的大小、回声、边界、有无彩色血流信号、血管位置等。超声造影观察病灶的增强方式和增强时相,包括起始时间、达峰时间、消退时间及病灶的增强表现。结果经手术和病理证实304个病灶为透明细胞肾癌,23个为乳头状肾癌,19个为嫌色细胞肾癌。不同亚型肾细胞癌常规超声表现没有明显差异。不同亚型肾细胞癌的增强时相差异无统计学意义(P>0.05)。透明细胞肾癌表现为皮质期同步增强、达峰值时呈高回声和等回声、实质期快速减退为主,而乳头状肾癌和嫌色细胞肾癌皮质期表现为同步增强和缓慢增强、达峰值时呈低回声和等回声、实质期以快速减退为主。乳头状肾癌与透明细胞肾癌比较,两组病灶皮质期、达峰值回声和实质期的表现差异有统计学意义(P均=0.000);嫌色细胞肾癌与透明细胞肾癌比较,两组病灶皮质期、达峰值回声和实质期的表现差异有统计学意义(P=0.000,P=0.000,P=0.001)。结论超声造影有助于肾细胞癌亚型的鉴别。     

超声造影联合多层螺旋CT鉴别诊断肾嫌色细胞癌与肾嗜酸细胞腺瘤的价值

目的 探讨超声造影联合多层螺旋CT在肾嫌色细胞癌与肾嗜酸细胞腺瘤鉴别诊断中的临床应用价值.方法 回顾性分析经手术病理证实的45例肾嫌色细胞癌和30例肾嗜酸细胞腺瘤患者的检查资料,比较其常规超声、超声造影及多层螺旋CT检查情况.绘制受试者工作特征(ROC)曲线分析超声造影、多层螺旋CT单独及联合应用对肾嫌色细胞癌与肾嗜酸...     

超声造影对肾细胞癌的鉴别诊断价值

目的 应用新型超声造影剂声诺维(SonoVue),观察肾细胞癌超声造影灌注特征,对肾细胞癌进行病理分型.方法 对42例肾细胞癌患者术前进行超声造影检查,观察造影剂开始显影、达峰及消退的全过程,分析时间-强度曲线值.结果 本组肾细胞癌中肾透明细胞癌31例,嫌色细胞癌6例,乳头状癌5例.28例肾透明细胞癌超声造影呈富血供表现,即快进慢退高增强的造影模式.本组嫌色细胞癌和乳头状癌及3例肾透明细胞癌呈乏血供表现.时间-强度曲线显示,肾透明细胞癌的到达时间、达峰时间明显快于肾嫌色细胞癌和乳头状癌,其峰值强度及消退强度也明显高于二者(P＜0.05).将肾细胞癌按其最大直径分为三组:小肿瘤(≤3 cm)、中等肿瘤(3～5 cm)、大肿瘤(≥5 cm).嫌色细胞癌超声造影全部呈均匀增强;乳头状癌小肿瘤组呈均匀增强,中肿瘤组呈不均匀性增强;肾透明细胞癌小肿瘤组以均匀增强为主,大肿瘤组全部为不均匀增强.结论 超声造影能够提供不同肾细胞癌微血管灌注特征,为肾细胞癌的分型、诊断及鉴别诊断提供更多的参考依据,有较高的临床应用价值.     

彩色多普勒超声对肾肿瘤鉴别诊断的价值

目的探讨彩色多普勒超声对肾脏肿瘤鉴别诊断的价值。方法对24例经手术及病理诊断的肾肿块声像图和彩色血流进行回顾性分析。结果24例中透明细胞肾癌18例；嫌色肾细胞癌1例；乳头状肾细胞癌1例；肾盂移行细胞癌1例；肾血管平滑肌脂肪瘤2例；出血性肾囊肿1例；均有手术及病理结果。结论彩色多普勒超声能显示各种肾肿瘤的声像图和血供特点，为临床诊断提供了重要价值。     

超声与多层螺旋CT对肾嗜酸细胞腺瘤及嫌色细胞癌的鉴别诊断价值

目的 探讨超声与多层螺旋CT对肾嗜酸细胞腺瘤及嫌色细胞癌的鉴别诊断价值。方法：回顾性分析经手术及病理证实的45例嫌色细胞癌和30例肾嗜酸细胞腺瘤临床资料,研究时间为2017年2月至2020年10月,均予以超声与多层螺旋CT检查,对比肾嗜酸细胞腺瘤与嫌色细胞癌的CT征象,观察平扫、皮质期、实质期、排泄期等时期的LKR值、△AT、△TTP、△PI,以及分析各期LKR值、△AT、△TTP、△PI、联合诊断的ROC曲线。结果 常规超声表现：肾嗜酸细胞腺瘤与嫌色细胞癌在病灶性质、回声、形态及边界比较中,差异无统计学意义(P＞0.05)。超声造影表现：肾嗜酸细胞腺瘤与嫌色细胞癌在增强方式、减退方式比较中,差异无统计学意义(P＞0.05); 肾嗜酸细胞腺瘤与嫌色细胞癌在峰值强度、增强均匀度、假包膜、△AT、△TTP、△PI比较中存在统计学意义(P＜0.05)。CT征象分析可见,肾嗜酸细胞腺瘤与嫌色细胞癌在星芒状瘢痕、均匀强化比较中存在统计学意义(P＜0.05); 肾嗜酸细胞腺瘤与嫌色细胞癌在囊变、坏死、钙化、包膜、轮辐状强化、节段性增强反转、出血所占比中差异无统计学意义(P＞0.05)。肾嗜酸细胞腺瘤与肾嫌色细胞癌的平扫LKR值比较,差异无统计学意义(P＞0.05);肾嗜酸细胞腺瘤皮质期、实质期及排泄期的LKR值高于肾嫌色细胞癌(P_均＜0.05)。ROC曲线分析显示,多层螺旋CT中平扫、皮质期、实质期、排泄期的LKR AUC值分别为(0.525、0.931、0.800、0.850,P＜0.05);△AT、△TTP、△PI的AUC值分别为(0.990、0.673、0.909,P＜0.05);联合诊断的AUC值为(0.955,P＜0.05)。结论 超声与多层螺旋CT在嫌色细胞癌诊断中均具有较高的预测价值,尤其是超声造影,能为肾嗜酸细胞腺瘤和嫌色细胞癌的鉴别提供重要信息,但为了避免漏诊情况发生,建议上述两种方法临床联合诊断。     

肾细胞癌超声造影与病理对照分析研究

目的：应用新型超声造影剂SonoVue观察肾细胞癌超声造影血流灌注特点,术后分析其病理特点。方法：对42例肾细胞癌患者术前进行超声造影检查,观察造影剂开始显影、达峰及消退的全过程,并用ACQ软件分析时间-强度曲线数值。结果：28个肾透明细胞癌超声造影呈富血供表现,时间－强度曲线分析显示透明细胞癌的ΔAT、ΔTTP低于其他两组,其ΔPI和ΔI60s明显高于其他两组,即“快进慢退高增强”的造影模式。另外3个肾透明细胞癌及所有的嫌色细胞癌和乳头状癌呈乏血供表现,嫌色细胞癌和乳头状癌的AT、TTP慢于周边肾组织,PI和I60低于周边肾组织,呈“慢进低增强”的造影特点。结论：实时超声造影能够提供不同肾细胞癌微血管灌注特征,为肾细胞癌的诊断及鉴别诊断提供了更多的参考依据,有较高的临床应用价值。     

肾嫌色细胞癌5例报道

目的：探讨肾嫌色细胞癌临床病理特点和诊治方法。方法：回顾性分析5例肾嫌色细胞癌患者临床资料,复习文献并进行讨论。结果：4例行肾癌根治术,1例行肾脏肿物摘除术,术后病理证实为肾嫌色细胞癌。病理分期：pT1N0M03例,pT2N0M0 1例,pT4N0M0 1例。病理分级：G12例,G2 1例,G3 2例。随访1～13个月,5例均无瘤存活。结论：肾嫌色细胞癌是一种低度恶性的肾细胞癌,确诊有赖于典型病理表现,辅以影像学检查,治疗以手术为主,预后较好。     

经直肠超声对前列腺外腺低回声病灶的鉴别诊断

目的 探讨经直肠超声（ＴＲＵＳ）对前列腺外腺低咽声病灶的鉴别诊断意义及其特点。方法 经ＴＲＵＳ发现周边区低回声病灶共１３４例,均经ＴＲＵＳ引导下活检获得病理结果,比较良,恶性病变的声像图特点。结果 前列腺外腺低回声恶性病变的特点包括外腺对称性消失,病灶边界模糊,累及前列腺包膜等。结论 ＴＲＵＳ检查前列腺外腺低回声病灶有助于鉴别诊断,有利于提高前列腺活检的效率。     

Interstitial fluid and hypoechoic wall: two sonographic signs of breast abscess

PURPOSE: Many mammographic and sonographic features of breast abscess overlap with those of carcinoma. We reviewed the usefulness of interstitial fluid and hypoechoic walls in the sonographic diagnosis of breast abscess. METHODS: The sonograms and records of 65 patients with breast infection and 60 contemporaneous patients with breast cancer were retrospectively reviewed. RESULTS: Of 49 abscesses identified in patients with breast infection, 14 (29%) had adjacent interstitial fluid that was sonographically visible, and 15 (31%) had a hypoechoic wall. No patients with breast cancer had either sign. The overall sensitivity of the presence of either sign was 55%, and the specificity was 100%. CONCLUSIONS: Two sonographic findings, interstitial fluid and a hypoechoic wall, are relatively specific for breast abscess and may aid in the diagnosis of breast disease.     

Suture granulomas: sonography enables a correct preoperative diagnosis

The purpose of this study was to examine if suture granulomas display distinct sonographic signs and if these signs enable an accurate preoperative diagnosis. In a retrospective and prospective study, the sonographic findings of 22 consecutive suture granulomas were investigated and correlated with subsequent operative results. The sonographic appearance of various surgical sutures in a water bath was also investigated. Sonography was performed with commercially available 5- to 13-MHz linear transducers. The sonographic findings of the suture granulomas included hypoechoic lesions in all cases and hyperechoic double or single lines within the hypoechoic lesions in 20 of 22 cases. Sonography enabled the correct preoperative diagnosis for the investigating radiologists in 20 cases. The sonographic appearance of sutures in a water bath was that of hyperechoic double or single lines. The sonographic signs of suture granulomas (hyperechoic double or single lines within hypoechoic lesions) indicate the correct preoperative diagnosis in a high percentage of cases.     

肉芽肿性小叶性乳腺炎超声表现

目的探讨肉芽肿性小叶性乳腺炎(GLM)的高频超声图像特征。方法对23例以乳腺包块就诊,经术前超声及手术病理证实为GLM患者的病例资料进行回顾性分析。在灰阶声像图上观察肿块大小、形状、边界、内部回声及后方回声。应用彩色多普勒血流成像(CDFI)观察病灶内部及其周围血流分布和供应情况。结果23例GLM患者(均经手术后病理证实)均为经产妇,年龄20～43岁。灰阶声像图显示12例表现为连续或不连续的不规则管状结构样低回声区,低回声区周围为高回声;5例表现为单发或多发、边界相对清楚、不均质低回声结节或肿块,其内可伴无回声区;5例表现为病变区腺体结构紊乱,未见明确边界,内部回声强弱不一,病变内可见无回声区;1例表现为边界模糊、形态不规则的低回声实质肿块伴后方回声衰减。23例中患处皮肤层增厚8例,6例伴有皮肤破溃,窦道形成。CDFI示22例(22/23)病变内部及周边动静脉血流信号明显增加。结论GLM病变的超声表现具有一定的特点,但这些表现不具有特征性,确诊仍需病理学检查。     

Roundworm obstruction: Sonographic diagnosis

We describe the sonographic findings in five pediatric patients with roundworm obstruction. All patients were referred with a clinical diagnosis of acute appendicitis. On ultrasonography (US), an individual worm, when viewed along its longitudinal axis, appeared as a hypoechoic tubular structure with well-defined, echogenic walls. Frequently, the individual body segments could be distinctly visualized. The alimentary canal of the worm was seen either as a single central echogenic line (when in a collapsed state) or as two parallel hyperechoic bands with a hypoechoic center (when distended). When examined transaxially, the individual worm resembled a target with its circular, echogenic body wall and its central dot-like alimentary canal. On prolonged scanning, the worms always showed curling movements. In two patients, a bolus of worms mixed with fecal matter and air produced an unusual appearance of a complex, echogenic mass (helminthoma). Although, an individual worm occasionally resembled an inflammed appendix, visualization of the alimentary canal and individual body segments along with its curling movements helped establish the correct diagnosis. All patients promptly responded to a hypertonic saline enema and no patient was subjected to surgery. Sonographic findings in roundworm obstruction are fairly characteristics to advocate the routine use of sonography for diagnosing this entity.     

肾上腺髓样脂肪瘤的超声诊断

目的 探讨肾上腺髓样脂肪瘤的声像图特点和超声诊断价值.方法 回顾性分析10例经病理证实的肾上腺髓样脂肪瘤患者超声表现,对病变的大小、包膜、内部回声特点及血流特点进行总结.结果 1例左肾上腺病变漏诊,其余9例的声像图特点为边界清晰,形态基本规则,内部呈均匀中等强回声或中等强回声与低回声相间,肿瘤内部未见无回声区,内部未测及血流信号.结论 肾上腺髓样脂肪瘤具有特征性的声像图表现,超声检查可作出正确诊断.     

Sonographic appearance of the submandibular glands in patients with immunoglobulin G4-related disease

Swelling of the salivary glands is often an initial sign of immunoglobulin G4 (IgG4)-related disease or IgG4-related sclerosing/autoimmune disease. We encountered 2 patients with IgG4-related disease who showed swollen submandibular glands with a unique characteristic sonographic pattern. Bilateral submandibular glands of both patients were enlarged with a smooth contour. The internal echo texture indicated multiple hypoechoic foci scattered against a heterogeneous background, which characteristically appeared with a mottled or irregular netlike appearance. A histopathologic examination of a resected section showed multiple foci of dense infiltrated lymphoplasmacytic cells and lymph follicles encircled by fibrous bands. A mottled appearance in the sonographic findings of the submandibular glands suggests the characteristic of IgG4-related disease and can be helpful in the differential diagnosis at the initial manifestation.     

Enthesopathy of the Lateral Cord of the Plantar Fascia

The objective of this study was to raise awareness of the diagnosis of enthesopathy of the lateral cord of the plantar fascia (LCPF) and describe its sonographic findings. We conducted a retrospective case series of 13 sonographic examinations with the diagnosis of LCPF enthesopathy. Two cadaver dissections of the plantar foot were performed for anatomic correlation. Sonographic findings of LCPF enthesopathy included generalized or focal hypoechoic thickening, loss of the normal fibrillar echo texture, cortical irregularity of the fifth metatarsal tuberosity, and vascularity on color Doppler imaging. Anatomic dissections of the plantar foot detailed the course of the LCPF and served as a guide for optimal sonographic imaging. Enthesopathy of the LCPF is an important etiology of nontraumatic pain at the base of the fifth metatarsal. Sonographic evaluation can readily show the characteristic findings of LCPF enthesopathy.     

Hurthle cell neoplasms of the thyroid: sonographic appearance and histologic characteristics

OBJECTIVE: The purpose of this study was to determine the sonographic features of Hürthle cell neoplasms (HCNs) of the thyroid. METHODS: We retrospectively analyzed the sonographic appearance of 15 histologically proven HCNs in 15 patients aged 16 to 70 years (mean age, 44 years). Sonographic features that were reviewed included the size and echogenicity of the tumors, the presence of cystic areas or calcifications, and detectable blood flow on color Doppler imaging. Correlation of sonographic findings with pathologic results was performed. RESULTS: The tumors ranged from 0.4 to 7 cm in diameter, but most were less than 3 cm in diameter. Four (27%) of the 15 tumors were homogeneously hypoechoic. Two tumors (13%) were predominantly hypoechoic with isoechoic areas to thyroid parenchyma. Two (13%) neoplasms were isoechoic to thyroid parenchyma. Four (27%) tumors were predominantly isoechoic, containing hypoechoic areas, and 3 (20%) tumors were hyperechoic. Three neoplasms contained cystic components. None of the tumors contained calcifications. One tumor was avascular on Doppler examination. One neoplasm showed only peripheral blood flow. Thirteen tumors showed internal vascularity, 7 of them with peripheral blood flow. Twelve HCNs were benign, and 3 were malignant on pathologic examination. CONCLUSIONS: Hürthle cell neoplasms show a spectrum of sonographic appearances from predominantly hypoechoic to hyperechoic lesions and from peripheral blood flow with no internal flow to extensively vascularized lesions. Pathologic criteria differentiating benign and malignant HCNs (absence or presence of a capsular breach, vascular or extrathyroidal tissue invasion, nodal involvement, and distant metastasis) are beyond the resolution of sonography and fine-needle aspiration biopsy and require removal of the entire lesion. This precludes diagnosis and characterization of HCNs by sonography.     

肉芽肿性小叶性乳腺炎的灰阶及彩色多普勒超声显像

目的回顾性分析肉芽肿性小叶性乳腺炎的灰阶和彩色多普勒超声表现，力求为这种少见的疾病提供诊断依据。方法12例手术病理证实的患者全部经过超声检查，先用二维观察肿块的部位、形态、大小等，再用彩色多普勒血流成像（CDFI）探测，按照Adler半定量方法进行血流分级，用频谱多普勒测量血管最高流速（PSV）、阻力指数（RI）、搏动指数（PI）。结果灰阶超声可分三型：（1）不规则低回声肿块，5例。（2）低回声结节，4例。（3）混合回声型，3例。CDFI探查，大部分病例病灶内血流较丰富；频谱测量，PSV8～22cm／s，平均（15±6）cm／s；P10．8～1．6，平均1．2±0．3；R10．51～0．79，平均0．65±0．14，测值范围较宽，无特异性。结论灰阶超声对肉芽肿性小叶性乳腺炎的诊断起着重要的作用，彩色血流显示较丰富，频谱分析未见明显的特异性。