超声自然组织谐波成像在胆囊隆起样病变中的应用方法探讨

目的:探讨超声自然组织谐波成像在胆囊隆起样病变中的应用。方法:采用Philip非凡彩色多普勒显像仪配有组织谐波成像技术,探头基波频率为2.0～5.0MHz变频探头,基波频度为3.5～5.0MHz,谐波频率为4.2～5.0MHz对患者胆囊检查,观察胆囊壁清晰度、胆囊隆起样病变数目、大小等改变。结果:检测87例中,31例在基波状态下,胆囊壁粗糙显示不清,改用二次谐波后胆囊壁显示清晰,并发现病变基波清晰显示率为64.3%,而二次谐波清晰显示率可达100%;另35例基波检查可疑胆囊底部病变,即基波清晰显示率为40.2%,二次谐波显示率达100%。结论:谐波成像技术中自然组织谐波(NTHI)对胆囊隆起样病变检查的应用,有利于提高对胆囊隆起样病变的诊断率。     

组织谐波显像在CK评价冠心病室壁运动中的应用

目的 :观察组织谐波显像 (THI)在彩色室壁运动技术 (CK)评价冠心病室壁运动中的作用。材料和方法 :冠心病二维图像质量好者 15例 (A组 )和欠佳者 16例 (B组 ) ,分别在基波 (FI)和谐波 (HI)显像下采集二维和CK图像 ,比较心内膜显示、CK图像采集率和质量以及评价室壁运动的准确性 (CK图像参数 )。结果 :A组后、侧、前壁和心尖部心内膜显示HI优于FI,但CK图像参数无差异。B组HI下心内膜显示和CK图像参数均显著好于FI。结论 :THI能显著改善声窗欠佳者二维图像心内膜显示 ,提高CK评价室壁运动的准确性 ,增加了CK的临床适用性     

组织谐波显像在CK冠心病室壁运动中的应用

目的观察组织谐波显像(THI)在彩色室壁运动技术(CK)评价冠心病室壁运动中的作用。材料和方法冠心病二维图像质量好者15例(A组)和欠佳者16例(B组),分别在基波(FI)和谐波(HI)显像下采集二维和CK图像,比较心内膜显示、CK图像采集率和质量以及评价室壁运动的准确性(CK图像参数)。结果A组后、侧、前壁和心尖部心内膜显示HI优于FI,但CK图像参数无差异。B组HI下心内膜显示和CK图像参数均显著好于FI。结论THI能显著改善声窗欠佳者二维图像心内膜显示,提高CK评价室壁运动的准确性,增加了CK的临床适用性。     

放射性核素骨显像对骨肿瘤样病变的影像学研究价值

骨肿瘤样病变是在病理、影像及临床表现上与骨肿瘤相似的一类疾病.放射性核素骨显像能够比较清楚地显示全身骨骼的形态及骨骼的血液供应和代谢情况,可以早期发现骨代谢的异常,灵敏度高于其他检查.目前关于骨肿瘤样病变的影像学资料以X射线、CT及MRI多见,该文拟对放射性核素骨显像对骨肿瘤样病变的诊断价值进行综述,旨在初步形成系统认识,以帮助临床医师提高对此类疾病的诊断水平.     

胆系结石的超声显像诊断

本文对超声显像诊断经手术证实的432例胆系结石进行了分析,总结了如何提高结石显现率的体会。认为：1．B超声的显像检查简便易行,显像率高,可做为胆系结石检查的首选方法;2．胆系结石可分为：①典型胆囊结石;②胆囊充满型结石;③胆囊泥砂样结石;④胆囊颈部结石;⑤胆囊嵌顿型结石;⑥肝内胆管结石;⑦肝外胆管结石;⑧胆系多发性结石八种类型。3利病人的体位变化,探头方向和角度的变化以及仪器前后场增益的调节等方法可提高胆系结石的显现率。     

骨显像对强直性脊柱炎的早期诊断价值

目的研究放射性核素骨显像对强直性脊柱炎(AS)早期诊断的价值.方法早期与可疑AS患者和对照组均行全身、局部及断层骨显像,测定骶髂关节/骶骨(SI/S)的放射性比值.结果早期与可疑AS患者的SI/S比值分别为1.53±0.11和1.57±0.10,与对照组(1.21±0.10)比较,差异均有显著性(t分别为11.9和15.0,P均<0.01).全身骨显像显示的5例AS患者腰椎及外周关节的病变X线平片均未能发现;AS患者椎骨断层显像可准确判断病变位置,还可发现平面显像不能显示或可疑的椎骨异常浓聚灶.结论放射性核素骨显像测定SI/S比值发现早期AS较X线平片灵敏;全身骨显像及断层显像对了解AS病变部位有明显优势.     

膀胱癌术后复发患者行^18F-FDGPET显像的1例报告

^18F-FDG是通过泌尿系排泄的，膀胱内是高浓聚区，因此^18F-FDG显像对于膀胱癌的诊断价值较差，但显像前做一下处理，对膀胱癌的诊断是有很大帮助的。现对1例膀胱癌术后患者行^18F-FDGPET全身显像谈一下显像经过。     

^99Tc-Sandostatin诊断高表达生长抑素受体的胰腺癌的实验研究

胰腺癌发病率在全身各恶性肿瘤中仅次于肺癌、肠癌和乳腺癌,占第4位.胰腺癌早期诊断困难,常用的影像学检查改变不明显.本研究自制99mTc-Sandostatin对荷胰腺癌裸鼠模型行SSR显像,探讨99mTc-Sandostatin显像诊断胰腺癌的可能性及与肿瘤组织SSR表达水平的关系.     

彩色多普勒超声与99mTC核素SPECT显像鉴别良恶性甲状腺结节的价值分析

目的 分析高频彩超与核素显像检查甲状腺良恶性结节的影像特征,比较两者的优缺点,探讨两者联合应用的诊断价值.方法 对68个甲状腺结节的彩超与核素检查结果对照病理进行回顾性分析.结果 两种影像学检查方法都可以显示甲状腺的形态、位置、大小.68个结节,超声全部查出,核素扫描只能显示54个.超声对甲状腺结节的大小、结构及血流清晰的显示独具优势,尤其是小于1cm的结节、钙化及颈部淋巴结超声显示清晰,而核素则无法显示.核素显像可以反应甲状腺摄锝功能,通过“冷热温凉”的特性来判断结节的性质,特别是利用血流灌注显像或亲肿瘤显像可进一步区分结节的良恶性,本组病例超声诊断符合率86.7％;14例做了动态血流灌注显像,其诊断符合率为75％;38例“冷凉”结节均做了亲肿瘤显像,其诊断符合率为90.9％;二者结合诊断符合率提高为92.3％.超声难以显示甲状腺功能状态.超声表现的囊、实性结节和核素显示的“冷热温凉”特性之间无统计学意义.结论 彩超与核素两种影像学检查方法各有特点、优势和不足,结合使用可进一步提高甲状腺良恶性结节鉴别的准确率.     

99mTc-Sandostatin诊断高表达生长抑素受体的胰腺癌的实验研究

胰腺癌发病率在全身各恶性肿瘤中仅次于肺癌、肠癌和乳腺癌,占第4位.胰腺癌早期诊断困难,常用的影像学检查改变不明显.本研究自制99mTc-Sandostatin对荷胰腺癌裸鼠模型行SSR显像,探讨99mTc-Sandostatin显像诊断胰腺癌的可能性及与肿瘤组织SSR表达水平的关系.     

急性尿路梗阻及尿路梗阻性肾周围炎的影像学研究

目的：分析急性尿路梗阻的原因及由尿路梗阻引起的肾周围炎的 CT、MR 影像表现,评价 CT、MR 对尿路梗阻及尿路梗阻性肾周围炎的诊断价值。方法分析72例急性尿路梗阻的原因及尿路梗阻性肾周围炎 CT、MR 表现,着重探讨 CT、MR 在输尿管结石及肾周围炎诊断中各自的优势。结果70例(72个部位)输尿管结石患者中,CT 诊断结石准确率为100%,MR 诊断结石准确率为59.7%;72例肾周围炎患者中,MR 对肾周软组织内积液的显示明显优于 CT。结论CT、MR 在尿路梗阻及尿路梗阻性肾周围炎诊断中各有优势,CT 对输尿管结石的诊断有明显的优势,MR 对肾周围炎诊断有明显优势。     

Contrast-enhanced harmonic imaging for the diagnosis of vesicoureteral reflux in pediatric patients.

OBJECTIVE: Harmonic imaging using phase or pulse inversion technology is a new sonographic diagnostic modality that has the potential to produce images of a higher quality than can be obtained with the conventional method. The aim of this study was to compare both types of harmonic modalities--tissue and contrast harmonic imaging--with the fundamental imaging mode in contrast-enhanced B-mode sonographic diagnosis of vesicoureteral reflux. SUBJECTS AND METHODS: Fifty-four children presenting for diagnostic examination of vesicoureteral reflux underwent standard sonography of the urinary tract in the fundamental mode, followed by intravesical administration of a galactose-based contrast medium containing microbubbles. The contrast-enhanced sonography was conducted by scanning the bladder and each kidney in transverse and longitudinal planes, from ventral and dorsal views, consecutively in B-mode using fundamental, contrast harmonic, and tissue harmonic imaging modalities. Soft-touch buttons on the console screen were used to alternate between the three imaging options, so that switching from one modality to the other could be done almost instantaneously. For comparison, in each patient, we selected one set of contrast-enhanced images of the bladder and two sets, one ventral and one dorsal, of the kidney. In a series, the images were compared and ranked from 1 to 3, with 1 being the best, with regard to sonomorphology (demarcation of the retrovesical space and renal pelvis as the potential sites to look for vesicoureteral reflux) and reflux detection and conspicuity, if present. RESULTS: In all, 248 sets of images were available for comparison. The delineation of both the retrovesical space and the renal pelvis was found to be best with tissue harmonic imaging in 84% and 96% of the image sets, respectively (p < 0.01). Forty-one sets of images were compared from 27 kidney-ureter image units of 22 children (41%) with reflux. The refluxing microbubbles were much more conspicuous in the harmonic imaging mode (tissue harmonic, 100%; contrast harmonic, 93%) than in the fundamental mode (p < 0.01). In eight kidney-ureter units, the reflux was detected only by using the harmonic imaging modalities. CONCLUSION: Visualization of the urinary tract and detection of ultrasound contrast media is significantly improved by the use of the harmonic imaging modalities. When both fundamental and harmonic imaging options are available, we recommend harmonic imaging for contrast-enhanced sonographic diagnosis of vesicoureteral reflux.     

分离团注单期成像技术在MSCT泌尿系成像中的应用价值

目的 探讨分离团注单期成像技术在MSCT泌尿系疾病检查中的可行性及临床应用价值.方法 选取我院临床资料完整的泌尿系疾病患者60例,按不同扫描方法分为A、B两组各30例,A组采用常规平扫、皮质期(20 ～ 30 s)、髓质期(55 ～60 s)、排泄期(5～15 min)扫描;B组采用平扫、分离团注一次扫描;应用VR、M...     

MRU在泌尿系梗阻性疾病中的临床应用价值

评价磁共振尿路造影（ＭＲＵ）对泌尿系梗阻性疾病的临床应用价值。材料和方法：采用快速自旋回波（ＦＳＥ）重Ｔ２加权序列对７０例患者进行泌尿系冠状位扫描,将图像按最大强度投影（ＭＩＰ）法重建出ＭＲＵ图像。经手术和病理证实为尿路梗阻者２４例,其中尿路结石１２例,尿路先天性梗４例,输尿管炎性狭窄３例,炎性息肉２例（其中１例为炎性息肉伴输尿管结石）,其他４例。结果：各例的ＭＲＵ均汪晰显示梗阻的尿路,对肾盂积水     

三聚氰胺致儿童泌尿系结石的临床与影像

目的：探讨食用含三聚氰胺奶粉儿童的泌尿系结石的临床特点和影像学特征。方法：回顾性分析8例儿童泌尿系结石的临床和影像学资料。结果：患儿均有明确食用含三聚氰胺奶粉史,其临床表现主要为不同程度哭闹、发热、呕吐、尿少、尿频、血尿等。8例中有7例患儿年龄〈3岁,占同组患儿的87.5%。B超及CT均可发现结石,单发结石1例,多发结石7例。但在腹部X线平片上结石不显影。结论：食用含三聚氰胺奶粉可引起儿童泌尿系统结石,临床症状无特异性,发病年龄偏小,但结石影像表现具有一定特点。     

组织谐波成像技术在壶腹周围梗阻的应用价值

目的探讨组织谐波成像技术在壶腹周围梗阻的应用价值。材料与方法对50例壶腹周围梗阻病人用组织谐波成像技术进行检查,作组织谐波成像前后声像图对比。结果组织谐波成像技术能明显减少壶腹周围胃肠气体干扰,病灶周围噪声明显减少,增强病灶界面回声,图像更均匀清晰,应用组织谐波成像前后,定性诊断符合率分别为74％、92％(P＜0．025,)X2=5．25)。结论组织谐波成像对壶腹周围梗阻定位、定性诊断较组织谐波成像前有明显提高。     

能谱CT有效平均原子序数对离体尿路结石成分分析的前瞻性研究

目的探讨能谱CT瞬时双能成像技术预测尿路结石成分准确性的意义。方法选择本院开放手术或腔内碎石、体外震波碎石收集的结石,经气相色谱仪分析后,分别埋入猪肾中,采用美国GE公司能谱CT(D iscovery CT 750HD)机,分别扫描,进行能谱分析,获取平均有效原子序数值并计算结石成分分析的准确率。结果本组60枚离体尿路结石能谱CT有效平均原子序数:一水草酸钙结石为14.3、二水草酸钙结石为14.51、磷酸钙结石为16.14、磷酸氢钙结石为14.12、尿酸结石为6.92、磷酸胺镁结石为8.49、胱氨酸结石为10.21,互相之间差异性均较明显。结论 能谱CT测定结石平均有效原子序数可以较准确判定结石化学成分。     

Value of tissue harmonic imaging (THI) and contrast harmonic imaging (CHI) in detection and characterisation of breast tumours

The purpose of this study was to investigate the extent to which tissue harmonic imaging (THI), speckle reduction imaging (SRI), spatial compounding (SC) and contrast can improve detection and differentiation of breast tumours. We examined 38 patients (14 benign, 24 malignant tumours) with different combinations of THI, SRI and SC. The effect on delineation, margin, tissue differentiation and posttumoral phenomena was evaluated with a three-point score. Additionally, 1oo not palpable tumours (diameters: 4–15 mm) were examined by contrast harmonic imaging (CHI) with power Doppler. After bolus injection (0.5 ml Optison), vascularisation and enhancement were observed for 20 min. The best combination for detection of margin, infiltration, echo pattern and posterior lesion boundary was the combination of SRI level 2 with SC low. THI was helpful for lesions OF more than 1 cm depth. In native Power Doppler, vessels were found in 54 of 100 lesions. Within 5 min after contrast medium (CM) injection, marginal and penetrating vessels increased in benign and malignant tumours and central vessels mostly in carcinomas (p<0.05). A diffuse CM accumulation was observed up to 20 min after injection in malignant tumours only (p<0.05). THI, SRI and SC improved delineation and tissue differentiation. Second-generation contrast agent allowed detection of tumour vascularisation with prolonged enhancement.     

Tissue harmonic and contrast-specific imaging: back to gray scale in ultrasound

The development of new US techniques that produce images based on nonlinear acoustic effects of US interaction with matter or microbubble contrast agents has opened new prospects for gray-scale US in native tissue and contrast imaging. Tissue harmonic imaging uses higher frequencies generated on propagation of the US beam through matter to improve image quality and resolve small anatomic structures and details, and is becoming a routine approach in US examination of many abdominal districts. Contrast-specific imaging techniques display enhancement of US agents in gray-scale with optimal contrast and spatial resolution, and offer high sensitivity either to microbubble movement or to microbubble destruction in dependence of the level of the applied acoustic peak pressure. Owing to the ability to exploit the microcirculation, contrast-specific techniques have enabled the evolution of contrast US from vascular imaging to the imaging of perfused tissues. Several studies have shown that these methods can substantially improve US detection and characterization of focal liver lesions, and promising results have been reported in other areas of investigation. This article reviews physical principles, technical issues, and clinical applications of tissue harmonic and contrast-specific imaging. It is foreseen that the new gray-scale US techniques will rapidly become a tool in numerous clinical scenarios.     

含三聚氰胺问题奶粉致泌尿系结石影像表现

目的：探讨含三聚氰胺问题奶粉致泌尿系结石的影像学特点。方法：回顾性分析620例有服用问题奶粉喂养史婴幼儿的影像学资料,对其中48例患有泌尿系结石患儿（总计82个部位）的影像学资料进行描述性分析。按检出部位计算,用优势比（OR值）来评价MSCT与B超结石的检出效果。结果：本组48例患儿均行B超,10个部位未检出,检出率88%;28例患儿行肾尿路平片（KUB）,结石均未检出,检出率0%;43例行MSCT,结石均检出,检出率100%。B超与MSCT在统计学上部位的检出率没有显著差异。结论：有服用问题奶粉喂养史婴幼儿泌尿系结石大部分为X线阴性结石,筛查首选B超检查,MSCT是诊断该疾病的有效补充,应根据患儿具体情况合理选择影像学检查方法。