二维及彩色多普勒超声诊断乳腺包块的临床价值

目的：探讨二维及彩色多普勒超声诊断乳腺包块的临床价值。方法应用高频探头对85例各种原因引起的乳腺包块进行检查,所有病例均经手术及病理证实,并与超声诊断对照分析。结果85例乳腺包块经病理证实良性者32例,二维＋多普勒超声准确诊断30例,诊断符合率为93．8％;恶性者53例,二维＋多普勒超声准确诊断50例,诊断符合率为94．3％,且无论良性或恶性,二维＋多普勒超声诊断符合率均较单纯二维声像图诊断率高。结论二维声像图结合彩色多普勒检查可大大提高诊断的正确率,对乳腺疾病的早期发现及良恶性鉴别具有重要意义。     

甲状腺结节的二维及彩色多普勒超声诊断研究

目的：探讨二维及彩色多普勒超声对甲状腺良、恶性结节的诊断及鉴别诊断价值。方法：120例甲状腺结节经二维超声了解其声像图表现，然后用彩色多普勒检查，观察结节内部及周边血流分布情况，并将其分为4级。结果：120例302个甲状腺结节中，良性结节264个，恶性结节38个。二维超声显示：恶性结节以实性低回声为主，内可见砂粒样钙化，边界不清，无声晕及包膜；良性结节以等、高回声及囊性、囊实性结节为主，形态规则，边界清，多有声晕及包膜。彩色多普勒超声显示：恶性结节的血流显示率明显高于良性结节，收缩期最高血流速度及阻力指数总体上高于良性结节，且以Ⅱ、Ⅲ级血流为主。结论：二维及彩色多普勒超声诊断甲状腺良、恶性结节准确率高。具有较大的临床应用价值。     

常规超声在乳腺病灶良恶性鉴别中的临床应用价值

目的 探讨常规超声在乳腺病灶良恶性鉴别中的临床应用价值.方法 对94例乳腺肿块患者进行超声检查,将所得的二维及彩色多普勒声像图特征与手术病理检查结果进行对比分析.结果 对超声检查方法与病理诊断符合情况分析发现,超声检查发现良性肿块61例,诊断符合率为88.41％（61/69）;超声检查发现恶性肿块23例,诊断符合率为92.00％（23/25）;对良性组和恶性组的诊断符合率进行统计学分析发现两组的诊断符合率无统计学差异（x2=0.39,P＞0.05）.良性组和恶性组在二维超声声像图方面有明显不同,其中良性组的二维超声声像图多以界限清楚,有包膜,形态规则,内部回声较均匀,后方无衰减,而恶性组的二维超声声像图则多以边界欠清楚或不清楚,无包膜,形态不规则,内部回声不均匀,后方存在衰减.结论 彩色多普勒超声对乳腺良、恶性病变的形态学检查有重要鉴别诊断价值,二维灰阶声像图的特征是乳腺肿块的首要诊断依据.     

彩色多普勒超声对小乳腺癌与乳腺增生的诊断价值研究

目的研究彩色多普勒超声对小乳腺癌与乳腺增生的诊断价值。方法收集我院经手术和病理活检确诊的乳腺增生与小乳腺癌患者各73例,比较分析其病灶形态的彩色多普勒超声二维声像图特征及血流信号图特征。对各指标率的变化进行统计分析。结果小乳腺癌和乳腺增生病灶形态的二维声像图特征及彩色血流图的比较,具有统计学意义（P〈0.05）。结论彩色多普勒超声检查可以根据病灶形态及血流信号的二维声像图特征对乳腺疾病进行有效的鉴别检查。     

高频彩色多普勒超声检查浅表软组织肿块的应用价值

目的：探讨高频超声及彩色多普勒血流显像（CDFI）对浅表软组织肿块的诊断价值。方法：对217例经病理证实的浅表软组织肿块的二维声像图及彩色多普勒血流显像进行分析。结果：217例中良性病变179例,恶性病变38例。超声对病变的检出率为100%,准确率为94.0%（204/217）。良恶性肿物的血流动力学参数Vmax、RI有显著性差异。结论：高频超声及彩色多普勒血流显像对浅表软组织肿块的诊断及鉴别诊断具有一定的临床价值。     

二维及彩色多普勒超声鉴别甲状腺结节良恶性的Logistic回归分析

目的:探讨二维及彩色多普勒超声声像图特征的Logistic回归模型分析对甲状腺结节良恶性鉴别诊断的意义。方法:选取经病理确诊的124个甲状腺结节,总结其二维及彩色多普勒声像图特征,建立Logistic回归模型并进行分析。结果:二分类Logistic回归模型分析共选出4项较敏感声像图特征,分别是微钙化、声晕、内部回声及血流分布。结论:二分类Logistic回归模型分析能筛选出对甲状腺结节良恶性鉴别有意义的二维及彩色多普勒超声声像图指标,对甲状腺结节良恶性鉴别有重要价值。     

超声鉴别腹水性质的临床价值

目的探讨超声对腹水性质鉴别的临床价值.材料与方法通过对肝硬化腹水67例,癌性腹水39例,结核性腹水14例进行观察,分析不同原因腹水患者的胆囊、肠管、腹水及腹膜的变化.结果胆囊壁三层样增厚、肠管飘浮征是预测肝硬化腹水的良好指标;癌性腹水表现为肠管粘附后腹壁,胆囊壁为单层或轻度增厚;而结核性腹水的主要征象为腹水内有众多纤细的条状分隔及"水草”样飘动的纤维束带.结论不同原因引起的腹水,声像图具有各自不同程度的特异性,较易作出腹水性质的鉴别诊断.超声是一种具有重要临床价值的检查方法.     

膀胱良性病变的声像图研究

目的：提高膀胱良恶性病变鉴别，探讨膀胱良性病变声像图表现及特点。方法：采用二维超声和彩色多普勒超声对58例膀胱良性病变进行基础研究。结果：良性病变表现为膀胱内壁粗糙不平，呈中等偏高回声或无回声。似“沙滩”或“蘑菇，，样改变，粘膜层、肌层无受累及浸润影像。结论：二维超声显示膀胱病变区域毛糙不平整；彩色多普勒显示良性病变血供丰富，周边呈“细曲树枝”状断续慢性血流，收缩峰值（Vs）速度〈20cm／s，阻力指数（RI）〈0．4，多为良性病变。     

高频彩色多普勒超声诊断与鉴别诊断阴囊肿块的价值

目的:探讨彩色多普勒超声对阴囊肿块的诊断与鉴别诊断价值.材料和方法:对34例阴囊肿块行彩色多普勒超声检查,恶性病变23 例,良性病变11例,分析恶性病变及良性病变的超声声像图特征.结果:恶性病变声像图特征是睾丸形态失常,体积增大,肿瘤呈低回声(15/23)或不均匀混合回声(8/23),边界不清楚,CDFI显示肿块周边和内部血流丰富,呈条状或树枝状血流.良性病变声像图特征是睾丸大小形态常正常,病变多呈低回声,边界清楚,形态规整,CDFI显示病变内血流信号较少(8/11)或无血流信号(3/11).超声对阴囊肿块性质的诊断准确率88.2%(30/34),与手术和穿刺病理结果无显著性差异(P＞0.05).结论:彩色多普勒超声对阴囊肿块诊断与鉴别诊断有较高的临床应用价值.     

探讨二维及彩色多普勒超声对甲状腺良恶性结节鉴别诊断的临床应用价值

目的探讨二维及彩色多普勒超声对甲状腺良恶性结节鉴别诊断的临床应用价值。方法选取2010年1月~2013年1月接受手术治疗的甲状腺结节患者60例,对其进行术前超声检查,并在手术完成后将患者甲状腺结节的良恶性与超声结果进行对比,判定二维及彩色多普勒超声对甲状腺良恶性结节鉴别诊断的价值。结果良性患者31例,共75个结节;恶性患者29例,共50个结节。且由二维超声图像可知,恶性患者结节形态无规则,低回声,边界不清晰,内部出现微小钙化,与良性患者差异显著,结果具有统计意义（P〈0.05）。结论二维及彩色多普勒超声对甲状腺良恶性结节鉴别效果明显,准确率高。     

Ultrasonographic features of pseudotumorous form of ascariasis

We report the ultrasonographic findings of a 60 year old woman with pseudotumorous form of ascariasis. Real-time ultrasonographic examination using a curved array transducer revealed grossly thickened small bowel loops, multiple small circular deposits throughout the peritoneal cavity, and a moderate amount of ascites. The English literature on the different forms of abdominal ascariasis is reviewed. Specific signs, which include the 'strip' sign, the 'four-lines', 'inner tube', or 'double tube' sign, the 'bull's eye' or 'target' sign, a 'worm mass' or 'spaghetti-like' appearance, and the 'zig-zag' sign can be present in any form of abdominal ascariasis, as they represent the image of the Ascaris worms visualized under ultrasonographic examination. However, the non-specific signs are not peculiar to A. lumbricoides infections, but are results of secondary changes due to A. lumbricoides infections in the corresponding organs.     

超声引导下穿刺活检对不明原因难治性腹水的诊断价值

目的 探讨超声引导下穿刺活检对临床不明原因难治性腹水的诊断价值.方法 回顾性分析25例不明原因的难治性腹水患者,对增厚腹膜或腹水中包块进行超声引导下穿刺活检.结果 超声检查发现腹膜局限性增厚病变10例,均呈中等或中等偏低回声,其中2例进行超声造影,均显示增厚的腹膜动脉期明显增强,造影剂于静脉期快速退出.腹膜不规则增厚伴网膜粘连、聚集,部分形成网膜饼样结构7例,腹膜或腹水中囊性包块5例,飘浮于腹水中的腹部实性包块2例,无明确包块仅见胰腺肿大1例.病理检查显示25例患者中恶性病变20例,其中恶性间皮瘤6例,胰腺囊腺癌2例,转移性腺癌9例,恶性神经鞘瘤、淋巴瘤、恶性纤维组织细胞瘤各1例.良性病变5例,其中结核3例,炎性病变和腹膜后纤维化各1例,5例良性病变均经半年以上的随访证实.结论 难治性腹水中的腹膜增厚性病变及腹水中的较小肿块行超声引导下穿刺活检,对于临床明确诊断具有较高的参考价值.     

Ultrasound-guided biopsy of greater omentum: an effective method to trace the origin of unclear ascites

Objectives

Thickened greater omentum is encountered with high frequency in patients with ascites. The purpose of our study was to assess the utility of greater omentum biopsy under the guidance of ultrasound (US) in tracing the origin of unclear ascites and differentiating benign and malignant ascites.

Materials and methods

We retrospectively reviewed our institutional database for all records of greater omentum biopsy cases. One hundred and ninety-four patients with unclear ascites and thickened greater omentum were included in the study. The sonograms of greater omentum were evaluated before undergoing the ultrasound-guided biopsy and a biopsy was considered successful if a specific benign or malignant diagnosis was rendered by the pathologist.

Results

Successful biopsy was rendered for 182 biopsy procedures (93.8%, 182/194) including tuberculosis (n = 114), chronic inflammation (n = 3), metastases (n = 58), malignant mesothelioma (n = 6) and pseudomyxoma peritonei (n = 1). Twelve biopsies were non-diagnostic. According to the results of biopsy and follow-up, the sensitivity and specificity of biopsy in distinguishing malignant ascites from benign ascities were respectively 95.6% (65/68) and 92.9% (117/126). The greater omentum of 84 cases of tuberculous peritonitis showed “cerebral fissure” sign and was well seen as an omental cake infiltrated with irregular nodules when involved by carcinomatosis. No “cerebral fissure” sign was observed in peritoneal carcinomatosis. The sensitivity and specificity of this sign in indicating the existence of tuberculous peritonitis were 73.5% (89/121) and 100% (73/73). Moreover, if the specific “cerebral fissure” sign was combined with the biopsy results, the specificity of biopsy in distinguishing malignant ascites from benign ascits increased to 96.8% (122/126).

Conclusion

Ultrasound-guided biopsy of greater omentum is an important and effective method to diagnose the unclear ascites for patients with thickened omentum if certain techniques could be paid attention to. “Cerebral fissure” sign of greater omentum was a specific sign in indicating the tuberculous peritonitis and could increase the specificity of biopsy in distinguishing malignant ascites from benign ascits if combined with the biopsy results.     

肾脏恶性肿瘤的超声诊断(附28例分析)

目的：探讨肾脏恶性肿瘤的超声及其他影像学诊断。方法：对28例经B超及其他影像学检查，并经手术、病理证实的病例进行回顾性分析。结果：B超定性诊断肾癌20例(20／28)；螺旋CT定性诊断10例(10／17)；MRI定性诊断7例(7／10)。结论：对于大于1cm的肾癌，B超及其他影像学检查定性诊断率相差不大；熟悉肾脏恶性肿瘤的二维及多普勒超声表现，结合临床病史及其他影像学检查，是减少漏、误诊，提高超声诊断水平的关键。     

乳腺肿块的超声图像浅析

目的:探讨乳腺肿块的超声图像特征并与病理对照。材料与方法:61例乳腺肿块患者,女性,年龄19～70岁,术前均接受了B超检查,术后经病理证实,使用仪器为PHASAR-AU530,7.5MHz水囊探头。结果:从61例患者中B超查出乳腺癌38例,良性肿块23例,相应于病理结果的诊断敏感性为92.1％,特异性为86％。乳腺恶性肿块的超声图像特征是形态不规则,无包膜,边界粗糙,回声增强,内部回声多为低回声实性,后方回声衰减等,这些表现也是与良性肿块的重要区别之点。结论:综合分析各个声像图特征是鉴别良性与恶性乳腺肿块的关键。     

绝经后卵巢肿瘤130例超声诊断分析

目的探讨绝经妇女卵巢肿瘤的临床及超声声像图特征。方法回顾性分析经手术证实的130例绝经后妇女卵巢肿瘤的临床资料及超声声像图特点。结果良性肿瘤94例（72.3%）,恶性肿瘤36例（27.7%）,绝经后卵巢肿块双侧病变的恶性率大于单侧病变者;单侧卵巢肿块最大径线〉10 cm的恶性率大于最大径线≤10 cm者;囊实性包块中多个分隔无助于良恶性的判断,有腹水者恶性率大于无腹水者。超声检查结果与病理结果对照符合104例,准确率为80%。结论超声声像图特征可为绝经后卵巢肿瘤的良恶性鉴别提供重要依据;绝经后浆液性囊腺瘤、成熟畸胎瘤、子宫内膜异位症的超声诊断准确率较绝经前高;少见卵巢肿瘤的超声诊断准确性还有待进一步提高。     

The value of computer-assisted sonographic tissue characterization in focal lesions of the thyroid

Thyroid lesions are a common observation in ultrasound examination. In most cases the differentiation of malignant and benign tissue is difficult. In this study 133 thyroid lesions were examined by an ultrasonographic tissue characterization system prior to surgery. The pathologic findings (29 cancers, 31 adenomas, 46 nodular goiters, 27 cysts) were examined with reference to the quantitative evaluation of the ultrasonic images (ROI method). The selected regions of interest (ROI) were analyzed with regard to the three most discriminating parameters. The overall accuracy of differentiation between malignant and benign thyroid nodules was 83.9%.     

Gray scale ultrasonographic evaluation of hepatic cystic disease.

Eight patients with various forms of hepatic cystic disease studied with gray scale ultrasonography are described. Four had solitary cysts, two had multiple simple liver cysts, and two had congenital polycystic liver and kidney disease. The spectrum of ultrasonographic features in benign cystic disease of the liver is discussed. All eight patients were felt to have malignant disease in the liver prior to ultrasonographic evaluation. The value of gray scale ultrasound as a noninvasive means of differentiating cystic disease from suspected metastatic disease is emphasized.     

探讨超声弹性成像对甲状腺良恶性结节鉴别诊断的应用价值

目的:研究超声弹性成像在鉴别甲状腺良、恶性结节临床诊断中的应用价值。方法:对术前52例(93个)甲状腺结节进行常规二维、彩色多普勒超声及弹性成像检查,对弹性成像进行分析,并与病理结果进行对照。结果:93个甲状腺结节中,良性结节64个,恶性结节29个。其良性结节中,47个结节评为1～2分,恶性结节中,27个结节评为4～5分,两组弹性成像评分比较有统计学差异(P<0.01)。其诊断恶性结节的敏感性87.10%、特异性96.77%、准确性93.55%。结论:超声弹性成像对鉴别甲状腺良恶性病变提供很大的帮助。     

B超,X线造影,内窥镜诊断肠道肿块的对照分析

目的：探讨Ｂ超在诊断肠道肿瘤中的价值。材料与方法：收集术前行Ｂ超检查经手术及病理证实的肠道肿瘤８８例，与Ｘ线造影及内窥镜检查结果做对照性分析。结果：定性诊断Ｂ超符合率９４３％，Ｘ线造影８５９％，内窥镜９７８％。定位诊断符合率Ｂ超６７％，Ｘ线造影７１％，内窥镜１００％。结论：Ｂ超诊断可以明确肠道肿瘤的大小、类型、范围，尤其对肠壁内外浸润深度、周围脏器转移及腹水的显示是Ｘ线造影及内窥镜达不到的。但因肠管游离性大及肠气干扰，Ｂ超对病变的定位及较小的肠系膜淋巴结显示还不够满意。