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61.
目的 探讨参照Bosniak分级CT标准更新版(2019版)的超声造影CT-Bosniak分级标准及超声造影RJ-Bosniak分级标准在预测肾脏囊性病变良恶性中的应用价值。方法 回顾性分析2015年6月至2020年7月在瑞金医院及瑞金医院无锡分院超声科进行超声造影检查的316例患者的347枚肾脏囊性病灶的超声造影声像图。参照2019版Bosniak分级CT标准和瑞金标准分别对超声造影声像图进行Bosniak分级,其中参照CT标准者定义为超声造影CT-Bosniak标准,按照瑞金医院临床实践经验总结所定分级标准定义为超声造影RJ-Bosniak分级标准。所有的入组病例最终由穿刺活检或手术病理学及增强CT或MRI等影像学检查随访证实。采用四格表计算2种超声造影Bosniak分级标准对肾囊性病变良恶性诊断的准确度、灵敏度、特异度等。结果 以手术或穿刺活检所得病理结果及临床最终诊断结果为金标准,347枚肾脏囊性病灶中良性病灶308枚,恶性病灶39枚。以Bosniak III级和IV级为恶性诊断标准,超声造影CT-Bosniak分级正确诊断良、恶性病灶各290个和36个,超声造影RJ- Bosniak分级正确诊断良、恶性病灶各292个和38个,诊断结果与金标准结果均呈高度一致(Kappa值分别为0.74和0.79),2种分级标准诊断结果之间的准确度、敏感度、特异度、阳性预测值、阴性预测值分别为93.95%(326/347)和95%(330/347)、92.31%(36/39)和97.44%(38/39)、94.15%(290/308)和94.81%(292/308)、66.67%(36/54)和70.37%(38/54)、98.98%(290/293)和99.66%(292/293),差异均无统计学意义,(P>0.05)。347枚病灶中CEUS CT-Bosniak 分级I级198个, II级45个, IIF级50个, III级26个, IV级28个;CEUS RJ-Bosniak分级I级198个, II级28个, IIF级66个, III级28个, IV级27个 。结论 超声造影结合Bosniak分级标准对肾囊性病变良恶性的鉴别诊断有较高的价值。瑞金医院所用的Bosniak分级标准使用简单、有效,值得在临床推广应用。 相似文献
62.
处女膜闭锁是女性外生殖器异常的一种,是原发性闭经的原因之一.主要症状为青春期进行性加剧的周期性下腹痛,但无月经来潮,B超见阴道子宫积血或盆腔肿物.临床上易与卵巢肿瘤蒂扭转等引起的腹痛混淆,要注重专科查体及影像学鉴别.笔者在工作中碰到1例处女膜闭锁误诊为卵巢肿瘤的患者,现报告如下. 相似文献
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Objective To compare the differences of psychopathologic symptoms between smokers and non-smokers in chronic and first-episode,drug-nalve schizophrenics.then it was attempted to explain the reasons why there is higher rate of smoking behavior in schizophrenia.Methods In all.427 male chronic schizophrenic patients(332 smokers and 95 non-smokers)and 63 male first-episode drug-naive patients with schizophrenia(22 smokers and 41 non-smokers)were collected.All patients were assessed with the Positive and Negative Syndrome Scale(PANSS).Results In chronic patients.the item scores of poor rapport and passive/apathetic social withdrawal of PANSS negative subscale were significantly lower in smokers than non-smokers(3.9 ±1.5 vs.4.4±1.7;3.6±1.6 vs.4.0±1.7.respectively,P<0.05),and so was the total scores of PANSS negative subscale(24.0±8.2 vs.26.3±9.5).In first-episode.drug-ndive patients.the itern scores of emotional withdrawal and passive/apathetic social withdrawal of PANSS negative subscale were significant lower in smokers than non-smokers(2.7±1.3 vs.3.5±1.3:2.7±1.3 vs.3.5±1.4,respectively,P<0.05).Conclusion It is suggested there are positive effects of cigarette smoking on the psychopathological symptoms of patients with schizophrenia,which misht be one of the mechanisms for higher rates of smoking behavior in schizophrenia. 相似文献
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Objective To investigate the feasibility of the low tube voltage setting and personalized contrast agent application in 64-row multi-slice spiral CT pulmonary angiography.Methods Ninety patients with high risk of pulmonary artery embolism were sequentially enrolled in the study and divided into 3 groups employing completely randomized design: (1) Regular group included 30 patients using 120 kV and fixed dose of 70 ml contrast agent, (2)Another 30 patients were in 120 kV group, using 120 kV and the contrast amount was determined according to the patient weight (1.0 ml/kg), (3) The remaining 30 patients were included in 100 kV group, using 100 kV and the contrast amount was also determined according to the patient weight(1.0 ml/kg).Administration of contrast agent was completed within 20 seconds for all the patients, followed by 20 ml of saline.The objective and subjective indexes for assessing CT image quality, CT dose index volume (CTDIvol) and effective received dose (ERD) were compared between 120 kV group and 100 kV group; then the contrast media volume, injection rate, objective CT image indexes and subjective indexes for image quality was compared between the 100 kV group and regular group.The variance analysis and post hoc test were employed for the statistical analysis.Results Compared with 120 kV group(3.4± 0.7), the image quality of 100 kV group(5.2±1.8)had higher noise(52.9%), but subjective index for the image quality demonstrated no differences(q=0.272 ,P=0.063)in mediastinum window while CTDIvol and ERD decreased for 34.9%[(9.5±0.0) vs (14.6±0.0) mGy]and 36.8%[(3.8±0.6) vs (2.4± 0.4) mSv].The mean CT values on pulmonary artery of 100 kV group[(269.2±54.7) HU]were 13.4% (31.8/237.4) higher than the 120 kV group[(237.4±62.9) HU], but there was no statistical differences eornpared to normal group(q=0.172,P=0.260).Conclusion Using low kV setting (100 kV) to reduce radiation dose is proved to be effective and feasible in 64-MSCT pulmonary angiography.Personalized contrast agent injection has clinical application value for specific patient group. 相似文献
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目的:建立水蛭(蚂蝗)滑石粉烫制品抗凝血酶活性标准。方法:采用滴定法测定不同批次的水蛭滑石粉烫制品抗凝血酶活性。结果:水蛭滑石粉烫制品抗凝血酶活性线性关系良好,其中y=1.027,54x+0.013,3,R=0.997,8,稳定性和重复性RSD均小于2.5%,测定的12批水蛭滑石粉烫制品含量测定标准在2.28~4.68 U/μL。结论:该方法工艺简单、操作方便;凝血酶滴定法简单且准确,可用于滑石粉烫水蛭的质量控制。 相似文献
70.