新生儿小脑发育与胎龄的相关性研究

目的　通过颅脑超声检测25~41周新生儿出生时的小脑,分析小脑随胎龄的发育规律,利于临床早期评估小脑发育。 方法　提取318例25~41周适于胎龄儿颅脑超声图像,测量小脑横径,蚓部高度、前后径、周长和面积,作统计学分析。 结果　小脑横径与胎龄最适曲线为直线方程Y=0.1036X+0.1929,R2=0.727(P<0.001)。蚓部高度与胎龄最适曲线为直线方程Y=0.069X-0.3156,R2=0.823(P<0.001);蚓部前后径与胎龄最适曲线为直线方程Y=0.0509X-0.5798,R2=0.735(P<0.001);蚓部周长与胎龄最适曲线为直线方程Y=0.2811X-1.5932,R2=0.782(P<0.001);蚓部面积与胎龄最适曲线为直线方程Y=0.2283X-4.4559,R2=0.817(P<0.001)。其中蚓部高度与胎龄的正相关性最强,相关系数为0.907(P<0.001)。 结论　在适于胎龄儿中,建立出生时小脑横径,蚓部高度、前后径、周长和面积与胎龄之间的宫外参考范围,以此为依据可为临床宫外诊断和评估小脑发育提供参考。     

颈动脉彩色多普勒超声对老年高血压患者颈动脉病变情况诊断价值

目的探讨颈动脉彩色多普勒超声对老年高血压患者颈动脉病变情况诊断价值。方法抽取60例老年高血压患者与57例健康者分别设为病例组与对照组,均行颈动脉彩色多普勒超声,比较两组检查结果。结果病例组颈动脉狭窄率为88.3%,斑块形成率为80.00%,内膜中层厚度(IMT)、颈动脉内径(D)、阻力指数(RI)均较对照组高(P <0.05);病例组颈内动脉、颈总动脉最大剪切率(SR)以及收缩期峰值流速(PSV)均低于对照组(P <0.05)。结论颈动脉彩色多普勒超声对老年高血压患者颈动脉病变具有较高诊断价值,值得推广。     

一种用于神经刺激研究的触屏控制小型超声发生器

超声发生器是研究超声刺激的重要工具,但是目前并无可供选择的专用设备。目前实验室所用超声发生器通常都用多台通用仪器搭建而成,体积大,操作复杂。本文设计了一种用于神经刺激研究的小型超声发生器,用触屏作为控制界面,方便刺激参数的输入和修改;独立的E类末级功放非常小巧,可接近换能器放置,换能器的电抗参数纳入功放从而省去了匹配电路,整机体积进一步缩小。内置的现场可编程门阵列（FPGA）产生脉冲方波,经专门的驱动电路后控制E类功放中MOSFET的通断。测试表明,本文设计的超声发生器产生的波形准确,最高频率可达2 MHz。配接自制的500 kHz换能器,在30 V电源电压下输出功率6.23 W,最大声压达到168.3 kPa,并且还有可提升的空间。该发生器体积小,操作方便,电路设计简单,适用于超声神经刺激的研究。     

Heel quantitative ultrasound parameters in subjects with the metabolic syndrome: the Camargo Cohort Study

Objectives

To compare bone parameters measured by calcaneous quantitative ultrasonography (BUS) in subjects with and without metabolic syndrome (MetS). In addition, we wanted to examine the association of each of the individual components of the syndrome with BUS measurements, to study the relationship between calciotropic hormones or bone turnover markers with BUS parameters in subjects with or without MetS, and to explore the possibility that the relationship between prevalent vertebral and non-vertebral fractures and BUS is influenced by MetS status.

Study design

Cross-sectional study.

Results

We investigated 1209 (421 men and 788 women) participants from the Camargo Cohort Study. Prevalence of MetS was 27% in men and 31% in women. Women, but not men, with MetS had higher age-adjusted BUS parameters compared with those without (p < 0.05), the difference disappearing after adjustment for BMI. Out of the five single components of MetS, only waist perimeter was significantly associated with BUS (p < 0.01), the association being restricted to women. In men and women with MetS (but not without) a positive significant association was observed between BUS and 25OHD levels. BUS parameters were associated with serum P1NP or CTX in normal women, but not in those with MetS. Prevalent vertebral and non-vertebral fractures and BUS parameters (BUA and SOS, respectively) are inversely associated, but this relationship, however, is not influenced by MetS status.

Conclusions

BUS parameters are higher in women with MetS, and this difference disappears after adjusting for BMI. MetS status did not influence the relationship between BUS parameters and vertebral or non-vertebral fractures.     

Experimental ablation of the pancreas with high intensity focused ultrasound (HIFU) in a porcine model

The aim of this study was to determine the feasibility and safety of high intensity focused ultrasound''s (HIFU) in pancreatic diseases. Twelve pigs were divided into three groups. The pancreases of pigs in Group A were ablated directly with HIFU, but those in Group B and C ablated by extracorporeal HIFU. The pigs in Group C were sacrificed at day 7 after HIFU. Serological parameters were determined pre-operation and post-operation. The entire pancreas was removed for histological examination. Each animal tolerate the HIFU ablation well. The complete necrosis was observed in targeted regions. The margins of the necrotic regions were clearly delineated from the surrounding normal tissues. Infiltration of inflammatory cells and phorocytosis on the boundary were found in group C. Blood and urine amylase levels were relatively steady after HIFU. No acute pancreatitis or severe complications occurred. In conclusion, HIFU ablation on the pancreas was safe and effective in experimental pigs.     

慢性非哺乳期乳腺炎超声声像图、钼靶及术后病理对照分析

目的：分析慢性非哺乳期乳腺炎（nonlactation mastitis NLM）声像图特征性表现,探讨彩色多普勒超声对NLM诊断和鉴别诊断价值。方法：病理证实NLM患者43例,回顾性分析其声像图、钼钯x线表现,并与病理结果进行对照。结果：本组43例中：导管扩张症（mammary duct ectasia MDE）19例（44％）、肉芽肿性乳腺小叶炎（granulomatous lobular mastitis GM）13例（30％）、其他非特殊感染性乳腺炎11例（26％）。声像图主要表现及特征：①乳头下方、乳晕区导管扩张或合并有囊性或混合性肿物;②囊性为主的较大混合性肿物;③皮肤单个或多个瘘口;④实性低回声肿物;⑤非肿块型病变。结论：声像图的特征性表现较好地反映NLM炎症病理过程,但在不同炎性类型中特征性表现具有共性,超声有时难易以做出炎症类型的病理诊断,超声、钼钯X线联合检查对于术前明确炎性或癌性病变具有重要意义。     

可视化融合成像技术诊治腰关节突关节综合征的疗效分析*

目的探讨可视化融合成像技术诊治腰关节突关节综合征的临床效果。方法临床纳入2017年6月至2020年5月于深圳市龙岗中心医院住院和门诊收治的80例腰关节突关节综合征患者作为研究对象,按随机数字表法分为两组,各40例。其中40例患者采用可视化融合成像技术引导下诊断及介入治疗者作为研究组,仅采用X线透视引导下诊断及介入治疗者作为对照组。观察两组患者治疗前后疼痛情况,分析两组患者诊疗效果及不良反应情况。结果研究组治疗后1周、3个月、6个月、12个月的VAS评分明显低于对照组,两组比较差异有统计学意义(P<0.05);在不同治疗时期疼痛缓解方面,对照组患者总有效率明显低于研究组,差异有统计学意义(P<0.05);在术区血肿形成、术区疼痛、消化道症状及下肢疼痛等不良反应方面,对照组不良事件发生率为25%,研究组为7.5%,两组比较差异有统计学意义(P<0.05)。结论可视化融合成像技术诊治腰关节突关节综合征的临床效果明显、持久及安全性高,值得临床应用推广。     

Quand faut-il évoquer en anténatal une disomie uniparentale paternelle 14 ?

The paternal uniparental disomy 14 is a rare malformation syndrome whose postnatal pathognomonic sign is the deformation of the rib as coat hanger. In prenatal, ultrasonographic signs are major recurrent polyhydramnios, a narrow thorax and deformed long bones short and sometimes other anomalies including ends. The authors report one rare case of prenatal paternal uniparental disomy 14 with the deformation of the rib as coat hanger. Prenatally, the narrow deformed thorax can be searched by ultrasound three-dimensional (3D) and/or helical CT and thus represent an aid to prenatal diagnosis.     

Fetal Echocardiography Assists in Determining Optimal Delivery Site

ObjectiveCongenital heart disease is one of the most common types of structural fetal abnormalities and a major cause of perinatal morbidity and mortality. Fetal echocardiography aids in the diagnosis of congenital heart disease, which allows management planning for parents and physicians, including continuation or termination of the pregnancy and triaging for location of delivery. This is a key component of planning, as transport of neonates entails risks, costs, and parental stress. In this study, we examined the outcomes of pregnancies with fetal cardiac anomalies diagnosed at a single tertiary care centre. We aimed to assess whether the system of directing affected pregnancies to either a tertiary and quaternary care centre is effective.MethodsWe identified pregnancies with fetal cardiac anomalies diagnosed on fetal echocardiography between 2005 and 2009. Information about diagnosis, pregnancy outcome, delivery location, and surgical management was collected. This information was analyzed retrospectively.ResultsAnomalies were demonstrated in 120 fetal echocardiography studies. Four of the babies (3.3%) were stillborn, and 27 (22.5%) pregnancies were terminated. There were 89 live born babies, and 74 of these (61.7%) survived the neonatal period. Fifteen babies (12.5%) died as neonates. Thirty-two pregnant women were triaged to deliver at the quaternary centre with pediatric cardiac surgery services, and 20 of these babies underwent surgery. Two of the 89 live born babies (2.2%) required emergency transfer.ConclusionFetal echocardiography is an important contributor to efficient use of pediatric cardiac services and minimizes need for neonatal transfer. Contemporary use of fetal echocardiography is associated with optimized delivery location.     

Ultrasound diagnosis of fetal head engagement

Objective

To compare clinical data and transperineal ultrasound results for the diagnosis of fetal head engagement.

Methods

The present prospective longitudinal study enrolled 100 term women attending the Mongi Slim Hospital, La Marsa, Tunisia, between July and September 2012. The clinical assessment of fetal engagement was compared with ultrasound measurements. Ultrasound examination was performed in the delivery room. The probe was placed on the ano-vulvar area. The measure used was the distance between the perineum and external table of fetal skull.

Results

The ultrasound measures of the perineum to external table of fetal skull ranged from 13 to 75 mm. The measures of the perineum to succedaneum bump ranged from 22 to 68 mm. A threshold of 55 mm was determined as the perineum to fetal head distance above which a diagnosis of engagement would be reversed. This proposed threshold had a positive predictive value of 98.6%, a sensitivity of 86.7%, and a specificity of 94.1%.

Conclusion

Transperineal ultrasound is a simple, rapid, and reproducible method for the diagnosis of fetal head engagement. It can be used in the delivery room in addition to clinical examination and when the latter is hampered by a succedaneum bump.