超声在小儿急腹症中的应用价值和经验探讨

目的研究彩色多普勒在小儿消化系统急腹症中的应用价值。方法回顾性分析阐述2019年1-12月期间医院收治的136例急腹症患儿的超声检查和临床资料,分析彩色多普勒超声诊断的符合率。结果彩色多普勒超声诊断急性肠系膜淋巴结炎符合率92.86%,急性阑尾炎符合率90.91%,肠套叠符合率97.44%,肠旋转不良伴中肠扭转符合率100%,肠梗阻符合率100%。结论彩色多普勒超声在诊断小儿急腹症中具有较高的符合率,是小儿急腹症首选的检查方法。     

超声弹性成像联合BI-RADS分类在乳腺微小癌诊断中的临床价值

目的:探讨在乳腺微小癌诊断中联合应用超声弹性成像及数据系统(BI-RADS)分类的临床价值。方法:选择2018年3月~2019年3月本院接收的疑似乳腺微小癌的96例患者作为研究对象。均进行超声弹性成像检查、BI-RADS分类,以病理检查结果为诊断金标准,比较单项检查与联合检查的准确率、灵敏度、特异度。结果:数据显示,在96例疑似乳腺微小癌患者中,共80例患者经病理检查确诊为乳腺微小癌,同时乳腺钼靶联合超声检查的准确性、灵敏度均高于单项检测,数据之间的差异有统计学意义(P<0.05)。此外,单项与联合检测的特异度对比,差异无统计学意义(P>0.05)。结论:在乳腺微小癌诊断中联合应用超声弹性成像及BI-RADS分类检查,可有效提高诊断准确性及灵敏度,对早期疾病诊断、临床治疗具有重要意义。     

复发性剖宫产瘢痕部位妊娠的临床分析

目的探讨复发性剖宫产瘢痕部位妊娠(RCSP)发生的相关因素及处理。方法选取2015年1月至2021年1月于川北医学院附属医院妇产科确诊的463例CSP并行聚焦超声消融(FUAS)或子宫动脉介入栓塞(UAE)联合宫腔镜手术治疗患者,随访其再妊娠情况,失访72例,成功随访391例,117例再次妊娠,24例为RCSP。回顾性分析RCSP患者的临床资料和处理方式。结果391例CSP患者,122例行FUAS联合宫腔镜手术,34例再次妊娠,5.9%(2/34)为RCSP;269例行UAE联合宫腔镜手术,83例再次妊娠,26.5%(22/83)为RCSP。UAE组RCSP发生率高于FUAS组,差异有统计学意义(P<0.05)。24例RCSP患者,22例行FUAS联合宫腔镜手术,2例行UAE联合宫腔镜手术,均一次性治疗成功。RCSP患者中,79.2%(19/24)剖宫产≥2次,87.5%(21/24)人工流产≥2次,70.8%(17/24)子宫下段瘢痕厚度≤3 mm。结论既往多次剖宫产史、多次人工流产史、子宫下段瘢痕厚度偏薄及CSP初次治疗方式可能与CSP复发相关。FUAS联合宫腔镜手术是CSP及RSCP的适宜治疗方式。     

二维超声评价原发性肾病综合征预后的价值

目的　探讨二维超声对原发性肾病综合征预后的判断价值。方法　根据临床检查结果将 12 0例原发性肾病综合征患者分为 3组 ,并与二维超声检查结果进行相关性分析。结果　完全缓解组的肾脏超声检查结果与对照组比较无显著性差异 (P >0 .0 5 ) ,部分缓解组的肾脏超声检查结果与对照组比较有显著性差异 (P <0 .0 5 ) ,无效组的肾脏超声检查结果与对照组比较有非常显著性差异 (P <0 .0 1)。结论　二维超声检查原发性肾病综合征患者的肾脏无异常时预后良好 ,而肾脏缩小越明显 ,肾皮质回声越强 ,则预后越差。     

“超声信息管理系统”中的数据整合

介绍“超声信息管理系统”中的数据整合研究。医院数学化仪器和计算机信息系统的使用积累了大量的数据,本文针对“高血压进程与心脏形态变化的关系”这一主题,重组计算机内的积累病例数据,在建立数据仓库和实现数据挖掘方面做了一些尝试。     

脉冲多普勒超声定量检测狭窄管流中流动指标的方法学探讨

目的　探讨狭窄管流中一系列流动指标的定量检测方法 ,包括 Reynolds数、相对频带展宽度(RSB)、层流剪应力、法向雷诺应力 (RNS)等。方法　采用临床使用的脉冲多普勒血流仪在狭窄前后多个位点进行多时点检测 ,得出流场特征 ,再分别评价各项指标。结果　定性评价见狭窄下游呈现鲜亮的“烛焰形”花色镶嵌湍流流型 ,狭窄后 1.0 cm处得到较大的 RSB、RNS等 ,1/ 2 R取样容积处湍流指标大于相应的轴心处。结论　狭窄后1.0 cm1/ 2 R取样容积处存在最大的湍流度 ;狭窄后各位点的数据离散度大于狭窄前。该研究为进一步在不同流场中开展生物力学的在体研究奠定了前期工作基础     

Polyorchidism in ultrasound examination: A case report

Polyorchidism is usually diagnosed incidentally when the patient undergoes imaging or surgery for some other reason. Although we are facing lack of evidence in different steps of diagnostic and therapeutic workup of these patients, this disorder is usually considered benign, not requiring any intervention. We report the case of a man complaining of a palpable mass in his scrotum. We evaluated the patient using ultrasound, MRI and serum tumour marker level measurement. The patient was finally diagnosed with polyorchidism (three testes). For the management, we recommended annual physical examination, US examination and serum tumour marker level measurement.     

Ultrasound-Guided Periprosthetic Biopsy in Failed Total Hip Arthroplasty: A Novel Approach to Test Infection in Patients With Dry Joints

BackgroundTo diagnose periprosthetic joint infection (PJI) preoperatively, ultrasound-guided joint aspiration (US-JA) may not be performed when effusion is minimal or absent. We aimed to report and investigate the diagnostic performance of ultrasound-guided periprosthetic biopsy (US-PB) of synovial tissue to obtain joint samples in patients without fluid around the implants.MethodsOne-hundred nine patients (55 men; mean age: 68 ± 13 years) with failed total hip arthroplasty (THA) who underwent revision surgery performed preoperative US-JA or US-PB to rule out PJI.ResultsSixty-nine of 109 patients had joint effusion and underwent US-JA, while the remaining 40 with dry joint required US-PB. Thirty-five of 109 patients (32.1%) had PJI, while 74/109 (67.9%) had aseptic THA failure. No immediate complications were observed in both groups. Technical success of US-PB was 100%, as the procedure was carried on as planned in all cases. Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of US-JA were 52.2%, 97.8%, 92.3%, 80.3%, and 82.6%, while for US-PB, they were 41.7%, 100%, 100%, 80%, and 82.5%, respectively, with no significant difference (P = .779). Using the final diagnosis as reference standard, we observed a moderate agreement with both US-JA (k = 0.56) and US-PB (k = 0.50).ConclusionWe present a novel US-guided technique to biopsy periprosthetic synovial tissue of failed THA to rule out PJI. We found similar diagnostic performance as compared with traditional US-JA. This supports future larger studies on this procedure that might be applied in patients without joint effusion.     

Is patient age associated with risk of malignancy in a ≥4 cm cytologically benign thyroid nodule?

BackgroundCurrent data regarding the risk of malignancy in a large thyroid nodule with benign fine-needle aspiration biopsy(FNAB) is conflicting. We investigated the impact of patient age on the risk of malignancy in nodules≥4 cm with benign cytology.MethodsWe performed a single-institution retrospective review of patients who underwent surgery from 07/2008–08/2019 for a cytologically benign thyroid nodule ≥4 cm. The relationship between malignant histopathology and patient and ultrasound features was assessed with multivariable logistic regression.ResultsOf 474 nodules identified, 25(5.3%) were malignant on final pathology. In patients <55 years old, 21/273(7.7%) nodules were malignant, compared to 4/201(2.0%) in patients ≥55. Patient age ≥55 was independently associated with significantly lower risk of malignancy(OR:0.2,95%CI:0.1–0.7,p = 0.011). Increasing nodule size >4 cm and high-risk ultrasound features were not associated with risk of malignancy(OR:1.0,95%CI:0.7–1.4,p = 0.980, and OR:9.6,95%CI:0.9–107.8,p = 0.066, respectively).ConclusionsPatients <55 years old are 3.7-fold more likely to have a falsely benign FNA biopsy in a nodule≥4 cm.     

The role of peripheral nerve stimulation in the era of ultrasound-guided regional anaesthesia

With the widespread use of ultrasound for localising nerves during peripheral nerve blockade, the value of electrical nerve stimulation of evoked motor responses has been questioned. Studies continue to show that, compared with nerve stimulation, ultrasound guidance alone leads to: significantly improved block success; decreased need for rescue analgesia; decreased procedural pain; and lower rates of vascular puncture. Nerve stimulation combined with ultrasound does also not appear to improve block success rates, apart from those blocks where the nerves are challenging to view, such as the obturator nerve. The role of nerve stimulation has changed in the last 15 years from a technique to locate nerves to that of an adjunct to ultrasound. Nerve stimulation can serve as a monitor against needle-nerve contact and may be useful in avoiding nerves that are in the needle trajectory during specific ultrasound guided techniques. Nerve stimulation is also a useful adjunct in teaching novices ultrasound-guided regional anaesthesia, especially when the position and or appearance of nerves may be variable. In this review, the changing role of nerve stimulation in contemporary regional anaesthetic practice is presented and discussed.