实时超声弹性成像技术对子宫内膜癌浸润子宫肌层的诊断价值研究

目的:探讨实时超声弹性成像技术在诊断子宫内膜癌浸润子宫肌层中的应用价值,以供参考。方法:随机选取2012年2月-2014年10月本院收治的子宫内膜癌浸润子宫肌层患者80例作为研究对象,所有患者均先接受实时超声弹性成像技术进行诊断,并按其诊断子宫肌层浸润程度结果分为两组,一组为浅肌层浸润,另一组为深肌层浸润。诊断后,对两组患者进行手术治疗,将患者的诊断结果与术后病理结果进行比较、分析,以此观察实时超声弹性成像技术在诊断子宫内膜癌浸润子宫肌层中的敏感度和准确度。结果:实时超声弹性成像技术的诊断结果与术后病理结果比较,差异无统计学意义(P0.05)。其中,实时超声弹性成像技术对浅肌层浸润组的灵敏度为61.25%,准确度为93.33%;对深肌层浸润组的灵敏度为38.75%,准确度为91.18%。结论:实时超声弹性成像技术在诊断子宫内膜癌浸润子宫肌层中,有肯定的应用价值,并且其诊断准确率较高,值得在临床中推广。     

超声弹性成像诊断乳腺肿瘤良恶性及淋巴结转移的研究

目的 探讨超声弹性成像技术对乳腺肿瘤良恶性及淋巴结转移的诊断价值,为鉴别乳腺良恶性肿瘤提供新的途径.方法 对100例女性患者共123个乳腺实质性肿块及206个淋巴结进行实时组织超声弹性成像,以5分法对病灶及淋巴结软硬度进行评分,与手术病理结果对照.结果 123个乳腺肿块中,良性病变48个,恶性病变75个.206个淋巴结中,良性反应性增生159个,恶性转移性病变47个.结论 超声弹性成像对乳腺肿物良恶性鉴别诊断有较高价值,并为判断腋窝淋巴结的性质提供有价值的信息.     

Comparison of 2 shear wave elastography systems in reproducibility and accuracy using an elasticity phantom

This study aimed to compare the accuracy and inter- and intra-observer reproducibility of the measured elasticity between 2 shear wave elastography systems. Three breast radiologists examined 8 targets of 4 different levels of stiffness (size: 11 mm, 4 mm) in an elasticity phantom (Customized 049A Elasticity QA Phantom, CIRS, Norfolk, VA, USA) using 2 different shear wave ultrasound elastography systems: SuperSonic Imagine (SSI) (SSI, Aix en Provence, France) and ShearScan (RS-80A, Samsung Medison, Seoul, Korea). Three radiologists performed ultrasound (US) elastography examinations for the phantom lesions using 2 equipment over a 1-week interval. Intra- and inter-observer reproducibility and the accuracy of the measured elasticity were analyzed and compared between the 2 systems. The accuracy of shape was also analyzed by shape-matching between B-mode and elastography color image. Intra-class correlation coefficients (ICC) were used in statistical analysis. For measured elasticity, the intra-observer and inter-observer reproducibility were excellent in both SSI and ShearScan (0.994 and 0.998). The overall accuracy was excellent in both systems, but the accuracy in small lesions (4 mm target) was lower in SSI than ShearScan (0.780 vs 0.967). The accuracy of shape-matching on the elastography image was 59.0% and 81.4% in the SSI and ShearScan, respectively. In conclusion, the SSI and ShearScan showed excellent intra- and inter-observer reproducibility. The accuracy of the Young''s modulus was high in both the SSI and ShearScan, but the SSI showed decreased accuracy in measurement of elasticity in small targets and poor shape-matching between the B-mode image and color-coded elastography image.     

Shear wave elastography of the tibial nerve in healthy subjects

The purpose of this study is to investigate sonoelastographic features of the tibial nerve.The study included 72 tibial nerves in 36 healthy subjects. High resolution ultrasound and Shear wave elastography were used to evaluate the tibial nerve. Cross sectional area and stiffness were measured.The mean cross sectional area of the tibial nerve was 13.4 mm². The mean shear elastic modulus of the tibial nerve in the short axis was 23.3 kPa. The mean shear elastic modulus of the tibial nerve in long axis was 26.1 kPa. The tibial nerve elastic modulus also showed no correlation with cross sectional area neither in the long axis nor short axis. Age, height, weight, and body mass index showed no correlation with tibial nerve elastic modulus in short or long axes.The elastic modulus of the tibial nerve has been determined in healthy subjects and can serve as a reference for future assessment of polyneuropathy.     

Enfermedad de Wilson: consideraciones para optimizar el seguimiento a largo plazo

Wilson's disease is a sistemic genetic disease caused by the excessive accumulation of copper. The first and main involvement is in the liver, which can range from mild and transient elevation of transaminases to the onset of an overt cirrhosis or acute liver failure. It is known that up to 20-30% of these patients may evolve to liver cirrhosis during follow-up. In clinical practice, liver fibrosis is assessed mainly by using indirect and non-invasive tools (laboratory tests, liver elastography, ultrasound), similar to other prevalent chronic liver diseases. However, despite the fact that liver elastography is a valuable tool in general hepatology, the evidence of its usefulness and accuracy in Wilsońs disease is scarce. This review summarizes the available scientific data and their limitations in Wilson's disease.     

Asociación Mexicana de Hepatología A.C. Guía Clínica de Hepatitis B

Hepatitis B virus (HBV) infection continues to be a worldwide public health problem. In Mexico, at least three million adults are estimated to have acquired hepatitis B (total hepatitis B core antibody [anti-HBc]-positive), and of those, 300,000 active carriers (hepatitis B surface antigen [HBsAg]-positive) could require treatment. Because HBV is preventable through vaccination, its universal application should be emphasized. HBV infection is a major risk factor for developing hepatocellular carcinoma. Semi-annual liver ultrasound and serum alpha-fetoprotein testing favor early detection of that cancer and should be carried out in all patients with chronic HBV infection, regardless of the presence of advanced fibrosis or cirrhosis. Currently, nucleoside/nucleotide analogues that have a high barrier to resistance are the first-line therapies.     

膝关节股骨远端软骨硬化前后力学性能分析

目的建立膝关节有限元模型,研究正常及软骨硬化情况下膝关节的应力、应变变化,为临床治疗膝关节骨性关节炎提供参考。方法通过Mimics、ANSYS等软件结合正常膝关节CT扫描图像数据,建立膝关节三维有限元模型,并施加350 N压力载荷,设定软骨硬化前后相关的材料参数,分析膝关节主要组织的应力、应变改变情况。结果膝关节股骨远端软骨硬化后,关节软骨的减震和传递负荷等作用基本消失;股骨应力、应变变化量最大,受力分布极不均匀,股骨前端应力、应变较内、外侧髁明显,整体受力也有明显增加;半月板的应力、应变值最大。结论长期的软骨破坏会影响关节软骨营养代谢,导致骨性关节炎疾病进一步恶化。研究结果可以较好阐释骨性关节炎发病过程和机理,同时为建立参数化研究系统提供相关数据。     

Acute hemodynamic effects of ethanol in conscious spontaneously hypertensive and normotensive rats

This study investigated the differential hemodynamic effects of small to high doses of ethanol in conscious age-matched spontaneously hypertensive rats (SHRs) and Wistar Kyoto rats (WKYs). Changes evoked by ethanol (0.25, 0.5, or 1 g/kg, i.v.) or equal volume of saline in mean arterial pressure (MAP), heart rate (HR), cardiac output (CO), stroke volume (SV), and total peripheral resistance (TPR) were followed for 90 min in the two rat strains. The baseline MAP (163 +/- 4 vs. 113 +/- 2 mm Hg) of SHRs was significantly (p < 0.05) higher, compared with WKYs due mainly to the presence of an elevated TPR 13.82 +/- 0.12 vs. 2.51 +/- 0.09 mm Hg/ml/min/100 g, p < 0.05) in SHRs. In both rat strains, all doses of ethanol produced immediate increases in MAP at 1 min, after which the MAP responses varied and depended on the rat strain and dose of ethanol used. In WKYs, 0.25 g/kg ethanol had no effect on MAP, but caused significant decreases in CO and SV and increased HR. Ethanol (0.5 and 1 g/kg) produced a short-lived (10 min) and dose-related increase in MAP. The higher dose (1 g/kg) of ethanol elicited significant (p < 0.05) increases in TPR that were counterbalanced by concomitant decreases in CO and SV. In SHRs, the two higher doses (0.5 and 1 g/kg) of ethanol elicited significant (p < 0.05) decreases and increases in MAP, respectively, compared with control (saline-treated) values. The pressor response to the 1 g/kg dose of ethanol was associated with an increase in TPR that achieved a statistical significance (p < 0.05) at 50 and 80 min after ethanol administration. HR was significantly (p < 0.05) reduced by the two higher doses of ethanol, whereas SV and CO were not changed. Blood ethanol concentrations measured 10, 30, and 60 min after ethanol administration were similar in SHRs and WKYs. These findings suggest that acute administration of ethanol to conscious rats elicits hemodynamic responses that are strain- and dose-dependent. In contrast to a short-lived and dose-related pressor response in WKYs, ethanol (0.5 and 1 g/kg) elicited opposite and longer lasting effects on MAP (decreases and increases, respectively) in SHRs. In both rat strains, the pressor response to the higher dose of ethanol was associated with an increase in TPR; an effect that was compromised by a concomitant decrease in CO in WKYs but not SHRs.     

Mapping of quantitative trait loci for hypnotic sensitivity to ethanol in crosses derived from the C57BL/6 and DBA/2 mouse strains

BACKGROUND: Acute ethanol sensitivity is thought to be a predisposing factor toward the development of alcoholism. Accumulated evidence suggests that this characteristic may be at least partly heritable. A widely accepted approach for identifying genes thought to contribute to alcoholism is to map quantitative trait loci (QTLs) for various ethanol-related behaviors in rodent models. METHODS: Ethanol sensitivity QTLs were interval-mapped in a C57BL/6 (B6) X DBA/2 (D2) F2 intercross that contained 391 mice. Sensitivity was measured as the duration of loss of righting reflex (LORR) after 4.1 g/kg ip. LORR also was evaluated in a chromosome 1 marker-assisted congenic strain that had an approximately 30 centiMorgan (cM) portion of D2 DNA from the distal end of chromosome 1 introgressed onto a B6 background. RESULTS: A suggestive QTL was mapped on chromosome 1 (LOD = 3.3; approximately 80 cM) and a provisional QTL on chromosome 5 (LOD = 2.3; approximately 26 cM). The provisional chromosome 5 QTL was found to be sex-specific (LOD = 2.5 for males; LOD < 1 for females) with the D2 allele increasing LORR. The chromosome 1 D2 allele decreased LORR. Consistent with the F2 QTL mapping, congenic mice heterozygous for the chromosome 1 interval (B6/D2) had a significantly different mean (+/- SEM) LORR of 74.0 +/- 4.9 min (n = 36) compared with 90.8 +/- 6.2 min (n = 33) for their homozygous (B6/B6) littermates (p = 0.02). Blood ethanol concentration at regain of righting reflex was 377 +/- 10 mg% for the B6/D2 and 368 +/- 10 mg% (p = NS) for the B6/B6. CONCLUSIONS: LORR results in the chromosome 1 congenic mice were consistent with and very similar to what was predicted from the QTL analysis in the B6 X D2 F2 population. These results support a suggestive LORR QTL on the distal end of mouse chromosome 1. The results also indicate that there is a provisional sex-specific LORR QTL on chromosome 5.     

超声剪切波弹性成像技术在乳腺肿块诊断方面的研究进展商静(综述),阮骊韬(审校)

我国乳腺癌发病呈明显上升和年轻化特点,二维高频超声为该病的首选检查手段具有较高的灵敏度但特异度不高。近年来超声剪切波弹性技术发展突飞猛进,为进一步提高乳腺肿块诊断效能提供了可能。本文就超声剪切波弹性成像技术的基本原理以及在乳腺肿块诊断方面应用进行综述。