Estimation of bladder wall location in ultrasound images

A method of automatically estimating the location of the bladder wall in ultrasound images is proposed. Obtaining this estimate is intended to be the first stage in the development of an automatic bladder volume calculation system. The first step in the bladder wall estimation scheme involves globally processing the images using standard image processing techniques to highlight the bladder wall. Separate processing sequences are required to highlight the anterior bladder wall and the posterior bladder wall. The sequence to highlight the anterior bladder wall involves Gaussian smoothing and second differencing followed by zero-crossing detection. Median filtering followed by thresholding and gradient detection is used to highlight as much of the rest of the bladder wall as was visible in the original images. Then a ‘bladder wall follower’—a line follower with rules based on the characteristics of ultrasound imaging and the anatomy involved—is applied to the processed images to estimate the bladder wall location by following the portions of the bladder wall which are highlighted and filling in the missing segments. The results achieved using this scheme are presented.     

Ultrasound in Obstructive Jaundice

The ultrasonographic findings of 44 patients, with obstructive jaundice were retrospectively reviewed. Our conclusions from this study are:

• (i) Ultrasound is an excellent modality for detecting dilatation of the biliary tree (in part or in total) and assessing the degree of dilatation, but it does not reliably detect the obstructing lesion often enough.
• (ii) It is important to adequately visualise the area of the extra-hepatic biliary tree and pancreatic head before suggesting the aetiology of any biliary tract dilatation regardless of the findings more proximally in the biliary tract.
• (iii) The optimal role of ultrasound is to detect a mass if one is present: tissue-typing requires histological or cytological examination of material from the mass.

     

超声联合血清TPO–Ab、Tg–Ab在桥本甲状腺炎临床进程评价中的应用价值

目的：探讨超声联合血清甲状腺过氧化物酶抗体（TPO–Ab）、甲状腺球蛋白抗体（Tg–Ab）评价桥本甲状腺炎（HT）临床进程的应用价值。方法：选择2021年9月至2022年8月贵州航天医院接诊的HT患者100例纳入观察组,另选择同期于贵州航天医院体检的健康者100例纳入对照组,两组研究对象均行彩色多普勒超声及血清TPO–Ab、Tg–Ab检查。比较两组研究对象血清TPO–Ab与Tg–Ab水平,并分析观察组患者术后病理或空心针穿刺活检组织病理学分级情况,以及观察组患者不同术后组织病理学分级患者血清TPO–Ab与Tg–Ab水平。以术后病理或空心针穿刺活检组织病理学分级为标准,评价超声、血清TPO–Ab与Tg–Ab单独及联合检测对观察组患者组织病理学分级的诊断准确度。结果：观察组患者血清TPO–Ab及Tg–Ab水平均高于对照组健康者,差异具有统计学意义（P <0.05）。观察组中,组织病理学分级为Ⅰ级的患者有58例,Ⅱ级有30例,Ⅲ级有12例;Ⅰ级患者血清TPO–Ab与Tg–Ab水平均低于Ⅱ、Ⅲ级患者,Ⅱ级患者血清TPO–Ab与Tg–Ab水平均低于Ⅲ级患者,差异均具有统计学意义（P <...     

不同影像技术对胰腺癌模型兔原位种植建模效果的评价与比较

目的:比较CT、MRI及超声平扫检查对胰腺癌模型兔建模效果的评价价值。方法:建立胰腺癌模型兔10只,对每只模型兔采用CT、MRI、超声平扫等影像检查,比较不同影像技术对模型兔肿瘤病灶的检出率;并对肿瘤采用磁共振波谱(MRS)分析肿瘤代谢情况。结果:建模成功3周末,死亡5只,存活5只;3种检查方式均能发现胰腺区的肿瘤病变和腹腔积液,检出率均能够达到100%。在对肿大淋巴结和血管包绕的检出中,MRI与CT的检出率相当,均优于超声平扫;在对远处转移的检出中,MRI要优于另外两种方式,但三种影像检查方法的病灶肿大淋巴结、血管包绕及远处转移等检出率比较,差异均无统计学意义(χ²=3.619,χ²=3.000,χ²=6.857;P>0.05)。MRS分析能够清晰显示胆碱(Ch)、肌酐(Cr)和N-乙酰天门冬氨酸(NAA)峰。结论:对动物肿瘤模型采用CT、MRI和超声平扫检查,可以获得较为满意的检测效果,但是在行动物实验过程中,需要根据实际的肿瘤种植位置和肿瘤转移位置采用合适的影像检查方法。     

侵袭性牙周炎患者疱疹病毒感染和外周血病毒载量

目的分析不同严重程度侵袭性牙周炎(AGP)患者疱疹病毒(HV)感染情况和外周血病毒载量。方法选取2014年12月-2019年12月济南市市中区人民医院口腔科收治的2600例AGP患者,根据病变程度分为轻度AGP组(n=82)、中度AGP组(n=578)、重度AGP组(n=1940),以同期100名健康人群为对照组。入组后,检测龈沟液HV病毒感染情况和血浆单纯疱疹病毒1型(HSV-1)、EB病毒(EBV)、人类巨细胞病毒(HCMV)、人类疱疹病毒6型(HHV-6)载量、牙周特征和血炎症因子水平。结果AGP患者牙周菌斑指数(PLI)、探诊深度(PD)、附着丧失(AL)、出血指数(BI)高于对照组(P<0.05),HSV-1、EBV、HCMV、HHV-6感染率和病毒载量高于对照组(P<0.05),白细胞(WBC)、降钙素原(PCT)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、C-反应蛋白(CRP)高于对照组(P<0.05);随着AGP病情严重程度增加,HSV-1、EBV、HCMV、HHV-6感染率和病毒载量、PLI、PD、AL、BI、WBC、PCT、IL-6、TNF-α和CRP均增加(P<0.05)。结论HV感染率和病毒载量与AGP患者血清炎症因子水平和牙周特征随病情严重程度增加而升高。     

胃肠道间质瘤的临床病理及免疫组化表达

目的：观察胃肠道间质肿瘤(gastrointestinal stromal tumor,GIST）临床病理特征及免疫组化表达,为临床诊断、治疗提供可靠依据。方法：采用常规病理切片HE染色,光镜观察,并行S－P法免疫组化Vimentin、CD34、SMA、Desmin、NF、S-100、EMA等标记物标记26例GIST。结果：26例GIST中,良性7例,恶性10例,低度恶性9例;发生于胃14例,小肠5例,回盲部2例,大肠和直肠5例;免疫组化Vimentin、CD34在瘤细胞中呈强阳性表达（阳性表达率分别为96．2％和84．6％）,肌源性和神经源性标记物SMA、S－100呈散在细胞阳性表达（阳性表达率分别为26．9％和15．4％）,而NF、EMA、Desmin均呈阴性表达。结论：GIST是一种源于原始间充质细胞的非定向分化的肿瘤,可伴有神经源性或／和肌源性分化,组织学上常以梭形细胞或上皮样细胞为主,具有类似肌源性或神经源性肿瘤的形态;临床手术切除前不易诊断,病理组织形态上易误诊为其它类型梭形细胞肿瘤;CD34和Vimentin对本瘤病理诊断具有较高的价值。     

El manejo de la torsión testicular en Urgencias: lecciones aprendidas de las reclamaciones por responsabilidad profesional médica

ObjectiveTo evaluate emergency care for testicular torsion in medical professional liability claims.MethodClaims related to testicular torsion from 2000 to 2018 were located. The assistance provided and the association with medical professional liability were analyzed.ResultsEighty complaints were identified, testicular pain was reported in 83.75% of first consultations, with a mean evolution time of 15.5 h. The mean time to diagnosis was 7.98 days. The first consultation was at the hospital in 75.1% of cases, but an ultrasound was performed only in 7.5%. When testicular torsion diagnosis was performed, 97.3% had undergone ancillary tests. The medical professional liability was significantly associated with non-criminal proceedings and with less than 6 h of symptoms’ evolution, and, within this subgroup, without undergoing an ultrasound scan.ConclusionsLate consultations, wrong diagnosis and late diagnosis are claimed. When medical professional liability are claimed by means of non-criminal law, the existence of responsibility is frequently considered, even more in those cases when the consultation took place before 6 h of evolution with no ancillary tests having been performed.