超声下两种颈内静脉置管法的比较

目的 超声下比较两种路径颈内静脉置管方法的准确性及并发症的发生率,寻找更安全、可靠的颈内静脉穿刺路径。方法 选择需行颈内静脉穿刺患者60例,随机分为传统中路法穿刺组(A组,n=30)与颈内静脉搏动点法穿刺组(B组,n=30)。观察颈总动脉直径(D1)、颈内静脉直径(D2)、颈总动脉和颈内静脉重叠覆盖率、穿刺路径距颈内静脉中心距离(D3)、穿刺路径距颈总动脉外侧距离(D4)及可能触及颈总动脉例数。结果 与A组比较,B组D3较小,差异有统计学意义(P<0.05);B组D4明显大于A组,差异有统计学意义(P<0.05)。结论 颈内静脉搏动点法行颈内静脉穿刺更准确,并发症发生率更低。     

基于深度学习的超声影像诊断对终末期慢性肾病的价值

目的 探讨基于深度学习的卷积神经网络模型DenseNet121对终末期肾病的诊断价值.方法 回顾性选择2019年1月1日至9月30日期间中日友好医院诊断为终末期肾病的489张肾超声影像和对照组450张健康肾超声影像.采用深度卷积神经网络模型DenseNet121进行网络的训练和验证,把是否为终末期肾病作为参考标准.然后...     

外周肌腱附着点超声检查在强直性脊柱炎诊断中的价值

目的 探讨肌腱附着点超声检查诊断强直性脊柱炎(AS)的价值.方法 20例AS患者,病程1-8(4.3±3.1)年.采用高频线阵探头(频率7-12 MHz)对6对肌腱附着点进行超声检查.临床检查时,患者有肌腱附着点部位自主疼痛、肿胀或压痛之一则定义为肌腱附着点炎.结果 AS患者肌腱附着点炎的超声诊断率高于临床检查(51.3％ vs.19.6％) (P＜0.05).AS患者肌腱附着点病变在超声上主要表现为肌腱插入骨皮质部位出现钙化(33.3％)、肌腱水肿(29.2％)、血流灌注(25.8％)、肌腱增厚(22.1％)、骨皮质不规则(12.9％)、骨侵蚀(9.6％)和滑囊炎(7.1％).47处临床检查肌腱附着点阳性病变中,44.7％超声检查未发现异常;而193处临床阴性附着点中,49.2％超声提示存在附着点病变.结论 超声检查可发现肌腱附着点结构和炎性病变,可作为AS患者临床检查的补充手段.     

Decision-making after ultrasound diagnosis of fetal abnormality

During the last few decades, the use of ultrasonography for the detection of fetal abnormalities has become widespread in many industrialised countries. This resulted in a shift in timing of the diagnosis of congenital abnormalities in infants from the neonatal period to the prenatal period. This has major implications for both clinicians and the couples involved. In case of ultrasound diagnosis of fetal anomaly, there are several options for the obstetric management, ranging from standard care to non-aggressive care and termination of pregnancy. This essay explores the context of both clinical and parental decision making after ultrasound diagnosis of fetal abnormality, with emphasis on the Dutch situation. While normal findings at ultrasound examination have strong beneficial psychological effects on the pregnant woman and her partner, the couple is often ill prepared for bad news about the health of their unborn child in the case of abnormal findings. This is, in particular, true in settings where ultrasonography for the detection of fetal abnormalities is offered as an integral part of antenatal care without appropriate counselling. An important question is to what extent the couple should be supported in decision making when a fetal abnormality is diagnosed. In this context, the parental perception of having a choice varies markedly. When parents consider end-of-life decisions, they experience both ambivalent and emotional feelings. On the one hand, they are committed to their pregnancy, while on the other hand, they want to protect their child, themselves and the family from the burden of severe disability. These complex parental reactions have implications for the counselling strategy.

胎儿胆囊结石的宫内诊断及临床意义

胎儿胆囊结石是胎儿期胆囊内发现结石、泥沙或回声光团,常在孕妇产检行超声检查时偶然发现。尽管每年行产科B超的人数越来越多,但胎儿胆囊结石的发病仍罕见。尽管胎儿胆囊结石的病因、发病机制、临床意义及自然转归尚不清楚,但胎儿胆囊结石结局是非常好的。多数学者认为胎儿胆囊结石是一种罕见、暂时的、发生在孕末3个月的病变,虽然它的存在不影响胎儿的预后和产科处理,但在产前及产后密切追踪超声检查是必要的。     

产前超声检查在胎儿泌尿系统异常中的应用价值

目的：探讨超声在胎儿泌尿系统异常中的应用价值。方法：通过分析18例胎儿泌尿系统异常的声像图特征,结合后续复查随访,判断病变的性质。结果：18例异常中,多数病例为功能性病变,器质性病变如无其他系统合并症,大多为非致死性。结论：超声对胎儿泌尿系统异常的检出及性质的判断有较大的优势,但也存在一定的客观局限性。     

Radiation-associated angiosarcoma of the breast with initial presentation as non-mass enhancement on MRI

Radiation-associated angiosarcoma of the breast (RAASB) is a rare and aggressive malignancy occurring after radiation therapy as part of breast cancer treatment. RAASB usually presents several years after prior radiation and typically involves the skin with or without involvement of the parenchyma. Most RAASB are detected as cutaneous changes on physical exam. Herein, we present a unique case of a clinically occult RAASB diagnosed as non-mass enhancement on annual surveillance breast MRI.     

胎儿出生体质量的MRI预测及其临床应用

产前预测胎儿出生体质量可评价胎儿宫内生长发育,指导分娩方式。MRI能清楚显示胎儿解剖结构和异常情况,通过测量胎儿体积（FBV）可以计算获得胎儿体质量预测值（EFW）,有助于高危儿的诊断和监测。综述MRI预测胎儿体质量的扫描技术、FBV的测量方法及EFW的计算方法,介绍其在识别大于胎龄儿及小于胎龄儿、高危产妇（糖尿病妊娠以及双胎妊娠）中的应用,展望MRI产前预测胎儿出生体质量的临床应用。     

超声引导下行胚胎移植对妊娠结局的影响

目的研究超声引导下行胚胎移植对体外受精-胚胎移植结局的影响。方法回顾性分析2008年6月至2010年1月,接受体外受精-胚胎移植（包括卵母细胞内单精子注射）治疗的436个移植周期的资料,按照胚胎移植时有无B超引导分为常规胚胎移植组（常规组）和超声引导下胚胎移植组（超声组）,分别有110个周期和326个周期,比较两组患者的临床妊娠率、胚胎种植率、胚胎残留率、异位妊娠率,困难移植率及内外移植管血染率。结果常规组和超声引导组的周期临床妊娠率分别是36.4%（40/110）和40.5%（132/326）,P〈0.05;胎种植率分别是16.4%（47/286）和23.5%（207/880）,P〈0.05;困难移植率分别是7.3%（8/110）和2.1%（7/326）,P〈0.05;内外移植管出血率7.3%（8/110）和4.6%（5/326）,P〈0.05;胚胎残留率分别是3.6%（4/110）和2.6%（8/326）,P〉0.05;异位妊娠率分别是2.2%（2/110）和1.5%（5/326）,P〉0.05。结论超声引导下行胚胎移植能提高体外受精-胚胎移植的胚胎种植率,降低困难移植率及内外移植管血染率,能有助于改善临床妊娠率,是一种有效的胚胎移植方法。     

COVID-19 vaccine-induced lymphadenopathies: incidence,course and imaging features from an ultrasound prospective study

Aimslymphadenopathy can occur after COVID-19 vaccination and when encountered at ultrasound examinations performed for other reasons might pose a diagnostic challenge. Purpose of the study was to evaluate the incidence, course and ultrasound imaging features of vaccine-induced lymphadenopathy.Methods89 healthy volunteers (median age 30, 76 females) were prospectively enrolled. Vaccine-related clinical side effects (e.g., fever, fatigue, palpable or painful lymphadenopathy) were recorded. Participants underwent bilateral axillary, supraclavicular and cervical lymph node stations ultrasound 1–4 weeks after the second dose and then again after 4–12 weeks in those who showed lymphadenopathy at the first ultrasound. B-mode, color-Doppler assessment, and shear-wave elastography (SWE) evaluation were performed. The correlation between lymphadenopathy and vaccine-related side effects was assessed using the Fisher’s exact test.ResultsPost-vaccine lymphadenopathy were found in 69/89 (78%) participants (37 single and 32 multiple lymphadenopathy). Among them, 60 presented vaccine-related side effects, but no statistically significant difference was observed between post-vaccine side effect and lymphadenopathy. Ultrasound features of vaccine-related lymphadenopathy consisted of absence of fatty hilum, round shape and diffuse or asymmetric cortical thickness (median cortical thickness of 5 mm). Vascular signal was mainly found to be increased, localized in both central and peripheral regions. SWE showed a soft cortical consistence in all cases (median value 11 Kpa). At follow-up, lymph-node morphology was completely restored in most cases (54/69, 78%) and in no case lymphadenopathy had worsened.ConclusionA high incidence of vaccine-induced lymphadenopathy was found in a population of healthy subjects, with nearly complete regression within 4–12 weeks.Supplementary InformationThe online version contains supplementary material available at 10.1007/s40477-022-00674-3.