超声引导下肿瘤内注射^90钇玻璃微球的肝癌综合治疗

超声引导下对２８例肝癌病人进行了肿瘤内注射＾９０钇玻璃微球（Ｙ－９０ＧＴ ＭＳ）为主的综合性治疗（部分病人配合肿块周边注射无水酒精及门静脉穿刺化疗）。随访２～１６个月（平均７．９个月），病人全健在。肿瘤缩小率为９１％，其中显著缩小达７５％；肿块回声呈致密增强，少数呈混合型或等回声型；肿瘤内及周边血流信号显著减少；原甲胎蛋白升高者１３例，１１例显著下降，其中６例降至正常；病人症状减轻，全身情况改善。     

Microembolic signals and clinical outcome in patients with acute stroke – a prospective study

The occurrence of microembolic signals (MES) in patients with transient ischemic attack (TIA) or stroke has already been described; the influence of the time interval between onset of symptoms and transcranial Doppler monitoring (TCD) on the MES rate or MES prevalence and the possible prognostic value of the early detected MES rate on the outcome of TIA or stroke symptoms in a 3 month interval are discussed. In a prospective study we evaluated 61 patients consecutively admitted to our stroke unit after their first ischemic neurological deficit involving the vascular territory of MCA and/or ACA. All of the patients underwent a 30-minute bilateral transcranial Doppler monitoring of their MCAs for the identification of MES. Monitoring was performed within 12.3 + -9.3 (average mean + -SD) hours of stroke onset for the first time, the second time 48 hours after first TCD monitoring. Prognosis for the recovery of neurological deficits was evaluated by using the Barthel index (BI) and Scandinavian Stroke Scale (SSS) at the time of admission of the patient to the stroke unit, and with Barthel indices after one month and after 3 months. As a result, 56% of all patients showed MES in at least one of the two registrations. MES were recorded not only on the symptomatic side. The MES prevalence between both TCD monitorings was significantly different (total MES prevalence: 1st TCD: 26 patients: 2nd TCD: 13 patients; p < 0.04; ipsilateral MES prevalence: 1st TCD: 19 patients; 2nd TCD: 9 patients; p < 0.01). The regression analysis showed a significant influence of the total MES rate on both neurological scores at admission (SSS: 0.03; Barthel index: 0.04), but not for the Barthel scores after one and three months. In conclusion, we found an influence of the time interval between onset of neurological symptoms of TIA or stroke on the MES rate and the prevalence of MES. The prevalence of MES or the MES rate, found after a short time interval to the onset of symptoms, did not have a prognostic value on the outcome of neurological deficits up to a three month follow-up.     

胎儿泌尿系畸形的产前超声诊断分析

为了提高小儿泌尿外科的诊治水平，报告应用Ｂ超检出胎儿泌尿系畸形１９例，均经尸解或产后手术证实。其中肾积水１０例，双肾发育不良４例，多囊肾２例，单侧肾多发囊肿２例，孤立肾并肾囊肿１例。对各种畸形的声像图特征及产前诊断的意义进行了讨论。认为，妊娠中晚期，胎儿肾盂分离值大于１．５ｃｍ时，一般可诊断肾积水；而在妊娠早期，胎儿肾盂分离值应与相应孕周的正常值进行比较，如大于相应孕周正常值，虽绝对值未超过１．５ｃｍ，亦应列为动态观察对象，定期复查，以便早期确诊。     

腹腔镜超声在经腹腔镜输尿管上段切开取石术中的应用

目的 探讨腹腔镜超声(LUS)在腹腔镜输尿管上段切开取石术中的应用价值。方法 对7例输尿管上段结石患者在腹腔镜输尿管上段切开取石术中应用LUS对输尿管和结石定位。结果 7例LUS检查输尿管均显像，超声引导下顺利游离出输尿管；7例结石均获得准确定位，5例用无损伤钳顺利取出结石，2例按LUS定位切开输尿管后取出结石。LUS检查时间9-20min，平均14min。结论 LUS在腹腔镜输尿管上段切开取石术中有实际应用价值。     

Animal study on lung injury caused by simulant segmented shock waves

ｓｕｇｇｅｓｔｓｔｈａｔｔｈｅｏｒｇａｎｓｗｉｔｈａｉｒｃａｖｉｔｙ,ｓｕｃｈａｓｔｈｅｌｕｎｇｓ,ｍａｙｐｒｏｂａｂｌｙｂｅｄａｍａｇｅｄｉｎｔｈｅｅｘｐａｎｓｉｎｇｄｕｒａｔｉｏｎｏｆｓｈｏｃｋｗａｖｅｓ,ｔｈｅｒｅｉｓｌｉｔｔｌｅｉｎｆｏｒｍａｔｉｏｎａｂｏｕｔｉｔ.13Ｔｈｅｐｕｒｐｏｓｅｏｆｔｈｉｓｓｔｕｄｙｉｓｔｏｉｎｖｅｓｔｉｇａｔｅｔｈｅｅｆｆｅｃｔｓｏｆｔｈｅｓｉｍｕｌａｎｔｐｒｅｓｓｕｒｅｗａｖｅｓｄｕｒｉｎｇｔｈｅｐｒｏｃｅｓｓｏｆｔｒａｎｓｍｉｓｓｉｏｎｏｆｓｈｏｃｋｗａｖｅｓ…     

Comparison of ultrasonic and histopathological features of carotid artery stenosis

Abstract

Besides the degree of carotid artery stenosis, the composition of the plaque may help to predict the thromboembolic risk. Low echogenicity on ultrasound and hemorrhage into the atheroma demonstrated histopathologically have been shown to be associated with a higher risk of embolism. Twenty-nine consecutive patients with carotid artery stenosis and scheduled for carotid endarterectomy were investigated preoperatively by B-mode ultrasound. Post-operatively the endarterectomy specimens were examined histopathologically. Neither atheroma with hemorrhage nor atheroma without hemorrhage were significantly associated with echolucent ultrasound presentation. Out of the 10 lesions echolucent and homogeneous on ultrasound, six corresponded to atheroma with hemorrhage, two corresponded to atheroma with hemorrhage plus thrombus, two corresponded to fibrous plaque plus thrombus, and one corresponded to pure thrombus. Out of the 4 lesions heterogeneous and predominantly echolucent, one corresponded to atheroma without hemorrhage plus thrombus, one corresponded to atheroma with hemorrhage, one corresponded to atheroma with hemorrhage plus thrombus, one corresponded to atheroma with hemorrhage plus fibrous plaque. Seven out of the 18 atheromas with hemorrhage did not present as purely or predominantly echolucent lesions, six of them were even homogeneouslyechogenic. Plaque surface could not reliably be predicted by ultrasound. In our study, there was no significant correlation between ultrasound and histology of the lesion. [Neural Res 1997; 19: 380-384]     

核素显像和B超测算甲状腺重量的对比研究

对照研究核素显像和Ｂ超测算甲状腺重量的相关性，为临床提供较准确及简易的方法。３６３例甲亢病人１３１Ｉ治疗前分别进行γ显像和Ｂ超检查，以测算甲状腺体积（重量），其中６５例弥漫性甲状腺肿合并甲亢病人１３１Ｉ治疗后６个月重复两种检查。３６３例病人显像和Ｂ超测算甲状腺重量相关良好（ｒ＝０９３，Ｐ＜００１），总体上显像所得重量平均值大于Ｂ超值，腺体厚度是影响测算结果的主要因素；１３１Ｉ治疗后腺体厚度缩小最著，显像值大于Ｂ超值更明显。甲状腺重量测算在一定范围内两种方法可互相替代。１３１Ｉ治疗后，Ｂ超测定值为准。存在结节时，以显像为优。     

磁共振胆胰管成像与B超对胆胰疾病诊断的价值

目的利用ROC曲线评估磁共振胆胰管成像（MRCP）与B超对胆胰系统疾病的诊断效能，探讨MRCP的临床应用价值。方法以2002年至2004年拟诊胆胰系统疾病的62例病例为研究对象，所有病例均有完整的MRCP、B超及最终诊断资料，应用ROCKIT软件进行ROC分析。结果MRCP与B超均是诊断胆胰系统疾病的有效方法，但MRCP的诊断准确率高于B超（MRCP的ROC曲线下面积a=0．930，B超的ROC曲线下面积a=0．739）。特别是在胆总管下段疾病的诊断上，MRCP明显优于B超。结论MRCP作为一种无创性检查，对胆胰疾病有很好的定位诊断效能，与原始图像相结合分析有助于判断病因。     

应用阴道超声波观察妊娠晚期子宫颈成熟度

应用阴道Ｂ超对６０例妊娠晚期妇女的宫颈进行观察，评估其成熟度，并与宫颈Ｂｉｓｈｏｐ评分相比较。结果表明：二者的符合率为７０％。阴道Ｂ超评分≥６分者均在短期内自然临产或引产成功。而Ｂｉｓｈｏｐ评分认为宫颈不成熟的２２例中，阴道Ｂ超诊断为成熟者１８例，其中２４小时内自然临产５例，引产成功１３例，阴道Ｂ超诊断为不成熟者４例。全部引产失败。６０例中有２０例与会阴部Ｂ超检查比较，其宫颈内口可全部显像，但宫颈外口显像者仅１０例，其余１０例经变换体位方能清晰显示图像，２０例中８例同时经腹部Ｂ超扫查，宫颈内外口图像显示均欠清晰。提示：阴道Ｂ超对宫颈成熟度诊断的正确率高于Ｂｉｓｈｏｐ评分法；阴道Ｂ超的宫颈显像率高、图像清晰。