【摘要】 目的 探讨弹性成像在甲状腺微小癌诊断中的应用价值。 方法 回顾性分析从2007年12月-2008年4月间经病理证实的10例甲状腺微小癌患者共11个病灶的超声表现。 结果 彩色多普勒超声诊断甲状腺微小癌8例8个病灶，利用弹性成像技术诊断10例10灶。传统彩色多普勒超声对甲状腺微小癌的诊断率为72.7%；利用弹性成像技术对甲状腺微小癌的诊断率为90.9%。 结论 弹性成像技术对于甲状腺微小癌是对彩色多普勒超声检查的有益的补充，能够显著提高超声对甲状腺微小癌诊断的准确性。【Abstract】 Objective To evaluate the application of US-elastography in diagnosis of thyroid microcacinoma. Methods The images of color ultrasound and ultrasound elastography from 11 lesions of 10 patients with thyroid micro-carcinoma diagnosed via histopathology between December 2007 and April 2008 were retrospectively analyzed. Results Eight patients with eight lesions were found by colour ultrasound and 10 patients with 10 lesions were observed by ultrasound elastography. The diagnosis accurate rate of ultrasonography was about 72.7% and of ultrasound elastography was about 90.0%. Conclusion US-Elastography is a beneficial addition in diagnosis of thyroid microcacinoma by colour ultrasound. It can remarkably develop the accurate rate of the diagnosis of the disease.
【摘要】 目的 分析超声对腺性膀胱炎的误、漏诊原因，探讨减少其误、漏诊的方法。 方法 回顾性分析2006年1月-2010年2月经病理证实的135例腺性膀胱炎的声像图表现。 结果 135例腺性膀胱炎患者中，超声误诊26例，误诊率19.3%，漏诊11例，漏诊率8.2%。误诊的主要原因：乳头结节型和团块型与膀胱肿瘤声像图极为相似、容易混淆，超声医师对膀胱壁各层次的观察不仔细，对病史重视不够；漏诊的主要原因：膀胱充盈不佳或不充盈，病变体积太小、位于前壁或顶部，或病变位于膀胱后壁及颈部被明显增生的前列腺、膀胱内血凝块及膀胱结石等掩盖。 结论 超声是诊断腺性膀胱炎常用方法，但存在一定的误、漏诊，改进检查方法，可减少其误、漏诊发生。【Abstract】 Objective To analyze the reasons of missed diagnosis and misdiagnosis of glandularis cystitis by ultrasonography. Methods The sonographic outcomes of 135 patients with glandular cystitis diagnosed by pathological examination from January 2006 to February 2010 were retrospectively analyzed. Results In 135 patients, misdiagnosis was in 26 with a rate of 19.3%, missed diagnosis was in 11 with a rate of 8.2%. The reasons of misdiagnosis included: the sonographic outcomes of mastoid and tuberculous conglomeration were similar to those of bladder tumour; the ultrasonographic professionals didn’t clearly observe each layer of the bladder wall, and didn’t pay enough attention to the disease history. The reasons of missed diagnosis included: the bladder was under-filled or unfilled, the size of the lesions were too small and were located at the anterior wall or the top, and the lesions were located at the posterior wall and neck of the bladder which were covered up by obvious prostate hyperplasia,and gores or stones of bladder so that the lesions could not be observed. Conclusion Ultrasonography is a usual method for diagnosing glandular cystitis,and we should ameliorate the examination to decrease the misdiagnosis and missed diagnosis.
目的 探讨甲状腺髓样癌的超声声像图特点，以提高超声诊断水平。 方法 回顾性分析2006年1月－ 2010年9月经手术切除及病理组织学证实的16例甲状腺髓样癌20个结节的超声声像图表现。 结果 20个甲状腺髓样癌结节中，结节呈低回声20个，结节内部有钙化灶者13个，结节内血流丰富者13个，合并有甲状腺乳头状微小癌1例，颈部淋巴结肿大17例。 结论 甲状腺髓样癌具有一定的超声声像图特点，了解这些特点可以提高超声对甲状腺髓样癌的诊断水平。
【摘要】 目的 探讨超声显像对肾上腺肿瘤的定位、定性诊断与鉴别诊断价值。 方法 对 2003年1月-2009年1月125例疑为肾上腺肿瘤患者进行超声及CT检查，并经手术与病理证实。超声显像诊断后经手术与病理证实为嗜铬细胞瘤48例，肾上腺皮质腺瘤41例，皮质腺癌11例，肾上腺转移癌 9例，髓样脂肪瘤8例，结节样增生2例，肾上腺结核4例，胰尾部肿瘤1例，肝脏肿瘤1例，肾上极肿瘤1例。 结果 肾上腺肿瘤的病理类型不同，声像图表现亦各不相同。超声显像定位诊断符合率为96.0%（120/125），定性诊断符合率为91.2% （114/125）。 结论 超声显像对肾上腺肿瘤的定位与定性诊断价值较大，可作为临床诊断的首选检查方法。【Abstract】 Objective To assess the value of ultrasonography in the diagnosis and differential diagnosis of tumors of adrenal gland. Methods From January 2003 to January 2009, 125 patients who were suspected to suffering from adrenal tumors underwent ultrasonography and CT examination. The results were then confirmed by surgery and pathology. There were 48 cases of pheochromocytoma, 41 adenoma, 11 adenocarcinoma, 9 metastatic tumor, 8 adrenal medullary lipoma, 2 nubblar hyperplasia, 4 tuberculosis of adrenal gland, 1 tumor of cauda pancreatic, 1 tumor of liver and 1 tumor of upper pole of kidney. Results The ultrasonographic features varied with different pathological types. The accuracy diagnosis of localizition and qualitation were 96.0% (120/125) and 91.2% (114/125) respectively. Conclusion Ultrasonography is useful in diagnosing tumors of adrenal gland, which may be used as the first choice for the disease.
Objective To discuss the diagnostic and differential diagnostic value of ultrasonography for primary testicular lymphoma (PTL) by studying the ultrasonographical image characteristics. Methods Thirty-one patients with PTL confirmed by postoperative histopathology between 2005 and 2015 were chosen to be the study subjects. We retrospectively analyzed their ultrasonographical features and clinical data. Results Most PTL patients were elderly men, and the initial symptom was mainly painless testis enlargement. Thirty-nine testicles were involved in the primary testicular lymphoma, including 23 unilateral and 8 bilateral. In the 31 patients, 22 had diffuse lesions and 9 nodal. Ultrasonography showed that most tumors were hypoechoic lesions, and part of them were hyperechoic linearly. The lesions had abundant blood flow signals with a low resistance index. Conclusions In elderly patients with painless testicular enlargement, the possibility of primary testicular lymphoma must be fist considered. Manifestations of primary testicular lymphoma have some distinctive characteristics, and combined with clinical history, they are helpful for the diagnosis and differential diagnosis of PTL.
Objective To investigate the curative effect of facility negative pressure closed drainage on wounds in earthquake. Methods We retrospectively analyzed the data of 35 patients treated by facility negative pressure closed drainage after debridement in earthquake. The same category patients treated by conventional therapy as the control group. Results Time of facility negative pressure closed drainage was 6-12 days, average 7.5±1.8 days. The woundswere all cured. The wounds closure were performed with skin grafting in 24, with secondary suturing in 4, with regionalflap transposition in 5, and with cross leg flap in 2. There were significant differences in time of secondary closure, timesof dressing and the total time of hospitalization between two groups (Plt;0.01). And there was a significant difference incurative effect of skin grafting between two groups (Plt;0.05). Conclusion Facility negative pressure closed drainage on treating wounds in earthquake is a simple, safe method, and has significant curative effect.
目的 总结直肠超声引导下经会阴前列腺12点穿刺活检术围手术期的护理经验。 方法 对2010年6月－2012年10月行直肠超声引导下经会阴前列腺12点穿刺活检术932例患者围手术期护理措施及要点予以回顾分析。 结果 932例患者顺利完成穿刺活检，术后除1例患者出现迷走神经反射综合征、经及时抢救缓解外，无其他并发症发生。 结论 直肠超声引导下经会阴前列腺12点穿刺活检术具有安全简便、无需肠道准备、并发症少、准确率高等优点，充分的围手术期护理是该活检术顺利完成的重要因素与环节。
目的 应用判别分析探讨不同指标对前列腺癌预测诊断中的应用价值。 方法 收集2008年1月－2011年9月经直肠超声检查并行经直肠超声引导下经会阴前列腺穿刺活检术，具有前列腺特异性抗原（PSA）、超声图像特征的941例患者以及其中含有血流阻力指数（RI）指标的200例患者的临床资料，采用最近距离及极大似然判别分析两种方法分别拟合患者年龄、血清PSA、经直肠前列腺超声声像图特征以及RI指标预测前列腺癌。 结果 最近距离判别分析显示RI对前列腺癌的判别无临床意义。联合患者年龄、超声检查和血清PSA值，判别结果提示超声、超声+年龄、年龄+超声+PSA三种判别的灵敏度逐渐增加。年龄+超声+PSA联合指标的灵敏度为88.89%，其错判率在20.00%以内。 结论 年龄+超声+PSA联合指标的极大似然判别分析可提高前列腺癌的诊断预测水平，避免前列腺穿刺给患者带来的痛苦，并给临床医生的临床诊断提供参考，有较好的应用价值。
Objective To explore the sonographic features of testicular torsion in adult males (≥25 years). Method We retrospectively analyzed the clinical, pathological and sonographic data of 79 adult male patients with testicular torsion, in whom 20 underwent resection of testis and 59 retained testis in West China Hospital from September 2006 to March 2017. Results There were 56 patients with spermatic cord nodules or mass with the largest mass of about 36 mm ×31 mm; the scrotal wall thickened in 48 patients with the thickness of 5–10 mm; axial changes of the affected testis were found in 24 patients; there were 61 patients with testicular growth in the affected side, while the affected testis was reduced in 7; there were 67 patients with asymmetric echo in the affected side, and the maximum hypoechoic area was about 36 mm×26 mm; the epididymis of the affected side in 35 patients with were unclear, and the epididymis of the affected side was enlarged in 19; 25 patients had hydrocele of testis; there was no blood flow in 49, blood flow reduced in 25, and blood flow increased in 5. Four patients were diagnosed by contrast-enhanced ultrasound, and there was no enhancement in 3 and partial enhancement in 1. Conclusion The sonographic features of testicular torsion in adult males are obvious, and the early diagnosis of testicular torsion can be confirmed by contrast-enhanced ultrasonography.
Objective To explore the feasibility of transluminal dual plane ultrasound (TDPU) in evaluating the structure and function of pelvic floor muscle. Methods Non anorectal diseases patients who visited the Department of Medical Ultrasound, West China Hospital of Sichuan University, medical staff and medical staff’s relatives volunteers between May and November 2022 were selected. According to the criteria for ultrasound diagnosis of pelvic organ prolapse (POP) and the pelvic organ prolapse quantification (POP-Q) scoring criteria, the subjects were divided into normal group and POP group. The changes of the thickness of the left and right puborectalis muscle (PRM), the internal anal sphincter (IAS) and the external anal sphincter (EAS) at 3-, 6- and 9-o’clock, the depth and height of the perineal body (PB) were compared, and the changes of the elastic Young’s modulus of PRM, EAS and PB were compared through real-time shear wave elastography. Results A total of 192 subjects were included, including 140 in the normal group and 52 in the POP group. There were statistically significant differences between the POP group and the normal group in terms of gestational frequency, parity, and history of vaginal delivery (P<0.05). There was no statistically significant difference in age, body mass index, menopausal history, and neonatal weight between the two groups (P>0.05). Under the condition of resting and maximum anal constriction, the thickness of PRM on the left and right sides of POP group was not significantly different from that of the normal group (P>0.05), but the elastic Young’s modulus of PRM on the left and right sides were lower than that of the normal group (P<0.05). At resting and maximum anal constriction, there was no significant difference in IAS thickness between the POP group and the normal group at 3-, 6- and 9-o’clock (P>0.05). At resting and maximum anal constriction, the thickness of deep and subcutaneous parts of EAS at 6-o’clock and the subcutaneous part of EAS at 9-o’clock in the POP group were smaller than those in the normal group (P<0.05). At resting and maximum anal constriction, the elastic Young’s modulus of EAS at 3-, 6- and 9-o’clock were lower than those in the normal group (P<0.05). There was no significant difference in the depth and height of PB between the POP group and the normal group at resting and maximum anal constriction (P>0.05). The elastic Young’s modulus of PB in the POP group was lower than that of the normal group (P<0.05). Under the condition of maximum anal constriction, the thickness of deep and subcutaneous parts of EAS at 3-o’clock in the POP group were lower than those in the normal group (P<0.05). Conclusion TDPU can quantitatively evaluate the structure and function of pelvic floor muscle through different states of resting and maximum anal constriction, and also can provide ultrasonic basis for the diagnosis and treatment of female pelvic floor dysfunction diseases.