【摘要】 目的 探讨急诊超声在右下腹急腹症诊断中的应用价值。 方法 回顾性分析2008年8月-2009年12月150例右下腹急腹症患者急诊超声检查结果，所有患者均经手术和病理资料或者临床治疗后得到证实，将超声诊断的结果与临床出院诊断进行对比分析。 结果 150例右下腹急腹症患者中，超声正确诊断126例（84%），漏诊18例，误诊6例，其中急性阑尾炎漏诊率最高，漏诊的主要原因为部分患者阑尾解剖位置特殊或者肠道气体干扰。 结论 超声检查能够较准确判断右下腹急腹症的病因。熟悉常见急腹症疾病的临床表现、体征及熟练掌握常见疾病的超声声像图特点，对右下腹急腹症的诊断及鉴别诊断至关重要。【Abstract】 Objective To evaluate acute ultrasonography in diagnosing right hypogastric acute abdomen. Methods The results of acute ultrasonography of 150 patients with right hypogastric acute abdomen were retrospectively analyzed. The disease was confirmed by surgery and pathological examination. The results of ultrasonography and clinical diagnosis were compared. Results Among 150 patients, correct ultrasonography diagnosis was found in 126 (84%), missed diagnosis in 18, and misdiagnosis in six; the highest rate of missed diagnosis occurred in patients with acute appendicitis. Conclusion Acute ultrasonography can feasibly and accurately diagnose right hypogastric acute abdomen. The accuracy depends on the common clinical manifestations and the common diseases ultrasonography characters of right hypogastric acute abdomen.
【摘要】 目的 探讨胃肠道间质瘤(GIST)彩色多普勒超声表现及其在诊断中的应用价值。 方法 回顾性分析2008年1月-2010年7月75例经病理证实的GIST的彩色多普勒超声声像图表现，将其与手术病理结果进行对比分析。 结果 GIST患者中男性高危险度肿瘤的比例较女性高（χ2=7.210，Plt;0.01）。肿瘤的大小、内部回声与其病理危险度高低有关:危险度低者、肿瘤最大径lt;5 cm，内部回声较均匀；危险度高者，肿瘤最大径≥5 cm，内部回声不均匀。肿瘤的彩色血流分布与其危险度高低无明显相关。常规的超声检查对肿瘤检出率较高，在胃及直肠的GIST诊断准确率高于其他部位的GIST。 结论 彩色多普勒超声检查有助于GIST的定位及分化程度的判断，可作为首选检查方法。【Abstract】 Objective To investigate the value of ultrasonography in the diagnosis of gastrointestinal stromal tumors (GIST). Methods The color sonographic performances obtained in 75 patients with pathologically proved GIST from January 2008 to July 2010 were retrospectively analyzed. The sonographic findings were compared with pathological results. Results The proportion of high-risk cancer in male patients with GIST was higher than that in women (χ2=7.210, Plt;0.01). The tumor size and internal echo level were related to its pathologic risk: in low-risk GIST, maximum tumor diameter was lt;5 cm, and internal echo was more homogeneous; in high-risk GIST, maximum tumor diameter was ≥ 5 cm and internal echo was heterogeneous. There was no statistical difference between tumor blood flow distribution and GIST risk. Routine sonography examination had a higher rate of cancer detection and had a higher accuracy in the diagnosis of GIST in the stomach and rectum than those in the other parts. Conclusion Sonography helps to locate and diagnose malignant GIST, which is a common and preferred screening method.
【摘要】 目的 比较肠充盈超声检查法与常规经腹超声检查法在结直肠肿瘤中的诊断价值。 方法 对2008年6月-2009年6月64例经临床病理确诊的结直肠肿瘤患者分别经腹常规超声及肠充盈超声检查。在肠充盈状态下观察病变的形态，对病变进行定位并观察结直肠肿瘤的彩色多普勒血流信号。比较肠充盈超声检查法及常规经腹超声检查法在结直肠肿瘤的检出、定位和显示血流的能力的差异。 结果 常规经腹部超声检查发现32例结直肠肿瘤（32/64），病灶敏感性为50%； 肠充盈超声检查法发现病灶55例（55/64）， 病灶敏感性为85.9%。经腹常规超声检查的定位准确率为21.9%（7/32），肠充盈超声检查法对结直肠肿瘤的定位准确率为89.1%（49/55）。两种方法比较差异有统计学的意义（Plt;0.05）。 结论 肠充盈超声检查法在结直肠肿瘤的病变敏感性检出、定位准确性等方面优于经腹常规超声检查；而不同病理类型的结直肠肿瘤具有不同的超声声像图特征。【Abstract】 Objective To compare the diagnostic value between intraluminal contrast-enhanced hydrocolon ultrasonography and conventional transabdominal ultrasonography for of colorectal neoplasms. Methods The conventional transabdominal ultrasonography and hydrocolonic ultrasonography using an intraluminal contrast agent were performed on 62 patients from June 2008 to June 2009. The morphological features and location of the lesion were observed and the blood flow signals were observed. The different diagnostic value between conventional transabdominal ultrasonography and intraluminal contrast-enhanced hydrocolon ultrasonography was compared. Results The sensitivity of the intraluminal contrast-enhanced hydrocolon ultrasonography in the depiction of the colorectal neoplasms (55/64, 85.9%) was higher than that of the conventional transabdominal ultrasonography (32/64, 50%, Plt;0.05). And the accuracy of the intraluminal contrast-enhanced hydrocolon ultrasonography in locating the colorectal neoplasms (48/55, 87.3%) was higher than that of the conventional transabdominal ultrasonography (7/32, 53.2%, Plt;0.05). Conclusion Intraluminal contrast-enhanced hydrocolon ultrasonography is more valuable for colorectal neoplasms than conventional transabdominal ultrasonography in detecting and locating colorectal neoplasms. Colorectal neoplasms with different pathological types may have different ultrasonic features.
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.
Crohn’s disease (CD) is one of inflammatory bowel diseases, characterized by lifelong relapsing-remitting clinical course. The choice of treatment protocols is based on the comprehensive evaluation of the disease. And the treatment protocols should be adjusted according to the response to the treatment and the drug tolerance. Repeated assessment of the activity of intestinal inflammation is very necessary. Each of endoscopy, Crohn’s Disease Activity Index, CT, magnetic resonance enterography, and ultrasonography (US) has its own disadvantages. US is widely used in clinical practice because of its no radiation, convenience, low cost, and high degree of patient tolerance. The two-dimensional ultrasound, Doppler ultrasound, elastosonography, and contrast-enhanced ultrasonography each provides some effective parameters for evaluation of CD activity. Some parameters are of high value, such as bowl wall thichness, bowl wall stratification, color Doppler signal, strain ratio, and relative enhancement, etc. The values of some parameters are disputed, such as the blood flow of superior mesenteric artery, time to peak, etc. Some studies combine several ultrasound parameters and calculate their respective weights to obtain an ultrasound scoring method. US, as a valid tool to evaluate CD activity, provides valuable help in solving clinical problems such as evaluation of therapeutic effect, mucosal healing, and postoperative recurrence.
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.
ObjectiveTo investigate the main influence factors of microbubble-enhanced sono-thrombolysis by an orthogonal array experimental design (OAD) and to confirm the optimal parameters of microbubble-enhanced sono-thrombolysis in vitro. Methods The peripheral blood was collected from 50 female Sprague Dawley rats to prepare the standard plasma, and then 100 μL standard plasma and 25 μL thrombin (0.15 U/μL) were mixed and incubated in 37℃ water bath for 3, 6, 12, and 24 hours respectively to prepare corresponding standardized thrombus. The physical parameters for the designed experiments included transmit powers of ultrasound (factor A: 5%, 25%, 50%, and 100%), microbubble volume (factor B: 50, 100, 200, and 400 μL), urokinase (UK) concentration (factor C: 100, 200, 400, and 800 U/mL), and thrombolysis time (factor D: 10, 20, 30, and 40 minutes), respectively. Then an OAD based on four parameters and four levels [L16(45)] was employed to optimize the thrombolysis conditions. The ultrasound frequency was 1.82 MHz. HE staining and scanning electron microscope (SEM) were used to observe the clots before and after thrombolysis. The thrombolysis rate was measured. ResultsHE staining and SEM observation showed that the fibrin was dissolved after thrombolysis. According to the OAD, the optimal parameter combination was C4-D4-A1-B4, indicating UK concentration 800 U/mL, thrombolysis time 40 minutes, transmit power of ultrasound 5%, and microbubble volume 400 μL, respectively. The four factors above had significant influence on thrombolysis (P lt; 0.05), and UK concentration was the most significant. There were significant differences in thrombolysis between different thrombolysis time (P lt; 0.05). ConclusionUnder the condition of fixed ultrasound frequency, microbubble-enhanced sono-thrombolysis efficiency is better in lower transmit power of ultrasound, higher UK concentration, longer thrombolysis time, higher microbubble volume, and shorter thrombolysis time
Transrectal contrast-enhanced ultrasound (CEUS) is an important examination for rectal tumors. The inhomogeneity of the CEUS images has important clinical significance. However, there is no objective method to evaluate this index. In this study, a method based on gray-level co-occurrence matrix (GLCM) is proposed to extract texture features of images and grade these images according the inhomogeneity. Specific processes include compressing the gray level of the image, calculating the texture statistics of gray level co-occurrence matrix, combining feature selection and principal component analysis (PCA) for dimensionality reduction, and training and validating quadratic discriminant analysis (QDA). After ten cross-validation, the overall accuracy rate of machine classification was 87.01%, and the accuracy of each level was as follows: Grade Ⅰ 52.94%, Grade Ⅱ 96.48% and Grade Ⅲ 92.35% respectively. The proposed method has high accuracy in judging grade Ⅱ and Ⅲ images, which can help to identify the grade of inhomogeneity of contrast-enhanced ultrasound images of rectal tumors, and may be used to assist clinical doctors in judging the grade of inhomogeneity of contrast-enhanced ultrasound of rectal tumors.