目的总结卵巢肿物经静脉超声造影(CEUS)的灌注表现,并分析其诊断价值。方法取81个(来源于66例患者)在手术前行CEUS检查且经手术病理证实的卵巢肿物。超声灌注图像的分析流程如下:首先选取卵巢肿物病灶的感兴趣区,然后通过软件得到灌注...目的总结卵巢肿物经静脉超声造影(CEUS)的灌注表现,并分析其诊断价值。方法取81个(来源于66例患者)在手术前行CEUS检查且经手术病理证实的卵巢肿物。超声灌注图像的分析流程如下:首先选取卵巢肿物病灶的感兴趣区,然后通过软件得到灌注的时间-强度曲线(TIC),对获取曲线进行拟合,最后得到病灶部位的超声灌注参数。超声灌注参数包括:上升时间(rise time,RT)、达峰时间(time to peak,TTP)、峰值强度(peak intensity,PI)、半衰期(time from peak to one half,TTH)和曲线下面积(area under the curve,AUC)。对同一个病灶进行两次灌注参数的测量,并进行测值的重复性检验。并在卵巢肿物的良性与恶性病变间、是否肿瘤性病变、良性与恶性肿瘤间、不同分期的肿瘤间、不同分化的肿瘤间、有无淋巴结转移间、原发性恶性肿瘤与否间,进行各灌注参数的组间差异性检验。将差异有统计学意义的灌注参数进行受试者工作特征(ROC)曲线分析,以确定灌注参数的诊断价值。结果在重复性检验中,本研究中的卵巢肿物的5个超声灌注参数均显示出良好的重复性。卵巢恶性肿物组、肿瘤组、良性肿瘤组的灌注参数PI、TTH和AUC分别高于良性肿物组、非肿瘤组、恶性肿瘤组(P<0.05)。ROC曲线分析显示,灌注参数PI、TTH和AUC可作为鉴别卵巢肿物良/恶性、肿瘤/非肿瘤、肿瘤良/恶性病变的有效指标,均以灌注参数AUC的诊断效力最强。AUC=877dB·s作为临界值诊断卵巢癌的灵敏度为87.3%,特异度为80.8%。超声灌注参数在不同分期的肿瘤间、不同分化的肿瘤间、有无淋巴结转移间、原发性恶性肿瘤与否间差异无统计学意义。结论恶变倾向越明显,CEUS中的PI、TTH和AUC越高,AUC对卵巢癌具有一定的诊断价值。展开更多
Fetal aortopulmonary septal defect （APSD） is an extremely rare condition, accounting for 0.1%-0.2% of all cardiac defects in live births world wide. Hospital mortality is 13% and 33% for simple and complex APSD,resp...Fetal aortopulmonary septal defect （APSD） is an extremely rare condition, accounting for 0.1%-0.2% of all cardiac defects in live births world wide. Hospital mortality is 13% and 33% for simple and complex APSD,respectively. This rare cardiac defect refers to a congenital malformation in the development of the arteriosus truncus septum, and is usually associated with a wide variety of other structural cardiac anomalies such as ventricular septal defect （VSD）, pulmonary valve stegnosis and so on. Prenatal diagnosis of an APSD is possible by echocardiography. In relevant literature, only two cases, which were diagnosed initially by prenatal echocardiography, have been reported.展开更多
文摘目的总结卵巢肿物经静脉超声造影(CEUS)的灌注表现,并分析其诊断价值。方法取81个(来源于66例患者)在手术前行CEUS检查且经手术病理证实的卵巢肿物。超声灌注图像的分析流程如下:首先选取卵巢肿物病灶的感兴趣区,然后通过软件得到灌注的时间-强度曲线(TIC),对获取曲线进行拟合,最后得到病灶部位的超声灌注参数。超声灌注参数包括:上升时间(rise time,RT)、达峰时间(time to peak,TTP)、峰值强度(peak intensity,PI)、半衰期(time from peak to one half,TTH)和曲线下面积(area under the curve,AUC)。对同一个病灶进行两次灌注参数的测量,并进行测值的重复性检验。并在卵巢肿物的良性与恶性病变间、是否肿瘤性病变、良性与恶性肿瘤间、不同分期的肿瘤间、不同分化的肿瘤间、有无淋巴结转移间、原发性恶性肿瘤与否间,进行各灌注参数的组间差异性检验。将差异有统计学意义的灌注参数进行受试者工作特征(ROC)曲线分析,以确定灌注参数的诊断价值。结果在重复性检验中,本研究中的卵巢肿物的5个超声灌注参数均显示出良好的重复性。卵巢恶性肿物组、肿瘤组、良性肿瘤组的灌注参数PI、TTH和AUC分别高于良性肿物组、非肿瘤组、恶性肿瘤组(P<0.05)。ROC曲线分析显示,灌注参数PI、TTH和AUC可作为鉴别卵巢肿物良/恶性、肿瘤/非肿瘤、肿瘤良/恶性病变的有效指标,均以灌注参数AUC的诊断效力最强。AUC=877dB·s作为临界值诊断卵巢癌的灵敏度为87.3%,特异度为80.8%。超声灌注参数在不同分期的肿瘤间、不同分化的肿瘤间、有无淋巴结转移间、原发性恶性肿瘤与否间差异无统计学意义。结论恶变倾向越明显,CEUS中的PI、TTH和AUC越高,AUC对卵巢癌具有一定的诊断价值。
文摘Fetal aortopulmonary septal defect （APSD） is an extremely rare condition, accounting for 0.1%-0.2% of all cardiac defects in live births world wide. Hospital mortality is 13% and 33% for simple and complex APSD,respectively. This rare cardiac defect refers to a congenital malformation in the development of the arteriosus truncus septum, and is usually associated with a wide variety of other structural cardiac anomalies such as ventricular septal defect （VSD）, pulmonary valve stegnosis and so on. Prenatal diagnosis of an APSD is possible by echocardiography. In relevant literature, only two cases, which were diagnosed initially by prenatal echocardiography, have been reported.
