Optimization of ultrasonic elastography by coded excitation and transmit-side multi-frequency compounding

To improve the quality of ultrasonic elastography, by taking the advantage of code excitation and frequency compounding, a transmitting-side multi-frequency with coded excitation for elastography （TFCCE） was proposed. TFCCE adopts the chirp signal excitation scheme and strikes a balance in the selection of sub-signal bandwidth, the bandwidth overlap and the number of sub-strain image based on theoretical derivation, so as to further improve the quality of elastic image. Experiments have proved that, compared with the other optimizing methods, the elastographyic signal-to-noise ratio（Re-SN） and contrast-to-noise ratio（Re-CN） are improved significantly with different echo signal-to-noise ratios （ReSN） and attenuation coefficients. When ReSN is 50 dB, compared with short pulse, Rc-SN and Re-CN obtained by TFCCE increase by 53% and 143%, respectively. Moreover, in a deeper investigation （85-95 mm）, the image has lower strain noise and clear details. When the attenuation coefficient is in the range of 0-1 dB/（cm.MHz）, Re-SN and Re-CN obtained by TFCCE can be kept in moderate ranges of 5〈Re-SN〈6.8 and 11.4〈Re-CN〈15.2, respectively. In particular, for higher tissue attenuation, the basic image quality cannot be ensured with short pulse excitation, while mediocre quality strain figure can be obtained by TFCCE. Therefore, the TFCCE technology can effectively improve the elastography quality and can be applied to ultrasonic clinical trials.

Relationship of the ultrasonic elastography parameter of thyroid carcinoma with the cancer cell growth and neovascularization in lesion tissue

Objective: To study the relationship of the ultrasonic elastography parameter of thyroid carcinoma with the cancer cell growth and neovascularization in lesion tissue. Methods:Patients with thyroid carcinoma who underwent surgical resection and were pathologically diagnosed in Dazhu People's Hospital between March 2015 and June 2017 were chosen as the case group, the patients who received ultrasonic examination and were diagnosed with benign thyroid tumor in Dazhu People's Hospital during the same period were selected as the control group, and the ultrasonic elastography parameter strain ratio as well as the oncogene expression and angiogenesis molecule contents in the thyroid carcinoma tissue and adjacent tissue was determined. Results: DMBT1, CCNG2 and Bax mRNA expression as well as ES protein level in thyroid carcinoma tissue were significantly lower than those in adjacent tissue whereas WIP1 and RET/PTC mRNA expression as well as VEGF, vWF and ANG-1 protein levels were significantly higher than those in adjacent tissue;DMBT1, CCNG2 and Bax mRNA expression as well as ES protein level in thyroid carcinoma tissue with strain ratio ≥3.14 were significantly lower than those in thyroid carcinoma tissue with strain ratio <3.14 whereas WIP1 and RET/PTC mRNA expression as well as VEGF, vWF and ANG-1 protein levels were significantly higher than those in thyroid carcinoma tissue with strain ratio <3.14. Conclusion:The testing threshold 3.14 of ultrasonic elastography parameter stain ratio of thyroid carcinoma can accurately assess the vitality of cancer cell growth and neovascularization in lesion tissue.

Value of transient ultrasonic elastography for evaluating the liver fibrosis and liver function in patients with drug-induced liver injury

Objective: To study the value of transient ultrasonic elastography for evaluating the liver fibrosis and liver function in patients with drug-induced liver injury. Methods: A total of 68 patients with drug-induced liver injury who were treated in our hospital between January 2016 and May 2017 were selected as drug-induced liver injury group, and 50 healthy volunteers who received physical examination in our hospital during the same period were selected as normal control group. The liver transient ultrasonic elastography parameter Stiffness levels as well as serum liver fibrosis index and liver function index contents of two groups of subjects were detected. Pearson test was used to evaluate the correlation of Stiffness levels with liver fibrosis and liver function damage degree in patients with drug-induced liver injury. Results:Stiffness level in drug-induced liver injury group was higher than that in normal control group;serum liver fibrosis indexes HA, LN, CⅣ, PⅢNP and CG contents were higher than those of normal control group;serum liver function indexes ALT, AST, ALP, STB and γ-GT contents were higher than those of normal control group. Conclusion: Transient ultrasonic elastography parameter Stiffness levels increase in patients with drug-induced liver injury, and the specific levels are consistent with the liver fibrosis and liver function damage degree, and can be used as the objective means to evaluate the disease severity.

Relationship of ultrasonic elastography parameters of cervical cancer with the cancer cell growth and angiogenesis in the lesion tissue

Objective: To study the relationship of ultrasonic elastography parameters of cervical cancer with the cancer cell growth and angiogenesis in the lesion tissue. Methods: A total of 110 patients who were diagnosed with cervical cancer in the hospital between December 2015 and January 2017 were collected as the observation group, 80 patients who received hysteroscopic cervical polyp resection in the hospital during the same period were collected as the control group. The levels of cervical ultrasonic elastography parameters in the two groups were detected, and fluorescence quantitative PCR was used to determine the expression of proliferation genes, apoptosis genes and angiogenesis-related genes in the lesion tissue. Pearson test was used to evaluate the correlation between cervical ultrasonic elastography parameters and the tumor malignancy indexes. Results: Elastic image press release index and strain ratio of local lesion of observation group were significantly higher than those of control group;GBP1 mRNA expression in lesion tissue of observation group was lower than that in lesion tissue of control group while Prdx4, STAT3 and Sp2 mRNA expression were higher than those in lesion tissue of control group;Survivin, FasL and Bcl-2 mRNA expression in lesion tissue of observation group were higher than those in lesion tissue of control group while Fas and Bax mRNA expression were lower than those in lesion tissue of control group;VEGF, MMP-9, COX-2 and HIF-1 mRNA in lesion tissue of observation group were significantly higher than those in lesion tissue of control group. Conclusion: Elastic image press release index and strain ratio of cervical tissue of patients with cervical cancer are higher, and the specific increase is directly correlated with the tumor malignancy.

UE参数、S-TK1、AG490、WIP1诊断TC

目的:探究UE参数、S-TK1、AG490、WIP1对甲状腺癌(TC)的诊断价值。方法:选择我院收治TC患者102例(TC组)和同期收治甲状腺结节良性患者73例(对照组)。比较两组UE参数、S-TK1、AG490、WIP1,分析各指标对TC的诊断价值。结果:TC组的弹性评分、SR值、S-TK1、WIP1水平均高于对照组,AG490低于对照组(P<0.05);ROC曲线分析发现五项指标联合诊断TC的AUC最高(P<0.05)。结论:UE参数与S-TK1、WIP1、AG490联合检测有利于临床诊断TC。

Ultrasonic elastography in clinical quantitative assessment of fatty liver

AIM: To investigate the clinical application of ultrasonic elastography in quantitative assessment of fatty liver grading. METHODS: A total of 105 patients with fatty liver were divided into mild group (n = 46), moderate group (n = 39), and severe group (n = 20). Forty-five healthy individuals served as a normal control group. All patients who underwent routine ultrasound scan and further ultrasonic elastography were evaluated accordingly to the evaluation standards for ultrasonic elastography. The ratio of surface areas of blue region/total surface area in the desired region was measured. RESULTS: Ultrasonic elastography technique, in comparison to traditional ultrasound, had a rather high consistence in grading of fatty liver [κ value = (95.3%63.6%)/(1%-63.6%) = 0.87, P = 0.001]. The score of ultrasonic elastography increased with the severity of fatty liver with a sensitivity of 97.14% and a specificity of 91.11%. A significant difference was found in the ratio of surface areas of blue regions between different groups (P < 0.05).CONCLUSION: Ultrasonic elastography can be used in quantitative assessment of the severity of fatty liver.

Preoperative neoadjuvant chemotherapy in patients with breast cancer evaluated using strain ultrasonic elastography

BACKGROUND The incidence of breast cancer in China is increasing while its mortality rate is decreasing.The annual breast cancer incidence in China is 39.2 million,accounting for two-thirds of the urban population.In China,breast cancer is the fifth most common malignant tumor overall and the most common in women,accounting for 17%of female malignant tumors.AIM To investigate the accuracy of strain ultrasound elastography(SUE)on the evaluation of preoperative neoadjuvant chemotherapy(NAC)in breast cancer.METHODS Overall,90 patients with breast cancer treated at our hospital between January 2018 and February 2019 were selected for this study.The patients received six cycles of NAC with docetaxel,epirubicin,and cyclophosphamide.Surgical treatment was also performed,and pathological reactivity was assessed.The patients were evaluated using conventional ultrasonography and SUE before biopsy.The differences between groups were analyzed to calculate the mean and standard deviation with significance measured using a t-test,while multivariate analysis was performed using logistic regression analysis.RESULTS Of the patients analyzed,20 had a pathological complete remission(pCR)while 70 did not achieve pCR after NAC.The ratio of the elastic strain ratio(SR)and elastic score of 4–5 in patients with pCR were 5.5±1.16 and 15.00%,respectively;these were significantly lower than those in patients without pCR(85%)and significantly higher than in patients without pCR(14%).SR and elastic score 4–5 were independent factors influencing NAC efficacy(OR=0.644,1.426 and 1.366,respectively,P<0.05).SR was positively correlated with elasticity score(rs=0.411,P<0.05).The area under the receiver operator characteristic curve of SR and SR combined with elastic score in predicting patients without pCR was 0.822 and 0.891,respectively(P<0.05).CONCLUSION Strain ultrasonic elastography may be used to evaluate the effects of preoperative NAC in patients with breast cancer.

常规超声及UE联合DBT对乳腺肿块良恶性诊断鉴别的准确性分析

目的 分析常规超声、超声弹性成像(UE)与数字乳腺断层合成(DBT)联合应用对乳腺肿块的定性诊断价值。方法 选择2022年1月至2023年12月152例乳腺肿块女性患者,年龄22~65岁,平均年龄44.12岁;身体质量指数18~26 kg/m^(2),平均身体质量指数22.45 kg/m^(2);肿块位置:左侧100例,右侧52例;肿块直径0.5~4.7cm,平均直径2.33 cm。均行常规超声、UE和DBT检查。以手术病理诊断为金标准,对比常规超声、UE和DBT单独使用与联合应用的定性诊断价值;对比良恶性乳腺肿块患者常规超声参数、UE参数和DBT参数。结果 手术病理诊断显示,152例均为单发性结节患者,共有152个肿块,84个为恶性,68个为良性。常规超声、UE和DBT单独使用对乳腺肿块良恶性的诊断效能对比,差异无统计学意义(P> 0.05);联合诊断灵敏度更高(95.24%vs 71.43%、76.19%、73.81%),对比单一诊断差异有统计学意义(P <0.05)。恶性乳腺肿块弹性应变率、肿块直径、直径变化率、肿块面积、面积比、边缘清晰占比低于良性(2.92%±0.54%vs 6.06%±1.72%、13.56 mm±3.32 mm vs 19.78 mm±3.72 mm、0.22%±0.05%vs 0.39%±0.12%、8.68 cm2±1.72 cm2vs 16.54 cm2±3.18 cm^(2)、1.21%±0.24%vs 1.92%±0.36%、4.76%vs 73.53%),UE评分、血流信号等级、边缘模糊、遮蔽、毛刺、肿块结构扭曲、血液运行增加和血管穿入占比明显高于良性,组间差异有显著统计学意义(P <0.01)。结论常规超声、UE与DBT联合应用,可准确诊断乳腺肿块良恶性,可将影像学征象作为评估依据,有应用价值。

Correlation between the ultrasonic elastography parameters of cervical cancer and the malignant biological behavior of cancer cells

Objective:To investigate the correlation between the ultrasonic elastography parameters of cervical cancer and the malignant biological behavior of cancer cells.Methods: A total of 180 patients with cervical cancer who were diagnosed and treated with radical operation in this hospital were selected as research objects, and the cervical cancer tissue and adjacent tissue samples were collected during operation and stored in liquid nitrogen tanks. The ultrasonic elastography strain ratio of cervical cancer and adjacent tissues was detected before operation, and the differences in the expression of genes associated with proliferation, invasion and autophagy were compared. Pearson test was used to evaluate the correlation between the cervical cancer strain ratio and the malignant biological behavior of cancer cells. Results: The strain ratio level of cervical cancer tissue was higher than that of adjacent tissue;expressions of proliferation-related genes AEG-1, TRAF6 and FoxM1 mRNA were higher than those in adjacent tissue whereas expressions of SFRP2, MST1 and Bmi-1 mRNA were lower than those in adjacent tissue;expressions of invasion-related genes ILK, Sox2, Twist, YB-1 and Rab11 mRNA were higher than those in adjacent tissue;expressions of autophagy-related genes ARHI, Beclin1, PULK and PI3KC3 mRNA were lower than those in adjacent tissue.Conclusions: Ultrasonic strain ratio level of cervical cancer is closely related to the proliferation, invasion and autophagy activity of cancer cells, and is positively correlated with the overall malignancy of the tumor.

Correlation of the pathological features of benign and malignant thyroid nodules with ultrasonic elastography parameters

Objective:To investigate the correlation of the pathological features of benign and malignant thyroid nodules with ultrasonic elastography parameters.Methods:A total of 176 patients with thyroid tumor who underwent thyroid tumor resection in this hospital between September 2016 and February 2018 were chosen as the research subjects, the 119 patients with thyroid cancer were selected as thyroid cancer group and the 57 patients with thyroid adenoma were selected as thyroid adenoma group. The thyroid cancer-related proliferation gene and thyroid cancer-related invasion gene expression as well as ultrasonic strain ratio in tumor tissues were compared between the two groups, and Pearson test was used to evaluate the correlation between above malignant molecule expression and ultrasonic strain ratio.Results: Thyroid cancer-related proliferation genes FOXA1, YAP and TPX2 mRNA expression in lesion tissues of thyroid cancer group were higher than those of thyroid adenoma group whereas EGCG and PDCD4 mRNA expression were lower than those of thyroid adenoma group;thyroid cancer-related invasion genes BRD4, Twist1, FoxM1 and SIRT1 expression were higher than those of thyroid adenoma group whereas Wortmannin and HIC1 mRNA expression were lower than those of thyroid adenoma group;ultrasonic strain ratio was higher than that of thyroid adenoma group. The Pearson test showed that the proliferation gene and invasion gene expression in thyroid cancer tissues were directly correlated with the ultrasonic strain ratio level.Conclusion: Thyroid cancer-related proliferation gene and invasion gene expression are directly correlated with ultrasonic strain ratio level, and ultrasonic elastography can be the reliable means to judge benign and malignant thyroid nodules.

BI-RADS分级联合UE在乳腺癌诊断中的价值分析

目的:探讨乳腺影像报告与数据系统(BI-RADS)分级联合超声弹性成像(UE)在乳腺癌诊断中的价值。方法:选取2019年1月—2022年1月洛阳伊洛医院检查的126例疑似乳腺癌患者作为研究对象,均采用BI-RADS分级及UE技术检查,以手术病理为金标准,判断两种检查方法联合使用的灵敏度、特异度、阳性预测值、阴性预测值、准确性。结果:126例患者中,手术病理结果显示78例患者为乳腺增生,48例为恶性肿瘤。乳腺癌组BI-RADS分级及UE评分较乳腺增生组更高,差异有统计学意义(t=7.641、10.618,P<0.05);联合检查灵敏度、特异度、阳性预测值、阴性预测值、准确性分别为95.83%、98.72%、97.87%、97.47%、97.62%,BI-RADS检查分别为79.17%、89.74%、82.61%、87.50%、85.71%,UE检查分别为77.08%、88.46%、80.43%、86.25%、84.13%,联合检查灵敏度、特异度、阳性预测值、阴性预测值、准确性较BI-RADS分级与UE检查更高,差异有统计学意义(χ^(2)=7.554、6.861、7.474、6.896、14.171,P<0.05)。结论:BI-RADS分级联合UE在乳腺癌的检查中具有较高的诊断价值,可有效提高疾病诊出率及诊断效能。

支气管镜下UE技术在肺门纵隔淋巴结定性诊断中的应用研究

目的分析支气管镜下超声弹性成像(UE)技术在肺门纵隔淋巴结定性诊断中的应用价值。方法选取2019年6月至2021年10月梅州市人民医院经肺部增强CT检查确诊的肺门纵膈肿大患者123例,全部患者均接受支气管镜下常规超声和UE技术检查。并以经气管镜超声引导针吸活检术(EBUS-TBNA)病理结果为金标准,分析支气管镜下常规超声、UE技术定性诊断肺门纵隔淋巴结的价值。结果123例接受EBUS-TBNA检查的患者中,共穿刺139枚淋巴结,经EBUS-TBNA病理结果确诊恶性淋巴结90枚(64.75%),良性49枚(35.25%)。在EBUS-TBNA病理结果诊断为恶性的90枚淋巴结中,支气管镜下常规超声诊断为恶性69枚,良性21枚;UE技术诊断为恶性80枚,良性10枚。EBUS-TBNA病理结果诊断为良性的49枚淋巴结中,支气管镜下常规超声诊断为良性35枚,恶性14枚;UE技术诊断为良性42枚,恶性7枚。支气管镜下常规超声定性诊断肺门纵膈淋巴结与EBUS-TBNA病理结果的一致性一般(Kappa值=0.466);UE技术定性诊断肺门纵膈淋巴结与EBUS-TBNA病理结果的一致性较好(Kappa值=0.736)。支气管镜下UE评分在淋巴结良恶性组中的差异有统计学意义(P<0.05)。支气管镜下常规超声定性诊断肺门纵膈淋巴结的敏感度、准确度、特异度、阴性预测值、阳性预测值分别为76.67%、74.82%、71.43%、62.50%、83.13%;UE技术定性诊断肺门纵膈淋巴结的敏感度、准确度、特异度、阴性预测值、阳性预测值分别为88.89%、87.77%、85.71%、80.77%、91.95%;支气管镜下UE技术定性诊断肺门纵膈淋巴结的敏感度、准确度、阴性预测值均高于常规超声检查,差异有统计学意义(P<0.05)。结论支气管镜下UE技术定性诊断肺门纵隔淋巴结与EBUS-TBNA病理结果的一致性较好,有利于肺门纵隔淋巴结良恶性的鉴别诊断。

VTIQ、UE联合CEUS对甲状腺TI-RADS 4类结节良恶性的评估价值

目的:探讨声触诊组织量化成像(VTIQ)、超声弹性成像(UE)联合超声造影(CEUS)对甲状腺影像报告及数据系统(TI-RADS)4类结节良恶性的评估价值。方法:回顾性分析96例(118个)甲状腺TI-RADS 4类结节患者的VTIQ、UE、CEUS影像资料;以手术病理结果为金标准,通过绘制工作者特征(ROC)曲线评估VTIQ、UE、CEUS及三者联合诊断甲状腺TI-RADS 4类结节良恶性的临床价值。结果:118个甲状腺TI-RADS 4类结节,包括恶性结节62个(52.54%),良性结节56个(47.46%)。恶性组SWV值为(3.44±0.62)m/s,高于良性组的(2.37±0.54)m/s(P<0.05);两组UE、CEUS评分比较,恶性组高于良性组(P<0.05)。VTIQ(SWV≥3.04 m/s)、UE(≥4分)、CEUS(≥4分)、三者联合诊断甲状腺TI-RADS 4类结节良恶性的AUC分别为0.862、0.891、0.860、0.933,敏感度分别为75.81%、79.03%、74.19%、88.71%,特异度为85.71%、71.43%、83.93%、87.50%,三者联合诊断的敏感度、特异度高于单独诊断(P<0.05)。结论:VTIQ、UE联合CEUS诊断甲状腺TI-RADS 4类结节良恶性的效能高于三者单独诊断,具有较高的临床应用价值。

超声E-cervix弹性成像参数与妊娠期高血压孕晚期分娩方式的关系

目的分析超声E-cervix弹性成像参数与妊娠期高血压孕晚期分娩方式的关系。方法纳入进行产检的孕晚期妊娠期高血压孕产妇100例,所有孕产妇均实施超声E-cervix弹性成像参数检查,所有孕产妇均随访至最终分娩,统计所有孕产妇的分娩方式并依据分娩方式分为2组(自然分娩及剖宫产),分析超声超声E-cervix弹性成像参数对妊娠期高血压孕晚期分娩方式选择的影响。结果经随访统计,100例妊娠期高血压孕晚期孕产妇自然分娩共63例,占比63.00%;剖宫产共37例,占37.00%;自然分娩组弹性对比指数(elasticity contrast index,ECI)、宫颈外口应变(external os strain,EOS)值均大于剖宫产组,硬度比值(hardness ratio,HR)、宫颈长度(cervical length,CL)、宫颈内口应变(internal os strain,IOS)、宫颈内外口应变比值(IOS/EOS)值小于剖宫产组,差异有统计学意义(P<0.05);经点二列相关性证实,超声E-cervix弹性成像参数与妊娠期高血压孕晚期分娩方式间的关系呈正相关(P<0.05)。结论超声E-cervix弹性成像参数可评价宫颈组织变化情况,或可作为评价宫颈成熟度的半定量指标,对妊娠期高血压孕晚期分娩方式的选择具有一定的指导意义。

超声瞬时弹性成像检测受控衰减参数评估非酒精性脂肪性肝病患者肝脂肪变程度价值研究

目的分析应用超声瞬时弹性成像检测的受控衰减参数(CAP)评估非酒精性脂肪性肝病(NAFLD)患者肝脂肪变程度的价值。方法2020年5月~2022年5月我院诊治的NAFLD患者78例,均接受肝脏超声检查和超声瞬时弹性成像检查,绘制受试者工作特征曲线(ROC)并计算曲线下面积(AUC)评估CAP诊断NAFLD患者肝脂肪变程度的效能。结果肝脏超声检查结果显示,78例NAFLD患者中包括轻度肝脂肪变41例、中度肝脂肪变23例和重度肝脂肪变14例;重度肝脂肪变患者血清ALT和AST水平分别为(77.2±14.9)U/L和(59.1±11.7)U/L,显著高于中度肝脂肪变患者【分别为(40.1±8.3)U/L和(35.9±6.2)U/L,P<0.05】或轻度肝脂肪变患者【分别为(26.7±5.5)U/L和(23.3±4.8)U/L,P<0.05】;重度肝脂肪变患者血清TG水平和CAP分别为(3.5±0.7)mmol/L和(317.7±27.6)dB/m,显著高于轻度肝脂肪变患者【分别为(1.6±0.6)mmol/L和(259.9±27.5)dB/m,P<0.05】或中度肝脂肪变患者【分别为(2.7±0.6)mmol/L和(292.1±30.7)dB/m,P<0.05】,而血清HDL-C水平为(0.8±0.4)mmol/L,显著低于轻度肝脂肪变患者【(1.3±0.3)mmol/L,P<0.05】或中度肝脂肪变患者【(1.1±0.3)mmol/L,P<0.05】;以CAP>285.4dB/m为截断点,诊断NAFLD患者中度肝脂肪变,以CAP>309.1dB/m为截断点,诊断NAFLD患者重度肝脂肪变,结果发现轻度肝脂肪变39例,中度肝脂肪变22例,重度肝脂肪变17例,其AUC、敏感度和特异度分别为0.783(95%CI:0.669~0.896)、78.3%和75.6%,和0.696(95%CI:0.515~0.876)、78.6%和69.6%(P<0.05)。结论应用CAP诊断NAFLD患者肝脂肪变程度可能比超声检查更准确,有很大的临床应用价值。

实时剪切波超声弹性成像在儿童疾病检查中的研究进展

实时剪切波超声弹性成像(SWE)作为超声医学领域的一种新的检查方法,通过声辐射力脉冲在组织不同深度上连续聚焦,反映组织绝对软硬度,已广泛应用于成人疾病检查中。目前SWE亦逐步应用于儿童相关疾病诊断,如脂肪肝、婴幼儿梗阻性黄疸、先天性胆总管囊肿、白血病弥漫性肝浸润等肝脏常见疾病,还应用于慢性肾病、新生儿缺氧缺血性脑病、先天性肌性斜颈及脑性瘫痪等其他儿科疾病中。

多模态超声在乳腺非肿块型病变鉴别诊断中的应用价值探析

目的 探析多模态超声在乳腺非肿块型病变鉴别诊断中的应用价值。方法 选择2022年3月—2023年3月本院收治的94例乳腺非肿块型病变患者为研究对象,对其进行常规超声、超声血流成像、超声弹性成像检查,以病理检查结果作为金标准,分析多模态超声(三者联合)在乳腺非肿块型病变鉴别诊断中的应用价值。结果 94例乳腺非肿块型病变患者经病理检查,其中41例确诊为乳腺癌,53例确诊为良性乳腺病变。常规超声、超声血流成像、超声弹性成像及多模态超声鉴别诊断乳腺非肿块型病变与病理检查的一致性kappa值分别为0.411、0.617、0.742、0.913。多模态超声检查鉴别诊断乳腺非肿块型病变的灵敏度为95.12%(39/41)、特异度为96.23%(51/53)、准确度为95.74%(90/94)、阳性预测值为95.12%(39/41)、阴性预测值为96.23%(51/53),高于单独的常规超声、超声血流成像、超声弹性成像的鉴别诊断结果,差异显著,具有统计学意义(P<0.05)。结论 多模态超声在乳腺非肿块型病变鉴别诊断中的应用价值较高,与病理结果的一致性较高,可提升诊断准确性。

超声剪切波弹性成像技术检测糖尿病患者不同功能状态下腓肠肌硬度及其临床意义

目的:应用超声剪切波弹性成像(SWE)技术检测2型糖尿病患者不同功能状态下腓肠肌的硬度,为临床早期发现骨骼肌损害提供客观化评价依据。方法:选取70例2型糖尿病患者作为糖尿病组,以70名健康体检者作为对照组。应用SWE技术分别测量2组研究对象腓肠肌在踝关节自然位松弛状态、踝关节跖屈位等张收缩状态和直立位等长收缩状态下的杨氏模量(E)值,并采用体质量指数(BMI)对E值进行标准化(E_(BMI)=E/BMI),比较2组研究对象腓肠肌不同状态下被动硬度和主动硬度的差异,采用Person相关性分析糖尿病患者E值与患者年龄、病程、糖化血红蛋白(HbA1c)水平和糖基化终产物(AGEs)水平的相关性。结果:2组研究对象腓肠肌在踝关节自然位被动硬度E值和E_(BMI)值比较差异无统计学意义(P>0.05);踝关节跖屈位主动硬度E值比较差异无统计学意义(P>0.05),糖尿病组患者E_(BMI)值组低于对照组(P<0.01);糖尿病组患者直立位主动硬度E值和E_(BMI)值均低于对照组(P<0.01)。糖尿病组患者腓肠肌主动硬度E值与患者病程、HbA1c水平和AGE水平呈负相关关系(r=-0.645,P<0.05;r=-0.741,P<0.05;r=-0.675,P<0.05),与患者年龄无相关性(r=-0.116,P>0.05)。结论:2型糖尿病患者存在腓肠肌主动硬度减低,被动硬度早期可能不受影响;采用超声SWE技术在直立位等长收缩状态下检测腓肠肌主动硬度有助于发现2型糖尿病患者亚临床阶段肌肉收缩功能减退。

超声弹性成像联合超声造影定量分析在缺血性脑梗死中的应用价值

目的:探讨超声弹性成像联合超声造影定量分析在缺血性脑梗死中的应用价值。方法:选取确诊的120例缺血性脑梗死患者,根据有无症状分为有症状组48例和无症状组72例。比较2组超声弹性成像参数、超声造影定量分析参数,采用ROC曲线分析超声弹性成像联合超声造影定量分析参数对缺血性脑梗死的诊断效能。结果:有症状组的杨氏模量最大值(E_(max))、最小值(E_(min))、平均值(E_(mean))均高于无症状组(均P<0.05)。有症状组的峰值强度(PI)高于无症状组(P<0.05),2组到达时间(AT)、达峰时间(TTP)、基础强度(BI)差异均无统计学意义(均P>0.05)。ROC曲线分析可见,E_(max)、E_(min)、E_(mean)、PI和联合诊断缺血性脑梗死的AUC分别为0.743、0.636、0.694、0.711、0.760,敏感度分别为85.90%、72.90%、77.10%、81.30%、93.80%,特异度分别为66.70%、53.40%、54.20%、54.20%、52.30%。结论:超声弹性成像联合超声造影定量分析对有症状缺血性脑梗死患者的诊断效能较高,可有效鉴别缺血性脑梗死患者。

高频超声联合超声弹性成像对PTC淋巴结转移的诊断价值

目的:分析高频超声(HFU)联合超声弹性成像(UE)对甲状腺乳头状癌(PTC)淋巴结转移的诊断价值。方法:选取112例PTC患者作为研究对象,所有患者均接受HFU及UE检查,以术后病理结果为依据,根据淋巴结转移情况分为非转移组(n=75)与转移组(n=37),比较两组HFU特征、UE参数(弹性应变率、蓝色面积比值),采用受试者工作特征(ROC)曲线分析HFU联合UE诊断淋巴结转移的价值。结果:转移组血流信号丰富、纵横比≥1、微钙化、侵犯被膜占比分别为72.97%、81.08%、72.22%、80.00%,均高于非转移组的21.33%、26.32%、24.68%、24.00%(P<0.05);转移组弹性应变率、蓝色面积比值均高于非转移组(P<0.05);ROC曲线显示,血流信号、纵横比、微钙化、侵犯被膜、弹性应变率及蓝色面积比值联合诊断PTC淋巴结转移的AUC为0.904,高于六者单独诊断的AUC:0.758、0.772、0.725、0.758、0.765、0.743(P<0.05)。结论:PTC淋巴结转移患者HFU主要表现为血流信号丰富、纵横比≥1、微钙化及侵犯被膜,UE参数明显增加,联合对PTC淋巴结转移具有较高的诊断效能。