Investigation of lacrimal sac space-occupying lesions using color doppler ultrasound, computed tomography, and computed tomography dacryocystography

AIM:To observe the imaging features of color Doppler ultrasound(CDU)and computed tomography(CT)or computed tomography dacryocystography(CT-DCG)in different types of lacrimal sac space-occupying lesions(SOLs).METHODS:This retrospective case series study included 21 patients with lacrimal sac SOLs who underwent lacrimal sac surgery between January 2018 and March 2022.The imaging features of CDU and CT or CT-DCG in these patients were extracted from the examination cloud system.The images were observed and analyzed.RESULTS:The detection rate of lacrimal SOLs between CDU(21/21,100%)and CT or CT-DCG(20/21,95.2%)had no statistically significant difference(P=1.0).CDU could detect the blood flow signals in all SOLs except mucocele and mucopeptide concretion.Among them,polyps had characteristic imaging changes on CDU and CT-DCG.The mucoceles and mucopeptide concretions had characteristic imaging changes on CDU,which could provide more information for differential diagnosis.CONCLUSION:The morphology and internal blood flow signals of lacrimal sac SOLs can be observed using CDU.CT or CT-DCG has advantages in observing structural damage around the lacrimal sac mass.Therefore,CDU may be used as a routine examination to exclude lacrimal sac SOLs before dacryocystorhinostomy in the absence of preoperative CT or CT-DCG.

A prospective study assessing the efficacy of abdominal computed tomography scan without bowel preparation in diagnosing intestinal wall and luminal lesions in patients presenting to the emergency room with abdominal complaints

AIM: To evaluate the positive predictive value of abdominal non-prepared computed tomography (CT) for diagnosing intestinal lumen or wall lesions in patients presenting to the emergency room (ER) with abdominal complaints.METHODS: For 1-year we prospectively evaluated all ER patients hospitalized after abdominal CT scan detected either intraluminal or intestinal wall lesions. These patients underwent colonoscopy serving as gold standard. Patients with prior abdominal pathology or CT findings of appendicitis or diverticulitis were excluded.RESULTS: Five hundred and sixty-eight abdominopelvic CT scans were performed in the ER, 96 had positive colonic findings. Sixty-two patients were excluded, 46 because of diverticulitis or appendicitis, 16 because of prior abdominal pathology. Of the remaining 34 patients, 14 did not undergo colonoscopy during hospitalization.Twenty eligible patients were included in the study. The positive predictive value of the CT scans performed in the ER was calculated to be 45% (95% CI 25-67).CONCLUSION: CT findings correlated with colonoscopic findings only in approximately half of the cases. Relying on non-prepared CT scan findings in planning patient management and colonoscopy may lead to unnecessary diagnostic work-ups.

Machine perfusion and the prevention of ischemic type biliary lesions following liver transplant:What is the evidence?

The widespread uptake of different machine perfusion(MP)strategies for liver transplant has been driven by an effort to minimize graft injury.Damage to the cholangiocytes during the liver donation,preservation,or early posttransplant period may result in stricturing of the biliary tree and inadequate biliary drainage.This problem continues to trouble clinicians,and may have catastrophic consequences for the graft and patient.Ischemic injury,as a result of compromised hepatic artery flow,is a well-known cause of biliary strictures,sepsis,and graft failure.However,very similar lesions can appear with a patent hepatic artery and these are known as ischemic type biliary lesions(ITBL)that are attributed to microcirculatory dysfunction rather than main hepatic arterial compromise.Both the warm and cold ischemic period duration appear to influence the onset of ITBL.All of the commonly used MP techniques deliver oxygen to the graft cells,and therefore may minimize the cholangiocyte injury and subsequently reduce the incidence of ITBL.As clinical experience and published evidence grows for these modalities,the impact they have on ITBL rates is important to consider.In this review,the evidence for the three commonly used MP strategies(abdominal normothermic regional perfusion[A-NRP],hypothermic oxygenated perfusion[HOPE],and normothermic machine perfusion[NMP])for ITBL prevention has been critically reviewed.Inconsistencies with ITBL definitions used in trials,coupled with variations in techniques of MP,make interpretation challenging.Overall,the evidence suggests that both HOPE and A-NRP prevent ITBL in donated after circulatory death grafts compared to cold storage.The evidence for ITBL prevention in donor after brain death grafts with any MP technique is weak.

Assessment of optic nerve and optic tract alterations in patients with orbital space-occupying lesions using probabilistic diffusion tractography

AIM: To investigate the diffusion changes in both the optic nerve and optic tract in orbital space-occupying lesion patients with decreased visual acuity, and its clinical significance using probabilistic diffusion tractography(PDT). METHODS: Twenty patients with orbital space-occupying lesions and 25 age-and gender-matched healthy persons were included. All patients and controls underwent routine orbital magnetic resonance imaging and diffusion tensor imaging(DTI), using a 3.0 T magnetic resonance scanner(Trio Tim Siemens). After the image data were preprocessed, each DTI parameters of the optic nerve and optic tract was obtained by PDT, including fractional anisotropy(FA), mean diffusivity(MD), axial diffusivity(AD) and radial diffusivity(RD). The asymmetry index(AI) of each parameter was calculated. Compared the parameters of the affected side optic nerve and ipsilateral optic tract with the contralateral side by paired sample t-test;compared AI of parameters of optic nerve and optic tract between the patient group and the control group by independent sample t-test. Patients were divided into threesubgroups according to the low vision grade standard of WHO, compared the FA and AI of FA between the three subgroups by single factor variance analysis. RESULTS: The affected side optic nerve presented significantly decreased FA, increased MD, AD, and RD values compared to the unaffected side(P<0.05). The AI of FA, MD, AD, and RD of optic nerve in the patients was significantly higher than that of the controls(P<0.05). The comparison results of the optic tract showed that there was no significant difference between the patient group and control group in terms of the bilateral optic tracts in patients(P>0.05). The AIs of the FA value of the optic nerve in the eyesight <0.1 subgroup was significantly higher than that in the other groups(P<0.05). CONCLUSION: FA, MD, AD, and RD of the affected side optic nerve of the orbital space-occupying lesions have significantly changed, the FA value is the most sensitive. The PDT could be a useful tool to provide valid quantitative markers of optic nerve injuries and evaluate the severity of orbital diseases, which other examinations cannot be acquired.

Recurrent orbital space-occupying lesions:a clinicopathologic study of 253 cases

Objective：To analyze the clinical features,histopathologic classification and frequencies of various types of recurrent orbital space-occupying lesions.Methods：A retrospective study was carried out in 253 consecutive patients with recurrent orbital spaceoccupying lesions treated by surgical excision in the Institute of Orbital Diseases,the General Hospital of the Armed Police Force from January 2009 to December 2010.Results：The patients included 123 males and 130 females aged 2 to 78 years（mean,36.2 years）,and the last recurrence interval after operation ranged from 1 month to 40 years（median,4.75 years）.Of all the cases,159（62.8%）,65（25.7%）,20（7.9%）,8（3.2%） and 1（0.4%） had previously experienced once,twice,three,four and six times of surgeries,respectively.Among them,29（11.5%） cases had recurred 3 times or over,and 37（14.6%） cases got recurrence in 10 or more years postoperatively.Most of the patients with local recurrence presented with various clinical manifestations,while 31（12.3%） cases were symptom-free.Two hundred and thirty-one（91.3%） cases underwent surgical removal of the recurrent orbital lesions,and another 22（8.7%） cases had to receive the exenteration of orbit.Categories of these recurrent orbital lesions after operation were as follows：lacrimal gland tumors,65（25.7%） cases;vasogenic diseases,54（21.3%） cases;neurogenic tumors,42（16.6%） cases;secondary tumors,24（9.5%） cases;orbital inflammation,21（8.3%） cases;myogenic tumors,14（5.5%） cases;fibrous and adipose tumors,12（4.7%） cases;lympho-hematopoietic tumors,7（2.8%） cases;bone or cartilage tumors,7（2.8%） cases;orbital cysts,6（2.4%） cases;and indefinitely differentiated tumor,1（0.4%） case.The 10 top histopathologic diagnoses were lacrimal gland pleomorphic adenoma,hemangiolymphangioma,lacrimal gland adenoid cystic carcinoma,meningioma,inflammatory pseudotumor,neurofibroma,sebaceous gland carcinoma,vascular malformation,rhabdomyosarcoma and hemangioma.Conclusions：The variety of recurrent orbital lesions after operation includes mainly of tumors except for vascular malformation and orbital inflammatory lesions.The lacrimal gland epithelial tumor is most prone to relapse after resection,and early and longer-term postoperative follow-up is needed.

Application of endoscopic submucosal dissection in duodenal space-occupying lesions

BACKGROUNDEndoscopic submucosal dissection (ESD) has been advocated by digestiveendoscopists because of its comparable therapeutic effect to surgery, reducedtrauma, faster recovery, and fewer complications. However, ESD for lesions of theduodenum is more challenging than those occurring at other levels of thegastrointestinal tract due to the thin intestinal wall of the duodenum, narrowintestinal space, rich peripheral blood flow, proximity to vital organs, and highrisks of critical adverse events including intraoperative and delayed bleeding andperforation. Because of the low prevalence of the disease and the high risks ofsevere adverse events, successful ESD for lesions of the duodenum has rarelybeen reported in recent years.AIM To investigate the efficacy and safety of ESD in the treatment of duodenal spaceoccupyinglesions.METHODS Clinical data of 24 cases of duodenal lesions treated by ESD at the DigestiveEndoscopy Center of the Affiliated Hospital of Qingdao University from January2016 to December 2019 were retrospectively analyzed.RESULTS All of the 24 cases from 23 patients underwent ESD treatment for duodenal spaceoccupyinglesions under general anesthesia, including 15 male and 8 femalepatients, with a mean age of 58.5 (32.0-74.0) years. There were 12 lesions (50%) inthe duodenal bulb, 9 (37.5%) in the descending part, and 3 (12.5%) in the ball descending junction. The mean diameter of the lesion was 12.75 (range, 11-22)mm. Thirteen lesions originated from the mucosa, of which 4 were low-gradeintraepithelial neoplasia, 3 were hyperplastic polyps, 2 were chronic mucositis, 2were adenomatous hyperplasia, 1 was high-grade intraepithelial neoplasia, and 1was tubular adenoma. Eleven lesions were in the submucosa, including 5neuroendocrine neoplasms, 2 cases of ectopic pancreas, 1 stromal tumor, 1leiomyoma, 1 submucosal duodenal adenoma, and 1 case of submucosal lymphfollicular hyperplasia. The intraoperative perforation rate was 20.8% (5/24),including 4 submucosal protuberant lesions and 1 depressed lesion. The meanlength of hospital stay was 5.7 (range, 3-10) d, and the average follow-up time was25.8 (range, 3.0–50.0) mo. No residual disease or recurrence was found in allpatients, and no complications, such as infection and stenosis, were found duringthe follow-up period.CONCLUSION ESD is safe and effective in the treatment of duodenal lesions;however, theendoscopists should pay more attention to the preoperative preparation,intraoperative skills, and postoperative treatment.

Association between the fMRI manifestations of activated brain areas and muscle strength in patients with space-occupying lesions in motor cortex

BACKGROUND ： Functional magnetic resonance imaging （fMRI） studies have disclosed the changes of the motor function in the motor cortex of ipsilateral and contralateral hemispheres of tumor, which have special significance for making the surgical planning and most greatly minimizing the postoperative functional damages. OBJECTIVE： To analyze the association between the manifestation characteristics of hand functional area and motor dysfunction using fMRI in patients with space-occupying lesions of tumor in motor cortex. DESIGN ： A case-controlled observation SETTING： Department of Radiology, Second Affiliated Hospital, Shantou University Medical College .PARTICIPANTS： Twenty-three patients （13 males and 10 females） with space-occupying lesions of central sulcus area, aged 21-53 years with a mean age of （47±1） years were selected from the Second Affiliated Hospital of Shantou University Medical College. All the patients were diagnosed by MR scanning as space-occupying lesions of motor area, and pathologically confirmed that the lesions involved central sulcus and central Iobule; Lesions occurred in left and right hemispheres in 13 and 10 cases respectively. The tumor types were astrocytoma （n =8）, metastatic tumours （n =7）, meningiomas （n =5） and oligodendroglioma （n =3）. The muscle strength was normal in 11 cases （grade 5） and obviously decreased in 12 cases （grade 2-3 in 3 cases and grade 4 in 9 cases）; muscle strengths of both upper and lower limbs were decreased in 7 cases, and only that of upper limbs was decreased in 5 cases. Informed consents were obtained from all the subjects. Meanwhile, 9 healthy physical examinees （5 males and 4 females） of 20-56 years old with an average of （34±1） years were taken as controls. All the patients and healthy subjects were right-handed. METHODS： All the enrolled subjects were examined with MR scanning and functional imaging. Twenty cases whose clinical symptoms were mild in the patient group and 9 healthy volunteers adopted simple active finger-tapping movements, and for the 3 cases whose clinical symptoms were severe in the patient group, the simple passive finger-tapping movements were used. The manifestations in the activated brain areas were analyzed in the patients with brain tumor of different muscle strength and the controls. The motor deficit and activation of contralateral primary motor cortex （M1） in simple finger-tapping movements were observed in the patient group. MAIN OUTCOME MEASURES： （1） Brain areas activated by finger-tapping movements in each group： （2） Activated volumes in hemisphere by finger-tapping movements between groups. RESULTS： The contralateral M1 area could not be activated in 1 case in the patient group,, all the other 22 patients and 9 healthy subjects were involved in the analysis of results. （1） In the control group, unilateral finger tapping movement activated the contralateral primary motor cortex （M1）, bilateral SMA and bilateral PMC. The activation volume was the largest in contralateral primary motor cortex （M1）, smaller in the SMA, and the smallest in PMC. The finger tapping movement in healthy subjects could activate contralateral primary motor cortex （M1）, bilateral SMA and bilateral PMC, which had no obvious differences from the manifestations of brain functional area activated by active finger tapping. There was no significant difference in the volume of activated functional areas between right and left hands. In the patient group, the central sulcos around the tumor in the activated M1 area displaced towards dorsal or ventral side, also extended. The distance of displacement in the functional area was determined as compared with the contralateral central sulcus, and the results suggested the M1 displacement, including that there were 10 cases with the M1 displacement larger than 10 mm in the patients with motor deficit, which were obviously more than in those without motor deficit （n =1, P 〈 0.01）, and the activated volume in contralateral M1 area was obvious smaller in the patients with motor deficit than in those without motor deficit （P 〈 0.01）. （2） The M1 activation and changes were observed in contralateral hemisphere in the patient group, and the activated volume was obviously larger than that in the control group （P 〈 0.01）. The activated volumes of M1 and PMC in ipsilateral hemisphere were obviously larger than those in the control group （P 〈 0.05）, but that of SMA had no obvious difference between the two groups （P 〉 0.05）. CONCLUSION： fMRI can be used to observe the activation of the brain motor functional areas of patient with space-occupying lesions in motor area, and evaluate the state of their motor function. The larger the distance of displacement of M1 compressed by tumor, the more obviously the muscle strength decreases in the patients.

A pilot study of radiologic measures of abdominal adiposity:weighty contributors to early pancreatic carcinogenesis worth evaluating?

Objective:Intra-abdominal fat is a risk factor for pancreatic cancer(PC),but little is known about its contribution to PC precursors known as intraductal papillary mucinous neoplasms(IPMNs).Our goal was to evaluate quantitative radiologic measures of abdominal/visceral obesity as possible diagnostic markers of IPMN severity/pathology.Methods:In a cohort of 34 surgically-resected,pathologically-confirmed IPMNs(17 benign;17 malignant) with preoperative abdominal computed tomography(CT) images,we calculated body mass index(BMI) and four radiologic measures of obesity:total abdominal fat(TAF) area,visceral fat area(VFA),subcutaneous fat area(SFA),and visceral to subcutaneous fat ratio(V/S).Measures were compared between groups using Wilcoxon two-sample exact tests and other metrics.Results:Mean BMI for individuals with malignant IPMNs(28.9 kg/m^2) was higher than mean BMI for those with benign IPMNs(25.8 kg/m^2)(P=0.045).Mean VFA was higher for patients with malignant IPMNs(199.3 cm^2) compared to benign IPMNs(120.4cm^2),P=0.092.V/S was significantly higher(P=0.013) for patients with malignant versus benign IPMNs(1.25 vs.0.69 cm^2),especially among females.The accuracy,sensitivity,specificity,and positive and negative predictive value of V/S in predicting malignant IPMN pathology were 74%,71%,76%,75%,and 72%,respectively.Conclusions:Preliminary findings suggest measures of visceral fat from routine medical images may help predict IPMN pathology,acting as potential noninvasive diagnostic adjuncts for management and targets for intervention that may be more biologically-relevant than BMI.Further investigation of gender-specific associations in larger,prospective IPMN cohorts is warranted to validate and expand upon these observations.

Pneumocephalus Following Combined Spinal-Epidural Anesthesia: A Case Report Analysis

Background: Combined spinal-epidural anesthesia (CSEA) is widely used in clinical anesthesia due to its rapid onset, reliable anesthetic effect, and strong controllability. Although advancements in technique have reduced the frequency and severity of common complications, reports of rare and serious complications such as pneumocephalus, remain scarce. Case Report: This article presents a case of pneumocephalus following CSEA in a middle-aged female patient undergoing surgery for an intrauterine space-occupying lesion. The patient experienced severe headache postoperatively, and imaging confirmed the presence of intracranial air. After receiving active symptomatic treatment, the patient recovered and was discharged. Conclusion: This case underscores the importance of adhering to standard anesthesia protocols and increasing awareness of rare CSEA complications, particularly the risk of pneumocephalus. Early recognition and timely management are crucial. There is a need to further enhance training and research in anesthetic procedures to improve clinical anesthesia quality and ensure patient safety.

经腹全子宫与次全子宫切除术治疗子宫良性病变的疗效观察

目的研究子宫良性病变患者应用经腹全子宫与次全子宫切除术的临床疗效。方法选取60例子宫良性病变患者,按照手术方法不同分为研究组与对照组,各30例。对照组采取经腹全子宫切除术,研究组采取经腹次全子宫切除术。比较两组临床效果。结果研究组手术时间、术后肛门排气时间、住院时间均短于对照组,术中出血量少于对照组(P<0.05)。术后1个月研究组卵泡刺激素水平低于对照组,雌二醇水平高于对照组(P<0.05)。研究组并发症发生率低于对照组(P<0.05)。两组病灶复发率、残留宫颈病变率及残端病变率比较差异无统计学意义(P>0.05)。结论子宫良性病变患者应用经腹次全子宫切除术治疗,效果确切,安全性较高,值得临床推广。

腹部超声中实时组织弹性成像联合剪切波速度测量在肝脏局灶性病变中的诊断价值

目的 分析腹部超声中实时组织弹性成像联合剪切波速度测量在肝脏局灶性病变中的诊断价值。方法 选择2019年3月至2021年3月郑州颐和医院收治的90例肝脏局灶性病变患者作为研究对象,所有患者均接受腹部超声中实时组织弹性成像与剪切波速度测量,以术后病理结果作为金标准,对比腹部超声中实时组织弹性成像联合剪切波速度测量诊断在肝脏局灶性病变性质中的鉴别价值。绘制受试者工作特征(ROC)曲线,分析腹部超声中实时组织弹性成像、剪切波速度测量及联合检测对肝脏局灶性病变性质中的鉴别价值。结果 以术后病理诊断结果为金标准,90例肝脏局灶性病变患者中恶性肿瘤有53个(58.89%),其中肝细胞癌35个(66.04%),肝转移癌10个(18.87%),胆管细胞癌8个(15.09%);良性肿瘤37个(41.11%),其中肝硬化结节12个(32.43%),血管瘤17个(45.94%),腺瘤4个(10.81%),炎性结节4个(10.81%)。腹部超声中实时组织弹性成像、剪切波速度测量及联合与金标准的一致性分别为0.402、0.586、0.767。三种诊断方式的特异度对比差异无统计学意义(P> 0.05);腹部超声中实时组织弹性成像、剪切波速度及联合诊断的准确度、灵敏度对比,以联合诊断最高,差异均有统计学意义(P <0.05);ROC曲线显示,腹部超声中实时组织弹性成像、剪切波速度及联合对肝脏局灶性病变的曲线下面积(AUC)分别为0.709(95%CI:0.599~0.818)、0.809(95%CI:0.716~0.901)、0.877(95%CI:0.794~0.960)。结论 腹部超声中实时组织弹性成像与剪切波速度均可有效鉴别肝脏局灶性病变性质,但通过联合检测的方式可提高诊断效能,值得应用。

腹部超声联合DCE-MRI在卵巢瘤样病变中的诊断灵敏性分析

研究分析腹部超声联合动态对比增强磁共振成像(DCE-MRI)在卵巢瘤样病变中的诊断灵敏性,以临床疑似卵巢瘤样病变患者为研究对象,所有患者术前均行腹部超声联合DCE-MRI检查,以术后病理结果为“金标准”,探究腹部超声联合DCE-MRI的阳性与阴性检出结果,对比腹部超声联合DCE-MRI的诊断效能(特异度、敏感度),同时比较腹部超声联合DCE-MRI检查的阻力指数(RI),使用配套软件自动计算容量转移常数(Ktrans)、速率常数(Kep)及血管外细胞外间隙容积比(Ve),作受试者操作特征(ROC)曲线分析模型诊断价值。结果发现,腹部超声联合DCE-MRI诊断的敏感度(96.77%)、特异度(98.55%)均高于单一腹部超声及DCE-MRI诊断结果(P<0.05);卵巢瘤样病变组RI指数高于卵巢肿瘤组,Ktrans、Kep、Ve水平低于卵巢肿瘤组(P<0.05);绘制ROC曲线预测模型最佳临界值为0.088,提示腹部超声联合DCE-MRI在卵巢瘤样病变中的诊断综合价值高。

王秀娟教授从“滞、虚、邪”论治胃癌前病变的经验

王秀娟教授认为胃癌前病变(precancerous lesions of gastric cancer, PLGC)病机演变规律为“因滞致虚,因虚夹邪”,即各种致病因素导致脾胃虚损,以致气滞、痰瘀、浊毒等病理产物内生,损伤胃络,久而形成微癥瘕。脾胃虚弱为致病之本,而气滞、痰瘀、浊毒为发病之标。治疗上祛邪兼以扶正,在祛痰、散浊、解毒的基础上,健脾纳运,培本固源,以改善患者症状,延缓微癥瘕发展进程。辨证治疗,疗效突出,可有效改善胃黏膜状态,控制甚至逆转萎缩、肠化生、非典型增生,发挥中医药的独特优势,为PLGC的治疗提供新的思路。

经阴道联合经腹部彩超在绝经后妇女子宫内膜良恶性病变诊断中的研究价值

目的:探讨经阴道联合经腹部彩超在绝经后妇女子宫内膜良恶性病变诊断中的研究价值。方法:选择2020年3月—2021年2月郑州市妇幼保健院就诊的76例绝经后子宫内膜病变患者作为研究对象,均行经阴道彩超检查、经腹部彩超检查,以病理诊断结果为“金标准”,比较两种方法单项检查、联合检查对子宫内膜病变的检查结果及良恶性病变鉴别诊断效能。结果:病理诊断结果证实,76例患者中诊断为子宫内膜增生25例,子宫内膜息肉20例,子宫黏膜下肌瘤14例,萎缩性内膜10例,子宫内膜癌7例。以病理诊断结果为“金标准”,三种方法检出子宫内膜增生、子宫内膜息肉、子宫黏膜下肌瘤、萎缩性内膜、子宫内膜癌的符合率比较,差异有统计学意义(χ^(2)=11.562、5.625、7.636、10.646、6.353,P<0.05)。以病理诊断结果为“金标准”,三种方法的准确度、敏感度、特异度、阴性预测值、假阳性率、假阴性率、正确指数比较,差异有统计学意义(χ^(2)=50.593、65.094、50.399、109.365、65.094、49.562、165.745,P<0.05)。三种方法诊断绝经后子宫内膜病变的阳性预测值比较,差异无统计学意义(P>0.05)。经Kappa一致性检验分析,阴道超声与金标准结果之间的一致性Kappa值为0.261,腹部彩超与金标准结果之间的一致性Kappa值为0.018,经阴道联合经腹部彩超与金标准结果之间的一致性Kappa值为0.861,腹部彩超、阴道超声的一致性较差,经阴道联合经腹部彩超的一致性良好。结论:经阴道联合经腹部彩超在绝经后妇女子宫内膜良、恶性病变诊断中的效果良好,可提高诊断准确性,有利于为临床早期诊治绝经后子宫内膜病变提供指导依据。

介入性超声在治疗腹部器官和腹腔感染性病灶中的临床应用研究

分析腹部器官与腹腔感染患者应用介入性超声治疗的效果。将腹部器官和腹腔感染性病灶患者56例以随机数表法分为对照组(n=18)和观察组(n=38),以2022年5月—2023年4月为治疗时间段,对照组患者应用腹腔镜切开引流术,观察组患者应用介入性超声治疗,比较两组穿刺引流一次成功率及病灶痊愈率、治疗情况、并发症总发生率、再手术率。结果表明,观察组病灶痊愈率明显高于对照组(P<0.05),观察组治疗情况优于对照组(P<0.05),观察组患者再手术率低于对照组(P<0.05)。研究发现,腹部器官与腹腔感染患者应用介入性超声治疗可显著提高病灶痊愈率,能够优化手术指标,减少相关并发症并降低再手术率,可促进预后改善,值得应用。

腹部彩超联合高频超声诊断良性胆囊息肉样病变的效果

目的分析腹部彩超联合高频超声诊断良性胆囊息肉样病变的效果。方法将本院2020年8月-2022年7月收治的70例胆囊息肉样病变患者纳入研究,进行腹部彩超结合高频超声检查,以手术病理为金标准,评估良性胆囊息肉样病变检出率,分析各种不同良性胆囊息肉样病变的影像特征及临床诊断的灵敏度、特异度及准确度。结果手术病理检出胆囊息肉样病变70例,腹部超声联合高频超声检出68例,检出率97.1%,对比差异不显著(P>0.05)。在不同类型良性胆囊息肉样病变的超声特征分析中,胆固醇息肉检出率最高,表现为多发病灶,其多发病于胆囊体基地较窄部位,表现为高回声信号,血流成像检查无明显信号。炎性息肉的发生率也较高,单发或多发病灶数量无差别,多在胆囊体、胆囊底部发病,检查见高回声,无明显血流信号。胆囊结石多为胆囊体单发病灶,检出高回声。胆囊腺瘤为胆囊颈单发病灶,检出高回声,未检出明显血流信号。腹部超声联合高频超声诊断良性胆囊息肉样病变的灵敏度为95.5%(63/66),特异度为100.0%(4/4),准确度为95.7%(67/70),与手术病理对比差异不显著(χ^(2)=3.070、0.000、3.070,P=0.080、1.000、0.080)。结论腹部彩超联合高频超声诊断良性胆囊息肉样病变,对并病变性质及类型的鉴别准确性高,临床应用效果好。

腹部超声联合阴道彩色多普勒超声检查在绝经阴道出血患者中的应用价值

目的探讨腹部超声联合阴道彩色多普勒超声检查在绝经阴道出血患者中的应用价值。方法选取2019年1月至2020年12月本院收治的90例疑似绝经阴道出血患者为研究对象,均实施腹部超声、阴道彩色多普勒超声检查。以子宫内膜刮诊检查结果为金标准,观察腹部超声联合阴道彩色多普勒超声检查在绝经阴道出血患者中的应用价值。结果腹部超声联合阴道彩色多普勒超声的漏诊率显著低于腹部超声、阴道彩色多普勒超声,准确度与灵敏度均高于腹部超声、阴道彩色多普勒超声,差异具有统计学意义(P<0.05)。腹部超声、阴道彩色多普勒超声、腹部超声联合阴道彩色多普勒超声均可检出不同类型的子宫内膜病变,但腹部超声联合阴道彩色多普勒超声对不同病变的诊断符合率更高。子宫内膜恶性病变患者的子宫内膜厚度、宫腔容积、血管化指数(VI)均大于良性病变,阻力指数(RI)、搏动指数(PI)、收缩期峰值流速(PSV)均小于良性病变,阴道出血时间在4~6个月及>6个月的占比均高于良性病变,差异具有统计学意义(P<0.05)。结论采用腹部超声联合阴道彩色多普勒超声对绝经阴道出血患者进行检查,可在一定程度上提高诊断的准确度,避免漏诊,客观显示子宫内膜良性、恶性病变的超声指标。

DIFFERENTIAL ULTRASONIC DIAGNOSES OF PULMONARY BENIGN AND MALIGNANT SPACE-OCCUPIED LESIONS OF THE PERIPHERAL TYPE

87 patients with pulmonary space-occupied lesions of the peripheral type which were either adhesive of close to pleura were examined using ultuasonography.Of them,64 cases of lung cancers and 23 of bening lesions were then confirmed by

经阴道超声与腹部超声对子宫内膜病变诊断对比分析

目的探讨经阴道超声检查诊断子宫内膜病变的临床价值。方法回顾性分析2011年7月～2013年7月120例病理诊断为子宫内膜病变患者的临床资料,其中子宫内膜增生58例,内膜息肉29例,黏膜下肌瘤25例和内膜癌8例。将患者术前腹部超声和阴道超声诊断结果分别与病理诊断结果进行对照,计算诊断准确率,并进行比较。结果子宫内膜增生、子宫内膜息肉、子宫黏膜下肌瘤和子宫内膜癌经阴道超声检查的诊断准确率分别为96.55%、100.00%、80.00%、75.00%,总准确率为92.50%;经腹部超声检查分别为82.76%、82.76%、60.00%、25.00%,总准确率为74.17%,前者的诊断准确率明显高于后者（χ2=4.372,P〈0.05）。结论经阴道超声检查对子宫内膜病变具有较高的诊断价值。

超声内镜与CT诊断壶腹周围病变的价值比较

目的:探讨并比较超声内镜(EUS)与腹部CT在壶腹周围病变中的诊断价值。方法:收集2009-2013年在我院疑诊壶腹部周围病变的病例,入选病例同时行EUS及腹部CT检查。比较两种方法对壶腹周围不同病变的诊断准确率。结果:确诊为壶腹部周围病变的病例共计151例,包括:胆总管结石、壶腹部肿瘤、壶腹部炎症、胰头肿瘤、胰腺囊肿,超声内镜对上述病变的诊断准确率分别83.6%、90.6%、56.5%、100.0%、100.0%,腹部CT对上述病变的诊断准确率分别为52.2%、56.3%、43.5%、91.3%、100.0%。超声内镜对壶腹部病变总的诊断准确率为84.1%,明显高于腹部CT(59.6%)。结论:EUS对壶腹部周围病变具有很高的诊断价值,诊断准确率高于腹部CT。