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.

Assessment of Uterine Receptivity by Endometrial and Subendometrial Blood Flows Measured by Vaginal Color Doppler Ultrasound in Women Undergoing IVF Treatment

Objective To evaluate endometrial and subendometrial blood flows measured by vaginal color Doppler ultrasound as a predicator of endometrial receptivity in women undergoing IVF treatment. Methods A total of 119 infertile patients undergoing the first IVF/ICSI-ET cycle were recruited. Three groups were divided according to a color Doppler ultrasound examination performed on the day of hCG injection. Group A, endometrial and subendometrial blood flows were 2 branches and below; group B, endometrial and subendometrial blood flows were between 3 and 4 branches; group C, endometrial and subendometrial blood flows were 5 branches and above. Patients were transferred 1-3 embryos each. Demographic data, ovarian responses, endometrial thickness, PI, RI, development of embryo and IVF result among groups were compared. Results Demographic data, ovarian responses, endometrial thickness, PI, RI and development of embryo among groups have no significant difference. The pregnancy rate of group A was significantly lower than that of group B （P〈0.05） and group C （P〈0.01）. The implantation rate of group A was significantly lower than than of group C （P〈0.01）. There was no significant difference of the rate of pregnancy and implantation between group B and group C （P〉0.05）. Conclusion Endometrial and subendometrial blood flows measured by vaginal color Doppler ultrasound is a good predicator of pregnancy during IVF treatment. A good endometrial and subendometrial blood flows is benefit for the result of IVF.

Hemodynamic analysis of esophageal varices in patients with liver cirrhosis using color Doppler ultrasound

AIM: To study the portal hemodynamics and their relationship with the size of esophageal varices seen at endoscopy and to evaluate whether these Doppler ultrasound parameters might predict variceal bleeding in patients with liver cirrhosis and portal hypertension.METHODS: One hundred and twenty cirrhotic patients with esophageal varices but without any previous bleeding were enrolled in the prospective study. During a 2-year observation period, 52 patients who had at least one episode of acute esophageal variceal hemorrhage constituted the bleeding group, and the remaining 68 patients without any previous hemorrhage constituted the non-bleeding group. All patients underwent endoscopy before or after color Doppler-ultrasonic examination, and images were interpreted independently by two endoscopists. The control group consisted of 30 healthy subjects, matched to the patient group in age and gender. Measurements of diameter,flow direction and flow velocity in the left gastric vein (LGV) and the portal vein (PV) were done in all patients and controls using color Doppler unit. After baseline measurements, 30 min after oral administration of 75 g glucose in 225 mL, changes of the diameter, flow velocity and direction in the PV and LGV were examined in 60 patients with esophageal varices and 15 healthy controls.RESULTS: The PV and LGV were detected successfully in 115 (96%) and 105 (88%) of 120 cirrhotic patients,respectively, and in 27 (90%) and 21 (70%) of 30 healthy controls, respectively. Among the 120 cirrhotic patients,37 had F1, 59 had F2, and 24 had F3 grade varices. Compared with the healthy controls, cirrhotic group had a significantly lower velocity in the PV, a significantly greater diameter of the PV and LGV, and a higher velocity in the LGV. In the cirrhotic group, no difference in portal flow velocity and diameter were observed between patients with or without esophageal variceal bleeding (EVB). However, the diameter and blood flow velocity of the LGV were significantly higher for EVB (+) group compared with EVB (-) group (P＜0.01).Diameter of the LGV increased with enlarged size of varices.There were differences between F1 and F2, F1 and F3 varices, but no differences between F2 and F3 varices (P = 0.125). However, variceal bleeding was more frequent in patients with a diameter of LGV ＞6 mm. The flow velocity in the LGV of healthy controls was 8.70±1.91 cm/s (n = 21). In patients with liver cirrhosis, it was 10.3±2.1 cm/s (n = 12) when the flow was hepatopetal and 13.5±2.3 cm/s (n = 87) when it was hepatofugal. As the size of varices enlarged, hepatofugal flow velocity increased (P＜0.01) and was significantly different between patients with F1 and F2 varices and between patients with F2 and F3 varices. Variceal bleeding was more frequent in patients with a hepatofugal flow velocity ＞15 cm/s (32 of 52 patients, 61.5%). Within the bleeding group, the mean LGV blood flow velocity was 16.6±2.62 cm/s. No correlation was observed between the portal blood flow velocity and EVB. In all healthy controls, the flow direction in the LGV was hepatopetal, toward the PV. In patients with F1 varices, flow direction was hepatopetal in 10 patients, to-and-fro state in 3 patients, and hepatofugal in the remaining 18. The flow was hepatofugal in 91% patients with F2 and all F3 varices. Changes in diameter of the PV and LGV were not significant before and after ingestion of glucose (PV: 1.41±1.5 cm before and 1.46±1.6 cm after; LGV: 0.57±1.7 cm before and 0.60±1.5 cm after).Flow direction in the LGV was hepatopetal and to-and-fro in 16 patients and hepatofugal in 44 patients before ingestion of glucose. Flow direction changed to hepatofugal in 9 of 16 patients with hepatopetal and to-and-fro blood flow after ingestion of glucose. In 44 patients with hepatofugal blood flow in the LGV, a significant increase in hepatofugal flow velocity was observed in 38 of 44 patients (86%) with esophageal vadces. There was a relationship between the percentage changes in flow velocity and the size of varices. Patients who responded excessively to food ingestion might have a high risk for bleeding. The changes of blood flow velocity in the LGV were greater than those in the PV (LGV: 28.3±26.1%, PV: 7.2±13.2%, P＜0.01), whereas no significant changes in the LGV occurred before and after ingestion of glucose in the control subjects.CONCLUSION: Hemodynamics of the PV is unrelated to the degree of endoscopic abnormalities in patients with liver cirrhosis. The most important combinations are endoscopic findings followed by the LGV hemodynamics.Duplex-Doppler ultrasonography has no value in the identification of patients with cirrhosis at risk of variceal bleeding. Hemodynamics of the LGV appears to be superior to those of the PV in predicting bleeding.

Clinical Evaluation of Color Doppler Ultrasound in Selecting the Optimal Treatment Modality for Infantile Hemangioma

客观我们调查了 1064 nm Nd 的功效和安全：钇铝柘榴石激光，强烈的搏动的光( IPL )，和在 hemangioma 的治疗的 lauromacrogol 注射，作为 hemangiomas 诊断了以便在选最佳的治疗 modality.Methods 为临床的婴儿的病人评估颜色 Doppler 超声指导的价值随机被划分成组 A ，谁在治疗，和组 B 前有颜色 Doppler 超声考试没有超声评估，有治疗。在组 A 的病人被 sonography 根据损害的深度分配进亚群：为有损害深度的那些的组 A-1 < 1.2 公里，并且诊脉轻治疗；为有损害深度 1.2mm 的那些的组 A-2 并且 < 3 公里，并且诊脉 1064 nm Nd : 钇铝柘榴石激光治疗；为有损害深度 3mm 的那些的组 A-3 并且 < 5 公里，并且被与长脉搏相结合的 IPL 对待 1064 nm Nd : 钇铝柘榴石激光治疗；为有损害深度的那些的组 A-4 5 公里，并且拿了 lauromacrogol 注射治疗。在组 B 的病人诊脉 1064 nm Nd : 没有外科手术前的超声评估的钇铝柘榴石激光治疗。功效和在这些组之间的治疗的不利反应完全被评估并且比较 statistically.Results 有 128 皮肤损害的 113 个病人在这研究被注册， 85 在组 A (吝啬的年龄 6.8 吗？？

The Diagnostic Value of Color Doppler Ultrasound and Grey Scale Sonography in Predicting the Malignancy of Thyroid Nodules

Retrospective study was done at KAUH to determine the sonographic characteristics in predicting the malignancy of thyroid nodules. The sample was 120 patients consisting of 70 benign nodules and 50 malignant nodules. Out of 120 patients, 106 (88.3%) female and 14 (11.7%) male patients. Out of 106 female patients, 64 (91.45) had benign and 42 had malignant thyroid nodules. Out of 14 (11.7) male patients, 6 had benign and 8 had malignant thyroid nodules. The youngest patient in our study was 31 years and the oldest patient was 76 years. The common range of patients age was ≥ 60 years and consisting of twenty (28.6%) benign thyroid nodules and fourteen (28%) malignant thyroid nodules. The majority of patients’ age group with malignant thyroid nodules were between 50 - 60 years and consisting of twenty (40%) malignant nodules. In our study, according to the result of gray scale and color Doppler ultrasonography, hypo-echogenicity, solid echo structure, micro-calcification and intra-nodular vascularity were the significant characteristics of malignancy in nodules with sensitivity (72%, 74%, 48% and 88% respectively), specificity (66%, 63%, 94% and 69% respectively), PPV (60%, 59%, 86% and 67% respectively) and NPV (77%, 77%, 72% and 89% respectively).

Measurement of Liver Size and Intrahepatic Blood Flow of Red-eared Turtles by Color Doppler Ultrasound

In the study, a total of 20 red-eared turtles （ half male and half female） were selected to conduct the measurement of liver size and intrahepatic blood flow of red-eared turtles by color Doppler ultrasound. The results showed that the fight hepatic lobe could be scanned through the right carotid anterior acoustic win- dow, and the left hepatic lobe could be scanned through the left carotid anterior acoustic window, but the vision would be obstructed by the air in trachea. The liver could also be scanned through the left femoral anterior acoustic window and the fight femoral anterior acoustic window when filling of bladder was good. The correla- tion regression analysis suggested that estimated values of liver showed no linear relationship with weight, the longest back curve and the widest back curve. Through the study, the normal indicators for ultrasound examination of red-eared turtle liver were established, in order to provide a reference for examination of turtle liver.

TREATMENT OF SIMPLE RENAL CYSTS BY COLOR DOPPLER ULTRASOUND GUIDED PERCUTANEOUS PUNCTURE CATHETERIZATION DRAINAGE AND 99% ETHANOL PERFUSION

Objective To investigate the effect and safety of the treatment of renal cysts with color Doppler ultrasound guided percutaneous puncture catheterization drainage and repeated 99% ethanol perfusion. MethodsFifty-eight patients with primary renal cysts were treated with color Doppler ultrasound guided percutaneous puncture catheterization drainage and 99% ethanol perfusion. If the cyst volume was<500 mL, the complete evacuation of the cyst was followed by injection with 99% ethanol in a volume equal to 25% of the total cyst volume, twice per day, 10 min for each injection. If the cyst volume was>500 mL, injection was given three times per day, 20 min for each injection, and the patient was asked to move in different positions to help distributing the ethanol over the cyst wall. ResultsFifty-eight cysts were detected in the 58 patients. Puncture was performed and the success rate was 100%. Central venous catheter was introduced into the cysts. After follow-up for 0.5 to 3 years, 56 renal cysts were disappeared. The cure rate was 96.6%, and the complications such as bleeding, infection, and organ injuries were not found. ConclusionThe treatment of renal cyst with color Doppler ultrasound guided percutaneous puncture catheterization drainage and 99% ethanol injection is an effective and safe method for the patients with renal cysts.

FEASIBILITY STUDY OF AN ULTRASOUND CONTRAST AGENT(LEVOVIST) IN COLOR DOPPLER IMAGING OF LIVER NEOPLASMS

ＩＮＴＲＯＤＵＣＴＩＯＮＣｏｌｏｒＤｏｐｐｌｅｒｉｍａｇｉｎｇ（ＣＤＩ）ｆｏｒｔｈｅｎｏｎｉｎｖａｓｉｖｅａｓｓｅｓｍｅｎｔｏｆｂｏｔｈｎｏｒｍａｌａｎｄａｂｎｏｒｍａｌｌｉｖｅｒｖａｓｃｕｌａｒｉｔｙｈａｖｅｏｆｅｒｅｄａｓｉｇｎｉｆｉｃａｎｔ...

Hemodynamic Changes on Color Doppler Flow Imaging and Intravenous Contrast-enhanced Ultrasound for Assessing Transplanted Liver and Early Diagnosis of Complications

The value of color Doppler flow imaging （CDFI） and intravenous contrast-enhanced ultrasound （CEUS） for assessing the transplanted liver and early diagnosing complications by examining hemodynamic changes was discussed. Seventy-five patients with orthotopic liver transplantation （OLT） underwent CDFI. The following parameters were measured： peak systolic velocity （PS）, resistance index （RI） and Doppler perfusion index （DPI） of the hepatic artery （HA）, time average velocity （TAV） of portal vein （PV） and velocity of hepatic vein （HV） in different stages postoperation, And 11 patients of them received CEUS. Thirty healthy subjects were enrolled as controls, The results showed that： （1） In 23 patients without obvious complications, TAV of PV within 15 days post-operation was significantly higher than in controls （P〈0.05）, PS and DPI of HA within 7 days postoperation were lower, but RI was higher than in controls （P〈0.05）; （2） When the hepatic artery thrombosis （HAT） occurred, PS and DPI of HA were obviously decreased, but TAV of PV significantly increased like a high saw-tooth wave; （3） While rejection occurred, both TAV of PV and PS of HA were decreased with the increase in RI of HA, and the triphasic wave of HV disappeared and displayed as saw-tooth wave; （4） The incidence of biliary complications in liver transplantation was increased when DPI was reduced; （5） Seven cases of hepatic carcinoma relapse after OLT demonstrated hyperecho in the arterial phase and hypoecho in the portal and later phase on CEUS; （6） In 2 cases of HA thrombus, there was no visualized enhancement in arterial phase of CEUS, but enhancement during the portal vein and parenchymal phase. It was concluded that the hemodynamic changes of PV, HA and HV in the transplanted liver are valuable for assessing the transplanted liver and early diagnosing complications on CDFI and CEUS.

Color Doppler ultrasonographic examination on the relationship between the gallbladder bed and major branch of the middle hepatic vein

BACKGROUND: There is a controversy about the risk of injury to the branch of the middle hepatic vein during lapa- roscopic cholecystectomy. This study was conducted to further investigate the relationship between the gallbladder bed and the branch of the middle hepatic vein. METHODS: Color Doppler ultrasound was used to exa- mine the anatomical relationship between the gallbladder bed and the branches of the middle hepatic vein in 143 healthy volunteers. RESULTS: Not all the middle hepatic vein extended close to the gallbladder bed, the branches and gallbladder beds in 23 subjects were not in the same plane during ultrasound scanning. In 21 of the 143 subjects the branch of the middle hepatic vein was completely adherent to the gallbladder bed with a diameter ranging from 1.2 mm to 3.6 mm. In 10 subjects the branches of the middle hepatic vein traversed approximately 1.0 mm from the gallbladder bed with a dia- meter ranging from 1.6 mm to 3.0 mm. CONCLUSIONS: In most subjects the branch of the middle hepatic vein and the gallbladder bed are well separated. Only patients with large branches of the middle hepatic vein close to the gallbladder bed are at risk of hemorrhage during laparoscopic cholecystectomy.

Correlation Study of Color Doppler Examination of Deep Veins of Both Lower Extremities Combined with Fibrinolysis System in Hypertension during Pregnancy

Objective: To investigate the correlation between deep static color Doppler ultrasound of both lower extremities combined with fibrinolytic system detection in pregnancy-induced hypertension. Methods: A total of 70 normal pregnant women, 70 pregnant women with hypertension during pregnancy, and 50 healthy non-pregnant women in the same period were selected as the research objects. The deep veins of both lower limbs were examined by Rili Erlangshen’s color Doppler ultrasound diagnostic instrument (CDU), and the fibrinolysis system was tested by enzyme-linked immunosorbent assay (ELISA) method and automatic hemagglutination analyzer. Results: Compared with the non-pregnant group, the inner diameters of the left/right femoral vein (CFV) and popliteal vein (POV) in the normal pregnancy group and the pregnancy-induced hypertension group were significantly widened, and the peak blood flow spectrum was significantly reduced. The difference was statistically significant (P < 0.01);FIB, PLG, t-PA, PAI, D-Dimer were significantly increased, the difference was statistically significant (P < 0.01);Compared with the normal pregnancy group, the inner diameter of the left/right femoral vein (CFV) in the hypertensive pregnancy group was significantly wider than that in the normal pregnancy group, and the peak value of the left/right POV blood flow spectrum was significantly lower than that in the normal pregnancy group, the difference was statistically significant (P < 0.01), while the left/right popliteal vein (POV) inner diameter, left/right CFV blood flow peak value did not change significantly from the normal pregnancy group, and the difference was not statistically significant (P > 0.05);FIB, PLG, PAI, D-Dimer of the hypertensive disease group during pregnancy significantly increased, the difference was statistically significant (P < 0.01), while t-PA was not statistically significant (P > 0.05). Conclusion: Normal pregnant women have a hypercoagulable state compared with healthy non-pregnant women, and pregnant women with hypertension during pregnancy are more likely to be in a pre-thrombotic state than pregnant women with normal pregnancy. Deep vein CDU examination of both lower extremities combined with blood fibrinolysis monitoring is of great value in the prevention and treatment of hypertension during pregnancy.

Paper Clinical Value of Color Doppler Ultrasonography in Diagnosis of Lower Extremity Arterial Disease of Diabetes Patients

Objective: To evaluate the diagnostic value of color Doppler ultrasound in the diagnosis of diabetic lower extremity vascular diseases. Methods: 48 patients with diabetic lower extremity vascular disease admitted in our hos-pital from September 2018 to September 2019 were included in the study and divided into the observation group, and another 48 patients with the same period of health examination in our hospital were included in the study and divided into the control group. Both groups used color Doppler ultrasound to detect the blood flow of lower extremity vessels. The incidence of blood flow, vascular diameter and stenosis, occlusion and arteriosclerosis of the lower extremity were observed. Results: The blood flow and vascular di-ameter of the lower extremity in the observation group were significantly lower than those in the control group (p < 0.05). The incidence of vascular stenosis, vascular occlusion, thrombus, intimal thickening and plaque in the observation group was 85.42%, 22.92%, 10.42% and 93.75% respectively, which was significantly higher than that in the control group was 10.42%, 0.00%, 0.00% and 14.58% (p < 0.05). The incidence of lower extremity vascular lesions in the observation group was significantly higher than that in the control group (p < 0.05). Conclusion: Color Doppler ultrasound is of high diagnostic value in the diagnosis of diabetic lower extremity vascular diseases, and can be used to determine the blood flow of the lower extremity and the inner diameter of popliteal artery, thigh artery, dorsalis pedis artery and so on. At the same time, it can also clearly show the specific situation of vascular occlusion, arteriosclerosis and thrombosis, which is of great signif-icance for the prevention and diagnosis of lower extremity vascular lesions, and can provide the basis for the treatment of lower extremity vascular lesions.

Measurements Of Cerebral Blood Flow in Postasphyxiated Newborns by Color Doppler Imaging（CDI）

Cerebral blood flow of 10 asphyxiated term newborns was continuously measured during the first 7 days of life and compared with that of 10 normal term infants by CDI. Frequency spectrum and blood flow variables in the anterior, middle and posterior cerebral arteries were studied. The results showed evidently lower systolic amplitude in patients than that in normal subjects. End diastolic amplitude was zero in part of vessels, and values of bloed flow variables were all lower in day 1 of the life as compared with the control groups. Frequency spectrum recovered to normal patterns in 9 survived infants in day 2. but blood flow variables recovered to normal by day 7. Values of resistance index (RI) rose to 1 in some vessels of moderate hypoxic ischemic encephalopathy (HIE) infants and stayed at 1 in the severe HIE infants. It is concluded that low CBF plays a key role in brain damage of post-asphyxiated newborns and RI may be an important parameter in the evaluation prognosis.

Role of color Doppler flow imaging in applicable anatomy of spleen vessels

AIM: To explore the role of color Doppler flow imaging (CDFI) in visualization of spleen vessels and to defi ne its value for spleen micro-invasive operation. METHODS: A total of 36 patients requiring laparoscopic splenectomy (LS) for various hematopathies and autoimmune diseases were randomly selected from April 2005 to May 2008. Anatomic types of spleen pedicle, adjacent relations between spleen vessels and pancreas, diameters of spleen artery and vein were detected and recorded by preoperative CDFI. Different operative procedures were performed according to different anatomic frameworks. The parameters were recorded by telerecording during LS and compared with those by preoperative CDFI using Chi-square test. RESULTS: Two anatomic types of spleen pedicle and four different adjacent relations between spleen vessels and pancreas were detected by CDFI. The diameters of spleen artery and vein detected by CDFI were 0.46 ± 0.09 cm and 0.85 ± 0.35 cm, respectively. There was no statistical difference between the parameters recorded by CDFI and by telerecording (χ2 = 0.250, 0.677, P > 0.05). LS was successfully performed following the anatomic information provided by preoperative CDFI.CONCLUSION: Different anatomic frameworks of spleen vessels can be provided by preoperative CDFI, which instructs micro-invasive operation of spleen and increase the safety of operation.

超声造影诊断下肢淋巴水肿的研究进展

下肢淋巴水肿是一种慢性、进行性疾病,严重影响患者生活质量;早期诊断和治疗可延缓病情进展,有利于改善患者预后。目前常见的下肢淋巴水肿诊断技术均具有一定的缺点而使应用受限。超声造影具有无创、便捷、实时、重复性好的特点,能够增强淋巴管中淋巴液的显像,对浅表淋巴管显像具有较高敏感度,近年来逐渐应用于下肢淋巴水肿诊断。本文对超声造影在下肢淋巴水肿中的应用情况进行综述。

DNA无创产前检测及彩色多普勒超声检查在高危孕妇胎儿 染色体异常筛查中的应用价值

目的探讨DNA无创产前检测(NIPT)及彩色多普勒超声(简称彩超)检查在高危孕妇胎儿染色体异常筛查中的应用价值。方法选取2020年1月至2022年12月于该院接受产前检查的5862例高危孕妇作为研究对象,均接受NIPT、彩超检查,以羊水穿刺结果或分娩结局作为诊断胎儿染色体异常的金标准,比较NIPT、彩超检查及二者联合检查对高危孕妇胎儿染色体异常的诊断效能。结果5862例高危孕妇中共检出167例胎儿染色体异常,检出率为2.85%。167例胎儿染色体异常中胎儿染色体数目异常161例,构成比为96.41%;胎儿染色体结构异常6例,构成比为3.59%。彩超检查共诊断出119例孕妇胎儿染色体异常,经一致性分析,彩超检查诊断胎儿染色体异常的灵敏度为0.713,特异度为0.884,准确率为87.96%,Kappa=0.215,P<0.05。NIPT共诊断出133例孕妇胎儿染色体异常,经一致性分析,NIPT诊断胎儿染色体异常的灵敏度为0.796,特异度为0.945,准确率为94.05%,Kappa=0.408,P<0.05。彩超检查联合NIPT共诊断出158例孕妇胎儿染色体异常,经一致性分析,二者联合检查诊断胎儿染色体异常的灵敏度为0.946,特异度为0.986,准确率为98.50%,Kappa=0.775,P<0.05。结论NIPT与彩超检查用于筛查高危孕妇胎儿染色体异常均具有一定价值,二者联合检查可获得更高的灵敏度、特异度和准确率,能有效降低漏诊及误诊风险。

钼靶和超声多普勒结合血清肿瘤标志物诊断早期乳腺癌研究

目的:探讨钼靶、超声多普勒和血清肿瘤标志物中血清前列腺特异抗原(PSA)、血清糖类抗原15-3(CA153)、黏蛋白1(MUC1)、人类生长分化因子3(GDF3)单独及联合检测在早期乳腺癌诊断中的价值。方法:选取2018年1月至2021年12月在唐山市人民医院经病理检查确诊的96例乳腺癌患者(乳腺癌组)和同期在本院接受诊治的70例乳腺良性疾病患者(良性病灶组)以及同时选取在本院体检健康的50名体检者(健康对照组),以术后病理检查为“金标准”,比较钼靶、超声多普勒检查以及血清PSA、CA153、MUC1、GDF3单独及6者联合应用对乳腺癌的诊断价值。结果:乳腺癌组96例乳腺癌患者中有78例乳腺超声诊断为恶性,阳性检出率为81.3%;80例钼靶X射线检查诊断为恶性,阳性检出率为83.1%;乳腺癌组的血清PSA、CA153、MUC1及GDF3的水平明显高于良性病灶组和健康对照组,差异均有统计学意义(t_(良性病灶组)=8.783、10.361、11.258、18.965;t_(健康对照组)=9.564、12.658、12.688、20.163,P<0.05);以乳腺癌作为因变量,血清PSA、CA153、MUC1及GDF3为自变量,进行Logistic回归分析,血清PSA、CA153、MUC1及GDF3是乳腺癌的重要危险因素(OR=1.165、1.168、1.472、1.248,P<0.05);受试者工作特征(ROC)曲线分析各指标单独应用时:乳腺超声、钼靶,血清PSA、CA153、MUC1及GDF3的ROC曲线下面积(AUC)(95%CI)、灵敏度和特异度分别为0.723(0.595~0.851)、82.56%和67.32%,0.761(0.636~0.886)、85.79%和65.36%,0.833(0.726~0.941)、81.48%和85.73%,0.837(0.738~0.926)、61.25%和70.17%,0.768(0.648~0.889)、71.49%和80.87%,0.613(0.469~0.758)、52.94%和50.57%;而6项联合应用时AUC(95%CI)、灵敏度和特异度分别为0.958(0.905~0.999)、96.37%和84.83%,其诊断效能更高。结论:钼靶、超声多普勒和血清PSA、CA153、MUC1、GDF3联合检测效能高于单独检测,有助于早期鉴别和诊断乳腺癌。

CT静脉造影与彩色多普勒超声检查在左髂静脉压迫综合征诊断中的临床价值

目的 研究CT静脉造影(CTV)与彩色多普勒超声(CDS)检查在左髂静脉压迫综合征(IVCS)诊断中的临床价值。方法 选取2022年1月至2023年6月入大庆龙南医院的81例左侧静脉曲张患者作为观察对象,所有患者均接受数字减影血管造影(DSA)检查,参考下肢静脉检查结果有无左IVCS分别作为观察组(n=27)与对照组(n=54)。两组患者均接受CTV或者CDS检查,比较两组患者的CTV左髂静脉前后径、CDS参数(压力梯度、血流速度、前后径),同时比较单一CTV、CDS与CTV联合CDS诊断左IVCS准确性,并采用受试者操作特征(ROC)曲线评估CTV、CDS单独及联合检测对IVCS的诊断价值。结果 观察组患者CTV及CDS左髂静脉前后径分别为(6.09±1.38)、(3.02±0.47) mm,均明显低于对照组[(7.41±1.72)、(5.11±0.58) mm],压力梯度、血流速度分别为(2.69±0.48) mmHg、(40.47±9.25) cm/s,均明显高于对照组[(0.89±0.32) mmHg、(27.53±6.92) cm/s],差异均有统计学意义(P<0.05)。左IVCS诊断中CTV左髂静脉前后径、CDS左髂静脉前后径及联合检查的准确率依次为87.95%、84.34%、91.57%。ROC曲线显示,以10.00 mm为临界值,左IVCS诊断中CTV的ROC曲线下面积(AUC)为0.905,灵敏性为81.47%,特异性为90.38%;CDS的AUC为0.839,灵敏性为74.09%,特异性为88.46%;CTV联合CDS的AUC为0.935,灵敏性为96.28%,特异性为86.49%。结论 左IVCS诊断中IVCS、CDS均具有良好效果,但两种技术联合诊断的准确性、灵敏性更高,早期阶段可为左IVCS诊断提供参考依据。

经阴道彩色多普勒超声在子宫内膜病变患者中的应用价值

目的分析经阴道彩色多普勒超声在子宫内膜病变患者中的应用价值。方法选取2021年2月至2022年4月南昌大学第四附属医院收治的88例子宫内膜病变患者作为研究对象,所有患者均接受经阴道彩色多普勒超声及病理学检查,按照病理学检查结果将患者分为息肉组与癌变组,每组44例。比较两组二维超声子宫内膜情况、病灶血流动力学情况、经阴道彩色多普勒超声血流相关参数;以病理学检查结果为金标准,分析经阴道彩色多普勒超声对子宫内膜癌变的诊断效能。结果癌变组子宫内膜厚度厚于息肉组,内膜-肌层分界清晰、病灶回声均匀占比均低于息肉组,差异有统计学意义(P<0.05);癌变组血流丰富占比高于息肉组,差异有统计学意义(P<0.05);癌变组血流阻力指数(RI)、搏动指数(PI)均低于息肉组,时间平均峰值流速(TAP)慢于息肉组,差异有统计学意义(P<0.05);经阴道彩色多普勒超声对子宫内膜癌变的诊断灵敏度为86.36%,特异度为84.09%,准确度为85.23%;诊断息肉的灵敏度为84.09%,特异度为86.36%,准确度为85.23%。结论经阴道彩色多普勒超声对子宫内膜病变的诊断准确率较高,能通过血流动力学、RI、PI、TAP及影像学表现鉴别息肉或癌变。