声带囊肿的音声检查及喉内显微手术

对12例声带囊肿作了音声检查和喉内显微手术。纤维动态喉锐录像检查可明确显示病变形状，病变部振幅变小、表面粘膜波消失，有助于鉴别诊断。喉发声分析示气流率升高、声时缩短、最高音下降、音域变窄。音声听觉心理评价主要为音声粗糙，兼有紧张，多伴有漏气。喉内显微手术术式分二种：粘膜下囊肿摘除术和带粘膜囊肿切除术。文中还讨论了中医对声带囊肿的认识。

用声诺维超声造影检查诊断输卵管堵塞的准确性评价

目的 :探讨用声诺维超声造影检查诊断输卵管堵塞的准确性。方法 :对近年来在我院就诊的40例输卵管堵塞患者(共有80条输卵管发生堵塞)的临床资料进行回顾性研究。这40例患者的病情均经手术探查被确诊为输卵管堵塞。我们将这40例患者随机分为声诺维组和双氧水组,每组各有20例患者。我院对声诺维组患者进行了声诺维超声造影检查,对双氧水组患者进行了双氧水超声造影检查,然后对比两组患者检查结果的准确性和不良反应的发生率。结果 :声诺维组患者检查结果的准确率明显高于双氧水组患者,其不良反应的发生率明显低于双氧水组患者,二者相比差异具有显著性(P<0.05)。结论 :用声诺维超声造影检查诊断输卵管堵塞具有准确率高和安全性好的优点。此检查方法可作为临床上诊断输卵管堵塞的优选方法。

彩色多普勒超声对扩张型心肌病与缺血性心肌病的鉴别诊断价值

【目的】探讨彩色多普勒超声对扩张型心肌病与缺血性心肌病诊断与鉴别诊断的临床价值。【方法】选取临床确诊的扩张型心肌病与缺血性心肌病患者各35例，将其超声声像图进行回顾性分析，比较两者在心脏形态学、心功能及血流动力学等指标的差异。【结果】①80％（28／35）的扩张型心肌病患者心室形态表现为球形，而71％（25／35）的缺血性心肌病表现为圆拱门形（P〈0．05）；②71%（25／35）的扩张型心肌病室壁运动呈弥漫性减弱，而80％（28／35）缺血性心肌病患者室壁运动呈节段性减弱（P〈0．05）；③扩张型心肌病以多瓣膜反流为主，而缺血性心肌病以二尖瓣反流为主（P〈0．05）。【结论】彩色多普勒超声是扩张型心肌病与缺血性心肌病的一种有价值且简单易行的无创性鉴别手段。

高血压患者左室重构和舒张功能变化与血管内皮功能关系的超声检测

目的研究原发性高血压患者左室重构和左室舒张功能的变化,并探讨其与肱动脉内皮依赖性舒张功能之间的关系。方法检测22例高血压病左室肥厚患者(LVH组),18例非左室肥厚患者(非LVH组)及20例正常对照者的心脏结构和功能,并观察肱动脉加压反应性充血后内径变化的百分率(FMD%)。结果高血压病LVH组与非LVH组肱动脉反应性充血后内径变化百分率(FMD%)、E/A均较正常对照组明显降低(P<0.05);左室质量指数(LVMI)高血压病LVH组较非LVH组及正常对照组明显增大(P<0.001);FMD%与LVMI明显相关(r=-0.721,P<0.01),并与E/A有相关性(r=0.392,P<0.05)。结论超声无创检测肱动脉内皮依赖性舒张功能为临床评估高血压病提供了一项重要信息。

超声引导下经皮肝穿刺活检对AFP阴性的肝占位性质判断

目的 探讨B超定位下经皮肝穿刺对AFP阴性的肝占位病变进行活检 ,确定肝占位性病变的性质 ,提高其诊断率。方法 对 12 0例性质未明的AFP阴性的肝占位病变 (≤ 10 .0cm )于B超检查后确定穿刺点、进针路线、方向及深度 ,消毒后局麻 ,用活检针于定位点进入病灶组织行穿刺 ,所获组织均送病理检查。结果 12 0例均在超声定位引导下 1次穿刺成功 ,病理组织学诊断敏感性为 97% ,特异性为 10 0 % ,准确性为 99% ,无严重并发症发生。结论 B超虽然能显示肝占位性病变组织病理相关的特征 ,然而对良恶性的鉴别仍有困难。B超定位下经皮对AFP阴性的肝占位行病灶穿刺活检术操作简单 ,术后病理诊断有助于对良恶性肿瘤的明确诊断 。

二维超声、超声造影及细针穿刺针感赋值评分在TI-RADS 3～4级甲状腺微小结节鉴别诊断中的应用

目的探讨二维超声、超声造影及超声引导下细针穿刺(US-FNA)针感赋值评分在甲状腺影像报告和数据系统(TI-RADS)3~4级甲状腺微小结节鉴别诊断中的应用价值。方法选取我院经病理证实的TI-RADS 3~4级甲状腺微小结节患者149例(共计149个结节),其中良性结节87个,恶性结节62个。比较良恶性结节的二维超声特征、超声造影特征及US-FNA针感情况;ROC曲线分析单独及联合赋值评分诊断恶性结节的相应截断值,并计算其诊断效能。结果良、恶性微小结节的二维超声征象即形态不规则、极低回声及低回声、微钙化及粗钙化、纵横比、声晕、声衰减比较差异均有统计学意义(均P<0.05);良、恶性微小结节的超声造影特征即增强模式、增强类型及增强速度比较差异均有统计学意义(均P<0.05);良、恶性微小结节的US-FNA针感比较差异有统计学意义(P<0.05)。二维超声、超声造影及USFNA针感两两联合赋值评分对甲状腺恶性微小结节的诊断准确率均可达80%以上,三者联合赋值评分诊断甲状腺恶性微小结节的敏感性最高(90.3%),其中超声造影、US-FNA联合赋值评分诊断的敏感性、特异性及准确率均可达80%以上(分别为80.6%、83.9%及82.3%)。结论对二维超声、超声造影及US-FNA相关指标进行联合赋值评分,可以提高TIRADS 3~4级甲状腺微小结节的诊断水平。

大腿根部恶性增生性外毛根鞘瘤超声表现1例

患者男，33岁．8年前发现左大腿根部大小2cm×3cm×2cm包块，未接受特殊治疗.

韶关地区新生儿耳声发射与耳聋基因联合筛查结果分析

目的:了解韶关地区新生儿听力筛查情况。方法:选择2017年1～6月在韶关市粤北人民医院出生的新生儿1 247例,所有新生儿应用耳蜗精灵为其进行耳声发射检查,由仪器自动判定通过或者不通过,初筛为出生后2～3 d,复筛于出生后42 d进行。在出生3 d内采集足跟血作为提取基因组DNA血样,由粤北人民医院检验科行耳聋基因微阵列检测,检测4个常见耳聋基因上的9个突变位点。结果:耳声发射初筛不通过484例,其中早产儿142例未通过。复筛均通过。1247例对象中49例耳聋基因筛查阳性,GJB2 235DelC突变16例,GJB2 299DelAT突变2例,GJB3 538C>T突变2例,SLC26A4 IVS7-2A>G突变14例,SLC26A42168A>G突变5例,SLC26A4 1229C>T突变3例,mtDNA 12SrRNA 1555A>G均质突变5例,mtDNA 12SrRNA 7445A>T均质突变1例,不在常规检查列表中;mtDNA 12SrRNA 1494C>T均质突变1例。结论:耳声发射初筛阳性率高于耳聋基因阳性率,复筛阳性率低于耳聋基因阳性率。在本地区没有耳聋家族史的新生儿中,GJB2和SLC26A4基因突变率较高,GJB3基因和线粒体DNA12SrRNA基因突变率较为少见。由于耳声发射检查采用瞬态诱发耳声发射筛查,对于听神经疾病的患儿有一定的假阳性及假阴性率,通过联合耳聋基因筛查可早期发现迟发性耳聋患儿,为人群听力障碍防控提供帮助。

超声鉴别诊断腹腔浆膜腔积液良恶性的价值研究

目的探讨超声对腹腔浆膜腔积液良恶性的鉴别诊断价值。方法选取我院腹腔浆膜腔积液患者104例,其中良性37例,恶性67例。比较良、恶性浆膜腔积液患者的腹腔超声特征;采用Logistic回归模型分析差异有统计学意义的主要诊断指标,分析其对恶性浆膜腔积液的诊断效能。结果良、恶性浆膜腔积液患者的胆囊壁厚度、后腹膜淋巴结肿大、肠管浮游、大网膜增厚/结节、大网膜血流情况及肠壁增厚比较差异均有统计学意义(均P<0.05)。经过二变量Logistic逐步回归,得到以下方程:恶性可能性=1/(1+e^(-z)),其中z=4.226×胆囊壁厚度+5.218×大网膜增厚/结节+3.024×肠壁增厚+4.892×肠管浮游-29.387;大网膜增厚/结节诊断恶性浆膜腔积液的OR值为7.375,高于其他自变量。当浆膜腔积液患者出现胆囊壁薄、大网膜增厚/结节、肠壁增厚,且肠管浮游征消失时,恶性可能性为99%。结论超声有助于浆膜腔积液良恶性的鉴别诊断;且胆囊壁厚度、大网膜增厚/结节、肠壁增厚及肠管浮游征是超声预测浆膜腔积液良恶性的有效特征指标。

腹部脏器损伤的超声波诊断

目的：探讨B超在闭合性腹部损伤合并内脏损伤中的应用价值。方法：回顾性总结和分析114例闭合性腹部伤合并内脏损伤的声像图表现，与手术及病理结果相对照。结果：本组超声检查与手术诊断完全符合者为78例，占68．4％，基本符合者为30例，占26．3％，误诊20例，占17．5％，漏诊15例，占13．2％，超声总符合率为94．7％。结论：超声能显示损伤的脏器、位置、程度和出血量的多少，对腹腔脏器破裂的诊断有较高的诊断价值，并能动态观察，指导临床治疗和随诊。

Correlations of transcranial sonography of substantia nigra characteristics with MRI iron deposition on substantia nigra in patients with Parkinson disease

Objective To explore the correlations of transcranial sonography of substantia nigra(SN-TCS)characteristics with MRI iron deposition on substantia nigra in patients with Parkinson disease(PD).Methods Data of SN-TCS and craniocerebral MRI in 120 PD patients were retrospectively analyzed.The patients were divided into iron deposition positive group(positive group,n=46)and iron deposition negative group(negative group,n=74)according to quantitative susceptibility mapping(QSM)value.Then parameters of SN-TCS and MRI were compared between groups(both P<0.05),and correlation analysis were also performed.Results The proportion of high echo positive,strong echo area and QSM value of substantia nigra,as well as of hyper-substantia nigra area/midbrain area(S/M)in positive group were all higher than those in negative group(all P<0.001).No significant difference of midbrain area was found between groups(P>0.05).Strong echo area of substantia nigra and S/M based on SN-TCS were both low-medium positively correlated with substantia nigra QSM value showed on MRI(r=0.497,0.529,both P<0.001).Conclusion SN-TCS characteristics of PD patients were correlated with MRI iron deposition on substantia nigra,among which strong echo area and S/M were valuable for evaluating iron deposition on substantia nigra.

E-Cervix imaging displaying cervical elasticity characteristics of healthy adult nulliparous women at different age groups and different menstrual cycle stages

Objective To observe the cervical elasticity of healthy adult nulliparous women at different age groups and different stages of menstrual cycle with E-Cervix imaging technology.Methods A total of 218 healthy adult nulliparous women who underwent transvaginal ultrasound examination for routine physical examination were retrospectively enrolled,including 103 in follicular phase,78 in ovulation phase and 37 in luteal phase.Cervical canal length(CL)and E-Cervix elasticity parameters were compared among different age groups and different stages of menstrual cycle,including elasticity contrast index(ECI),hardness ratio(HR),cervical internal and external orifice strain values(IOS and EOS)and IOS/EOS ratio.Results No significant difference of CL nor cervical elasticity parameters was detected among healthy adult nulliparous women at different age groups(all P>0.05).There were significant differences of ECI,HR and IOS among different menstrual cycle stages(all P<0.05),among which women in follicular phase had higher ECI and IOS but lower HR than those in luteal phase(all P<0.05).Conclusion No significant difference of cervical elasticity existed among healthy adult nulliparous women at different age groups.Meanwhile,cervical elasticity of healthy adult nulliparous women changed during menstrual cycle,in follicular phase had higher ECI and IOS but lower HR than in luteal phase.

Ultrafast pulse wave velocity technique for evaluating changes of carotid artery elasticity in Hashimoto thyroiditis patients with euthyroidism

Objective To explore the value of ultrafast pulse wave velocity(UFPWV)technique for evaluating changes of carotid artery elasticity in Hashimoto thyroiditis(HT)patients with euthyroidism.Methods Conventional ultrasound and UFPWV for carotid artery were prospectively performed in 91 HT patients with euthyroidism(HT group)and 81 healthy subjects(control group).Clinical data and ultrasonic parameters were compared between groups.Spearman correlation analysis was performed to observe the correlations of carotid pulse wave velocity in end of systole(PWV-ES)with clinical indexes and other ultrasonic parameters in HT group.Multiple stepwise linear regression analysis was used to screen the independent impact factors of increased carotid PWV-ES in HT group.Results Significant differences of thyroid peroxidase antibody(TPOAb),thyroglobulin antibody(TgAb),total cholesterol(TC),low density lipoprotein and neutrophil-lymphocyte ratio(NLR)were found between groups(all P<0.05).The carotid PWV-ES in HT group was significantly higher than that in control group(P<0.05),while no significant difference of carotid artery intima-media thickness(CIMT)nor carotid pulse wave velocity in beginning of systole(PWV-BS)was found between groups(both P>0.05).Carotid PWV-ES in HT group was positively correlated with patients'age,body mass index,TPOAb,TC,triglyceride,NLR and CIMT(r=0.217—0.707,all P<0.05).Patients'age,TPOAb and NLR were all independent impact factors of increased carotid PWV-ES in HT patients with euthyroidism(all P<0.05).Conclusion UFPWV technique could be used to evaluate changes of carotid artery elasticity in HT patients with euthyroidism,among which PWV-ES was relatively sensitive.

Application progresses of ultrasound for snakebites and relative complications

Snakebite has become a serious public health problem with high mortality and disability rates.Ultrasound can provide imaging basis for diagnosis and treatment of snakebites and relative complications.The application progresses of ultrasound in snakebites and complications were reviewed in this article.

Ultrasonic manifestations and age distribution of internal abdominal hernia in children

Objective To observe the ultrasonic manifestations and age distribution of internal abdominal hernia in children.Methods Data of 53 children with internal abdominal hernia confirmed by operation were retrospectively analyzed.The ultrasonic findings were observed,and the age distribution of children was analyzed.Results Among 53 cases,"cross sign"was observed in 22 cases(22/53,41.51%),and"hernia ring beak sign"was detected in 26 cases(26/53,49.06%)by preoperative ultrasound,according to which 21 cases were diagnosed as internal abdominal hernia,with the accuracy of 39.62%(21/53).Meanwhile,manifestations of intestinal obstruction were noticed in 48 cases(48/53,90.57%),and intestinal necrosis was considered in 22 cases(22/53,41.51%).Four cases were misdiagnosed as intestinal perforation,appendicitis,intestinal atresia and volvulus,each in 1 case.The onset age of postoperative adhesive band internal hernia was larger than that of mesenteric hiatal hernia(P<0.05),while no significant difference of onset age was found among other types of internal abdominal hernias(all P>0.05).Intestinal ischemic necrosis was found in 25 cases,while the incidence of intestinal necrosis in children aged≤1 year,>1 and≤3 years,>3 and≤7 years and those>7 years was 66.67%(12/18),33.33%(4/12),36.36%(4/11)and 41.67%(5/12),respectively.Conclusion The characteristic ultrasonic findings of internal abdominal hernia in children included"cross sign"and"hernia ring beak sign".Internal abdominal hernia in children under 1 year had high risk of intestinal necrosis.

Polar residual network model for assisting evaluation on rat myocardial infarction segment in myocardial contrast echocardiography

Objective To investigate the value of polar residual network(PResNet)model for assisting evaluation on rat myocardial infarction(MI)segment in myocardial contrast echocardiography(MCE).Methods Twenty-five male SD rats were randomly divided into MI group(n=15)and sham operation group(n=10).MI models were established in MI group through ligation of the left anterior descending coronary artery using atraumatic suture,while no intervention was given to those in sham operation group after thoracotomy.MCE images of both basal and papillary muscle levels on the short axis section of left ventricles were acquired after 1 week,which were assessed independently by 2 junior and 2 senior ultrasound physicians.The evaluating efficacy of MI segment,the mean interpretation time and the consistency were compared whether under the assistance of PResNet model or not.Results No significant difference of efficacy of evaluation on MI segment was found for senior physicians with or without assistance of PResNet model(both P>0.05).Under the assistance of PResNet model,the efficacy of junior physicians for diagnosing MI segment was significantly improved compared with that without the assistance of PResNet model(both P<0.01),and was comparable to that of senior physicians.Under the assistance of PResNet model,the mean interpretation time of each physician was significantly shorter than that without assistance(all P<0.001),and the consistency between junior physicians and among junior and senior physicians were both moderate(Kappa=0.692,0.542),which became better under the assistance(Kappa=0.763,0.749).Conclusion PResNet could improve the efficacy of junior physicians for evaluation on rat MI segment in MCE images,shorten interpretation time with different aptitudes,also improve the consistency to some extent.

Right heart modified myocardial performance index and ductus venosus spectrum parameters in pre-eclampsia fetuses for predicting adverse pregnancy outcomes

Objective To observe the values of changes of right heart modified myocardial performance index(Mod-MPI)and ductus venosus(DV)spectrum parameters in pre-eclampsia fetuses for predicting adverse pregnancy outcomes.Methods Eighty-one pregnant women diagnosed as pre-eclampsia were prospectively enrolled and divided into severe pre-eclampsia(SPE)group(n=39)and mild pre-eclampsia(MPE)group(n=42),while 85 healthy pregnant women were taken as controls(control group).Fetal right heart function parameters,including right ventricular isovolumetric relaxation time(IRT),isovolumetric contraction time(ICT),ejection time(ET),total spent time(TST),Mod-MPI,tricuspid valve peak flow velocity ratio in early and late diastole(TV-E/A),as well as blood flow velocities in each waveform of DV spectrum(S,V,D,and A wave)were obtained,and the pulsatility index(PI)and the ratio of blood flow velocities in each waveform of the DV(S/V,S/D,S/A,V/D,V/A,D/A)were calculated.Intrauterine fetal distress,preterm delivery,neonatal asphyxia and newborn with low weight were considered as adverse pregnancy outcomes.The correlations of right heart Mod-MPI and TV-E/A with DV parameters in pre-eclampsia fetuses were assessed,and their predictive efficacies for adverse pregnancy outcomes were evaluated for right heart Mod-MPI and DV using the receiver operating characteristics(ROC)and the area under the curves(AUC).Results Compared with control group and MPE group,fetal right heart IRT,ICT and Mod-MPI increased and ET decreased in SPE group(all P<0.05).No significant differences of right heart TST and TV-E/A among 3 groups(both P>0.05).Fetal DV A-wave velocity and V/D values progressively decreased but PI progressively increased in control,MPE and SPE groups(all P<0.05).Fetal right heart Mod-MPI in pre-eclampsia was moderately positively correlated with DV PI(r=0.637,P=0.016),while TV-E/A was weakly negatively correlated with DV V/D(r=-0.355,P=0.043).Adverse pregnancy outcomes were noticed in 59 pre-eclampsia cases.The AUC of fetal right heart Mod-MPI and DV PI for predicting adverse pregnancy outcomes in pre-eclampsia cases was 0.897 and 0.848,respectively,without significant difference(Z=0.460,P=0.400).Conclusion Changes of right heart Mod-MPI and DV spectrum parameters in pre-eclampsia fetuses had high value for predicting adverse pregnancy outcomes.

Cranial ultrasound in perioperative period of acute severe traumatic brain injury

Objective To observe the value of cranial ultrasound for perioperative patients with acute severe traumatic brain injury(sTBI).Methods Data of 55 sTBI patients who underwent craniotomy were retrospectively analyzed.The patients were divided into observation group(n=15)and control group(n=40)according to received perioperative cranial ultrasound or not.The general data and surgical data were compared between groups,and ultrasonic data of observation group were analyzed.Results The proportions of good prognosis 1 and 6 months after operation in observation group were both higher than those in control group,while the incidence of cerebral infarction in observation group was lower than that in control group(all P<0.05).No significant difference of general data nor other surgical data was found between groups(all P>0.05).Acute encephalocele occurred in 1 case in observation group during operation,and cranial ultrasound accurately showed the contralateral secondary epidural hematoma.Increased intracranial pressure in different degrees were found in all 15 cases(15/15,100%)in observation group after operation with transcranial color coded Doppler(TCCD)or transcranial Doppler(TCD),while cerebral vascular spasm was observed in 5 cases(5/15,33.33%),among them 4 cases(4/5,80.00%)were diagnosed cerebral infarction based on CT examination.Conclusion Cranial ultrasound could be used to evaluate changes of sTBI in perioperative period and guide adjusting treatment strategy in time,being valuable for reducing risk of postoperative cerebral infarction and improving prognosis.