结直肠超声与经腹超声在前列腺癌诊断中的效果对比

目的:分析结直肠超声与经腹超声在前列腺癌中的诊断价值。方法:选取2022年1月至2022年10月128例疑为前列腺癌患者,入选患者均行结直肠超声与经腹超声检查,以磁共振检查为金标准,评价两种超声方法的敏感度、特异度、阳性预测值、阴性预测值,并比较两组各指标的差异。结果:本组128例患者经磁共振检查确诊前列腺癌65例,结直肠超声检查的敏感度为84.6%,特异度为84.1%,阳性预测值为84.6%,阴性预测值为84.1%,经腹超声检查的敏感度为61.5%,特异度为65.1%,阳性预测值为64.5%,阴性预测值为62.1%,结直肠超声的敏感度、特异度、阳性预测值、阴性预测值均高于经腹超声(P<0.05)。结论:结直肠超声在前列腺癌中的诊断价值高于经腹超声,可推广应用。

经直肠超声充盈造影诊断结直肠癌的应用意义评定

目的:评定经直肠超声充盈造影诊断结直肠癌的应用意义。方法:随机选择2014年1月-2016年12月本院收治的100例直肠癌高危人群作为研究对象,均先行空腹超声检查,再经肛门注入造影剂填充结直肠诊断,以病理作为金标准,对比两种检查方法的诊断肿瘤的准确率。结果:经直肠超声造影诊断肿瘤71例,与病理对照准确率达86.59%(71/82);经空腹超声诊断肿瘤24例,与病理对照准确率达29.27%(24/82);经直肠超声造影诊断肿瘤的准确率明显高于经空腹超声,差异有统计学意义(P<0.05)。经直肠超声造影的肠管管壁回声反应肿块清晰,显示肠管管壁侵犯范围和层次明显优于经空腹超声。结论:经直肠超声充盈造影诊断结直肠肿瘤高危人群具有重要意义,可以提高诊断直肠癌肿瘤的准确率,加强对直肠和周边正常组织关系的了解,为结直肠癌术前诊断和术后观察提供更多的信息参考。

结直肠充盈超声声学造影技术对小儿肠息肉诊断的研究

目的:探究结直肠充盈超声声学造影技术诊断小儿肠息肉的临床价值及影像学表现。方法:选取东莞市第八人民医院2019年2月-2020年12月的患儿8例,均确诊为肠息肉。对8例患儿均实施结直肠充盈造影超声检查与常规经腹部超声检查,分析超声表现。结果:经结直肠镜和病理活检确诊的8例肠息肉患儿中,直径<20 mm的肠息肉结直肠充盈造影超声检查确诊率为87.5%,常规经腹部超声检查确诊率为62.5%,二者比较差异有统计学意义(P<0.05)。结直肠充盈造影超声检查对位于直肠的息肉检出率显著高于常规经腹部超声检查,差异有统计学意义(P<0.05)。结论:对于结直肠息肉患儿,相较于有创的结直肠镜检查,无创超声在提高患儿检查依从性及保护患儿方面均有明显优势,而相较于传统的经腹部超声检查,结直肠充盈超声声学造影技术对息肉定位、血流、大小的检出能力更显著。

康复新液直肠滴入治疗对结直肠息肉黏膜下切除术后肠道恢复情况及复发的影响

目的观察结直肠息肉黏膜下切除术后患者采用康复新液直肠滴入治疗的效果及对肠道恢复情况与复发的影响,为临床粘膜下切除结直肠息肉术后恢复及降低复发率提供参考。方法选取在我院行结直肠息肉黏膜下切除术后患者81例,随机数字表法分为治疗组41例,对照组40例,两组患者术后均予以抗感染、止血等常规处理,治疗组在常规处理基础上加用康复新液直肠滴入治疗,观察两组患者术后临床症状(大便次数、粘液血便、腹痛)改善情况、肠道恢复情况及3个月、6个月后的复发情况。结果治疗后,治疗组临床症状评分均显著低于对照组,差异明显(P<0.05);治疗组肠壁厚度、缺损长度显著低于对照组,复发率低于对照组,差异明显(P<0.05)。结论结直肠息肉黏膜下切除术后采用康复新液能显著缓解大便次数增多、粘液血便、腹痛等症状,加速肠壁黏膜恢复,减少复发概率。

常用影像学检查对结直肠癌的诊断及术前评估价值

结直肠癌作为一种典型的消化系统恶性肿瘤其发生风险会随着患者年龄的增加而不断上升,手术主要适用于早期患者,因此早诊断、早治疗才是保证结直肠癌患者生命的关键,而有效的手术很大程度上依靠于准确的术前分期评估,因此临床多以超声、CT、MRI等影像学检查来获知病灶的位置、大小、形态、分期等信息。文章试探究多层螺旋CT、MRI成像、结直肠超声、PET/CT对结直肠癌的诊断及术前评估价值。

Comparison of hydrocolonic sonograpy accuracy in preoperative staging between colon and rectal cancer

AIM:To compare the accuracy of hydrocolonic sonography (HUS) in determining the depth of invasion (T stage) in colon and rectal cancer. METHODS:A total of 1000-2000 mL of saline was instilled per rectum using a system for barium enemas,and then ultrasonography was conducted by a SSA-270A (Toshiba Co,Japan) sonolayer unit with a 3.75 MHz for 17 patients with colon cancer and 13 patients with rectal cancer before operation.After operation,T stage in HUS was compared with postoperative histological findings. RESULTS:Overall,the accuracy of T stage was 70%.It was 88% in colon cancer and 46% in rectal cancer.In evaluating nodal state,the accuracy of HUS was low in both colon (71%) and rectal cancers (46%) compared with conventional CT or MRI.The overall accuracy of N staging was 60%. CONCLUSION:HUS is valuable to evaluate the depth of invasion in colon cancer,but is less valuable in rectal cancer.Because HUS is low-cost,noninvasive,and readily available at any place,this technique seems to be useful to determine the preoperative staging in colon cancer,but not in rectal cancer.

Contrast-enhanced intraoperative ultrasonography equipped with late Kupffer-phase image obtained by sonazoid in patients with colorectal liver metastases

AIM: To find occult metastases during hepatectomy in patients with colorectal cancer liver metastases (CRCLM), contrast-enhanced intraoperative ultrasonography (CE-IOUS) was performed using a new microbubble agent, sonazoid, which provides a parenchyma-specific contrast image based on its accumulation in the Kupffer cells. METHODS: Eight patients with CRCLM underwent CE- IOUS using sonazoid before hepatectomy. The liver was investigated during a late Kupffer-phase imaging, which is a valuable characteristic of sonazoid. RESULTS: CE-IOUS using sonazoid provided the early vascular- and sinusoidal-phase images for 10 min followed by the late Kupffer-phase image up to 30 min after the injection of sonazoid. IOUS did not provide new findings of metastatic lesion in the 8 patients. However, during the late Kupffer-phase image of sonazoid, a metastatic lesion was newly found in two of the 8 patients. These newly detected lesions were removed by an additional hepatectomy and histopathologically diagnosed as a metastasis. CONCLUSION: CE-IOUS using sonazoid can allow surgeons to investigate the whole liver with enough time and to find new metastases intraoperatively.

Response evaluation of chemotherapy in metastatic colorectal cancer by contrast enhanced ultrasound

AIM： To evaluate whether contrast enhanced ultra- sound （CEUS） might also be used for response predic- tion and early response evaluation in patients receiving bevacizumab based chemotherapy for metastasized colorectal cancer.METHODS： Thirty consecutive patients with non prima- ry resectable liver metastases from colorectal cancer underwent CEUS before treatment （CEUS date 1） and before the second （CEUS date 2） and fourth （CEU5 date 3） cycle of bevacizumab based chemotherapy. Three parameters [PEAK, Time to peak （l-I-P） and RISE RATE]were correlated with radiological response.RESULTS： For neoadjuvant purpose a reduction of tu- mour mass was required to assume clinical response. Based on these response criteria there was a significant （P 〈 0.001） correlation in TTP between metastases of responders （9.08 s） and non-responders （14.76 s） ar- chived on CEUS date 1. By calculating a standardized quotient （metastases divided by normal liver tissue） we were able to define a cut off, predicting response with a sensitivity of 92.3 % and a specificity of 100 %. To reflect a palliative intention only those patients with progressive disease were classified as non-responders. In this stetting -FI-P was also significantly （P 〈 0.01） dif- ferent between responders and non-responders. In con- trast, Peak and Rise rate did not show any significant difference between responder and non-responder. CONCLUSION： CEUS might serve as a surrogate mark- er to predict treatment response in patients with me- tastasized colorectal cancer who receive antiangiogenic therapy.