Diagnostic value of different color ultrasound diagnostic method in endometrial lesions

BACKGROUND Endometrial lesions include endometrial cancer and inferior fibroids.Among them,endometrial cancer as a malignant tumor seriously endangers the life and health of patients.Ultrasonography is an important means of diagnosing female reproductive system diseases,and it is of critical value for the early diagnosis of endometrial cancer.However,different ultrasound inspection programs have achieved different results.It is of great significance to choose a suitable inspection program.AIM To explore the diagnostic efficacy of different ultrasonic examination methods in clinical endometrial lesions.METHODS The 140 patients with endometrial lesions who were treated in our hospital from April 2018 to October 2019 were used as the research subjects.All patients underwent transvaginal color ultrasound and transabdominal color ultrasound.We compared the diagnostic coincidence and image display effects of the two different examination methods,and the endometrial thickness,blood flow,uterine effusion and resistance index of different diseases were observed by transvaginal color ultrasound.RESULTS The diagnostic coincidence rate of all types of diseases of transvaginal color ultrasound was significantly higher than that of transabdominal color ultrasound(P=0.001,0.005,0.001 and 0.001).In addition,the excellent and good rate of image display of transvaginal color ultrasound was higher than that of transabdominal color ultrasound(P=0.001).There were significant differences in endometrial thickness in patients with different types of endometrial lesions through the transvaginal color examination(P=0.001).The incidence rate of uterine effusion in patients with endometrial carcinoma was significantly higher than that in patients with other types of endometrial lesions(P=0.001),and the rate of the blood flow was the highest(P=0.001).The comparison of blood flow resistance index indicated that the blood flow resistance index in endometrial cancer patients was the lowest,which shows that the difference was statistically significant(P=0.001).CONCLUSION The overall diagnostic efficacy of transvaginal color ultrasound in the clinical diagnosis of endometrial lesions is better than that of transabdominal color ultrasound,which held higher diagnostic coincidence rate and image display effect.There were significant differences in the thickness of the endometrium and the blood flow in different types of lesions.

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 varices. 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

Objective We investigated the efficacy and safety of 1064 nm Nd： YAG laser, intense pulsed light （IPL）, and lauromacrogol injection in the treatment of hemangioma, in order to evaluate the value of color Doppler ultrasound guidance in choosing the optimal treatment modality. Methods Infantile patients who were clinical diagnosed as hemangiomas were randomly divided into group A, who had color Doppler ultrasound examinations before the treatment, and group B who had the treatment without ultrasound evaluation. Patients in the group A were assigned into subgroups according to the depth of lesion by sonography： group A-1 for those who had a lesion depth 〈1.2 mm, and took intense pulsed light therapy; group A-2 for those who had a lesion depth ≥1.2mm and 〈 3 mm, and took long pulse 1064 nm Nd：YAG laser therapy; group A-3 for those who had a lesion depth ≥3mm and 〈5 mm, and were treated by IPL combined with long pulse 1064 nm Nd：YAG laser treatment; Group A-4 for those who had a lesion depth ≥5 mm, and took lauromacrogol injection therapy. Patients in the group B took long pulse 1064 nm Nd：YAG laser treatment without preoperative ultrasound evaluation. The efficacy and adverse reactions of the treatments between the groups were evaluated and compared statistically. Results Totally 113 patients with 128 skin lesions were enrolled in this study, 85 in the group A （mean age 6.8±7.9 months） and 28 in the group B （mean age 6.9±9.9 months）. The mean depth of hemangioma was 3.3±1.1 mm in the group A, ranging from 0.5-7.8 mm, with 0.8±0.4 mm, 2.2±0.4 mm, 4.2±0.6 mm and 6.2±0.7 mm in group A1, A2, A3 and A4, respectively. The cure rates and effective rates in the group A were significantly higher than those in the group B （cure rates： 64.5% vs 56.3%, U=3.378, P=0.045; effective rates： 89.5% vs 78.1%, U=4.163, P=0.041）. The adverse effect rates of the group A （vesicle 20.0%, pigmentation 46.9%, scarring 17.7%） were lower than those of the group B （vesicle 21.9%, pigmentation 60.4%, scarring 25.0%）. Incidences of pigmentation and scarring were statistically significantly different （U=3.884, P=0.034, and U=4.016, P=0.032 respectively） between the two groups. Conclusion With the guidance of color Doppler ultrasound, the efficacy and safety of long pulse 1064 nmNd：YAG laser, intense pulsed light, and lauromacrogol injection in the treatment of infantile hemangioma have better outcomes compared to laser treatment alone without preoperative ultrasound examination.

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.

Evaluation of Prognosis of Brain Function with Early Transcranial Color Doppler Ultrasound in Patients after Cardiopulmonary Resuscitation

Objective: To evaluate the clinical value of transcranial color Doppler ultrasound (TCCD) in assessing cerebral function after cardiopulmonary resuscitation (CPR). Methods: A prospective study was conducted in 52 patients with cardiac arrest treated by CPR from January 2018 to January 2020, and its clinical data were analyzed. According to classification of cerebral performance category (CPC), 31 cases (CPC grade 1 - 2) were selected in the good prognosis group and 21 cases (CPC grade 3 - 5) in the poor prognosis group. The cerebral blood flow was measured by transcranial Doppler ultrasound (TCCD) 24 h after CPR, and the differences were compared between the two groups in stroke index, diastolic blood flow velocity (Vd), systolic peak blood flow velocity (Vs) and mean peak blood flow velocity (Vm). The ROC curve of cerebral blood flow after CPR was drawn to predict the prognosis of brain function. Results: The data showed that the pulsatility index of middle cerebral artery of the poor prognosis group decreased within 24 h;the difference between the two groups was statistically significant (p < 0.05);the Vd, Vs, Vm increased in the good prognosis group;the difference between the two groups was statistically significant (p < 0.05). The ROC curve of cerebral blood flow after CPR was drawn to predict the prognosis of brain function, and the results showed that the area under the curve and the optimal critical value of cerebral blood flow were 0.731 and 5.69. The sensitivity and specificity were 67.3% and 79.1% respectively. Conclusion: The cerebral blood flow increase in the early stage of successful CPR is positively correlated with the prognosis of cerebral functional resuscitation. Monitoring intracranial blood flow after CPR by TCCD has clinical value to evaluate prognosis of brain function.

Differentiation of atypical hepatic hemangioma from liver metastases: Diagnostic performance of a novel type of color contrast enhanced ultrasound

BACKGROUND In clinical practice,the diagnosis is sometimes difficult with contrast-enhanced ultrasound(CEUS)when the case has an atypical perfusion pattern.Color parametric imaging(CPI)is an analysis software for CEUS with better detection of temporal differences in CEUS imaging using arbitrary colors.It measures the differences in arrival time of the contrast agent in lesions so that the perfusion features of atypical hemangioma and colorectal cancer(CRC)liver metastasis can be distinguished.AIM To evaluate the role of a novel type of CPI of CEUS in the differential diagnosis of atypical hemangioma from liver metastases in patients with a history of CRC.METHODS From January 2016 to July 2018,42 patients including 20 cases of atypical hemangioma and 22 cases of liver metastases from CRC were enrolled.These patients had a mean age of 60.5±9.3 years(range:39-75 years).All patients received ultrasound,CEUS and CPI examinations.Resident and staff radiologists independently and retrospectively reviewed CEUS and CPI images.Two sets of criteria were assigned:(1)Routine CEUS alone;and(2)CEUS and CPI.The diagnostic sensitivity,specificity,accuracy and receiver operating characteristic(ROC)curve of resident and staff radiologists were analyzed.RESULTS The following CPI features were significantly different between liver hemangioma and liver metastases analyzed by staff and resident radiologists:Peripheral nodular enhancement(65%-70.0%vs 4.5%-13.6%,P<0.001,P=0.001),mosaic/chaotic enhancement(5%-10%vs 68.2%-63.6%,P<0.001,P<0.001)and feeding artery(20%vs 59.1%-54.5%,P=0.010,P=0.021).CPI imaging offered significant improvements in detection rates compared with routine CEUS in both resident and staff groups.By resident radiologists,the specificity and accuracy of CEUS+CPI were significantly increased compared with that of CEUS(77.3%vs 45.5%,P=0.030;78.6%vs 50.0%,P=0.006).In addition,the area under the curve(AUC)of CEUS+CPI was significantly higher than that of CEUS(0.803 vs 0.757,P=0.036).By staff radiologists,accuracy was improved in CEUS+CPI(81.0%vs 54.8%,P=0.010),whereas no significant differences in specificity and sensitivity were found(P=0.144,P=0.112).The AUC of CEUS+CPI was significantly higher than that of CEUS(0.890 vs 0.825,P=0.013)by staff radiologists.CONCLUSION Compared with routine CEUS,CPI could provide specific information on the hemodynamic features of liver lesions and help to differentiate atypical hemangioma from liver metastases in patients with CRC,even for senior radiologists.

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.

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.

Diagnosis of parathyroid tumor using Color Doppler ultrasound

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高频彩色多普勒超声联合常规超声诊断早孕期胎儿发育异常的价值分析

目的探究早孕期胎儿发育异常诊断中,在常规超声的基础上联合应用高频彩色多普勒超声的价值。方法研究样本共计72例,均选取郑州大学第二附属医院超声科2022年6月至2024年3月期间收入的早孕期孕妇,依据随机数字表法将其分为研究组(n=36,高频彩色多普勒超声+常规超声)、对照组(n=36,常规超声),金标准为分娩以及随访结果,分析其在检出情况、诊断效能及漏诊差异。结果金标准检查结果为阳性15例(20.83%),阴性57例(79.17%),其中研究组阳性11例,阴性25例,对照组阳性4例,阴性32例。对照组使用常规超声检出阳性16例,阴性20例,研究组使用高频彩色多普勒超声联合常规超声检出阳性15例,阴性21例。研究组准确率、特异度均高于对照组,差异有统计学意义(P<0.05),研究组漏诊率显著低于对照组,差异有统计学意义(P<0.05)。结论常规超声联合高频彩色多普勒超声诊断早孕期胎儿发育异常能够显著提升临床检出以及诊断准确情况,降低漏诊率,整体临床应用价值较为理想,具有临床应用意义。

颈动脉斑块超声特征与缺血性脑血管病的关系

目的探究颈动脉斑块超声特征与缺血性脑血管病(ICVD)的关系。方法回顾性分析新郑华信民生医院2021年2月至2023年3月接收的64例ICVD患者(ICVD组)与30例非ICVD患者(对照组)的临床资料,所纳入人群均已完成颈部血管彩色多普勒超声检查,比较两组颈总动脉(CCA)的中层厚度(IMT)、血流参数[收缩期峰值流速(PSV)、舒张末期流速(EDV)、阻力指数(RI)]、斑块厚度、斑块长度、斑块位置及斑块回声性质。分析上述有因素与ICVD患者颈动脉斑块形成间的关系。结果ICVD组CCA的IMT、收缩期峰值流速(PSV)、舒张末期流速(EDV)、阻力指数(RI)指标均高于对照组,差异均有统计学意义(P<0.05)。ICVD组64例患者共检出89个颈动脉斑块,对照组30例患者共检出22个颈动脉斑块,ICVD组颈动脉斑块厚度与长度高于对照组,斑块回声性质中强回声占比高于对照组,差异均有统计学意义(P<0.05);两组斑块位置比较,差异无统计学意义(P>0.05)。CCA的IMT、PSV、EDV、RI水平以及颈动脉斑块厚度、斑块长度、斑块回声性质均为颈动脉斑块形成后引起ICVD的相关影响因素,差异均有统计学意义(P<0.05)。结论颈动脉IMT、血流参数及斑块特征与ICVD的发生存在密切关联,颈动脉IMT、PSV、EDV、RI升高,颈动脉斑块厚度、长度增加,强回声性质斑块增多,均可能导致ICVD发生风险提升,临床有必要加强对存在此类特征患者的病情监测,尽早明确其是否患有ICVD,及时予以科学诊疗,改善其预后情况。

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 define 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 （X^2 = 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.

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。

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。

彩色多普勒超声血流评分对附件扭转患者卵巢活性的预测价值

目的研究卵巢彩色多普勒血流成像(CDFI)评分预测附件扭转患者卵巢活性的价值。方法选取经手术证实的32例附件扭转患者,根据卵巢血流信号进行评分,将其与术中卵巢活性进行对比分析。结果卵巢CDFI评分推测卵巢存活的灵敏度为90%,特异度为81.82%,阳性预测值为69.23%,阴性预测值为94.74%,卵巢CDFI血流存在与手术中卵巢存活的一致性较好,Kappa值为0.664。结论CDFI能够对附件扭转者卵巢活性进行预估,卵巢血流评分可为临床提供较为可靠、有效的影像学依据。