The value of color Doppler ultrasonography in monitoring normal orthotopic liver transplantation and postoperative complications

OBJECTIVE: To assess the value of color Doppler ultrasonography in monitoring normal orthotopic liver transplantation and postoperative complications. METHODS: Forty-one patients after orthotopic liver transplantation were examined by using color Doppler flow imaging to observe the hepatic blood flow and change of ultrasonography of the hepatic parenchyma and bile duct. The measured indexes included maximum blood flow velocity, time-average blood flow velocity (TAV), resistance index (RI) and diameter of the bile duct. RESULTS: Among 41 patients, 17 (41.5%) suffered from liver transplant rejection. Of the 17 patients, 13 (76.4%) showed decrease of TAV of the portal vein, 15 (88.25%) low-amplitude single-phase serrated wave or negative biphasic wave of the hepatic vein, 9 (52.9%) increased hepatic arterial RI, and 5 (29.4%) slightly dilated bile duct. Sonography showed disappearance of the hepatic artery blood flow around the portal vein in 5 (12.2%) of the 41 patients with hepatic artery thrombosis in the postoperative period. Slight dilatation of the intrahepatic bile duct was found in 3 (7.3%) of the 41 patients in the early postoperational period and it normalized within 2 weeks. Ultrasonography of 20 patients (48.8%) revealed a visible dilatation of the intrahepatic bile duct, which was worsening gradually. The causes of bile duct dilatation included biliary stricture in 2 patients (10%), stone in 15 patients (75%) and others in 3 patients (15%). CONCLUSIONS: Color Doppler ultrasonography is valuable for monitoring normal liver transplantation and postoperative complications.

Different hemodynamic responses by color Doppler ultrasonography studies between sildenafil non-responders and responders

Aim： To determine if there are different penile hemodynamic patterns between sildenafil non-responders and responders by using color Doppler ultrasonography. Methods： A total of 69 erectile dysfunction （ED） patients aged 22-79 years were enrolled into the present study. Thirty-eight （55.1%） men with ED who did not respond to four attempts of treatment with 100 mg sildenafil after re-education were classified as sildenafil non-responders. A com- bination of three vasodilator drugs, 1.25 mg papaverine, 0.4 mg phentolamine and 5 ug prostaglandin E1, was given by intracavernous injection before penile Doppler ultrasonography was carried out. The erectile response to intracavernous injection and vascular parameters including peak systolic velocity （PSV）, resistance index （RI）, end diastolic velocity （EDV） and cavernosa artery diameter （CD） were measured and the results between sildenafil nonresponders and responders were compared. Results： No statistical difference in vascular parameters measured by Doppler ultrasonography studies between non-responders and responders was noted. Sildenafil non-responders had a poorer penile rigidity response to intracavernous injection than responders （P 〈 0.05）. Among patients with adequate PSV （〉 30 cm/s） and abnormal EDV （〉 5 cm/s）, individuals in the non-responder group had fewer positive responses to intracavernous vasodilator injection than in the responder group （35.3% vs. 72.2%, P 〈 0.05）. Advanced age and comorbidity with diabetes mellitus were significantly associated with sildenafil non-response （P 〈 0.05）. Conclusion： Sildenafil non-responders were characterized by a poorer penile rigidity response to intracavernous injection and had an associated impaired veno-occlusive mechanism. Advanced age and comorbidity with diabetes mellitus were two common factors associated with non-response.

Use of color Doppler ultrasonography in the diagnosis of anomalous connection in pancreatobiliary disease

AIM: To estimate the detectability of anomalous connection in pancreatobiliary disease (ACPBD) cases, measuring gallbladder wall blood flow (GWBF).METHODS: In the retrospective study, we enrolled 42subjects with gallbladder wall thickening. GWBF velocity was determined as an average value of the peak velocity of color signals on the gallbladder wall, three times in each case. Based on the findings on endoscopic ultrasonography (EUS) or endoscopic retrograde cholangiopancreatography (ERCP), the 42 subjects were divided into 11 cases with ACPBD and 31 cases without ACPBD. In the prospective study, the subjects were 92 cases with gallbladder wall thickening. Using the cut-off level of the flow velocity obtained in the retrospective study, the usefulness of measuring GWBF velocity in diagnosing ACPBD was evaluated.RESULTS: In the retrospective study, imaging of GWBF was obtained in 40 of the 42 subjects. The mean GWBF velocity of the ACPBD cases was 29.4±3.9 cm/s(mean±SD), which was significantly different (P＜0.0001;95% CI 5.48-13.2) from that of the without ACPBD cases(20.1±5.9 cm/s). Based on this result, we prepared a receiver operating characteristic curve, and the cut-off level appropriate for diagnosing ACPBD was estimated to be 25 cm/s. In the prospective study, GWBF was detected in 86 of the 92 subjects. Based on the EUS or ERCP findings, the 92 subjects were divided into 15 cases with ACPBD and 77 cases without ACPBD. When a cut-off level of 25 cm/s was employed, ACPBD could be diagnosed with a sensitivity of 87.0% (13/15) and a specificity of87.3% (62/71).CONCLUSION: Measurement of GWBF velocity, which is less invasive and provides objective values, is very useful for diagnosing ACPBD prior to the development of malignant tumors in cases with gallbladder wall thickening.

COLOR DOPPLER ULTRASONOGRAPHY APPEARANCES OF RENAL VEIN THROMBOSIS AND ITS DIAGNOSTIC VALUE

Objective To evaluate color Doppler ultrasonography (CDU) appearances of renal vein thrombosis (RVT) and its diagnostic value.Methods Ten patients with RVT were analyzed retrospectively. Renal structure, distributions of intrarenal flow signals, echogenicity, and flow fullness in main renal veins were observed with CDU. Resistance index (RI) was recorded from the waveforms of segmental or interlobar renal artery.Results Ten kidneys in nine patients were confirmed to have thrombus within the main renal veins, and one patient was confirmed to have thrombus within the small intrarenal veins. The appearances of the main renal vein thrombosis included full of solid echogenicity or strip echogenicity and complete or partial filling defect within the main renal veins, and absent or a few intrarenal venous flow signals in 70% of kidneys involved. The appearances of intrarenal vein thrombosis included obscure renal structure and no venous flow signal within the involved part of the kidneys. Reverse diastolic flow in the intrarenal artery had only a sensitivity of 36% (4/11); in other 7 kidneys without intrarenal arterial reverse diastolic flow, increased RI (mean, 0.84; range, 0.74-0.96) was found.Conclusion CDU is helpful for rapid clinical diagnosis and follow-up of RVT, and therefore can be the first imaging modality of choice for RVT.

A study of the hypoechoic hypertrophic lesions and hypoechoic cancer lesions in hypertrophic prostate inner glands with transrectal color doppler ultrasonography

Objective: To observe the sonographic and hemodynamic features of hypoechoic hypertrophic lesions and hypoechoic cancer lesions in the hypertrophic prostate inner glands, in order to raise the accuracy of early diagnosis rate for prostate cancer. Methods: 31 cases of hypoechoic hypertrophic lesions and 18 cases of hypoechoic cancer lesions in the hypertrophic prostate inner glands were observed by transrectal ultrasonography and comparatively analyze the shape, edge and the systolic peak velocity (Vs) , resistance index (RI) and pulsatility index (PI) of the lesions. Results: In contrast with hypertrophic group, the cancer group presented irregular shape and unclear edge, and obviously higher Vs, RI and PI. Conclusion: The sonographic appearance and Vs. RI. PI have important value in distinguishing hypoechoic hypertrophic lesions and hypoechoic cancer lesions in the hypertrophic prostate inner glands.

Value of identifying and diagnosing mammary carcinoma and non-lactation mastitis lump by color Doppler ultrasonography

Objective: To evaluate the value of identifying and diagnosing mammary carcinoma and non-lactation mastitis lump (NLM) by multicolor Doppler ultrasonography. Methods: We compared and analyzed the examination results of 69 cases of mammary carcinoma proved by surgical pathology and 22 cases of NLM before surgery by multicolor Doppler ultra-sonography. Results: The detection rates of mammary carcinoma and NLM focus by ultrasonic examining were 100%. The shape, envelope, foul line, blood stream between sound and image of two diseases were similar. Of the two diseases, the representation with slight calcification in lump, lower echo in low echo, bloodstream distribution and resistance were different. Conclusion: By analyzing the sound and image representation of mammary lump, we find color Doppler ultrasonography has significant value in identifying and diagnosing mammary carcinoma and non-lactation mastitis lump.

Graves' Disease Thyroid Color-Flow Doppler Ultrasonography Assessment: Review Article

Graves’ disease, as known today, is an autoimmune, diffuse, chronic disease of thyroid gland, as described by Robert Graves in 1835. It presents genetic predisposition and unknown etiology evidence, which is influenced in its development by several factors, including environment (dietary iodine intake, stress, drugs and infections). The disease is characterized by one or more changes: hyperthyroidism, goiter, ophthalmopathy, skin changes and pretibial myxedema, around 5% less common, and other symptoms 90% to 95%. One of the most relevant clinical practice aspects in Graves’ disease patients management is to distinguish Graves’ disease in initial phase, from other types of destructive thyrotoxicosis, in addition to evaluate therapeutic methods and efficient follow up, as well as predict early recurrence or remission of disease. Scintigraphy with pertechnetate (99 mTc) and TSH levels dosage are considered the choice for this purpose. However, they present some technical difficulties, as they are not widely available and have contraindications. In this scenario, thyroid color-flow doppler ultrasonography (US Doppler) presents a viable alternative, as a widely available, low cost, non-invasive and radiation free method, providing initial diagnosis and patients with Graves’ disease follow up. In adittion, this method is used in differential diagnosis with other causes of thyrotoxicosis in the early stage.

Color Doppler sonography and angioscintigraphy in hepatic Hodgkin's lymphoma

AIM： To estimate the characteristics of Color Doppler findings and the results of hepatic radionuclide angiography （HRA） in secondary Hodgkin＇s hepatic lymphoma. METHODS： The research included patients with a diagnosis of Hodgkin＇s lymphoma with metastatic focal lesions in the liver and controls. Morphologic characteristics of focal liver lesions and hemodynamic parameters were examined by pulsed and Color Doppler in the portal, hepatic and splenic veins were examined. Hepatic perfusion index （HPI） estimated by HRA was calculated. was observed. Lesions were mostly hypoechoic and mixed, solitary or multiple. Some of the patients presented with dilated splenic veins and hepatofugal blood flow. A pulse wave was registered in the centre and at the margins of lymphoma. The average velocity of the pulse wave was higher at the margins （P 〉 0.05）. A continuous venous wave was found only at the margins of lymphoma. There was no linear correlation between lymphoma size and velocity of pulse and continuous wave （r = 390, P 〈 0.01）. HPI was significantly lower in patients with lymphomas than in controls （P 〈 0.05）, pointing out increased arterial perfusion in comparison to portal perfusion. CONCLUSION： Color Doppler ultrasonography is a sensitive method for the detection of neovascularization in Hodgkin＇s hepatic lymphoma and estimation of its intensity. Hepatic radionuclide angiography can additionally help in the assesment of vascularisation of liver lesions.

Radiation induced renal arterial stenosis detected by color duplex ultrasonography: case report

Renal artery stenosis as a complication from radiation therapy is not common, but it is life threatening and needs to be corrected urgently in order to prevent renal failure even losing kidney. The diagnostic criteria of renal artery stenosis in the adults by color duplex ultrasonography have been established, which may play an important role in screening radiation induced renal artery stenosis.

18 MHz彩色多普勒超声检查对黄斑前膜的临床诊断价值

目的:探讨18 MHz彩色多普勒超声对黄斑前膜的诊断价值。方法:收集2020-01/2022-01期间在我院经眼底检查拟诊白内障和玻璃体混浊的患者44例80眼,分别通过光学相干断层扫描法(OCT)与18 MHz彩色多普勒超声对患眼进行检查,比较18 MHz彩色多普勒超声与OCT对黄斑前膜诊断敏感度、特异性、准确度的差异。结果:经18 MHz彩色多普勒超声检测80眼中,62眼为黄斑前膜,18眼为非黄斑前膜;经OCT确诊确实为黄斑前膜的54眼,非黄斑前膜的13眼,漏诊5眼,误诊8眼;18 MHz彩色多普勒超声与OCT诊断一致性较高(Kappa=0.892,P<0.05);18 MHz彩色多普勒超声检测黄斑前膜敏感性为92%,特异性为62%,漏诊率为8%,误诊率为38%,正确率为84%;与OCT检测相比,18 MHz彩色多普勒超声检测特异性、正确率、阳性预测准确率、阴性预测准确率降低,误诊率升高(均P<0.05),诊断敏感性与漏诊率比较无差异(均P>0.05)。结论:18 MHz彩色多普勒超声对黄斑前膜病变具有一定鉴定价值,与OCT检验具有一致性。

剪切波弹性成像定量参数与不同病程非特异性腰痛及功能障碍的相关性

目的:研究剪切波弹性成像(SWE)定量参数与不同病程非特异性腰痛及功能障碍的相关性。方法:本研究采取前瞻性研究,选取我院2021年5月—2023年5月期间收治的200例非特异性腰痛患者作为研究对象,另外选取同期进行健康体检的志愿者100例作为对照组,同时对两组研究对象行剪切波超声成像以及超微血管成像测量。分别对研究组以及对照组,急性组、亚急性组以及慢性组患者的多裂肌、竖脊肌的肌肉厚度、血流速度、血流阻力指数、弹性模量值、功能障碍情况进行比较。研究肌肉厚度、血流速度、血流阻力指数、弹性模量值与功能障碍、疼痛情况以及姿势控制情况的相关性。结果:研究组与对照组、不同病程患者的多裂肌肌肉厚度、血流速度、弹性模量值、血流阻力指数之间的差异存在统计学意义。研究组患者的视觉模拟评分、Oswestry残疾指数高于对照组,前屈腰部活动度、后伸腰部活动度、左腿前侧、左腿后内侧、右腿前侧、右腿后内侧低于对照组。结论:SWE定量参数与不同病程非特异性腰痛及功能障碍呈现显著的相关性,可作为诊断以及治疗效果评价的重要定量依据。

基于超声纹理特征与基于超声造影的预测模型鉴别最大径≤2 cm乳腺良恶性结节的对比研究

目的比较基于二维超声纹理特征(2D-Ultrasomics)的预测模型与基于超声造影(CEUS)的预测模型鉴别最大径≤2 cm乳腺良恶性结节的诊断价值。方法选取我院经病理确诊的乳腺结节患者109例(共112个结节),依据病理结果分为良性组58个和恶性组54个,均行二维超声及彩色多普勒(2D-CDUS)、CEUS检查,比较两组超声检查结果的差异;基于二维超声图像提取2D-Ultrasomics,使用最小绝对收缩和选择算子(LASSO)进行特征筛选。采用多因素Logistic回归分别构建2D-CDUS模型、2D-CDUS结合CEUS(2D-CD+CEUS)模型、2D-CDUS结合2D-Ultrasomics(2DCDUS+Ultrasomics)模型,绘制受试者工作特征(ROC)曲线评估各模型鉴别最大径≤2 cm乳腺良恶性结节的诊断效能;采用Hosmer-Lemeshow拟合优度检验评估模型的拟合度;绘制临床决策曲线评估模型的临床适用性。结果两组结节2D-CDUS图像特征(内部回声、边界、血流、短径)和CEUS图像特征(增强方式、增强时相、造影边界、增强均匀性、增强病灶范围)比较差异均有统计学意义(均P<0.05)。共提取818个2D-Ultrasomics,经过LASSO筛选后保留6个关键特征。根据多因素Logistic回归分析结果,纳入边界、短径构建2D-CDUS模型,纳入边界、短径、造影边界构建2D-CD+CEUS模型,纳入短径、灰度游程长度矩阵、灰度依赖矩阵、灰度大小区矩阵构建2D-CDUS+Ultrasomics模型。ROC曲线分析显示,2D-CDUS+Ultrasomics模型鉴别最大径≤2 cm乳腺良恶性结节的曲线下面积(AUC)为0.917,高于2D-CD+CEUS模型、2D-CDUS模型的AUC(0.892、0.823),且2D-CD+CEUS模型的AUC高于2D-CDUS模型的AUC,差异均有统计学意义(均P<0.001)。Hosmer-Lemeshow拟合优度检验显示,2D-CDUS模型、2D-CD+CEUS模型和2D-CDUS+Ultrasomics模型均具有良好的拟合度(P=0.818、0.103、0.281)。临床决策曲线分析显示,2D-CDUS+Ultrasomics模型在0.20~0.39、0.43~0.78及0.88~0.91概率阈值范围内具有较高的临床获益。结论基于2D-Ultrasomics的预测模型较基于CEUS的预测模型能更准确地鉴别最大径≤2 cm乳腺良恶性结节,有助于临床早期准确诊断乳腺小结节和制定治疗决策。

Portalsystemic hemodynamic changes in chronic severe hepatitis B: An ultrasonographic study

AIM： To evaluate portalsystemic hemodynamic changes in chronic severe hepatitis B. METHODS： Hemodynamic parameters included portal vein diameter （PVD）, portal vein peak velocity （PVPV）, portal vein volume （PW）, spleen length （SPL）, spleen vein diameter （SPVD）, spleen vein volume （SPW） and umbilical vein recanalization. They were measured by Color Doppler ultrasonography in 36 patients with chronic severe hepatitis B, compared with 51 normal controls, 61 patients with chronic hepatitis B, 46 patients with compensable cirrhosis, and 36 patients with decompensable cirrhosis. RESULTS： In the group of chronic severe hepatitis B, PVD （12.38 ± 1.23 mm） was significantly different from the normal control, compensable cirrhosis and decompensable cirrhosis groups （P = 0.000-0.026）, but not significantly different from the chronic hepatitis group. PVPV （16.15 ± 3.82 cm/s） dropped more significantly in the chronic severe hepatitis B group than the normal control, chronic hepatitis B and compensable cirrhosis groups （P = 0.000-0.011）. PW （667.53 ± 192.83 mL/min） dropped significantly as compared with the four comparison groups （P = 0.000-0.004）. SPL （120.42 ± 18.36 mm） and SPVD （7.52 ± 1.52 mm） were longer in the normal control and chronic hepatitis B groups （P = 0.000-0.009）, yet they were significantly shorter than those in the decompensable cirrhosis group （P = 0.000）. SPW （242.51 ± 137.70 mL/min） was also lower than the decompensable cirrhosis group （P = 0.000）. The umbilical vein recanalization rate （75%） was higher than the chronic hepatitis B and compensable cirrhosis groups. In the course of progression from chronic hepatitis to decompensable cirrhosis, PVD, SPL and SPVD gradually increased and showed significant differences between every two groups （P = 0.000-0.002）. CONCLUSION： Patients with chronic severe hepatitis B have a tendency to develop acute portal hypertension, resulting in significantly reduced portal vein perfusion, Observation of the portalsystemic hemodynamic changes may be contributed to the disease progression of chronic liver disease.

TVS三步法系统超声评估深部子宫内膜异位症的价值初探

目的:应用经阴道超声(TVS)三步法系统超声评估深部子宫内膜异位症(DIE)的诊断价值。方法:57例疑似DIE患者在我院接受手术。所有患者在手术前接受TVS三步法系统超声评估,术前详细询问病史、准确记录病灶的部位、大小及特征性超声表现,将结果与手术和(或)组织学进行对照。结果:根据病变发生部位、大小的不同,TVS三步法系统超声评估DIE的敏感度为55.3%~99.7%,特异度为84.7%~96.6%。结论:TVS三步法在检测DIE的位置、范围及深度方面具有价值,有助于在术前对DIE患者进行全面评估。

脂肪肉瘤的超声图像特征分析

目的 分析并总结脂肪肉瘤的超声图像特征。方法 回顾性分析我院经手术病理证实的31例脂肪肉瘤患者的超声资料,分析不同病理亚型的脂肪肉瘤超声图像特征。结果 31例患者中,去分化脂肪肉瘤13例,高分化脂肪肉瘤10例,多形性脂肪肉瘤4例,黏液样脂肪肉瘤4例;肿瘤最大径为(16.97±9.70)cm,以等或高回声(61.3%,19/31)为主,且回声分布多不均匀(90.3%,28/31),CDFI多表现为乏血供,Adler血流分级以0、Ⅰ级为主(96.8%,30/31)。其中,高分化脂肪肉瘤以高回声为主(70.0%,7/10);去分化脂肪肉瘤边界多不清晰(92.3%,12/13),以低回声(46.2%,6/13)和高回声(30.8%,4/13)的双相模式为主;多形性脂肪肉瘤边界多清晰(3/4);黏液样脂肪肉瘤CDFI均表现为极度乏血供(4/4)。结论 脂肪肉瘤的超声表现具有一定的特征性,对临床辅助诊断该病能够提供一定的帮助。

超声造影评估无症状性ICA重度狭窄患者CAS术后脑灌注改变的研究

目的:应用超声造影评估无症状性颈内动脉(ICA)重度狭窄患者行颈动脉支架置入术(CAS)后的脑灌注改变的价值。方法:选取2020年7月-2022年12月我院行CAS术的单侧ICA重度狭窄患者18例,男14例,女4例,平均年龄(62.6±7.3)岁。患者无临床症状或仅表现为轻度头痛、头晕。分别于CAS术前、术后12 h内行双侧经颅超声造影检查,选取基底节区作为感兴趣区(ROI)进行时间-强度曲线分析,测量参数为达峰时间(TTP),平均通过时间(MTT),上升斜率(WIS),峰值强度(PI),曲线下面积(AUC),计算患侧与健侧参数的相对值rTTP,rMTT,rWIS,rPI,rAUC,及CAS术后改变量ΔrTTP,ΔrMTT,Δr WIS,Δr PI,ΔrAUC。比较CAS术前、术后参数绝对值与相对值,并对CAS术前相对值与术后改变量的相关性进行分析。结果:CAS术前,患侧TTP(22.17±3.34) s,MTT (33.73±5.88) s均较健侧延长,WIS (1.75±0.68) dB/s低于健侧(P<0.05),而PI,AUC双侧比较无统计学差异;CAS术后,患侧参数绝对值仅WIS (2.14±0.69) dB/s较术前增高(P<0.05);相对值rTTP (1.02±0.08),r MTT(0.96±0.10)低于术前,rWIS (1.02±0.17)较术前增高(P<0.05);CAS术前相对值rTTP,rMTT,rWIS分别与术后改变量ΔrTTP,Δr MTT,ΔrWIS存在负相关关系(r值分别为-0.592,-0.754及-0.730)。结论:超声造影可评估无症状性ICA重度狭窄患者CAS术后脑灌注的改变,术后双侧灌注差异性降低,且患侧术前脑灌注受损程度越重,术后改善越明显。

超声对女性生殖系统恶性苗勒管混合瘤的诊断价值

目的:探讨女性生殖系统恶性苗勒管混合瘤(MMMT)的超声特征,以期提高对该疾病的诊断水平。方法:回顾性分析2018年1月—2023年7月经我院病理证实的生殖系统MMMT 37例,分析其临床特征并总结其超声征象。37例患者平均年龄56岁,其中32例发生于子宫,4例发生于宫颈,1例发生于卵巢;35例主诉为阴道出血或流液,2例为盆腔包块。结果:术前32例进行了血清CA125检查,8例高于正常,余24例正常。CA125水平与肿块大小及临床分期无相关性。女性生殖系统MMMT彩色多普勒超声具有特征性表现:单发,回声疏松;体积大,平均长径52 mm,其中16例长径大于80 mm。由内部向浆膜层生长,无明显包膜,但可见与正常组织有分界。疏松的不均质中低回声相间分布,呈“小梁样”。肿块较大时内部可见“裂隙样”无回声区,中央区可见中低回声与高回声杂乱分布,呈“蜂窝状”改变;周边血流信号均丰富,肿块较大者中央区血流信号不丰富。结论:女性生殖系统MMMT多发生于子宫,症状多为绝经后阴道流血、流液;彩色多普勒超声具有较为特征性的表现,加强对其特征的认识有助于尽早诊断。

彩色多普勒超声在眼弓蛔虫病和少儿特发性后葡萄膜炎鉴别诊断中的应用

目的探讨彩色多普勒超声在眼弓蛔虫病和少儿特发性后葡萄膜炎鉴别诊断中的应用。方法回顾性临床研究。2015年1月至2017年12月就诊于首都医科大学附属北京同仁医院,18例(18只眼)临床确诊为眼弓蛔虫病和21例(29只眼)临床诊断为特发性葡萄膜炎(除外单纯前葡萄膜炎)患儿的眼部超声影像表现及病史资料。利用卡方检验,分析眼弓蛔虫病和少儿特发性后葡萄膜炎的特征性超声表现。结果眼弓蛔虫病超声中均可探及玻璃体内弱点状回声炎性混浊及玻璃体内条带状增生条索,8只眼(44.4%)可探及后极部球壁增生团块,10只眼(55.6%)可探及周边部球壁增生团块,17只眼(94.4%)可探及牵拉性视网膜脱离。少儿特发性后葡萄膜炎超声中均可探及玻璃体内弱点状炎性混浊,4只眼(13.8%)可探及玻璃体内条带状增生条索,12只眼(41.4%)可探及与视盘回声相延续的后极部球壁回声增厚伴低回声间隙。卡方检验结果,超声表现中玻璃体增生条索、球壁增生团块及牵拉性视网膜脱离支持OT的诊断(χ^(2)值分别为33.150、15.533、19.262和33.197,均P<0.01),玻璃体内弱点状回声及后极部球壁增厚伴低回声间隙支持少儿特发性后葡萄膜炎的诊断(χ^(2)值分别为32.785和10.002,均P<0.01)。结论彩色多普勒超声在眼弓蛔虫病和少儿特发性后葡萄膜炎鉴别诊断中有一定应用价值。

高频多普勒超声诊断肘管综合征和腕管综合征的临床价值

目的 :探讨高频多普勒超声(High-frequency Doppler ultrasound,HFU)在肘管综合征(Cubital tunnel syndrome,CuTS)和腕管综合征(Carpal tunnel syndrome,CTS)诊断和病因检测中的临床价值。方法 :选择2021年1-12月在我院就诊的CTS(n=46例)、CuTS(n=41例)患者作为研究对象,所有患者均行HFU检查,观察健侧和患侧HFU检查结果 、HFU诊断CuTS和CTS的临床价值、HFU预测CuTS和CTS病因与手术结果的一致性。结果:41例CuTS患者患侧尺神经卡处直径和横截面面积(CSA)均低于健侧相应位置,差异有统计学意义(P<0.05);患侧尺神经肿胀处直径、CSA、面积肿胀率、厚度肿胀率均高于健侧相应位置,差异有统计学意义(P<0.05)。CTS患者患侧正中神经腕管入口处前后径、左右径和CSA均高于健侧相应位置,差异有统计学意义(P<0.05)。尺神经肿胀处CSA预测CuTS的曲线下面积(AUC)最高。正中神经腕管入口处CSA预测CTS的AUC高于前后径和左右径。HFU检测CuTS病因中滑膜瘤、骨赘结缔组织增生、肿大淋巴结、关节腔滑膜炎结果与手术结果完全一致(P=0.000),肘管中囊肿、关节腔积液与手术结果高度相关(P<0.001)。HFU检测CTS病因与手术结果完全一致(P=0.000)。结论:HFU在CuTS和CTS诊断和病因检测中均具有重要价值,值得临床推广应用。

胎儿胸腔内异常强回声的声像图特征在产前诊断隔离肺与先天性肺囊性腺瘤样病变中的价值

目的 探讨胎儿胸腔内异常强回声的声像图特征在产前诊断隔离肺与先天性肺囊性腺瘤样病变(CCAM)中的价值,为鉴别诊断和评估预后提供依据。方法 对2017年1月至2019年11月安徽医科大学第一附属医院产前超声检查中发现的31例胎儿胸腔内异常强回声的声像图特征及随访结果进行回顾性分析。结果 31例胎儿胸腔内异常强回声中,其中18例Ⅲ型CCAM产前超声显示胸腔内高回声边界清晰,内部回声尚均匀,未见明显的囊泡样回声且显示为肺动脉供血;12例隔离肺产前超声显示胸腔内高回声界限清晰,呈叶状或三角形,大小不一,内部回声尚均匀,未见明显的囊泡样回声,多位于左侧胸腔中下部为主动脉供血;1例隔离肺合并CCAM表现为胸腔内见稍强回声囊实性包块,形态规则,边界清晰,稍强回声内可见多个小囊性回声,透声良好,伴纵隔移位,可追踪源自胸主动脉的滋养血管。8例CCAM及6例隔离肺晚孕随访肿块缩小甚至消失,3例终止妊娠。剩余28例胎儿产后均无明显呼吸窘迫,生存率达100%。结论 产前超声依据胸腔内异常高回声的边界、形态、内部回声有无囊泡样结构以及异常高回声血供来源在鉴别诊断胎儿隔离肺与CCAM有重要意义、并可用于持续观察随访,对临床处理及判断预后有重要的指导意义。