Quantitative flow ratio and intravascular ultrasound guided percutaneous coronary intervention of left anterior descending lesion concomitant with severe coronary myocardial bridge

Severe coronary stenosis concomitant with congenital coronary myocardial bridge(MB)is a tough scenario for cardiologist to perform revascularization,for which the complication rates including in-stent restenosis,stent fracture,stent thrombosis and even coronary perforation are still high.[1,2]Meanwhile,the necessity of revascularization in such patients is worth prudent evaluation.Cardiac imaging modalities are crucial and helpful in making revascularized decisions and strategies.Herein,we report a case using quantitative flow ratio(QFR)and intravascular ultrasound(IVUS)to facilitate accurate revascularization in a patient with both severe coronary stenosis and deep coronary MB.

Contrast enhanced ultrasound with quantitative perfusion analysis for objective characterization of pancreatic ductal adenocarcinoma: A feasibility study

The aim of this study was to determine whether contrast enhanced ultrasound(CEUS) quantitative perfusion analysis allows an objective characterization of ductal adenocarcinoma(ADK) of the pancreas. Patients with pancreatic ADK underwent CEUS. All examinations were performed on an Acuson S2000 system(Siemens, Erlangen, Germany) after the iv administration of 2.4 mL contrast agent(SonoVue, Bracco, Milan, Italy). All lesions were pathologically proved. An operator manu-ally drew different regions of interest within the tumor and the adjacent parenchyma to allow the quantita-tive perfusion analysis. The mean values of peak of enhancement, time to peak and ascending curve were calculated and compared using the Student's t test. The quantitative perfusion analysis was possible in all lesions. The mean values of the peak of enhancement, time to peak and ascending curve were 17.19%, 7.97 s and 159.52% s within the tumor and 33.57%, 8.89 s and 355.29% s within the adjacent parenchyma. The peak of enhancement and the ascending curve values were significantly different within the tumor and the ad-jacent parenchyma. Thus, CEUS allows the quantitative perfusion analysis of pancreatic ductal adenocarcinoma.

Photoacoustic/ultrasound dual-modal imaging of human nails: A pilot study

Traditional diagnostic techniques including visual examination,ultrasound(US),and magnetic resonance imaging(MRI)have limitations of in-depth information for the detection of nail disorders,resolution,and practicality.This pilot study,for thefirst time,evaluates a dualmodality imaging system that combines photoacoustic tomography(PAT)with the US for the multiparametric quantitative assessment of human nail.The study involved a small cohort offive healthy volunteers who underwent PAT/US imaging for acquiring the nail unit data.The PAT/US dual-modality imaging successfully revealed thefine anatomical structures and microvascular distribution within the nail and nail bed.Moreover,this system utilized multispectral PAT to analyze functional tissue parameters,including oxygenated hemoglobin,deoxyhemoglobin,oxygen saturation,and collagen under tourniquet and cold stimulus tests to evaluate changes in the microcirculation of the nail bed.The quantitative analysis of multispectral PAT reconstructed images demonstrated heightened sensitivity in detecting alterations in blood oxygenation levels and collagen content within the nail bed,under simulated different physiological conditions.This pilot study highlights the potential of PAT/US dual-modality imaging as a real-time,noninvasive diagnostic modality for evaluating human nail health and for early detection of nail bed pathologies.

Dynamic contrast enhanced ultrasound in differential diagnosis of hepatocellular carcinoma: A systematic review and meta-analysis

BACKGROUND Non-invasive differential diagnosis between hepatocellular carcinoma(HCC)and other liver cancer(i.e.cholangiocarcinoma or metastasis)is highly challenging and definitive diagnosis still relies on histological exam.The patterns of enhancement and wash-out of liver nodules can be used to stratify the risk of malignancy only in cirrhotic patients and HCC frequently shows atypical features.Dynamic contrast-enhanced ultrasound(DCEUS)with standardized software could help to overcome these obstacles,providing functional and quantitative parameters and potentially improving accuracy in the evaluation of tumor perfusion.AIM To explore clinical evidence regarding the application of DCEUS in the differential diagnosis of liver nodules.METHODS A comprehensive literature search of clinical studies was performed to identify the parameters of DCEUS that could relate to histological diagnosis.In accordance with the study protocol,a qualitative and quantitative analysis of the evidence was planned.RESULTS Rise time was significantly higher in HCC patients with a standardized mean difference(SMD)of 0.83(95%CI:0.48-1.18).Similarly,other statistically significant parameters were mean transit time local with a SMD of 0.73(95%CI:0.20-1.27),peak enhancement with a SMD of 0.37(95%CI:0.03-0.70),area wash-in area under the curve with a SMD of 0.47(95%CI:0.13-0.81),wash-out area under the curve with a SMD of 0.55(95%CI:0.21-0.89)and wash-in and wash-out area under the curve with SMD of 0.51(95%CI:0.17-0.85).SMD resulted not significant in fall time and wash-in rate,but the latter presented a trend towards greater values in HCC compared to intrahepatic cholangiocarcinoma.CONCLUSION DCEUS could improve non-invasive diagnosis of HCC,leading to less liver biopsy and early treatment.This quantitative analysis needs to be applied on larger cohorts to confirm these preliminary results.

QUS与DXA在绝经期女性骨质疏松伴有胸肋关节痛患者中的诊断价值

目的探讨定量超声(quantitative ultrasound,QUS)与双能X线吸收仪(dual energy X-ray absorptiometer,DXA)对绝经期女性骨质疏松伴有胸肋关节痛患者骨密度检测的诊断价值。方法将行健康体检的260例绝经期女性且伴有胸肋关节痛患者作为研究对象,均行DXA监测(B组)、QUS检测(A组),以DXA诊断结果作为金标准,比较2组检测准确率、敏感度及特异度的差异,分析QUS检测在绝经期女性骨质疏松伴有胸肋关节痛患者中的诊断价值。结果B组检出骨质疏松症52例,不同年龄组患者之间骨密度差异有统计学意义(P<0.05);A组检出骨质疏松症48例,不同年龄组患者之间骨密度差异有统计学意义(P<0.05)。以B组诊断结果作为金标准,A组诊断骨质疏松症的敏感度为92.31%,特异度为99.42%,阳性预测值为97.22%,阴性预测值为96.10%。结论QUS用于诊断绝经期骨质疏松伴有胸肋关节痛患者具有较好的敏感度和特异度,阳性预测值较高,且无辐射,故有较好的临床应用前景。

Ultrasound-based techniques for the diagnosis of liver steatosis

Non-alcoholic fatty liver disease(NAFLD)is the leading cause of diffuse liver disease.An accurate estimate of the fat in the liver is important in the diagnostic work-up of patients with NAFLD because the degree of liver steatosis is linked to the metabolic syndrome and the cardiovascular risk.Ultrasound(US)B-mode imaging allows to subjectively estimate the fatty infiltration in the liver;however,it has a low performance for the detection of mild steatosis.Quantitative US is based on the analysis of the radiofrequency echoes detected by an US system,and it allows to calculate a backscatter coefficient or an attenuation coefficient or the sound speed.The estimation of the backscatter coefficient is rather cumbersome and requires the use of a phantom for addressing all sources of variability.Controlled attenuation parameter(CAP)available on the FibroScan system(Echosens,France)measures the attenuation of the US beam.CAP is accurate in grading fatty infiltration-even though there is an overlap between consecutive grade of liver steatosis-and the values are not influenced by liver fibrosis.Several US manufacturers are developing or have already developed software for quantifying the attenuation of the US beam.Preliminary results show that proprietary technologies implemented in US systems seem more accurate than CAP for grading liver steatosis.Another available method for quantifying liver steatosis is based on the computation of the sound speed and the initial results appear promising.

Screening and early diagnosis of osteoporosis through X-ray and ultrasound based techniques

Effective prevention and management of osteoporosis would require suitable methods for population screenings and early diagnosis. Current clinicallyavailable diagnostic methods are mainly based on the use of either X-rays or ultrasound(US). All X-ray based methods provide a measure of bone mineral density(BMD), but it has been demonstrated that other structural aspects of the bone are important in determining fracture risk, such as mechanical features and elastic properties, which cannot be assessed using densitometric techniques. Among the most commonly used techniques, dual X-ray absorptiometry(DXA) is considered the current 'gold standard' for osteoporosis diagnosis and fracture risk prediction. Unfortunately, as other X-ray based techniques, DXA has specific limitations(e.g., use of ionizing radiation, large size of the equipment, high costs, limited availability) that hinder its application for population screenings and primary care diagnosis. This has resulted in an increasing interest in developing reliable pre-screening tools for osteoporosis such as quantitative ultrasound(QUS) scanners, which do not involve ionizing radiation exposure and represent a cheaper solution exploiting portable and widely available devices. Furthermore, the usefulness of QUS techniques in fracture risk prediction has been proven and, with the last developments, they are also becoming a more and more reliable approach for assessing bone quality. However, the US assessment of osteoporosis is currently used only as a pre-screening tool, requiring a subsequent diagnosis confirmation by means of a DXA evaluation. Here we illustrate the state of art in the early diagnosis of this 'silent disease' and show up recent advances for its prevention and improved management through early diagnosis.

Contrast-enhanced ultrasound imaging for intestinal lymphoma

BACKGROUND Intestinal lymphoma is a rare tumor.Contrast-enhanced ultrasound(CEUS)findings of intestinal lymphoma have not been reported previously,and the relationship between CEUS and clinicopathological features and prognostic factors is still unknown.AIM To describe the B-mode US and CEUS features of intestinal lymphoma and investigate the correlation of CEUS and histopathological features.METHODS This was a single-center retrospective study.Eighteen patients with histologically confirmed intestinal lymphoma underwent B-mode US and CEUS examinations between October 2016 and November 2019.We summarized the features of Bmode US and CUES imaging of intestinal lymphoma and compared the frequency of tumor necrosis in intestinal lymphomas with reference to different pathological subtypes(aggressive or indolent)and clinical stage(early or advanced).The time–intensity curve parameters of CEUS were also compared between patients with normal and elevated serum lactate dehydrogenase.RESULTS In B-mode imaging,four patterns were observed in intestinal lymphoma:Mass type(12/18,66.7%),infiltration type(1/18,5.6%),mesentery type(4/18,22.2%)and mixed type(1/18,5.6%).All cases were hypoechoic and no cystic areas were detected.On CEUS,most cases(17/18,94.4%)showed arterial hyperechoic enhancement.All cases showed arterial enhancement followed by venous wash out.A relatively high rate of tumor necrosis(11/18,61.1%)was observed in this study.Tumor necrosis on CEUS was more frequent in aggressive subtypes(10/13,76.9%)than in indolent subtypes(1/5,20.0%)(P=0.047).There were no correlations between tumor necrosis and lesion size and Ann Arbor stage.There was no significant difference in time–intensity curve parameters between normal and elevated lactate dehydrogenase groups.CONCLUSION B-mode US and CEUS findings of intestinal lymphoma are characteristic.We observed a high rate of tumor necrosis,which appeared more frequently in aggressive pathological subtypes of intestinal lymphoma.

Applications of endoscopic ultrasound elastography in pancreatic diseases: From literature to real life

Elastography is a non-invasive method widely used to measure the stiffness of the tissues,and it is available in most endoscopic ultrasound machines,using either qualitative or quantitative techniques.Endoscopic ultrasound elastography is a tool that should be applied to obtain a complementary evaluation of pancreatic diseases,together with other imaging tests and clinical data.Elastography can be informative,especially when studying pancreatic masses and help the clinician in the differential diagnosis between benign or malignant lesions.However,further studies are necessary to standardize the method,increase the reproducibility and establish definitive cut-offs to distinguish between benign and malignant pancreatic masses.Moreover,even if promising,elastography still provides little information in the evaluation of benign conditions.

Dynamic contrast enhanced ultrasound in gastrointestinal diseases:A current trend or an indispensable tool?

Contrast enhanced ultrasound(CEUS)has been widely implemented in clinical practice because of the enormous quantity of information it provides,along with its low cost,reproducibility,minimal invasiveness,and safety of the secondgeneration ultrasound contrast agents.To overcome the limitation of CEUS given by the subjective evaluation of the contrast enhancement behaviour,quantitative analysis of contrast kinetics with generation of time-intensity curves has been introduced in recent years.The quantification of perfusion parameters[named as dynamic-CEUS(D-CEUS)]has several applications in gastrointestinal neoplastic and inflammatory disorders.However,the limited availability of large studies and the heterogeneity of the technologies employed have precluded the standardisation of D-CEUS,which potentially represents a valuable tool for clinical practice in management of gastrointestinal diseases.In this article,we reviewed the evidence exploring the application of D-CEUS in gastrointestinal diseases,with a special focus on liver,pancreas,and inflammatory bowel diseases.

Screening with ultrasound of the heel may contribute to the prevention in osteoporosis

Objective:To calibrate a Quantitative Ultrasonography(QUS)system against densitometryby defining the sensitivity and specificity of the method,and to propose a series of QUS interpre-tation thresholds to classify the individual risk with regards to the risk of developing osteoporosisin later life.Methods:Subjects were recruited in New York City over a 1-year period.Women with amen-orrhea for at least 12 months were defined as postmenopausal,and all other women as premeno-pausal.Bone mineral density(BMD)was measured with a dual energy X-ray absorptiometer(DXA)and QUS performed with the calcaneus of broadband ultrasound attenuation(BUA)andspeed of sound(SOS)using the Lunar Achilles system.Statistical analysis was performed usingSPSS software Version 10.0.Results:Two hundred twenty-eight premenopausal and menopausal women were recruited.Most of the participants were Hispanic,Caucasian and African-American in this study.All thesubjects had DXA and QUS examined and T-score was got from both.The statistical resultsshowed that the T-score of QUS has a significant relationship with that of DXA(spine:r=0.557,P<0.0001;femur:r=0.611,P<0.0001).Both QUS and DXA T-score has a significant andnegative relationship with age(QUS:r=-0.241,P<0.0001;Spine:r=-0.277,P<0.0001;femur:-0.296,P<0.0001).When T-score of heel ultrasound -1.5 was set as the interpreta-tion threshold,the osteoporosis patients with T-score of DXA-femur scan(100%)and DXA-spine(77.10%)less than -2.5 were detected.As well,the specificities of T-score -1.5 ofQUS for DXA-femur and DXA-spine were 67.5% and 72.8%,respectively.In addition,if we set-1.0 of T-score of QUS as the cutoff,74.80% and 79.60% of the osteopenia based on DXA ofspine and femur were identified.The specificities were 59.4% and 57.7%.Conclusions:QUS of the calcaneus may be an effective method for providing risk stratifica-tion for osteoporosis,and for the closely associated future risk for fragility-fracture.

Analysis of the characteristics of diabetic peripheral nerve damage by high frequency ultrasound combined with QTT

Objective: High frequency ultrasound combined with policy thermal perception testing (QTT) was used to analyze the characteristics of nerve damage in diabetic peripheral neuropathy (DPN), and then provided the basis for the clinical prevention, diagnosis and treatment of DPN. Methods: A total of 110 DPN patients admitted to the hospital from December 2015 to May 2018 were selected, and the characteristics of nerve damage in diabetic peripheral neuropathy were analyzed by ultrasound and QTT. Results: In the results of QTT, the abnormal proportion of the CDT, WDT, CPT and HPT of the lower limbs in DPN's were all higher than the upper limbs;The difference of WDT and HPT in the age and course groups of patients in the upper limbs was statistically significant, the abnormal proportion of WDT and HPT in patients aged 60 years or above or with a course of 10 years or more were all above 45%, higher than those in other groups. The patients with larger mean amplitude of glycemic excursions (MAGE) were significantly higher than those with smaller MAGE, regardless of the abnormal proportion of WDT and HPT observed in upper limbs, lower limbs or upper and lower limbs;The results of ultrasonic measurement of nerve cross sectional area showed: the proportion of patients with ulnar nerve and median nerve abnormally thickened in the high age group (≥45 years) and the long course group (>10 years) was significantly higher than that in the low age group (<45 years) and the short course group (<10 years), the proportion of patients with larger MAGE with abnormal enlargement of median nerve was significantly higher than those with smaller MAGE. The thickening of ulnar nerve, median nerve and peroneal nerve was obvious in the patients of MAGE > 4 mmol/L. Conclusion: (1) The main nerve damage in DPN patients was thermal sensation damage, and the lower limb nerve was more vulnerable than the upper limb nerve. (2) The incidence of ulnar and median nerve damage was higher in patients aged 45 years and older or over 10 years of course. (3) Patients with large MAGE (> 4 mmo/L) had higher incidence of median nerve damage. The above characteristics of nerve damage can provide basis for clinical prevention, diagnosis and treatment of DPN.

心肌超声造影定量分析辅助诊断左心房非活动性黏液瘤一例

1病例资料患者女性,51岁,因“发现血压升高6年余,反复头晕1年余”于2022年1月25日入院。患者6年前诊断为“高血压1级,低危组”,规律服用硝苯地平缓释片,20 mg/d,血压控制平稳。近1年来反复出现头晕,无头疼、恶心呕吐,无视物旋转,无肢体麻木等。既往无特殊。查体:血压135/80 mmHg,体温36.5℃,神志清楚,步行入院,双肺未闻及干湿啰音;心界不大,心率76次/min,心律齐,未闻及病理性杂音;腹软,无压痛,肝脾肋下未触及;双下肢无水肿,生理反射正常,病理反射未引出。头部CT检查未见异常。

血管内超声测定定量血流分数对临界病变冠状动脉介入手术策略的价值

目的结合血管内超声结果分析定量血流分数在评估冠状动脉中重度狭窄及介入手术策略的指导价值。方法回顾性收集2022年2—10月在北京安贞医院住院行冠状动脉造影(CA)和/或经皮冠状动脉介入治疗(PCI)并接受靶血管血管内超声检查(IVUS)的患者110例,基于IVUS结果定量测定靶血管最小管腔面积(MLA)和斑块负荷(PB)等参数。利用患者的冠状动脉造影图像数据,对接受治疗的靶病变血管计算定量血流分数(QFR)。以IVUS结果为依据,评价QFR对血管病变程度的诊断及对行介入手术策略的价值。结果筛选临界病变并行IVUS检查110例,其中IVUS图像伪影严重13例,血管严重迂曲18例,造影显示全程病变或图像质量不佳24例,最终共计入组患者55例、靶血管55支。以IVUS管腔面积≤3 mm^(2)或IVUS管腔面积≤4 mm^(2)并且IVUS斑块负荷≥70%,作为血管显著狭窄引起心肌缺血的诊断标准。患者QFR值为0.75±0.12,MLA为(3.32±0.74)mm^(2),PB为(70±9)%。QFR值≤0.800时与IVUS评价冠状动脉狭窄缺血的一致性良好(Kappa=0.656,P<0.01,95%CI 0.452~0.860)。QFR的敏感度为0.853,特异度为0.810,阳性预测值为87.9%,阴性预测值为77.3%;MLA和QFR值之间存在中度正相关关系(r=0.566,P<0.01)。PB和QFR值之间存在轻度负相关关系(r=-0.371,P<0.01)。结论QFR对冠脉临界病变狭窄治疗决策的指导具有良好的诊断意义。

实时剪切波弹性成像联合超声造影参数在鉴别甲状腺实性结节良恶性的诊断价值研究

目的 评估实时剪切波弹性成像(SWE)杨氏模量联合超声造影(CEUS)参数在鉴别甲状腺结节良恶性中的诊断价值。方法 以2020年6月至2022年11月在宝鸡市人民医院经细针穿刺活检或手术病理证实的甲状腺结节病人为研究对象,按照研究目标设定的纳入/排除标准,最终纳入106例共106个结节,行常规超声及SWE检查,记录结节超声特征及弹性参数,后行CEUS检查,并对结节动态造影图像进行定量参数分析,获取造影时间-强度曲线(TIC)图及相关CEUS参数。比较SWE参数Еmax、Еmin、Еmean与CEUS参数PI、TTP、MTT、超声造影TIC曲线下面积(AUC)及联合参数在鉴别甲状腺结节良恶性中的诊断价值。结果 106例甲状腺结节中,甲状腺良性结节(TBN)组60例和恶性结节(TMN)组46例;两组结节一般资料比较中,病人年龄平均值TBN组(42.37±5.54)岁与TMN组(39.56±4.69)岁相比差异有统计学意义(P<0.05),结节血流分布差异有统计学意义(P<0.05);两组结节SWE杨氏模量Emax、Emin、Emean平均值中,TBN组平均值分别为(39.29±12.59)Kp、(14.19±4.60)Kp、(23.01±7.93)Kp,TMN组平均值分别为(104.35±35.62)Kp、(35.09±17.53)Kp、(62.13±22.94)Kp,两组相比差异有统计学意义(P<0.05);两组结节CEUS定性及定量各参数PI、TTP、AUC平均值中,TBN组各参数平均值分别为(45.88±4.22)dB、(22.02±1.97)s、(4177.58±426.29)dB·s,TMN组各参数平均值分别为(35.64±4.16)dB、(24.98±3.91)s、(3280.94±315.76)dB·s,TMN组PI、AUC均低于TBN组,而TMN组TTP长于TBN组,两组相比差异有统计学意义(P<0.05);SWE及CEUS参数联合诊断受试者操作特征(ROC)曲线下面积(AUC)、准确性及对应的灵敏度、特异度均高于各参数单独诊断,且均差异有统计学意义(P<0.05)。SWE各参数单独及联合诊断ROC曲线成对比较,Еmax比Еmin、Еmean比Еmin成对比较差异有统计学意义(Z=2.60、3.00,P<0.05)。CEUS各参数单独及联合诊断ROC曲线成对比较,TTP与联合诊断成对比较差异有统计学意义(Z=2.35,P<0.05)。Emean截断值为32.21 KPa时,SWE-Emean联合CEUS特征鉴别甲状腺结节良恶性的诊断效能均优于SWE-Emean或CEUS单独诊断。结论SWE杨氏模量联合CEUS参数可提高甲状腺结节诊断准确性。

基于心脏超声构建心房颤动射频消融术后复发的预测模型

目的基于心脏超声构建心房颤动射频消融术后复发的预测模型,评价其临床效果。方法选取2021年7月至2023年7月郑州大学第一附属医院收治的306例接受心房颤动射频消融术患者为研究对象,根据术后6个月内复发情况分为复发组、未复发组。比较两组临床资料及心脏超声定量参数,分析术后复发的影响因素,构建术后复发的预测模型,并进行评价与验证。结果306例患者术后6个月内复发89例,复发率为29.08%;复发组高血压、阻塞性睡眠呼吸暂停低通气综合征(OSAHS)、慢性心力衰竭患者占比高于未复发组,病程长于未复发组,左房前后径、右房横径、肺动脉收缩压、经二尖瓣左室舒张早期血流速度/组织多普勒成像舒张早期二尖瓣环运动速度(E/e’)高于未复发组(P<0.05)。高血压、OSAHS、慢性心力衰竭、病程、左房前后径、E/e’均是术后复发的相关影响因素(P<0.05);构建预测模型,该模型的C-index为0.899,评价与验证结果显示该模型具有较高预测价值及明显临床正向净收益。结论左房前后径、慢性心力衰竭、病程、E/e’、高血压、OSAHS是心房颤动射频消融术后复发的独立影响因素,基于上述因素构建随机森林预测模型具有较好预测效能及临床正向净收益,可为临床早期预测术后复发情况提供参考,并对后续临床决策具有一定指导意义。

量化教学在超声医学住院医师心脏超声规范化培训中的实践

量化教学是住院医师在教师指导下完成规定数量的实践操作,掌握必要的理论知识,从而达到住院医师规范化培训要求的标准。深圳市第二人民医院超声科教研室开展量化教学3年以来,教学成果突出,加强住院医师的临床实践操作,能够较快地让住院医师掌握心脏超声的操作技巧,提高诊断水平,增强了住院医师学习心脏超声的兴趣和信心。量化教学为心脏超声教学改革打下了基础。

一测多评法测定法制半夏曲中11种成分含量及其GRA、EW-TOPSIS质量评价

目的采用一测多评(QAMS)法同时测定法制半夏曲中肌苷、鸟苷、腺苷等11种成分含量,并建立其灰色关联度分析(GRA)联合熵权逼近理想解排序分析法(EW-TOPSIS)综合质量评价方法。方法采用Shimadzu C 18色谱柱;乙腈-0.5%醋酸为流动相,梯度洗脱,流速1.0 mL·min-1;检测波长254和290 nm。以对甲氧基肉桂酸乙酯为内参比物质,计算其他10个成分的相对校正因子(RCF),测定各成分含量。采用GRA联合EW-TOPSIS模型对法制半夏曲进行综合质量评价。结果法制半夏曲中11种成分在一定浓度范围内线性关系良好,相关系数均>0.999;平均加样回收率96.94%~100.12%(RSD<2.0%,n=9);QAMS与外标法(ESM)实测值无明显差异。GRA模型相对关联度0.2903~0.6187,EW-TOPSIS模型相对接近度0.2114~0.6343;GRA和EW-TOPSIS模型综合评价结果基本一致。结论QAMS法便捷、准确,可用于法制半夏曲多指标成分定量控制,GRA联合EW-TOPSIS模型可用于法制半夏曲综合质量评价。

三维超声血管斑块定量分析在颈动脉斑块性质诊断与评估中的临床价值研究

探讨三维超声血管斑块定量分析技术在颈动脉斑块性质诊断与评估中的临床价值。选取2022年1月—2023年1月于成都中医药大学附属医院就诊的85例颈动脉斑块患者作为研究对象。所有患者均接受三维超声血管斑块定量分析技术检查以及颈动脉CTA检查,以CTA检查结果作为金标准,明确颈动脉狭窄程度、声像图特征以及斑块性质情况。结果显示,不同狭窄程度患者NWI比较,差异有统计学意义(P<0.05)。不同斑块性质NWI以及GSM比较,差异有统计学意义(P<0.05),但斑块厚度、斑块体积、最大面积狭窄率比较无统计学差异(P>0.05)。研究发现,三维超声血管斑块定量分析技术在评估颈动脉狭窄程度以及斑块性质方面具有较高的准确性,能够对相关指标进行量化分析,该检查方案无创、方便、快捷,具有临床应用及推广价值。

超声弹性成像联合超声造影定量分析在缺血性脑梗死中的应用价值

目的:探讨超声弹性成像联合超声造影定量分析在缺血性脑梗死中的应用价值。方法:选取确诊的120例缺血性脑梗死患者,根据有无症状分为有症状组48例和无症状组72例。比较2组超声弹性成像参数、超声造影定量分析参数,采用ROC曲线分析超声弹性成像联合超声造影定量分析参数对缺血性脑梗死的诊断效能。结果:有症状组的杨氏模量最大值(E_(max))、最小值(E_(min))、平均值(E_(mean))均高于无症状组(均P<0.05)。有症状组的峰值强度(PI)高于无症状组(P<0.05),2组到达时间(AT)、达峰时间(TTP)、基础强度(BI)差异均无统计学意义(均P>0.05)。ROC曲线分析可见,E_(max)、E_(min)、E_(mean)、PI和联合诊断缺血性脑梗死的AUC分别为0.743、0.636、0.694、0.711、0.760,敏感度分别为85.90%、72.90%、77.10%、81.30%、93.80%,特异度分别为66.70%、53.40%、54.20%、54.20%、52.30%。结论:超声弹性成像联合超声造影定量分析对有症状缺血性脑梗死患者的诊断效能较高,可有效鉴别缺血性脑梗死患者。