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.

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.

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.

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.

TRANSVAGINAL COLOR DOPPLER STUDY OF UTEROPLACENTAL CIRCULATION IN NORMAL EARLY PREGNANCY

A cross sectional transvaginal color Doppler study of the uteroplacental circulation was performed on 105 pregnant women with normal intrauterine pregnancy. Gestational age was ranged from 4 to 12 weeks. The blood flow velocity waveforms were obtained from four separate parts of the uteroplacental circulation: uterine, arcuate, radial, and spiral arteries. The resistance index (RI) and peak systolic velocity (PSV) were analyzed. The RI significantly decreased and PSV increased with advancing gestation in uterine artery and its branches (P<0 05). The RI gradully decreased from uterine artery through arcuate, radial to spiral arteries (P<0 05). At the same time, the PSV decreased from uterine artery then arcuate to radial artery, but PSV in spiral arteries were higher than that in radial artery (P<0 05). The results showed that transvaginal color Dopper ultrasonography was a simple, reliable method to assess the uteroplacental circulation in the early pregnancy; the detection of PSV was useful parameter for better understanding of physiological and pathophysiological hemodynamic changes as well as RI.

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.

Prospective Study of Color Doppler Ultrasonography in the Diagnosis of Breast Disease.

One hundred and four cases of breast disease were examined by color Doppler ultrasonography (CDUS). Malignant lesions were rich in blood blow signal and 56% of +++-++++grade while benign lesions had little blood flow signal

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.

Laparoscopic splenectomy： color Doppler flow imaging for preoperative evaluation

Background Laparoscopic splenectomy （LS） is currently the standard approach for resection of a normal-sized spleen. However, this method becomes technical challenge in cases of splenomegaly due to intraoperative hemorrhage. A complete understanding of the splenic vessel anatomy is important to facilitate the difficult laparoscopic procedure. In this retrospective study, we examined the role of color Doppler flow imaging （CDFI） in splenic vessel anatomy and evaluated its value for LS. Methods Forty-eight patients who underwent splenectomy for various hematologic and autoimmune disorders from May 2004 to December 2007 were enrolled in this study. Twenty-three patients underwent preoperative CDFI examination that included examination of the anatomic type of splenic pedicle, the adjacent relationship between the splenic vessel and pancreas, and spleen size （CDFI group）. In the remaining 25 patients, ultrasonic inspections of the splenic vessel were not performed （non-CDFI group）. Laparoscopic splenectomies in the CDFI group were performed in accordance with the information provided by the preoperative CDFI in each patient. In the non-CDFI group, LS was performed according to the conventional method. In the CDFI group, the constituent ratios of the above-mentioned parameters by CDFI were compared with those recorded during LS using the chi square test. The effectiveness of the technique on surgery in both groups was compared with an independent sample Student＇s ttest. Results All laparoscopic splenectomies in both groups were performed successfully. However, 2 cases in the non-CDFI group were converted to LS with the assistance of micro-incision because the branches of the splenic vein were inadvertently torn. Two anatomic types of splenic pedicle and four different adjacent relationships between the splenic vessel and pancreas were detected by CDFI. About 80% of spleens fit the criteria of megalosplenia. There were no statistically significant differences between the constituent ratios of the parameters by CDFI and those by intraoperative telerecording in the CDFI group （χ^2=0.383, 1.072, 0.119, P=0.536, 0.784, 0.730）. However, statistically significant differences were observed in the operative time （（158.70±42.51） minutes vs （200.65±47.89） minutes, P=0.003）, intraoperative blood loss （（55.87±17.36） ml vs （101.83±62.21） ml, P=0.001）, and recovery time of gastrointestinal function （（24.39±8.88） hours vs （30.60±9.45） hours, P=0.024） between the groups. Conclusions The individual operative route and schedule can be successfully determined on the basis of various kinds of reproducible anatomic frameworks of the spleen provided by preoperative CDFI. This technique facilitates the surgical procedure, shortens the operative time, reduces intraoperative blood loss and decreases the risk of LS in splenomegaly cases.

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.RESULTS:In the majority of patients,hepatomegaly 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.

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。

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。

彩色多普勒超声联合甲状腺功能检测在桥本甲状腺炎诊断中的应用

目的探讨彩色多普勒超声联合甲状腺功能检测在桥本甲状腺炎(HT)诊断中的应用价值。方法回顾性分析2021年1月至2022年1月于贵州航天医院就诊的126例疑似HT患者的临床资料,患者均进行彩色多普勒超声检查、甲状腺功能指标[甲状腺过氧化物酶抗体(TPOAb)、抗甲状腺球蛋白抗体(TgAb)]检测,以临床或病理诊断为金标准,比较彩色多普勒超声、甲状腺功能指标及联合检查HT的诊断效能,采用Kappa检验评估各检查方法与金标准的一致性,评估其诊断效能。结果126例疑似HT的患者经临床或病理检查,最终确诊110例。110例HT患者的TPOAb水平为(303.46±74.43)IU/ml,TgAb水平为(39.06±10.12)%。彩色多普勒超声检查诊断HT的灵敏度为88.18%、特异度为87.50%、准确度为88.10%,与金标准一致性Kappa值为0.585;TPOAb检查诊断HT的灵敏度为74.55%、特异度为81.25%、准确度为75.40%,与金标准一致性Kappa值为0.335;TgAb检查诊断HT的灵敏度为75.45%、特异度为87.50%、准确度为76.98%,与金标准一致性Kappa值为0.378;联合诊断HT的灵敏度为98.18%、特异度为87.50%、准确度为96.83%,与金标准一致性Kappa值为0.857,以上各种方法诊断HT的效能:联合检查诊断灵敏度、准确度及阴性预测值高于其他3种诊断方式(P<0.05)。结论与单一彩色多普勒超声或甲状腺功能检查比较,彩色多普勒超声联合甲状腺功能检测诊断效能更高,有助于临床医师鉴别诊断,改善患者预后。

经阴道三维能量多普勒超声联合二维剪切波弹性成像预测备孕女性妊娠结局的临床价值

目的应用经阴道三维能量多普勒超声(3D-PDI)联合二维剪切波弹性成像(2D-SWE)评估备孕女性子宫内膜容受性,探讨其预测妊娠结局的临床应用价值。方法选取在我院接受卵泡检测的87例备孕女性,均于排卵第7~8天(种植窗期)行经阴道3D-PDI检查,于增殖期行2D-SWE检查,然后随访6周,根据妊娠结局将其分为受孕组31例和未受孕组56例。比较两组子宫内膜厚度、容积、回声类型、血流分型、子宫螺旋动脉搏动指数(PI)、阻力指数(RI)、收缩期峰值流速与舒张末期流速比值(S/D)、血管化指数(VI)、血流指数(FI)、血管化血流指数(VFI),以及子宫内膜杨氏模量平均值(以下简称杨氏模量值)的差异。绘制受试者工作特征(ROC)曲线分析经阴道3D-PDI和2D-SWE参数单独及联合应用对备孕女性妊娠结局的预测价值。结果受孕组子宫内膜厚度和FI均高于未受孕组,S/D和子宫内膜杨氏模量值均低于未受孕组,差异均有统计学意义(均P<0.05);两组子宫内膜容积、回声类型、血流分型及PI、RI、VI、VFI比较差异均无统计学意义。ROC曲线分析显示,子宫内膜厚度、FI、S/D和子宫内膜杨氏模量值预测备孕女性妊娠结局的曲线下面积分别为0.789、0.851、0.853和0.840,联合应用的曲线下面积为0.895,高于各参数单独应用,差异均有统计学意义(均P<0.05)。结论经阴道3D-PDI联合2D-SWE可准确评估备孕女性子宫内膜容受性,对预测其妊娠结局有较好的临床应用价值。

经阴道彩色多普勒超声在子宫内膜病变患者中的应用价值

目的分析经阴道彩色多普勒超声在子宫内膜病变患者中的应用价值。方法选取2021年2月至2022年4月南昌大学第四附属医院收治的88例子宫内膜病变患者作为研究对象,所有患者均接受经阴道彩色多普勒超声及病理学检查,按照病理学检查结果将患者分为息肉组与癌变组,每组44例。比较两组二维超声子宫内膜情况、病灶血流动力学情况、经阴道彩色多普勒超声血流相关参数;以病理学检查结果为金标准,分析经阴道彩色多普勒超声对子宫内膜癌变的诊断效能。结果癌变组子宫内膜厚度厚于息肉组,内膜-肌层分界清晰、病灶回声均匀占比均低于息肉组,差异有统计学意义(P<0.05);癌变组血流丰富占比高于息肉组,差异有统计学意义(P<0.05);癌变组血流阻力指数(RI)、搏动指数(PI)均低于息肉组,时间平均峰值流速(TAP)慢于息肉组,差异有统计学意义(P<0.05);经阴道彩色多普勒超声对子宫内膜癌变的诊断灵敏度为86.36%,特异度为84.09%,准确度为85.23%;诊断息肉的灵敏度为84.09%,特异度为86.36%,准确度为85.23%。结论经阴道彩色多普勒超声对子宫内膜病变的诊断准确率较高,能通过血流动力学、RI、PI、TAP及影像学表现鉴别息肉或癌变。

经阴道彩色多普勒超声联合阴道镜诊断宫颈癌的价值

目的分析经阴道彩色多普勒超声联合阴道镜诊断宫颈癌的价值。方法选取2020年7月至2023年7月在淄博市中心医院就诊的100例疑似宫颈癌患者,给予经阴道彩色多普勒超声、阴道镜检查,以病理结果为金标准,分析不同检查方法的诊断效能。结果病理结果阳性72例,联合检查阳性71例。与经阴道彩色多普勒超声相比,联合检查的敏感度、特异度、准确性、阳性预测值、阴性预测值更高(P<0.05);与阴道镜相比,联合检查的敏感度、准确性、阳性预测值、阴性预测值更高(P<0.05)。结论经阴道彩色多普勒超声联合阴道镜诊断宫颈癌的效能较高。

超声分层应变技术评估急性病毒性心肌炎患者左心室收缩功能及与磁共振比较

目的:探讨超声分层应变技术评估急性病毒性心肌炎(AVMC)患者左室心肌收缩功能的价值。方法:前瞻性选取2020年1月—2023年2月在我院经临床诊断为AVMC且左室射血分数(LVEF)≥50%的患者37例作为病例组,另随机选取同期健康志愿者37例作为对照组,比较两组常规超声心动图参数,并将病例组常规超声心动图参数与心脏磁共振(CMR)参数做对比分析;应用超声分层应变技术测量两组左室三层心肌收缩期整体纵向应变(GLS)及周向应变(GCS),分析组间差异及与CMR参数的相关性。结果:两组间常规超声心动图参数差异无统计学意义(P>0.05)。与CMR比较,常规超声心动图低估了病例组左室舒张末期容积(LVEDV)、左室收缩末期容积(LVESV)及每搏输出量(SV)(P<0.05)。病例组左室三层心肌GLS及GCS的绝对值较对照组均显著减低(P<0.001),与CMR参数视觉存在分数(VPS)均成负相关(P均<0.001)、LVEF均成正相关(P均<0.01)。结论:超声分层应变技术在早期识别AVMC患者左室心肌收缩功能损害中具有一定临床应用价值。

超声多模态评估复发性流产患者的子宫内膜容受性与妊娠结局相关性研究

目的:探讨多模态超声评估复发性流产(RSA)患者子宫内膜容受性(ER)与妊娠结局相关性分析。方法:采用前瞻性双盲队列研究,选取在潍坊市人民医院于黄体中期(排卵后7~9天)行经阴道超声ER评估的2 458例,筛选后随机选取98例RSA患者作为研究组,随机选取96例正常人(无自然流产史且具有正常生育史)为正常对照组,分别记录两组子宫内膜形态学参数(内膜厚度、内膜容积、内膜类型、内膜蠕动频率)以及子宫血流动力学参数(内膜及内膜下血流类型、血管血流指数(VFI)、血管化指数(VI)、血流指数(FI)、子宫动脉收缩峰值血流速度与舒张末期血流速度比值(S/D)、子宫动脉搏动指数(PI)、阻力指数(RI))。追踪RSA组和对照组的妊娠结局,分为RSA妊娠成功组(46例)、RSA未妊娠组(52例)、正常妊娠成功组(80例)和正常未妊娠组(16例),使用统计学方法对不同妊娠结局患者的ER超声参数进行差异分析,以受试者工作特征曲线(ROC曲线)分析各参数以及各参数并联诊断对妊娠结局的预测价值。结果:RSA组子宫内膜厚度、内膜容积、VI、FI、VFI均小于对照组,子宫动脉RI、PI、S/D高于对照组。追踪妊娠结局:RSA妊娠成功患者的VI、FI、VFI显著高于RSA未妊娠组,差异有统计学意义(P<0.05)。Ⅰ、Ⅱ、Ⅲ型内膜血流的妊娠成功率分别为63.8%、77.6%、92.5%,A、B、C型内膜的妊娠成功率分别为89.8%、66.6%、65.5%,差异有统计学差异(P<0.05)。通过ROC曲线分析,各超声参数的最佳截断值、AUC、特异性、灵敏性分别为:子宫内膜厚度(6.2 mm、0.664、0.365、0.894)、子宫内膜容积(2.13 cm3、0.776、0.500、0.831)、子宫动脉RI(0.84、0.639、0.472、0.788)、PI(2.27、0.591、0.493、0.692)、S/D (6.295、0.622、0.788、0.507)、VI (6.09、0.846、0.923、0.655)、FI (12.61、0.736、0.769、0.704),VFI(0.775、0.841、0.904、0.676)。各参数并联诊断预测妊娠结局的AUC为0.867,敏感性为82.4%,特异性为84.6%。结论:RSA患者于黄体中期行超声检查发现子宫内膜形态学及血流动力学较正常人有明显差异,ER可以通过超声技术来预测RSA患者的妊娠结局,将各超声参数并联诊断ER的价值较单一参数更大。

HD-Flow联合STIC在胎儿肺动脉闭锁合并室间隔缺损诊断中的应用价值

目的:探讨高分辨率血流成像(HD-Flow)联合时间-空间复合成像(STIC)诊断胎儿肺动脉闭锁合并室缺(PA-VSD)的临床价值。方法:分析经胎儿超声心动图诊断的44例PA-VSD胎儿心脏二维、HD-Flow联合STIC图像,评估HD-Flow联合STIC在PA-VSD不同分型诊断中的效能,并探讨PA-VSD胎儿动脉导管内径与左、右肺动脉内径相关性。结果:HD-Flow联合STIC诊断44例PA-VSD,其中A型42例,C型2例。HD-Flow联合STIC能够清晰显示胎儿肺动脉及其分支血管及动脉导管血流;Pearson相关性分析表明A型动脉导管内径和左、右肺动脉内径均呈正相关(r=0.507、0.404,P<0.01)。结论:HD-Flow联合STIC能够明确诊断PA-VSD并分型,有较大的临床应用价值,A型PA-VSD胎儿动脉导管内径与左、右肺动脉内径存在正相关。