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.

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.

Diagnosis and treatment experience of atypical hepatic cystic echinococcosis type 1 at a tertiary center in China

BACKGROUND Some hydatid cysts of cystic echinococcosis type 1(CE1)lack well-defined cyst walls or distinctive endocysts,making them difficult to differentiate from simple hepatic cysts.AIM To investigate the diagnostic methods for atypical hepatic CE1 and the clinical efficacy of laparoscopic surgeries.METHODS The clinical data of 93 patients who had a history of visiting endemic areas of CE and were diagnosed with cystic liver lesions for the first time at the People's Hospital of Xinjiang Uygur Autonomous Region(China)from January 2018 to September 2023 were retrospectively analyzed.Clinical diagnoses were made based on findings from serum immunoglobulin tests for echinococcosis,routine abdominal ultrasound,high-frequency ultrasound,abdominal computed tomography(CT)scan,and laparoscopy.Subsequent to the treatments,these patients underwent reexaminations at the outpatient clinic until October 2023.The evaluations included the diagnostic precision of diverse examinations,the efficacy of surgical approaches,and the incidence of CE recurrence.RESULTS All 93 patients were diagnosed with simple hepatic cysts by conventional abdominal ultrasound and abdominal CT scan.Among them,16 patients were preoperatively diagnosed with atypical CE1,and 77 were diagnosed with simple hepatic cysts by high-frequency ultrasound.All the 16 patients preoperatively diagnosed with atypical CE1 underwent laparoscopy,of whom 14 patients were intraoperatively confirmed to have CE1,which was consistent with the postoperative pathological diagnosis,one patient was diagnosed with a mesothelial cyst of the liver,and the other was diagnosed with a hepatic cyst combined with local infection.Among the 77 patients who were preoperatively diagnosed with simple hepatic cysts,4 received aspiration sclerotherapy of hepatic cysts,and 19 received laparoscopic fenestration.These patients were intraoperatively diagnosed with simple hepatic cysts.During the followup period,none of the 14 patients with CE1 experienced recurrence or implantation of hydatid scolices.One of the 77 patients was finally confirmed to have CE complicated with implantation to the right intercostal space.CONCLUSION Abdominal high-frequency ultrasound can detect CE1 hydatid cysts.The laparoscopic technique serves as a more effective diagnostic and therapeutic tool for CE.

TCD脑血流监测在颈动脉内膜剥脱术中指导血压调控的应用

目的探讨经颅彩色超声多普勒系统(TCD)监测脑血流在颈动脉内膜剥脱术(CEA)中指导血压个体化调控的作用。方法选择2018年12月至2020年12月在邢台市第三医院收治的140例拟行CEA治疗的颈动脉狭窄患者,其中男性74例,女性66例;年龄45~65岁,平均年龄57.41岁;糖尿病10例,高血压12例;美国麻醉师协会(ASA)分级:Ⅱ级30例,Ⅲ级110例。采用随机数字表法分为研究组和对照组,每组分为70例。对照组采用传统手段控制血压,研究组根据TCD脑血流参数指导调节血压。术中连续监测两组患者的有创动脉压力并对大脑中动脉平均血流速度进行监测。记录两组各个时刻点大脑中动脉血流速度(Vm)及外周有创动脉收缩压,比较两组患者围术期相关指标,统计术中心动过速/心动过缓发生次数及术后心脑血管事件发生情况。结果研究组术中硝酸甘油、去甲肾上腺素用量低于对照组[(34.87±10.27)μg vs(48.56±6.92)μg、(15.97±4.54)μg vs(24.15±3.99)μg。P<0.05],心动过缓发生率明显少于对照组(2.86%vs 19.40%。P<0.05)。在T00、T0、T3和T4时,两组间Vm值和收缩压比较,差异无统计学意义(P>0.05)。在T1和T2时,研究组Vm值和收缩压明显低于对照组[T1:(38.87±6.19)cm/s vs(44.42±4.16)cm/s,(119.84±8.12)mmHg vs(150.78±6.51)mmHg;T2:(29.46±4.58)cm/s vs(34.94±3.64)cm/s,(142.04±10.91)mmHg vs(152.23±5.84)mmHg。P<0.05]。其中两组患者在T2时Vm值显著下降[(29.46±4.58)cm/s vs(34.94±3.64)cm/s。P<0.05],收缩压值显著上升[(142.04±10.91)mmHg vs(152.23±5.84)mmHg。P<0.05]。研究组术后并发症发生率低于对照组(7.14%vs 20.90%。P<0.05)。研究组CEA后颈动脉超声心动图改变或术后再狭窄<50%、50%~69%和继发血栓形成的患者数明显少于对照组(2.86%vs 11.94%、2.86%vs 13.43%、1.43%vs 8.96%、0.00%vs 5.97%。P<0.05)。结论TCD监测颈动脉狭窄患者脑血管血流动力学对CEA麻醉中血压的调控具有较好的指导意义,有利于实现血压个体化调控,提高血压调控准确率,减少心脑血管事件的出现。

乳腺超声影像评分系统在乳腺肿块良恶性鉴别中的应用效果

目的:分析乳腺超声影像评分系统在乳腺肿块良恶性鉴别中的应用效果。方法:选取2022年8月—2023年7月昆山市第二人民医院收治的62例乳腺肿块患者作为研究对象,均行彩色多普勒超声检查,运用乳腺超声影像评分系统进行乳腺肿块良恶性的鉴别诊断,以病理诊断结果为“金标准”,分析乳腺超声影像评分系统鉴别乳腺肿块良恶性的效能。结果:病理诊断结果显示,62例乳腺肿块患者中,良性肿块38例(61.29%),恶性肿块24例(38.71%)。乳腺超声影像评分系统诊断结果显示,62例乳腺肿块患者中,良性肿块36例(58.06%),恶性肿块26例(41.94%)。乳腺超声影像评分系统鉴别乳腺肿块良恶性的准确率、灵敏度、特异度、阳性预测值、阴性预测值依次为87.10%(54/62)、87.50%(21/24)、86.84%(33/38)、80.77%(21/26)、91.67%(33/36)。结论:乳腺超声影像评分系统鉴别乳腺肿块良恶性的效能较好,有助于病情评估,可为治疗方案的制定提供参考依据,值得临床应用。

New Approach to Measuring the Ankle and Toe Brachial Indices as New Markers for Early Detection of Lower Extremity Peripheral Artery Disease

Background: Lower extremity Peripheral artery disease (PAD) is caused by atherosclerosis, or Plaque buildup, that reduces the blood flow to the legs and feet. PAD affects approximately 230 million adults worldwide and is associated with an increased risk of coronary heart disease, stroke, and leg amputation. The first-line method for diagnosis of PAD is the Ankle Brachial Index (ABI), which is the ratio of ankle to brachial higher systolic pressure measured in ankles and arms. The Toe Brachial Index (TBI), which is the ratio of the toe systolic pressure to brachial higher systolic pressure measured in both arms, is considered to be an alternative to the ABI in screening for PAD. The ABI and TBI are measured on the right and left side, and the lower of these numbers is the patient’s overall ABI and TBI. Clinical studies and meta-analysis reviews have shown that the conventional ABI measurement, which uses a cuff, and handheld sphygmomanometer and continuous-wave Doppler tracings, provides an acceptable-to-high specificity level but low sensitivity when compared with vascular color Doppler ultrasound, and/or angiography methods. Another study has shown that the TBI measurement has greater sensitivity but lower specificity than the ABI when compared with vascular color Doppler ultrasound diagnostic based on waveforms. The aim of this clinical study was to evaluate the specificity and sensitivity of the VasoPad System comparing its results to the vascular color doppler ultrasound waveforms. Materials and Methods: The VasoPad System is an automated device using the pulse wave method to measure the arms and ankles dorsalis and tibial posterior artery blood pressures, the photoplethysmography second derivative (PTGSD) to estimate the toe systolic pressure, a patented photoplethysmography (PTG) index marker and volume plethysmography via cuffs during deflation. Vascular Color Doppler ultrasound can diagnose stenosis through the direct visualization of atherosclerosis or plaques and through waveform analysis. The vascular color Doppler ultrasound provides 3 waveform types. The type 1, triphasic waveform is normal blood flow and no atherosclerosis or plaque, the type 2, diphasic waveform is seen when there are atherosclerosis plaques, but normal blood flow, and the type 3, monophasic waveform reflects stenosis with diameter reduction > 50%. Results: The sum of the overall ABI and TBI VasoPad values, called Sum of Brachial Indices (SBI), gave a specificity of 88.89% and sensitivity of 100% for detecting vascular color Doppler ultrasound biphasic and monophasic waveforms versus triphasic waveforms with a cutoff ≤ 1.36 (P Conclusion: The VasoPad was useful for detecting PAD, which is fully defined as having vessel stenosis > 50% (Doppler monophasic waveforms) but also early stage of atherosclerosis plaque of the lower extremities (Doppler biphasic waveforms). The VasoPad method provided a remarkable sensitivity of 100% and a specificity level similar to those of the conventional ABI test method compared with the vascular color Doppler ultrasound. In addition to being useful to screen and detect PAD, the VasoPad offers early detection of lower extremity atherosclerosis, with normal blood flow (Doppler biphasic waveforms), which could provide greater treatment options and thus reduce the overall number of lower extremity complications.

输尿管结石急诊患者CT和超声结果比较

目的:探讨急诊输尿管结石患者的泌尿系平扫CT和泌尿系彩超的选择。方法:回顾性分析晋江市医院急诊科2020年1月至12月收治的输尿管结石患者的临床资料。根据所选择的影像学检查将其分为CT组和彩超组,总共967例,其中CT组382例,彩超组585例。CT组均行泌尿系平扫CT检查,彩超组均行泌尿系彩超检查。比较两组患者的输尿管结石、肾周炎和/或输尿管炎的检出率;比较患者对检查过程及检查结果的满意率。结果:CT组输尿管结石、肾周炎/输尿管炎的检出率较彩超组高,差异有统计学意义(P<0.05)。CT组对检查结果及检查过程满意率较彩超组高,差异有统计学意义(P<0.05)。结论:对于输尿管结石患者,泌尿系平扫CT在判断病情、明确有无相关并发症优于泌尿系彩超,对于无明显禁忌症患者可作为输尿管结石患者影像学检查的优先选择。

超声诊断单脐动脉畸形影像学特征、器官畸形发生及分娩结局分析

目的:分析单脐动脉畸形的超声诊断特征与遗传学信息。方法:回顾性分析2018年1月-2022年10月本院产前检查超声检查5465例诊断出单脐动脉畸形128例(单脐组)孕产妇资料,同期不伴有单脐动脉畸形的孕产妇128例为对照组,观察单脐动脉畸形的超声诊断特征及分娩结局(获得了关于产前超声诊断特征和产后结局等的详细数据。结果:单脐动脉畸形发生率为2.3%,单脐组剖宫产率、早产率、引产率及小于胎龄儿比例均高于对照组,胎儿出生体重、1 min及5 min Apgar评分均低于对照组,脐动脉收缩期峰值流速与舒张末期流速的比值(25.8%)及阻力指数异常升高比例(21.1%)均高于对照组(9.4%、7.0%)(均P<0.05);单脐组伴有至少1个器官系统异常31例(24.2%),其中29.0%发现有染色体异常,泌尿系统畸形发生率最高为15例、其次是心血管系统为11例,伴有器官系统异常的胎儿羊水减少(9.7%)和羊水增加(6.0%)比例高于不伴有器官系统异常胎儿(1.0%、0)(P<0.05)。单脐动脉畸形的超声诊断特征为下腹部仅可显示1红1蓝的彩色信号;下腹部横切面仅见1条脐动脉血流信号;失去正常“品”字结构,呈“吕”字形。结论:产前超声诊断单脐动脉畸形具有影像学特征,诊断后需要对胎儿进行结构观察,重点观察泌尿系统和心血管系统,如发现相关畸形及时进行基因检测。

TREATMENT OF SIMPLE RENAL CYSTS BY COLOR DOPPLER ULTRASOUND GUIDED PERCUTANEOUS PUNCTURE CATHETERIZATION DRAINAGE AND 99% ETHANOL PERFUSION

Objective To investigate the effect and safety of the treatment of renal cysts with color Doppler ultrasound guided percutaneous puncture catheterization drainage and repeated 99% ethanol perfusion. MethodsFifty-eight patients with primary renal cysts were treated with color Doppler ultrasound guided percutaneous puncture catheterization drainage and 99% ethanol perfusion. If the cyst volume was<500 mL, the complete evacuation of the cyst was followed by injection with 99% ethanol in a volume equal to 25% of the total cyst volume, twice per day, 10 min for each injection. If the cyst volume was>500 mL, injection was given three times per day, 20 min for each injection, and the patient was asked to move in different positions to help distributing the ethanol over the cyst wall. ResultsFifty-eight cysts were detected in the 58 patients. Puncture was performed and the success rate was 100%. Central venous catheter was introduced into the cysts. After follow-up for 0.5 to 3 years, 56 renal cysts were disappeared. The cure rate was 96.6%, and the complications such as bleeding, infection, and organ injuries were not found. ConclusionThe treatment of renal cyst with color Doppler ultrasound guided percutaneous puncture catheterization drainage and 99% ethanol injection is an effective and safe method for the patients with renal cysts.

SMI、CDFI检查联合GI-RADS分类对卵巢肿瘤良恶性评估价值

目的探讨超微血管成像(SMI)、彩色多普勒超声血流显像(CDFI)检查联合超声妇科影像报告和数据系统(GI-RADS)分类对卵巢肿瘤良恶性的评估价值。方法选取2019年9月至2022年3月富平县医院收治的168例卵巢肿瘤患者的临床资料,根据穿刺或术后病理组织检查结果分为恶性组(n=56)和良性组(n=112)。采用SMI和CDFI检查分别观察同一肿瘤血流情况,采用Adler分级标准评估病灶血流丰富程度,观察病灶血管条数。以GI-RADS分类1~4a类为良性,4b~5类为恶性,SMI检查、CDFI检查或GI-RADS分类任一参数为恶性则诊断为联合预测结果恶性。通过一致性分析,分别评价GI-RADS分类、CDFI检查联合GI-RADS分类、SMI检查联合GI-RADS分类对卵巢肿瘤恶性的预测价值。结果两组GI-RADS分类患者例数比较,差异有统计学意义(P<0.05)。恶性组SMI检查和CDFI检查血流丰富程度均明显高于良性组,差异均有统计学意义(P<0.05);恶性组SMI检查血流丰富程度明显高于CDFI检查,差异有统计学意义(P<0.05);良性组SMI和CDFI检查血流丰富程度比较,差异无统计学意义(P>0.05),SMI检查较CDFI检查更易检出恶性肿瘤中的3级血流。恶性组SMI和CDFI检查检出血管条数均明显多于良性组,差异均有统计学意义(P<0.05)。168例卵巢肿瘤患者中GI-RADS分类预测恶性49例,灵敏度为0.875,特异度为0.902,准确率为0.893,Kappa值为0.751;168例卵巢肿瘤患者中CDFI检查联合GI-RADS分类预测恶性53例,灵敏度为0.946,特异度为0.938,准确率为0.940,Kappa值为0.868;168例卵巢肿瘤患者中SMI检查联合GI-RADS分类预测恶性55例,灵敏度为0.982,特异度为0.955,准确率为0.964,Kappa值为0.921。结论SMI检查、GI-RADS分类对卵巢肿瘤良恶性均具有较好的鉴别诊断效能,SMI检查联合GI-RADS分类较CDFI检查联合GI-RADS分类诊断的灵敏度、特异度更高。

超声间接征象对诊断急性阑尾炎的应用价值

目的探讨急性阑尾炎超声间接征象与炎症程度的关系及临床意义。方法应用彩超检查207例急性阑尾炎患者,分析其间接征象。结果急性阑尾炎时超声间接征象中阳性率较高的征象为:局部探头压痛及反跳痛、回盲部水肿、右下腹局部强回声、右下腹肠间隙积液、肠系膜淋巴结肿大等;超声间接征象与阑尾炎严重程度相关,阑尾炎越严重,间接征象阳性率越高。结论超声间接征象能确切反映阑尾周围组织炎症,正确认识超声间接征象有助于提高对急性阑尾炎的诊断。

术中超声在颅脑深部肿瘤术中的应用

目的探讨术中超声在颅脑深部肿瘤切除术中的应用价值。方法对24例颅脑深部肿瘤患者术中行超声检查,应用灰阶及彩色多普勒超声探测病灶,确定肿瘤的部位、深度、大小、内部回声等,指导手术入路的选择,术后判断肿瘤的切除程度。结果术中超声对24例颅脑深部肿瘤清晰地显示,超声显示肿瘤的部位与术前CT和/或MRI相吻合;术中超声定位准确率100%,为手术提供了最佳入路点;肿瘤全切19例(83.3%),次全切5例(16.7%)。结论术中超声可以实时显示颅脑深部肿瘤的部位和监控肿瘤切除情况,及时发现残留肿瘤,提高手术成功率和降低手术并发症的发生。

颈动脉超声检查及超敏C反应蛋白检测对2型糖尿病患者急性心梗的诊断价值

目的探讨颈动脉超声检查及超敏C反应蛋白检测对2型糖尿病合并心肌梗死的诊断价值。方法选择180例单纯2型糖尿病患者(单纯糖尿病组)、143例2型糖尿病合并急性心肌梗死患者(糖尿病合并急性心肌梗死组)及150例健康者(对照组),均进行彩色多普勒超声检查,测量各组患者的颈动脉内-中膜厚度(IMT),观察颈动脉内的斑块数量及性质,同时测量并比较各组患者的血清超敏C反应蛋白(hs-CRP)。结果 3组间IMT、颈动脉斑块数目及斑块性质比较有显著差异(P<0.05)。糖尿病合并急性心肌梗死的患者中,颈动脉斑块不稳定者其hs-CRP浓度(13.88±5.70)mg/L显著高于斑块稳定者(9.36±5.54)mg/L(P<0.05)。结论颈动脉超声检查联合超敏C反应蛋白检测对2型糖尿病合并心肌梗死的早期诊断具有重要意义。

二维斑点追踪技术评价肥厚型心肌病左房功能的研究

目的探讨应用二维斑点追踪技术(2DT)评价肥厚型心肌病(HCM)患者左房功能的价值。方法 HCM组患者28例,健康对照组30例,测量其左房内径,室间隔及左室后壁厚度,左室流出道压差,二尖瓣口E、A峰值,计算E/A值,计算左房主动排空分数(LAAEF)及左房被动排空分数(LAPEF)。应用2DT技术,获取房间隔、左房侧壁、下壁及前壁的基底段、中间段及房顶段的长轴方向的应变及应变率曲线,记录各房壁各节段左室收缩期峰值应变及应变率(Ss、SRs)、舒张早期峰值应变率(SRe)、舒张晚期峰值应变率(SRa),计算其平均值(mSs、mSRs、mSRe、mSRa)。结果 HCM组左房内径、室间隔及左室后壁厚度、左室流出道压差、A峰及LAAEF显著大于对照组(P<0.05),E峰、E/A及LAPEF则显著低于对照组(P<0.01);HCM组与对照组比较,HCM组左房mSs、mSRs、mSRe均明显减低,mSRa则明显增高,差异均有统计学意义(P<0.01);HCM患者左房mSRa与LAAEF呈显著正相关(r=0.780,P<0.01)。结论 HCM患者左房的储备功能及管道功能下降,辅泵功能增加,2DT可以准确评价左心房功能的变化。

组织多普勒Tei指数评价西地那非对肺动脉高压患者右室功能的影响

目的利用组织多普勒Tei指数观察肺动脉高压患者口服西地那非后对右室功能的影响。方法入选者为我院21例肺动脉高压病人,给予西地那非25 mg,每日口服3次,在服药前及服药后4 w、12 w,分别测量右室大小、右室射血分数、肺动脉收缩压及组织多普勒三尖瓣环的等容舒张时间(IRT)、等容收缩时间(ICT)、射血时间(ET)、右室Tei指数及6 min步行距离(6MWD)变化。结果服药4 w后,和基线比较,6MWD增加(346.4±32.1)VS(367.3±36.7),P<0.05),右室三尖瓣环的IRT、ICT缩短(P<0.05),右室Tei指数减低(P<0.05),12 w后,6MWD进一步地增加(346.4±32.1)VS(398.7±38.9),(P<0.01),肺动脉收缩压减低(76.7±20.5)mmHg VS(64.2±18.1)mmHg(P<0.05),ET延长(P<0.05),右室三尖瓣环的IRT、ICT缩短,右室Tei指数减低(P<0.01)。结论口服西地那非可以降低肺动脉压,改善右室功能,右室Tei指数可以敏感地反应右室功能变化。

彩色超声对胎儿泌尿系统畸形筛查的临床价值

目的探讨彩色多普勒超声对胎儿泌尿系统畸形筛查诊断临床价值。方法对21例20-24周孕妇应用采色多普勒超声进行产前常规检查,观察各器官的血流动力学变化进行分析和总结。结果21例按部位正确诊断19例(90％),提示诊断3例(10％)。结论利用彩色多普勒超声作产前胎儿畸形筛查,能及早做出诊断,为临床治疗方法提供重要的指征,对优生优育具有一定的应用价值。

VTE风险评估智能预警系统在髋部骨折患者深静脉血栓预防中的应用

目的研究静脉血栓栓塞症(Venous Thromboem-bolism,VTE)风险评估智能预警系统在髋部骨折患者深静脉血栓预防中的应用效果。方法将2019年3—12月VTE风险评估智能预警系统应用前的髋部骨折患者174例分为应用前组;将2020年1—10月系统使用后的髋部骨折患者141例分为应用后组,比较两组患者血栓风险评估率、出血风险评估率、物理预防措施落实率、血栓发生率、彩超筛查率及全因死亡率。结果应用VTE风险评估智能预警系统后,髋部骨折患者血栓风险评估率从系统应用前的64.94%上升至97.16%;出血风险评估率由系统应用前的51.15%上升至87.23%;物理预防措施落实率由系统应用前的59.20%上升至78.72%;彩超筛查率由系统应用前的74.14%上升至85.82%,差异均有统计学意义(P<0.05);系统应用后彩超筛查率明显上升,血栓发生率由应用前的15.50%上升至15.70%,差异无统计学意义(χ2=0.002,P>0.05);患者的全因死亡率从20.53%下降至10.45%,差异有统计学意义(χ2=5.427,P<0.05)。结论 VTE风险评估智能预警系统具有早期预警、实时监控、及时处置等优点,它的应用有效规范了医院VTE的管理,降低了髋部骨折患者的死亡率,提高了医疗质量,值得临床推广。

GE Logiq E9超声维修案例分析

本文通过两例GE Logiq E9超声维修案例进行细致分析,总结出常见的维修思路期待能帮助提高同行对该设备的维修能力。案例一为设备无法开机,案例二为设备开机后图像故障。根据已有知识对设备故障的初步判断,再经过运行原理来逐一排查故障核心点,分别通过更换PC端的内存条、带有CW的接收板排除了故障,使设备恢复正常运行。而且我们发现对于无法开机的情况故障大多出在后端,只有充分了解相关电路原理等才能为快速、高效维修提供有力的保证。

基于改良评分体系的彩色多普勒超声结合弹性成像对女性乳腺肿块鉴别诊断的应用

目的评估基于改良评分体系的彩色多普勒超声(CDFI)结合弹性成像诊断乳腺肿块的价值。方法二维超声成像发现乳腺包块后,通过对CDFI以及阻力指数RI、弹性成像获得数据,按照不同权重综合评分,以病理结果为金标准,分别对CDFI、CDFI+RI、弹性成像、综合评分四种方法进行比较,分析乳腺癌诊断的符合率、敏感性以及特异性的差异。结果综合评分法在符合率、敏感性以及特异性等方面优于其他方法敏感性、特异性CDFI最低,仅25%和89.3%,CDH+RI与弹性成像逐渐增高,分别为37.5%、90.0%和43.0%、92.85%。综合评分法(≥6分)最高,分别达到81.25%、95%。约登指数依次为0.143、0.275、0.35、0.76c结论彩色多普勒超声结合弹性成像的改良评分体系,有利于早期发现乳腺肿瘤,无创、可重复,值得临床推广。