目的 探讨彩色多普勒超声诊断膀胱破裂的诊断价值,以提高膀胱破裂的超声诊断水平。 方法 回顾性分析2002年1月－2011年9月术前行彩色超声检查诊断膀胱破裂并经手术证实的5例患者资料，下腹加压检查和经导尿管注水试验检查作为超声判断有无膀胱破裂的重要检查方法。 结果 5例均为腹膜外型膀胱破裂,彩色多普勒血流显像明确诊断4例，漏诊1例，超声检查是诊断膀胱破裂的有效方法。 结论 彩色多普勒超声可以作为膀胱破裂的首选检查技术。Objective To investigate the value of color doppler flow image (CDFI) in diagnosing bladder rupture, in order to promote the ultrasound diagnosis for the disease. Methods We retrospectively analyzed the medical data of 5 patients with bladder rupture diagnosed by CDFI before operation and confirmed by surgery. Pressing the lower abdomen and injecting water through catheter were the main examination methods for CDFI in diagnosing bladder rupture. Results All the 5 cases were bladder rupture of extraperitoneal type. Four were diagnosed with CDFI, and 1 was misdiagnosed. The ultrasonic examination was an effective technology in diagnosing bladder rupture. Conclusion CDFI may be regarded as the first diagnostic technology for bladder rupture.
【摘要】 目的 总结胆囊壁隆起样病变超声及病理特点，以提高此类疾病的鉴别诊断水平。 方法 回顾性分析2008-2009年222例经手术和病理证实的胆囊隆起样病变患者的临床资料，对其超声特点及病理学结果进行分析。 结果 胆固醇沉积症（包括附壁型37例和息肉型138例）175例（78.8%），炎性息肉（增生性息肉）3例（1.4%），腺瘤14例（6.3%），有7例腺瘤伴非典性增生，腺肌增生症1例（0.5%），单纯胆囊炎29例（13.1%）。 结论 超声对胆囊隆起样病变的诊断敏感性极高，能清晰显示其大小、数目、回声情况、病变形态和边界情况及局部胆囊壁的变化，有无合并结石等，还可方便地行随访观察，了解其动态变化，是简便可靠的诊断方法。【Abstract】 Objective To Summarize the common sonographical and pathological characteristics of apophysis lesions of the gallbladder, so as to improve the level of diagnosis and differential diagnosis. Methods Sonographical appearance and pathological characteristics of 222 patients from 2008 to 2009 with apophysis lesions of the gallbladder which were confirmed by pathologic diagnosis and operation were reviewed retrospectively. Results One hundred and seventy-five (78.8%) of the patients had gallbladder cholesterol lipoidosis and 138 (62.2%) of them had gallbladder cholesterol polyps;3 patients (1.4%) had gallbladder inflammatory polyp;14 patients (6.3%) had gallbladder adenomatoid polyps and 7 of them were accompanied with dyplasis and atypical hyperplasia; 1 (0.5%) patients (0.5%) had cholecystic adenomyosis. Tenty-nine patients (13.1%) had cholecystitis only. Conclusion Ultrasonography is quilt sensitive to this disease and can disply the size, number, echo, shape of the lesions and can show that if complicate with cholecystolithiasis.Ultrasonography is also accomplished in follow-up and can be one of the most dependable examination methods.
目的：通过超声对185例肾上腺肿瘤诊断及漏诊、误诊病例分析，寻找影响肾上腺肿瘤超声漏诊及误诊的因素。 方法：本文回顾性分析185例肾上腺肿瘤超声与病理的资料，对超声漏诊和误诊原因进行了分类、归纳和总结。结果：通过185例肾上腺肿瘤的超声检查，超声诊断出肾上腺病变122例，诊断正确率65.95%，明显低于相关文献报道，漏诊57例，误诊6例。漏误诊率(34.05%)，明显高于相关文献报道，综合分析其病理及影像学资料，将漏误诊原因归纳为五种：①左侧肾上腺肿瘤；②小于2.0 cm的肿瘤；③混合性回声的肿瘤；④临床及超声医师对肾上腺肿瘤认识不足；⑤误诊的主要原因是由于肿瘤巨大，造成定位困难。结论：通过对肾上腺肿瘤漏诊及误诊分析，可以提高超声诊断的准确性，降低漏误诊率。
ObjectiveTo analyze the characteristics of ultrasound images for soft tissue lymphoma and discuss the diagnostic value of ultrasonography. MethodsBetween January 2008 and August 2014, the ultrasound images of 25 soft tissue lymphomas confirmed by histopathology and immunohistochemistry were retrospectively analyzed. ResultsOf the total 25 patients with soft tissue lymphoma (histological types of non-Hodgkin's lymphoma), there were 10 females and 15 males. Among them, 14 had diffuse large B-cell lymphoma (56%, 14/25). There was a primary lymphoma located in the lower leg, and all the rest 24 cases were secondary lymphoma. Of the 24 secondary cases, 19 presented solitary lesion located respectively in limbs (8 cases), trunk (7 cases) and head & neck (4 cases); the other 5 cases presented multiple lesions located respectively in limbs and trunk. Among all the lesions, 12 were located in muscular layer, presenting weak echo mass with irregular shape growing along the direction of muscular fibers; and 13 were located in skin and subcutaneous soft tissue, among which 4 cases showed diffused thickening of skin and subcutaneous layer with irregular hypoechoic areas on ultrasound examination, and 9 cases showed nodular or hypoechoic irregular shaped lesion, iso-hyperechoic, with heterogeneous internal echogenecity having unclear boundary. ConclusionUnderstanding the characteristics of soft tissue lymphoma on ultrasound images will help to improve diagnostic accuracy.
【摘要】 目的 用高频超声对正常女性乳腺健康体检，探讨其在临床及乳腺普查方面的应用价值。 方法 对2006年1月－2009年12月间7 532例健康女性乳腺体检声像图进行分析，并对各年龄段的乳腺病变超声结果分布情况进行统计。 结果 共检出乳腺病变2 861例（37.98%），正常者4 671例（62.02%）。所有受检者中，囊性病变1 904例（25.28%），实性病变944 例（12.53%），混合性病变13例（0.17%），伴有副乳者692例。囊性病变及实性病变单侧多于双侧，混合性病变均为单侧。常见病中，囊性病变多于实性病变，发病年龄分布在20～30岁及31～40岁年龄段。 结论 高频超声作为女性乳腺疾病的一种常规检查，能对乳腺占位性疾病提供较为准确的诊断，对乳腺癌早期发现、早期诊断、早期治疗提供一种科学依据。【Abstract】 Objective To explore the clinical value of high-frequency sonography for normal clinical breast examination in breast screening. Methods From January 2006 to December 2009, 7 532 healthy women underwent breast sonography. The results of sonography in the individuals with different ages were statistically analyzed. Results Breast lesions were found in 2 861 cases (37.98%) and the other 4 671 were healthy. Among all of the individuals, 1 904 cases (25.28%) had cystic lesions, 944 (12.53%) had solid lesions and 13 (0.17%) had mixed lesions. There were 692 cases of accessory mammary tissue. Unilateral cystic nodules and solid nodules were more common than bilateral ones, whereas mixed nodules were usually sunilaterally. Cystic nodules were more common than solid nodules. Most common onset of breast lesions is in the individuals with the age of 20-30 and 31-40 years. Conclusion High-frequency sonography, as an examination for normal clinical breast screening provides more accurate diagnosis and early detection of breast lesions, which can provide scientific evidence for early detection, diagnosis and treatment for breast cancer.
【摘要】 目的 探讨胃肠道间质瘤(GIST)彩色多普勒超声表现及其在诊断中的应用价值。 方法 回顾性分析2008年1月-2010年7月75例经病理证实的GIST的彩色多普勒超声声像图表现，将其与手术病理结果进行对比分析。 结果 GIST患者中男性高危险度肿瘤的比例较女性高（χ2=7.210，Plt;0.01）。肿瘤的大小、内部回声与其病理危险度高低有关:危险度低者、肿瘤最大径lt;5 cm，内部回声较均匀；危险度高者，肿瘤最大径≥5 cm，内部回声不均匀。肿瘤的彩色血流分布与其危险度高低无明显相关。常规的超声检查对肿瘤检出率较高，在胃及直肠的GIST诊断准确率高于其他部位的GIST。 结论 彩色多普勒超声检查有助于GIST的定位及分化程度的判断，可作为首选检查方法。【Abstract】 Objective To investigate the value of ultrasonography in the diagnosis of gastrointestinal stromal tumors (GIST). Methods The color sonographic performances obtained in 75 patients with pathologically proved GIST from January 2008 to July 2010 were retrospectively analyzed. The sonographic findings were compared with pathological results. Results The proportion of high-risk cancer in male patients with GIST was higher than that in women (χ2=7.210, Plt;0.01). The tumor size and internal echo level were related to its pathologic risk: in low-risk GIST, maximum tumor diameter was lt;5 cm, and internal echo was more homogeneous; in high-risk GIST, maximum tumor diameter was ≥ 5 cm and internal echo was heterogeneous. There was no statistical difference between tumor blood flow distribution and GIST risk. Routine sonography examination had a higher rate of cancer detection and had a higher accuracy in the diagnosis of GIST in the stomach and rectum than those in the other parts. Conclusion Sonography helps to locate and diagnose malignant GIST, which is a common and preferred screening method.
ObjectiveTo explore the diagnostic value of sonography in thyroid imaging reporting and data system (TI-RADS) for thyroid nodules. MethodsA total of 292 patients (423 nodules) underwent thyroid examination with high frequency ultrasound. The results were retrospectively compared with histopathological diagnosis and TI-RADS lexicon. ResultsThe category 1-5 of 423 thyroid nodules were evaluated by using TI-RADS, and it’s frequency of being malignancy rate was 0(0/129), 6.3%(11/176), 33.3%(10/30), 86.8%(46/53), and 100% (35/35), respectively. The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value for benign thyroid nodule of ultrasound in TI-RADS was 96.3%（309/321）, 83.3%（85/102）, 93.1%（394/423）, 94.8%（309/326）, and 87.6%（85/97）, respectively. Positive likelihood ratio, negative likelihood ratio, and Youden’ index was 5.77, 0.04, and 79.6%, respectively. The benign and malignancy nodule of TI-RADS category were statistically difference in shape, margin, echogenicity, echotexture, composition, and calcification inside the nodule (Plt;0.001). ConclusionsTI-RADS lexicon has an important guiding value for clinical diagnosis and treatment in ultrasound examination of thyroid nodule.
ObjectiveTo evaluate the value of preoperative risk assessment of papillary thyroid carcinoma with ultrasound for clinic diagnosis and treatment.MethodsThe data of 400 patients with papillary thyroid carcinoma received operative treatment in 2017 were retrospectively analyzed. Recorded and analyzed the ultrasonic risk assessment and postoperative grading of clinic risk assessment, to evaluate coherence and correlation between them.ResultsThere were 400 lesions with an average size of (12.8±8.5) mm. Among 400 lesions, diameter of 214 lesions less than 10 mm, diameter of 178 lesions were between 10 mm and 40 mm, and diameter of 8 lesions were larger than 40 mm. A total of 242 cases had lymph node metastasis and 309 cases had capsule invasion. Clinical and ultrasoud risk assessment was performed on 400 lesions. There were 224 lesions with low risk of clinical risk stratification vs. 111 lesions with low ultrasonic risk, 148 lesions with intermediate risk of clinical risk stratification vs. 270 lesions with intermediate ultrasonic risk, and 28 lesions with high risk of clinical risk stratification vs. 19 lesions with high ultrasonic risk. The consistency of postoperative recurrence risk stratification and preoperative ultrasound recurrence risk stratification was moderate (κ=0.414, P<0.01). In addition, the consistency between ultrasound examination and clinical lymph node metastasis was poor (κ=0.291, P<0.05), and the consistency of invasion of the capsule was moderate (κ=0.402, P<0.05).ConclusionPre- operative evaluation of recurrence risk grading before thyroid ultrasound, focusing on individualized preoperative assessment, the assessment is more detailed and detailed, and is helpful for follow-up treatment and early screening for recurrence risk.