目的 探討內鏡逆行胰膽管造影(ERCP)檢查及內鏡治療在腹腔鏡膽囊切除(LC)術前、術后的應用價值。 方法 對61例擬行LC的患者術前或術后行ERCP檢查，發現異常再行內鏡治療。結果 LC術前行ERCP者42例中39例顯影，其中37例伴有其他膽管疾病，占94.9%。術后行ERCP者19例均顯影，總的插管成功率為95.1%。LC術前或術后42例行EST治療，4例行EPBD，2例行ERBD，15例行ENBD，另4例在行ERCP檢查后改開腹手術，取石成功率為92.9%。結論 診治性ERCP在LC前、后的應用，對進一步明確診斷、選擇手術方式、預防LC的并發癥和提高LC的成功率具有重要價值。
ObjectiveTo evaluate the diagnostic value of contrast enhanced ultrasound (CEUS) to the sentinel lymph node (SLN) of breast cancer. MethodsSeventy-two operable breast cancer patients with clinically negative axillary lymph node were enrolled.Sulphur hexafluoride microbubbles for injection (SonoVue) was used alone as the tracer agent for the sentinel lymph node biopsy (SLNB), and axillary dissection was performed after the methylene blue location.All SLNs were examined pathologically with HE staining.The SLN diagnosis result of contrast enhanced ultrasound and postoperative pathological examination result were comparative analyzed. ResultsAfter the injection of SonoVue can obtain a clear image of the lymphatic vessels and SLN.The success rate of CEUS imaging was 84.72% (61/72) in this group of 72 patients, and the false negative rate was 12.12% (4/33).The sensitivity and specificity of diagnosis by CEUS was 92.50% (37/40) and 92.59% (50/54), respectively, the diagnostic odds ratio (DOR) was 154.17.By the pathology results as the gold standard, the internal consistency of these two methods was good (Kappa value=0.848, P < 0.01). ConclusionCEUS may be a useful orientation and determination method for SLNs.
The ability of quickscan(QS)to assess haemodynamically significant lesions in the iliac and femoro-popliteal arteries was studied.Quickscan was prospectively and independently compared to intra-arterial digital subtraction angiography(IADSA)of the iliac and femoro-popliteal arteries.In 176 patients 757 arterial segments were evaluated.A QS frequency ratio of 1:3 or greater had a sensitivity of 88%,a specificity of 94% and accuracy of 92% in detecting stenosisgt;5O% diameter(67% area)reduction as shown on IADSA.In the detection of occlusion,QS had a sensitivity of 91%,specificity of 95% and accuracy of 94%.There was significant correlation between area reduction found by QS and the calf/brachial pressure index(CBI)(r=-0.77,Plt;0.01).Thirty-seven patients underwent an angioplasty based on QS finding alone.All 37 were successful.The authors conclude that quickscan can provide an inexpensive,quick and non-invasive screening technique for the routine initial assessment of peripheral vascular disease.The results indicate that an agreement with angiography which is as good as duplex scanning.It has potential to replace angiography for workup prior to surgical or catheter intervention,in the assessment of the success of the procedure and its continuing follow-up.