【摘要】 目的 探討急診超聲在右下腹急腹癥診斷中的應用價值。 方法 回顧性分析2008年8月-2009年12月150例右下腹急腹癥患者急診超聲檢查結果，所有患者均經手術和病理資料或者臨床治療后得到證實，將超聲診斷的結果與臨床出院診斷進行對比分析。 結果 150例右下腹急腹癥患者中，超聲正確診斷126例（84%），漏診18例，誤診6例，其中急性闌尾炎漏診率最高，漏診的主要原因為部分患者闌尾解剖位置特殊或者腸道氣體干擾。 結論 超聲檢查能夠較準確判斷右下腹急腹癥的病因。熟悉常見急腹癥疾病的臨床表現、體征及熟練掌握常見疾病的超聲聲像圖特點，對右下腹急腹癥的診斷及鑒別診斷至關重要。【Abstract】 Objective To evaluate acute ultrasonography in diagnosing right hypogastric acute abdomen. Methods The results of acute ultrasonography of 150 patients with right hypogastric acute abdomen were retrospectively analyzed. The disease was confirmed by surgery and pathological examination. The results of ultrasonography and clinical diagnosis were compared. Results Among 150 patients, correct ultrasonography diagnosis was found in 126 (84%), missed diagnosis in 18, and misdiagnosis in six; the highest rate of missed diagnosis occurred in patients with acute appendicitis. Conclusion Acute ultrasonography can feasibly and accurately diagnose right hypogastric acute abdomen. The accuracy depends on the common clinical manifestations and the common diseases ultrasonography characters of right hypogastric acute abdomen.
【摘要】 目的 探討胃腸道間質瘤(GIST)彩色多普勒超聲表現及其在診斷中的應用價值。 方法 回顧性分析2008年1月-2010年7月75例經病理證實的GIST的彩色多普勒超聲聲像圖表現，將其與手術病理結果進行對比分析。 結果 GIST患者中男性高危險度腫瘤的比例較女性高（χ2=7.210，Plt;0.01）。腫瘤的大小、內部回聲與其病理危險度高低有關:危險度低者、腫瘤最大徑lt;5 cm，內部回聲較均勻；危險度高者，腫瘤最大徑≥5 cm，內部回聲不均勻。腫瘤的彩色血流分布與其危險度高低無明顯相關。常規的超聲檢查對腫瘤檢出率較高，在胃及直腸的GIST診斷準確率高于其他部位的GIST。 結論 彩色多普勒超聲檢查有助于GIST的定位及分化程度的判斷，可作為首選檢查方法。【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.
Crohn’s disease (CD) is one of inflammatory bowel diseases, characterized by lifelong relapsing-remitting clinical course. The choice of treatment protocols is based on the comprehensive evaluation of the disease. And the treatment protocols should be adjusted according to the response to the treatment and the drug tolerance. Repeated assessment of the activity of intestinal inflammation is very necessary. Each of endoscopy, Crohn’s Disease Activity Index, CT, magnetic resonance enterography, and ultrasonography (US) has its own disadvantages. US is widely used in clinical practice because of its no radiation, convenience, low cost, and high degree of patient tolerance. The two-dimensional ultrasound, Doppler ultrasound, elastosonography, and contrast-enhanced ultrasonography each provides some effective parameters for evaluation of CD activity. Some parameters are of high value, such as bowl wall thichness, bowl wall stratification, color Doppler signal, strain ratio, and relative enhancement, etc. The values of some parameters are disputed, such as the blood flow of superior mesenteric artery, time to peak, etc. Some studies combine several ultrasound parameters and calculate their respective weights to obtain an ultrasound scoring method. US, as a valid tool to evaluate CD activity, provides valuable help in solving clinical problems such as evaluation of therapeutic effect, mucosal healing, and postoperative recurrence.
Objective To explore the sonographic features of testicular torsion in adult males (≥25 years). Method We retrospectively analyzed the clinical, pathological and sonographic data of 79 adult male patients with testicular torsion, in whom 20 underwent resection of testis and 59 retained testis in West China Hospital from September 2006 to March 2017. Results There were 56 patients with spermatic cord nodules or mass with the largest mass of about 36 mm ×31 mm; the scrotal wall thickened in 48 patients with the thickness of 5–10 mm; axial changes of the affected testis were found in 24 patients; there were 61 patients with testicular growth in the affected side, while the affected testis was reduced in 7; there were 67 patients with asymmetric echo in the affected side, and the maximum hypoechoic area was about 36 mm×26 mm; the epididymis of the affected side in 35 patients with were unclear, and the epididymis of the affected side was enlarged in 19; 25 patients had hydrocele of testis; there was no blood flow in 49, blood flow reduced in 25, and blood flow increased in 5. Four patients were diagnosed by contrast-enhanced ultrasound, and there was no enhancement in 3 and partial enhancement in 1. Conclusion The sonographic features of testicular torsion in adult males are obvious, and the early diagnosis of testicular torsion can be confirmed by contrast-enhanced ultrasonography.
【摘要】 目的 比較腸充盈超聲檢查法與常規經腹超聲檢查法在結直腸腫瘤中的診斷價值。 方法 對2008年6月-2009年6月64例經臨床病理確診的結直腸腫瘤患者分別經腹常規超聲及腸充盈超聲檢查。在腸充盈狀態下觀察病變的形態，對病變進行定位并觀察結直腸腫瘤的彩色多普勒血流信號。比較腸充盈超聲檢查法及常規經腹超聲檢查法在結直腸腫瘤的檢出、定位和顯示血流的能力的差異。 結果 常規經腹部超聲檢查發現32例結直腸腫瘤（32/64），病灶敏感性為50%； 腸充盈超聲檢查法發現病灶55例（55/64）， 病灶敏感性為85.9%。經腹常規超聲檢查的定位準確率為21.9%（7/32），腸充盈超聲檢查法對結直腸腫瘤的定位準確率為89.1%（49/55）。兩種方法比較差異有統計學的意義（Plt;0.05）。 結論 腸充盈超聲檢查法在結直腸腫瘤的病變敏感性檢出、定位準確性等方面優于經腹常規超聲檢查；而不同病理類型的結直腸腫瘤具有不同的超聲聲像圖特征。【Abstract】 Objective To compare the diagnostic value between intraluminal contrast-enhanced hydrocolon ultrasonography and conventional transabdominal ultrasonography for of colorectal neoplasms. Methods The conventional transabdominal ultrasonography and hydrocolonic ultrasonography using an intraluminal contrast agent were performed on 62 patients from June 2008 to June 2009. The morphological features and location of the lesion were observed and the blood flow signals were observed. The different diagnostic value between conventional transabdominal ultrasonography and intraluminal contrast-enhanced hydrocolon ultrasonography was compared. Results The sensitivity of the intraluminal contrast-enhanced hydrocolon ultrasonography in the depiction of the colorectal neoplasms (55/64, 85.9%) was higher than that of the conventional transabdominal ultrasonography (32/64, 50%, Plt;0.05). And the accuracy of the intraluminal contrast-enhanced hydrocolon ultrasonography in locating the colorectal neoplasms (48/55, 87.3%) was higher than that of the conventional transabdominal ultrasonography (7/32, 53.2%, Plt;0.05). Conclusion Intraluminal contrast-enhanced hydrocolon ultrasonography is more valuable for colorectal neoplasms than conventional transabdominal ultrasonography in detecting and locating colorectal neoplasms. Colorectal neoplasms with different pathological types may have different ultrasonic features.
Objective To explore the feasibility of transluminal dual plane ultrasound (TDPU) in evaluating the structure and function of pelvic floor muscle. Methods Non anorectal diseases patients who visited the Department of Medical Ultrasound, West China Hospital of Sichuan University, medical staff and medical staff’s relatives volunteers between May and November 2022 were selected. According to the criteria for ultrasound diagnosis of pelvic organ prolapse (POP) and the pelvic organ prolapse quantification (POP-Q) scoring criteria, the subjects were divided into normal group and POP group. The changes of the thickness of the left and right puborectalis muscle (PRM), the internal anal sphincter (IAS) and the external anal sphincter (EAS) at 3-, 6- and 9-o’clock, the depth and height of the perineal body (PB) were compared, and the changes of the elastic Young’s modulus of PRM, EAS and PB were compared through real-time shear wave elastography. Results A total of 192 subjects were included, including 140 in the normal group and 52 in the POP group. There were statistically significant differences between the POP group and the normal group in terms of gestational frequency, parity, and history of vaginal delivery (P<0.05). There was no statistically significant difference in age, body mass index, menopausal history, and neonatal weight between the two groups (P>0.05). Under the condition of resting and maximum anal constriction, the thickness of PRM on the left and right sides of POP group was not significantly different from that of the normal group (P>0.05), but the elastic Young’s modulus of PRM on the left and right sides were lower than that of the normal group (P<0.05). At resting and maximum anal constriction, there was no significant difference in IAS thickness between the POP group and the normal group at 3-, 6- and 9-o’clock (P>0.05). At resting and maximum anal constriction, the thickness of deep and subcutaneous parts of EAS at 6-o’clock and the subcutaneous part of EAS at 9-o’clock in the POP group were smaller than those in the normal group (P<0.05). At resting and maximum anal constriction, the elastic Young’s modulus of EAS at 3-, 6- and 9-o’clock were lower than those in the normal group (P<0.05). There was no significant difference in the depth and height of PB between the POP group and the normal group at resting and maximum anal constriction (P>0.05). The elastic Young’s modulus of PB in the POP group was lower than that of the normal group (P<0.05). Under the condition of maximum anal constriction, the thickness of deep and subcutaneous parts of EAS at 3-o’clock in the POP group were lower than those in the normal group (P<0.05). Conclusion TDPU can quantitatively evaluate the structure and function of pelvic floor muscle through different states of resting and maximum anal constriction, and also can provide ultrasonic basis for the diagnosis and treatment of female pelvic floor dysfunction diseases.
ObjectiveTo investigate the main influence factors of microbubble-enhanced sono-thrombolysis by an orthogonal array experimental design (OAD) and to confirm the optimal parameters of microbubble-enhanced sono-thrombolysis in vitro. Methods The peripheral blood was collected from 50 female Sprague Dawley rats to prepare the standard plasma, and then 100 μL standard plasma and 25 μL thrombin (0.15 U/μL) were mixed and incubated in 37℃ water bath for 3, 6, 12, and 24 hours respectively to prepare corresponding standardized thrombus. The physical parameters for the designed experiments included transmit powers of ultrasound (factor A: 5%, 25%, 50%, and 100%), microbubble volume (factor B: 50, 100, 200, and 400 μL), urokinase (UK) concentration (factor C: 100, 200, 400, and 800 U/mL), and thrombolysis time (factor D: 10, 20, 30, and 40 minutes), respectively. Then an OAD based on four parameters and four levels [L16(45)] was employed to optimize the thrombolysis conditions. The ultrasound frequency was 1.82 MHz. HE staining and scanning electron microscope (SEM) were used to observe the clots before and after thrombolysis. The thrombolysis rate was measured. ResultsHE staining and SEM observation showed that the fibrin was dissolved after thrombolysis. According to the OAD, the optimal parameter combination was C4-D4-A1-B4, indicating UK concentration 800 U/mL, thrombolysis time 40 minutes, transmit power of ultrasound 5%, and microbubble volume 400 μL, respectively. The four factors above had significant influence on thrombolysis (P lt; 0.05), and UK concentration was the most significant. There were significant differences in thrombolysis between different thrombolysis time (P lt; 0.05). ConclusionUnder the condition of fixed ultrasound frequency, microbubble-enhanced sono-thrombolysis efficiency is better in lower transmit power of ultrasound, higher UK concentration, longer thrombolysis time, higher microbubble volume, and shorter thrombolysis time
Transrectal contrast-enhanced ultrasound (CEUS) is an important examination for rectal tumors. The inhomogeneity of the CEUS images has important clinical significance. However, there is no objective method to evaluate this index. In this study, a method based on gray-level co-occurrence matrix (GLCM) is proposed to extract texture features of images and grade these images according the inhomogeneity. Specific processes include compressing the gray level of the image, calculating the texture statistics of gray level co-occurrence matrix, combining feature selection and principal component analysis (PCA) for dimensionality reduction, and training and validating quadratic discriminant analysis (QDA). After ten cross-validation, the overall accuracy rate of machine classification was 87.01%, and the accuracy of each level was as follows: Grade Ⅰ 52.94%, Grade Ⅱ 96.48% and Grade Ⅲ 92.35% respectively. The proposed method has high accuracy in judging grade Ⅱ and Ⅲ images, which can help to identify the grade of inhomogeneity of contrast-enhanced ultrasound images of rectal tumors, and may be used to assist clinical doctors in judging the grade of inhomogeneity of contrast-enhanced ultrasound of rectal tumors.