ObjectiveTo evaluate the clinical application of percutaneous injection of hemostatic agents guided by ultrasound for arresting active hemorrhage after renal biopsy. MethodsFrom January 2019 to December 2022, 10 cases of active hemorrhage after renal biopsy on ultrasound were retrospectively examined. Hemorrhage continued despite simple compression and it was treated by a percutaneous injection of hemostatic agents under ultrasonic guidance. Then hemostatic outcomes were also evaluated by ultrasound. ResultsUltrasound could detect the hemorrhagic site to enable an accurate injection of hemostatic agents. After injection, there was no active hemorrhage. ConclusionsPercutaneous injection of hemostatic drugs guided by ultrasound for arresting active hemorrhage after renal biopsy offer the advantages of rapid, accurate, effective, simple, repeatable and non-radioactive. This technique is a novel alternative for bedside immediate management of active hemorrhage after renal biopsy. At the same time, considering the safety of two kinds of hemostatic agents, hemocoagulase may be preferentially selected for local hemostasis of active hemorrhage after renal biopsy. When hemocoagulase fails to control active hemorrhage, thrombin can be replaced for hemostasis.

Background We summarized the clinical and liver histopathological features of patients with liver injury of unknown origin. We aimed to assess the value of ultrasound-guided percutaneous liver biopsy in diagnosing liver injury of unknown origin. Methods We analyzed the clinical data and ultrasound-guided percutaneous liver biopsy results of 94 patients admitted to Zhongshan Hospital of Xiamen University from January 2018 to February 2023. Results Among the 94 patients, 37 were males and 57 were females, the ratio of males to females was about 2:3, and the average age was (52.7±12.6) years. Most of the patients presented with fatigue, pruritus, jaundice, abdominal distension, and poor appetite, while 33 patients (35.1%) were admitted due to abnormal liver function or cirrhosis. All patients underwent ultrasound-guided percutaneous liver biopsy, which led to a clinical diagnosis in 90 patients (95.7%). 43 cases (45.7%) of autoimmune liver disease (AILD), including 23 cases (24.5%) were primary biliary cholangitis (PBC), 3 cases (3.2%) were autoimmune hepatitis (AIH),14 cases (14.9%) were PBC-AIH overlap syndrome(PBC-AIH OS) and 3 cases (3.2%) were IgG4-associated liver disease. 21 cases (22.3%) of metabolic-associated fatty liver disease (MAFLD),15 cases (16.0%) of drug-induced liver injury (DILI), 6 cases (6.4%) of alcoholic liver disease (ALD), 1 case (1.1%) of AIH combined with MAFLD, hemochromatosis in 1 case (1.1%), Budd-Chiari syndrome (BSC) in 1 case (1.1%), and congenital hepatic fibrosis (CHF) in 1 case (1.1%), 1 case (1.1%) with idiopathic noncirrhotic portal hypertension(INCPH) and 4 cases (4.3%) were still with undetermined etiology. Conclusions AILD, MAFLD and DILI are the most common causes in patients with unknown causes of liver injury. Ultrasound-guided percutaneous liver biopsy plays an important role in defining the cause of unexplained liver injury.

目的 观察男性乳腺癌超声及临床病理学表现.方法 纳入30例男性乳腺癌患者,观察其超声及临床病理学表现;根据有无淋巴结转移分为阳性组和阴性组并进行比较.结果 24例表现为单侧乳腺乳头周围无痛性肿物(24/30,80.00％),可伴腋下肿物、乳晕及周围皮肤红肿破溃或乳头溢液;病理类型以浸润性导管癌(IDC)为主(22/30,73.33％).30例中,28例超声检出乳腺病灶(28/30,93.33％),多表现为形态不规则(25/28,89.29％)的低回声(24/28,85.71％)肿物,边缘多不光整(22/28,78.57％),内部回声多不均(22/28,78.57％),血流多较丰富,少见钙化(5/28,17.86％)或后方回声衰减(2/28,7.14％).超声检出16例腋窝或锁骨上、下淋巴结肿大,均经病理证实为淋巴结转移(阳性组);12例未见淋巴结肿大(阴性组);组间仅乳腺肿物最大径差异有统计学意义(P＜0.05).雌激素受体(ER)和孕激素受体(PR)阳性率均为95.65％(22/23).结论 男性乳腺癌临床多表现为单侧乳腺乳头周围无痛性肿物;超声多呈形态不规则的低回声肿物,边缘多不光整,内部回声不均,血流多较丰富;病理类型以IDC为主,ER、PR阳性率高而人表皮生长因子受体2(HER-2)阳性率甚低,过半呈Ki-67高表达.

目的 比较美国放射学会甲状腺影像报告与数据系统(ACR-TIRADS)与欧洲甲状腺影像报告与数据系统(EU-TIRADS)指南对甲状腺良、恶性结节的诊断价值及其细针穿刺细胞学(FNA)指征的临床应用价值.资料与方法 回顾性分析经FNA或手术病理证实的582例患者661个甲状腺结节,其中良性结节304个,恶性结节357个.所有结节进行ACR-TIRADS及EU-TIRADS分类.通过构建受试者工作特征曲线,比较ACR-TIRADS及EU-TIRADS对甲状腺结节的诊断效能;比较2个指南中推荐的FNA截断值的临床意义.结果 ACR-TIRADS分类的甲状腺结节恶性风险为:2类7.5％(5/66),3类10.4％(7/67),4类39.7％(66/166),5类79.0％(279/353);EU-TIRADS为:3类9.7％(12/124),4类22.9％(19/83),5类73.4％(326/444).ACR-TIRADS及EU-TIRADS判断甲状腺结节良恶性的敏感度、特异度、准确率、阳性预测值及阴性预测值分别为78.2％、75.7％、77.0％、79.0％、74.7％及91.3％、61.2％、77.4％、73.4％、85.7％.ACR-TIRADS推荐的FNA截断值对甲状腺结节处理的特异度高于EU-TIRADS(58.2％比26.6％,χ2=92.092,P<0.001),而敏感度低于EU-TIRADS(61.9％比95.2％,χ2=113.203,P<0.001).结论 ACR-TIRADS及EU-TIRADS对甲状腺结节均具有较高的诊断效能,ACR-TIRADS的诊断特异度较高,而EU-TIRADS的诊断敏感度较高;两个指南中推荐的FNA截断值具有不同的临床意义.

Purpose To assess a cutoff value and the diagnosis performance of CT in fine-needle aspirate washout fluid (FNA-CT) and serum in consecutive patients with thyroid nodules by chemiluminescence immunoassay method (CLIA).Methods 1,941 healthy persons, 212 patients with 235 thyroid nodules were investigated. They were classified into were classified into healthy, nodular goiter, chronic thyroiditis, thyroid follicular neoplasm, papillary thyroid carcinoma, follicular thyroid carcinoma and medullary thyroid carcinoma. Serum CT and FNA-CT were measured by CLIA.Results Serum CT median concentration in MTC was 301.0 pg/mL, significantly higher than other groups. The cutoff value of serum CT was 13.8 pg/mL, leading 100.00% sensitivity, 97.99% specificity and 0.86 Kappa value in MTC. The FNA-CT median concentration in MTC nodules was 5000.0 pg/mL, significantly higher than other groups. A receiver operating characteristic analysis of MTC nodules and non-MTC nodules indicated that the cutoff value was 91.6pg/mL, leading to 100.00% sensitivity, 97.25% specificity and 0.84 Kappa value.Conclusion FNA-CT and serum were perfect marker for the differential diagnosis of medullary thyroid carcinoma in patients with thyroid nodules. The optimal cutoff values with CLIA were 13.8 pg/mL and 91.6pg/mL, respectively.

目的:观察超声引导下射频消融治疗甲状腺良性结节效果.方法:选取笔者所在医院甲状腺良性结节患者82例(2017年8月-2018年11月),随机分为甲状腺切除术治疗的对照组(41例)与超声引导下射频消融术治疗的观察组(41例),观察患者手术情况、甲状腺功能及并发症发生率.结果:与对照组相比,观察组手术时间、出血量、住院时间少,甲状腺功能各指标较优,并发症发生率低,差异均有统计学意义(P＜0.05).结论:在甲状腺良性结节患者治疗中,给予患者超声引导下射频消融术治疗,能减少手术时间及出血量,改善甲状腺功能,降低并发症发生率,促进术后身体康复,减少住院时间,取得了较好的治疗效果,值得借鉴.

目的 探讨超声造影联合经皮射频消融(RFA)在肝癌破裂出血治疗中的应用价值.方法 回顾分析2013年9月至2019年3月在厦门大学附属中山医院经超声造影引导下急诊行经皮射频消融止血治疗的31个肝癌破裂出血病灶,其中6个病灶为肝癌在经皮穿刺活检出现沿穿刺针道出血,导致腹腔血性积液;25个病灶为肝癌自发破裂出血,31个病灶均在射频消融前通过超声造影检查证实存在肝癌破裂活动性出血征象,并确定出血部位,随即在超声引导下经皮射频消融止血治疗,术后超声造影即刻评价止血效果.结果 31个病灶在射频消融术前通过超声造影均能确定出血部位,并能准确引导射频针至出血点,达到精准射频消融止血目的.术后利用超声造影即刻评估止血效果,所有病灶有效止血.结论 超声造影与经皮射频消融两种方法的联合,在肝癌破裂出血的止血治疗中具有快速、有效、微创、简便、可重复性的优点,并能即刻评价止血效果,射频消融止血同时还可达到减少癌细胞活性的治疗效果.

Objective: To investigate the release of progastrin-releasing peptide (ProGRP) in patients with thyroid nodules and the value of ProGRP in fine-needle aspirate washout fluid (FNA-ProGRP) in the differential diagnosis between medullary thyroid carcinoma (MTC) and non-MTC thyroid nodules. Methods: We investigated 2,446 healthy persons and 212 patients with 235 thyroid nodules. They were classified into healthy, nodular goiter, chronic thyroiditis, thyroid follicular neoplasm, papillary thyroid carcinoma, follicular thyroid carcinoma, and medullary thyroid carcinoma. The serum ProGRP and FNA-ProGRP were measured. Results: The serum ProGRP median concentration in MTC was 124.40 pg/mL, significantly higher than in other groups. The cutoff value of serum ProGRP was 68.30 pg/mL, leading to 53.85% sensitivity, 96.98% specificity, and 0.51 kappa value in MTC. The FNA-ProGRP median concentration in MTC nodules was 2,096.00 pg/mL, significantly higher than in other groups. A receiver operating characteristic analysis of MTC nodules and non-MTC nodules indicated that the cutoff value was 22.77 pg/mL, leading to 94.12% sensitivity, 98.27% specificity, and 0.85 kappa value. Conclusion: FNA-ProGRP measurement could be served as an ancillary method for the differential diagnosis between MTC and non-MTC thyroid nodules. Abbreviations: CEA = carcinoembryonic antigen; CT = calcitonin; FNAC = fine-needle aspiration cytology; FNA-CT = calcitonin in fine-needle aspirate washout fluid; FNA-ProGRP = ProGRP in fine-needle aspirate washout fluid; MTC = medullary thyroid carcinoma; ProGRP = progastrin-releasing peptide; SCLC = small-cell lung cancer; TM = tumor marker

目的 分析脾脏硬化性血管瘤样结节性转化(SANT)的超声表现.方法 对经手术病理证实的8例SANT患者的声像图进行回顾性分析,观察病灶部位,大小、形态、边界、内部回声以及血流分布等情况,并与大体及镜下病理表现进行对照研究.结果 本组8例脾脏SANT,共观察9个病灶,其中7个呈外生性生长;病灶多呈类圆形,平均最大径(5.48士1.69)cm,边界尚清晰.病灶呈等或偏低回声,内部可见数量不等的条状或小片状高回声,多乏血供,未见明显囊性变或钙化.脾脏SANT病理表现为边界清楚的病灶,内可见纤维硬化组织包绕、分隔血管瘤样结节.结论 脾脏SANT声像图表现具有一定特征.

目的 探讨彩色多普勒超声在诊断大腿肌层肿块中的应用价值.方法 将30例大腿肌层肿块的超声表现与病理结果比对,进行回顾性分析.结果 大腿肌层肿块中恶性肿瘤8例(26.7％),包含黏液性纤维肉瘤、黏液性脂肪肉瘤、腺泡状软组织肉瘤、未分化多形性纤维组织细胞瘤和恶性孤立性纤维性肿瘤;良性肿瘤18例(60.0％),包含脂肪瘤、神经鞘瘤、血管瘤、血管脂肪瘤和黏液瘤;肿瘤样病变4例(13.3％),包含肌肉脓肿、骨化性肌炎、结节性筋膜炎.超声诊断大腿肌层肿块的总符合率为53.3％ (16/30),其中,良性肿瘤符合率(72.2％),高于恶性肿瘤符合率(12.5％)及肿瘤样病变符合率(50％).结论 大腿肌层良恶性肿瘤及肿瘤样病变的超声声像图有一定特征,能够为临床诊治提供有价值的参考.

胎儿泌尿系畸形是常见的一种先天性畸形,发生率为1/600～1/800[1],而胎儿泌尿道扩张占胎儿泌尿系畸形相当比率,有的出生后需手术治疗,有的影响双肾功能愈后极差.正确认识胎儿泌尿道扩张声像表现,对临床产前咨询、愈后评估、是否终止妊娠将提供有力依据.本文总结了14例胎儿异常泌尿道扩张产前超声表现,现报道如下.

Objective To evaluate the efficiency of contrast-enhanced ultrasound( CEUS) in the diagnosis of focal liver lesions( FLL) . Methods 68 patients with 74 FLLs underwent and the result was analyzed retrospectively. The contrast agent used was SonoVue( Bracco,Italy) . The lesions were confirmed by histopathology or other imaging method. Results The diagnostic accuracy of CEUS in identifying malignant FLLs was 97. 92% . The diagnostic sensitivity of CEUS for the nodules smaller than 10 mm in diameter was 95. 97% . Conclusion CEUS is a convenient,safe,noninvasive,comparatively inexpensive and effective method for diagnosis of focal liver lesions.

Objectives To investigate the role of routine follow-up urine cyfra21-1 detecting combined with ultrasonography in detection of recurrence in postoperative bladder transitional cell carcinoma patients.Methods Sixty seven patients under surveillance after reserved bladder operations were recruited from February 2004 to December 2006. Standard ECLIA was used to determine the concentration of urine cyfra21-1. Ultrasonography and cystoscopy were all performed several days thereafter. Cystoscopic biopsy findings were the golden standard for the detection of recurrence of bladder cancer.Results Twenty one patients were detected recurrent tumors by cystoscopic biopsy(31.3%). While 23 patients were positive by urine cyfra21-1 detecting, and 19 cases positive by ultrasonography. Combining urine cyfra21-1 measuring with ultrasonography, the positive cases rose to 26(38.8%), and only one case (4.76%) was omitted.Conclusions Routine follow-up cystoscopy may be partially replaced by urine cyfra21-1 detecting combined with ultrasonography to monitor the recurrence of bladder transitional cell carcinoma.

目的 探讨应用对比脉冲序列(CPS)超声造影成像技术评价PEI治疗疗效的价值.方法 在47例原发性肝癌(HCC)病人PEI治疗后,采用超声造影剂声诺维(SonoVue)、Acuson Sequior 512超声仪和CPS实时造影成像技术进行超声造影显像,观察病灶的血流灌注,并与常规彩超及增强CT进行对照,超声检查后随访半年以上.结果 应用CPS实时造影成像技术,本组的64个病灶PEI治疗后肝肿瘤灭活诊断正确率96.8%,与增强CT检查结果相同,明显高于常规彩超的64.1%.结论 超声造影能于PEI治疗后判断肿瘤坏死情况,可望成为评价肝癌PEI治疗疗效的可靠方法.

Objective To investigate the value of real-time contrast-enhanced ultrasonography in the assessment of the efficacy on ultrasound-guided intralesional treatment of hepatomas.Methods Thirty-two patients with 39 lesions submitted to ultrasound-guided intralesional treatment underwent both real-time SonoVue-enhanced ultrasonography and enhanced CT scan.The ultimate diagnosis were regarded as the standard in determining the efficacy of real-time contrast-enhanced ultrasonography.Results Ehancement were both detected in 14 lesions by real-time contrast-enhanced ultrasonography and enhanced CT scans,but 4 lesions by the routine color Doppler ultrasonography.The sensitivity and accuracy of the routine color-Doppler ultrasonography were obviously lower than those of the real-time contrast-enhanced ultrasonography.Conclusions Real-time contrast-enhanced ultrasonography may be an effective and reliable method for assessing ultrasound-guided intralesional treatment.

Purpose: To evaluate the value of transrectal ultrasound (TRUS) guided biopsy of prostate in detecting prostate tumors. Materials and Methods: TRUS guided biopsy was conducted in 36 patients with elevated PSA, or an abnormal finding on DRE or TRUS. Results: The biopsy at suspicious area confirmed 19 cases of prostate cancer, and 17 benign prostate hyperplasia . Conclusion: TRUS guided biopsy was an effective method for diagnosing prostate cancer.