患者女,38岁,因“发现左乳肿块7个月,迅速增大伴皮肤破溃1月余”就诊.查体:双侧乳腺不对称,右乳发育良好,左乳形态失常,体积明显增大,表面可见约5 cm×5 cm皮肤破溃,左乳内可触及约20 cm×15 cm质硬肿块,活动度差;双腋下及左锁骨上窝可触及类圆形肿大淋巴结.超声检查:左乳见巨大隆起性包块,大小无法测量,包块实质呈低回声,内回声不均,边界尚清,局部呈分叶状,无钙化(图1A);CDFI示包块内血流信号Ⅱ～Ⅲ级(图1B);双腋下及左锁骨上窝可见多个类圆形淋巴结样回声,最大者1.7 cm×1.2 am.

肝内胆管错构瘤无明显的临床症状,在常规超声检查中很容易漏诊误诊,了解该病的各种超声特点,有助于提高超声对该病诊断的准确性,减低误诊率.本文对超声易误诊肝内胆管错构瘤一例进行研究分析.

糖尿病足是糖尿病治疗的难题之一,是糖尿病患者下肢截肢致残的主要原因[1]。许多糖尿病患者初诊后是有较长的存活期的[2],案例报道和流行病学调查分析显示糖尿病与跟腱断裂是有明显关系的[3],糖尿病导致的下肢综合征与糖尿病发病率和致死率有显著的相关性[2],预防糖尿病下肢的病变是糖尿病患者晚期生活质量明显改善的关键之一,所以对糖尿病患者下肢早期异常改变的发现是至关重要的,可以极大程度上改善糖尿病患者后期的生

目的:探讨颈动脉和下肢动脉粥样硬化(AS)的超声检查结果及其危险因素,阐明各危险因素对不同部位AS的作用程度.方法:选择颈动脉及下肢动脉彩色多普勒超声检查的受检者366名,根据超声影像学结果将其分为健康组(n=133)、单纯颈动脉硬化组(CAD组,n=42)、单纯下肢动脉硬化组(PAD组,n=69)和颈动脉硬化并发下肢动脉硬化组(CAD+ PAD组,n=122).分析各组受检者的性别、年龄、吸烟史、饮酒史、高血压(HBP)、糖尿病(DM)史、高血脂和体质量指数(BMI)等危险因素,并对下肢动脉硬化斑块形成危险因素进行Logistic回归分析.结果:受检者中颈动脉斑块的检出率为44.8％ (164/366),下肢动脉硬化的检出率为52.1％ (191/366).与健康组比较,PAD组和CAD+ PAD组受检者的年龄、吸烟率、HBP检出率及高血糖的检出率升高(P＜0.05).与CAD组比较,PAD组和CAD+ PAD组受检者吸烟率及DM检出率均升高(P＜0.01).Logistic回归分析,男性、高龄(45～59、60～74、≥75岁)、吸烟和高血糖是下肢动脉硬化的危险因素(OR=2.520,OR=3.056,OR=6.895,OR=29.483,OR=4.136,OR=3.736,P＜0.001).结论:AS的形成是多重因素共同作用的结果,高龄、吸烟和高血糖是AS斑块形成的重要危险因素,其中吸烟和高血糖者下肢AS的发病率明显高于颈动脉.

动脉粥样硬化（atherosclerosis,AS）是心脑血管疾病的主要病因之一。超声检查是一种无创、经济、快捷的方法。通过颈动脉超声检测颈动脉内膜中层厚度（intima-media thickness,IMT）及观察颈部斑块形态目前研究较多,但对动脉硬化与锁骨下动脉的关系研究较少。本研究对随机人群锁骨下动脉进行筛查,旨在探讨锁骨下动脉粥样硬化常累及的部位,同时探讨锁骨下动脉粥样硬化斑块发生的危险因素。

Objective To determine the degree of volume reduction of major arteries of lower extremities with the three-dimensional ultrasound volume method and to compare the measuring results of clinical stage,ankle-brachial index(ABI)and transcutaneous oxygen pressure(TcPO2)of arterial ischemic disease,and to explore its clinical value.Methods 60patients(March 2011-February 2012,with ultrasound examination in our hospital,unilateral limb,total of 60arteries,without ipsilateral iliac artery stenosis or occlusion)with arterial sclerosis obstruction(ASO)were selected and the vascular volumes of the selected arteries segments were measured with GI3DQ technique,then the reduction degree of overall volume of narrow lower extremity arteries was calculated.According the results of the calculation,the patients were divided into the mild(the reduction of volume 30%49%),the moderate(the reduction of volume 50%-70%)and severe(the reduction of volume 70%)groups(n=20)and the volume reduction of major arteries of lower extremities was measured with the three-dimensional ultrasound volume method,and the statistical correlation analysis was performed with clinical stage,ABI and TcPO2.Results The patients showed reduced lower extremity arterial volume in varying degrees,the reduction extent and ASO clinical stage showed a moderate correlation(r=0.500,P0.01).The ABI of the patients in mild group was 0.72-0.90,in moderate group 0.44-0.69,in severe group 0.40.The TcPO2 in mild group was 42-50mmHg,in moderate group 24-41 mmHg,in severe group 22 mmHg.The results showed that the correlation coefficient(R2)of three-dimensional ultrasound volume and ABI,as well as the R2 of three-dimensional ultrasound volume and TcPO2 were 0.9987and 0.9957,and there was linear correlation between the two sets of comparative data.Conclusion The three-dimensional ultrasound measurement of lower extremity arterial volume to assess the degree of arterial ischemia can be used as a new,comprehensive non-invasive imaging method in the evaluation of lower limb ischemia.