目的:研究彩色多普勒超声联合血清P53、midkine及胸苷激酶1(S-TK1)鉴别甲状腺结节良恶性的临床价值.方法:将2015年1月～2020年1月我院收治的420例甲状腺结节患者纳入研究.将其按照术后病理学检查结果的不同分成恶性结节组150例与良性结节组270例.比较两组各项超声图像特征,血清P53、midkine及S-TK1水平.以受试者工作特征(ROC)曲线分析彩色多普勒超声联合血清P53、midkine、S-TK1或以上方式单独检测诊断甲状腺恶性结节的能效.结果:恶性结节组超声图像特征中形态不规则,边界不清晰,无包膜,内部钙化以及血流分级为2～3级人数占比均高于良性结节组(P＜0.05).恶性结节组血清P53、midkine及S-TK1水平均高于良性结节组(P＜0.05).经ROC曲线分析可得:彩色多普勒超声联合血清P53、midkine、S-TK1诊断甲状腺恶性结节的曲线下面积为0.895、灵敏度为0.92以及特异度为0.88均高于上述方式单独检测.结论:彩色多普勒超声联合血清P53、midkine及S-TK1鉴别甲状腺结节良恶性的临床价值较高.

探讨二维灰阶超声联合超声造影(CEUS)对睾丸表皮样囊肿的诊断价值.方法选择2009年7月至2015年12月空军军医大学第一附属医院收治的经手术组织病理证实为睾丸表皮样囊肿的47例患者,回顾性分析患者检查的声像图资料,分析超声术前诊断睾丸表皮样囊肿的准确度.结果二维超声术前诊断睾丸表皮样囊肿准确度为85.71％(42/49),二维灰阶联合CEUS诊断准确度为93.88％(46/49).结论二维灰阶联合CEUS对睾丸表皮样囊肿诊断价值较高.

Objective To investigate the clinical significance of color Doppler ultrasonography in the hemodynamics of portal and splenic vein in patients with cirrhosis.Methods From June 2013 to July 2016,80 cases patients with cirrhosis from Chinese Medicine Hospital of Weinan City as the study objects (observation group),50 cases health check-up in same hospital as control group.All objects were accepted abdominal color doppler ultrasonic detection,hemodynamic differences of portal and splenic vein in patients with different degree of liver injury and degree of esophageal varices were analyzed,and the correlation between the degree of hepatic injury and the degree of esophageal varices and the portal vein and splenic vein hemodynamics was examined.Results Dpv、Ipv、Dsv and Isv of observation group were significantly lower than that of control group (P ＜ 0.05),and Vpv and Vsv of observation group were significantly lower than that of control group(P ＜ 0.05);Dpv 、Ipv 、Dsv and Isv of patients with Child-Pauh class C were significantly higher than that of class A and class B (P ＜ 0.05),Vpv and Vsv were significantly lower than class A and class B (P ＜ 0.05).Vpv and Ipv in patients with moderate and severe gastroesophageal varices were significantly higher than those without esophageal varices (P ＜ 0.05).Dpv,Ipv,Dsv and Isv were positively correlated with liver function classification (r =0.621,0.731,0.592,0.725,P ＜ 0.05),while Vpv 、Vsv were negatively correlated with liver function classification (r =-0.655,-0.625,P ＜ 0.05).Dpv、Ipv、Dsv、Isv we re positively correlated with esophageal varices degree (r =0.429,0.532,0.721,0.740,P ＜ 0.05),while Vpv and Vsv were negatively correlated with esophageal varices degree (r =-0.410,-0.752,P ＜ 0.05).Conclusion Color Doppler ultrasound for detecting hemodynamics of portal and splenic vein can indirectly reflect the degree of liver injury and whether to merge esophageal gastric varices and the severity of varicose.

快速、便捷的超声影像学检查为急腹症的诊断提供了直接手段.加强急腹症的超声诊断教学对超声专业学生提高急腹症诊断准确率有重要意义.结合影像学教学及临床实际应用,将PBL教学法引入急腹症超声诊断学教学中,探索一种以病案为引导,以声像图为核心,以疾病诊断为根本的网络式分析逆向教学新模式,加强教学互动,提高实践能力.

周围神经损伤是临床常见病变，尤其是伴随着交通事故的发生和外伤引起的臂丛神经损伤因其受损平面高、累及节段多、神经再生速度慢等特点成为临床的棘手问题。由于缺少快速、简便、准确的影像学诊断方法，常延误治疗的最佳时机，致残率较高。目前多数超声医师对神经声像图特征缺乏认识，对神经的显示及病变的诊断缺乏经验。然而，要开展臂丛神经病变的诊断，首先要熟悉、掌握正常神经的检查方法和图像特点。随着超声技术的不断进步，已证实超声可清晰显示正常的臂丛神经根及相应椎间孔的图像并定位[1]，但针对其正常值测量的相关文献尚未见报道。本研究探讨应用高频超声显示、定位正常臂丛神经根的方法，确定其超声测量值范围。

目的 探讨高频超声在诊断小儿输尿管息肉的临床应用价值. 方法 总结28例临床怀疑为小儿输尿管息肉的高频超声表现特点,并与其他放射影像检查及病理结果相对照,分别计算其准确度、灵敏度、特异度、阳性预测值、阴性预测值,评价高频超声对小儿输尿管息肉的诊断价值. 结果 28例患儿中有23例经病理确诊为输尿管上皮乳头性息肉,高频超声对其中22例病变均显示清晰,1例未发现.高频超声诊断小儿输尿管息肉的准确度、灵敏度、特异度、阳性预测值、阴性预测值分别为:89.3％、95.7％、61％、91.7％、75％,优于同组资料的其他影像检查方法. 结论 高频超声成像可清晰显示小儿输尿管息肉的部位、数目及形态,准确率高,在该疾病诊断上具有重要临床价值.

Objective To explore the value of real-time tissue elastography(RTE)and conventional ultrasonography in diagnosis of cervical lymph node benign and malignant lesions in patients with thyroid carcinoma after operation.Methods Cervical lymph nodes of 69 patients with thyroid carcinoma after operation were examined by conventional ultrasonography and ultrasonic elastography.Lymph nodes'size,shape,border,internal echo,corticomedullary boundaries and lymphatic hilar were observed by conventional ultrasonography.Lymph nodes and peripheral tissues were observed by RTE.One hundred and thirteen lymph nodes were confirmed by biopsy and pathology.Results Non-metastatic lymph nodes were scored 5 to 6(Ⅰ~Ⅱ grade),and cervical lymph node metastasis with thyroid carcinoma after operation were scored 7 to 10(Ⅲ~Ⅴgrade).The accuracy,sensitivity,specificity,positive predictive value,negative predictive value and Kappa value of RTE were 90.6%,86.7%,89.2%,92.0%,75.9% and 0.91,respectively.The accuracy,sensitivity,specificity,positive predictive value,negative predictive value and kappa value of conventional ultrasonography were 80.1%,90.1%,59.5%,81.0%,51.7% and 0.72,respectively.The diagnostic consistency of RTE was better than that of conr entional ultrasound.Conclusion RTE has the characteristics of simple and accurate diagnostic consistency,which contribute to the differential diagnosis of thyroid postoperative cervical lymph node metastasis.

1 临床资料 2000-01/2007-02怀疑肾移植术后输尿管梗阻患者15(男11,女4)例,年龄21～68(42±15)岁,术后时间10d～5 a.患者均行超声和静脉肾盂造影检查,部分经外科手术治疗.

目前,超声对结节性甲状腺肿伴腺瘤的报道较少.本文分析了162例结节性甲状腺肿伴腺瘤的二维及彩色多普勒超声(CDFI)声像图表现,旨在提高超声诊断结节性甲状腺肿伴腺瘤的准确率.

1 临床资料 患者,男,23岁,未婚.右侧睾丸肿痛半年余.半年前患者无意间发现右侧睾丸肿大,轻痛,质硬,平卧位阴囊内包块大小不变,当地医院诊为附睾炎,经抗炎治疗无效且增大.