目的 超声较易分辨典型的乳腺肿块,但对于乳腺非肿块样病变的诊断目前研究较少.文中旨在分析乳腺非肿块样病变的超声表现,探究多模态超声对乳腺非肿块样病变的诊断效能,以提高诊断准确性.方法 回顾性分析2019年6月至2020年12月江苏省肿瘤医院超声科收治的62例乳腺非肿块样病变患者临床资料.采用常规超声、自动乳腺全容积成像(ABUS)、多模态超声进行诊断.与病理结果对照,探究多模态超声检查的准确度、敏感度、特异度、阳性预测值和阴性预测值.结果 62例病灶中,病理诊断为良性18例、恶性44例.以病理诊断为金标准进行诊断试验结果显示,常规超声诊断、ABUS检测和多模态超声等三种超声诊断结果一致性检验均具有统计学意义(P<0.05),其kappa值分别为0.337、0.499和0.531,依次升高.多模态超声的诊断准确度、敏感度和特异度分别为82.26％、83.67％和76.92％,阳性预测值和阴性预测值为93.18％和55.56％.结论 多模态超声的诊断敏感度和特异度等指标优于常规超声诊断、ABUS检测,其对乳腺非肿块样病变具有较高的临床诊断意义.

目的:对超声诊断的BIRADS4级乳腺进行弹性成像分析及经皮超声引导下穿刺活检,对比二者诊断价值.方法:对2013年6月—2016年3月我院130例超声诊断为BIRADS4级的乳腺肿块进行回顾性分析,以手术病理为金标准,对比弹性超声成像及经皮超声引导穿刺的诊断价值.结果:经弹性应变率比值分析,130例BIRADS4级肿块中有68例仍为BIRADS4级,19例升级为BIRADS5级,43例降级为BIRADS3级.对照术后大病理,经超声弹性应变率比值分析与经超声引导穿刺活检的灵敏度,特异度及准确率分别为87.03%、77.63%、81.53%及83.33%、96.05%、90.76%,在良性肿块的诊断上二者差异无统计学意义(P>0.05),在恶性肿块的诊断上二者差异具有统计学意义(P<0.05).结论:经皮超声引导下乳腺肿块穿刺对BIRADS4级肿块的诊断价值大于弹性应变率比值分析,是仅次于术后大病理的一种诊断方式.

目的：研究超声引导下乳腺穿刺活检的临床应用性。方法选取2013年2月~2014年6月来我院就诊的300例乳腺病变患者,年龄37~71岁,平均年龄为(43±1.5)岁。在300例患者中4例腋窝病变,乳腺病变296例。未明确包块患者12例,可触及乳腺包块288例。对300例患者进行回顾性分析超声引导下乳腺穿刺活检的病理学检查结果,与手术后活检病理诊断结果进行对照比较,确定超声引导下乳腺穿刺活检的准确率。结果良性病变80例,恶性肿瘤208例,良性肿瘤12例,诊断的准确率高达98.8%。300例患者中有4例为恶性,23例为可触阴性。结论超声引导下乳腺穿刺活检安全可靠,在乳腺疾病手术可以通过超声引导穿刺活检明确的诊断其病变的机理,在早期的诊断、外科手术方式与治疗方法的确定提供有价值的临床诊断依据。

目的：对比分析颈部良恶性淋巴结的超声影像学特征，探讨超声在良恶性颈部肿大淋巴结鉴别诊断中的价值。方法对48例经穿刺活检的颈部恶性淋巴结与80例健康体检中颈部正常淋巴结的二维、彩色多普勒、弹性成像声像图特征分析比较。结果48例63个恶性淋巴结与80例129个良性淋巴结长轴切面上的最大径与横轴切面上的最大径比值(L/S)，差异有统计学意义(P＜0.05)。弹性应变率值有助于鉴别良恶性淋巴结，差异有统计学意义。结论高频、彩色多普勒超声结合弹性应变率值可有助于鉴别颈部良、恶性淋巴结。

Objective To study the correlation between the real-time contrast-enhanced ultrasonography parameters and tumor microvessel density( MVD) of invasive ductal carcinoma ( IDC) . Methods 52 cases of IDC who diagnosed pathologically in operation or puncturation underwent contrast-enhanced ultrasonography. Intratumoral vascularity was assessed by time-intensity curve analysis software to measure the quantitative parameters. All IDC tissue samples were graded pathologically by HE staining. Immunohistochemical staining using anti-CD34 was performed to evaluate the microvessel density in surgical specimens,and the correlation between the parameters of contrast-enhanced ultrasonography and MVD was analyzed. Results Of 52 patients,25 cases were diagnosed as well-differentiated,27 cases as poorly differentiated. MVD in the group of well-differentiated and poorly differentiated was ( 2. 87 ± 0. 97) % and ( 4. 32 ± 1. 07) % respectively,MVD with differentiations was found to have statistic significance( P < 0. 001) . The enhancement parameters showed that the peak intensity and areas under the time-intensity curves were significantly higher in poorly differentiated than those in other well-differentiated ones ( P < 0. 05) . It showed significantly correlations between the same enhancement parameters and MVD( P < 0. 05) ,and areas under the time-intensity curves had the best correlation with MVD ( r = 0. 89,P < 0. 001) . Conclusions The parameters of contrast-enhanced ultrasonography correlations in IDC areclosely correlated with MVD,which may be applicable to histological grading of IDC.

Objective: To investigate the DNA damage of mouse bone marrow hematopoietic cells in non-irradiation area after being irradiated by way of left-half-body. Methods 6～8 weeks male Kunming strain mice were randomly divided into 4 groups i.e. normal control (NC), total-body-irradiated (TBI), left-half-body-irradiated (LHBI), and total-body-shield-irradiated (TBSI). Half-body-irradiated model were made with two pieces of 5cm×8cm×16cm overlapped lead bricks shielding right-side body and irradiated with 8.0 Gy 60Co γ-ray. The TNF-α, SOD, MDA in mouse serum were measured and the DNA damages of bone marrow hematopoietic cells were observed by comet assay and the frequency of polychromatic erythrocytes micronucleated(fMPCE). Results In the left-half-body-irradiated condition,The TNF-αand MDA were increased and the SOD was decreased in serum remarkably(compared with NC,P0.01 ); In non-irradiation area, the fMPCE and the percentage of bone marrow hematopoietic cells with comet-like tail, were aggravated significantly. Conclusions Our study suggest that the local irradiation result in the DNA damage of bone marrow hematopoietic cells in non-irradiation area, and the increasing of TNF-αand reactive oxygen or free radicals may play an important role in the damages.

Objective To study the effects of pervanadate(Per),the inhibitor of protein tyrosine phosphotases on the alterations of mitochondrial membrane potential(MMP)and the apoptosis of BET-2 cells induced by ionizing irradiation.Methods BET-2 cells were divided into Per-treated groups and non-Per groups and incubated after ionizing irradiation.The MMP and apoptosis were measured with FCM.Results After irradiation was given,the MMP of BET-2 cells was reduced in the early stage significantly,and the apoptosis appeared,and these changes had a dose-dependent pattern and a time-course fashion.Per potently enhanced the MMP of BET-2 cells and prevented irradiation-treated cells from apoptosis.Conclusion Per reversed the repression of mitochondrial membrane potential and suppress apoptosis induced by ionizing irradiation in the hematopoietic cells.

目的 探讨局部电离辐射对小鼠非照射区域骨髓造血组织血管内皮生长因子(VEGF)表达的影响.方法 将6～8周龄雄性昆明小鼠随机分为正常对照组、全身照射组、全身屏蔽照射组以及左半身照射组,用铅屏蔽建立半身照射模型,以8.0Gy 60Coγ射线照射,观察小鼠外周血白细胞和骨髓有核细胞计数,检测血清SOD、MDA变化,用Westem blotting和免疫组织化学结合激光共聚焦显微镜观察骨髓造血组织VEGF表达的改变.结果 在半身照射条件下,小鼠外周血白细胞降低,未照射侧骨髓有核细胞计数减少,血清MDA升高,SOD降低(与正常对照组比,P＜0.01);非照射区域骨髓造血组织VEGF表达明显减少,VEGF阳性细胞显著下降(与正常对照组比,P＜0.01).结论 局部电离辐射作用后,可导致非照射区域骨髓造血组织增殖抑制,VEGF表达显著减少,氧自由基激活可能参与了该损伤过程.