目的 应用速度矢量成像技术(X-Strain)检测低钙透析液对维持性血液透析(MHD)患者颈动脉形变能力及弹性的早期影响.方法 应用X-Strain技术检测30例未发生形态学颈动脉粥样硬化的MHD患者使用低钙透析液前后颈动脉形变能力及弹性的变化.结果 ①使用低钙透析液后MHD患者血钙、血磷、钙磷乘积均降低,甲状旁腺素升高,差异有统计学意义;②使用低钙透析液后,入组前未发生形态学颈动脉粥样硬化的MHD患者颈动脉IMT、RI降低,EDV升高,差异有统计学意义;③使用低钙透析液后,入组前未发生形态学颈动脉粥样硬化的MHD患者颈动脉X-Strain参数,S1、S2、S3、S4、S6、Sr1、Sr2、Sr3、Sr4、Sr5、Sr6、CS、CSr均升高,差异有统计学意义;④CS、CSr与血钙、钙磷乘积、IMT、RI有明显相关性;⑤一元线性回归分析示,血钙、钙磷乘积、IMT、RI对CS、CSr有显著影响,其中血钙对CS及CSr的独立影响力最大.结论 应用X-Strain技术能检测出低钙透析液对未发生形态学颈动脉粥样硬化的MHD患者颈动脉形变能力及弹性的影响,为预防血管异位钙化问题提供新的治疗佐证.

Objective: To evaluate elasticity score and the critical point of strain ratio by ultrasonograms in differential diagnosis of thyroid nodules.Methods: Elasticity imaging was used to examine 78 cases of patient with 122 thyroid nodules.The elasticity scores and strain ratio were retrospectively reviewed and compared with pathology.According to the pathological findings are divided into benign and malignant groups.Results:(1)An elasticity score of 1-3was observed in 90 of 122 nodules,while a score of 4 and 5 in the rest of 32 nodules,which displayed a sensitivity of 75%,a specificity of 82% and a accuracy of 80%;(2) strain ratio: Of the 122 lesions,90 were benign and 32were malignant.The average of strain ratio of benignnodules was 2.34+1.02,while that of malignancy was 4.15+1.09;(3) According to the ROC curve,the critical point was 3.30,which displayed a sensitivity of 81%,a specificity of 90% and a accuracy of 87%.The area under the receiver operating characteristic curve was 0.831.Conclusion: The strain ratio and elasticity score in elasticity images is helpful in the differential diagnosis of thyroid lesions.

患者女,37岁.因上腹部不适来诊,曾行胃镜检查诊为浅表性胃炎、胃窦部小弯侧黏膜下占位.清晨空腹并迅速喝下500ml矿泉水后行超声检查,见胃壁层次清晰,黏膜欠光滑,胃窦部小弯侧黏膜下层探及-大小约为1.2 cm×0.7 cm低回声结节(图1),呈类圆形,边界清晰,基底较宽,表面黏膜光滑连续,内部回声不均匀,可探及小无回声及强回声.CDFl:结节内未探及明显血流信号.超声提示:浅表性胃炎,胃内低回声结节(异位胰腺可能).术中冰冻切片证实为异位胰腺.

<正>慢性肾病(CKD)是一个全世界的公共健康问题,并能预测心血管疾病,其定义为肾小球滤过率估测值(eGFR)<60ml-1.min-1.1.73m-2。糖尿病肾病是糖尿病常见而难治的慢性并发症,一旦发生肾脏损害,将会进行性发展,导致肾功能不全,甚至尿毒症,因此早期诊断和防治具有重要意义。

<正>患者女,25岁,间歇性左肋腹部疼痛伴小便颜色较深。体格检查:左肾区叩痛,血尿(+++)。超声检查:泌尿系统未见异常。平卧位检查左肾静脉近肾门段扩张(图1),最大内径0.98cm,于腹主动脉与肠系膜上动脉之间未探及左肾静脉,腹主动脉与脊柱之间可见一线条样回声,其左侧与扩张的左肾静脉相延续,右侧与下腔静脉相连,最窄处内径0.22cm,两者内径之比大于4∶1。近肾门段左肾静脉血流充盈佳,腹主动脉与脊柱之间可见狭细的血流信号通过。直立位检查示近肾门段左肾静脉最大内

Objective To evaluate the carotid elasticity in patients with maintenance hemodialysis(MHD) with QAS technique.Methods 50 normal subjects,46 MHD patients without plaque and 47 MHD patients with plaque were examined respectively with QAS technique,and the differences of the carotid artery elasticity index were compared between the three groups.Results ① Systolic,diastolic and pulse pressure in carotid artery plaque group and non-plaque group were higher than the control group;body weight,LDL and CRP in carotid artery plaque group were higher than those without plaque group;② Compared with the control group,d,DC,β and PWV of the MHD without plaque group had significant differences;d,IMT,DC,CC,α,β,PWV and AIx of MHD with plaque group had significant differences.MHD with plaque group compared with the non-plaque group,the differences of the carotid d,IMT,α,β,PWV and AIx was statistically significant;③ There were significantly correlations between d,IMT,DC,α,β and PWV,and CC was significantly related to IMT,α,β,PWV and DC,and AIx were significantly related to d,IMT and DC;④ Logistic regression analysis showed that carotid diameter d,AIx,systolic,CRP,serum calcium and albumin were statistically significant,and the risk of carotid artery plaque increased with the value increasing.Conclusion It can early detect the changes of carotid artery elasticity using QAS technique,thereby providing an important means of detection for assessing aorta damage of MHD patients.

Objective To assess the current situation and teaching reform of ultrasonography in clinical medicine.Methods The teaching characteristics of ultrasonography in clinical medicine and the problems existed in traditional ultrasonography teaching were analyzed,then the modified measures were proposed.Results Teaching quality was improved in ultrasonography in clinical medicine,by revising program,perfecting contents and diversifying measures.Conclusions The improvement of traditional course system of ultrasonography in clinical medicine was benefit to promote teaching quality and develop the comprehensive abilities of students.

Chronic renal failure(CRF) is a kind of disease that damage multitude systems and organs,including different degrees and different kinds of cardiovascular and vessel complications.The maintenance hemodialysis(MHD) has been applied in the treatment of end stage renal disease,but the cardiovascular and vessel complications are still the dead diseases in patients with CRF and MHD.Ultrasound is widely applied in diagnosis and assessment of cardiac and vessel complications in patients with CRF and MHD.The progresses of ultrasound studying in the cardiac and vessel complications in patients with CRF and MHD were reviewed in this article.