在紧急避撞场景下,驾驶员极易因慌乱和误判,产生异常驾驶行为,故提前检测出驾驶员的异常行为对于确保驾驶员自身和周边交通的安全有重要意义.为此,本文中提出了综合转向盘转角残差序列和相平面图判断的异常驾驶行为检测方法.首先,基于相平面法确定车辆稳定性边界;接着,建立基于模型预测控制的驾驶员模型,构造实际驾驶操作与驾驶员模型参考输入间的转向盘转角残差序列;最后,计算驾驶员异常行为因子和评价函数,实现了对车辆偏离预期行驶轨迹的异常行为检测.仿真和硬件在环试验结果表明,所提出的异常驾驶行为检测方法能最晚于车辆偏离轨迹0.5 s前检测出驾驶员异常行为.

超声弹性成像(UE)为新型超声诊断技术,通过直接测量弹性模量反映肌肉硬度变化,近年来逐渐用于定量评估卒中后痉挛(PSS)程度及指导治疗PSS.本文对UE评估PSS研究进展进行综述.

目的 探讨实时剪切波弹性成像评价A型肉毒毒素治疗扭转型痉挛性斜颈疗效的临床应用价值.方法 选取扭转型痉挛性斜颈患者46例(观察组)及健康志愿者50例(对照组),观察组进行A型肉毒毒素治疗,于治疗前及治疗后2周进行Tsui评分,同时应用实时剪切波超声弹性成像技术测量观察组及对照组的胸锁乳突肌、头夹肌杨氏模量值,对2组结果进行统计分析.结果 观察组治疗后Tsui评分较治疗前下降(P<0.01),治疗后胸锁乳突肌、头夹肌杨氏模量值较治疗前下降,差异有统计学意义(P<0.01),与对照组同名肌比较,差异有统计学意义(P<0.01).结论 实时剪切波超声弹性成像技术有助于评价A型肉毒毒素治疗扭转型痉挛性斜颈肌痉挛的疗效.

Objective:To investigate the value of ultrasound elastography strain ratio (SR)and breast imaging reporting and data system (BI-RADS)classification in differential diagnosis of small breast mass so as to improve diagnostic accuracy of the condition. Methods:SR and BI-RADS classification of 200 patients with a total of 390 small breast masses (diameter≤15 mm)were retrospectively analyzed,the results were further compared with those of postoperative pathology. ROC curve was built to analyze the differential diagnosis ability of SR combined with BI-RADS classification for benign and malignant breast mass. Result:Among the 390 small masses,237 (60.8%)were benign lesions and the rest 153 (39.2%)were malignant. The SR of benign lesions was significantly lower than that of malignant lesions (P<0.05). The sensitivity,specificity,positive predictive value,negative predictive value and AUC of BI-RADS classification combined with SR were higher than those of BI-RADS clas-sification or SR alone(all P<0.05). Conclusions:BI-RADS classification combined with SR can improve the assessment abil-ity of malignant risks and the diagnostic accuracy of small breast masses.

目的:探讨经阴道超声(TVS)及磁共振成像(MRI)联合数字减影血管造影技术(DSA)在早期剖宫产瘢痕妊娠(CSP)诊治中的应用价值.方法:选择我院收治的临床拟诊CSP患者23例,停经时间41～49天,分别行TVS、MRI、DSA检查,所有患者行子宫动脉栓塞术,术后TVS随访.结果:①TVS明确诊断CSP 17例,不能明确诊断6例,其中3例于子宫下段见孕囊回声,不能明确孕囊与瘢痕的位置关系;3例包块周边环状血流信号不明显,不能除外难免流产孕囊滞留于瘢痕处.MRI检查23例均明确诊断.②所有患者行DSA下子宫动脉栓塞术,手术成功.术后3天TVS检查:2例孕囊自行排出,1例包块完全吸收,15例见包块缩小且周围血流信号明显减少,5例包块未见明显缩小但周围血流信号明显减少.③14例于治疗后1周行刮宫手术,手术顺利,术中术后24小时出血量60 ～ 155 ml;6例经MRI诊断包块位于肌层的患者未行刮宫术,密切随访血β-HCG及TVS,包块于栓塞术后4～10周后完全吸收.结论:TVS是CSP的首选诊断方法及子宫动脉栓塞术后评价疗效的方法,当超声检查不能明确诊断时,MRI是必要的辅助手段.DSA下行子宫动脉栓塞术对于早期CSP是一种安全、有效的治疗方法.

Objective To evaluate the application value of contrast-enhanced ultrasound ( CEUS) in the diagnosis of renal occupied lesions systematically.Methods The related literatures which used CEUS in the diagnosis of renal occu-pied lesions were searched from Pubmed, Embase, Cochrane Library, CBM and CNKI database.The heterogeneity test was conducted on these literatures by using Stata 12.0 and Meta-disc software.The weighted sensitivity, specificity, diagnosis odds ratio, positive likelihood ratio and negative likelihood ratio were calculated as well as the summary receiver operating characteristic ( SROC) curve.Results Fourteen literatures were included, the weighted sensitivity, specificity, diagnostic odds ratio, positive likelihood ratio and negative likelihood ratio were 0.957, 0.748, 66.277, 3.797 and 0.057, respec-tively;and the SROC curve was 0.96.Conclusion Using CEUS has a low missed diagnosis rate, an relative high misdi-agnosis rate and small range of summary sensitivity in the differential diagnosis of renal occupied lesions.

肝纤维化(LF)是肝硬化的早期改变,如果在此时消除病因,积极治疗,纤维化可以逐步缓解.我们应用无创的超声弹性成像技术评估LF程度,并探讨LF指数诊断早期肝硬化期及LF期的最佳临界值.一、材料与方法1.研究对象:选取2010年6月至2013年3月在我院就诊的慢性肝炎患者123例,其中男89例,女34例,平均年龄(43.7±9.2)岁,其中乙肝114例,丙肝9例.病理获取途径为肝穿刺活检.排除可能导致肝实质病变的慢性疾病及可能影响肝脏弹性的其他病变.肝穿刺活检组织的LF分级标准按Metavir分级:S0,无LF;S1,汇管区有纤维化但无分隔;S2,汇管区有纤维化伴少量分隔;S3,有大量分隔但无肝硬化;S4,早期肝硬化。

目的 探讨高频超声在无症状型系统性硬化病(systemic sclerosis,SSc)腕管综合征早期诊断的应用价值.方法 研究组选取49例SSc患者,对照组选取30例健康人,应用高频超声分别测量腕管豌豆骨水平处的正中神经截面积(median nerve area,MNA),正中神经横径(median nerve transversal diameter,MNT)以及正中神经前后径(median nerve antero-posterior diameter,MNAP),计算正中神经扁平率(median nerve flattening ratio,MNFR)同时记录病程、类型(弥漫型或局限型)及皮肤受累阶段(水肿期,纤维化期,萎缩期).结果 SSc患者正中神经横截面积,正中神经横径,正中神经扁平率明显高于对照组,差异有统计学意义(P＜0.05),而正中神经前后径在两组间比较无统计学意义(P＞0.05).正中神经扁平率与病程呈正相关,Spearman等级相关系数为0.3.结论 高频超声在早期诊断无症状型SSc患者腕管综合征有较高的临床价值.

目的 探讨超声造影(contrast-enhanced ultrasound,CEUS)在评价2型糖尿病及合并微血管病变的骨骼肌微循环障碍中的应用价值.方法 收集对照组30例、2型糖尿病(type 2 diabetes mellitus,DM)组30例、2型糖尿病合并微血管病变(type 2 diabetes mellitus with microvascular complications,DM+ MC)组28例,超声造影观察各组小腿骨骼肌血流灌注情况,选择性观察其中的小动脉、肌肉组织和小静脉,运用数学模型分析时间-强度曲线,获取造影剂到达时间、造影剂渡越时间等灌注参数.同时所有研究对象均空腹测血糖及全血黏度、C-反应蛋白值等血液流变参数.结果 DM+ MC组动脉到静脉、肌肉到静脉的造影剂渡越时间显著比DM组及对照组延长,差异有统计学意义(P＜0.05).DM+ MC组全血黏度比DM组及对照组高,差异有统计学意义(P＜0.05).全血黏度与血糖、C-反应蛋白有高度相关性(P＜0.01).结论 超声造影一定程度上可以评价骨骼肌微循环障碍,微循环障碍可能与血液流变参数异常有关.

Objective To evaluate lower extremity deep venous hemodynamic changes and lower extremity deep venous disease in abdominal obesity.Methods To compare venous flow parameters of the lower limbs as assessed by Duplex ultrasound scanning in obese and nonobese individuals according to body mass index(BMI).Venous hemodynamics were studied in a prospective cohort study in nonobese( BMI ＜ 25 kg/m2) and obese individuals( BMI ＞ 30 kg/m2 ).Diameter,peak,mean,and minimum velocities were assessed.Results The study examined 45 limbs in 24 nonobese individuals and 44 limbs in 22 obese individuals.The diameter of the femoral vein was significantly greater in obese vs nonobese limbs ( 10.4 ± 1.3) mm vs (7.1 ± 1.0) mm,P ＜ 0.01 ).Calculation of venous amplitude and shear stress showed significantly higher values in nonobese vs obese limbs [ ( 11 ± 5 ) vs ( 8 ± 3 ) cm/s ],( P ＜ 0.01 ) and [ (0.50 ± 0.17 ) vs ( 0.30 ± 0.09 ) ] dyn/cm2,( P ＜ 0.01 ).Spearman rank correlation revealed a significant inverse correlation between waist-to-hip ratios and waist circumference and velocities amplitude (peak ve locity-minim velocity),and shear stress.Conclusions Lower limb venous flow parameters differ significantly between obese and nonobese individuals.These findings suggest the mechanical role of abdominal adipose tissue potentially leading to elevated risk for both chronic venous insufficiency and venous thromboembolism.

Objective To investigate the value of real-time ultrasonic elastography(USE)in identifying the diagnosis of breast masses.Methods Fifty-eight patients with 66 lesions were examined by real-time USE.The strain ratio of the lesion and nearby breast tissue was calculated by the strain ratio measure method equipped with the ultrasonic machine.The cut-off of strain ratio is 3.08.All the cases were proved by surgical pathology.Results There were 45 benign and 21 malignant lesions.The strain ratio of benign lesions was(1.88±1.29),and that of the malignancy was (5.79±5.36).There was significant difference between two groups(P0.01).The sensitivity,specificity, and accuracy in USE in diagnosing malignant breast lesions were 85.7%,95.6%,and 97%.Conclusion Ultrasonic elastography has high value in identifying breast malignancy and benignancy.

Objective To investigate the relationship between carotid atherosclerotic plaques on sonography and coronary artery disease(CAD).Methods Totally,89 patients with suspected coronary artery disease were divided into CAD group and control group according to the results of coronary angiography.The CAD group was further divided into non-MI and MI groups according to the history of myocardial infarction before.All patients underwent carotid sonography and the atherosclerotic plaques were classified into stable and unstable plaques.The incidence rate of plaque was calculated and compared statistically.Results The incidence rate of plaque in CAD group was significantly higher than that in CON group(P0.05).The incidence of unstable plaque was statistical different between the non-MI group and MI group(P0.05).Conclusion The presence of carotid atherosclerotic plaques is related with the coronary artery disease.The unstable plaque on carotid sonography correlates with myocardial infarction.

<正>自1986年造影剂首次被Matsuda应用于肝脏超声检查以来[1],转移性肝癌的检出率得到了明显的提高,避免了不必要的手术治疗,在国外已常规应用于恶性肿瘤病人的检测,国内目前也做了大量这方面的工作,现就超声造影在转移性肝癌的研究应用作一综述。

Objective To discuss the clinical value of color Doppler flow imaging(CDFI) in examining vertebral artery. Methods Totally, 323 abnormal vertebral arteries were analyzed retrospectively on the changes of morphology and hemodynamics on CDFI, and 30 normal vertebral arteries as a control group. Then the results of CDFI were compared with those of magnetic resonance imaging (MRI) and digital subtraction angiography (DSA). Results In the 323 cases, 76 were vertebral arteries stenosis, 26 were occlusion with plaques, and 43 were bended vertebral arteries. the measurements of CDFI were similar with those of MRI and DSA . The systolic peak flow velocity(PSV) of vertebral arteries were obviously reduced in 216 patients(PSV<25cm/s). There were 9 cases with vertebral arteries flow partly in opposite direction with that in carotid, while MRI and DSA were not able to find these problems. There were 11 cases with vertebral arterial flow completely in opposite direction with that in carotid. DSA made the same diagnosis with CDFI, however, MRI were not able to make the correct diagnosis. Conclusion Examination of vertebral arteries with CDFI routinely is important to the diagnosis of cerebrovascular diseases.

Objective To discuss the characteristics of carotid morphologic and hemodynamic in patients with hypertension. Methods We performed high frequency ultrasound on carotid artery in 119 primary hypertension individuals and 34 control subjects, then analyzed the carotid morphologic and hemodynamic changes by the statistical software. Results 1.The significant difference was found in inner diameter of carotid artery in grade 3 groups compared with control cases(p<0.05).The intima-media thickness (IMT) of common carotid artery(CCA) and the Crouse integration in hypertension groups were also significant higher than that in the control group(p<0.05).2.There were significant differences in the peak systolic velocity and end diastolic velocity of CCA between hypertension groups and control group(p<0.05). 3.Significant positive correlation between pulse pressure (PP) and IMT of CCA was found (R=0.339,p<0.01). The IMT of CCA and atherosclerotic plaques presence rate in group PP≥60mmHg were significant higher than those in group PP<60mmHg(p<0.01). Conclusion There is significant positive correlation between hypertension and carotid atherosclerosis, furthermore, carotid atherosclerosis is correlated with different hypertension grades and the pulse pressure. High frequency ultrasound is able to reveal the condition of carotid in hypertension patients accurately.

超声介入是在超声显像的引导下,经皮穿刺完成组织活检、液体抽吸和引流等操作[1].穿刺活检后在癌瘤体内注入无水乙醇或乙酸直接杀伤肿瘤细胞,在抽吸积液后囊腔内注入硬化剂目的是抑制囊液分泌.此项治疗措施与经导管肝动脉化疗栓塞术相比,操作简单,并发症少[2].我院自2002年7月～2004年6月对37例患者采用超声引导下的微创介入治疗,获得了满意的效果.现将手术配合与护理措施报道如下.