甲状腺功能亢进症(hyperthyroidism,甲亢)又称甲状腺毒症(hyrotoxicosis),是由于甲状腺内或甲状腺外的多种原因引起血中甲状腺激素过量,作用于全身的组织和器官,造成机体的神经、循环、消化等各系统兴奋性增高和代谢亢进为主要表现的疾病总称.有学者把甲亢定义仅限于由甲状腺合成过多甲状腺激素所产生的高代谢综合征,以区别于摄入外源性甲状腺激素或因甲状腺炎症致甲状腺激素外溢所致者.甲亢是危害人类健康的一种常见内分泌疾病,患病率约为o.5%-1%,可发生于任何年龄,而最多见于青年及中年的女性[1].

目的利用麦默通抽吸旋切系统取得乳腺增生症活检组织进行的病理诊断资料,分析比较该组病变组织学与超声声像图的相应关系,并发现早期癌变倾向,选择合理治疗方案。方法应用Aucson公司Sequoia512型彩超诊断仪,发现可疑病变,在超声引导下应用麦默通旋切系统活检。结果术前超声提示乳腺小肿快的82例(乳腺腺瘤32例,乳腺增生症的41例,囊肿4例;导管扩张5例病人)。病理结果为纤维腺瘤27例伴非典型增生的4例;各型乳腺腺病48例伴不同程度非典型增生的9例;腺病伴导管潴留3例:导管扩张症3例;乳癌2例。结论超声引导麦默通抽吸旋切系统对小病灶穿刺准确、创伤小、操作安全等优点,彩色多普勒超声能直观地显示乳腺小病灶,并且对其二维声像并结合彩色多普勒血流特点及血流参数的分析有利于乳腺病变的定位和分辨病灶细微差别,从而多角度分析声像图与组织学的相应关系。

Objective To discuss the diagnosis value of Colored Doppler for emergent cases in department of gynecology and obstetrics.Methods The sonograms of 168 cases with various emergencies proved by operation and pathological examination in department of gynecology and obstetrics were collected and an analysis was made;follow-up was made to 48 cases receiving no surgical treatment so as to study the curative effect.Results Out of the 168 emergent cases proved by operation and pathological examination,there were 109 cases with ectopic pregnancy,11 cases with corpus luteum breaking,9 cases with the torsion of ovary cysts and polycystic ovary,29 cases with incomplete abortion and missed abortion,4 cases with trophoblastic tumor and 6 cases with hydrosalpinx.Out of the 46 cases receiving no surgical treatment,there were 19 cases with pelvic inflammation,5 cases with fetal distress,22 cases with extrauterine pregnancy,1 case with pregnancy combined with calculus of ureter.The follow-up showed changes in sonograms.Conclusions Ultrasound can provide basis for diagnosis in the emergent cases in department of gynecology and obstetrics;it is of certain clinical value in punctuation guided by ultrasound for those cases receiving expectant treatment and in follow-up.

目的利用麦墨通抽吸旋切系统取得乳腺增生症进行的病理资料,分析比较该组病变组织学与超声声像图的相应关系,并发现早期癌变倾向,选择合理治疗方案。方法应用Aucson公司Sequoia 512型彩超诊断仪,发现可疑病变,在超声引导下应用麦默通旋切系统活检。结果术前超声揭示乳腺腺瘤的32例,乳腺增生症的41例,囊肿4例,导管扩张的5例病人。病理结果如下:纤维腺瘤27例伴非典型增生的4例;各型乳腺腺病48例,伴不同程度非典型产生的9例;腺瘤伴导管渚留3例;导管扩张症3例;乳瘤2例。结论超声引导麦默通抽吸旋切系统对小病灶穿刺准确、创伤小、操作安全等优点,彩色多普勒超声能直观地显示乳腺小病灶,并且对其二维声像并结合彩色多普勒血流特点及血流参数的分析有利于乳腺病变的定位和分辨病灶细微差别,从而多角度分析声像图与组织学的相应关系。

Objective To discuss the 3-dimensional radioactive volume method in measuring the volume of thyroid gland in balloon model.Methods Tc(99m) salt solution in different volume and dosage was injected into the thyroid gland of the balloon model and then radioactive apparatus was applied to detect the image.Results The volume was confirmed to the amount of injected solution,the biggest error in measuring was smaller than 6%;there was no significant difference of the volumes with different dosages and same volume of solution(P0.05) and the detecting time had no affect.Conclusion 3-dimensional radioactive volume method may guide the drug dosage in treating hyperthyroidism in a fast and accurate way.

肝脏移植目前已成为治疗终末期肝病的有效手段.在肝移植的围手术期,彩色多普勒超声(ColorDoppler Ultrasonography,CDU/S)的运用不仅可提供协助诊断的重要资料,而且可准确显示门静脉(PV)、肝动脉(HA)、肝静脉(HV)和下腔静脉(IVC)的结构及走向和血流状况,是术后相关并发症诊断的重要依据[1].

目的探讨各型阑尾炎在彩色多普勒超声(CDFI)上的声像图特点,提高超声诊断的符合率.方法对急性下腹疼痛待查做腹部B超检查而发现阑尾炎的46例病例的超声诊断资料进行回顾分析.结果发现不同类型的急性阑尾炎有不同的声像改变,如阑尾增粗,壁增厚,直径变大,多呈腊肠样或指状的低回声团块,管腔内可有不等量积液或结石,横断面为同心圆或靶环征,所有病例均有显著、敏感的局部压痛.结论彩色超声在阑尾炎诊断上有重要价值,能显示急性阑尾炎各个病理时期的表现,并可为阑尾炎的分型提供参考,能帮助临床医生尽早诊断急性阑尾炎确定手术或非手术治疗提供客观依据.

Objective To evaluate the value of Delta image technology in diagnosing liver tumor. Methods Sixty patients with liver tumors were examined by Delta image technology of ultrasound, and the images were compared and analyzed. Results Delta image technology of ultrasound increases features of liver tumor, the border echo of all liver space-occupying lesion was clearer and inner echo of liver tumor was less-distributed. Conclusion Delta imaging technology of ultrasound increase features of liver tumor,and can improve the diagnosis of little liver tumor. So it has special advantages and clinical value in liver tumors.

目的探讨超声自由扩展成像技术在乳腺病变中的应用价值.方法在普通二维超声对34例乳腺病变患者进行扫查基础上、使用超声自由扩展成像技术对病变区进行全景成像,并对图像进行对比分析.结果超声自由扩展成像技术能完整记录乳房的情况,病变区的大小和特征及与周边组织的关系,而且能准确测量病变的大小.超声自由扩展成像技术获取的图像减弱了伪像干扰,分辨率明显提高.结论超声自由扩展像技术能为临床提供更多的信息有助诊断,是二维超声技术的有益补充和完善.

Objective: To evaluate the efficacy of cluster electrode radiofrequency ablation (RFA) to treat primary liver carcinoma. Methods: 47 patients with 53 primary liver tumors confirmed histologically were treated with RF-2000 TMRFA under ultrasound or CT guidance. The blood supply and coagulation necrosis in the treated tumors were evaluated with ultrasound and CT. Results: Blood supply of tumors was disappeared in 65.3% (32/49) and compete coagulation necrosis of tumors was seen in 66.0% (35/53) after RFA. The rate of complete blood supply extinction was 100% in the 20 tumors 3?cm in diameter (another 4?tumors without blood supply before RFA), and the rate of completely concreted necrosis of the 24 tumors (3?cm) was 100%. Blood supply was completely disappeared in 81.8% (9/11) tumors and complete coagulation necrosis was observed in 72.7% (8/11) tumors of 3～5?cm. However, the rate of complete blood supply extinction and coagulation necrosis was significantly lower in the tumors 5?cm. The patients with tumor 5?cm had longer survival time. Conclusion: RFA is minimally invasive, safe and effective for primary liver carcinoma. The smaller the tumor is, the more effective the therapeutic efficacy is.

目的:探讨超声引导经皮集束电极射频消融(RFA)治疗中小肝癌(直径≤5cm)的疗效.方法:利用RF-2000品肿癌射频治疗系统,在B超引导下对29例中小肝癌患者34个肿块进行经皮肝穿刺射频热凝冶疗,并用B超及CT检查以了解RFA治疗效果,随访观察其复发和生存情况.结果:RFA治疗后93.3%(28/30)的肿块血供消失(另4个直径≤3 cm的肿块治疗前即无血供),且94.1%(32/34)的肿块呈完全凝固性坏死.对有血供的2个肿块再次进行了 RFA治疗.随防6月～3年,29例中现存活25例,半年生存率100%.存活的25例中,已有6例生存半年,7例生存1年,7例生存2年,5例生存3年.结论:集束电极RFA治疗中小肝癌创伤小,安全,疗效可靠.

目的:肾组织活检是肾脏疾病检查的一项重要诊断,为探讨国产自动同步负压肾穿装置的临床应用价值.方法:应用该装置对165例肾病患者进行彩超引导下肾穿活检效果满意.本组165例,男116例,女49例,年龄6-66岁.使用仪器为ACUSON 128及SEQOIA 512型彩超仪,探头频率2.5～4.0 MHz,配有穿刺引导器.穿刺枪及穿刺针选用南京军区福州总医院肾病中心研制的自动同步负压肾穿装置,由自动同步负压器、20号导管针、16G穿刺针组装构成.取材部位选肾下极实质部.结果:肾活检165例,一次取材成功156例,二次取材成功7例,总取材成功率100%,平均取材长度1.6 cm,经病理诊断有系膜增生性肾小球肾炎59例,膜性增生性肾小球肾炎26例,IgA肾病38例,局灶性硬化性肾小球肾炎17例,毛细血管内膜增生性肾炎9例,轻度病变性肾小球肾病10例,狼疮性肾炎6例.结论:血尿、蛋白尿在临床上是肾弥漫性病理改变的常见症状,二维及彩色能量图对其诊断的敏感性较差,超声引导下穿刺活检完全不受肾功能及年龄限制,凡声像图能清晰显示肾脏及其周围组织解剖结构者均可行肾穿刺活检.并且安全、准确可靠,取材质量高,并发症少.术中穿刺者应具备熟练的穿刺技术,做到准确定位与患者密切配合,均能保证穿刺成功并取材满意.本组165例均采用国产自动同步负压肾穿装置,在操作程序、穿刺成功率和取材质量上均可与进口穿刺枪相媲美,可谓价廉物美,应予推广.

目的:探讨彩色多普勒能量图(Color Doppler energy,CDE)在经皮肝穿多弹头射频治疗肝癌中的应用价值.方法:对35例肝癌患者行65次射频治疗,应用彩色多普勒超声对治疗前后肿瘤的大小及血供改变进行对比观察.结果:35例于治疗后一周,15例治疗后30天,7例于治疗后半年进行B超及CT复查.47个肿块术后不同程度缩小的31个(65.9%),血流信号消失的35个(81.4%).其中1例2.3 cm×2.1 cm瘤体基本消失,2例发现新生病灶.结论:CDE在超声引导经皮肝穿多弹头射频治疗肝癌中,在术前诊断、引导定位及术后疗效的评价方面均具有重要的应用价值.

目的探讨自由扫查超声成像技术在临床的应用价值.方法在使用二维、CDFI、CDE及Doppler对25例四肢软组织病变患者进行扫查基础上,使用自由扫查超声成像技术对病变区进行全景成像,并对图像进行对比分析.结果自由扫查超声成像技术不仅能完整记录并反映病变的大小和特征,而且能准确反映病变的位置,及与周边组织的关系.结论自由扫查超声成像技术与实时二维超声技术和血流检测技术结合能为临床提供更多的信息有助于诊断,是二维超声技术的有益补充和完善.

Objective:To explore the value of the exact diagnosis of Gravesdisease by color Doppler ultrasound without having typical characteristics which have been known ever.Methods：To summarize seventy-six proved hyperthyoidism that were confirmed by clinical and laboratory examination.Results:There were some difference in ultrasonic image from those of traditional viewpoint:Asymmetrical thyroid gland on both side,7 cases(7/76,9%);Among the 76 cases,only 26 cases manifested "fire-sea sign” or "island sign"(26/76,36.8%);others manifiested only a little blood stream.Conclusions:Color Doppler ultrasound plays an important role in accurate diagnosis of atypical hyperthyroidism with characteristics of a little blood stream.

目的:探讨经皮各部位器官占位性病变穿刺诊断与治疗的应用价值.方法:对876例各部位器官占位性病变行超声引导下经皮穿刺诊断与治疗.结果:本组诊断性引导下穿刺374例,经细胞学、组织学及穿刺置管造影检查结果证实,恶性肿瘤175例,良性病变196例,诊断不明3例.良恶性病变诊断准确率达99.2%(371/374).本组治疗性引导下穿刺502例,治疗有效21例,治疗痊愈478例,总有效率99.4%(499/502).本组无1例死亡,4例发生严重并发症,占0.46%(4/876).结论:超声引导下经皮穿刺术,在各部位器官占位性病变的诊断与治疗中有其独特的应用价值.