Objective:To investigate the clinical value of location by mammography and ultrasound in the resection of non-palpable breast calcification(NPBC).Methods: The data of 28 cases of NPBC were collected and analyzed.The NPBCs were resected with the mammography and ultrasound location.The resected samples were reexamined by mammography and the remedy resection was performed when necessary.Results:Twenty-six out of 28(93%) cases were once resected,and the other 2(7%) cases were remedy resected.The resection rate was 100%.Conclusion:Preoperative location by ultrasound and mammography is useful to the resection of NPBC and early treatment of breast cancer.

目的:探讨高频彩色多普勒(CDFI) 超声在乳腺肿块诊断中的作用.方法:应用高频彩色多普勒(CDFI) 超声技术对57 例乳腺肿块的患者进行超声检查, 检测肿块大小、形态、边界、内部回声、纵横比, 观察肿块内部及周边有无血流信号及其血流动力学表现,并结合临床病史,做出超声诊断,与手术病理结果相比较.结果:高频CDFI 超声对乳腺肿块检出率为100 %,对乳腺肿块的良、恶性的诊断符合率为85.96 %.结论:高频彩色多普勒(CDFI) 超声可以较准确地对乳腺肿块作出诊断及鉴别诊断 ,具有较高的临床应用价值.

我院血管外科自1997-2003年采用瓣膜戴戒加浅静脉剥脱术治疗原发性下肢深静脉瓣膜功能不全(primary deep venous insufficiency, PDVI)患者19例(31例患肢),取得较好疗效,现报告如下.

Objective To study the clinical therapeutic effects of primary deep venous valve insufficiency in lower limb by venous external valvuloplasty by using the valve of superficial femoral vein and summarize the experience.Methods Forty-seven patients were treated by venous external valvuloplasty by using the first valve of superficial femoral vein with fascia lata or polytetrafluroethylene (PTFE).Results Therapeutic effects were very good and the symptom disappeared or lightened.Conclusion Venous external valvuloplasty is effective and applied in treating primary deep venous valve insufficiency in lower limb.

目的:比较近红外光扫描和超声检查对乳腺肿块的诊断价值,并分析二者联合应用的必要性.方法:将361例乳腺肿块患者的术后病理诊断结果与手术前近红外光扫描和超声检查结果对照.结果:病理证实乳腺癌196例(54.3%),近红外光扫描确诊180例,误诊16例;超声检查确诊168例,误诊13例,15例性质难定.良性病变165例(45.7%),近红外光扫描确诊142例,误诊23例;超声检查确诊151例,误诊14例.近红外光扫描的灵敏度、特异度、准确度分别为91.8%、86.1%、89.2%,超声检查的相应值为85.7%、91.5%、88.4%.结论:两种检查方法对乳腺肿块的诊断符合率差异无显著意义(P＞0.05),但乳腺良性肿块,尤其是直径小于1 cm或较大范围(大于5 cn),超声检查的正确性优于近红外光扫描;而乳腺恶性肿瘤,特别是直径小于2cm或低度恶性肿瘤超声检查较难明确定性,近红外光扫描的诊断符合率较高;两者结合可提高乳腺肿块的诊断准确率.

1资料和方法1998-01/2003-04经手术和病理证实的导管内乳头状瘤67(女66,男1)例,年龄21～74岁.有乳头溢液史63例,(血性溢液31例,浆液性25例,清亮液7例,乳头道液伴乳晕区肿块12例.

Objective To study the relationship between vascular function of legs and insulin resistance in patients with type 2 diabetes mellitus. Methods 80 diabetic patients (M 48, F 32) without apparent manifestations of ischemia and edema of legs, with normal colour of skin, and normal pulsation of dosalis pedis arteria were studied. Vascular function was determined by a limb impendance blood flow gragh apparatus. Insulin sensitivity index (ISI)=1/FPG×FIns. Insulin resistance index=HOMA IR=FPG×FIns/22.5. The relationship of vascular function of ankle tose and knee ankle segments with ISI, H IR in all of patients was observed. Results The results were as follows: 1. Vascular elasticity became worse than normal along with the decrement of ISI and the increment of H IR. 2. Vascular resistance increased gradually while lowering ISI and increasing H IR. 3. Volume of blood flow in legs was associated with ISI and H IR, and the decrement of ISI and increment of H IR led to the decrement of volume of blood flow in legs. Conclusion There is a close relationship between vascular function of legs and insulin resistance in patients with type 2 diabetes without clinically apparent evidence of ischemia of legs. Increment of insulin resistance might be an independent risk factor in the early stage of peripheral vasculr disease in type 2 diabetes mellitus.

1资料和方法1998-01/2002-08手术切除、病理诊断明确的乳腺肿块205(女203,男2)例,年龄19～74(平均46)岁. 205例乳腺肿块中,由病理确诊为良性病变69例(33.7%),其中纤维腺瘤37例;导管内乳头状瘤5例;乳腺囊肿7例;脂肪瘤4例;慢性炎症10例;乳腺腺病6例. 近红外光检查确诊61例,误诊8例;超声检查确诊63例,误诊6例. 近红外光与超声检查对乳腺良性病变术前共同确诊58例,共同误诊3例. 2种方法诊断良性病变的符合率无明显差异(P>0.05). 由病理确诊为乳腺癌136例(66.3%),近红外光检查确诊121例,误诊15例;超声检查确诊115例,误诊12例,9例性质不确定. 近红外光与超声检查对乳腺癌术前共同确诊107例,共同误诊7例. 在病灶不同大小的乳腺癌中,近红外光确诊的病例分别为直径<2 cm 21(21/27),2～5 cm 83(83/93),>5 cm 16(16/16);超声检查确诊的病例分别为直径<2 cm 18(18/27),2～ 5 cm 82(82/93),>5 cm 16(15/16). 2种方法诊断恶性病变的符合率亦无明显差异(P>0.05). 近红外光检查的灵敏度89.0%,特异度88.4%,准确度88.8%;超声检查的灵敏度84.6%,特异度91.3%,准确度86.8%.

AIM To evaluate the methods of Doppler ultra sound blood flow waveform analysis and/or segmental pressure of personal vascular laboratory (PVL) on the diagnosis of the lower extremity arterial ischemic disease. METHODS Twenty two cases (31 limbs) of suspected arteriosclerosis obliterans (ASO) and 15 cases (20 limbs) of suspected thromboangiitis obliterans (TAO) diagnosed by PVL were compared with the results of arteriography. RESULTS Compared with the golden standard of arteriography. The accuracy rate of the ultrasonic Doppler blood flow waveform analysis in the locational diagnosis of lower extremity arterial disease was 94.1 percent, and the accuracy rate of the segmental pressure was 90.2 percent, respectively. CONCLUSION Combined with clinical data, the analysis of blood flow waveform and segmental pressure were of significance in the diagnosis of lower extremity arterial ischemic disease. The method is non invasive and practical.

AIM　To evaluate the correctness rate of the Doppler u ltrasonic (DU) ex ploration applied to the examination of the leg deep vein valve (VV) functions. METHODS　Using Doppler ultrasonic to explore the two groups of p atients with one gro up (16 legs) of normal deep vein valve function and another group (35 legs) inefficiency deep vein valve function, The results were compared with those of venography of leg deep vein. RESULTS　Correctness rate in the normal group was 94% and in the abnormal group was 89%. Its sensitiv ity and specificity werc 97% and 79% respectively. Total a greement rate was 90%. CONCLUSION　Doppler ultrasonic exploration can be applied to the evaluation of the leg deep vein v alve functi on. It is asy, rapid and non-traumatic and can also partially replace the venography.

目的评价近红外光扫描诊断乳腺癌的意义. 方法将近红外光扫描诊断为乳腺癌的172例患者与术后病理诊断对照. 结果近红外光扫描诊断乳腺癌的正确率为91.3%.肿块长径在2～5cm及>5cm者,其诊断正确率为95.4%和100%;<2cm者,则为74.4%;并检出2例临床无明显包块的早期乳腺癌.157例病理确诊的乳腺癌,40～50岁发病率最高(31.2%),其次为30～40岁组(28.7%).近红外光扫描图像灰影伴血管改变越明显,该肿瘤也越趋于高恶性度.良性病变误诊为乳腺癌15例,占8.7%. 结论近红外光扫描是鉴别良性、恶性病变及诊断乳腺癌的简便、无创、有效的辅助手段,并有助于诊断早期乳腺癌.

目的 评价乳房包块近红外光扫描诊断的正确性。方法 将４８９ 例乳房包块患者的术前近红外光扫描诊断与术后病理对照。结果 近红外光扫描诊断乳腺恶性病变的正确率为８５８５ ％ ，且近红外光扫描的乳腺癌图像越典型，该肿瘤越趋于高恶性度；良性病变的诊断正确率为８９７９ ％ ，误诊共４０ 例，占８１８ ％ ，其中将乳腺癌误诊为良性１１ 例，良性误诊为恶性２９ 例。结论 近红外光扫描能比较明确地将乳腺疾病分类诊断，是鉴别乳腺良性、恶性病变的有效辅助手段，且直观、简便、无创伤。