Objective:To discuss the quantitative evaluation of left ventricular systolic function in patients with light-chain amyloidosis (AL) by pressure-strain loop (PSL).Methods:Forty-six patients with clinically diagnosed as AL in the Affiliated Tumor Hospital of Zhengzhou University from January 2018 to December 2020 were selected as case group, and they were divided into 2 groups according to whether the thickness of interventricular septum and posterior wall at end-diastole was >12 mm; ①cardiac amyloidosis (CA) group (21 cases, the thickness>12mm); ②non cardiac amyloidosis (NCA) group (25 cases, the thickness≤12 mm). Twenty five healthy volunteers were selected as control group at the same time. Routine echocardiography was performed in all subjects.Two-dimensional dynamic images of the left ventricular apical two-chamber, three-chamber, and four-chamber views were collected for three consecutive cardiac cycles using two-dimensional speckle-tracking. A tracing analysis was conducted and blood pressure was entered on the off-line Echo PAC 203 software, and the left ventricular global longitudinal strain (GLS), peak strain time dispersion(PSD), global myocardial work index (GWI), global constructive work (GCW), global wasted work (GWW) and global work efficiency (GWE) were obtained. The differences of GLS, PSD and myocardial work (GWI, GCW, GWW, GWE) parameters were compared between groups, and Pearson correlation was used to analyze the correlations.Results:①Routine echocardiography: Compared with the control group and NCA group, inter-ventricular septum thickness (IVST), left ventricle posterior wall thickness (LVPWT), left ventricular mass index (LVMI), left atrial diameter (LAD), and E/e′ in CA group were increased, while left ventricular ejection fraction (LVEF) was decreased; ②Compared with the control group, GLS, GWI, and GCW in NCA group were decreased, while there were no statistically differences in GWE, PSD, and GWW between the two groups (all P>0.05); Compared with the control group and NCA group, GLS, GWI, GCW, and GWE were obviously decreased, while PSD and GWW were obviously increased in CA group.③ Correlation analysis showed that: the absolute value of GLS was positively correlated with GWI, GCW and GWE ( r=0.654, 0.695, 0.788; all P<0.001), and negatively correlated with GWW, and PSD ( r=-0.710, -0.625; all P<0.001). Besides, PSD had negative correlation with GWI, GCW and GWE ( r=-0.754, -0.653, -0.702; all P<0.001), and positive correlation with GWW ( r=0.676, P<0.001). Conclusions:PSL can quantitatively evaluate the left ventricular systolic function of AL patients, while the myocardial work parameters are conducive to evaluate the degree of cardiac involvement in the course of AL patients.

目的：探讨超声应变率成像(SRI)评价食管癌放射治疗(放疗)术后心脏损伤的临床价值。方法78例确诊为食管癌并且接受放疗治疗的患者作为研究对象，所有患者在接受放疗治疗前后均接受超声超声应变率成像检查，比较放疗前后患者心脏各部位收缩期最大变应率(s)舒张早期最大变应率(e)变化情况。结果放疗后前壁基底段、后壁基底段以及前间隔基底段三个位点的s和e值[(1.85±0.42)、(1.02±0.62)、(1.09±0.63)和(1.68±0.48)、(2.04±0.64)、(1.01±0.65)]较前均明显降低(P<0.05)，而下壁基底段的s和e值与放疗前比较差异无统计学意义(P>0.05)。结论超声应变率成像能够准确分析食管癌放疗术后心脏功能的损伤，可作为常规检查手段，值得在临床中推广应用。

Objective To evaluate the clinical value of color Doppler ultrasonography in the diagnosis of early breast can-cer. Methods Group selection from January 2010 to January 2016 in our hospital were diagnosed in 224 cases of breast cancer patients as the research object, the early breast cancer (early breast cancer group, namely mass diameter is less than or equal to 1.0 cm) in 54 cases, diameter >1.0 cm in diameter breast cancer (breast cancer group) in 170 cases, select the same period in our hospital diagnosed 60 cases of breast benign nodules were as control group. All patients were examined by color Doppler ultrasound, and the differences between the three groups were compared. Results From ultrasound images is compared, the large breast cancer appear burrs on the edges of the sign(71.76% vs 31.48%,χ2=4.356), mass posterior e-cho attenuation (36.47% vs 16.67%,χ2=3.594)and mass aspect ratio > 1 (29.41% vs 14.81%,χ2=3.668)and lymph node metastasis ratio(40.00%vs 14.81%,χ2=4.685)was significantly higher than that of early breast cancer, the differences were statistically significant (P<0.05). The proportion of early stage breast cancer with edge burr(90.74%vs 31.67%,χ2=4.985), calcification (57.41% vs 16.67%,χ2=4.646), blood flow (92.59% vs 30.00%,χ2=5.026) and resistance index (66.67% vs 6.6%,χ2=9.478) was significantly higher than that in patients with benign breast nodules, the difference was statistically significant (all P< 0.05). Conclusion Color Doppler ultrasound in the diagnosis of early breast cancer with high clinical value, which breast microcalcifications, hypoechoic rim burr sign, display blood flow and vascular resistance index > 0.7 is early breast cancer in ultrasound image features.

目的：探讨高频超声及钼靶X线诊断乳腺癌的临床价值。方法420例乳腺癌患者为研究对象,其中125例患者仅行钼靶X线检查,140例患者仅行高频超声检查,155例患者同时行钼靶X线和高频超声检查。与术后病理结果比较分析高频超声与钼靶X线诊断乳腺癌的临床价值。结果钼靶X线诊断乳腺癌的符合率、误诊率和漏诊率分别为78.40%、9.60%和12.00%；高频超声诊断乳腺癌的符合率、误诊率和漏诊率分别为77.86%、9.29%和12.86%；二者联合诊断乳腺癌的符合率、误诊率和漏诊率分别为91.61%、4.52%和3.87%。联合诊断乳腺癌的符合率明显高于二者单独诊断,且误诊率和漏诊率均明显低于二者单独诊断,差异均有统计学意义(P<0.05)。结论高频超声及钼靶X线诊断乳腺癌各有优势,二者联合诊断乳腺癌的准确性明显提高,值得在临床中推广应用。

Objective To evaluate the value of color Doppler ultrasound combined with MRI in the diagnosis of small breast cancer. Methods Convenient selection from January 2010 to January 2016 diagnosed in our hospital for small breast carcinoma (maximum lesion diameter is less than or equal to 2 cm) of 89 cases of patients (unilateral) as the object of study, all patients underwent breast color Doppler ultrasound and magnetic resonance imaging (MRI), to compare the two methods respectively diagnosis and combined the clinical value of small breast cancer diagnosis. Results 89 breast cancer tumors less than 1.0 cm in diameter with a total of 36 cases, 1.0cm<diameter is less than or equal to a total of 53 cases of 2.0 cm. For breast cancer mass diameter is less than or equal to 1.0 cm in diameter, detection rate of ultrasound and MRI of the joint inspection (94.44%) was significantly higher than that of ultrasound alone (75.00%) or MRI (77.78%) examination, differences were statistically significant and combined diagnosis compared (all P< 0.05);and for 1.0 cm < mass diameter 2 cm in patients with breast cancer, ultrasound and magnetic resonance imaging (MRI) of the joint inspection (96.23%) detection rate although higher than the single application of ultrasound (88.68%) or MRI (90.57%), but the difference was not statistically significant (and combined diagnosis compared, P> 0.05). Tumor in color Doppler ultrasound image manifestations were round or oval in shape, the boundary clear or fuzzy, tumor blood flow showed short-term shaped, smaller diameter flow grade for grade I, larger diameter flow grade for grade II - III. Mean blood flow resistance index (0.73 ±0.08). In MRI images on the part of the mass with ill defined margins and visible spiculation; T1 weighted imaging showed low signal or signal, the part of the mass on T2 weighted images showed mixed high signal, with the increase of the diameter of the tumor, the enhancement curve more performance for the type II and III. Conclusion Color Doppler ultrasound in the diagnosis of small breast cancer accuracy is high, and simple, economical, can be used as the first choice for screening small breast cancer, combined with the value of MRI diagnosis of small breast cancer is more excellent.

目的：探讨内镜超声(EUS)诊断食管癌术前分期的临床价值。方法98例食管癌患者的临床分期结果，与术前EUS诊断的分期结果进行比较，分析EUS诊断食管癌术前分期的准确性。结果病理证实T1、T2、T3和T4期分别有15、32、36和15例， EUS诊断正确的T1、T2、T3和T4期分别有15、30、33和12例，诊断准确率分别为100.00%、93.75%、91.67%和80.00%，总体准确率为91.84%(90/98)。病理证实N0和N1期分别有42例和56例， EUS诊断正确的N0和N1期分别有33例和48例，诊断准确率分别为78.57%和85.71%，总体准确率为82.65%(81/98)。结论内镜超声对食管癌术前分期具有较高的临床价值，可作为术前制定手术方法可靠的辅助检查手段，值得在临床中推广应用。

目的：探讨经腹超声诊断腹段食管癌的临床价值。方法142例食管病变患者为研究对象,所有患者均经手术获得病理学结果,并接受经腹超声检查。分析食管癌和食管良性病变在经腹超声图像上的差异。结果142例患者中食管炎29例,食管溃疡24例,食管癌69例,食管静脉曲张5例, Barrett食管3例,食管息肉5例,未见明显异常7例。正常食管表现为典型的环形特征,周边为低回声,中间为高回声。食管癌表现为食管外膜连续性中断或食管壁不规则增厚,食管的实质回声不均匀,内部可见点状气体回声,肿瘤组织与周围边界不清晰。食管癌患者食管壁厚度为8.2~24.6 mm,平均厚度为(11.4±5.2)mm；食管良性疾病患者食管壁厚度为3.4~5.2 mm,平均厚度为(4.1±0.6)mm；二者食管壁厚度比较差异具有统计学意义(P<0.05)。结论经腹超声可通过测量食管壁厚度及声像改变来诊断食管癌,对于诊断腹段食管癌具有重要的临床价值,值得在临床中推广应用。

Objective To analyze the ultrasonographic characteristics of ureter involvement with non-Hodgkin lymphoma( NHL ). Methods Ultrasonographic characteristics of ureter involvement with non-Hodgkin lymphoma in 819 patients were retrospectively analyzed,which were verified by pathology lately 4 years in tumor hospital. Results There were 50 patients with abnormal kidney ultrasono-graphic characteristics,however,there were 5 patients with abnormal ureter. There were progressive changes of ultrasonographic characteristics in kidney and ureter. Such as diffuse pathologic changes in side to double kidney medulla and ureter. Conclusions The occurrence rate of the NHL,renal involvement is relatively high,nevertheless,urter involvement is rare and lack of recognition in NHL. So it is important to further research by ultrasonography in NHL.

Objectives To explore the application of instantaneous wave intensity for early diagnosis of systemic lupus erythematosus (SLE)‐induced atherosclerosis, we observed carotid elasticity by instantaneous wave intensity in premenopausal women with SLE. Methods The study included 3 groups (each group with 30 participants): SLE1 (course of disease <5 years), SLE2 (course of disease ≥5 years) and healthy control. Carotid parameters, including instantaneous acceleration wave intensity, instantaneous deceleration wave intensity, negative area, stiffness constant, wave intensity pulse wave velocity, stiffness constant pulse wave velocity, pressure strain elastic modulus, arterial compliance, augmentation index, and intima‐media thickness, were measured. Results Compared with the control group, the instantaneous deceleration wave intensity, stiffness constant, pressure strain elastic modulus, wave intensity pulse wave velocity, and stiffness constant pulse wave velocity were significantly increased but the arterial compliance was significantly decreased in the SLE1 and SLE2 groups (all P ≤ .01). The instantaneous acceleration wave intensity, augmentation index, and negative area tended to increase in all 3 groups, but there were no statistical differences among the groups. The instantaneous deceleration wave intensity, stiffness constant, pressure strain elastic modulus, wave intensity pulse wave velocity, and stiffness constant pulse wave velocity were significantly higher in the SLE2 group than the SLE1 group, but the arterial compliance was significantly lower in the SLE2 group than the SLE1 group (all P ≤ .01). Conclusions Instantaneous wave intensity can be used to evaluate carotid elasticity in the patients with SLE, which is important for early prevention and treatment of cardiovascular disease.

Objective To study the relations between left ventricular ejection fraction (LVEF) and contractive synchronism in patients with three-vessels coronary artery disease by real-time three-dimensional echocardiography (RT3DE).Methods Forty patients with three-vessel disease coronary artery disease (CAD) and 20 patients without CAD confirmed by selective coronary angiography were choosed.CAD patients were divided into old myocardial infarction group (OMI,n =20) and non-myocardial infarction group(nMI,n =20).The left ventricle end-diastole volume(LVEDV),ejection fraction (LVEF),the 16 segments and those standard deviation (Tmsv16-SD),the maximal difference of time among all 16 segments (Tmsv16-Dif) were measured by RT3DE.Results Compared with control group:LVEDV,Tmsv16-SD and Tmsv16-Dif were significantly increased,LVEF was significantly decreased in CAD patients (P ＜0.01).Compared with nMI group,the same change happened in OMI group (P ＜ 0.05).In CAD patients group,LVEF was negatively correlated with Tmsv16-SD (r =-0.594,P ＜ 0.01)and Tmsv16-Dif (r =-0.498,P ＜ 0.01).Conclusions Left ventricular remodeling is resulted in three-vessel disease.The left ventricular remodeling in OMI outweights nMI.Left ventricular contractive synchronism index can reflect left ventricular systolic function in certain degree.

Objective:To approach the left ventricular myocardial systolic dyssynchrony in patients with three-vessel disease using of Real-time Three-dimensional Echocardiography (RT3DE).Methods:Were researched patients with three-vessel disease coronary artery disease (CAD) and 20 patients without CAD verified by selective coronary angiography.Left ventricular synchronism index were measured by Philips iE33.Results:Compared with control group:end-diastolic leftventricular volume ( LVEDV) the 16 segments and those standard deviation(Tmsv16-SD),the maximal difference of time among all 16 segments(Tmsv16-Dif) and those heart rate correction value(Tmsv16-SD%,Tmsv16-Dif%) were significantly increased.Conclusion:Left ventricular myocardial systolic dyssynchrony takes place in patients with three-vessel disease.There were important values to judge left ventricular systolic synchronism in patients with three-vessel disease using of RT3DE.

Objective To explore the causes and treatment of the complications of alcohol sclerotherapy for hepatic and renal cysts with ultrasound-guided. Methods In recent 4 years, 202 cases of hepatic and renal cysts were treated by alcohol sclerotherapy with ultrasound-guided,among which complications were found in 23 cases by retrospective analysis. Results 22 cases were treated successfully. In 1 case, the needle was falling off from the cyst cavity, the liquid of cyst was drained out. Conclusions Alcohol sclerotherapy is a generally applied and efficient method for hepatic and renal cysts. But a few complications might occur due to different factors, which could be treated successfully if you found them early.

目的探讨超声在乳腺肿块鉴别诊断中的应用价值。方法应用二维超声、彩色多普勒超声研究69例72个乳腺肿块的超声改变,与其病理诊断结果对照,分析总结乳腺良恶性肿块的超声特征。结果经手术病理证实乳腺癌40例,良性肿瘤32例。超声诊断符合率90.2%。结论彩色多普勒超声与肿块的二维超声征象相结合可提高乳腺肿块的超声鉴别诊断准确率。

目的 探讨实时三维超声心动图(RT-3DE)左心室同步性指标预测冠心病(CAD)患者冠状动脉旁路移植术(CABG)后左心室逆重构价值.方法 经选择性冠状动脉造影证实为3支冠状动脉病变的31例CAD患者,应用RT-3DE于术前及术后1个月测量左心室舒张末容积(LVEDV)及16节段同步性等指标,依据CABG术后LVEDV减少≥15%为左心室逆重构标准将病例组分为有反应组(A组,LVEDV减少≥15%)和无反应组(B组,LVEDV减少＜15%),并与20例冠状动脉正常的受检者对比分析,且对CAD患者LVEDV与左心室16节段达峰时间最大差值(Tmsv16-Dif)及标准差(Tmsv16-SD)做相关分析.结果 与对照组比较,CAD患者手术前后左心室同步性指标均显著降低(P<0.01);与术前比较,A组左心室同步性有显著提高(P<0.01),B组则无明显提高改善(P>0.05).CAD患者LVEDV与左心室Tmsv16-Dif及Tmsv16-SD均呈显著正相关(分别为r=0.751,P<0.01;r=0.655,P<0.01).结论 CABG术后发生左心室逆重构的患者其同步性提高,且LVEDV与左心室同步性指标相关良好,此表明左心室同步性指标亦可作为一种新的预测心室逆重构的方法应用于临床.

冠状动脉粥样硬化性心脏病是中老年最常见的疾病,其主要病理变化是心脏重构,其中左心室的构型改变尤为显著.进行性的左室重构可致心腔增大伴功能减退,最终发展至不可逆心肌损害.如何定量评价其重构程度目前报道尚少.本研究旨在运用实时三维超声心动图综合评价三支冠状动脉病变对左心室重构的影响,以指导治疗及评价疗效.