Objective:To explore the diagnostic value of micropure imaging (MI) combined with strain elastography (SE) in correcting artificial intelligence (AI) S-Detect technology for benign and malignant breast complex cystic and solid masses. Methods:The S-Detect diagnosis results were corrected based on the manifestations of MI and SE of the 145 breast complex cystic and solid masses. Postoperative pathological results were used as the gold standard to calculate the diagnostic sensitivity, specificity, and accuracy before and after correction. Additionally, receiver operating characteristic (ROC) curves were drawn for both groups, and the areas under the curves were compared. Results:There were 80 benign and 65 malignant pathological results. After the correction of S-Detect, the diagnostic sensitivity, specificity, and accuracy, as well as the areas under the ROC curves, were all improved compared to before the correction. Conclusion:Combining MI and SE to correct the diagnostic results of S-Detect can help improve the diagnostic efficacy of breast complex cystic and solid masses.

目的 探讨人工智能S-Detect技术联合智能三维超微血管成像(3D-SMI)技术对乳腺结节良恶性的诊断价值.方法 选取2021年1月-2023年2月151例(192个结节)乳腺病变患者为研究对象.采用常规超声检查、S-Detect技术、智能3D-SMI技术对乳腺结节进行良恶性鉴别,以术后病理结果为金标准,绘制受试者工作特征(ROC)曲线,分析常规超声检查、S-Detect技术、智能3D-SMI技术及三者联合诊断对乳腺结节良恶性的诊断效能.结果 192个结节中,病理证实良性结节112个,恶性结节80个.常规超声检查、S-Detect技术、智能3D-SMI技术及三者联合诊断的敏感度、特异度和准确度分别为70.00％、83.93％、78.13％,78.75％、79.46％、79.17％,71.25％、93.75％、84.38％,90.00％、80.36％、84.38％.三者联合诊断的诊断效能较常规超声检查、S-Detect技术高,差异有统计学意义(Z=2.567,P=0.010;Z=2.533,P=0.011).常规超声检查、S-Detect技术、智能3D-SMI技术的曲线下面积(AUC)比较,差异无统计学意义(P＞0.05).结论 人工智能S-Detect技术与智能3D-SMI技术联合应用可辅助常规超声诊断乳腺结节的良恶性,有助于提高诊断的准确率.

目的:探讨多模态超声特征分型在乳腺囊实混合性肿块良恶性鉴别诊断中的价值.方法:回顾性分析 106 例经病理证实的乳腺囊实混合性肿块(108 个),术前行常规超声、萤火虫成像、超微血管三维成像(Smart 3D SMI)及应变弹性成像(SE).应用多模态超声对肿块特征分型,并对常规超声的乳腺影像报告和数据系统(BI-RADS)分类结果进行校正.以术后病理为金标准,比较分析校正前后的鉴别诊断效能.结果:106 例中良性 61 例(62 个病灶),恶性 45 例(46 个病灶).常规超声BI-RADS分类结果校正后的诊断敏感度、特异度、准确率、阳性预测值、阴性预测值、AUC分别为 89.13%、80.65%、84.26%、77.36%、90.91%、0.849,均高于校正前.结论:常规超声BI-RADS分类经多模态超声校正后,可提高对乳腺囊实混合性肿块良恶性的鉴别诊断效能.

Objective:To investigate the correlation of musculoskeletal ultrasound characteristics with the knee function in patients with knee osteoarthritis (KOA). Methods :Eighty patients with KOA in our hospital from January 2020 to May 2021 were enrolled,and all patients received musculoskeletal ultrasound and digital radiography (DR) examinations. The Lysholm knee score was used to assess the knee function of the affected and contralateral sides,then the correlation of characteristics of musculoskeletal ultrasound with the Lysholm knee score was analyzed.Results:The Lysholm knee score of the affected side was significantly lower than that of healthy side (P＜0.05). The severity of KOA seriously affected the knee function,moreover,the analysis showed that the knee function was negatively correlated with the severity of KOA.Conclusion:Musculoskeletal ultrasound is of great clinical value in the diagnosis of KOA,and the severity of disease also has a significant impact on knee function.

目的 应用列线图探讨超声联合血清学指标早期预测乳腺癌术后化疗患者的心脏毒性.方法 前瞻性选取在我院乳腺外科经术后病理确诊的乳腺癌女性患者148例,所有患者均于术后2周接受化疗,根据化疗1年后是否发生左室射血分数(LVEF)下降超过10％,将患者分为毒性组与无毒性组.比较两组患者化疗前与化疗3周期常规超声心动图指标、血清学指标及二维斑点追踪(2D-STI)指标差值的差异.采用多因素COX回归筛选预测心脏毒性的指标并建立列线图预测患者出现心脏毒性的概率.绘制受试者工作特征(ROC)曲线分析各指标评估术后早期心脏毒性风险的价值.结果 共随访148例患者,失访2例,余146例患者纳入研究,其中毒性组18例,无毒性组128例.多因素COX回归显示化疗前与化疗3周期高敏感性心肌肌钙蛋白I差值(Δhs-cTnI)、N末端B型利钠肽前体差值(ΔNT-proBNP)和整体纵向峰值应变差值(ΔGLS)是预测乳腺癌术后化疗患者心脏毒性的独立风险指标(HR=1.030、1.003、1.853,均P<0.05).基于Δhs-cTnI、ΔNT-proBNP和ΔGLS建立的列线图提示患者心脏毒性风险方面具有良好的辨别力(C-index=0.904)和校准度(χ2=8.170,P=0.417,Hosmer-Lemeshow检验).ROC曲线分析结果显示,列线图预测患者发生心脏毒性风险的曲线下面积最高,为0.904.结论 ΔGLS联合Δhs-cTnI、ΔNT-proBNP绘制的列线图有助于早期评估乳腺癌术后化疗患者发生心脏毒性的风险.

目的:基于超声数据建立能够预测机械通气患者呼吸机撤机成功率的列线图.方法:选择我院ICU收治的需要有创机械通气的患者82例,所有患者均接受自主呼吸试验(SBT).在拔管前测定患者血清脑钠肽(BNP)水平,记录心、肺以及膈肌超声数据.撤机拨管后维持自主呼吸48 h以上的患者纳入撤机成功组,其余患者纳入撤机失败组.比较两组临床资料以及心、肺、膈肌超声数据.采用多因素Logistic回归筛选能够预测撤机结局的指标,并建立列线图根据预测指标判断撤机成功率.结果:撤机成功组52例(63.4％),撤机失败组30例(36.6％).多因素分析显示,BNP(P=0.048)、左心房压力(LAP) (P=0.021)、肺部超声B线评分(LUBS) (P=-0.039)和膈肌功能(P=0.020)是影响撤机结局的独立影响因子.基于上述数据建立用于预测机械通气患者撤机成功的列线图具有良好的辨别力(AUG=0.850)和校准度(x2=6.438,P=-0.598,Hosmer-Lemeshow检验).结论:基于心、肺、膈肌超声数据联合BNP建立的列线图可以用于预测机械通气患者撤机成功率.

目的:研究超声斑点追踪显像(STI)技术对高龄高血压患者早期心肌功能损伤的诊断价值.方法:收集医院收治的60例高龄高血压患者,将其纳入观察组,同期收集60名健康体检者为对照组.两组均行常规超声心动图检查,利用STI检测不同部位收缩期平均峰值速度、收缩期平均峰值应变、收缩期平均峰值应变率(s-1),分析其两组数据差异.结果:两组左室射血分数(％)、左室短轴缩短率和二尖瓣舒张早期与晚期血流峰值速度比值(E/A)值差异无统计学意义.观察组基底段、中间段及心尖段收缩期平均峰值速度均低于对照组,其差异有统计学意义(t=2.290,t=3.181,t=2.921;P<0.05);基底段、中间段及心尖段收缩期平均峰值应变均高于对照组,其差异有统计学意义(t=3.199,t=3.273,t=2.627;P<0.05).观察组基底段收缩期平均峰值应变率(s-1)为(-1.75±0.47),高于对照组的(-1.93±0.49),差异有统计学意义(t=2.054,P<0.05).两组中间段、心尖段收缩期平均峰值应变率(s-1)相比,差异无统计学意义.结论:在高血压患者左室射血分数明显下降之前,STI即可识别早期心肌功能损伤,对防治高血压相关的心肌功能损伤具有一定临床意义.

目的 探讨经阴道多普勒彩超结合CEA、CA125在宫颈癌诊断中的应用价值.方法 选取2017年1月至2019年6月上海中医药大学附属曙光医院收治的200例宫颈癌疑似患者作为研究对象.首先分别采用单纯经阴道多普勒彩超、CEA、CA125诊断宫颈癌,随后采用联合检查再次诊断,全部疑似患者最终经病理诊断确诊宫颈癌176例,比较各检查方案在宫颈癌诊断中的应用价值.结果 宫颈癌组患者经阴道多普勒彩超检查,宫颈左右径、前后径,血流动力学参数PSV及CPD均大于非宫颈癌组患者,差异具有统计学意义(P＜0.05);血清CEA和CA125水平亦明显高于非宫颈癌组患者,差异具有统计学意义(P＜0.05).经阴道多普勒彩超、CEA联合CA125诊断的灵敏度、特异度、阴性预测值、阳性似然及诊断正确率均高于3者单独诊断,而阴性似然比最低,差异具有统计学意义(P＜0.05).三组间特异度均相近,差异无统计学意义(P＞0.05).经阴道多普勒彩超诊断的灵敏度、特异度、阴性预测值、阳性似然及诊断正确率均高于CEA、CA125单独诊断组,差异具有统计学意义(P＜0.05),而阴性似然比低于两者,差异具有统计学意义(P＜0.05).结论 经阴道多普勒彩超、CEA联合CA125检查可有效提高宫颈癌的诊断准确性和临床意义.

Objective To investigate the relationship of hypersensitive C reactive protein with carotid atherosclerosis and serum calcium and phosphorus in elderly patients with type 2 diabetes mellitus plus hypertension and increased homocysteine . Methods A total of 105 subjects were enrolled .Carotid intima-media thickness(CIMT) was determined by doppler ultrasound .All the participants were divided into three groups :control group (n=30 ,CIMT<0.9 mm) ,common carotid sclerosis group (n=30 ,0.9 mm≤CIMT<1.2 mm) and common carotid plaque group (n=45 ,CIMT ≥1.2 mm) .Common carotid plaque group was again divided into stable plaque subgroup (n= 20)and unstable plaque subgroup (n=25) .Serum hypersensitive C reactive protein (hsC‐RP ) , homocysteine (Hcy ) ,calcium and phosphorus levels were detected .Logistic regression was used to evaluate the risk factors for CIMT . Results The level of hsC‐RP [(16.88 ± 5.31 ) vs (11.56 ± 5.52 ) mg/L ] ,Hcy [(19.47 ± 10.18 ) vs (14.93 ± 3.41 )μmol/L] and CIMT[(0.98 ± 0.09) vs (0.93 ± 0.05) mm] were significantly higher in common carotid plaque group than in common carotid sclerosis group (P<0.05). There were no significant difference in Ca2+ [(2.24 ± 0.3) vs(2.26 ± 0.16) mmol/L] ,P3 - [(1.19 ± 0.25) vs (1.13 ± 1.14) mmol/L] between the two groups(P>0.05).The levels of lipoproteins (LP) and HbA1 c were significantly higher in common carotid sclerosis group and common carotid plaque group than in the control group (P<0.05).The TC was higher in common carotid plaque group than in the control group[(4.32 ± 1.10) vs (3.69 ± 0.67)mmol/L , P<0.05].Pearson correlation analysis showed than CIM T was positively associated with hsC‐RP and Hcy (r=0.560 ,0.452 ,P<0.01). Logistic regression analysis showed that CIMT is independently associated with hsC‐RP and Hcy(OR=1.501 ,1.523 ,P<0.01). Conclusion The levels of serum hsC‐RP and Hcy were not only independent risk factors for carotid artery atherosclerosis but also related to the stability of atherosclerosis plaque in the patients with type 2 diabetes mellitus with hypertension .