Objective:A study was conducted to explore the application value of high-frequency ultrasound combined with MicroPure technology in the differential diagnosis of benign and malignant thyroid nodules.Methods:A retrospective study was conducted. A total of 100 patients with thyroid nodule (126 nodules) who were admitted into the First Affiliated Hospital of Bengbu Medical College from November 2019 to September 2020 were included. The patients comprised 42 males and 58 females, aged 19-56 years old. All patients received preoperative high frequency ultrasound and MicroPure imaging examination and were diagnosed as benign and malignant by pathology after surgery. (1) The ultrasound image features and the image quality of high frequency ultrasound and MicroPure technique were analyzed. (2) The detection rates of microcalcification in thyroid malignant nodules by the two different imaging methods were compared. (3) Area under the curve (AUC) of the diagnosis of benign and malignant thyroid nodules by using high frequency ultrasound and combined imaging methods were compared.Results:Among the 126 nodules, 68 were malignant, and 58 were benign. Ultrasonic diagnosis results were as follows. High frequency ultrasound images showed 76 malignant and 50 benign nodules. High frequency ultrasound combined with MicroPure imaging showed 72 malignant and 54 benign nodules. (1) On high frequency ultrasound images, the microcalcifications of malignant thyroid nodules were mostly distributed in clusters and dotted with strong echo. In the MicroPure imaging mode, the microcalcifications were clearer and brighter, but the number of microcalcifications was generally less than those shown on high frequency ultrasound images. (2) Among malignant nodules, the detection rate of microcalcifications by MicroPure technology was 86.8% (59/68), which was higher than that by high frequency ultrasound 72.1%(49/68), and the difference between the two was statistically significant (χ 2=22.785, P<0.05). (3) The AUC of high frequency ultrasound combined and high frequency with MicroPure imaging in the diagnosis of benign and malignant thyroid nodules were 0.918 , and 0.755, respectively, and the differences was statistically significant ( Z=3.937, P<0.05). The sensitivity, specificity, and accuracy of high frequency ultrasound combined with MicroPure imaging in the diagnosis of benign and malignant thyroid nodules were 87.9%, 95.6%, 92.1%, respectively. Conclusions:The detection rate of microcalcification of thyroid cancer by MicroPure technology is higher than that by high frequency ultrasound. Moreover, the display effect is better, and the combined diagnosis of benign and malignant thyroid nodules have higher accuracy.

Objective:This study aimed to explore the application value of ultrasound-guided percutaneous puncture biopsy in the diagnosis of subpleural pulmonary lesions.Methods:A retrospective case-control study was conducted. The data of patients with subpleural lung disease who underwent ultrasound-guided puncture biopsy in the First Affiliated Hospital of Bengbu Medical College from January 2018 to November 2020 were included. A total of 178 patients comprising 120 males and 58 females aged 22-69(57.3±7.8) years old were included. According to the gold standard of surgical pathological diagnosis, the patients were divided into benign and malignant groups, comprising 56 and 122 cases, respectively. The differences in ultrasonographic manifestations between the two groups were compared to observe the sampling success and complication rates of ultrasound-guided needle biopsy and to evaluate the sensitivity and specificity of the diagnostic accuracy of this technique in the diagnosis of subpleural lung disease. Positive, negative predictive values and 95% confidence interval( CI) were obtained. Results:No statistically significant difference in the comparison of baseline data, such as gender and age, was found between the two groups (all P values>0.05). Statistically significant differences were found in the ultrasonographic manifestations of the lesions between the two groups in morphology, i. e., presence of air bronchial sign, blood flow signal, and others (all P values<0.05), although no statistically significant differences were found in lesion sides and boundary and internal echo (all P values>0.05). The success rate of ultrasound-guided puncture biopsy was 96.07% (171/178), and the complication rate was 3.31%. The diagnostic accuracy was 93.82% (95% CI 89.21%-96.88%). The sensitivity was 90.98% (95% CI 84.44%-95.41%). The specificity was 100% (95% CI 92.32%-100.00%). The positive predictive value was 100% (95% CI 95.98%-100.00%). The negative predictive value was 83.58% (95% CI 72.77%-90.75%). Conclusions:The ultrasound findings of subpleural pulmonary lesions can provide certain diagnostic information for the differentiation of benign and malignant lesions. The ultrasound-guided needle biopsy has the advantages of real-time observation, low complication rate, and high diagnostic accuracy. It is useful for subpleural lung diseases, the diagnosis of which has important clinical value.

目的 探讨利用直肠引导探头经阴道行盆腔肿块穿刺活检的可行性及应用价值.方法 30例盆腔实质性肿块患者根据肿块距腹壁及盆底的距离分为2组各15例,一组行超声引导下经皮经腹盆腔肿块穿刺活检(经皮经腹穿刺组),一组利用直肠引导探头经阴道行盆腔肿块穿刺活检(经阴道穿刺组),所取组织均行病理检查.结果 2组取材成功率均为100％,经皮经腹组病理阳性率86.7％(13/15),穿刺术后腹痛率6.7％(1/15);经阴道组病理阳性率93.3％(14/15),穿刺术后术区疼痛率6.7％(1/15),均未出现其他严重不良反应.结论 超声引导下利用直肠引导探头经阴道行盆腔肿块穿刺活检方法简单、安全、可行,取材准确性高,对于位置深在、考虑有肠管损伤风险的盆腔肿块取材活检有较高临床应用价值,值得参考.

目的:探讨超声弹性对比指数(elasticity contrast index,ECI)在诊断甲状腺结节中的应用价值,同时比较不同测量方法的效能.方法:选取甲状腺结节病人31例共36个结节,分别以勾勒横切面结节边界、横切面结节内不均质区、纵切面结节边界3种方法测量ECI,绘制受试者工作特征(ROC)曲线,比较不同测量方法对甲状腺结节的诊断效能.结果:3种方法中,横切面结节内不均质区测量法ROC曲线下面积最大,为0.82,对应ECI界值2.93,其评价甲状腺结节恶性风险的敏感性、特异性、准确性分别为82.0％、76.4％、75.3％,以横切面结节内不均质区法测定,恶性结节的ECI值高于良性结节(P<0.05).结论:横切面结节内不均质区测量ECI法对甲状腺结节有较高的诊断效能.

目的 探讨超声弹性对比指数(elasticity contrast index,ECI)对乳腺癌腋窝淋巴结良恶性的鉴别诊断价值方法 选取2016年5月—2019年10月本院收治的乳腺癌患者60例共107枚腋窝淋巴结,行超声检查,记录淋巴结的短径、深度和淋巴结距离腋动脉的距离,并行超声弹性成像,记录ECI值.以病理作为最终诊断结果 ,运用受试者工作特征曲线(ROC)评价其ECI值的检出效能.对恶性淋巴结组的无关变量运用Logistic回归分析,以明确影响ECI值的相关参数.结果 107枚淋巴结中,恶性淋巴结为70枚,良性淋巴结为37枚,恶性淋巴结组的ECI值为(4.13±1.41),良性淋巴结组为(2.54±0.81),ECI的临界值为2.73,差异均具有统计学意义(P<0.01).弹性成像诊断恶性淋巴结的准确性与淋巴结到腋动脉距离显著相关(OR=1.24,P<0.01).结论 ECI值在乳腺癌腋窝淋巴结良恶性的鉴别方面具有重要价值,可作为常规二维超声的重要补充.

目的:探讨Sandwich教学法结合仿真体模在超声介入课程教学中的应用效果.方法:选取蚌埠医学院影像专业学生80人,随机分为试验组和对照组,各40人.试验组实施Sandwich法结合仿真体模的联合教学法,对照组实施传统教学法.教学结束后,对2组学生的理论考试成绩、技能考核成绩、教学满意度及问卷结果进行比较.结果:试验组理论考核成绩、技能考核成绩、教学满意度和调查问卷结果均优于对照组,差异有统计学意义(P均<0.05).结论:Sandwich教学法与仿真体模相结合的教学方式可提升学生对超声介入课程的学习兴趣和满意度,锻炼实际动手操作能力,提高教学效果.

目的:探讨超微血管三维立体超声成像(SMART 3D-SMI)在甲状腺良恶性结节鉴别诊断中的应用价值.方法:应用彩色多普勒成像(CDFI)、超微血流成像(2D-SMI)以及SMART 3D-SMI观察和记录结节的血流的分布和形态特征,并比较3种方法联合灰阶超声鉴别良、恶性结节的诊断效能.结果:CDFI、2D-SMI及SMART 3D-SMI对甲状腺良性结节血流的分级差异无统计学意义(P>0.05),对恶性结节血流的分级差异有统计学意义(P<0.01).灰阶超声联合CDFI、2D-SMI及SMART 3D-SMI诊断甲状腺良恶性结节的敏感度分别为71.1％vs 80.0％vs 88.9％;特异度分别为72.7％vs 80.0％vs 89.1％;准确度分别为72.0％vs 80.0％vs 89.0％;阳性预测值分别为68.1％vs 76.5％vs 87.0％;阴性预测值分别为75.5％vs 83.0％vs 90.7％;ROC曲线下面积分别为0.719 vs 0.800 vs 0.890.结论:SMART 3D-SMI可以较好地评价甲状腺结节微血管的空间分布和形态特点.联合应用SMART 3D-SMI和灰阶超声鉴别诊断甲状腺结节具有较大的临床价值.

Objective:This study aimed to explore the application value of the ultraphonic ultrafast pulse wave velocity (UFPWV) technique in the quantitative evaluation of the carotid vascular wall elasticity changes of patients with type 2 diabetes mellitus.Methods:This retrospective study included the imaging data of 97 cases of type 2 diabetes mellitus admitted at the First Affiliated Hospital of Bengbu Medical College in Anhui Province from July 2018 to March 2019 as the observation group. The cases consisted of 47 males and 50 females aged between 20 and 74 (46.6±9.3) years. In accordance with the carotid intima-media thickness (IMT), the observation group was divided into carotid atherosclerotic plaque group(groups A), carotid IMT thickening group(group B), and IMT normal group(group C). Group C was divided further into lower extremity atherosclerotic plaque group(group C1) and lower extremity arteries without plaque group(group C2) on the basis of the lower extremity arteries with or without plaque. A total of 64 volunteers with normal blood glucose and IMT were selected as the control group. The control group included 25 males and 39 females aged between 20 and 74 (44.3±12.0). The pulse wave velocity (PWV) was acquired via the ultrafast pulse wave technique, which included the beginning and ending of the systole (BS and ES, respectively), and the differences between the parameters were analyzed.Results:In the observation group, the PWV-BS and the PWV-ES values were (9.51±1.25)and (10.79±1.64)m/s, respectively, in group A; (8.47±0.91) and (9.81±1.05) m/s, respectively, in group B; and (7.97±0.77) and (9.07±0.74) m/s, respectively, in group C. The PWV-BS and the PWV-ES values in the control group were (6.10±1.00) and 7.40±1.20 m/s, respectively. The results of carotid artery PWV-BS and PWV-ES in groups A, B, and C and the control group gradually decreased, and the differences were statistically significant (all P values<0.05). Within group C, the PWV-BS and the PWV-ES values were (7.83±0.85) and (8.82±0.59) m/s, respectively, in group C1 and (8.14±0.64) and (9.34±0. 79) m/s, respectively, in group C2. The PWV-ES in group C1 was significantly higher than that in group C2 ( t=3.402, P<0.01). By contrast, no statistical significance on the PWV-BS values existed between the two groups ( P>0.05). Conclusions:The UFPWV technique can be used to evaluate the carotid elastic changes in patients with type 2 diabetes mellitus quantitatively and can assess the progression of atherosclerosis in patients with normal carotid artery morphology through the changes in PWV-ES values. This technique is significant for clinical diagnosis and treatment.

目的 探讨剪切波弹性成像在定量评估慢性肾脏病中的临床应用价值.方法 分别对105例CKD患者和50例健康志愿者测量肾脏长径、实质厚度、Emean、Emax及Emin值.分析比较两组间及CKD不同分期之间各参数的差异;将CKD组的各参数与不同分期之间进行相关性分析.绘制ROC曲线,计算正常与CKD患者肾脏杨氏模量的界值.结果 正常组与CKD组肾脏长径、实质厚度、Emean、Emax及Emin值的比较差异均有统计学意义(P＜0.001);CKD组不同分期之间各参数的差异均具有统计学意义(P＜0.001);肾脏长径、实质厚度与CKD分期之间呈显著负相关,Emean、Emax、Emin与CKD分期之间呈显著正相关.ROC曲线结果示以Emean=2.735、Emax=5.565、Emin=1.15 kPa作为诊断正常组与CKD组的临界值,其灵敏度分别为89.9％、78.1％、79％,特异度分别为91.4％、97.1％、91.4％.结论 剪切波弹性成像可以作为一种非侵入性的技术对慢性肾脏病进行定量评估,实时观察慢性肾脏病疾病的进展,提高对CKD的早期诊断.

目的:观察超声联合乳管镜定位在病理性乳头溢液伴有乳管内肿瘤手术中的疗效,并评估其临床应用价值.方法:将83例病理性乳头溢液伴乳管内肿瘤的女性患者随机分为观察组和对照组,观察组43例,使用超声联合乳管镜定位进行肿瘤联合病变乳管切除;对照组40例,使用乳管镜定位进行肿瘤联合病变乳管切除,两组患者手术过程中均记录手术时间,并称重术后标本的重量,统计术后病理检出结果.结果:观察组患者手术用时(47.8±6.9)min,对照组患者手术用时(49.4±6.4)min,两组患者手术用时比较差异无统计学意义(t=-1.069,P=0.276);观察组患者术后标本重量为(9.2±1.3)g,对照组重(14.7±2.6)g,两组患者术后标本重量比较差异有统计学意义(t=-12.472,P=0.000);观察组患者术后病理检出42例(97.67％),对照组患者病理检出36例(90.00％),两组患者病理检出结果比较差异无统计学意义(χ2=2.156,P=0.191).结论:使用超声联合乳管镜定位,对病理性乳头溢液伴有乳管内肿瘤的患者进行手术时,与单纯乳管镜定位手术相比,手术用时并没有延长,但是术中切除的组织量明显减少,手术创伤小.且超声联合乳管镜定位的病理检出率与单纯乳管镜定位手术相比并无差别,值得临床推广使用.

目的:探讨超声弹性对比指数(elasticity contrast index,ECI)在甲状腺结节鉴别诊断中的应用价值.方法:选取甲状腺结节患者85例共120个结节,行高分辨率超声检查,记录结节的二维超声特征及结节距颈动脉的距离,并行弹性成像检查(记录ECI值),以手术病理结果为金标准,绘制ECI诊断甲状腺良恶性结节的受试者工作特征(receiver operating characteristic,ROC)曲线.结果:120个结节中,恶性结节65个,良性结节55个,恶性结节的ECI值(3.54±1.23)显著高于良性结节的ECI值(2.65±1.98),差异有统计学意义(P＜0.01).ECI鉴别甲状腺结节良恶性的最佳临界值为2.90.钙化组结节的ECI值(3.50±1.55)显著高于无钙化组结节的ECI值(2.45±1.23),差异有统计学意义(P＜0.01),但两组组内良恶性结节的ECI值差异均无统计学意义.所有结节和恶性结节的ECI值与结节距颈动脉的距离显著相关,相关系数分别为0.298和0.397,差异有统计学意义(P＜0.001).ECI值对距离颈动脉≥10 mm的恶性结节的诊断效能优于距离颈动脉＜10 mm的恶性结节.结论:ECI在甲状腺结节的良恶性鉴别诊断中具有一定价值,可作为常规超声的重要补充.

目的 探讨超声引导下注射平阳霉素治疗纵膈淋巴管囊肿的疗效.方法 对12例纵膈淋巴管囊肿患者在超声引导下注射平阳霉素,注射前先行超声定位,平阳霉素用利多卡因溶解成2 mg·mL-1的溶液,一次最大用量不超过32 mg,共注射l～3次.结果 9例囊肿完全消失,3例囊肿明显缩小,个别患者有短暂发热,心跳加速,呼吸急促等不良反应.结论 超声引导下注射平阳霉素治疗纵膈淋巴管囊肿具有定位准确、损伤小、并发症少、疗效好等优点,值得临床推广应用.

目的:通过总结临床触诊阴性乳腺癌的误诊原因,提高乳腺癌的诊断水平.方法:对23例经病理证实的临床触诊均阴性的乳腺癌误诊过程进行回顾性分析,总结误诊原因.结果:23例初诊均误诊为良性疾病,其中乳腺增生病16例,乳腺增生伴瘤样形成趋势4例,术后瘢痕形成1例,乳头湿疹1例,乳腺导管内乳头状瘤1例.误诊时间分别为3个月至1年.结论:临床触诊阴性乳腺癌往往表现(触诊阴性、辅助检查征象)不典型,临床医生应改进观念,提高警惕,及时运用或联合运用适当的检查方法,可提高诊断准确率.

目的 比较超声引导下聚桂醇和平阳霉素介入治疗静脉畸形的效果.方法 回顾性分析我院介入治疗的53例静脉畸形患者的临床资料,按治疗方法不同分为平阳霉素组27例与聚桂醇组26例.在实时超声引导下,单用平阳霉素或聚桂醇注射治疗.4周注射1次,4次为1个疗程.治疗前超声评估畸形静脉腔的体积;疗程结束后6个月观察临床疗效及超声评估畸形静脉腔的体积缩小情况.观察术后近远期并发症,如肺栓塞、皮肤溃疡、局部肿胀、发热等.结果 53例患者均完成1个疗程治疗,并于疗程结束后6个月随访1次.治疗前,2组畸形静脉腔的体积差异无统计学意义(P＞0.05);治疗后,聚桂醇组畸形静脉腔的体积小于平阳霉素组,差异有统计学意义(P＜0.01);2组治疗后畸形静脉腔的体积均较治疗前明显缩小,差异有统计学意义(P＜0.01).随访6个月时,平阳霉素组治愈率37.0％ (10/27),聚桂醇组治愈率88.5％ (23/26),差异有统计学意义(Z=3.838,P＜0.01).聚桂醇组治疗均未出现肺栓塞.聚桂醇组并发症发生率为30.8％ (8/26),差异无统计学意义(P＞0.05),平阳霉素组为18.5％ (5/27),差异无统计学意义(x2 =0.536,P＞0.05).结论 对于畸形腔隙大、位置深在、回流速度快的静脉畸形,超声引导下聚桂醇泡沫硬化治疗效果优于平阳霉素,且两者并发症发生率无差异.

目的：观察超声引导下置入猪尾巴引流导管在治疗巧克力囊肿中的作用。方法：选取我院2011．1-2013．12间收治的巧克力囊肿患者65例，随机分猪尾巴引流导管组33例及BD针组32例，两组患者均采在超声引导下进行注射平阳霉素治疗，治疗操作固定引导医师及操作医师，注射前均先行彩超定位，将平阳霉素用利多卡因溶解成4mg／ml的溶液，一次最大用量不超过32mg，共注射l次，一个月及三个月后复查治疗效果。结果：引流导管组33例囊肿中29例完全消失，3例囊肿体积缩小2／3以上；BD针组17例囊肿完全消失，13例体积缩小1／2以上，2例体积缩小1／3；个别患者有短暂发热、心跳加速，呼吸急促等不良反应。结论：超声引导下经下置入猪尾巴引流导管在平阳霉素注射治疗巧克力囊肿具有定位准确、损伤小、治疗彻底、并发症少、值得推广。

在甲状腺疾病发生发展中,血清促甲状腺素(TSH)水平常先于甲状腺激素变化,是甲状腺结节发生的生长因子,更可能与部分结节性甲状腺肿发生癌变有关.