Abstract Background To evaluate the hemodynamic characteristics of normal upper extremity arteries from the brachial artery to the fingertip arterioles. Methods We analyzed the characteristics and changes in the regularities of ultrasonic parameters in the upper extremity arteries of 104 healthy volunteers using color Doppler flow imaging and Angio Planewave UltraSensitive™ imaging. The measured ultrasonic parameters included the vessel diameter, blood-flow spectrum waveform, peak systolic velocity, end-diastolic velocity, resistance index, pulsatility index, ratio of PSV to EDV, blood-flow volume, along with systolic acceleration of each BA, radial artery, superficial palmar arch artery, palmar proper digital artery, and third-grade artery arch of the fingernail bed. Results From BA to FN3AA, the diameter, PSV, RI, S/D, VFlow, and slope of the artery significantly decreased (P < 0.001), and size of the parameters significantly correlated with the anatomic position of the arteries. The blood-flow spectrum gradually changed from various waveforms to fixed monophasic waves. There was a linear relationship between the distribution of monophasic waveforms and arterial groups (R = -0.453; P < 0.001). When the blood-flow spectrum of BA and RA showed a monophasic waveform, their branch arteries showed the same. The waveforms of PPDA and FN3AA were also monophasic. Conclusion Regular changes in the blood-flow spectrum waveform and hemodynamic parameters are related to the anatomic position of the upper limb arteries. CDFI combined with Angio PLUS accurately and systematically evaluates the hemodynamic characteristics of the upper extremity arteries.

Objective To explore the effect of illness perception interventions based on Meleis’s transitions theory on the rehabilitation of patients with functional dyspepsia. Methods 120 patients with functional dyspepsia were selected by convenient sampling in the outpatient department of gastroenterology of a tertiary A hospital in Nanchong,Sichuan Province from July to October 2021. They were divided into a control group and an experimental group with 60 cases in each group by SPSS 22.0 random number table method,and 20 cases were taken as a group to establish a Wechat group respectively. On the basis of routine outpatient care,the experimental group received illness perception interventions based on Meleis’s transitions theory;the control group received routine outpatient care and received relevant health education information through WeChat group. The duration of the intervention was 8 weeks. Data were collected by the Brief Illness Perception Questionnaire,Dyspepsia Symptoms Severity,the Affect Balance Scale,Nepean Dyspepsia Index-Short Form and so on. The cognitive level of disease,dyspepsia symptom severity,emotional balance and health-related quality of life of the 2 groups were compared before and after intervention. Results In the control group,3 cases were lost to follow-up. The cognitive level of disease and health-related quality of life of intra-group comparison and post-intervention comparison between the 2 groups were higher than those before the intervention;the severity of symptoms was lower than that before the intervention;the emotional balance was better than that before the intervention. The difference was statistically significant（P＜0.05）. After the intervention,the cognitive level of disease and health-related quality of life in the experimental group were higher than those in the control group;the severity of symptoms was lower than that in the control group;the emotional balance was better than that in the control group. The difference was statistically significant（P＜0.001）. Conclusion The illness perception intervention based on Meleis’s transitions theory is helpful to improve the cognitive level of disease in patients with functional dyspepsia,to reduce symptoms and negative emotions,and to improve health-related quality of life.

BACKGROUNDThe sonographic appearance in intrahepatic space-occupying lesions under the background of fatty liver is atypical. This study aimed to explore the value of contrast-enhanced ultrasonography (CEUS) in the differential diagnosis of intrahepatic space-occupying lesions under the background of fatty liver.METHODSTwenty-one patients with intrahepatic space-occupying lesions under the background of fatty liver who were treated in our hospital from January 2017 to September 2020 and met the inclusion/ exclusion criteria were enrolled in this study. The clinical and imaging data, size, location, shape, and other characteristics of the lesions were analyzed. The accuracy of conventional ultrasound and contrast-enhanced ultrasound in diagnosing intrahepatic space-occupying lesions under the background of fatty liver were compared.RESULTSThe 21 patients had moderate to severe fatty liver, including 11 cases with malignant lesions (52.38%) and 10 cases with benign lesions (47.62%). The accuracy of CEUS (90.48%) was significantly higher than that of conventional ultrasound (61.90%) in diagnosing intrahepatic space-occupying lesions under the background of fatty liver. A total of 33 lesions were detected in 21 patients, which were hypoechoic. Liver abscesses mainly showed ring-shaped enhancement in the arterial phase and low enhancement in the portal phase, with abscess necrosis in the center and no significant enhancement. Liver cyst lesions showed no significant enhancement in the arterial, portal, and delayed phases. The three stages of focal fat loss were synchronized and simultaneously enhanced with surrounding fatty liver tissues. The area under the diagnostic curve of conventional ultrasound and CEUS was 0.668 and 0.809, respectively, and the area under the curve of CEUS detection was the largest (P<0.05).CONCLUSIONSCEUS can effectively improve the diagnostic accuracy of intrahepatic space-occupying lesions under the background of fatty liver, and is an effective means to differentially diagnose intrahepatic space-occupying lesions under the background of fatty liver.

BACKGROUND:Thyroid nodules are a common thyroid disorder. The aim of the present study was to observe the application value of ultrasonic shear wave elastography (SWE) and contrast-enhanced ultrasound (CEUS) in the differential diagnosis of patients with benign and malignant thyroid lesions. METHODS:Eighty-two patients with thyroid nodules (96 thyroid nodules) at our hospital were enrolled. All patients underwent ultrasonic SWE and CEUS examination. With surgical pathology as the gold standard, the Young's modulus, CEUS imaging features, and quantitative parameters were compared between the benign and malignant groups. The diagnostic efficiency of SWE, CEUS, and their combination was analyzed by receiver-operating characteristic curve (ROC). RESULTS:The average of the Young's modulus in the malignant group was significantly higher than that of the benign group (P<0.05). There were significant differences in the CEUS images of nodules between the benign and malignant groups in terms of boundary conditions, morphology, perfusion intensity, homogeneous enhancement, and perfusion defects (P<0.05), while there were no significant difference in initial increase time, peak intensity, time to peak, and area under the curve (P>0.05). The curve sharpness in the benign group was significantly lower than that of the malignant group (P<0.05). ROC analysis found that the diagnostic sensitivity and specificity of SWE, CEUS, and their combination were 90.1% and 81.6%, 67.8% and 75.4%, and 97.3% and 71.5%, respectively. CONCLUSIONS:Compared with CEUS, the sensitivity and specificity of SWE were relatively higher in the differential diagnosis of benign and malignant thyroid lesions, and a combination of both can improve the diagnostic sensitivity of SWE alone to a certain extent.

目的 分析应用弹性成像技术探查乳腺癌患者同侧腋窝前哨淋巴结(SLN)的剪切波速度并和粗针穿刺病理结果进行对比分析,探讨弹性成像技术对诊断前哨淋巴结转移的价值.方法 以粗针穿刺病理检测结果为金标准,回顾性分析66例乳腺癌患者同侧腋窝的101枚SLN的超声造影结果及弹性成像探查结果;将弹性成像结果和病理做对照研究.结果 66例患者超声造影成功检出SLN101枚,淋巴结穿刺标本中42枚为转移性淋巴结,59枚为未转移性淋巴结,应用弹性成像技术检测腋窝前哨淋巴结的灵敏度、特异度、准确度分别是84.6％、84.1％、85.6％,ROC曲线下面积是0.919(P<0.05).结论 弹性成像技术是鉴别腋窝前哨淋巴结性质的一种有效方法,在超声造影的基础上加以弹性成像技术的评估,能为临床提供更为全面的诊断信息.

Introduction: This research was conducted to explore the relationship between the systemic immune-inflammation index (SII) and breast imaging-reporting and data system (BI-RADS) classification using ultrasonography and the survival of patients with triple-negative breast cancer (TNBC) in a cohort of Chinese. Methods: A total of 215 TNBC patients treated at our hospital between November 2008 and March 2016 were enrolled in this study. We used the log-rank test and Kaplan-Meier curves to assess the overall survival (OS) and disease-free survival (DFS) differences between groups. The prognostic role of SII and other clinicopathological characteristics in TNBC patients were identified using the Cox regression model. Results: Patients with low and high SII had median OS of 60.9 and 40.3 months, respectively, (HR=3.78, 95% CI: 2.16-4.15, P<0.001); while the median DFS was 22.4 months and 14.4 months for TNBC patients with low and high SII, respectively (HR=3.16, 95% CI: 1.82-4.02, P<0.001). For patients with grade 5 ultrasonographic BI-RADS classification, the median DFS and OS were 41.2 and 16.5 months, respectively, whereas, it was 57.7 and 21.3 months, respectively, for those with BI-RADS grades 3-4 (P<0.01). According to multivariable analyses, increased SII was a risk factor that independently predicted poor OS (HR=2.96, 95% CI: 2.18-3.98, P<0.001) and DFS (HR=2.85, 95% CI: 1.62-3.81, P=0.005). In addition, tumor stage, BI-RADS, and histological grade also independently predicted poor OS (P=0.002, <0.001, 0.004). Conclusion: Pretreatment SII and BI-RADS 5 were independent indicators for prognosis in TNBC patients. It is imperative to conduct prospective studies to evaluate the potential role of SII in patient selection, treatment guidance, and design of clinical trials.

目的 探究超声造影评估不同亚型功能性消化不良(FD)患者胃排空的价值.方法 选择四川省人民医院东院收治的FD患者188例,分为上腹痛综合征(EPS)组和餐后不适综合征(PDS)组,同时选择85例健康体检者作为对照组.观察禁食、0、30、60、90和120 min时全胃腔容积(TGCV)、胃排空率的变化.比较患者治疗前与治疗后120 min的胃排空率差异.结果 两组FD患者超声与核素扫描的120 min平均胃排空率比较,差异无统计学意义(P >0.05).3组不同时间点的TGCV和胃排空率比较,差异有统计学意义(P <0.05),3组患者TGCV胃排空率比较,差异有统计学意义(P <0.05),3组患者TGCV、胃排空率变化趋势比较,差异有统计学意义(P <0.05).EPS组和PDS组患者治疗前后的胃排空率比较,差异有统计学意义(P <0.05).结论 超声造影可以客观地评估FD患者疗效,传统治疗方案对PDS患者的疗效优于EPS患者.

目的 探讨常规超声联合经皮超声造影(CEUS)对乳腺癌患者同侧前哨淋巴结(SEN)转移的诊断价值.方法 以粗针穿刺病理检测结果为金标准,回顾性分析并比较2017年3月～12月川北医学院附属医院66例乳腺癌患者同侧腋窝的101枚SLN常规超声及CEUS结果;最后根据CEUS中淋巴结的不同灌注方式分组进行评分.采用Logistic回归和受试者工作特征(ROC)曲线对两种方法进行分析,采用Z检验对曲线进行评估,采用McNe-mar检验比较两种方法分析的结果,根据CEUS的ROC曲线确定截断值并对SLN进行评估.结果 比较两种方法的ROC曲线下面积,常规超声为0.779,CEUS为0.772,差异无统计学意义(P＞0.05).常规超声的灵敏度是51.11％,特异度是89.47％,符合率是72.55％;CEUS的灵敏度是46.67％,特异度是93.10％,符合率是72.82％,两种方法各个指标之间比较差异均无统计学意义(P＞0.05).根据经皮CEUS的ROC曲线取截断值的评分方法可辅助对SLN良恶性的评估.结论 经皮CEUS显示的SLN灌注模式对评估SLN的良恶性有较高的实用价值,是对常规超声检测腋窝淋巴结的一个有力补充.

Objective To investigate the correlation between thickening swollen lesser omental sac by ultrasonography and APACHE Ⅱ scoring in acute pancreatitis.Methods Twenty-nine patients with acute pancreatitis were selected.The thickness of the lesser omental sac were measured by ultrasonography.The correlation between the swelling degree of lesser omental sac and APACHE Ⅱ score was analyzed.Differences in omental thickness and APACH Ⅱ scores between ICU patients and non-ICU patients were compared.Results The lesser omental sac thickness of 29 patients with acute pancreatitis was (1.92±0.56) cm and the APACHE Ⅱ score was 7.17 ± 0.73.The degree of omentum swelling was positively correlated with APACHE Ⅱ score (r=0.780,P=-0.022).The thickness of lesser omental sac in patients with ICU was (3.63±0.85) cm,while that in non-ICU patients was (1.48±0.80) cm,the difference was statistically significant(P=0.000).The APACH Ⅱ score was 13.50±6.72 in ICU patients and 5.48±4.72 in non-ICU patients,the difference was statistically significant(P=0.000).Conclusion There is significant positive correlation between thickening swollen lesser omental sac by ultrasonography and APACHE Ⅱ scoring in acute pancreatitis.It could be used as an indicator to evaluate the severity of acute pancreatitis.

目的 比较超声造影(CEUS)与CT对膀胱癌术前分期的诊断价值.方法 回顾性分析52例膀胱癌患者共63个膀胱癌病灶的CEUS及CT资料,分别根据术前CEUS及CT影像特点对病灶进行分期,并与术后病理检查结果进行对比,比较CEUS分期和CT分期与病理分期的符合率.绘制ROC曲线,比较CEUS、CT对膀胱癌的诊断价值.结果 术前CEUS结果与病理结果的符合率为87％,术前CT结果与病理结果的符合率为68％.CEUS、CT对Ta～T1、T3～T4期膀胱癌的诊断符合率比较差异无统计学意义(P均＞0.05),CEUS对T2a、T2b期膀胱癌的诊断符合率高于CT(P均＜0.05).CEUS诊断T2a、T2b期膀胱癌的灵敏度、特异度、阴性预测值、阳性预测值均高于CT(P均＜0.05).结论 术前CEUS对T2a、T2b期膀胱癌的分期诊断符合率、诊断价值均高于CT检查.

目的 探讨脾脏血管瘤的超声造影(CEUS)表现及鉴别诊断要点.方法 回顾性分析经增强CT、MRI检查临床确诊或手术病理证实的15例30个病灶脾脏血管瘤的CEUS资料.结果 15例30个病灶中,28个脾脏血管瘤病灶常规超声均为高回声病灶,2个病灶为低回声病灶,经超声造影后15例30个病灶均在动脉期出现增强,其中8个病灶表现为动脉期呈周边结节状向心增强,静脉期高于或等于脾脏回声,15个病灶表现为动脉期均匀强化,静脉期高于或等于脾脏回声,7个病灶表现为动脉期低增强,静脉期逐步向内缓慢充填后呈低增强.结论 CEUS能动态显示脾脏血管瘤的增强特征,有助于其诊断和鉴别诊断.

目的 探讨microRNA-9(miR-9)和microRNA-210(miR-210)检测联合彩色多普勒超声诊断乳腺癌的价值.方法 选取2015年3月至2018年3月四川省人民医院东院乳腺外科收治的乳腺癌患者175例(乳腺癌组)和乳腺良性病变患者162例(良性病变组).以是否患有乳腺癌为因变量,采用Logistic回归分析影响宫颈癌患病的影响因素;以术后病理检查结果作为金标准比较彩色多普勒超声,miR-9、miR-210检测及联合诊断乳腺癌的准确性.结果 乳腺癌发病的危险因素包括乳腺癌家族史、月经规律与否、人表皮生长因子受体2(HER2)表达、miR-9表达和miR-210表达(P<0.05);彩色多普勒超声诊断乳腺癌的敏感性为83.43％,特异性为69.14％.miR-9检测诊断乳腺癌的曲线下面积(AUC)为0.753,miR-210的AUC为0.747.彩色多普勒超声联合miR-9、miR-210检测诊断为乳腺癌AUC为0.934,敏感性为89.78％,特异性为85.12％.结论 彩色多普勒超声联合血清miR-9、miR-210检测可以较好地诊断乳腺癌,为临床早期诊断、筛查乳腺癌提供参考.

目的 对比分析2016美国临床内分泌协会(AACE)/美国内分泌学院(ACE)/内分泌学相关医学指南(AME)甲状腺超声诊断指南与甲状腺影像学报告及数据系统(TI-RADS)诊断标准对甲状腺结节良恶性的诊断价值.方法 按TI-RADS分类系统中的评分标准评分,以病理检查结果为金标准,回顾性分析150例患者共203个甲状腺结节的二维超声及彩色多普勒超声检查结果,采用MecNemar检验及构建患者的工作特征(re-ceiver operating characteristic,ROC)曲线比较分析2016AACE/ACE/AME甲状腺超声诊断指南与TI-RADS分类系统对甲状腺良恶性结节的超声诊断意义.结果 恶性结节75个,良性结节128个,2种评价方法对比分析,2016AACE/ACE/AME甲状腺超声诊断指南的灵敏度、特异度及准确度分别为84％、83％和84％,TI-RADS的敏感度、 特异度及准确度分别为84％、61％和76％,2016AACE/ACE/AME甲状腺超声诊断指南对甲状腺结节诊断的特异度、准确度要高于TI-RADS,2种方法比较差异无统计学意义(P>0.05),但2种方法结合后,ROC曲线下面积为0.911,特异度、准确度及诊断价值高于单一方法.结论 2016AACE/ACE/AME版甲状腺超声诊断指南在甲状腺结节良恶性鉴别中具有较高的实用价值,是TI-RADS分类系统的良好补充,两者结合能够提高甲状腺结节良恶性的诊断.

目的 探讨超声造影(CEUS)在评价膀胱癌术前分期中的应用价值.方法 回顾性分析52例膀胱癌患者共63个膀胱癌病灶的CEUS资料,对其术前超声造影的影像特点对病灶进行分期,并与术后病理分期进行对比研究.结果 CEUS术前检查结果与病理对照,总的对照符合率为87％,其中Ta-1期6例,T2a期27例,T2b期24例,T3-4期6例.CEUS对不同分期膀胱癌的诊断符合率分别为:Ta-1期的诊断符合率是94％,T2a期的诊断符合率是89％,T2b期CEUS的诊断符合率是94％,T3-4期的诊断符合率是98％.结论 CEUS对膀胱癌的术前分期有较高的准确性,是对常规超声检测膀胱癌的一个有力补充.

Objective To investigate the correlation between contrast-enhanced ultrasound (CEUS) and Egr-1 gene expression in patients with cervical carcinoma.Methods CEUS of 40 patients with cervical cancer was analyzed.The tumor morphological feature,distribution,and characteristics of Doppler blood flow were correlated with the expression of Egr-1.Results The peak intensity (PI) of tumor (75.71±2.13) was significantly higher (P＜0.001) than that of normal tissue (58.12±1.92) whereas the time to peak (TFP,32.43± 1.76) was significantly shorter (P=0.003) than that of normal tissues (40.41±2.24).The Egr-1 gene expression of cervical cancer was significantly lower than that of adjacent tissues (P＜0.001) and was significantly correlated with tumor size ＜4 cm,lymph node metastasis,and higher pathological grade (P＜0.05).The degree of contrast enhancement of cervical cancer was correlated with the expression of Egr-1 and did not correlate significantly with tumor size,lymph node metastasis,and pathological grade (P＞0.05).Heterogeneous enhancement was significantly more frequent at low than high Egr-1 expression (P＜0.05).Conclusion CEUS is useful to evaluate the prognosis of cervical cancer.

目的 探讨《2016版甲状腺超声诊断指南》中列举的超声特征在甲状腺良恶性结节鉴别中的应用价值.方法 对150例患者共203个甲状腺结节行二维超声及彩色多普勒超声检查,根据《2016版甲状腺超声诊断指南》中列举的超声特征在甲状腺良恶性结节的超声特征,结合穿刺活检病理或手术结果行单因素分析,分析其诊断意义.结果 恶性结节75个,良性结节128个,良、恶性结节在包膜、边界、回声水平、钙化、后方衰减、声晕、血流方面差异有统计学意义(P<0.05).结论 《2016版甲状腺超声诊断指南》在甲状腺结节良恶性鉴别中具有较高的实用价值.

Objective To analyze the ultrasound ifndings and pathological results of anaplastic thyroid carcinoma, and to explore the diagnostic value of ultrasound.Methods The ultrasonographic features of 12 cases with anaplastic thyroid carcinoma were analyzed retrospectively and conifrmed by pathology.Results12 patients with anaplastic thyroid cancer in females&nbsp;and 12 patients with 12 lesions, 10 were hypoechoic lesions, 9 cases of unclear edge, 11 cases without calciifcation, 10 cases were thyroid membrane baptized, aspect ratio < 1 of the 10 cases, there are cervical lymph node metastasis in 10 cases.Conclusion Ultrasound imaging can accurately assess the special features of anaplastic thyroid carcinoma, which can help for diagnosis.

Objective To discuss the diagnostic value of superb micro-vascular imagine ( SMI ) technology combined with contrast-enhanced ultrasound in the diagnosis of hyperplastic nodulel in cirrhosis and primary well -differentiated small hepatocellu-lar carcinoma ( HCC) .Methods The SMI and contrast-enhanced ultrasound of 30 cases of hyperplastic nodulel in cirrhosis and 30 cases of primary well-differentiated small HCC were analysed retrospectively .Results SMI can be sensitive to the capture of low blood flow signals .The internal and marginal blood flow differentiation of SMI on nodules of cirrhosis and primary well -differ-entiated small HCC showed significant differences ( P <0.05).Contrast enhanced ultrasound ( P <0.05) can better show di-rect visualization of the micro blood flow in nodules .The difference between the two groups was statistically significant ( P <0.05).There was a good correlation between SMI and contrast-enhanced ultrasound ( r =0.557).Conclusion SMI technology combined with contrast enhanced ultrasound can significantly improve the diagnosis and differential diagnosis of hyperplastic nod -ulel in cirrhosis and primary well-differentiated small HCC .

梗阻性黄疸是是由于肝外胆管或肝内胆管阻塞所致的黄疸，是肝胆疾病的最常见和最严重的表现形式。梗阻性黄疸的病因诊断对于制定治疗方案及预后判断均有指导意义，其诊断依据主要靠影像学检查。随着医学影像学的发展，近年来梗阻性黄疸的定位、定性诊断有了长足的进步，检查方法趋于多样化。如何选择适宜的检查方法并加以合理应用，对梗阻性黄疸的诊断与治疗是至关重要的。本文回顾性对比分析1年来经超声、CT、磁共振胰胆管造影（MRCP）诊断，并经手术病理或临床证实的50例梗阻性黄疸的病例，探讨超声、CT、MRCP对胆道梗阻的影像表现及临床价值。

目的：分析老年人甲状腺癌的超声表现与病理结果，探讨超声对老年人甲状腺癌的诊断价值。方法：回顾性分析50例老年患者甲状腺癌的超声表现，并与手术病理对照研究。结果：本组50例老年患者甲状腺癌中女性多见，以乳头状癌和滤泡癌最常见，各类型甲状腺癌在二维超声图像上有很多共同之处，但也存在一些差异性。结论：通过超声的声像图特征可以较准确评估病变的特征，超声可作为老年人甲状腺癌的首选筛查方式。