目的:探讨超声诊断糖尿病肾病(DN)合并非酒精性脂肪肝(NAFLD)及其与心脏瓣膜钙化(HVC)的相关性.方法:选取医院收治的120例DN患者,根据有无NAFLD将其分为合并NAFLD组(56例)和未合并NAFLD组(64例).两组患者均行肝脏超声及经胸超声心动图检查,并行血常规及血脂检测,比较两组血常规指标、血脂指标以及超声心动图指标,对DN合并NAFLD的影响因素进行Logistic回归分析.根据超声二维图像特征对NAFLD进行严重程度分级,统计HVC发生率,并对其钙化程度进行评分,分析NAFLD严重程度与HVC程度的相关性.结果:在两组120例DN患者中有56例(占46.67%)合并NAFLD.两组患者的血红蛋白、血小板计数、总胆固醇(TC)、舒张期末室间隔厚度(IVST)、左心室舒张末期内径(LVDD)、左心室后壁厚度(LVPWT)、左室射血分数(LVEF)以及左心室短轴缩短率(LVFS)指标比较差异无统计学意义;合并NAFLD组患者的甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、左心房内径(LAD)及颈动脉内中膜厚度(IMT)均高于未合并NAFLD组,低密度脂蛋白胆固醇(LDL-C)低于未合并NAFLD组,差异有统计学意义(t=17.591,t=10.125,t=4.050,t=7.174,t=13.253;P＜0.05);多因素Logistic回归分析显示,TG、LDL-C、HDL-C、LAD及IMT是DN合并NAFLD的独立影响因素;二维超声诊断结果显示,56例合并NAFLD组患者中,26例为轻度NAFLD,17例为中度NAFLD,13例为重度NAFLD;41例(占34.17%)出现HVC,其中19例为轻度HVC,13例为中度HVC,9例为重度HVC;DN合并NAFLD严重程度与HVC钙化程度呈正相关(r=0.724,P＜0.05).结论:DN合并NAFLD与血脂异常、LAD及IMT密切相关,且NAFLD严重程度与HVC钙化程度正相关,通过超声诊断能够预测HVC风险,故应给予高度重视.

目的 探讨超声造影(CEUS)对肝细胞癌(HCC)患者微波消融(MWA)疗效的评估价值及对局部复发的预测价值.方法 选取中南大学湘雅医学院附属海口医院自2020 年1 月至2022 年1 月收治的106 例接受MWA治疗的HCC患者为研究对象.所有患者分别于术前、术后1 个月,进行超声造影(CEUS)与增强CT(CECT)检查.根据 1 年随访结果将患者分为复发组(n =21)与未复发组(n =85).记录并比较两组术前CEUS的上升时间(RT)、达峰时间(TTP)、峰值强度、平均通道时间、曲线下面积.采用多因素Logistic回归分析检验HCC患者MWA后局部复发的影响因素.绘制受试者工作特征(ROC)曲线分析CEUS定量参数对肿瘤复发的预测价值.结果 CEUS、CECT评估消融疗效的准确性分别为92.45%(98/106)、94.34%(100/106),差异无统计学意义(P＞0.05).复发组、未复发组患者肿瘤直径比较,差异有统计学意义(P＜0.05).复发组患者RT、TTP均低于未复发组,差异均有统计学意义(P＜0.05).多因素Logistic回归分析结果显示,RT、TTP均为HCC患者MWA后局部复发的影响因素(P＜0.05).RT联合TTP预测HCC患者MWA治疗后复发的ROC曲线下面积为0.903(95%可信区间0.835～0.961).结论 CEUS检查可用于HCC患者MWA治疗的消融疗效评估,同时CEUS定量数据可对肿瘤的局部复发进行有效预测,可作为后续随访、检查的手段.

Tumor thermal ablation technique is a new technology that is born and developed on the basis of modern imaging technology. Real-time monitoring and immediately evaluating the range of thermal ablation is the key to ensure the safety of treatment and to achieve satisfactory curative effect. As a new ultrasonic tissue characterization method, ultrasound elasticity imaging is paid increasing attention to in respect of thermal therapy. In this paper, we intro-duce the application of ultrasound elasticity imaging in living animal experiment, in vitro experiment and the noninva-sive monitoring of clinical experiment for thermal ablation, and summarize the research status home and abroad. Future developments of ultrasound elasticity imaging in noninvasive monitoring for thermal therapy are also discussed.

Objective To explore the clinical value of ultrasound-guided biopsy in the diagnosis of pulmonary tumor.Methods The data of hospital ultrasound-guided biopsy in 92 cases with lung mass were analyzed retrospectively.Results 92 cases with pulmonary mass were abtained successfully in one time,and lung cancer,inflammatory lesions and tuberculosis accounted for 57.8%,22.2% and 4.4%.Conclusion Ultrasound-guided biopsy is safe,rapid,accurate and efficient to identify pulmonary mass.