Predictive value of Doppler ultrasound in childhood pneumonia

This study aimed to determine the predictive value of intercostal and pulmonary artery Doppler flow patterns in the outcome of childhood pneumonia. Pneumonia was classified according to type of pleural effusion and the ultrasound features of consolidations. Doppler flow patterns of intercostal and pulmonary arteries were analysed and correlated with pneumonia type and hospital stay. Of 83 pneumonia cases, 55 were uncomplicated and 28 were complicated. Pleural effusion was present in 54 cases, with 29 non-septated and 25 septated cases. Patients with uncomplicated pneumonia did not have abnormal Doppler flow patterns, compared with 64% (18 of 28) of patients with complicated pneumonia. Doppler ultrasound patterns in childhood pneumonia were correlated with pneumonia type and may be predictive of pneumonia outcome.     

双功能超声在下肢水肿病变诊断中的应用

目的探讨和分析双功能超声在诊断下肢水肿疾病的应用价值。方法应用双功能超声检查62例下肢水肿患者,对其中43例深静脉血栓及其他19例不同疾病声像图特点进行分析归纳总结。结果本组下肢水肿病因深静脉血栓居首占69.4%,且左下肢发病高于右下肢;小腿浅静脉血栓占1.6%;其他病因占29%。结论双功能超声在下肢水肿病因诊断及鉴别诊断中具有重要意义,是诊断下肢水肿理想、无创的检查方法。     

Measurement of blood flow in the vertebral artery using colour duplex Doppler ultrasound: establishment of the reliability of selected parameters

This study was designed to determine the reliability of the ultrasound testing procedure for evaluating vertebral artery blood flow, and to determine a robust testing protocol for future studies. Blood flow parameters were tested in ten asymptomatic subjects (mean age 33 years, standard deviation 6 years 8 months) using colour duplex Doppler imaging. Volume flow rate data at C5-6 demonstrated good reliability from a single measurement (Intraclass correlation coefficient [ICC]=0.81). Peak velocity sampled at C1-2 showed poor reliability if a single measurement was used (ICC=0.26) improving to fair levels with three measurements (ICC=0.77). Reliability for this parameter was good if five measurements were taken (ICC=0.83-0.84). Systolic/diastolic ratio measured at C5-6 showed poor reliability (ICC=0.57) if a single measurement was taken in the manner of Thiel et al. (1994). This improved to fair reliability (ICC=0.75) if the mean of three measurements was used. There was no further improvement if five measures were sampled. Sampling at C2-3 in the manner of Refshauge (1994) was found to be technically difficult and it was not possible to detect a Doppler shift in three of the ten subjects at this level. Reliability of peak velocity at C2-3 was found to be poor, regardless of whether single or multiple averaged measurements were taken (ICC=0.37-0.63). Mean (time averaged) velocity measurements at C2-3 showed poor reliability if a single measurement was taken (ICC=0.39), fair reliability if the first three measurements were averaged (ICC=0.73) and good to high reliability levels if five measurements were sampled (ICC=0.88-0.91). A review of the literature suggests that sampling volume flow rate at C5-6 and peak velocity at C1-2 represents a clinically meaningful combination of parameters to detect narrowing in the VA. The results of this current study indicate the desirability of taking a single measurement of volume flow rate at C5-6 and the mean of three measurements of peak velocity at C1-2, with the additional calculation of the standard error of measurement, if reliable results are to be achieved.     

Thermography and colour duplex ultrasound assessments of arterio-venous fistula function in renal patients

Vascular and clinical assessments of arterio-venous fistula (AVF) function and access are important in patients undergoing or preparing to undergo renal dialysis. Objective assessment techniques include colour duplex ultrasound and more recently medical infrared thermography. Ideally, these should help assess problems relating to fistula failure or to vascular steal from the hand which can result from excessive fistula blood flow. The clinical value of thermography, as yet, has not been assessed for this patient group. The aims of this study were therefore to investigate the relationships between thermography skin temperature measurement and (a) quantitative ultrasound measurement of AVF blood flow, and (b) qualitative clinical assessment of vascular steal from the hands. Fifteen adult patients underwent thermal imaging of the upper limbs, colour duplex ultrasound to derive AVF blood flow from brachial artery blood flow measurements, and a clinical evaluation for vascular steal. Temperature measurements were extracted from the thermograms, including bilateral arm and hand (Fistula -- Non-Fistula) differences, for comparison with derived AVF blood flow and steal grading. Derived AVF blood flow ranged from 30 to 1,950 ml min(-1), with a mean rate close to one litre per minute. Thermography detected the warmer superficial veins in proximity to the patent fistulas, with bilateral differences in fistula region skin temperature correlated with derived AVF blood flow (using maximum temperature measurements the correlation was +0.71 [p < 0.01]; and using mean temperature measurements the correlation was +0.56 [p < 0.05]). When thermography measurements were compared with the clinical assessment of steal the mean hand temperature differences separated steal from non-steal patients with an accuracy of greater than 90%. In summary, we have now demonstrated the potential clinical value of medical infrared thermography for assessing AVF function in renal patients.     

彩色血流显像及相关参数在甲状腺乳头状癌中的诊断价值

目的探讨甲状腺乳头状癌的彩色血流显像特点并定量分析其相关参数。方法分析经手术病理证实的29例甲状腺乳头状癌和84例良性结节的血流特点并定量分析相关血流参数。结果甲状腺乳头状癌血流分级以Ⅱ级为主,且血流分布杂乱、走行迂曲;良性结节血流分级以Ⅲ级为主,且血流分布比较规则。甲状腺乳头状癌内部血流搏动指数（PI）及阻力指数（RI）均高于良性结节,差异有统计学意义。ROC曲线提示PI〉0．8,RI〉0．6提示有恶性倾向。结论彩色血流显像能够显示结节的血流供应情况,若结节内血流分布杂乱、走行迂曲,且PI〉0．8,RI〉0．6时,要警惕恶性的可能。     

彩超诊断小儿肠系膜淋巴结炎的临床意义

目的 探讨高频超声对小儿肠系膜淋巴结炎的临床诊断。方法运用彩色多普勒超声对75例腹痛小儿，常规进行肝、胆、胰、脾、肾、阑尾等检查后，重点扫查及早右侧淋巴结的大小、形态及数量。结果 75例患儿均在右侧腹腔检测到数枚圆形、椭圆形低回声结节，直径大于0.9cm以上，以腹腔内及早右侧为主，具有临床意义。结论 高频超声对小儿腹腔内结构层次显示清晰，对肿大的淋巴结定位定性准确，对临床治疗有指导意义。     

双通道经颅多普勒超声对失语症患者语言功能恢复的预测研究

目的对脑卒中后Broca失语患者的语言功能恢复进行早期预测,并且对经颅多普勒超声(TCD)预测失语症预后的价值进行探讨。方法脑卒中后Broca失语的患者28例,发病后早期(5～10d)进行语言康复训练,2个月后根据恢复程度的不同分为无好转组和好转组,利用双通道TCD分别测定休息期和语言作业期的双侧大脑中动脉血流速度(MFV)的变化。结果无好转组患者和好转组患者脑梗死发生部位和体积、治疗前语言作业评分之间差异无显著性意义。对照组与患者组、患者组治疗前后的MFV之间比较差异没有统计学意义。对照组、B组和G组休息期和作业期MFV的变化百分比比较发现,G组患者的左半球MFV变化(8.1±1.1)%显著高于B组患者(2.7±0.9)%;对照组和G组患者治疗前左侧大脑中动脉作业期的MFV变化(8.7±0.5)%,(5.9±1.2)%显著高于右侧大脑中动脉犤(5.9±0.31)%,(3.7±0.6)%,t=3.012,2.898,P<0.01犦。结论左侧大脑半球参与了早期的语言恢复过程,对语言功能恢复起重要作用,TCD作为临床常规检查在早期预测失语症恢复方面有一定价值。     

彩色多普勒超声在睾丸急诊患者中的诊断价值

目的：评价彩色多普勒超声在睾丸急诊患者中的诊断价值。方法：回顾性分析143例经手术及保守治疗的睾丸急诊患者的声像图表现。结果：143例睾丸急诊患者中,78例睾丸炎,22例睾丸扭转,43例睾丸外伤,其中1例睾丸破裂误诊为睾丸扭转,彩色多普勒超声诊断符合率约99.3％（142/143）。结论：彩色多普勒超声在睾丸急诊患者中的诊断符合率高,对临床治疗方案的选择具有重要的指导意义。     

彩色多普勒超声参数列线图模型在瘢痕妊娠术中大出血风险中的预测价值

目的：探究彩色多普勒超声参数列线图模型在瘢痕妊娠(CSP)术中大出血风险中的预测价值。方法：回顾性分析了2017年9月至2021年9月在甘肃省妇幼保健院收治的254例经病理确诊的CSP患者的临床资料,根据清宫、宫/腹腔镜手术治疗时的出血量分为两组,其中研究组60例(出血量≥400ml),对照组194例(出血量<400ml)。比较两组患者临床及超声特征之间的差异。采用Logistic回归筛选CSP术中大出血的危险因素,然后构建列线图预测模型并通过校准图及ROC曲线对预测模型进行评估。结果：与对照组比较,研究组患者残余肌层厚度降低(P<0.05),病灶大小及腹痛、病灶类型为包块型、血流分级III级的发生率升高(P<0.05)。Logistic回归分析结果示,腹痛、病灶大小、残余肌层厚度、病灶类型、血流分级为CSP患者术中大出血的危险因素(P<0.05)。列线图校准曲线示,模型预测的大出血发生率与实际发生率具有较好的一致性,列线图预测模型的ROC曲线下面积AUC=0.878(95%CI：0.831-0.926,P<0.05)。结论：通过彩色多普勒参数构建的列线图预测模型对CSP患者术中大出血风险具有较好的预测价值。     

Feasibility of dynamic 3-D color Doppler ultrasound for imaging penile vascular change in renal transplant patients with erectile dysfunction responding to sildenafil

Renal transplant recipients (RTRs) have a high incidence of erectile dysfunction (ED). Differentiation of penile vasculogenic impotence from other causes is important for treatment. Conventional 2-D color Doppler assessment after intracavernosal stimulant injection often fails to produce reliable results because of limited views by the cross-sectional imaging and the painful procedure. In comparison to the findings in three healthy volunteers, we determined cavernosal vascular hemodynamics in eight RTRs with ED before and after oral sildenafil by using live 3-D ultrasound and dynamic 3-D color Doppler. Results showed that, before sildenafil, penile arterial flow signals could only be reliably detected in one patient. After sildenafil, all had reliably detectable flow with grades II to III erection. Our data suggest that 3-D volumetric changes of the penis and its vasculature during erection can be studied by this technique and that this method could be useful for the evaluation of new drugs and therapeutic biofeedback.     

颈部血管彩超、经颅多普勒超声与脑血管造影的一致性分析

目的探讨颈部血管彩超、经颅多普勒超声(TCD)对颈动脉狭窄、椎-基底动脉狭窄和动脉粥样硬化斑块的诊断价值,分析其与脑血管造影的一致性。方法选取2019年1月~2020年6月106例动脉粥样硬化性脑梗死患者为观察组,53例无脑梗死的动脉粥样硬化高血压病和(或)高脂血症患者为对照组。比较两组颈部血管彩超和TCD对颈动脉与椎-基底动脉中重度以上狭窄、不稳定型斑块的检出率。以脑血管造影为金标准,分析颈部血管彩超和TCD的诊断一致性。结果观察组颈动脉与椎-基底动脉中度狭窄、重度狭窄、完全闭塞的检出率均高于对照组(P < 0.05)。观察组颈动脉粥样硬化不稳定型斑块的检出率高于对照组(P < 0.05)。颈部血管彩超联合TCD对中重度以上狭窄检出的敏感度为93.75%,特异性为88.46%,准确率为92.45%,一致性较高(Kappa=0.801);对不稳定型斑块检出的敏感度为87.67%,特异性为87.88%,准确率为87.74%,一致性较高(Kappa= 0.725)。结论颈部血管彩超和TCD诊断颈动脉狭窄、椎-基底动脉狭窄和动脉粥样硬化斑块准确、无创、便捷,对脑梗死的预防、诊断、病因分析具有重要的参考意义。     

动态肺超声、膈肌和左心功能评估对重症机械通气患者撤机预测价值

[摘要] 目的：评估肺超声动态监测肺水变化联合膈肌功能对重症机械通气（MV）患者撤机的预测价值。 方法：选取重症医学科112例接受MV＞48h并符合撤机条件患者,于自主呼吸试验（SBT）0min采用床旁超声测量左室射血分数（LVEF）、左室短轴缩短率（LVFS）、舒张功能指标和胸前区肺超声水肿评分（A-LUES 0min）;于SBT 15min测量膈肌移动度（DE）及A-LUES 15min,并计算△A-LUES。采用ROC曲线评价各指标预测撤机结果的价值。 结果：64例撤机成功（成功组）,48例撤机失败（失败组）,失败组LVEF、DE、e’明显低于成功组,E/e’、A-LUES 15min、△A-LUES明显高于成功组（P＜0.05）;分别以51.50%、6.48cm/s、10.36、10.35mm、1.50分作为LVEF、e’、E/e’、DE和△A-LUES的阈值,预测撤机结果的敏感度分别为 93.75%、90.63%、62.50%、85.94%和77.08%,特异度分别为27.08%、52.08%、75.00%、56.25%和67.19%,AUC分别为0.613、0.735、0.652、0.786和0.793;△A-LUES联合DE对预测撤机结果的敏感度为89.58%,特异度为82.81%,AUC为0.909。 结论：超声监测肺水动态变化、膈肌功能和左心功能对撤机成败有较好的预测价值。     

二维超声、频谱及彩色多普勒超声在评价实验性兔急性肾衰竭中的价值比较

目的 比较二维超声、频谱及彩色多普勒超声在诊断急性肾衰竭（ＡＲＦ）中的价值。方法 兔后腿肌注５０％甘油１２￣１５ｍｌ／ｋｇ,建立ＡＲＦ动物模型,分别于给药前（Ｔ０）、给药后１、３…１３ｄ（Ｔ１、Ｔ３…Ｔ１３）共８个时间点行超声检查,二维超声用于观察肾脏大小及回声改变,频谱多普勒用于定量分析肾血流动力学改变,彩色多普勒血流显像（ＣＤＦＩ）及彩色多普勒能量显像（ＣＤＰＩ）用于定性分析肾血流灌注情况,将肾血流情况分为３级：Ⅰ级,肾血流灌注正常,血流信号可延至肾包膜下;Ⅱ级,肾血流灌注不良,血流信号可延至肾皮质,但不能至肾包膜下;Ⅲ级,肾血流灌注重度不良,血流信号不能延至肾皮质。结果 肾脏大小及肾血流动力学改变均从Ｔ３开始,Ｔ５、Ｔ７达高峰,Ｔ９时多已恢复至正常,且肾皮质增厚与肾体积增大高度相关。Ｔ０时所有兔肾ＣＤＦＩ     

Increased expression of connective tissue growth factor in patients with urethral stricture

Urethral stricture (US) is a urologic disorder with a high morbidity and recurrence rate, and may arise due to external trauma, surgical procedures or urethritis. The pathogenesis of US is closely associated with scar formation, including excessive collagen-rich connective tissues. Previous studies have shown that connective tissue growth factor (CTGF) plays a key role in the fibrosis process of many tissues and organs, such as kidney and lung. We investigated the variation of CTGF expression in urethral tissues from 12 patients with US and normal urethral tissues. The stricture length range was 1 to 2.5 cm, and 4 patients underwent repeated urethral dilatation. The normal urethral tissues were obtained from 6 patients with heart disease, who were suffering from brain death. The expression of CTGF mRNA and protein was analyzed by real-time PCR, immunohistochemistry, and western blotting analyses. Results showed that the expression level of CTGF mRNA was significantly increased in US patients compared with the control. In addition, US patients who have longer history and more repeated surgical procedures have extremely high CTGF mRNA levels and its protein expression, while the age of patients, position of injury and stricture length were not found obvious relation with CTGF expression. Moreover, the degree of collagen deposition and muscle fiber proliferation in the submucosa is consistent with the increase in CTGF expression. In conclusion, our data suggest that the up-regulation of CTGF expression may be responsible for the fibrosis process of urethral tissues in US patients.     

彩色多普勒技术诊断急性肾损伤的应用价值

目的探讨彩色超声多普勒技术诊断急性肾损伤（AKI）的临床应用价值。方法92例危重病患者中,73例没有慢性肾功能衰竭史并未使用利尿剂的患者被纳入研究。由受过超声检查专门训练的临床医师进行床边超声检查,研究周期为11个月,其中未出现 AKI 的患者23例,暂时性 AKI 的32例,永久性 AKI的患者18例。结果在非 AKI 组,血流阻力指数分别为0．63±0．11（RA）,0．59±0．10（SRA）和0．52±0．07（LRA）,在暂时性 AKI 组分别为0．78±0．10（RA）,0．75±0．09（SRA）和0．72±0．08（LRA）,在永久性 AKI 组分别为0．76±0．12（RA）,0．73±0．10（SRA）和0．72±0．08（LRA）。AKI 的 R、I 及 F 期患者的血流阻力指数差异有统计学意义（P ＜0．01）。各组血管的血流阻力指数 ROC 曲线下面积分别为0．703,0．690,0．722,均大于0．5,但各组之间差异无统计学意义（P ＞0．05）。结论彩色超声多普勒技术诊断危重症患者 AKI 有一定价值。     

彩超在肝硬化门静脉高压中的诊断价值分析

目的:探讨彩超在肝硬化门静脉高压中的诊断价值.方法:选取2018年8月—2020年7月肝硬化患者70例,其中34例为肝硬化失代偿期,纳入失代偿期组,36例为肝硬化代偿期,纳入代偿期组.健康人员35例作为正常对照组.比较各组肝动脉和门静脉血流动力学情况.结果:失代偿期组、代偿期组肝动脉和脾动脉的阻力指数、门脉高压指数均明...     

颈动脉超声参数在评价维持性血液透析患者动脉粥样硬化性心血管疾病中的应用

目的 探讨维持性血液透析(MHD)患者颈动脉超声参数与Framingham危险评分(FRS)的关系及在预测动脉粥样硬化性心血管疾病(ASCVD)中的价值.方法 共入选129例MHD患者,采用FRS和共存疾病指数(ICED)评估MHD患者ASCVD及危险因素;颈动脉B超测定颈总动脉内-中膜厚度(CCA-IMT)、颈总动脉最大内-中膜厚度(CCA-IMTmax),计算颈总动脉内-中膜横切面积(CCA-IMarea),同时记录有无颈动脉斑块(CPs).结果 根据血管病变支数和严重程度评分分组,结果显示,随着血管支数增加和病变程度加重,CCA-IMT、CCA-IMarea、CCA-IMTmax、CPs和FRS逐渐增高(P＜0.01).Logistic回归分析结果显示CPs、FRS是预测ASCVD发生的独立变量;CPs、FRS可独立预测冠状动脉性心脏病发生;CCA-IMT、CCA-IMarea可独立预测脑血管疾病发生;CPs、CCA-IMT、CCA-IMarea、FRS均可预测外周血管疾病发生.结论 CCA-IMT预测ASCVD的准确性优于CCA-IMarea、CCA-IMTmax.