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1.
超声评估乳癌患者腋下淋巴结转移的临床价值   总被引:2,自引:0,他引:2  
目的:通过对乳癌原发灶的灰阶超声,彩色多普勒(Color Doppler Flow Imaging,CDFI),频谱多普勒检查,评估腋下淋巴结有无转移。方法:术前运用超声检测122例乳癌患者原发灶的声学特性,术后根据腋下淋巴结有无转移分为两组,比较两组间年龄,原发灶的部位(象限分布),大小,内部回声,有无卫星灶,CDFI,频谱多普勒有无显著差异。结果:患者的年龄,内部回声,有无卫星灶,两组间无显著性差异;原发灶的大小,部位两组间有显著差异;CDFI显示:腋下淋巴结阳性组原发灶内血流比阴性组丰富(P<0.05);频谱多普勒显示:阳性组峰值流速(Vmax)高于阴性组(P<0.01),其中Vmax>33cm/s的14例患者腋下淋巴结均呈阳性。阻力指数(RI):两组间无显著差异,但如把RI=1的8位患者单独列组,两组间有显著差异(P<0.01)。结论:运用灰阶超声、多谱勒超声评价癌肿的声学特性,对判断腋下淋巴结状态,指导临床治疗,有一定帮助。  相似文献   

2.
目的探讨乳腺癌的彩色多普勒超声血流特点及红外热成像特征与腋窝淋巴结转移的关系,进而评价其在预后判断中的价值。方法将术前67个单侧浸润性乳腺癌(有腋窝淋巴结转移即LN ,31例;无腋窝淋巴结转移即LN-,36例)的彩色多普勒超声血流参数(Vmas,RI,PI)及红外热像图的病变部位与对侧镜像部位的平均温差(AT)分别与术后乳腺癌的液窝淋巴结转移情况进行比较分析。结果LN 组的彩色多普勒血流RI值及红外热像图的AT值均明显高于LN-组(分别P=0.007,P=0.002),而二组间的彩色多普勒血流的Vmax值及PI值均无显著性差异(分别P=0.26,P=0.18)。结论彩色多普勒血流RI值及红外热像图的AT值与乳腺癌腋窝淋巴结转移密切相关,二者结合对乳腺癌预后判断具有重要意义。  相似文献   

3.
The purposes of this study were (1) to evaluate the color Doppler sonographic findings in patients with transitional cell carcinoma of the bladder and renal pelvis, (2) to determine if color Doppler sonography could predict tumor grade and stage, and (3) to determine whether tumor vascularity is related to size. A total of 15 patients with 16 bladder transitional cell carcinomas and one patient with renal pelvic transitional cell carcinoma were evaluated prospectively with transabdominal color Doppler ultrasonography. The presence or absence of visible vascularity and the resistive index were correlated with tumor size, cytologic grade, and tumor stage. Statistical analysis was performed with Fisher's exact test. Seven (41%) of 17 tumors had visible vascularity: five (45%) of 11 high-grade transitional cell carcinomas were vascular, whereas two (33%) of six low-grade transitional cell carcinomas were vascular (P = 1.00). Three of five (60%) of the invasive lesions were vascular, but the vascularity was not predictive of tumor stage (P = 0.593). The vascular high-grade tumors tended to have more numerous and larger visible vessels than the vascular low-grade lesions. No tumor smaller then 23 mm was vascular, but the size of the tumor was not predictive of the vascularity (P = 0.1172). The resistive index was measurable in six tumors, but it was not predictive of grade or stage. Color Doppler ultrasonography is not helpful clinically in the evaluation of transitional cell carcinoma as tumor grade, stage, and size are not related to vascularity.(ABSTRACT TRUNCATED AT 250 WORDS)  相似文献   

4.
前列腺外周带血流高阻力指数(RI) 对前列腺癌的诊断价值   总被引:14,自引:4,他引:14  
目的探索彩色多普勒超声的血流指标对前列腺癌的诊断价值.方法采用彩色多普勒双平面直肠腔内探头检测前列腺,重点检测前列腺外周带血流参数指标.结果前列腺增生67例,前列腺癌58例.前列腺外周带血流2级以上前列腺增生58%,前列腺癌74.13%,P<0.10;前列腺增生和前列腺癌的Vmax均值分别是10.77 cm/s和12.91 cm/s,RI分别是0.71和0.82,Vmax和RI在两组间有显著统计学差异(P<0.001);以RI 0.75为临界值,对前列腺癌诊断的敏感性87.5%、特异性92.4%、准确性75%和阳性预测值84%.结论前列腺外周带血流增多,RI>0.75时,对前列腺癌的诊断价值明显提高.  相似文献   

5.
经直肠彩色多普勒超声膀胱肿瘤显像的临床价值   总被引:6,自引:0,他引:6  
目的 探讨经直肠腔内彩色多普勒超声显像对膀胱肿瘤的临床价值。方法 对 3 6例膀胱肿瘤患者先经腹壁再经直肠进行彩色多普勒超声检查 ,对两种方法的显示率进行比较 ,记录血流参数 ,进行统计学分析。结果 经腹壁和经直肠彩色多普勒显像肿瘤显示率分别为 61%和 97% ,有显著差异 (P <0 .0 5 )。最大血流速度Vmax和最小血流速度Vmin在较小的肿瘤低 ,较大肿瘤高。阻力指数RI在较小的肿瘤高 ,较大肿瘤低 ,但没有统计学差异 (P >0 .0 5 )。结论 膀胱肿瘤彩色多普勒超声显像经直肠检查方法优于经腹壁方法 ,特别是小于 2 .0cm的膀胱肿瘤  相似文献   

6.
Kudo M  Tochio H  Zhou P 《Intervirology》2004,47(3-5):154-161
Doppler spectral analysis using color Doppler ultrasonography (US) was performed in a total of 133 patients with 135 hepatic tumors, including 88 hepatocellular carcinomas (HCCs), 30 metastatic hepatic cancers, 15 hemangiomas and 2 focal nodular hyperplasias (FNHs). Mean +/- SD of maximum velocity (Vmax) in hemangiomas (15.0 +/- 16.0 cm/s) was significantly lower than in HCCs (34.9 +/- 26.7 cm/s) and in metastases (37.9 +/- 17.4 cm/s). Mean +/- SD of the pulsatility index (PI) in hemangiomas (0.45 +/- 0.41) was significantly lower than in HCCs (1.52 +/- 0.71) and metastases (1.44 +/- 0.43). Mean +/- SD of Vmax and PI in FNH was 20.0 +/- 11.3 cm/s and 0.90 +/- 0.35, respectively. HCC showed a wide spectrum in terms of Vmax and PI; however, 18% of the HCC nodules had relatively high PI (>2.0). Specificity of Vmax more than >60 cm/s and PI more than 2.0 for the diagnosis of HCC were 92 and 94%, respectively. On the other hand, 87% of hemangiomas showed relatively lower Vmax (<30 cm/s) and 87% of hemangiomas showed relatively low PI (<1.0 cm/s). Specificity of Vmax less than 30 cm/s and PI less than 1.0 for the diagnosis of hemangioma were 47 and 78%, respectively. When taking account of both parameters, Vmax and PI, diagnostic efficacy for hemangioma and HCC was greatly improved (sensitivity, specificity, accuracy, positive predictive value and negative predictive value of 80, 86, 85, 41 and 97%, respectively, in hemangioma, and 38, 85, 54, 83 and 58%, respectively, in HCC) as compared with the results with Vmax or PI alone. In conclusion, in addition to the information obtained by Vmax, simultaneous measurement of PI adds valuable information useful in the noninvasive differentiation among hepatic tumors by Doppler spectral analysis at color Doppler US.  相似文献   

7.
血流速度测定在乳腺肿瘤诊断中的应用价值   总被引:38,自引:1,他引:38  
作者应用彩色多普勒超声测定了76例乳腺肿瘤内血流收缩期峰速和阻力指数,并对其临床应用价值作了分析。结果表明恶性肿瘤VP值明显高于良性肿瘤,良恶性肿瘤RI值无显著性差异。统计学分析了显示良恶性肿瘤之间的临界流速值为12cm/sec,该值对直径2cm以下乳癌诊断敏感性、特异性和准确性分别为95.5%、100%和96.6%。作者认为流速测定有助于乳腺肿瘤,特别是直径2cm以下肿瘤的鉴别诊断。  相似文献   

8.
Purpose We studied the relation between intratumoral hemodynamics and histopathologic characteristics in patients with colorectal carcinoma.Methods A series of 82 patients with 28 well-differentiated adenocarcinomas, 40 moderately differentiated adenocarcinomas, 10 poorly differentiated adenocarcinomas, and 4 mucinous adenocarcinomas underwent color Doppler examination and surgical treatment. The waveform of blood flow in the thickened wall of the colon was analyzed by determining the maximum velocity (Vmax) and resistance index (RI). These parameters were compared with histopathologic findings of the resected specimens: gross form, tumor size, depth of invasion, histologic stage, and histopathologic classification.Results Both Vmax and RI were higher in the invasive tumors rather than the expansive ones. Vmax and tumor size were not correlated; however, the RI increased proportionately with tumor size in tumors larger than 4cm in diameter. Both parameters increased with depth of invasion and histologic stage through stage IIIb. Both were markedly higher in mucinous adenocarcinomas than in the other histopathologic types. Furthermore, Vmax in well, moderately, and poorly differentiated adenocarcinomas did not differ significantly, although RI was negatively associated with the degree of differentiation.Conclusions We concluded that blood-flow analysis is closely associated with histopathologic findings of colorectal carcinomas and that it provides information useful in the clinical management of these patients.  相似文献   

9.
张清 《上海医学影像》2008,17(3):249-250
目的探讨二维超声及彩色多普勒超声在检查乳腺癌中的表现和特征,评价其在诊断乳腺癌中的应用价值。方法回顾性分析135例经手术及病理证实为乳腺癌患者的超声表现:包括二维声像图特征及彩色多普勒表现:肿块内部及周围的血供情况,血流峰值速度和阻力指数等血流动力学参数。结果135例乳腺癌中,乳腺浸润性导管癌128例,筛状癌3例,髓样癌1例,小叶癌原位癌2例和纤维腺瘤伴肉瘤变l例。超声所见:135例中超声发现肿块129例,大小为0.2em~3.4era不等,肿块纵横径比大于1占69%(89/129),肿块边界不整齐,约占70%(90/129),2例肿块不明显但局部可见沙粒样钙化点及局部血流信号异常。沙粒样钙化点占52.6%(70/129);彩色多普勒发现血流信号占79.8%(103/129),频谱多普勒示血流峰值速度(PSV)为18-49ends,阻力指数(RI)为0.67~0.96,RI〉0.7占93.2%(96/103)。超声漏诊4例。结论当彩色多普勒超声在乳腺肿块内部或周围,或异常回声区内探及丰富血流信号,流速曲线显示为高速高阻时,要高度怀疑乳腺癌,彩色多普勒超声在乳腺良恶性肿瘤的诊断与鉴别诊断中发挥重要的作用。  相似文献   

10.
目的 探讨二维及彩超在乳腺良恶性肿块鉴别诊断中的价值。方法 45例肿块经二维超声了解其形态、边界、边缘、内部回声、有无后方衰减及侧方声影;然后用彩色多普勒检查,观察肿块内部血流丰富程度,并根据其丰富程度分成4个等级,并测量阻力指数。结果 良恶性乳腺肿块二维声像特征存在一定重叠;二者血流丰富程度及阻力指数有助于鉴别诊断。结论 二维声像图与彩色多普勒相结合,在乳腺良恶性肿块的鉴别诊断中,有着重要的诊断价值。  相似文献   

11.
PURPOSE: We compared the usefulness of Levovist-enhanced power Doppler imaging (PDI) and helical CT in the depiction of tumor vascularity before and after percutaneous ablation of small hepatocellular carcinomas (HCCs). METHODS: Thirty-one cirrhotic patients with solitary unresectable HCCs smaller than 5 cm (mean size, 2.7 +/- 0.8 cm; range, 1.5-5.0 cm) recruited over a 15-month period were treated with percutaneous ethanol injection (n = 9) or radiofrequency ablation (n = 22). PDI, contrast-enhanced PDI (using Levovist), and multiphase contrast-enhanced helical CT were performed before and after percutaneous ablation, and vascularity findings were compared. RESULTS: Levovist significantly increased baseline intratumoral Doppler signals on PDI compared to non-contrast PDI. The most frequent tumor vascularity pattern was heterogeneous (45%). Vascularity was identified in all tumors by both contrast-enhanced PDI and helical CT before ablation. After percutaneous ablation, intratumoral vascularity was detected in 11 tumors by contrast-enhanced PDI and in 15 tumors by CT. The sensitivity, specificity, and diagnostic accuracy of contrast-enhanced PDI in demonstrating intratumoral vascularity, with CT being the gold standard, were 66%, 93%, and 81%, respectively. There was significant agreement between the 2 modalities in the depiction of tumor vascularity after ablation (kappa = 0.6, p = 0.001). However, there were 5 false negatives and 1 false positive with contrast-enhanced PDI. Complete tumor necrosis was achieved in 21 patients (68%). CONCLUSIONS: There was a good concordance between contrast-enhanced PDI and helical CT in the depiction of HCC vascularity before and after percutaneous ablation. However, although contrast-enhanced PDI may be useful for real-time guidance of treatment, its low sensitivity makes it inadequate to accurately assess the completeness of ablation.  相似文献   

12.
彩色多普勒联合脉冲多普勒诊断小肝癌的研究   总被引:1,自引:0,他引:1  
本文就经手术及/或病理证实的≤3cm的肝内占位性病变56例(71个病灶)进行了彩色多普勒(DCFI)和脉冲多普勒(PD)的联合研究,其中原发性肝癌38例,肝血管瘤13例,肝局灶凝固性坏死3例,其它2例。DCFI与PD联合应用,在小肝癌中有86.96%可检测到动脉谱,而肝血管瘤和肝良性肿瘤组中仅分别为37%和33%,显著低于小肝癌组,多普勒流速和阻力指数(RI)显示流速在小肝癌与肝血管瘤等组之间无显著差异,如以肝小病灶内出现彩条并且测及动脉谱和RI>50%作为诊断小肝癌的指标,则其诊断小肝癌的特异性(96%)、准确性(90.14%)均显著高于单纯的二维超声(分别为56%和67.6%),而敏感性(86.96%)亦高于单纯的二维超声。作者认为彩色多普勒和脉冲多普勒联合应用可作为小肝癌诊断的新的手段。  相似文献   

13.
OBJECTIVE: We prospectively evaluated low-stage breast cancers treated with neoadjuvant chemotherapy using whole-volume sonography and color Doppler imaging. METHODS: Thirty-four women with breast cancer (mean maximum size, 2.4 cm) received neoadjuvant chemotherapy with doxorubicin and docetaxel. Targeted whole-volume sonography of tumor sites was performed before and after chemotherapy to assess mass size, color pixel speed-weighted density, and American College of Radiology Breast Imaging Reporting and Data System sonographic characteristics. After chemotherapy, tumor sites were excised by lumpectomy or mastectomy. RESULTS: Three (11.3%) of 34 patients had a complete histologic response. After chemotherapy, correlation was r = 0.716 between final histologic and sonographic sizes. Compared with histologic residual tumors, sonography had 4 false-negative results, 3 false-positive results, and 27 true-positive results (sensitivity, 87%), with no false-negative results among a subgroup of tumors of 7 mm and larger (sensitivity, 100%). The 3 cases with false-positive results were histologic fibrosis or biopsy changes. Mean speed-weighted density was 0.015 before and 0.0082 after chemotherapy (P = .03). After chemotherapy, vascularity was less common within (P = .06) or adjacent to (P = .009) masses or in tumor sites (P = .05). Prechemotherapy variables of gray scale characteristics and vascularity were compared with final histologic size, and all had P > .20. CONCLUSIONS: Postchemotherapy sensitivity of sonography was high for residual tumors of 7 mm or larger. Correlation was moderate between histologic and sonographic final tumor sizes. False-positive results were caused by fibrosis or biopsy-related changes. False-negative results occurred with residual tumor size of 6 mm or smaller. After chemotherapy, vascularity usually decreased, and this was not specific for complete response. Before chemotherapy, no vascular or gray scale feature at initial imaging predicted complete responders.  相似文献   

14.
目的 研究超声造影及能量多普勒技术测定乳腺肿瘤的彩色象素密度与病理微血管密度的相关性。方法 应用超声造影和能量多普勒技术观察 5 1例乳腺肿块血流信号 (2 8例良性 ,2 3例恶性 ) ,计算机辅助测量肿瘤血流的彩色象素密度 ,对手术标本进行抗CD3 4因子免疫组化染色测量肿瘤微血管密度。结果 彩色象素密度及微血管密度值均表现为同样梯度 ,即恶性组 >良性组 >对照组 (10例远离肿块的周围乳腺组织 )。恶性组中腋下淋巴结转移组的彩色象素密度及微血管面密度均高于无腋下淋巴结转移组 (P <0 .0 5 )。能量多普勒测定的彩色象素密度与病理微血管面密度有较好的相关性 (r =0 .84,P<0 .0 0 1)。结论 能量多普勒血流定量测值与肿瘤微血管密度测值相关性较好 ,能量多普勒超声造影对乳腺肿瘤的鉴别诊断及乳癌预后的评估有帮助  相似文献   

15.
彩色及能量多普勒超声在乳腺肿块鉴别诊断中的价值研究   总被引:3,自引:0,他引:3  
目的探讨彩色及能量多普勒超声在乳腺肿块鉴别诊断中的价值。方法对89个乳腺肿块(良性47个,恶性42个)进行彩色及能量多普勒超声检查,分析血流分布特征及血流动力学参数,并与手术病理对照。结果恶性肿块组中周边和内部均有血流者为63.4%,良性肿块组为28.0%,两组之间在血流分布部位上的差异有统计学意义(P=0.013);恶性肿块组中有分支状血流者为65.9%,良性肿块组为24.0%,两组之间在血流分布形态上的差异有统计学意义(P=0.001);恶性肿块组63.4%有穿入型血流信号,良性肿块组仅20.0%有穿入型血流信号,两者间的差异有统计学意义(P=0.001)。恶性组的阻力指数(RI)、搏动指数(PI)明显大于良性组(P〈0.001),加速度时间(AT)明显小于良性组(P〈0.001);以PI〉1.35,RI〉0.75,AT〈90ms为临界值,诊断恶性肿块的敏感性分别为87%、87%、39%,特异性分别为88%、80%、96%,准确性分别为88%、85%、61%。结论彩色多普勒超声作为一种无创性影像检查方法,可清晰显示乳腺肿物的二维声像图特征和血流特征,对乳腺肿块良、恶性鉴别诊断具有重要临床应用价值。  相似文献   

16.
乳腺神经内分泌癌的超声表现及其临床、病理特征   总被引:3,自引:0,他引:3  
目的 观察乳腺神经内分泌癌的超声表现及其临床、病理特征.方法 回顾性分析经病理证实的5例乳腺神经内分泌癌的临床、超声表现和组织病理学特征.结果 患者均为女性,年龄43~70岁[平均(55.2±12.2)岁].4例肿块位于右侧乳房,1例位于左侧乳房,大小0.65~3.90 cm[平均(2.04±1.17)cm].5例肿块超声为不均匀低回声,4例形态不规则,1例为圆形;4例边界清晰,1例边界模糊;其中2例有钙化,超声表现为点状强回声.彩色多普勒血流显像示肿块3例血流丰富,1例未见明确血流.病理:大体形态学均表现为实性肿物、颜色灰白,边界尚清.结论 乳腺神经内分泌癌超声表现有一定的特征性,声像图表现为不均质低回声实性肿块,形态不规则,边界清晰,血流丰富.  相似文献   

17.
OBJECTIVE: The purpose of our study was to analyze the accuracy of quantitative analysis of tumor vascularity on power Doppler sonograms in differentiating malignant and benign solid thyroid nodules using tumor histologic evaluation as the reference standard. Methods. Eighty-six solid thyroid tumors (46 malignant and 40 benign) in 56 consecutive patients (mean age +/- SD, 53.1 +/- 11.6 years; 12 male and 44 female) referred for the surgical treatment were included in our study. Visual and qualitative analysis of patterns of nodule vascularity was performed for all tumors. Quantification of the power Doppler sonograms was performed with normalized and weighted vascular indices (VIs). The accuracy of sonographic criteria for thyroid cancer was evaluated with univariate analysis. Results. Among benign thyroid tumors, there was a statistically significant increase in the levels of intranodular vascularization with an increase in tumor size (P < .001). In all tumors, increased intranodular vascularization showed 65.2% sensitivity, 52.5% specificity, and 58.9% overall accuracy in differentiation between benign and malignant thyroid lesions. In tumors smaller than 2 cm, it had 65.5% sensitivity, 85.7% specificity, and 72.1% overall accuracy. Quantitative analysis of tumor vascularity significantly overperformed visual analysis of power Doppler patterns (P < .05). Among thyroid lesions with diameters of less than 2 cm, a normalized VI of greater than 0.14 had 72.4% sensitivity, 100% specificity, and 86.2% overall accuracy. A weighted VI of greater than 0.24 showed compatible results, with 69.0% sensitivity, 100% specificity, and 84.5% overall accuracy. CONCLUSIONS: Our study indicates that in small thyroid nodules, quantitative analysis of tumor vascularity has benefits over visual inspection and can be useful in differentiation between benign and malignant thyroid tumors.  相似文献   

18.
彩色速度成像及脉冲多普勒测量正常人颈动脉流速对照   总被引:1,自引:0,他引:1  
目的:探讨彩色速度成像(CVI)测量血流速度的准确性。方法:对60位正常人分别用CVI和脉冲多普勒方法测量左右颈动脉的最大血流速度(Vmax)和阻抗系数(RI)并进行统计学处理。结果:两种方法测量女性左侧颈动脉Vmax分别为7744±1851cm/s、8360±1990cm/s(r=0959),RI分别为0733±0054、0719±0047(r=0904);右侧颈动脉Vmax分别为7395±1918cm/s、7949±1822cm/s(r=0955),RI分别为0736±0058、0734±0061(r=0927);男性左侧颈动脉Vmax分别为9417±2435cm/s、9776±2408cm/s(r=0971),RI分别为0759±0064、0743±0057(r=0910);右侧颈动脉Vmax分别为9196±2389cm/s、9796±2497cm/s(r=0954),RI分别为0789±0052、0783±0055(r=0902)。结论:两种方法对血流Vmax及RI的测量均相关很好(p<0001),证实了CVI技术测量  相似文献   

19.
OBJECTIVE: To record the correlation between color power Doppler sonographic measurement of breast tumor vasculature and immunohistochemical analysis of microvessel density for the quantitation of angiogenesis. METHODS: Women with palpable breast masses scheduled for excision biopsy were scanned with two- and three-dimensional color power Doppler sonography before and after the administration of a sonographic contrast agent. Vessel counts were performed on two- and three-dimensional sonographic images before and after contrast agent administration. All tumors were surgically removed and underwent immunohistochemical analysis for microvessel density assessment. The sonographic measure of tumor vascularity was correlated with microvessel density. RESULTS: Pathologic examination showed 43 breast cancers and 14 benign breast masses. Higher microvessel density was noted in malignant than benign breast masses (P < .0005). Color power Doppler sonographic measurement of tumor vessel number showed a significant positive correlation with tumor size (P < .05) and progesterone receptor negativity (P < .05). A significant positive correlation was observed between microvessel density and the number of intratumoral blood vessels assessed by both two- and three-dimensional color power Doppler sonography (P < .05). Regression models showed three-dimensional color power Doppler sonography to have a significantly higher correlation with microvessel density when compared with two-dimensional color power Doppler sonography at baseline (P < .005). The administration of a sonographic contrast agent did not improve correlation with microvessel density. CONCLUSIONS: A significant correlation was shown between color power Doppler sonographic measurement of tumor vascularity and microvessel density by immunohistochemical analysis. Further improvement in Doppler sonographic techniques to map capillary vessel flow should be explored to improve the current association with pathologic findings.  相似文献   

20.
应用彩色多普勒血流显像(CDFI)观察了24例原发性肝癌(HCC)患者肝内动脉(IHA)血流并与正常组进行了比较,结果表明:正常组肝内动脉左外支(LIHA)与右前支(RIHA)搏动指数(PI)、收缩期峰值流速(Vmax)无明显差异。肿瘤直径>3.0cm时,有肿瘤区的IHA比无肿瘤区IHA的PI低而Vmax高,这种改变与肿瘤大小、门静脉癌栓和A-V瘘有关。  相似文献   

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