超声多探头检查在新生儿颅脑疾病诊断中的应用

目的研究超声低频探头和低频探头联合高频探头检查在新生儿颅脑疾病诊断中的准确率和敏感性。 方法选取河源市妇幼保健院自2017年1月至2018年12月收治的有颅脑疾病高危因素(早产、低体质量、多胎妊娠、出生过程有缺氧窒息及产时感染)的新生儿90例作为研究对象。采用随机数字表法将所有新生儿平均分为2组，研究组（45例）给予低频探头联合高频探头进行探查，对照组（45例）仅给予低频探头进行探查。结合CT检查结果和临床治疗，比较2种检测方法的准确率和敏感性。 结果研究组检测新生儿缺氧缺血性脑病、脑室内出血和室管膜下出血诊断准确率分别为87.5%、100%、100%，高于相应对照组（15.38%、12.5%、0%），差异有统计学意义（P<0.05）；研究组和对照组检测脑实质内出血和脑积水的诊断准确率分别为87.5%、100%以及42.85%、66.67%，差异无统计学意义（P>0.05）。研究组检测新生儿颅脑疾病的效率为82.22%，高于对照组（22.22%），差异具有统计学意义（P<0.05）。 结论使用超声低频探头联合高频探头的方法提高了缺氧缺血性脑病、脑室内出血、室管膜下出血等新生儿颅脑疾病诊断的准确率，在诊断新生儿脑实质内出血和脑积水的准确率没有差异，且对颅脑疾病诊断的敏感性较高，因此具有较为重要的临床意义。     

高、低频超声联合应用在老年人急性阑尾炎诊断中的价值

目的探讨高、低频超声联合应用在老年急性阑尾炎患者中的诊断价值。方法对2013年在我院急救中心就诊的62名老年急性阑尾炎患者,先用低频超声检查,后行高频超声检查,确定阑尾位置、走形、回声及血流情况,做出急性阑尾炎的超声诊断。结果 62名老年急性阑尾炎患者中,低、高频联合超声诊断检出58例,漏诊3例,误诊1例,与术后病理诊断符合率为93.5%。结论低频及高频超声联合检查急性阑尾炎分别从整体和局部入手,起到互补的作用,从而提高阑尾炎的显示率及诊断的准确性。     

高危足月新生儿355例颅脑超声与MRI的影像学对比分析

目的通过分析该院出生的高危足月新生儿的颅脑彩色多普勒超声结果并比较异常者颅脑超声与MRI结果,总结两者在诊断高危足月新生儿颅内疾病的应用价值及差异性。方法收集2017-01～2019-01在该院出生的355例高危足月新生儿的临床资料与出生7 d内的颅脑超声及头颅MRI检查结果。结果颅脑病变阳性者共85例(23. 9%),其中颅脑超声诊断室管膜下囊肿66例(18. 6%),与头颅MRI的44例(12. 4%)比较,差异有统计学意义(P 0. 05)。颅脑超声检出脑室内出血与MRI结果相近,差异无统计学意义(P0. 05)。而缺氧缺血性脑病、小脑病变、蛛网膜下腔出血的阳性率MRI高于超声,其中MRI对蛛网膜下腔出血的灵敏度较高,两者比较差异有统计学意义(P 0. 05)。结论多普勒超声检查具有安全性、可重复性高等特点,能准确诊断出颅内出血、室管膜下囊肿、缺氧缺血性脑病等高危足月新生儿常见的颅内疾病,但对颅脑边缘及后颅窝的病变分辨率差。     

X线钼靶、高频超声联合应用对早期乳腺癌的诊断价值

目的探讨X线钼靶、高频超声联合诊断早期乳腺癌（EBC）的价值。方法采用x线钼靶、高频超声及两者联用对144例女性乳腺肿物患者进行检查,比较三种检查方法的差异。结果X线钼靶与高频超声检查联合应用的乳腺癌阳性诊断符合率均高于单行x线钼靶检查或高频超声检查。结论X线钼靶摄片和高频超声检查各有优势,联合应用能明显提高乳腺癌诊断的阳性率。     

低频超声联合高频超声对胆囊增生性疾病的诊断价值

目的探讨低频超声联合高频超声诊断胆囊良性病变的临床价值。方法回顾性分析2015年1月-2016年1月新疆图木舒克市人民医院门诊收治的经手术病理证实为胆囊良性病变患者110例。所有患者均先行常规低频超声检查并记录检查结果;然后联合高频超声进行检查并记录结果。对比分析常规低频超声检查和联合高频超声检查的病理诊断符合率。计数资料组间比较采用χ2检验。结果110例患者中,常规低频超声检查与病理诊断结果相符合的有83例;联合高频超声检查与病理诊断结果相符合有102例,其中胆囊息肉样病变70例(68.63%),胆囊腺肌增生症32例(31.37%),另有8例误诊,误诊率为7.3%;低频超声联合高频超声检查的病理诊断符合率(92.73%)明显高于低频超声检查(75.45%),差异有统计学意义(χ2=12.266,P=0.001)。结论低频超声联合高频超声检查,有利于提高胆囊良性病变的诊断准确率。     

二维超声与四维超声联合应用对胎儿隐性脊柱裂的研究

目的探讨二维超声与四维超声联合应用对胎儿隐性脊柱裂的诊断价值。方法选择2013年1月至2015年12月到本院进行产前筛查,经普通超声检查怀疑脊柱发育异常且不能明确诊断的胎儿的孕妇80例,根据诊断方法不同将孕妇分为两组,比较两组超声诊断胎儿隐性脊柱裂的效果、超声影像质量、漏诊和误诊率等指标,以评价四维超声的准确性、安全性和临床应用价值。结果二维超声检查确诊隐性脊柱裂2例,四维超声检查确诊7例,新生儿出生后随访结果隐性脊柱裂为8例。二维超声检查与随访结果一致性比较,Kappa=0.184,两者诊断一致性较低;四维超声检查与随访结果一致性比较,Kappa=0.769,两者诊断一致性较好。二维超声诊断胎儿隐性脊柱裂的准确率为25%,四维超声诊断胎儿隐性脊柱裂的准确率为100%,χ2=4.001,P0.05,差异具有统计学意义。二维超声检出的2例隐性脊柱裂均为孕晚期孕妇,占二维超声检出率的100%。四维超声检出的3例隐性脊柱裂均为孕中期孕妇,占四维超声检出率的37.50%;5例为孕晚期,占四维超声检出率的62.50%。结论超声检查是产前筛查胎儿隐性脊柱裂的简单有效的首选方法,四维超声动态检查可弥补二维超声检查的不足而提供清晰、直观,连续的动态的声像图而提高诊断的准确性。     

心脏彩超联合颈动脉超声检查在疑似冠心病诊断中的临床价值研究

目的心脏彩超联合与颈动脉超声检查在疑似冠心病诊断中的临床价值。方法本次纳入2019年1-12月期间本院收治的101例疑似冠心病患者展开研究,分别进行心脏彩超、颈动脉超声检查,将各组的心肌做功指数(Tei index,Tei)、颈动脉内膜中层厚度(intima-media thickness,IMT)、斑块积分进行比较,计算诊断效能。结果 101例患者中有冠心病69例、非冠心病32例,其中冠心病组的Tei指数、IMT、斑块积分比非冠心病组高,差异具有统计学意义(P0.05);心脏彩超阳性检出率低于冠脉造影检查(P0.05),颈动脉超声、联合检查的阳性检出率与冠脉造影检查相差不大(P0.05);联合检查的敏感度、特异度、准确性、阳性预测值、阴性预测值高于心脏彩超,敏感度、准确性、阴性预测值高于颈动脉超声,联合检查的ROC曲线下面积大于单一检查,差异具有统计学意义(P0.05)。结论心脏彩超联合颈动脉超声检查应用在诊断疑似冠心病患者中具有较高的诊断效能,可为临床诊治提供进一步的临床提示。     

胎儿超声心动图产前诊断先天性心脏病准确性评价

目的 评价胎儿超声心动图产前诊断先天性心脏病的准确性.方法 回顾2001年1月至2007年12月诊断为先天性心脏病胎儿的超声心动图资料,将产前诊断与胎儿心脏病理诊断或出生后新生儿超声心动图诊断结果进行比较.结果 研究期间共诊断胎儿先天性心脏病113例,初次检查时平均孕周为26.8周.79例(70%)行胎儿心脏病理检查或新生儿超声心动图检查确诊,其中68例产前诊断与产后诊断相符,产前诊断准确率86%.锥干畸形诊断准确率77%(24/31),间隔缺损96%(26/27),瓣膜畸形90%(9/10),单心室畸形83%(5/6).产前假阳性诊断4例,阳性预测值95%(75/79).结论 胎儿超声心动图检查是先天性心脏病产前诊断的有效方法,能够对各种常见类型的先天性心脏病进行准确诊断.完整的分段诊断是降低漏诊及误诊率,提高诊断准确性的关键.     

新生儿坏死性小肠结肠炎应用超声诊断的临床价值

目的探讨新生儿坏死性小肠结肠炎患儿应用超声诊断的临床价值,以提高诊断正确率。方法收集2013年1月至2015年6月于我院治疗的96例新生儿坏死性小肠结肠炎患儿的临床资料,分析并比较其超声检查与X线平片检查结果。结果经X线检查显示,96例新生儿坏死性小肠结肠炎患儿中有36例(37.5%)肠壁积气,12例(12.5%)门静脉积气;经超声检查显示,96例新生儿坏死性小肠结肠炎患儿中肠壁增厚有89例(92.71%),肠壁积气61例(63.54%),门静脉积气29例(40.63%)。超声对肠壁积气的阳性检出率为63.54%,明显高于X线平片检查的37.5%,差异具有统计学意义(P0.05)。结论超声对新生儿坏死性小肠结肠炎具有较高的诊断价值,可提高新生儿坏死性小肠结肠炎患儿的早期诊断准确率,值得临床应用。     

阴道超声在妇产科泌尿系统疾病诊断中的价值

目的探讨阴道超声在妇产科和一些泌尿系统疾病中的诊断价值。方法应用阴道超声技术对409例妇产科疾病、2例输尿管下段结石、1例膀胱肿瘤进行超声诊断;运用阴道超声探头经腹部检查65例婴幼儿泌尿系统。结果本组阴超检查结果均经手术病理或临床证实,其中妇产科疾病及婴幼儿泌尿系统结石超声诊断符合率分别为95.84%、89.23%。结论阴道超声检查无需充盈膀胱,肠气干扰少,可以快速、准确的诊断妇产科疾病及一些泌尿系统疾病,具有较高的临床应用价值。     

重型颅脑损伤合并严重胸损伤的临床救治

目的 探讨重型颅脑损伤合并严重胸损伤的诊断和治疗.方法 对32例重型颅脑损伤合并严重胸损伤的临床资料进行分析.结果 GOS预后评分:恢复良好14例,中残9例,重残3例,植物生存2例,死亡4例.结论 重型颅脑损伤合并严重胸损伤其伤情复杂而严重,伤残率和病死率较高.全面详细的检查、正确的诊断和及时有效的治疗和处理,弄清颅脑损伤和胸部损伤的关系,积极防治成人呼吸窘迫综合征(ARDS)及肺部感染等并发症,是提高抢救成功率的关键.     

Ultrasonography of haemophilic arthropathy

Imaging is an essential tool for evaluation and monitoring of haemophilic arthropathy. Ultrasonography is increasingly used for joint assessment, due to its great sensitivity for soft tissue and relatively low cost. To assess the joint status and the role of ultrasonography in routine diagnosis and monitoring of joint disease in cohort haemophilic patients. Findings of patients with haemophilia, who routinely underwent ultrasonography were retrospectively evaluated to assess their joint status and the role of ultrasonography in routine diagnosis and monitoring of joint disease. Out of 325 joints examined (115 ankles, 210 knees), ultrasonography identified damages in 50% of ankles and 33% of knees in overall 111 patients, aged 7-80 years (median = 29 years). Synovial hypertrophy and cartilage abnormalities were the most frequent observations (88% and 76% in affected knees, respectively). Pristine joints were more frequently found in patients on primary prophylaxis, young age or no bleeding in the year prior to examination. Furthermore, no concordance was found between presence of joint changes at ultrasonography, and clinical joint status. Ultrasonography was shown to be able to detect joint damage involving soft tissues and bone surface. Its use might allow frequent monitoring of patients with haemophilia and early detection of arthropathy. For these reasons it might represent a valid tool in the routine management of haemophilia.     

Role of ultrasonography in diagnosis of neutropenic enteritis: a study of 4 cases

Neutropenic enteritis is a septic or inflammatory disease of the colon. It is usually encountered in patients with hematological malignancy who have undergone chemotherapy, and it presents as fever, diarrhea, and abdominal pain, although the symptoms are not always specific. The diagnostic features of neutropenic enteritis revealed by barium enema, CT and ultrasonography have been reported previously. Here we report 4 cases of neutropenic enteritis in which ultrasound was used for diagnosis, and also for monitoring the clinical course of the disease. Because neutropenic enteritis is rapidly progressive, early diagnosis and therapeutic intervention are required. We believe that ultrasonography is a useful method for examining patients with neutropenic enteritis, being noninvasive, mobile, and providing rapid results in real time, thus aiding early diagnosis and clinical follow-up.     

B超在膝关节病变中的诊断意义

目的评价B超对膝关节病变诊断的价值及临床意义.方法对34例68个膝关节病变包括骨关节炎或类风湿关节炎的患者进行B超检查,分析结果并与膝关节X线平片及磁共振（MR）作对照.结果在滑膜增厚、关节腔积液、软骨病变、软骨下骨质破坏、膕窝囊肿及半月板变性等方面,B超检查具有良好的分辨率,检出率分别为71%、72%、74%、43%、6%和16%,与X线对比两者差异有统计学意义（P＜0.05）,与MR比较,两者差异无统计学意义（P＞0.05）,但在关节间隙、骨赘形成及骨质疏松等反映骨性改变方面,不如X线及MR敏感.结论B超对于膝关节病变的诊断具有独特的价值及临床意义.     

Improvement in diagnosis and management of musculoskeletal conditions with one-stop clinic-based ultrasonography

We evaluated the impact of clinic-based musculoskeletal ultrasonography (MSUS) on diagnosis and management of cases as seen in day-to-day rheumatology practice. Data were retrieved for demography, background condition, clinical findings, indications, regions scanned, and outcomes of MSUS, and categorised as: new-patients and follow-up. New-patient records were analysed as to whether MSUS had helped to confirm or change clinical diagnosis or was of no additional help. In follow-ups, we determined whether MSUS had helped in disease assessment, detection of co-existing problems or revision of diagnosis. Its impact on treatment decisions was noted. A total of 237 patients (146 women; mean age 55.9 +/- 17.2 years) had 264 regions scanned; hands,50.7%. In 78/237 (32.9%) there was disagreement between clinical and MSUS findings. Amongst new-patients (72), 13/39 (33.3%) referred with inflammatory arthritis had no MSUS evidence of inflammation in or around joints. In 76.3% it helped in confirming or changing diagnosis. Of the follow-ups (165), in 78.7%, 13.9% and 7.2% it helped in assessment, detection of co-existing problems and revision of diagnosis, respectively. MSUS influenced treatment in 45/165 (27.27%) cases. In 60/67 (89.55%) cases of rheumatoid arthritis (RA), it was done for disease assessment; in 31/60 (51.66%) it influenced treatment. MSUS, as a clinic-based service in rheumatology, has significant impact on the diagnosis and treatment of patients. This has potential to reduce diagnostic uncertainty and follow-up visits and ensure better outcomes.     

Quantitative analysis of ductus proliferation, proliferative activity, Kupffer cell proliferation and angiogenesis in differential diagnosis of biliary atresia and neonatal hepatitis

BACKGROUND/AIMS: The clinical presentation of cholestasis in infancy caused by neonatal hepatitis and biliary atresia are very similar. Differential diagnosis is sometimes very difficult. The diagnostic accuracy is very important. The surgical treatment of biliary atresia should be performed as early as possible. If cases of biliary atresia are misdiagnosed, they will become progressive cirrhosis and if cases of neonatal hepatitis are misdiagnosed, they will result in unnecessary laparotomy. The aim of this study is to determine the role of quantitative analysis of ductus proliferation, proliferative activity, Kupffer cell proliferation and angiogenesis in the differential diagnosis of biliary atresia and neonatal hepatitis. METHODOLOGY: This study included 60 infants, 30 with neonatal hepatitis and 30 with biliary atresia. Differential diagnosis was done by ultrasonography, cholescintigraphy and liver biopsy. The parafifin-embedded tissue sections of liver biopsies underwent immunohistochemistry with Ki67 to mark proliferation activity, cytokeratin to mark the proliferating ductuli, vimentin to mark Kupffer cells, and CD34 to mark capillary vessels. Number of ductuli per high power field, number of Ki-67 positive cells per ductus, number of Kupffer cells per high power field and number of capillary vessels per high power field were calculated. Independent T test was used for statistical evaluation. RESULTS: Independent sample T test indicated that there is a significant difference for proliferating ductuli and proliferation activity between neonatal hepatitis and biliary atresia. Biliary atresia cases represent more proliferating ductuli and proliferation activity in ductal epithelial cells than neonatal hepatitis cases. There is no statistical significance for Kupffer cell proliferation and vascularization. CONCLUSIONS: Our results indicate that, quantitative analysis of proliferating ductuli and proliferation activity of ductal epithelial cells may be helpful in differential diagnosis of neonatal hepatitis and biliary atresia. Besides neither Kupffer cell proliferation nor vascularization are found to be useful in differential diagnosis.     

节段分析法在胎儿先天性心脏病超声诊断中的临床应用

目的探讨节段分析法（segmentalanalysis）在胎儿先天性心脏病（CHD）超声诊断中的临床应用价值。方法回顾性分析2010年6月至2011年11月应用节段性分析法超声检查出的26例心脏畸形胎儿,其中简单型先天性心脏病（室间隔缺损、房间隔缺损）10例,复杂型先天性心脏病16例。结果26例心脏畸形胎儿中,出生后彩超证实5例（室间隔缺损4例、房间隔缺损1例）,误诊1例（产前诊断为膜周型室间隔缺损,产后彩超证实为右冠状动脉右室瘘）,其余心脏畸形胎儿经随访及省级医院超声复查证实后作引产处理。结论节段分析法在胎儿心脏超声检查中能系统地分析心脏结构异常,对于提高简单型先天性心脏病诊断准确度价值不大,对于复杂型先天性心脏病能提供更准确、更完善的诊断结果,对于妊娠筛选及产后干预有重要临床指导意义。     

Comparison of different diagnostic methods in infants with Cholestasis

INTRODUCTIONCholestatic jaundice in early infancy is an important clinical condition that results from diminished bile flow and/or excretion, and can be caused by a number of disorders. Idiopathic neonatal hepatitis (INH) and biliary atresia (BA) are two …     

内镜超声检查对食管平滑肌瘤的诊治价值

目的 探讨内镜超声检查(EUS)对食管平滑肌瘤的诊治价值.方法 分析研究经EUS诊断为食管平滑肌瘤患者的临床表现及血清学、常规胃镜、EUS等检查结果.将EUS的诊断结果与内镜或手术切除的组织病理诊断结果进行比较.治疗后随访2～36个月,平均14.3个月,以观察疾病复发情况.结果 EUS诊断食管平滑肌瘤191例.患者的临床表现、血清学检查、常规胃镜和螺旋CT对食管平滑肌瘤无特异性诊断作用.116例分别接受内镜(111例)或外科手术(5例)摘除治疗,101例术后组织病理确诊为食管平滑肌瘤,EUS对该病的诊断准确率为87%.随访75例未治疗者和116例治疗者,发现前者病灶无明显变化,后者术后无复发.结论 食管平滑肌瘤是一种良性肿瘤,EUS对该病的诊治具有较高的临床价值.