【Abstract】 Objective To compare the accuracy of color-doppler ultrasonography, mammography and near-infrared light scanning for diagnosing breast diseases. Methods The diagnostic accuracy of the above three imaging methods were analyzed and compared with each other on the basis of the postoperative pathological results. ResultsFive hundreds and sixty-five cases (breast cancer: 274 cases, benign diseases: 291 cases) were examined. The sensitivity of color-doppler ultrasonography, mammography and near-infrared light scanning for diagnosing breast cancer were 83.7%(200/239), 84.2%(64/76) and 76.9%(100/130), respectively. The specificity were 88.6%(226/255), 93.2%(69/74) and 82.6%(114/138), and the accuracy were 86.2%(426/494), 88.7%(133/150) and 79.9%(214/268), respectively. Color-doppler ultrasonography and mammography were superior to near-infrared light in the item of accuracy (P<0.05), especially for lesions of breast cancers that were less than 2 cm. The false negative rate of near-infrared light was higher (48.8%, 21/43)than those of the other methods in detecting breast cancer at early stage. The sensitivity for detecting intraductal papilloma and inflammation of breast using color-doppler ultrasonography were 58.8%(10/17) and 69.2%(18/26), respectively, which were higher than that of near-infrared light scanning 〔0 and 23.5%(4/17), P<0.05 and P<0.01〕. The sensitivity and the accuracy of near-infrared light without physical examination reduced significantly, in which the sensitivity reduced from 76.9%(100/130) to 56.9%(74/130), P<0.01, and the accuracy reduced from 79.9%(214/298) to 61.9%(166/268), P<0.01. Conclusion Color-doppler ultrasonography and mammography are accurate imaging methods for diagnosing breast diseases.
目的 总结超声引导下经皮经肝穿刺胆管引流术(PTCD)的优、缺点,为临床治疗重症急性胆管炎(SAC)提供参考。方法 回顾性分析我院1994年8月至2008年7月期间对156例老年SAC患者行在超声引导下的PTCD治疗的临床资料。结果 156例行PTCD均获成功,1次穿刺成功140例,其成功率达89.7%(140/156); 16例首次穿刺失败后再次穿刺均成功。无一例发生腹腔出血、胆汁性腹膜炎等并发症。本组引流效果较好,中毒危象缓解,黄疸减退,肝功能改善。结论 PTCD较外科手术创伤小、操作简单、快速,具有微创的特点,对老年、有严重合并症及复杂疾病不能耐受手术及麻醉的SAC患者,其作为紧急抢救措施切实可行,并为后期施行根治性手术争取了时间。
Objective To explore the feasibility of transcatheter closure of congenital heart disease (CHD) under the guidance of transthoracic echocardiography (TTE). Methods A total of 37 patients with CHD who received transcatheter closure under the guidance of transthoracic echocardiography from November 2013 through November 2015 in our hospital were recruited. There were 15 males and 22 females, aged 1 to 16 years. Among them 32 patients suffered atrial septal defect and 5 patients had patent ductus arteriosus. The transcatheter closure of CHD was performed under the guidance of TTE. The patients underwent echocardiography follow-up at one, three and six months after surgery. Results Closure devices were successfully implanted in 37 patients under TTE guidance. The procedure was simple and safe. During the follow-up, no severe complication such as valvular injury, pericardial effusion, residual shunt and peripheral vascular injury occurred. Conclusion Transcatheter closure of CHD under TTE guidance is a feasible method and worth further clinical application.
目的 分析彩色多普勒超声对肝硬化患者门静脉血流改变的评价作用。 方法 选择2010年1月-2011年4月收治的50例肝硬化患者作为观察组,其中代偿期患者27例,失代偿期患者23例;同时设置健康对照组50名,比较两组的门静脉内径(Dpv)、门静脉平均血流速度(Vpv)、门静脉血流量(Qpv)。 结果 观察组患者的Dpv增宽,Vpv减慢,Qpv减少,与对照组比较,差异均有统计学意义(P<0.05);且失代偿期患者的改变更为明显,与代偿期患者间差异有统计学意义(P<0.05)。 结论 彩色多普勒超声检查门静脉血流改变可以对肝硬化患者进行初步确诊。
Objective To determine the accuracy of endorectal ultrasonography (ERUS) in preoperative staging of rectal cancer and investigate the limitations and pitfalls of ERUS. Methods Ninety-four patients with rectal cancer were examined preoperatively by ERUS between September 2008 and November 2009 in this hospital. The size, shape, echo pattern, infiltration depth, and extra-rectal invasion of lesions were observed. The results of ERUS staging were compared with histopathology findings of the resected specimens. Results The overall accuracy of ERUS in T staging was 63.8% (60/94). The accuracies of ERUS for pT1, pT2, pT3, and pT4 tumor were 87.2% (82/94), 76.6% (72/94), 76.6% (72/94), and 97.9% (92/94), respectively. The sensitivity, specificity, and accuracy of ERUS for advanced rectal cancer (pT3+pT4) were 70.8% (34/48), 78.3% (36/46), and 74.5% (70/94), respectively. The sensitivity, specificity, and accuracy of ERUS in lymph node metastasis were 75.0% (42/56), 42.1% (16/38), and 61.7% (58/94), respectively. There was no significant difference of accuracy among various tumor locations above anocutaneous line (P=0.495). The accuracy of ERUS for T staging improved with experience, the T staging accuracy improved from 40.0% after assessment of 30 cases to 81.3% after 94 cases were examined (P=0.026). Conclusions The ERUS provides a good accuracy rate for assessment of the depth of tumor invasion and lymph node metastasis of rectal cancer, and has become an important imaging tool for preoperative staging rectal cancer. The operator experience, peritumoral inflammation mainly influences the accuracy of ERUS.