声触诊组织定量成像联合声诺维超声造影对乳腺BI-RADS 4类结节的鉴别诊断价值

摘要 目的：探讨声触诊组织定量成像（VTIQ）联合声诺维超声造影对乳腺BI-RADS 4类结节的鉴别诊断价值。方法：将我院2018年6月至2019年12月门诊及住院诊治的90例女性乳腺结节患者作为研究对象,利用VTIQ超声弹性成像技术,获取剪切波速度最大值（SWVmax）、剪切波速度最小值（SWVmin）、剪切波速度平均值（SWVmean）,声诺维超声造影评估病灶回声、形态、血管充盈情况。以手术病理或超声引导穿刺活检病理结果作为金标准,分析VTIQ超声弹性成像联合声诺维超声造影对乳腺BI-RADS 4类结节的鉴别诊断价值。结果：90例患者（90个乳腺结节）中,经手术病理检查62例,经超声引导穿刺活检28例,其中良性结节48例,恶性结节42例。乳腺BI-RADS 4类良性及恶性结节的SWVmax、SWVmin及SWVmean比较有统计学差异（P<0.05）;以SWVmax≥3.83 m/s作为截断点,鉴别诊断乳腺BI-RADS 4类良恶性结节的曲线下面积（AUC）、敏感度、特异度分别为0.875、83.33%、91.67%,均高于SWVmin及SWVmean。SWVmax、声诺维超声造影与联合诊断的准确率比较无统计学差异（P>0.05）。SWVmax联合声诺维超声造影检查在鉴别诊断乳腺BI-RADS 4类良恶性结节的AUC、敏感度、特异度分别为0.914、95.24%、87.50%,诊断效能最佳。结论：声诺维超声造影、VTIQ超声弹性成像在乳腺BI-RADS 4类结节鉴别诊断中有一定的价值,VTIQ超声弹性成像的SWVmax参数诊断效能优于SWVmin及SWVmean,VTIQ超声弹性成像联合声诺维超声造影可提升乳腺BI-RADS 4类结节鉴别诊断效能。     

超短脉冲微波高效激发的高分辨率热声成像

微波热声成像综合了微波成像和超声成像的优点,具有很好的穿透深度及较高的图像分辨率。热声成像的激发源通常为基于脉冲调制的亚微秒级脉冲微波,激发能量密度约为几mJ/cm2,激发出的热声信号主频通常为2 MHz,成像分辨率约为500μm。随着热声成像向着临床应用方向发展,能否有效的减小辐射剂量并提高成像分辨率,是热声成像系统设计成败的一个关键因素。为了有效改善微波热声成像中热损伤及分辨率,设计开发了超短脉冲微波热声成像系统,实验结果表明该系统提高了热声转化效率约两个数量级,成像分辨率达到105μm,为热声成像的临床应用铺平了道路。     

超声造影与B型超声对人颈动脉内膜-中层厚度及斑块的诊断价值分析

摘要 目的：探讨超声造影（CEUS）与B型超声在诊断人颈动脉内膜-中层厚度（CIMT）及斑块中的临床应用价值。方法：选取2018年10月至2022年12月内蒙古自治区人民医院健康体检者142例,均行颈动脉B型超声和CEUS成像检查。记录左右侧颈动脉各分段点CIMT近壁和远壁值,然后取平均值。采用半定量的方法进行评分,以确定在B型超声和CEUS成像过程中的CIMT可视化。比较B型超声和CEUS成像技术对斑块检出的差异。根据CIMT平均值进行进一步分组,分析CIMT与亚临床左心功能障碍之间的关系。结果：在B型超声成像上,左右侧颈动脉CIMT远壁的可视化评分均明显高于CIMT近壁,差异有统计学意义（P＜0.05）;在CEUS成像上,左右侧颈动脉CIMT远壁的可视化评分均高于CIMT近壁,差异有统计学意义（P＜0.05）。与B型超声成像模式对比,在CEUS成像模式中左右侧颈动脉CIMT远壁和近壁的可视化评分均得到显著提高,差异有统计学意义（P＜0.05）。142例健康体检者中,B型超声总共检测出271个斑块,CEUS总共检测出293个斑块,斑块检出率组间比较差异有统计学意义（P＜0.05）。随着CIMT平均值的逐渐增大,LVM逐渐减小,LVGLS逐渐增大,差异有统计学意义（P＜0.05）。CIMT平均值的大小与LVEDD、LVESD和LVEF差异无统计学意义（P＞0.05）。结论：CEUS改善了CIMT的可视化,并能更好地检测出颈动脉斑块（主要为低回声斑块）,对预测心血管疾病的发生有一定临床价值。     

微波热声成像技术用于人体甲状腺检测

本文首次通过人体实验验证了微波热声成像技术用于人体甲状腺检测的可行性.文章首先讨论了该技术用于人体甲状腺检测的可行性;然后对3名志愿者的健康甲状腺进行了微波热声成像实验.结果表明:微波热声成像能够对人体健康甲状腺进行清晰成像,能够真实反映皮肤、甲状腺和气管等不同组织的结构特征;并且一次完整的检测过程时间约5 s,系统操作简单成像快速.综上所述,微波热声成像技术有望为甲状腺疾病的基础研究和临床诊断提供一种新的影像学参考.     

超声造影在甲状腺结节鉴别诊断及良性结节微波消融治疗中的应用价值

摘要 目的：研究超声造影在甲状腺结节鉴别诊断及良性结节微波消融治疗中的应用价值。方法：选取2015年1月～2018年2月我院收治的甲状腺结节患者100例作为研究对象,所有纳入对象均进行超声造影检查,分析甲状腺结节的超声造影特征,并与病理诊断结果进行对照。此外,将甲状腺良性结节患者以随机抽签法分成超声造影组31例和常规超声组30例。超声造影组微波消融治疗前后均予以超声造影配合,常规超声组微波消融治疗前后均予以常规超声配合。比较两组治疗前后甲状腺结节造影情况以及术后1年结节复发情况。结果：甲状腺恶性结节增强强度为低增强、增强模式为不均匀、无环绕增强占比均高于良性结节（均P＜0.05）。以病理诊断为金标准,超声造影诊断恶性甲状腺结节的灵敏度为92.31%、特异度为78.69%、准确度为84.00%。治疗后超声造影组甲状腺结节最长径、体积均低于常规超声组（均P＜0.05）。超声造影组术后1年结节复发率为0.00%,低于常规超声组的16.67%（P＜0.05）。结论：超声造影应用于甲状腺结节鉴别诊断的价值较高,且结合微波消融治疗良性结节的效果明显,预后理想,值得临床推广应用。     

超声E成像在非酒精性脂肪性肝病中的诊断价值研究

摘要 目的：研究超声E成像在非酒精性脂肪性肝病中的诊断价值。方法：选取2018年1月-2020年2月我院诊断的非酒精性脂肪性肝病患者120例作为观察组,另外,选取同期健康体检的志愿者101例作为对照组,分别对两组受试者进行超声E成像、MR mDixon序列检查,比较两组受试者以及不同病情严重程度患者的谷丙转氨酶（ALT）、谷草转氨酶（AST）、总胆红素（TBIL）、碱性磷酸酶（ALP）、杨氏模量值（ElastPQ）以及脂肪含量之间的差异,分析患者的病情严重程度与ElastPQ以及脂肪含量的相关性。结果：观察组的ALT、AST、TBIL、ALP、ElastPQ以及脂肪含量显著高于对照组（P＜0.05）;不同病情严重程度患者的ALT、AST、TBIL、ALP、ElastPQ以及脂肪含量之间的差异有统计学意义（P＜0.05）,ALT、AST、TBIL、ALP、ElastPQ以及脂肪含量从高到低依次为重度组、中度组以及轻度组,患者的病情严重程度与ElastPQ以及脂肪含量呈正相关（P＜0.05）,ElastPQ与脂肪含量呈正相关（P＜0.05）。结论：超声E成像对于非酒精性脂肪性肝病患者肝脏组织的受损程度具有较高的诊断价值,建议临床推广应用。     

超声多技术联合在良恶性甲状腺结节鉴别诊断中的应用价值

摘要 目的：分析超声剪切波弹性成像（SWE）、超声造影（CEUS）、声触诊组织成像及定量（VTIQ）、促甲状腺激素（TSH）多技术联合在甲状腺结节良恶性鉴别诊断中的应用价值。方法：选取宁德市医院甲状腺不确定性质结节患者120例,以病理结果为金标准将其分为良性组和恶性组,分析两组SWE、CEUS、VTIQ各影像参数及术前TSH水平差异,绘制受试者工作特征曲线（ROC）评估上述技术联合对甲状腺结节良恶性的鉴别诊断价值。结果：120例患者共检出128个结节,其中良性47个,恶性81个;恶性组SWE中弹性模量值（Emax、Emin、Emean）均大于良性组（P＜0.01）;恶性组、良性组在CEUS中强化差异有显著性（P＜0.05）;VTIQ中恶性组剪切波速度（SWV）最大值、最小值、平均值均大于良性组（P＜0.01）;恶性组患者术前TSH水平高于良性组（P＜0.01）;ROC曲线分析显示,SWE、CEUS、VTIQ、TSH联合检测诊断甲状腺结节良恶性的效能最高,其灵敏度、特异度、准确度、曲线下面积（AUC）分别为85.19%、89.36%、86.72%、0.873。结论：SWE、CEUS、VTIQ、TSH联合对区分甲状腺结节良恶性有较高价值。     

光声成像及其在生物医学中的应用

光声成像是一种新近迅速发展起来、基于生物组织内部光学吸收差异、以超声作媒介的无损生物光子成像方法,它结合了纯光学成像的高对比度特性和纯超声成像的高穿透深度特性的优点,以超声探测器探测光声波代替光学成像中的光子检测,从原理上避开了光学散射的影响,可以提供高对比度和高分辨率的组织影像,为研究生物组织的结构形态、生理特征、代谢功能、病理特征等提供了重要手段,在生物医学临床诊断以及在体组织结构和功能成像领域具有广泛的应用前景.对光声成像技术的机理、光声成像技术和方法、光声图像重建算法以及光声成像在生物医学上的应用情况作一个简单介绍,希望有助于推动我国在该领域的科研和开发应用工作的迅速发展.     

小波阈值降噪的超声多普勒技术在胎儿中枢神经系统畸形筛查中的临床应用价值

摘要 目的：探究小波阈值降噪的超声多普勒技术在胎儿中枢神经系统（CNS）畸形筛查中的临床应用价值。方法：选择2018年1月-2021年1月于本院进行规范化妊娠早期超声结构筛查的1092例11-13+6周单胎妊娠孕妇,所有孕妇均进行常规超声和小波阈值降噪的超声多普勒技术的检查,并对其妊娠过程和结果进行随访。结果：1092例胎儿产后病理或超声检查显示,胎儿CNS畸形共计19例,发生率为1.74％（19/1092）。其中,露脑畸形8例,无脑畸形5例,前脑无裂畸形3例,脑膜膨出2例,脊柱裂1例。基于小波阈值降噪的超声多普勒技术对胎儿CNS畸形检出的符合率94.74%（18/19）显著高于常规超声63.16%（12/19）,差异有统计学意义（P<0.05）;且基于小波阈值降噪的超声多普勒技术检出胎儿CNS畸形的准确性、敏感度、特异度、阳性预测值、阴性预测值均显著高于常规超声,差异均均有统计学意义（P<0.05）。结论：小波阈值降噪的超声多普勒技术对妊娠早期孕妇进行规范化结构筛查更有助于及早发现胎儿CNS畸形,对降低畸形胎儿的出生率以及指导临床治疗方案的选择具有重要指导意义。     

叶酸受体靶向的金纳米棒用于细胞内光声成像

目的 分子成像技术具有“早期检测”的特点,由于分子水平上的畸变早于解剖水平上的变化。本研究采用细胞内光声分子成像（PMI）方法,对靶向到癌细胞上的叶酸-金纳米棒（FA-AuNRs）精确定位成像。方法 本文合成了FA-AuNRs,并对其性质包括形貌、吸收光谱和生物相容性进行了研究。修饰叶酸赋予FA-AuNRs特异性靶向到叶酸受体高表达癌细胞的能力。然后,通过PMI实验研究FA-AuNRs对癌细胞的靶向特异性。结果 FA-AuNRs呈棒状,在~800 nm处有一近红外吸收峰。在癌细胞的细胞质中观察到强光声信号,而在正常细胞中只有弱光声信号,表明FA-AuNRs通过叶酸受体介导的内吞作用被癌细胞选择性摄取。这项研究证明了PMI能够实现对靶向到癌细胞上的FA-AuNRs精确定位成像。结论 借助特异性靶向作用,可以通过PMI获得癌细胞表面分子信息。该方法有望实现在细胞和分子水平上对生物过程进行可视化、表征和量化。     

超声分子成像的研究进展

超声成像无创、无放射性、低成本、实时成像的优点,使其成为目前世界上应用最广的成像手段之一。特别是超声造影剂引入之后,超声成像的图像分辨率和灵敏度得到了大大提高,使超声成像在临床上得到了进一步应用。近年来,随着分子生物学和超声成像技术的不断发展,人们提出了＂超声分子成像＂的概念。它是一项结合了分子靶向造影剂和超声影像技术的能在分子水平下观察病理变化的新兴技术,目前这一技术还处于研究初期阶段。但大量临床前的研究成果已表明超声分子成像在诊断血管生成、炎症和血栓三种疾病具有很大应用前景。本文主要综述了目前常用超声造影剂的种类以及超声分子成像技术的研究现状,并对该技术进行了讨论和展望。     

超声分子成像的研究进展

超声成像无创、无放射性、低成本、实时成像的优点,使其成为目前世界上应用最广的成像手段之一。特别是超声造影剂引入之后,超声成像的图像分辨率和灵敏度得到了大大提高,使超声成像在临床上得到了进一步应用。近年来,随着分子生物学和超声成像技术的不断发展,人们提出了"超声分子成像"的概念。它是一项结合了分子靶向造影剂和超声影像技术的能在分子水平下观察病理变化的新兴技术,目前这一技术还处于研究初期阶段。但大量临床前的研究成果已表明超声分子成像在诊断血管生成、炎症和血栓三种疾病具有很大应用前景。本文主要综述了目前常用超声造影剂的种类以及超声分子成像技术的研究现状,并对该技术进行了讨论和展望。     

Nanoscale biomaterials for terahertz imaging: A non-invasive approach for early cancer detection

Terahertz (THz) technology is developing a non-invasive imaging system for biosensing and clinical diagnosis. THz medical imaging mainly benefits from great sensitivity in detecting changes in water content and structural variations in diseased cells versus normal tissues. Compared to healthy tissues, cancerous tumors contain a higher level of water molecules and show structural changes, resulting in different THz absorption. Here we described the principle of THz imaging and advancement in the field of translational biomedicine and early detection of pathologic tissue, with a particular focus on oncology. In addition, although the main forte of THz imaging relies on detecting differences in water content to distinguish the exact margin of tumor, THz displays limited contrast in living tissue for in-vivo clinical imaging. In the last few years, nanotechnology has attracted attention to aid THz medical imaging and various nanoparticles have been investigated as contrast enhancements to improve the accuracy, sensitivity, and specificity of THz images. Most of these multimodal contrast agents take advantage of the temperature-dependent of THz spectrum to the conformational variation of the water molecule. We discuss advances in developing THz contrast agents to accelerate the advancement of non-invasive THz imaging with improved sensitivity and specificity for translational clinical oncology.     

In vivo visualizing of organs and tissues with liposomes

Abstract

The application of liposomes as carriers for imaging agents is considered. Liposomes loaded with the appropriate contrast agents have been shown to be suitable for gamma-, magnetic resonance (MR), computed tomography (CT) and ultrasound imaging. The methods are briefly described to prepare liposomes loaded with different contrast agents, as well as some data on their biodistribution. The application of contrast-loaded liposomes for liver/spleen, tumor, lymph nodes, infection and inflammation sites, myocardial infarction, and blood pool imaging is briefly reviewed together with some data available on the use of liposome for the ophtalmological imaging. New trends in the use of contrast-loaded liposomes are also considered, such as the application of long-circulating polymer-modified liposomes for imaging purposes and development of new lipid-coated liposome-like contrast agents.     

Agents described in the Molecular Imaging and Contrast Agent Database for imaging carbonic anhydrase IX expression

Abstract

Carbonic anhydrase IX (CA IX) is selectively expressed in a range of hypoxic tumours and is a validated endogenous hypoxia marker with prognostic significance; hence, CA IX is of great interest as a molecular imaging target in oncology. In this review, we present an overview of the different imaging agents and imaging modalities that have been applied for the in vivo detection of CA IX. The imaging agents reviewed are all entries in the Molecular Imaging and Contrast Agent Database (MICAD) and comprise antibody, antibody fragments and small molecule imaging agents. The effectiveness of these agents for imaging CA IX in vivo gave variable performance; however, a number of agents proved very capable. As molecular imaging has become indispensable in current medical practice we anticipate that the clinical significance of CA IX will see continued development and improvements in imaging agents for targeting this enzyme.     

Vasa vasorum and molecular imaging of atherosclerotic plaques using nonlinear contrast intravascular ultrasound

There is increasing evidence that presence and location of neovascular vasa vasorum play an important role in atherosclerotic plaque pathogenesis and stability. This paper describes a method to detect vasa vasorum with high contrast and high spatial resolution. It uses second harmonic or subharmonic intravascular ultrasound, in combination with ultrasound contrast agents. The same technology in combination with targeted contrast agents is suited for molecular imaging. The potential for vasa vasorum imaging is illustrated using an atherosclerotic animal model and the potential for molecular imaging is illustrated using phantom experiments.     

Mapping Intravascular Ultrasound Controversies in Interventional Cardiology Practice

Intravascular ultrasound is a catheter-based imaging modality that was developed to investigate the condition of coronary arteries and assess the vulnerability of coronary atherosclerotic plaques in particular. Since its introduction in the clinic 20 years ago, use of intravascular ultrasound innovation has been relatively limited. Intravascular ultrasound remains a niche technology; its clinical practice did not vastly expand, except in Japan, where intravascular ultrasound is an appraised tool for guiding percutaneous coronary interventions. In this qualitative research study, we follow scholarship on the sociology of innovation in exploring both the current adoption practices and perspectives on the future of intravascular ultrasound. We conducted a survey of biomedical experts with experience in the technology, the practice, and the commercialization of intravascular ultrasound. The collected information enabled us to map intravascular ultrasound controversies as well as to outline the dynamics of the international network of experts that generates intravascular ultrasound innovations and uses intravascular ultrasound technologies. While the technology is praised for its capacity to measure coronary atherosclerotic plaque morphology and is steadily used in clinical research, the lack of demonstrated benefits of intravascular ultrasound guided coronary interventions emerges as the strongest factor that prevents its expansion. Furthermore, most of the controversies identified were external to intravascular ultrasound technology itself, meaning that decision making at the industrial, financial and regulatory levels are likely to determine the future of intravascular ultrasound. In light of opinions from the responding experts'', a wider adoption of intravascular ultrasound as a stand-alone imaging modality seems rather uncertain, but the appeal for this technology may be renewed by improving image quality and through combination with complementary imaging modalities.     

Gas fIIIed lipid bilayers as imaging contrast agents

Abstract

Gas bubbles are highly efficient reflectors of sound and are therefore useful as contrast agents for diagnostic ultrasound. In general, in order to pass through the pulmonary circulation and provide contrast for the systemic circulation the gas bubbles must be of defined diameter and stabilized by a coating material. Our group has developed gas bubbles which are stabilized within lipid bilayers. These bubbles may be formed with stable size and gas content. In vivo studies in rabbit and porcine models show sustained ventricular enhancement, increased arterial doppler signal following intravenous injection and myocardial perfusion enhancement following injection into the aortic root of pigs. Preliminary toxicity studies suggest that the therapeutic index (LD50 dose divided by imaging dose) is greater than 400 to 1. For therapy, these agents may be used to increase the capture of ultrasonic energy for hyperthermia to augment local tissue heating. An exciting new class of agents based upon gas fIIIed lipid bilayers has been developed. Work is presently underway to take these agents into clinical trials.     

超声空化效应和超声微泡在生物医学中的应用

近年来,随着超声技术在医疗领域的广泛应用及超声造影剂研制的进展,空化效应和超声造影剂协同运用作为一种高效、安全、操作简单,且具有一定靶向性的无创治疗手段,在基因治疗、药物输送、溶栓和治栓,以及炎症与肿瘤的靶向诊断与治疗方面显示了巨大的运用潜力。简要综述了超声空化效应和超声微泡的治疗机制及应用。