高龄患者下肢深静脉血栓超声诊断的Logistic回归分析

目的：应用Logistic回归筛选高龄患者下肢深静脉血栓灰阶及彩色多普勒超声诊断特征。方法：对我院150例主动要求下肢深静脉血栓灰阶及彩色多普勒超声检查的高龄患者,应用超声检查观察血管管径、管腔内回声及血流动力学等特征,进行Logistic回归分析,筛选超声诊断特征,对Logistic回归模型预测诊断绘制受试者工作曲线图（ROC）,评估模型效果。结果：150例超声检查高龄患者,发生下肢深静脉栓塞129例,占86.00%。Logistic回归筛选,血管管径、管腔内回声、管壁内壁、血流信号改变4个变量进入回归模型,Logistic回归模型预测超声检出的ROC曲线下面积为0.903,灵敏度为90.3%,特异度为93.8%。结论：以高龄患者下肢深静脉血栓超声特征建立的Logistic回归模型对该病具有较好的预测诊断价值。     

麦默通微创手术结合导管冲洗负压引流治疗乳房脓肿的临床效果观察

目的：探讨麦默通微创手术结合导管冲洗负压引流治疗乳房脓肿的临床效果。方法：选择2007年10月~2012年9月在我院治疗的180例乳房脓肿患者,全部在超声定位引导下行麦默通微创手术结合导管冲洗负压引流治疗,并观察其临床效果。结果：180例乳房脓肿患者完全恢复,住院天数6~10天,无1例并发乳瘘。常规病理结果均符合临床诊断。1~2年随访中,临床检查及乳腺B超检查均未发现复发迹象。结论：麦默通微创手术结合导管冲洗负压引流技术治疗乳房脓肿,切口隐蔽,操作简便,治疗彻底,可减少由于反复穿刺引起的感染,尤其适用于脓腔直径较大、位置较深、细针反复穿刺无效或复发者;术后换药冲洗简单易行,换药次数降低,明显减轻了患者痛苦;拔管后切口无需缝合,瘢痕小,并能维持乳房良好形态,提高了病人术后的生活质量,符合当今女性的审美要求。     

Sonoporation: Mechanistic insights and ongoing challenges for gene transfer

Microbubbles first developed as ultrasound contrast agents have been used to assist ultrasound for cellular drug and gene delivery. Their oscillation behavior during ultrasound exposure leads to transient membrane permeability of surrounding cells, facilitating targeted local delivery. The increased cell uptake of extracellular compounds by ultrasound in the presence of microbubbles is attributed to a phenomenon called sonoporation. In this review, we summarize current state of the art concerning microbubble–cell interactions and cellular effects leading to sonoporation and its application for gene delivery. Optimization of sonoporation protocol and composition of microbubbles for gene delivery are discussed.     

A fast bilateral filter with application to artefact reduction

Elastography in medical ultrasound is an imaging technique that displays information about tissue stiffness. However, elastography suffers from artefact noise that may come from two dominant sources: decorrelation error and amplitude modulation error. In order to reduce artefact and improve the quality of ultrasonic elastography, a fast bilateral filter is proposed in this study based on local histogram. The presented filter is derived from a conventional bilateral filter, and a local histogram is introduced to speed up the filter. The proposed algorithm can reduce artefact noise and, at the same time, maintain the tissue structure. Both simulation and phantom testing show that the proposed method can improve the quality of ultrasonic elastography in terms of tissue elastographic signal-to-noise ratio and elastographic contrast-to-noise ratio values.     

55例桥本甲状腺炎合并结节的超声声像图及误诊分析

目的:对桥本甲状腺炎(HT)合并结节样病变的超声诊断以及误诊情况进行分析.方法:选取本院在2011年6月～2012年6月收治的55例桥本甲状腺炎合并单发和多发结节患者作为研究对象,全部患者均经过手术及病理学证实,对全部结节样病变的超声影像图进行分析,并对该病的诊断率提高的方式进行讨论.结果:在全部患者中,单个结节24例,合并乳头状癌为7例,合并滤泡性腺瘤为3例;多个结节为31例,合并乳头状癌为5例,合并滤泡性腺瘤为3例,合并结甲11例.其中,35例与病理相符,诊断准确率63.6％,误诊20例,有18例误诊为结节性甲状腺肿,2例为甲状腺癌,误诊率为36.4％.单纯性桥本甲状腺炎结节与甲状腺癌结节,在结节的形态、边界、内部伴有钙化的形态上以及血流信号的分布上有显著差异.结论:全面检查血清学的甲状腺抗体,并关注结节之外的腺体回声以及腺体供血的状况;应该高度注意结节是否出现形态不规则、伴有钙化灶以及边界模糊的特征,提示恶变的可能,给临床医生以最有价值的提示,全面提高超声的正确诊断率.     

彩色多普勒超声检查在妇科肿瘤诊断中的准确性研究

目的:分析彩色多普勒超声检查在妇科良恶性肿瘤诊断方面的准确性,探讨其临床应用价值.方法:选取在我院经手术病理确诊的妇科肿瘤患者99例作为研究对象,其中恶性肿瘤组42例,良性肿瘤组57例;对两组患者术前CT和彩色B超检查结果进行回顾统计,分析彩超诊断妇科肿瘤的准确性.结果:彩色B超诊断的灵敏度为82.8％,CT诊断的灵敏度90.9％,组间差异无统计学意义,P＞0.05;彩超诊断的特异度为88.2％,CT诊断的特异度86.9％,组间差异无统计学意义,P＞0.05;CT与病理诊断的符合率为89.3％,彩色B超与病理诊断符合率为85.7％,组间差异无统计学意义,P＞0.05.结论:彩色多普勒超声对妇科良恶性肿瘤病变的诊断准确性高,具有较高的临床应用价值.     

B超在肝囊型包虫病诊断中的临床价值与意义

目的：评价B超在肝囊型包虫病诊断中的价值与临床意义。方法：回顾性分析我院2000年12月至2011年12月收治的接受B超检查和手术治疗的332肝囊型包虫病例的临床资料。结果：332例肝囊型包虫病患者中,303例经过手术证实;肝囊型包虫病的B超分型可分为单发单囊型、多发单囊型、多子囊型、破裂感染型和坏死钙化型。单发单囊型患者以低年龄组多发,而高年龄组较少;破裂感染型以高年龄组多发;坏死钙化型病人共3例年龄均在60岁以上;破裂感染型占各型中病例数最多。结论：B型超声检查是肝囊型包虫病的主要检查方法,可确定包虫病的分型,了解包虫囊肿的部位、数目、大小和结构,为术前诊断、手术定位、观察治疗效果提供参考依据。     

甲苯胺蓝介导的超声疗法对牙菌斑中细菌灭活效果的研究

目的：验证甲苯胺蓝介导超声对龈上牙菌斑中细菌的抑制作用。方法：从门诊20例牙周炎病人下前牙区取龈上菌斑一份,每个患者的菌斑于实验室培养后,在同一甲苯胺蓝浓度下与不同超声强度联合作用,利用涂板计数法分析其对菌斑中细菌的抑制作用。实验分组：空白组、单独甲苯胺蓝组、单独超声组、甲苯胺蓝＋超声组。结果：单独超声作用时没有灭菌效果,细菌数目反而有所增长（P〈0.05）,超声联合甲苯胺蓝作用时取得明显的灭菌效果,超声强度2W/CM2灭菌率可达到79%。结论：低强度超声能够促进细菌生长,甲苯胺蓝介导一定强度的超声疗法对龈上牙菌斑中的细菌有良好的抑制作用。     

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。     

Wideband Optical Detector of Ultrasound for Medical Imaging Applications

Optical sensors of ultrasound are a promising alternative to piezoelectric techniques, as has been recently demonstrated in the field of optoacoustic imaging. In medical applications, one of the major limitations of optical sensing technology is its susceptibility to environmental conditions, e.g. changes in pressure and temperature, which may saturate the detection. Additionally, the clinical environment often imposes stringent limits on the size and robustness of the sensor. In this work, the combination of pulse interferometry and fiber-based optical sensing is demonstrated for ultrasound detection. Pulse interferometry enables robust performance of the readout system in the presence of rapid variations in the environmental conditions, whereas the use of all-fiber technology leads to a mechanically flexible sensing element compatible with highly demanding medical applications such as intravascular imaging. In order to achieve a short sensor length, a pi-phase-shifted fiber Bragg grating is used, which acts as a resonator trapping light over an effective length of 350 µm. To enable high bandwidth, the sensor is used for sideway detection of ultrasound, which is highly beneficial in circumferential imaging geometries such as intravascular imaging. An optoacoustic imaging setup is used to determine the response of the sensor for acoustic point sources at different positions.