高频超声联合低频超声检查诊断新生儿颅脑病变的临床价值研究

摘要 目的：探讨高频联合低频超声对新生儿颅脑病变的诊断价值,为新生儿颅脑病变的诊断提供依据。方法：选择2019年1月-2021年4月安徽省儿童医院接诊并疑似出现颅脑病变的新生儿62例作为研究对象,所有研究对象均应用高频超声联合低频超声探头对颅脑进行检查,并住院治疗。比较高频超声、低频超声、高频联合低频超声对新生儿颅脑病变的检出率;根据出院诊断结果比较高频超声、低频超声及联合检查与临床诊断符合情况及对颅脑病变的诊断价值。结果：高频超声检出颅脑病变35例（56.45%）,低频超声检出颅脑病变27例（43.55%）,高频超声联合低频超声检出颅脑病变53例（85.48%）,高频超声联合低频超声对新生儿颅脑病变的检出率显著高于高频超声、低频超声（P<0.05）;高频超声对新生儿颅脑病变的检出率显著高于低频超声（P<0.05）。高频联合低频超声对新生儿颅脑疾病诊断与临床诊断总体符合率高于高频超声、低频超声,高频超声对新生儿颅脑疾病诊断与临床诊断总体符合率高于低频超声（P<0.05）。高频联合低频超声对新生儿不同颅脑疾病诊断灵敏度、准确度显著高于高频超声、低频超声（P<0.05）,高频超声对新生儿不同颅脑疾病诊断灵敏度、准确度显著高于低频超声（P<0.05）,三种检查方法对新生儿不同颅脑疾病诊断特异度比较无统计学意义（P>0.05）。结论：高频联合低频超声检查诊断新生儿不同颅脑病变的灵敏度、准确度均较高,具有一定的临床应用价值。     

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。     

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.     

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。     

阴道彩超对宫角妊娠的诊断运用评价

目的：探究阴道彩超对宫角妊娠的诊断价值,为宫角妊娠的临床诊断提出有效方法。方法：对我院2010年4月～2013年4月收治的80例初诊宫角妊娠患者进行回顾性分析,对比其经腹彩超和经阴道彩超的的诊断结果与术后病理确诊差异。结果：阴道彩超下宫角妊娠共分三种表现,包括胚囊型、包块型和破裂型;阴道彩超显示,所有初诊宫角妊娠患者均可见孕囊与子宫内膜相连,其肌层厚度在7．5-11.3mm间,平均（10．5±1．7）mm;二次检查中,经腹超声确诊59例宫角妊娠,经阴道超声确诊51例,病理诊断共确诊宫角妊娠48例。经腹超声诊断准确率为81．4％,明显低于经阴道超声的94．1％,两组数据对比存在显著统计学差异。经腹超声两次检查符合率为73．8％,显著低于经阴道超声的96．2％,两组数据对比存在显著统计学差异。结论：阴道彩超较经腹彩超对宫角妊娠具有更高的诊断准确率,通过图像判断,能够有效对宫角妊娠、输卵菅间质部妊娠进行有效鉴别诊断,可作为指导临床早期干预方案、制定跟踪随访措施的关键依据。     

新型声学造影剂在常规诊断超声频率下对在 体肾脏及离体培养细胞影响的研究

目的：评价新型超声造影剂在常规诊断超声频率下对组织细胞结构的影响。资料和方法：体外培养的人近曲小管上皮细胞分为造影剂无超声照射组,单纯超声照射组,MI 1．5,造影剂加超声照射组。MI 0．28,造影剂加超声照射组,MI 1．5。超声照射时间为10分钟。实验完后用2.5％的戊二醛固定4小时,送电镜室做扫描电镜。正常免肾经耳缘静脉按0．02ml／kg团注脂氟显（新桥医院超声科实验室自制）,用6MHz的超声频率照射,MI 0．28。照射10分钟。活体取肾皮质。放入3．0％的戊二醛溶液中固定,送电镜室做投射电镜。结果：离体培养的人近端小管上皮细胞单纯超声照射、单纯加造影剂、造影剂加超声照射MI 0．28和MI 1．5时扫描电镜观察细胞形态无改变,细胞表面未见异常。透射电镜观察免肾小囊腔和肾小管上皮细胞超微结构未见特异性政变。结论：新型脂质体声学造影剂在诊断剂量超声照射下不会对组织细胞结构产生影响。新型脂质体声学造影剂在诊断剂量下是安全的。     

Ultrasound-accelerated enzymatic synthesis of sugar esters in nonaqueous solvents

Comparative studies of enzymatic synthesis of glucose esters under ultrasound and shaking were carried out in nonaqueous media. The influence of solvents, enzymes, chain length of the acyl donors, the power of the ultrasound bath, and intermittent ultrasound on the enzymatic synthesis was investigated. Among the eight solvents selected, pyridine was the most appropriate with alkaline protease from Bacillus subtilis whether under ultrasound or shaking. The acceleration effect of ultrasound with Novozym 435 and the alkaline protease from B. subtilis-catalyzed transesterification increased with the chain length of acyl donors, decreasing from C(10) to C(4). We also investigated the influence of the power (50, 100, and 120 W) of the ultrasound irradiation and the manner of operation (continuous ultrasound, 10 min ultrasound/20 min shaking without ultrasound) on the transesterification. The results showed that higher power and continual operational gave the better acceleration. Ultrasound did not change the character and selectivity of the enzyme in the transesterification.     

肿瘤的超声波治疗

文中就超声波热疗,高强度聚焦超声以及低频超声波在肿瘤治疗中的应用进行了描述。早期主要是利用超声波的热效应来治疗肿瘤,近年来兴起的高强度聚焦超声是热疗法的另一发展。它瞬间使肿瘤组织温度升至65℃以上,导致靶区组织凝固和坏死来达到对肿瘤的“热切除”,是一种安全、有效的肿瘤治疗手段,具有无限潜力。尽管低频超声治疗肿瘤的机制尚不明了,但因其可以诱导细胞凋亡,为肿瘤的治疗提供了新的途径,其治疗作用已受到重视。     

Real-time three-dimensional ultrasound methods for shape analysis and visualization.

Real-time three-dimensional (RT3D) ultrasound is a relatively new imaging modality that uses a special ultrasound transducer consisting of a matrix array of elements. The array electronically steers an ultrasound beam to interrogate a 3D volume of tissue. The real-time nature of RT3D ultrasound differentiates it from reconstructed 3D ultrasound, in which a conventional ultrasound transducer is moved mechanically through the third dimension. RT3D ultrasound is considerably faster than reconstructed 3D ultrasound, making it suitable for capturing continuous rapid motion such as that of the beating heart. Although RT3D ultrasound has not yet found widespread clinical use, these scanners are presently employed in more than 20 locations worldwide, primarily for cardiac research. The author helped develop the RT3D ultrasound technology as well as specialized analysis and visualization methods for the resulting data. In developing such methods, it has been necessary to consider the physical and mathematical processes by which the ultrasound data are collected. Difficulties arise because of high noise, variation in contrast and intensity between scans, ultrasound's nonrectilinear coordinate system, and the anisotropic nature of the echoes themselves. This article reviews these specific difficulties and provides solutions that are applicable to generalized analysis and visualization of RT3D ultrasound data. Some of the methods presented can also be applied to other imaging modalities with nonrectilinear coordinates.     

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。     

Assisted ultrasound applications for the production of safe foods

Ultrasound requires high power and longer treatment times to inactivate micro‐organisms when compared to ultrasound combined with other technologies. Previous reports have shown that the effectiveness of ultrasound as a decontamination technology can be increased by combining it with another treatment such as pressure, heat and antimicrobial solutions. Assisted ultrasound, the combination of ultrasound with another technology, is more energy efficient, and it has less impact on the food properties. In this review paper, the power ultrasound antimicrobial mechanisms of action, the antimicrobial effects of ultrasound in combination with other physical processes and antimicrobial solutions are comprehensively discussed. Furthermore, the present interest on using these technologies as alternative processing and decontamination methods is presented. Research outputs on the application of ultrasound combined with physical processes are showcased including applications of thermosonication, manosonication, manothermosonication and osmosonication. Antimicrobial efficacy, energy requirements and optimal operation conditions of the different assisted ultrasound technologies are critically discussed, and their impact on the food industry for future applications is presented. Overall, this review paper highlights the importance and recent developments of assisted ultrasound for enhancing food safety.     

Epidemiological prenatal ultrasound studies

Epidemiological studies have indicated no association between diagnostic ultrasound exposure during pregnancy and childhood malignancies. Diagnostic ultrasound imaging does not seem to influence birth weight, whereas frequent Doppler ultrasound was associated with reduced birth weight in one study. Most experts do not believe that ultrasound exposure during pregnancy is associated with reduced birth weight. There are no confirmed statistically significant associations between ultrasound and dyslexia and neurological development during childhood. However, two randomised controlled trials and two cohort studies have been unable to rule out a possible association between ultrasound and left-handedness among males.     

Assessment of bone architecture with ultrasonometry: experimental and clinical experience

Over the last decade, ultrasound technology has been introduced as a method of analysing bone tissue in clinical practice, and several studies have compared various ultrasound devices with dual-energy X-ray absorptiometry (DXA). Unlike DXA, the ultrasound technique is not limited to the measurement of bone density - it also has the potential to provide information on the mechanical and architectural characteristics of bone. The first generation of ultrasound devices used the speed of sound and attenuation of the ultrasound signal to obtain information on bone mineral content. Second generation ultrasound devices, which analyse the ultrasound signal received, permit the study of bone structure and elasticity, in addition to its mineral content, in both experimental studies and clinical practice. This is accomplished by signal processing analysis, the study of backscattering and the application of Biot's theory. This approach to the study of bone tissue represents the future for the development of ultrasound technology for use in clinical practice.     

腰腹肌运动联合超声波对非特异性下腰痛的治疗效果及机制

为了解腰腹肌运动联合超声波治疗的效果,本研究对腰腹肌运动联合超声波治疗非特异性下腰痛进行了探讨。研究显示,治疗4周后,腰腹肌运动+超声波治疗组的疼痛评分(0.73)显著低于超声波治疗组(1.22)(p<0.05)。腰腹肌运动+超声波治疗组的立位体前屈活动幅度(2.35 cm)显著低于超声波治疗组(6.23 cm)(p<0.05)。腰腹肌运动+超声波治疗组的屈伸肌总功和屈伸肌峰值力矩比显著高于超声波治疗组(p<0.05)。腰腹肌运动+超声波治疗组的Oswestry功能障碍指数问卷表(ODI)评分显著低于超声波治疗组(p<0.05)。治疗4周后,腰腹肌运动+超声波治疗组的血清超氧化物歧化酶(SOD)和过氧化氢酶(CAT)水平显著高于超声波治疗组,而丙二醛(MDA)水平显著低于超声波治疗组(p<0.05)。为了进一步考察运动联合超声波疗法对下腰痛的治疗机制,本研究建立了完全弗氏佐剂诱导的腰椎间盘退变大鼠模型。采用阿利新蓝染色检测大鼠椎间盘纤维环区和髓核区蛋白多糖的水平,并采用免疫组化染色检测蛋白聚糖和Ⅱ型胶原的表达,发现运动联合超声波治疗可明显提高大鼠蛋白多糖、Ⅱ型胶原和蛋白聚糖水平。本研究表明,与超声波治疗相比,腰腹肌运动联合超声波治疗可更大程度地降低非特异性下腰痛患者的疼痛,提高肌肉功能和腰椎功能,增强血清抗氧化能力,并减少氧化应激损伤。此外,该联合疗法可明显提高腰椎间盘退变大鼠椎间盘中的蛋白多糖、Ⅱ型胶原和蛋白聚糖水平。     

Birth of cloned miniature pigs derived from somatic cell nuclear transferred embryos activated by ultrasound treatment

The present study was carried out to determine (1) the optimal duty cycle of ultrasound for activation of pig oocytes and cloned embryos derived from miniature pig fetal fibroblasts and (2) whether cloned embryos can develop to term following activation by ultrasound stimulation. When oocytes were exposed to ultrasound with 20% or 30% duty cycle, the blastocyst formation rates were significantly (P < 0.05) higher than that of oocytes exposed to ultrasound with 10% duty cycle. In contrast, the blastocyst formation rate of cloned embryos decreased as the duty cycle of ultrasound increased; the value of embryos exposed to ultrasound with 10% duty cycle was significantly (P < 0.05) higher than that of embryos exposed to ultrasound with 50% duty cycle. When cloned embryos exposed to ultrasound with 10% duty cycle were transferred into the oviducts of two recipient gilts to assess their development in vivo, the pregnancy of one of the gilts was maintained to term and two piglets were delivered via Cesarean section. The results of the present study showed that (1) although the duty cycle of ultrasound affects in vitro development after activation of both pig oocytes and miniature pig cloned embryos, the optimal duty cycle is different between them and (2) miniature pig cloned embryos have the ability to develop into piglets after activation by ultrasound stimulation.     

Strain imaging of the lateral collateral ligament using high frequency and conventional ultrasound imaging: An ex-vivo comparison

Recent first attempts of in situ ultrasound strain imaging in collateral ligaments encountered a number of challenges and illustrated a clear need for additional studies and more thorough validation of the available strain imaging methods. Therefore, in this study we experimentally validated ultrasound strain measurements of ex vivo human lateral collateral ligaments in an axial loading condition. Moreover, the use of high frequency ultrasound (>20 MHz) for strain measurement was explored and its performance compared to conventional ultrasound. The ligaments were stretched up to 5% strain and ultrasound measurements were compared to surface strain measurements from optical digital image correlation (DIC) techniques. The results show good correlations between ultrasound based and DIC based strain measures with R² values of 0.71 and 0.93 for high frequency and conventional ultrasound, subsequently. The performance of conventional ultrasound was significantly higher compared to high frequency ultrasound strain imaging, as the high frequency based method seemed more prone to errors. This study demonstrates that ultrasound strain imaging is feasible in ex vivo lateral collateral ligaments, which are relatively small structures. Additional studies should be designed for a more informed assessment of optimal in vivo strain measurements in collateral knee ligaments.     

超声技术鉴别子宫肌瘤和子宫腺肌病

子宫肌瘤和腺肌病的准确鉴别在妇科临床诊治中有十分重要的意义,各种鉴别诊断技术中,超声技术因其无损性、简便性而成为常规的一种方法。超声成像技术是其中较为成熟的方法。在综述B型成像、彩色血流成像结合脉冲多普勒、彩色血流功率成像和三维彩色功率成像等四种超声成像技术鉴别子宫肌瘤和子宫腺肌病情况的基础上,介绍了两种新的超声鉴别方法：超声弹性检测技术、基于其他声学特征参数检测的组织定征技术。     

超声对酶的影响

超声对酶的影响与超声的强度和介质的性质有关。适宜的超声可提高酶促反应速度,较低强度的超声可提高酶的活性,而较高强度的超声会降低酶促反应速度甚至使酶失活。介质性质不同时,超声对酶活力的促进效果与稳定性不同。非极性介质中酶对于超声的抗性要优于水溶液。在较低强度的超声作用下,超声增加了底物的传质作用,并可导致酶分子的构象发生变化。     

一种非酒精性脂肪性肝病的超声影像人工智能辅助诊断系统开发

摘要 目的：结合人工智能方法设计针对肝脏超声影像的辅助诊断系统，辅助医生对大样本肝脏超声影像数据的标准化和高效化诊断，实现基于肝脏超声图像的非酒精性脂肪性肝病的精准诊断。方法：通过开发肝脏超声影像的识别与分类、脂肪肝分级分析和肝脏脂肪含量定量分析三个模块，建立一套非酒精性脂肪性肝病的超声影像人工智能辅助诊断系统，该系统能够自动区分输入到系统中不同采样视野的超声影像类型，并对肝脏超声图像进行数字化分析，给出待测超声图像是否呈现脂肪肝以及其肝脏脂肪含量的百分比值。结果：本研究中的超声图像识别分类模块可高通量区分出肝肾比图像和衰减率图像的两类超声影像，其分类的准确率达100%。脂肪肝分级分析模块在测试集数据的准确率达到84%，展现出可胜任辅助医生诊断的能力。基于人工肝脏脂肪含量定量方法开发的肝脏脂肪含量定量分析模块的准确率达到67.74%。结论：本研究已开发出一套基于肝脏超声影像的智能辅助诊断系统，可以辅助医生快速、简单、无创地筛选出潜在患有脂肪肝的患者，虽然现阶段实现肝脏脂肪定量分析仍有难度，但已展现出较大的临床应用潜力。