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Objective:To measure the skin thickness in patients with erysipelas by high-frequency ultrasonography (HF-USG), and to compare the clinical efficacy of systemic antibiotics alone versus their combination with glucocorticoids in the treatment of erysipelas.Methods:Hospitalized patients with erysipelas were enrolled from Zhongda Hospital, Southeast University from January to December in 2021, and randomly divided into the study group and control group according to the order of visits. The study group was treated with systemic cefathiamidine for 7 days followed by oral methylprednisolone at a dose of 0.4 mg·kg -1·d -1, while the control group was treated with cefathiamidine alone. Before and after the treatment for 10 days, the thicknesses of the epidermis-dermis layers and subcutaneous tissues were measured by HF-USG at the sites of the most severe skin lesions on the affected limbs and at the corresponding sites on the healthy limbs, and white blood cell (WBC) counts, neutrophil (NEU) counts, as well as C-reaction protein (CRP) levels were determined. The t test and non-parametric test were used to compare the efficacy between two groups. Results:A total of 23 patients with erysipelas were enrolled. Among the 12 patients in the study group, 8 were males and 4 were females, and their age was 71.4 ± 11.4 years. Among the 11 patients in the control group, 7 were males and 4 were females, and their age was 67.4 ± 11.1 years. Before treatment, the thicknesses of the epidermis-dermis layers (0.33 ± 0.12 cm) and subcutaneous tissues (1.08 ± 0.49 cm) in the study group were not significantly different from those in the control group (0.25 ± 0.09 cm, 0.98 ± 0.46 cm; t = -1.83, -0.49, P = 0.081, 0.626, respectively). After the 10-day treatment, the thicknesses of the epidermis-dermis layers and subcutaneous tissues of the skin lesions on the affected limbs significantly decreased in both groups compared with those before treatment (both P < 0.05), and the decrease in the thicknesses of subcutaneous tissues was significantly stronger in the study group (0.32 ± 0.33 cm) than in the control group (0.10 ± 0.07 cm; t = 2.20, P = 0.039). Before treatment, the WBC counts ([11.16 ± 4.42] × 10 9/L), NEU counts ([8.26 ± 4.16] × 10 9/L) and CRP levels (median [ Q1, Q3]: 72.20 [19.28, 140.50] mg/L) in the study group were not significantly different from those in the control group ([10.10 ± 4.53] × 10 9/L, [7.21 ± 3.00] × 10 9/L, 34.40 [8.00, 74.20] mg/L, respectively; t or Z = 0.60, 0.71, -0.85, P = 0.578, 0.496, 0.196, respectively). After the 10-day treatment, the WBC counts, NEU counts, and CRP levels significantly decreased in both groups compared with those before treatment (all P < 0.05) . Conclusion:The combined treatment with systemic antibiotics and glucocorticoids could effectively alleviate skin inflammation, and more rapidly reduce the thicknesses of inflamed subcutaneous tissues in patients with erysipelas compared with systemic antibiotics alone.
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Objective:To explore the high-frequency ultrasonographic and clinical features of superficial intravascular tumors.Methods:Thirteen superficial intravascular tumor patients who underwent ultrasound examination form Beijing Jishuitan Hospital during 2016-2020 were retrospectively analyzed. The location, anatomic blood vessels, shape, size, boundary, internal echo, blood flow and clinical characteristics of the tumors were analyzed.Results:Among the 13 cases, most of the tumors were oval like or long strip, and a few were round like. All 11 cases of primary intravascular tumors showed hypoechoic mass; 2 cases of intravascular metastasis or recurrence showed solid hypoechoic with hyperechoic mass. Arterial blood flow spectrum was detected in 12 cases. Two patients with glomus tumor showed typical tenderness at the fixed point. Two patients had a history of bone tumors in the upper or lower extremities.Conclusions:High frequency ultrasound can clearly recognize the location of the superficial intravascular tumors, describe the morphological characteristics and sonographic features of the tumor, then help to make a more accurate qualitative diagnosis.
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Objective:To explore the application of microvascular flow imaging (MVFI) combined with high-frequency ultrasonography in children with haemophilic arthropathy A (HAA).Methods:Retrospective study.A total of 82 children diagnosed with HAA in the First Affiliated Hospital of Zhengzhou University from October 2018 to October 2020 were recruited.The elbow, knee and ankle joints of each child were examined by high-frequency ultrasonography.The numbers of thickened synovial joints were recorded.Blood flow signals of the thickening of synovial joints was checked by the MVFI and power Doppler ultrasound (PDUS), respectively.Color flow signals were graded by the semi-quantitative scoring systems.The chi- square test and independent multi-group ordinal multi-category rank-sum test were used to compare the differences of MVFI and PDUS in the display of thickened synovial blood flow. Results:A total of 254 joints were involved in 82 children with HAA, including synovial hypertrophy in 188 joints, hydrops articuli in 146 joints, fibrotic septa in 66 joints, cartilage damage in 63 joints, haemosider indeposition in 45 joints, bone erosion in 25 joints, osteophytes in 15 joints and bone remodeling in 8 joints.Grade Ⅱ synovial thickened joints were the most common.The proportion of blood flow signals detected by PDUS in thickened synovial membranes was significantly higher than that detected MVFI (52.66% vs.70.21%, χ2=12.225, P<0.05). Numbers of grade 0 and Ⅰ joints with thickened synovial membranes detected by MVFI were less than those of PDUS, while the opposite result was obtained in detecting grade Ⅱ and Ⅲ joints ( H=21.158, P<0.05). Compared with PDUS, MVFI more sensitively visualized the blood flow of the thickened synovial membrane. Conclusions:MVFI can more prominently detect the thickened synovial blood flow in children with HAA.A combined application of MVFI and high-frequency ultrasonography contributes to the evaluation of children with HAA.
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Disfiguring dermatoses are a group of cutaneous diseases that affects the appearance and mental health of patients to various extents. Patients usually have high expectations for the treatment outcome, and there is an urgent need for convenient and accurate non-invasive auxiliary evaluation tools for better diagnosis and treatment. With the development of high-frequency ultrasonography, more and more skin diseases, including disfiguring dermatoses, have been objectively and accurately assessed by this technology. This review summarizes research progress in the application of high-frequency ultrasonography in the diagnosis and treatment of some disfiguring dermatoses.
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Objective:To evaluate the diagnostic accuracy and application value of high-frequency ultrasonography in proximal radial nerve injuries associated with humeral shaft fractures.Methods:A retrospective case series study was performed for 19 patients with proximal radial nerve injuries associated with humeral shaft fractures treated in Huashan Hospital Affiliated to Fudan University from August 2014 to September 2020. The were 17 males and 2 were females，with the age range of 16-55 years ［（38.1±12.7）years］. Of all，11 patients were injured at the left side and 8 at the right side. All the patients had histories of traumatic humeral shaft fracture and were treated in other hospitals，including internal fixation in 17 patients，external fixation in 1 and internal fixation combined with external fixation in 1. All patients underwent radial nerve exploration surgeries，among which 8 had high-level radial nerve release and 11 had high-level radial nerve suture or graft transplantation. All patients underwent high-frequency ultrasound examination before surgery. The ultrasonographic characteristics of the radial nerve were recorded，including the continuity of the epineurium，honey-comb structure on the transversal section，neuromas on the longitudinal section and external scar or callus or metal fixation compressing the nerve. The injury type and neural continuity of each radial nerve were evaluated. The radial nerves of type Ⅰ，type Ⅱ，type Ⅲa ，type Ⅲa ，type Ⅲb and type Ⅳ appeared as normal，swelling，short-segment compressed，neuroma-like and ruptured，respectively. Taking the intraoperative findings as the gold standard，the diagnostic coincidence rate，sensitivity，specificity，positive predictive value and negative predictive of high-frequency ultrasound were analyzed in diagnosis of proximal radial nerve injuries associated with humeral shaft fractures.Results:According to ultrasonographic characteristics，proximal radial nerve injuries were classified into 4 types in 5 subtypes. It was confirmed by surgeries that there were 1 patient with type Ⅱ，4 with type Ⅲa，1 with type Ⅲb and 13 with type Ⅳ，with no type Ⅰ. The diagnostic coincidence rate of high-frequency ultrasound was 89%. The diagnostic coincidence rate of type Ⅱ，type Ⅲa，type Ⅲa，type Ⅲb and type Ⅳ was 100%，100%，100% and 85%，respectively. The sensitivity of high-frequency ultrasound for evaluating the neural continuity was 75%，the specificity was 100%，the positive predictive value was 100%，the negative predictive value was 85%.Conclusions:The high-frequency ultrasound has a relatively high sensitivity and specificity in diagnosis of proximal radial nerve injuries associated with humeral shaft fractures，which can provide relatively accurate morphological information for clinical diagnosis and treatment.
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Objective To analyze and compare the independent and combined diagnostic values of high frequency ultrasonography (HFU) and molybdenum target imaging (MTI) for early breast tumor in a prospective study.Methods 258 patients with breast mass which were suspected as breast tumors by physical examination received HFU,MTI,their combined applications and operative treatments.Comparative studies were made between the surgical pathology and imaging evaluations.Results Totally 258 cases were enrolled in this study.Surgical pathology confirmed 135 cases of early breast cancer and 123 cases of benign breast tumor.For the diagnosis of early breast cancer,combined application was more effective than HFU or MTI alone in sensitivity (P0.05).In the patients of early breast cancer, compared with HFU,MTI found less nodules of calcification(18.3% vs 36.5%,P<0.01),but revealed more axillary lymph metastasis (69.0% vs 33.3%,P<0.01).Conclusion HFU and MTI alone or their combined application are reliable imaging methods for the diagnosis of early breast cancer.For the sensitivity and accuracy of diagnosis, combined applications has more superior advantages.
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Objective To analyze the features of normal high-frequency ultrasonography of tarsal tunnel. Methods Forty volunteers (20 males and 20 females) were examined with high-frequency ultrasound (12 MHz). The tendons,nerve and blood vessels in tarsal tunnel were observed from short-axis and long-axis views dynamically. The areas of tarsal tunnel and posterior tibial nerve were measured and com-pared between the males and females. Results High-frequency ultrasonography depicted the anatomical structure of tarsal tunnel,and the tendons,nerve and blood vessels presented different sonographic features that were easy to differentiate. The area of tarsal tunnel: male (7.61 ±1.00) cm2,female (6. 61 ± 1. 07) cm2 (P <0. 01). The area of posterior tibial nerve: male (9. 59 ± 0. 75) mm2,female (8.91 ±0.74) mm2(P<0.01). Conclusion High-frequency ultrasonography can clearly show and accurately measure the tarsal tunnel structure. To be familiar with the normal ultrasonographic anatomy of tarsal tunnel will help to improve the efficacy of ultrasound diagnosis of tarsal tunnel abnormalities.
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Objective To explore the value of high frequency ultrasonography for the early diagnosis of hyperuricemia in patients with joint disease.Methods Ninety-eight patients with hyperuricemia and 100 healthy persons,according to with or without history of acute gout attack,were divided into symptomatic group,asymptomatic group and control group,whose first metatarsophalangeal joint,ankle and knee were examined by high frequency ultrasonography.Chi-square test was used for statistical analysis.Results ① The joint lesions detection rate in the symptomatic group,asymptomatic group and the control group was 57％ (13/23),16％ (12/75),0 (0/100) respectively.There was statistical significant difference between the symptomatic group and the asymptomatic group (x2=9.69,P＜0.05).② The symptomatic group had 29 joint involvement (29/138),including 25 at the first metatarsophalangeal joint,3 at the ankle and one at the knee joint.The asymptomatic group had 14 joints involved (14/450),which were all located at the first metatarsophalangeal joint.③ The sonographic appearance of the two groups of arthropathy were synovial thickening,effusion,crystal deposition andbone erosion.The symptoms group presented as tophi,and increased synovial blood flow.Conclusion Patients with asymptomatic hyperuricemia may have joint diseases.The joint disease detection rate of the symptomatic group is higher than that of the asymptomatic group.High frequency ultrasonography can be used a conventional imaging method for the screening of patients with hyperuricemia joint disease.The focus of the screening of asymptomatic patients is the first metatarsophalangeal joint.The focus of the screening of symptomatic patients is the first metatarsophalangeal joint and the joints that were attacked in the past history.
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lerosis of the lower extremity artery in patients with type 2 MD.
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Objective To describe the imaging of the vagina massive hemorrhage patients,which is caused by pero-abortion by the high-frequency ultrasonic examination,and to establish the character of ultrasound.Methods 56 patients,who have the vagina massive hemorrhage after the drug abortion,were checked by the high-frequency ultrasonic examination,to observe if there are fetus in the uterus.Results There all have fetus in the uterus in 56 patients by the high-frequency ultrasonic examination.Including 8 patients who have little residues;22 patients have residues complic fluidify in the uterus;26 patients have admix residues.Conclusions After the drug abortion,the vagina massive hemorrhage,which is caused by pero-abortion,is the severity complication endangering the life of the patients,we cound found the pero-abortion early by the high-frequency ultrasonic examination and clinical observe.
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0.05)from that obtained by ultrasonography or mammography alone.Conclusions:The high frequency ultrasonography can be the first choice for diagnosing breast malignant tumor,uhrasonography combined mammography can increase the CDR of breast malignant tumor.
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Objective To evaluate the diagnostic role of high frequency ultrasonography(HFU) and CDFI for breast tumor,especially to evaluate the correlation of pathology in hyperplasia of breast.Methods HFU and CDFI findings were compared with pathological study in 196 cases with confirmed breast tumor.The tumor of breast were divided into three groups.They were 81 cases of fibrocystic disease ofbreast,70 cases of breast cancer and 45 cases of fibroadenoma disease of breast.Results The benign and nicious tumor of breast haddifferent and typical represent of HFU,because dates of HUF had correlation with those of pathology,such as tumor boundary,internalecho,mononode and multinode,calcification,attenuation and CDFI.Some patients had crossed represent of HUF and CDFI.Thesensitivity,specificity and accuracy rate were calculated apart from.The sensitivity of fibroscystic disease of breast was 89%,the specificity was 96.5%,the accuracy was 93%,the negative predictive value was 93%,the postive predictive valus was 95%;the sensitivity of cancer of breast was 89%,the specificity was 94%,the accuracy was 92%,the negative predictive value was 96%,the post predictive valus was 89%;the sensitivity of fibroadenoma of breast was 89%,the specifity was 93%,the accuracy was 92%,the negative predictive value was 96%,the postive predictive value was 80%.Conclusion HUF in combination with CDFI are useful in diagnosis of both male and female breast tumor.This study may be helpful in raising the ultrasonic diagnosis rate in breast tumor.