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RESUMEN Fundamento: el doppler transcraneal es una técnica que se mantiene en constante desarrollo y constituye una medida indirecta de la presión intracraneal. Objetivo: demostrar el valor pronóstico del doppler transcraneal en pacientes con hemorragia intraparenquimatosa cerebral espontánea. Método: se realizó un estudio prospectivo a 50 pacientes ingresados con el diagnóstico de hemorragia intraparenquimatosa cerebral de causa no traumática, en las primeras 12 horas de su admisión, se determinó el índice de pulsatilidad y velocidad media en la arteria cerebral media bilateralmente. Se realizó un estudio univariado a edad, presencia de sangre intraventricular, velocidad media, volumen del hematoma y valores del doppler transcraneal. Se evaluó la existencia de correlación entre los valores del índice de pulsatilidad con la velocidad media. A los valores del doppler transcraneal se le hallaron los valores predictivos. Resultados: se obtuvo una asociación significativa entre volumen del hematoma, valores del doppler transcraneal y electrocardiograma con la sobrevida. Además, se encontró correlación entre este último parámetro y el doppler trancraneal. El área bajo la curva de característica operativa del receptor del doppler transcraneal en el hemisferio afectado fue altamente predictiva de mortalidad con alta sensibilidad y especificidad para puntos de corte del índice de pulsatilidad en 1,85 y de velocidad media en 32,3 cm/s. Conclusiones: la escala de coma de Glasgow y el volumen de hematoma son los principales indicadores pronósticos de sobrevida en pacientes con hemorragia intraparenquimatosa espontánea.
ABSTRACT Background: transcranial doppler is a technique which is constantly being developed and constitutes an indirect measure of intracranial pressure. Objective: to demonstrate the prognostic value of transcranial doppler in patients with spontaneous cerebral intraparenchymal hemorrhage. Method: a prospective study was carried out on 50 patients admitted with the diagnosis of intraparenchymal cerebral hemorrhage of non-traumatic cause in the first 12 hours of admission, the pulsatility rate and average velocity in the middle cerebral artery was determined bilaterally. A univariate study was performed at age, presence of intraventricular blood, average speed, hematoma volume and transcranial doppler values. The existence of correlation between the pulsatility index values and average speed with the average speed was evaluated. The values of transcranial doppler were found their predictive values. Results: a significant association was obtained among hematoma volume, transcranial doppler values and electrocardiogram with survival. In addition, a correlation was found between this last parameter and the transcranial doppler. The area under the operating characteristic curve of the transcranial doppler receptor in the affected hemisphere was highly predictive of mortality with high sensitivity and specificity for cut-off points of the pulsatility index at 1.85 and average speed at 32.3 cm/s. Conclusions: glasgow coma scale and hematoma volume are the main prognostic indicators of survival in patients with spontaneous intraparenchymal hemorrhage.
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Objective To investigate the clinical effect of percutaneous transhepatic bile duct drainage guided by ultrasound.Methods From June 2016 to June 2018,100 patients with obstructive jaundice in Lishui Central Hospital were treated with ultrasound -guided percutaneous transhepatic bile duct drainage.The success rate and postoperative complications of the patients were analyzed.Results Among 100 cases,98 cases were successful , 2 cases failed,and the failure rate was 2%.The success rate of one -time catheterization in 0.5-2.0 cm patients with intrahepatic bile duct diameter (98.91%) was significantly higher than that in intrahepatic bile duct diameter 0.3-0.4 cm patients(87.50%),compared with two different diameter puncture catheterization ,the difference was statistically significant ( χ2 ＝12.369, P ＜0.05 ).All 98 cases with successful puncture were followed up after operation (P＜0.05),and there was no statistically significant difference between the two groups ( P＜0.05).The drainage tube was removed in 2 cases,bile duct infection was found in 2 cases,the remaining patients were unobstructed, and there were no obvious complications.Conclusion Ultrasound-guided percutaneous transhepatic catheterization and drainage for the treatment of obstructive jaundice caused by malignant tumor is simple ,reliable,safe and effective, and has a certain clinical value.It is worthy of popularizing and application.
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Objective@#To investigate the clinical effect of percutaneous transhepatic bile duct drainage guided by ultrasound.@*Methods@#From June 2016 to June 2018, 100 patients with obstructive jaundice in Lishui Central Hospital were treated with ultrasound-guided percutaneous transhepatic bile duct drainage.The success rate and postoperative complications of the patients were analyzed.@*Results@#Among 100 cases, 98 cases were successful, 2 cases failed, and the failure rate was 2%.The success rate of one-time catheterization in 0.5-2.0 cm patients with intrahepatic bile duct diameter(98.91%) was significantly higher than that in intrahepatic bile duct diameter 0.3-0.4 cm patients(87.50%), compared with two different diameter puncture catheterization, the difference was statistically significant(χ2=12.369, P<0.05). All 98 cases with successful puncture were followed up after operation (P<0.05), and there was no statistically significant difference between the two groups(P<0.05). The drainage tube was removed in 2 cases, bile duct infection was found in 2 cases, the remaining patients were unobstructed, and there were no obvious complications.@*Conclusion@#Ultrasound-guided percutaneous transhepatic catheterization and drainage for the treatment of obstructive jaundice caused by malignant tumor is simple, reliable, safe and effective, and has a certain clinical value.It is worthy of popularizing and application.
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Pneumonia is a major disease threatening the health of children, and its diagnosis mainly depends on medical history, physical examination, chest X-ray and CT examination. The reliability of the physical examination was low, while the chest X-ray and CT examination had certain radiation damage to children. Therefore, in recent years, the application of lung ul-trasound is popular in diagnosis of pneumonia in pediatric patients. This article reviewed the application of lung ultrasonography in diagnosis and follow-up of pneumonia in pediatric patients..
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Objective To evaluate the diagnostic value of gray-scale ultrasonography (GSU) combined with contrast-enhanced ultrasonography (CEUS) and real-time elastography imaging (EI) in solid thyroid nodules.Methods A total of 124 solid nodules were collected from Xuanwu Hospital of Capital Medical University from September 2011 to November 2014, including 49 benign nodules and 75 malignant nodules conifrmed by surgical pathology. The data of multimodal imaging were retrospectively analyzed and compared with the pathological results. The parameters among the groups were compared byχ2 test. Four diagnostic models including the statistically signiifcant independent variables were established accord to different combinations of routine ultrasound examination. The binary Logistic regression equation using the pathological results as the dependent variable Y and the ultrasound features of thyroid nodules as independent variableX was established for calculating the area under the receiver operator curve (ROC) and multiple regression analysis furthermore.Results There were statistically significant differences in aspect ratio, margin condition, echo type, CEUS features, elastic imaging score and elastic strain rate of benign and malignant thyroid nodules(χ2=13.966, 7.106, 24.215, 17.250 and 27.158,P<0.05).The four Logistic regression models were statistically signiifcant (χ2=5.37, 5.37, 8.155, 8.155, allP<0.05). By using modelⅠ,Ⅱ,Ⅲ andⅣ, the diagnostic sensitivity, speciifcity and accuracy of malignant nodules were (73.8%, 75.9%, 79.7%, 83.3%), (67.5%, 70.7%, 85.2%, 86.7%), and (71.8%, 74.2% 81.8%, 84.4%) respectively. The area under the ROC of logistic equation predicted values were (0.778, 0.809, 0.875 and 0.898, allP<0.01). Multivariate categorical analysis showed that aspect ratio, margin condition and the elastic strain rate ratio (χ2=13.73, 7.541 and 11.461, allP<0.05) of thyroid nodules were effective diagnostic indicators. Conclusions Our study indicated that CEUS and EI could be helpful modality for GSU to improve the diagnostic accuracy of thyroid nodules. The combined application of multi mode ultrasound examination has a high diagnostic value.
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Objective To investigate the ultrasonic performance of carotid atherosclerotic plaque and the correlation between microvessel density in plaque .Methods 87 cases of patients undergoing carotid artery plaque dissection were selected .113 plaques were found .All patients were taken carotid color Doppler sonography test and analysis of the plaque .The maximum thickness of plaques was taken HE stained ,and the vessel density in the plaque was counted .The correlation with sonographic performance of plaques was analyzed .Results The maximum plaque thicknesses in hard plaque ,soft plaque and mixed plaque were (0.49 ±0.05)mm,(0.36 ±0.08)mm and (0.39 ± 0.10)mm,respectively,and cross-sectional area stenosis rates were (88.32 ±6.51)%,(68.92 ±12.05)% and (71.95 ±13.04)%,respectively,the differences were statistically significant (F=16.329,23.723,all Pmixed plaques>hard plaque,the differences were statistically significant (t=6.579 and 9.392,all P<0.05).Pearson cor-relation analysis showed that the maximum plaque thickness and cross -sectional area stenosis rate in soft plaque were positive correlation between microvascular density values (r=0.372,P=0.011;r=0.438,P=0.000).Conclusion Color Doppler ultrasound examination might indirectly reflect microvessel densities in carotid artery plaque .It could be used preliminary assessment of vulnerability of carotid artery plaque .
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Objective To evaluate the clinical value of artificial hydrothorax combined with one-lung ventilation to aid ablation treatment of liver carcinoma in the hepatic dome.Methods Twenty-one patients with liver carcinoma located in the hepatic dome and affected by the lung gas were enrolled.Double lumen endobronchial intubation anesthesia was used and thoracical tube was used to apply artificial pleural effusion.The lesions'ultrasound image were recorded for the patients without artificial hydrothorax,or with artificial hydrothorax only and artificial hydrothorax combined with one-lung ventilation.Ultrasound images were reviewed and scored as 1-5 according to the clarity and completeness of the lesion.Ablation efficacy and adverse reactions were recorded in the follow-up.Results Twenty-one patients were successfully applied artificial hydrothorax and one lung ventilation.The average normal saline used for artificial hydrothorax were (738± 260)ml.The ultrasound score for not using artificial hydrothorax,using artificial hydrothorax only and artificial hydrothorax combined with one lung ventilation were 1.13 ± 0.35 (1-2),3.00 ± 0.85 (2-5) and 4.53 ± 0.64(3-5),respectively,statistical difference was found between each method(P ＜0.05).Artificial hydrothorax combined with one-lung ventilation had much higher ultrasound score than the other 2 methods.No complication related to artificial hydrothorax or one-lung ventilation was found.CT/MRI at one month after ablation showed that all the lesions were completely ablated.In the follow-up for 2-14 months on average,1 case of local tumor progression and 1 case of intrahapetic relapse were found.Conclusions Artificial hydrothorax combine one-lung ventilation could effectively enhance ultrasound image for the lesions in the dome whose acoustic window was affected by lung gas.
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Objective To analyze the clinical value of the high frequency ultrasound in the enlarged superfi-cial lymph nodes diagnosis.Methods The enlarged superficial lymph nodes features and clinical data of 128 cases of enlarged superficial lymph nodes patients was studied in our hospital.Results The coincidence rate of the high-fre-quency ultrasound in the diagnosis of enlarged superficial lymph nodes was 90.5%.There were 20 cases misdiag-nosed.The long and short diameter of lymph nodes in the benign group were (2.2 ±0.8)cm,(1.0 ±0.4)cm.The long and short diameter of lymph nodes in the malignant group were (3.4 ±1.0)cm,(1.7 ±0.9)cm.The two groups had significant difference (t=9.13,5.11,all P <0.05).The RI of the malignant group and benign group were (0.44 ±0.06) and (0.83 ±0.23),respectively.The two groups had significant difference (t=5.06,P<0.05). Conclusion The high-frequency ultrasound has a high application value in the diagnosis of lymph nodes.It could effectively reduce the misdiagnosis and miss diagnosis in combination with characteristics of nodular internal blood flow and nodular morphology characteristics.
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Type B ultrasonic scanning was performed routinely for 10 944 pregnant women at their third semester when they visited outpatient department or were admitted to our hospital during January 2004 to December 2008, and their fetal heart rate, amniotic fluid, umbilical cord and neonate conditions were monitored and recorded during delivery. The sensitivity and specificity of type B ultrasonic were 95.74% (3301/3448) and 96. 25 % (7215/7496). Umbilical abnormality was diagnosed in 3448 pregnancies by type B ultrasonic scanning, with prevalence of 31.51%, cesarean section was performed in 44.00 %, fetal distress occurred in 18. 27% of them, 15.46% of them with Apgar score equal to or less than seven, and fetal death occurred in 2. 41% of them, all significantly higher than those in pregnant women without umbilical abnormal (23. 77%, 8. 56%, 7.84% and 1.36%, respectively, all P ＜0. 01 ). Cesarean section was performed in 41.90 % of those with 0. 8 cm or more in the notch depth of nuchal cord entanglement,fetal distress occurred in 29.76% of them, 25.30% of them with Apgar score equal to or less than seven and fetal death occurred in 4. 05% of them, all significantly higher than those in pregnant women with the notch depth less than 0. 8 cm (20. 22%, 8. 60%, 9. 26% and 0. 54%, respectively, all P ＜0. 01 ). Type B ultrasonic scanning plays an important role in clinical diagnosis for umbilical abnormality, guiding selection of delivery method and improving neonatal prognosis.
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Objective To explore the application of high-frequency color Doppler in the diagnosis of infant intussusception and the selection of reduction mode according tO the hemodynamic situations of intussusception intestine tube and blood vessel in mesentery.Methods A total of 377 cases of doubtful intussusception infants wete checked by high-frequency color Doppler.After they had been diagnosed,the hemodynamic situations of intussuscepiton intestine tube and blood vessel in mesentery were carefully observed and the ultra-sound had 3 types and then the hydrostatic enema reduction was chosen as treatment method.Results A total of 263 cases was diagnosed by highfrequency colot Doppler with rate of coincidence of 100%.Among them are 253 successful cases reduced by hydrostatic enema.The successful rate of reduction was 96.2%and the 10 failed cases were changed to be treated bv operation.The intestinal wall of intussusception tube in failure group had serious dropsy without blood flow shown.Conclusions It is accurate that the infant intussusception is diagnosed by high-frequency color Doppler.According to the hemodynamic situations of intussusceptin intestine tube and blood vessel in mesentery,the infant intussusception can be divided into 3 types as follows:type Ⅰ:the blood signal of intestinal tube and wall is up or normal,which shall be reduced by hydrostatic enema;type Ⅱ:the blood signal of intestinal tube and wall is small with high obstruction index,which shall be reduced by hydrostatic enema as possible as it can;type Ⅲ:the intestinal wall has serious dropsy with rather high obstruction index and without blood flow shown,in which the hydrostatic enema redHetion shall bebanned and the operation shall be carried out as soon as possible.
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Objective The aim of the study was to determine the diagnostic value of color Doppler ultrasound in the assessment of the retinal detachment. Methods The changes of ultrasonograph of the retinal detachment were retrospectively observed in 35 cases of 31 opei-ation proven retinal detachment patients. Results Color Doppler ultrasound had an accuracy of 97.1% (34/35) for diagnosing retinal detachment. In 33 cases of retinal detachment, the results of color Doppler flow imaging(CDFI) showed the color blood-flow signal in the vitreous membrane echo,extending with central retinal artery and vein. Conclusion For the color blood-flow signal in the vitreous membrane echo by CDFI ,extending with central retinal artery and vein, has a specificity of diagnostic value for retinal detachment, and the color Doppler ultrasound has a high accuracy for diagnosing retinal detachment.
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El propósito del trabajo fue establecer la validez y confiabilidad de la Ecografía del Timo en niños menores de 6 años de edad, de ambos sexos, en la actualidad es una de las herramientas que puede evaluar la función de la respuesta inmunitaria en forma confiable yno invasiva. Metodos. La validez de la ultrasonografía del timo, es demostrada frente aun patrón de oro, en niños fallecidos se ejecutó la ecografía vs. la Anatomía Patológica (Grupo 1); y en otros niños la ecografía vs. laTomografía Axial Computarizada (TAC)(Grupo 2). La confiabilidad, fue evaluada a nivel intra observador (Grupo 3), se evaluó su estado nutricional mediante: peso para talla, peso para la edad, talla para la edad. A todos los niños, con evaluación de la TAC yla confiabilidad se les realizó un examen y un cuestionario de tipo clínico pediátrico. Resultados. Tanto la evaluación por anatomía patológica (n=5), como por tomografía axial computarizada (n=4) vs. la ecografía del timo no muestran diferencias estadísticamente signifi cativas en la mediciones realizadas en el tamaño del timo en los niños evaluados. En el grupo 3 (n=15), el índice de correlación intraclase es de 0.96. Se realizaron los cálculos de One-way ANOVA + test de Scheffe y elanálisis de varianza (ANOVA). Conclusion. La validez de la ecografía del timo en niños es adecuada, esuna herramienta que mide lo que dice medir. La confi abilidad intraobservador, establece un índice de correlación casi perfecto conun personal adecuadamente entrenado para medir con la ecografía el timo en niños.
Abstract. Evaluation of the thymus size: validity and reliableness of thymussonography in children. Introduction. The porpuse of this paper was to stablish the validity and the reliableness of thymus sonography in children under 6 years of age of both sexes. At present, thymus songraphy is one of the tools for assessing the function of the immune response by means of a reliable and non-invasive method. Methods. The validity of thymus ultrasongraphy is demonstrated in front of a gold standard, in dead children, sonography was performed and compared to pathological anatomy (group 1); and in other children, sonography was compared to computerized axial tomography (TAC) (group 2). The reliableness was evaluated at the intraobserver level (group 3). The children ́s nutritional status was assessed by: weight for height; weight for age; and height for age. On all children with TAC and reliableness evaluation a clinical exam was performed and a paediatric clinic questionnaire was fi lled out. Results. The evaluation by pathological anatomy (n=5) as well as the computerized axial tomography as compared to thymus sonography did not show statistically signifi cant differences in the measurements of thymus size. In group 3 (n=15), the intraobserver correlation index was 0.96. Statistical analysis was performed using one-way ANOVA + test of a Scheffé and analysis of variance (ANOVA). Conclusion.The validity of the thymus sonography in children is adequate, it is a tool that measures what it says it measures. The intraobserver reliableness establishes an almost perfect correlation index in a well trained person for measuring thymus size by sonography in children.
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Humans , Male , Female , Infant , Child, Preschool , Thymus Gland , Reproducibility of Results , Thymus Gland/anatomy & histology , Tomography, X-Ray Computed/instrumentationABSTRACT
A primary mucosa-associated lymphoid tissue lymphoma (MALT lymphoma) of the breast is extremely rare. We report a case of a MALT lymphoma of the breast that presented as a palpable left breast mass in a 37-year-old woman. A physical examination revealed a large firm, and fixed mass in the left inner breast. Mammograms showed a large, isodense mass in the lower inner quadrant of the left breast and an enlarged lymph node in the axilla. A sonogram demonstrated a 5 cm sized, oval, circumscribed, and heterogeneously hypoechoic mass with posterior acoustic enhancement. A surgical biopsy was performed, and the pathology revealed a MALT lymphoma.
Subject(s)
Adult , Female , Humans , Acoustics , Axilla , Biopsy , Breast Neoplasms , Breast , Lymph Nodes , Lymphoma, B-Cell, Marginal Zone , Mammography , Pathology , Physical Examination , UltrasonographyABSTRACT
Objective To observe the hemodynamic change of small artery in patients with type 2 diabetes. Methods We measured peak systolic velocity (PSV), end-diastolic velocity (EDV), pulse index (PI), resistance index (RI) of ocular artery (OA), central retinal artery (CRA), finger artery, dorsal pedis artery and interlobar artery of patients with early-stage type 2 diabetes. Results The decrease in PSV and EDV values occurred early in CRA of type 2 diabetics while RI and PI values increased. Conclusion The hemodynamic change of CRA occurs earliest among general small arteries of type 2 diabetic patients.