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Background: AUB is a common and debilitating condition and it is one of the main gynaecological reasons for hysterectomy. Ultrasonography can be as good as histopathology (HPE) in the diagnosis of abnormal uterine bleeding. Hence, our study was conducted to validate the ultrasonographic findings with HPE findings in diagnosis of AUB.Methods: A hospital based cross-sectional analytical study was conducted among 86 patients with abnormal uterine bleeding in the department of Obstetrics and Gynaecology in collaboration with department of Pathology, RIMS, Imphal from September 2017 to March 2019. The clinical history and socio demographic profile were collected using a pre-designed proforma. General physical examination, pelvic examination and ultrasonagraphy was carried out and the hysterectomy specimens were subjected to histopathological examination.Results: Fibromyoma was diagnosed by ultrasound in 62.8% of the patients and it was the common diagnosis in this study. The sensitivity, specificity, positive predictive value, negative predictive value and kappa statistics of USG for diagnosing leiomyoma was 92.9%, 93.3%, 96.3%, 87.5% and 84.9% respectively. The sensitivity, specificity, positive predictive value, negative predictive value and kappa statistics of USG for diagnosing adenomyosis was 53.8%, 98.6%, 87.5%, 92.3% and 62.3% respectively.Conclusions: The study provides an evidence that ultrasonography has good diagnostic accuracy as histopathology in the diagnosis of fibroid in patients with abnormal uterine bleeding. However, as with all the diagnostic procedures, the utility of ultrasound in the diagnosis of adenomyosis is questionable, since it has a low sensitivity amidst good specificity.
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Objective To analyze the clinical value of CDUS in the diagnosis of thyroid cancer.Methods 97 patients with TMC were diagnosed by CDUS and CT,the clinical value of CDUS was evaluated.Results A total of 1 1 2 lesions TMC,CT diagnosis of 81 ,CDUS confirmed 99,the positive rates were 72.32%,88.39% respectively.In 97 cases,1 3 cases of lymph node metastasis,CT diagnosis of lymph node metastasis rate was 53.85%,CDUS of 92.31 %.CDUS in diagnosis of TMC was effective than CT diagnosis (χ2 =4.887,P =0.027).Conclusion CDUS has important value in the diagnosis of TMC.
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OBJECTIVE: To evaluate the clinical value of high-frequency ultrasonagraphy in testing carpal canal structure in the diagnosis of patients with occupational hand-arm vibration disease( HAVD). METHODS: Eighteen patients with occupational mild HAVD( 36 wrists) were selected as the case group and 20 healthy volunteers( 40 wrists) were enrolled as the control group by using convenience sampling method. The color doppler ultrasound was used to measure the crosssectional areas( CSA) of median nerve at the level of pisiform bone,the thickness of transverse carpal ligament,and the internal diameter of median nerve and the CSA of median nerve at the level of hamate hook of the 2 groups. Fisher discriminant analysis and receiver operating characteristic( ROC) curve were performed to assess the effect of diagnosing HAVD with the CSA of median nerve at the level of pisiform bone in patients with HAVD. RESULTS: The CSA of median nerve at the level of pisiform bone in both hands was smaller than that of the control group( P < 0. 01). However,there was no statistical significance in the thickness of transverse carpal ligament of both hands,the internal diameter of median nerve and the CSA of median nerve at the level of hamate hook in the case and control groups( P > 0. 05). Through the Fisher discriminant analysis which was carried on and the distinction equation which was established meanwhile by using the CSA of median nerve at the level of pisiform bone in both hands as HAVD diagnostic criterion,the HAVD predictive accuracy rate was 78. 9%. The ROC curve was underway with the discriminant score as an indicator for distinguishing HAVD,and the result showed that the area under the curve was 0. 842,with sensitivity of 75. 00% and specificity of 88. 90%. CONCLUSION: High-frequency ultrasonography can be used to observe and quantify the imaging changes of carpal canal structure in patients with HAVD,which can provide objective and scientific diagnostic basis for the diagnosis of HAVD.
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Objective To investigate the feasibility of ultrasound-guided interscalenus brachial plexus block used for the emergency surgery.Method From August to December 2007 80 patients from the Integrated Traditional Chinese and Western Medicine Hospital of Wenzhou,ASA Ⅰ to Ⅲ,age 18 to 68 years old,weight 45 to 75 kg,without deformity on the shoulder or neck,without limb paresthesia,without contraindications of interscalenus brachial plexus block,were scheduled for emergency surgery of upper limb.They were randomly divided into two groups:interscalenus block guided by ultrasound group(group U,re =40)and nerve stimulator group(group N,re = 40).Patients of both groups received 20 mL mixture of 0.75%ropivacaine and 2%lidocaine.The onset time,and the analgesic efficacy of axillary nerve,lateral antebrachial cutaneous nerve,radial nerve,median nerve,median cutaneous nerve of arm,median antebrachial cutaneous nerve and ulnar nerve,and duration of anesthesia were observed.Statistical analysis was performed by t test,rank sum test and X2 test.Results The onset time of analgesia after nerve block was shorter in group U than that in group N(P＜0.01).The rate of perfect analgesia after nerve block in group U was higher than that in group N(100%vs.87.5%,X2 = 5.267,P = 0.027).The duration of anesthesia lasted in group U was(378 ± 151)minutes and that in group N was(365 ± 163)minutes(t= 0.363,P = 0.718).ConclusionsCompared with the method of nerve block guided by nerve stimulator,the ultrasound-guided interscalenus block offers faster onset and better analgesic efficacy.It is an ideal technique of brachial plexus block for the emergency surgery.
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Objective To compare the efficacy of interscalene brachial plexus block using an ultrasound-guided method with nerostimulator-guided method.Methods Ninety ASAⅠ～Ⅱ patients scheduled for surgery of the upper extremity were randomly allocated into three groups(n=30),Control group: nerve stimulator-guided and single-injection group;US group: ultrasound-guided with nerve stimulator confirmation and single-injection group;UD group: ultrasound-guided with nerve stimulator confirmation and double-injection group.Thirty mL 0.5% ropivocaine was injected in each group.The patient in group UD received half the volume of ropivocaine injected around the two target nerves.Results The average onset time of sensory blockade in the UD group was significantly shorter than in the US group and Control group.The rate of satisfactory sensory blockade in the UD group was significantly higher than in the US group and Control group.Conclusion Ultrasound-guided interscalene brachial plexus block may shorten the onset time with fewer adverse events.The ultrasound-guided double-injection method may significantly improve the quality of blockade.
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Objective To explore the value of MRI in detecting the corpus callosum agenesis suspected by US.Methods 19 women with complicated pregnancies,aged from 20 to 37 years(average 28 years) and with gestation from 20 to 38weeks(average 29 weeks) were studied with a 1.5 T superconductive MR unit within 24 hours after ultrasound examinations and suspected with fetal corpus callosum agenesis.T2WI and T1WI were performed using HASTE and FLASH,respectively.The features of MRI and ultrasound were compared with that of autopsy or follow-up outcome.Results Of the 19 fetus,14 cases with fetal corpus callosum,3 cases with mild enlargement of lateral cerebral ventricle and 2 cases with leukodystrophy were confirmed by MRI.Of them,accompained with Dandy-Walker syndrome in one and lipoma of corpus callosum in one.One case of Dandy-Walker syndrome and microcephalus respectively missed by US was detected by MRI.Conclusion MRI is superior in displaying fetal corpus callosum agenesis than ultrasound,which is helpful in conforming the diagnosis of fetal corpus callosum,classification and additional cerebral anomalies.