The value of ultrasound in diagnosis of neonatal upper and lower gastrointestinal perforation / 中国小儿急救医学

Objective To explore the value of ultrasound in the differential diagnosis of neonatal upper and lower gastrointestinal tract ( GIT) perforation. Methods We retrospectively reviewed the ultra-sound findings of 42 neonates of surgery-confirmed neonatal GIT perforation in our hospital from January 1, 2015 to December 31,2018. The accuracy of ultrasound for detecting GIT perforation and the ultrasound fea-tures of upper and lower GIT perforation were evaluated. Results (1)Of the 42 neonates with GIT perfora-tion,1 case didn′t undergo ultrasound,2 cases were missed,and 1 case was misdiagnosed. Thirty-eight neo-nates were diagnosed of GIT perforation by ultrasound preoperatively,with a detection rate of 92. 7%(38/41). The locations of GIT perforation were identified by ultrasound in 30 cases(78. 9%,30/38),including 11 cases of upper GIT perforation and 19 cases of lower GIT perforation. (2)A common sonographic finding of GIT perforation in 38 cases was pneumoperitoneum,which appeared as an echogenic line with posterior rever-beration artifact under diaphragm or anterior to hepatic/splenic surface and a "stratosphere" sign in M-mode sonography. Free gas changed position when the patient′s position was changed,and didn′t change due to re-spiratory change. Besides,free gas dispersed with compression on abdomen,and gathered without compres-sion. (3)Upper GIT perforation was showed that poor filling of the stomach cavity,and the abdominal free gas sharply increased. Lower GIT perforation was characterized by collapsed bowel,blurred and interrupted intestinal wall structure, and more accompanied with intestinal obstruction. ( 4 ) There was no significant difference of detection rate between ultrasound and X-ray in diagnosing GIT perforation [92. 7%(38/41) vs. 83. 3%(35/42)]( P>0. 05),whereas ultrasound more sensitive for a very small amount of free gas in the early stage of perforation. (5) Helicobacter pylori infection was found in two cases of GIT perforation. Conclusion Ultrasound can be used for differential diagnosis of upper and lower GIT perforation,and could be recommended as the first choice for detecting GIT perforation in neonatal patients.

Progress of contrast-enhanced voiding ultrasonography in diagnosis of vesicoureteric reflux in children / 中国医学影像技术

Vesicoureteric reflux (VUR) is an important association of pediatric urinary tract infection in children. Contrast-enhanced voiding urosonography (CeVUS) has proven to be a safe and reliable imaging technique for detecting children VUR. The advancements of CeVUS in evaluation of children VUR were reviewed in this article.

Assessment of skeletal muscle early myopathy with contrast‐enhanced ultrasound in rabbit model of diabetes mellitus / 中华超声影像学杂志

Objective To evaluate early skeletal muscle myopathy with contrast‐enhanced ultrasound ( CEUS) in diabetic rabbits . Methods Alloxan ( 100 mg/kg ) was given intravenously to 11 New Zealand w hite rabbits . Another 5 age‐matched normal rabbits were used as controls .CEUS was performed at baseline and 1 ,2 ,3 months after the establishment of diabetes ,respectively . T hen ,skeletal muscle samples were obtained for pathological observation . Additionally ,the diabetic rabbits were divided into 3 groups according to their pathologic findings : mild , moderate , and severe myopathy group . M icro‐perfusion parameters ,including artery‐to‐vein transit time ( A‐VT T ) ,muscle tissue mean transit time ( M‐M T T ) and muscle tissue peak intensity ( M‐PI) were calculated . Results T he diabetic rabbits exhibited a lower body weight increase and a decrease of muscle thickness .Plasma levels of triglyceride ,cholesterol and creatinine were significantly higher in diabetic group than those in control group ( P ＜0 .05) . T he A‐V T T and M‐M T T values of the diabetic rabbits significantly increased over time ( all P ＜ 0 .05 ) ,whereas M‐PI value significantly decreased compared with that in control group ( P ＝ 0 .013 ) . Besides ,the A‐V T T value was significantly higher in severe myopathy group than that in mild group ( P ＝0 .001) . T he M‐M T T values in both moderate and severe groups were significantly higher w hen compared to that in mild group ( all P ＜0 .05) . T he A‐VT T and M‐M T T values were correlated with the severity of diabetic myopathy( e＝0 .898 , P ＜0 .001 ;e＝ 0 .527 , P ＝ 0 .01 ) . Conclusions Diabetic rabbits have defective skeletal muscle micro‐ perfusion in the early stage . CEUS can quantify impaire muscle microcirculation ,and is a valuable tool for assessment of diabetic myopathy .

The value of ultrasound in diagnosis of neonatal upper and lower gastrointestinal perforation / 中国小儿急救医学

Objective@#To explore the value of ultrasound in the differential diagnosis of neonatal upper and lower gastrointestinal tract(GIT)perforation.@*Methods@#We retrospectively reviewed the ultrasound findings of 42 neonates of surgery-confirmed neonatal GIT perforation in our hospital from January 1, 2015 to December 31, 2018.The accuracy of ultrasound for detecting GIT perforation and the ultrasound features of upper and lower GIT perforation were evaluated.@*Results@#(1)Of the 42 neonates with GIT perforation, 1 case didn′t undergo ultrasound, 2 cases were missed, and 1 case was misdiagnosed.Thirty-eight neonates were diagnosed of GIT perforation by ultrasound preoperatively, with a detection rate of 92.7%(38/41). The locations of GIT perforation were identified by ultrasound in 30 cases(78.9%, 30/38), including 11 cases of upper GIT perforation and 19 cases of lower GIT perforation.(2)A common sonographic finding of GIT perforation in 38 cases was pneumoperitoneum, which appeared as an echogenic line with posterior reverberation artifact under diaphragm or anterior to hepatic/splenic surface and a "stratosphere" sign in M-mode sonography.Free gas changed position when the patient′s position was changed, and didn′t change due to respiratory change.Besides, free gas dispersed with compression on abdomen, and gathered without compression.(3)Upper GIT perforation was showed that poor filling of the stomach cavity, and the abdominal free gas sharply increased.Lower GIT perforation was characterized by collapsed bowel, blurred and interrupted intestinal wall structure, and more accompanied with intestinal obstruction.(4)There was no significant difference of detection rate between ultrasound and X-ray in diagnosing GIT perforation[92.7%(38/41)vs.83.3%(35/42)](P>0.05), whereas ultrasound more sensitive for a very small amount of free gas in the early stage of perforation.(5)Helicobacter pylori infection was found in two cases of GIT perforation.@*Conclusion@#Ultrasound can be used for differential diagnosis of upper and lower GIT perforation, and could be recommended as the first choice for detecting GIT perforation in neonatal patients.