• 主题
高级搜索  >
历史搜索 清空历史
您现在的位置：首页> 中文期刊>临床医学>医药卫生>中华医学超声杂志（电子版）

中华医学超声杂志（电子版）

中华医学超声杂志（电子版）

北大核心

CSCD

CSTPCD

Chinese Journal of Medical Ultrasound(Electronic Edition)
本刊为中华医学会主办的医学超声专业学术电子期刊，是一本在载体形式上与纸媒体相补的多媒体光盘期刊（CD-ROM）。本刊以电子期刊特有的表现形式，图文声像并茂,具有很强的互动性。并以医学超声、影像、介入及相关专业医生和技术人员为主要读者对象，报道医学超声领域领先的科研成果、临床诊断治疗技术和经验，以及与医学超声技术密切相关的医学和工程基础理论研究。本刊的办刊宗旨是：贯彻党和国家的卫生工作方针政策，贯彻理论与实践、普及与提高相结合的办刊方针，反映我国医学超声临床和科研工作的重大进展，促进国内外超声医学学术交流。
更多
  • 发文量：4177
  • 被引量：2239
  • H指数：2
  • 开始收录时间：2004,1(1)
  • CNKI综合因子：0.657
  • 维普期刊影响因子： 1.65
  • 万方期刊影响因子：1.22
  • 创刊时间：2004
  • 国内刊号/CN：11-9115/R
    国际刊号/ISSN：1672-6448
  • 发行周期：月刊
    邮发代号：80-313
  • 主管单位：中华人民共和国卫生部
    主办单位：中华医学会
中华医学超声杂志（电子版）-联系信息
  • 主编：
  • 电话：010-51322622
  • 邮箱：csbjb@cma.org.cn
  • 地址：北京东河沿街69号616室
  • 邮编：100052
中华医学超声杂志（电子版）-获奖情况
  • 暂无获奖信息
  • 收录汇总
  • 刊内文献检索
  • 投稿信息

刊期浏览

相关中文期刊

相关中文会议

相关外文期刊

相关外文会议

最新期刊

热门期刊

中华医学超声杂志（电子版） >2022年第12期
搜索

学科

年度

全选（0）
排序：
共4384条结果
  • 摘要：目的 探讨超声诊断两种不同族别女性乳腺肿块发病病谱的偏重.方法 应用彩色多普勒超声诊断维吾尔族女性及汉族女性乳腺肿块患者各131例,以病理结果为诊断金标准,分析维吾尔族及汉族女性乳腺肿块发病病谱的不同.结果 维吾尔族、汉族女性乳腺恶性肿块阳性率分别为16%(21/131)、29%(38/131),以汉族女性多见,差异有统计学意义(χ2=6.429,P＜0.05),81%(17/21)的维吾尔女性乳腺恶性肿块直径多≥2 cm,伴卫星灶占23%(5/21);维吾尔族、汉族女性纤维腺瘤发病率分别为48%(64/131)、25%(33/131),维吾尔女性发病率较高,差异有统计学意义(χ2=16.609,P＜0.05);囊性增生汉族女性发病率43%(56/131),明显高于维吾尔族女性发病率29%(38/131),差异有统计学意义(χ2=5.446,P＜0.05).结论 维吾尔族、汉族女性乳腺肿块发病病谱各有偏重,超声作为常规检查手段,结合临床资料可为乳腺肿块提供可靠诊疗依据.%Objective To discuss the evaluation of color Doppler ultrasonographic diagnosis in breast lumps of different races. Methods A total of 262 female patients with breast lumps were examined by the color Doppler ultrasound, then compared to the pathological data and analyzed the disease spectrum of different race in malignant and benign breast lumps. Results The malignant tumor rate of Han nationality female was 29% ( 38/131 ), which was significant higher than that of Uygur female( 16% ,21/131 , t = 6.429,P <0. 05 ). The fibro-adenoma rate of Uygur female was higher( 48% ,64/131 ) than that of Han nationality female( 25% ,33/131 ), there was significant difference between the two races (χ2=16. 609, P < 0. 05 ). In breast cystic hyperplasia, the positive rate of Han nationality female( 43% ,56/131 )was obviously higher than that of Uygur female( 29% ,38/131 ),and the differences were statistically significant( t =5.44,P < 0. 05 ). Conclusions Therewas different disease spectrum of breast lumps in Uygur female and Han nationality female. Combined with clinical material, the color Doppler ultrasound can provide reliable basis for clinical diagnosis and treatment.
  • 摘要：Objective To evaluate the clinical value of the elastic strain scores on ultrasonography in the differential diagnosis of thyroid solid nodules. Methods Elasticity imaging was used to examine 72 cases of thyroid nodules from April to July, 2009( including 102 lesions )to obtain the elastic strain scores. All the cases were divided into the benign group and the malignant group according to the pathology after surgery, and the difference of the elastic strain scores between the two groups was analysed. A receiver operating characteristic(ROC )curve was used to assess the value of the elastic strain scores in diagnosis of malignant thyroid solid nodules. Summarising the common elasticity imaging of thyroid solid nodules.Results The difference of the elastic strain scores between benign and malignant thyroid solid nodules( including 29 maligant and 73 benign )was significant(χ2 =36.064, P <0.05 ). The sensitivity, specificity and accuracy of elastic strain scores were 93. 1% ( 27/29 ),72. 6%( 53/73 )and 78. 4% ( 80/102 ). The positive predictive value was 57.4%( 27/47 )and the negative was 96.4%( 53/55 ). The positive likelihoodratio was 3. 39 and the negative was 0. 09. According to ROC analysis, the AUC of strain scores was 0. 822. Conclusions The elastic strain scores is a good indicator to evaluate the thyroid diseases. It is helpful in the differential diagnoisis of thyroid lesions.%目的 评价弹性评分在甲状腺实质性结节良、恶性鉴别中的应用价值.方法 对2009年4月至2009年7月72例(共102个结节)甲状腺实质性结节患者术前进行弹性成像超声检查,获得弹性评分结果,以手术病理为金标准,分析弹性评分在实质性结节良恶性组中的差异,并运用ROC曲线评价弹性评分在甲状腺实质性结节良恶性鉴别诊断中的价值,总结常见甲状腺实质性结节的弹性成像表现.结果 良恶性甲状腺结节(29个恶性结节与73个良性结节)的弹性评分的分布,差异有统计学意义(χ2=36.064,P＜0.05);弹性评分法诊断甲状腺实质性结节良、恶性敏感度为93.1%(27/29),特异度为72.6%(53/73),阳性预测值为57.4%(27/47),阴性预测值为96.4%(53/55).阳性似然比为3.39,阴性似然比为0.09,准确性为78.4%(80/102),ROC曲线下面积为0.822.结论 甲状腺实时弹性成像评分是评价甲状腺结节的良好指标,为超声鉴别诊断良恶性甲状腺实质性结节提供有效的判别指标.
  • 摘要：目的 探讨彩色多普勒超声引导下无水乙醇治疗继发性甲状旁腺功能亢进临床效果及应用价值.方法 观察分析23例超声引导下无水乙醇治疗继发性甲状旁腺功能亢进患者治疗前后超声声像图改变,以及血清甲状旁腺激素(PTH)水平等变化.结果 增生的甲状旁腺注入无水乙醇后回声增强,腺体体积缩小[(2.1±0.6)cm3,(1.3±0.5)cm3,t=8.41,P＜0.01],彩色血流减少,血清PTH水平降低[(908±408)ng/L,(491±225)ng/L,t=9.55,P＜0.01].结论 超声引导下无水乙醇治疗继发甲状旁腺功能亢进是一种有效、安全、副作用少的介入治疗方法,具有重要的临床应用价值.%Objective To explore the clinic value and efficacy of the therapy of secondary hyperparathyroidism with color Doppler ultrasound guided percutaneous injection of ethanol. Methods Twenty-three cases of secondary hyperparathyroidism were treated with color Doppler ultrasound guided percutaneous injection of ethanol. Changes of sonogram and the levels of parathyroid hormone were observed before and after treatment. Results After injection of ethanol into hyperplastic epithelial body, echoes enhanced, gland shrinked[(2.1 ±0.6 )cm , ( 1.3 ±0.5 )cm , t = 8. 41 , P < 0.01],serum parathyroid hormone levels[( 908 ±408 )ng/L,( 491 ±225 )ng/L,t = 9.55,P<0.01]and color flow decreased. Conclusions The therapy of secondary hyperparathyroidism with color Doppler ultrasound guided percutaneous injection of ethanol is a more effective and safer intervention treatment with less side effect. It has an important clinical value.
  • 摘要：Objective To evaluate the negative predictive value( NPV )of sonography for the exclusion of acute appendicitis. Methods Two hundred and forty-one patients with suspected acute appendicitis who were examined by ultrasound in our hospital were reviewed retrospectively. Sonographic findings were divided into 4 grades from a normal appendix identified ( grade 1 ) to frankly acute appendicitis ( grade 4 ). Sonographic findings were compared with surgical and pathologic findings. Results A total of 93 patients had positive sonographic findings, with 13 cases were false positive results. The rest of the 148 patients with negative results ( grade 1 ), 7 patients with negative sonographic findings undergone surgery and were diagnosed as appendicitis. On the basis of these numbers, the sensitivity, specificity, NPV , the positive predictive value ( PPV)of sonography were 91. 95%( 80/87),91.56%( 141/154 ),95. 27%( 141/148),86.02% ( 80/93 ). Conclusions Sonography has a high NPV( 95. 27% ) for the exclusion of acute appendicitis even if the appendix is not visualized, and may be able to find out other causes of acute abdominal pain. Therefore, ultrasound plays a very importantrole in diagnosis and differential diagnosis of patients with acute right lower abdominal pain.%目的 探讨超声检查的阴性预测值对排除急性阑尾炎的临床应用价值.方法 回顾性分析临床上怀疑为急性阑尾炎的241例患者的超声声像图表现,根据声像图特点将其分为4级,再将超声检查结果与外科手术及病理结果进行比较.结果 241例患者中超声诊断阳性结果93例(2、3、4级),最终发现13例为假阳性结果;148例阴性结果(1级)中7例因临床症状及体征明显行手术治疗,病理结果均提示为急性单纯性阑尾炎.超声诊断急性阑尾炎的敏感度为91.95%(80/87),特异度为91.56%(141/154),阴性预测值为95.27%(141/148),阳性预测值为86.02%(80/93),准确性为91.70%(221/241).结论 超声检查具有较高的阴性预测值,可有效地排除阑尾炎,同时或可发现引起患者急性腹痛的其他病因,因此在急性右下腹痛患者的诊断和鉴别诊断中具有非常重要的作用.
  • 摘要：@@ 肝细胞肝癌是世界上第六大常见恶性肿瘤,占癌症死亡原因的第三位[1],原发性肝癌是肝硬化最严重的并发症之一,小肝癌(small hepatocellular carcinoma,SHCC)的早期诊断是提高肝癌患者生存率的关键因素.穿刺活检病理学检查仍被视为诊断的金标准,但由于其有创性不易被患者接受,且对于位置深的小病灶假阴性率也较高.二维超声检查因其无创及可重复等优点常作为肝硬化及肝癌的诊断及随访方法.
  • 摘要：@@ 患者男,43岁.活动后胸闷、气促4个月.8个月前以主诉"持续性胸痛1 h"就诊于当地医院,心电图示Ⅰ、avL导联ST段弓背向上抬高0.3～0.5 mv,诊断为"急性高侧壁心肌梗死",给予溶栓、营养心肌、对症治疗,出院前复查心电图示Ⅰ、avL导联ST段回落至基线、T波倒置.4个月前因情绪变化,突发胸闷、气促后间断出现上述症状,活动后加重,于当地医院行X线检查,发现心影向左侧明显扩大,诊断心包囊肿,遂来我院就诊.
  • 摘要：@@ 患者男,57岁,咯血、胸闷、痰中带血3个月,曾就诊当地医院,查结核菌素试验(+),行抗结核治疗未见好转,并出现胸腔积液,胸腔穿刺引流出血性液体,病理涂片查到腺癌细胞,胸部CT示右肺下叶占位、右侧胸腔积液,骨发射单光子计算机断层扫描、颅脑CT检查未见转移灶.转入我院后放置胸腔闭式引流,并于全麻下行胸腔镜探查、右侧胸腔肿物切除及胸膜活检术,术后确诊为右肺下叶腺癌伴胸膜转移.
  • 摘要：Objective To evaluate the clinical valve of pulmonary artery hypertension( PAH ) in patients with systemic sclerosis ( SSc ) by echocardiography. Methods This study included 29 healthy participants as the control group and 23 patients with systemic sclerosis. All of them were examined by echocardiography. Right atrial diameter ( Rad ), left ventricular diastolic diameter ( LVdd ), right ventricular diastolic diameter RVdd )and main pulmonary artery diameter MPA )were measured. Pulmonary valve flow velocity( Vpa ) , right ventricular preejection period( RPEP ) , right ventricular ejection period ( RVET ) and acceleration time( AcT)were measured by pulse wave Doppler( PWD ) , AcT/RVET. AcT/RPEP. RPEP/RVET was measured. Tricuspid regurgitation velocity( TRVmax )and pressure gradient( PG )were measured to estimate pulmonany arterial systotic pressure( PASP ). Results Rad was( 41. 74 ± 5. 19 )mm in SSc group, and ( 36. 89 ± 3. 22 )mm in the control group, there were significant differences between the two groups( t = 4. 122, P =0. 000 ). LVdd/RVdd was( 2. 04 ± 0. 27 ) in SSc group, and ( 2. 18 ±0. 15 )in the control group, there were significant differences between the two groups( t = -2. 312, P = 0. 025 ). MPA was ( 22. 23 ± 3. 04 ) mm in SSc group, and( 19. 34 ± 1. 70 ) mm in the control group, there were significant differences between the two groups( t =4. 308, P =0. 000 ). Vpa was ( 0. 85 ±0. 15 )m/s in SSc group,and ( 0. 88 ±0. 17 )m/s in the control group,there were no significant difference between the two groups( Z=0.851,P=0. 393 ). AcT was ( 118.26 ±30. 87 )ms in SSc group, and( 145. 44 ± 6. 28 )ms in the control group, there were significant differences between the two groups( t = - 3. 365 , P = 0. 002 ). RVET and RPEP in SSc group were( 330. 78 ±54. 31 )and( 96. 26 ±26. 11 )ms,and in the control group were( 340. 10 ± 27. 05 ) and ( 87. 52 ± 20. 44 )ms, espectively. There were no significant difference between the two groups( t = - 0. 808, 1. 317, P = 0.423,0. 195 ). AcT/RVET,AcT/PREP and RPEP/RVET ratio in SSc group were ( 0.37 ±0. 11 ),( 1. 29 ±0.43 ) and( 0. 31 ±0. 74 ),and in the control group were ( 0. 43 ± 0. 70 ) ,( 1. 74 ± 0. 47 )and ( 0. 26 ± 0. 69 ). There were significant differences between the two groups( t =2.466, -2. 466 ,2. 678 ,P = 0. 017 ,0. 001 ,0. 000 ). Eight of 23 patients were identified PAH( 34. 8% ). Conclusion Echocardiography can be used to quantify pulmonary artery hypertension in patients with systemic sclerosis.%目的 探讨超声心动图评价系统性硬化病(SSc)患者肺动脉高压的临床价值.方法 连续选择23例SSc患者及29名年龄和性别匹配的健康志愿者.常规二维超声测量各房室内径,主肺动脉内径(MPA);多普勒超声测定肺动脉前向血流速度(Vpa)、右心室射血前期(RPEP)、右心室射血期(RVET)、肺动脉血流加速时间(AcT),并计算其比值:AcT/RVET、AcT/RPEP、RPEP/RVET;利用三尖瓣反流压差估测肺动脉收缩压.结果 SSc患者右心房上下径(Rad)、左右心室内径比值(LVdd/RVdd)分别为(41.74±5.19)mm、(2.04±0.27),对照组分别为(36.89±3.22)mm、(2.18±0.15),两组比较差异有统计学意义(t=4.122、-2.312,P=0.000、0.025).SSc患者MPA为(22.23±3.04)mm,对照组为(19.34±1.70)mm,两组比较差异有统计学意义(t=4.308,P=0.000).SSc患者Vpa、AcT分别为(0.88±0.17)m/s、(118.26±30.87)ms,对照组分别为(0.85±0.15)m/s、(145.44±6.28)ms,两组比较差异有统计学意义(t=0.851、-3.365,P=0.393、0.002).SSc患者RVET、RPEP分别为(330.78±54.31)ms、(96.26±26.11)ms,对照组的分别为(340.10±27.05)ms、(87.52±20.44)ms,两组比较差异无统计学意义(t=-0.808、1.317,P=0.423、0.195).SSc患者AcT/RVET、AcT/PREP、RPEP/RVET比值分别为(0.37±0.11)、(1.29±0.43)、(0.31±0.74),对照组的分别为(0.43±0.70)、(1.74±0.47)、(0.26±0.69),差异有统计学意义(t=-2.466、-3.611、2.678,P=0.017、0.001、0.000).SSc组8例(34.8%,8/23)发生肺动脉高压(PAH).结论 超声心动图可作为评价SSc患者肺动脉压力的重要方法.
  • 摘要：目的 应用斑点追踪技术评价肥厚型心肌病患者局部心肌收缩功能,同时应用心肌超声造影观察肥厚型心肌病患者局部心肌灌注改变,并探讨局部心肌收缩功能与灌注之间的关系.方法 对肥厚型心肌病患者(35例)和健康对照组(17名)行常规超声心动图检查,应用斑点追踪技术测量各节段二维应变值.按照患者就诊顺序随机进行心肌超声造影检查后对35例肥厚型心肌病患者中的20例愿意行造影检查者行心肌超声造影检查,测量系统自动给出心肌造影强度定量分析拟合指数函数Y=A(1-e-Kt)中的A值、K值并进行分析.结果 肥厚型心肌病患者心肌的总体纵向应变值、总体圆周应变值和总体径向应变值(23.48±1.86,24.22±3.95,41.05±10.28)均较健康对照组(15.76±3.63,20.03±4.24,30.83±11.28)明显减低,差异有统计学意义(t=-7.775、-3.167、-2.913,P均<0.01);总体圆周应变绝对值和A值正相关,有统计学意义(R=0.610,t=3.079,P<0.01);总体纵向应变绝对值与K值负相关,有统计学意义(R=0.469,t=-2.252,P<0.05);总体圆周应变绝对值与K值负相关,有统计学意义(R=0.550,t=-2.632,P<0.05).结论 肥厚型心肌病患者局部心肌收缩功能减低与灌注损伤有关,心肌超声造影检查是研究和诊断肥厚型心肌病可靠、有效的方法.%Objective To evaluate the regional myocardial function in patients with hypertrophic cardiomyopathy by speckle tracking imaging, then to observe the perfusion by myocardial contrast echocardiography and to explore the correlation between abnormal regional myocardial function and perfusion in patients with hypertrophic cardiomyopathy. Methods Fifty-two persons were investigated ( 35 patients with hypertrophic cardiomyopathy, 17 controls were included)to analyze the two-dimensional strain by speckle tracking imaging in the 3 left ventricle short-axis views( including mitral annulus level view, papillary muscle level view, left ventricle short-axis apical view)and the 3 left ventricle long-axis apical views( two-chamber view,four-chamber view,left ventricle long-axis apical view ). Twenty volunteers of the thirty-five patients with hypertrophic cardiomyopathy were examined by myocardial contrast echocardiography after they did it randomized as the order of the time registered. A and K of the exponential function Y = A( 1 - e-Kt )fitted by the curves and made by the myocardial signal intensity to time were obtained automatically. Results The global longitudinal strain, global circumferential strain and global radial strain of patients with hypertrophic cardiomyopathy were all significantly lower than controls, The difference was significant 23.48 ±1.86 vs 15. 76 ± 3. 63 ,24. 22 ± 3. 95 vs20.03 ±4.24,41.05 ±10.28 vs 30. 83 ± 11. 28 ,t = -7.775, -3.167, -2.913, all P <0. 01 ). The absolute value of circumferential strain were related to A and K ( R=0. 610, t =3. 079, P <0. 01 ;R =0. 550, t = - 2. 632, P < 0. 05 ); and the absolute value of longitudinal strain were related to K( R = 0. 469 , t = - 2. 252, P < 0.05 ). Conclusions The regional myocardial function in patients with hypertrophic cardiomyopathy were impaired compared with control group, and perfusion defects were related to the impairment. Myocardial contrast echocardiography is a reliable and effective way to study and diagnose the hypertrophic cardiomyopathy.
  • 摘要：Objective To evaluate the non-left ventricular hypertrophy ( NLVH )longitudinal systolic function in patients with primary hypertension using two-dimensional strain in echocardiography. Methods According to the left ventricular mass index( LVMI )and relative wall thick( RWT ),30 patients with hypertension were chosen and 30 normal control subjects,who were determined by transthoracic echocardiography in routine parameters. Height frame rate two-dimensional images were recorded from the apical four-chamber view,two-chamber view and long-axis of the left ventricle. The peak systolic longitudinal strain of 18 segments and 3 whole views were measured using two-dimensional strain software,and eventually the strain of 18 segments were showed in a Bull s eye,and compared wall strain gradient with classification. Results No significant difference in the peak systolic longitudinal strain of 3 whole views were found between the control group and NLVH group. However, the average peak systolic longitudinal strain of base segments were significantly different in the NLVH group compared with the control group [( - 16. 98 ± 5. 60 )% , ( - 19. 29 ± 2. 68 )% , t = - 4. 072, P = 0. 000 J,The peak systolic longitudinal strain of some segments and walls in the NLVH group were significantly lower than those in the control group, for example, the basal segment of septal and anterior[( - 14. 30 ±3. 54 )% ,( - 18.40 ±2. 30 )% ,t = -4. 341, P =0. 000 );the basal segment of[( -14.60 ±4. 35 )% ,( -19.15 ±2.37)% ,t= -4.112, P =0.000); the middle segment of side[( 17.45 ±4. 86)%,( -20.25 ± 2. 94 )% , t = -2.205,P = 0. 034 )]; the middle segment of anterior[( - 17. 95 ± 3. 00 )% , ( -21.70 ± 2. 96 )% ,t = - 3. 981, P = 0. 000]; side[( - 19. 15 ± 6. 68 )% , ( -21.47 ±4. 05 )% ,t = -2. 298, P =0. 024]; Anterior[( - 19. 37 ±6. 10 )% , ( -22.58 ±4.41 )% ,t = -3. 312,P =0.001 ). The part of counter-gradient and completely counter-gradient of the wall ratio in NLVH group were significantly higher than the control group, reaching 18% and 5% . Conclusions Two-dimensional strain in echocardiography can show the decline of systolic function in part of the wall and the myocardial segments before the global systolic function in patients with primary hypertension, and give them positioning and quantitative analysis. The decline of local systolic function is related to the reducing of resilience in fibrous ring of heart and the change of strain gradient which arosed by hypertension.%目的 将二维应变技术应用于左心室心肌未重构的原发性高血压患者,探讨其评价左心室心肌长轴方向收缩功能的临床应用价值.方法 应用常规超声计算左心室质量指数和相对室壁厚度,选取30例左心室心肌无重构的1-2级高血压患者,及30名健康者做健康对照组,分别采集心尖左心室长轴切面、心尖四腔心切面、心尖两腔心切面的二维动态图,运用二维应变技术,获取左心室18个节段收缩期峰值应变的牛眼图,及左心室3个心尖切面及整体的全局收缩期峰值应变值,并对室壁应变梯度进行分类比较.结果 高血压组左心室3个心尖切面及整体的全局收缩期峰值应变值略降低,但不具有统计学意义(P＞0.05).而高血压组基底段的平均收缩期峰值应变明显低于健康对照组[(-16.98±5.60)%,(-19.29±2.68)%,t=-4.072,P=0.000];高血压组室间隔和前壁基底段应变分别为(-14.30±3.54)%、(-14.60±4.35)%,健康对照组的分别为(-18.40±2.30)%、(-19.15±2.37),两组比较差异有统计学意义(t=-4.341、-4.112,P均=0.000);高血压组侧壁和前壁中间段应变分别为(17.45±4.86)%、(-17.95±3.00)%,健康对照组的分别为(-20.25±2.94)%、(-21.70±2.96)%,两组比较差异有统计学意义(t=-2.205、-3.981,P=0.034、0.000);高血压组侧壁和前壁平均应变分别为(-19.15±6.68)%、(-19.37±6.10)%,健康对照组的分别为(-21.47±4.05)%、(-22.58±4.41)%,两组比较差异有统计学意义(t=-2.298、-3.312,P=0.024、0.001).高血压组不完全逆梯度和完全逆梯度的室壁比例较健康对照组明显增高,达到18%和5%.结论 二维应变技术能够在未重构高血压患者左心室整体收缩功能出现明显异常前,显示出部分室壁及心肌节段的收缩功能降低,并可对心肌节段的收缩功能进行定量、定位分析;局部收缩功能的降低考虑与高血压引起心纤维环弹性降低和应变梯度的改变有关.
  • 摘要：目的 探讨小儿消化道重复畸形的超声诊断价值.方法 回顾性分析我院2000年4月至2010年9月收治的25例消化道重复畸形患儿的超声声像图表现.结果 25例消化道重复畸形患儿发生在回肠20例,空肠3例,结肠1例,食管1例.其中20例呈典型的声像图表现:大小不等厚壁囊性团块,外径2~11 cm,<5 cm者16例.囊壁的边界尚清,肠壁呈"强-弱-强"3层结构特点,彩色多普勒可显示囊壁血流信号;1例超声声像图显示为右侧胸腔内肠管样回声,肠管扩张,可见蠕动,彩色多普勒示肠管可见点状血流信号;4例呈非典型声像图表现,其中2例表现为薄壁囊性团块,未显示明显肠壁3层结构,内可见分隔样回声,彩色多普勒示囊壁无明显血流信号;1例仅表现为肠梗阻,部分肠管积液、扩张;1例仅有少量腹腔积液,未显示明显腹腔团块回声.结论 小儿消化道重复畸形的超声声像图表现具有一定特征性.提高对其病理类型的认识并采用合适的超声检查操作方法,将有助于提高该病的术前诊断水平.%Objective To investigate the value of ultrasound diagnosis in alimentary duplication in children. Methods The sonographic features were analysed retrospectively in 25 cases of alimentary duplication in Shenzhen Children s Hospital from April 2000 to September 2010, compared with surgical and pathological results. Results A total of 25 cases occurred in the ileum 20 cases,3 cases in jejunum,one case in colon, one case in esophagus. The sonography of 20 patients with alimentary duplication showed typical sonographic appearances including a thick-walled cystic mass and sizes of 2-11 cm( 16 cases <5 cm ), three-tier structure of intestinal wall. The color Doppler flow image( CDFI)showed that thick-walled had some blood supply. One patient with esophagus duplication showed the bowel-like echo accompanied with peristalsis in the right chest. Four patients showed atypical sonographic appearances including 2 cases of the thin-walled cystic mass with the separate echo, one case of intestinal canal extension and one case of peritoneal fluid. Conclusions There are characteristic ultrasound features in children with alimentary duplication. Improving the knowledge of pathological types and mastering the operation method can help improve the level of preoperative diagnosis.
  • 摘要：@@ 患者男,65岁,以左侧颌面部无痛性肿块两年,近期生长迅速,明显增大入院.查体可见左侧颌面部大小约12.0 cm×8.0 cm肿块,肿块部及周边皮肤光滑,未见痣样回声(图1).口内检查于颊部23、24牙龈处见一大小约1.0 cm×0.5 cm肿物,有蒂,表面黏膜发黑,无触压痛,质软,可活动(图2).左侧颌下及颈部可触及淋巴结,无压痛.超声检查示:于左侧颌面部探及一形态不规则呈"分叶状"实性偏低回声团块,内部回声欠均匀,范围约9.3 cm×7.0 cm,边界尚清,基底窄,向口内延伸(图3,4).彩色多普勒显示其内及周边有丰富"树枝状"血流信号(图5).
  • 摘要：@@ 患者男,75岁.因高脂餐后恶心、呕吐、右上腹持续性疼痛17 h就诊.既往有胆结石病史.查体:体温37.9℃,心率96次/min,血压120/80 mm Hg(1 mm Hg=0.133 kPa),呼吸18次/min.急性痛苦病容,巩膜及全身皮肤无黄染.右上腹部稍隆起,可扪及一鸭卵大肿物,质中等,有明显触痛.实验室检查:WBC:16.7×109/L,中性粒细胞:0.938,RBC:4.22×1012/L,HGB:130 g/L,PLT:175×109/L.
  • 摘要：@@ 患者男,43岁,因"右侧腰部疼痛1 d,伴恶心、呕吐就诊.查体:腹平软,右侧肾区叩击痛(+),双侧输尿管径路无触痛点.尿常规:隐血(+++).超声检查示(图1):右侧输尿管下段开口处见无回声区,大小约4.0 cm×3.5 cm,左侧输尿管下段开口处见无回声区,大小约1.3 cm×1.2 cm,凸向膀胱内,壁薄、光滑,右侧无回声区内见一团状强回声,直径约1.6 cm,后方伴声影,改变体位可移动.双肾未见明显异常.超声诊断:双侧输尿管下段囊肿,右侧囊内伴较大结石.
  • 摘要：目的 探讨肝内胆管细胞癌(ICC) 经皮微波消融治疗的有效性.方法 对病理诊断为ICC的26例患者47个结节(最大径1.0～9.9 cm,平均2.9±1.8 cm)行超声引导下经皮微波消融治疗.消融治疗范围超过癌周1.0 cm.治疗后定期随访4～35个月,随访期间微波消融灶内或周边超声造影增强影像出现新发病变视为局部肿瘤进展.结果 超声引导下对26例ICC 45个结节行根治性微波消融治疗,消融后1个月超声造影或增强MRI显示40个消融灶内或边缘无增强表现,达到完全消融;5个消融灶内或边缘有增强表现,为局部肿瘤进展,消融治疗有效率为88.9%(40/45);另2个结节行姑息性微波消融治疗.随访期内6个结节消融后发生局部肿瘤进展,局部进展率为13.3%(6/45).全组26例患者经皮微波消融治疗后6、12和24个月累计生存率分别为80.8%(21/26)、61.5%(16/26)和53.8%(14/26).术后并发症发生率为19.2%(5/26),包括肝脓肿4例(抗感染和置管引流后均治愈),针道种植1例(外科手术切除治愈).结论 超声引导下经皮微波消融ICC安全有效,可作为不适合手术切除ICC患者的治疗选择.%Objective To investigate the safety and efficacy of the percutaneous microwave ablation of intrahepatic cholangiocarcinoma ( ICC ). Methods Pathological diagnosed in 26 patients with ICC,and a total of 47 lesions( maximum diameter of 1. 0-9. 9 cm, mean 2. 9 ± 1. 8 cm ) were treated with ultrasound-guided percutaneous microwave ablation. The range of ablation treatment of ICC was 1. 0 cm over the noncancerous. In the follow-up period,new lesions appearing in the contrast-enhanced ultrasound imaging in or around the microwave ablation lesions were regarded as local tumor progression. The regular follow-up period was 4-35 months. Results Forty-fivenodules underwent radical microwave ablation, and 40 ablation lesions achieved complete ablation, which were shown in contrast-enhanced ultrasound or MRI without internal or edge enhanced performance 1 month later. While other 5 ablation lesions with internal or edge enhanced performance were local progression, and the technique effective rate was 88. 9%( 40/45 ). The other two nodules used palliative treatment of microwave ablation. The local progression rate was 13. 3% ( 6/45 ). The 6, 12,24 months cumulative survival rates of 26 cases were 80. 8%( 21/26 ),61. 5%( 16/26 ) and 53. 8%( 14/26 ). The major complication rate was 19. 2%( 5/26 ),including liver abscess in 4 cases and needle tract planting in 1 case. Both complications were overcomed with antibiotic treatment combined with catheter drainage for abscess and resection for needle tract seeding. Conclusion Percutaneous microwave ablation is a safe and effective method for the ICC,and it can be used as a treatment option for the ICC patients who are not suitable for surgical resection.
  • 摘要：@@ 输卵管源性因素是造成妇女不孕的最常见因素,准确评价输卵管状态不仅有助于诊断不孕的原因,也可为临床治疗提供重要依据.子宫输卵管超声造影(hysterosalpingo-contrast sonography,HyCoSy)是近年来开展无创性检查不孕症的新方法,随着超声造影成像技术的发展,使其在诊断宫腔、尤其对输卵管通畅性方面表现出明显优势.目前国内普遍采取的诊断输卵管通畅性的筛查方法为X线子宫输卵管造影(hysterosalpingography,HSG)和腹腔镜直视下输卵管通染液.但HSG使生殖器官暴露于放射线中,患者有可能发生对X线碘油造影引起的超敏反应;其次碘油吸收较慢,可引起输卵管黏膜肉芽组织增生,甚至造成腹腔粘连,严重并发症则可导致肺栓塞等;腹腔镜检查是诊断输卵管通畅性的金标准,在直视条件下既可作为检查手段也可进行治疗,但其具有创伤性且费用较昂贵.HyCoSy具有无创、安全、简单经济、无辐射且可重复观察等优点,随着新型超声造影剂及超声造影技术的发展,HyCoSy将会逐渐成为诊断输卵管通畅性的重要方法[1-3].本文将对子宫输卵管超声造影在不孕症患者诊治中的应用进行综述.
  • 摘要：@@ 目前,甲状腺疾病已经成为内分泌系统的第二大疾病,全球范围内有超过3亿人患有甲状腺疾病.超声是甲状腺疾病首选的影像学检查方法,已成为临床评估和处理甲状腺疾病最有效的检查方法[1].研究表明,不同国家和地区甲状腺癌发病率增加并不是罹患甲状腺癌患者数目增加的真正原因,而是甲状腺癌诊断敏感性提高所致,而这种敏感度的提高主要归因于甲状腺超声检查和细针抽吸技术[2].
  • 摘要：@@ 流行性腮腺炎(epidemic parotitis mumps)是临床常见病,以发热、腮腺肿大为典型症状[1],本研究对147例流行性腮腺炎的超声特征进行回顾性分析,总结如下.rn一、资料与方法rn1.对象:选取2009年4月至2011年4月以面部肿痛、发热2～3 d就诊,经我院临床确诊的流行性腮腺炎患者147例,男87例,女60例,年龄2～42岁,其中＜15岁103例,15～18岁33例,18岁以上11例.147例均有明确的该病接触史及群体发病现象,体温38℃～41℃,白细胞计数正常或稍高,淋巴细胞比例增高.
  • 摘要：@@ 患者女,30岁,因发现左侧腘窝下方皮下包块3年余,近2个月感觉胀痛就诊.无外伤史,有长久站立工作史.入院查体:左侧腘窝下方可触及一大小约6.0 cm×2.0 cm 椭圆形包块,质软、向皮肤表面隆起,活动度差,触之无压痛,表面呈暗红色,无渗液.超声所见:左侧腘窝下方可见一个大小6.3 cm×4.1 cm×1.9 cm 椭圆形囊性回声团,边界清晰,包膜完整,其内见"云雾状"密集点状强回声漂浮回旋,其远、近端均可见与小隐静脉相通,管腔内未见确切血栓回声,其远端小隐静脉略扩张,内径约0.4 cm,走行正常(图1~5).
  • 摘要：@@ 患者女,39岁,孕2产1,既往月经规律,无痛经史,末次月经2011年5月14日,停经67 d.近两天出现恶心、呕吐等症状,无腹痛、阴道流血等症状.于7月20日来院就诊.妇科检查:外阴、阴道、宫颈无异常,子宫前位,如孕2个月大小,无压痛,双附件未触及异常包块.超声检查:子宫前位,体积轻度增大,宫腔内可见一大小8.2 cm×5.9 cm×4.4 cm妊娠囊,囊内示一胎儿,头臀长约3.3 cm,胎心搏动规律、良好.妊娠囊上方相邻处另见一范围6.9 cm×5.6 cm×5.0 cm无回声区,边界清,内透声尚可,妊娠囊与之相邻间回声带较厚(图1),CDFI:未探及明显血流信号.双附件未见明显异常.超声提示:早孕(妊娠约10 周);妊娠囊上方无回声区(子宫肌层囊肿可能性大).
  • 摘要：@@ 患者女,34岁,因停经70 d,超声提示宫内早孕在我院门诊行清宫术,术中清出陈旧胎物组织约30 g,伴少量凝血块,术中子宫收缩差,出血较多(量不详),无腹痛及发热不适.术后经临床抗感染及促进子宫收缩治疗后患者阴道出血不止入院治疗.
  • 摘要：目的 分析微波消融(MWA)治疗肝脏恶性肿瘤并发症发生的原因及其防治措施.方法 对328例肝脏恶性肿瘤患者进行MWA治疗,其中原发性肝癌298例[肝细胞肝癌286例,胆管细胞癌12例,病灶最大直径(2.3±1.1)cm],肝转移癌30例[来源于大肠癌16例,胰腺癌6例,胆囊癌3例,十二指肠乳头癌、乳腺癌、胃癌、胃间质瘤各1例,病灶最大直径(2.6±1.4)cm].328例(655个病灶,经皮、腹腔镜、开腹)3种途径进行MWA治疗,治疗后定期随访.根据患者临床症状、影像学及血清学检查判断并发症的发生.结果 328例655个病灶共行391例次MWA治疗,平均每例次治疗1.7个病灶.312例次在超声引导下经皮完成治疗,20例次和5例次分别在开腹手术和腹腔镜手术辅助下完成治疗,54例次同时行肝切除或其他脏器切除联合治疗.328例中发生轻微并发症12例次,发生率3.1%(12/391,其中3例少量腹腔出血,2例消融灶液化,1例门静脉血栓,5例胸腔积液,1例皮肤烫伤);发生严重并发症11例次,发生率2.8%(11/391,2例腹腔出血,4例肝功能不全,2例膈疝,1例胆漏,2例顽固性胸腔积液);1例死亡,病死率0.3%(1/391).结论 MWA治疗肝脏恶性肿瘤并发症少,易于耐受.合理地选择病例,采用适当的辅助方法有助于增加治疗的安全性.%Objective To analyze the causes of the complications in treating hepatic malignant tumor with microwave ablation( MWA ), and to explore the management for the complications. Methods Three hundred and twenty-eight patients were treated with MWA, including 298 cases of primary liver cancer and 30 cases of metastatic liver cancer. The average largest diameter of the two groups lesions was( 2. 3 ±1. 1 )cm and ( 2.6 ± 1.4 )cm, respectively. MWA was performed through percutaneous, laparoscopy or laparotomy approach. Follow-up examinations were performed regularly. Complicationswere identified by clinical symptoms, imaging techniques and serologic examinations. Results Three hundred and twenty-eight patients with 655 lesions( average, 1. 7 nodules ) received MWA( 391 procedures ). MWA was performed by the percutaneous approach( 312 cases ),laparoscopy( 5 cases ),or open surgical treatment( 74 cases ). Minor complications occurred in 12( 12/391,3. 1% )patients, including: little bleeding ( 3 cases ), ablated area liquefaction ( 2 cases ), portal vein thrombosis ( 1 cases ), pleural effusion( 5 cases ),and skin burn( 1 case ). Major complications occurred in 11 ( 11/391,2. 8% )patients, including: hemorrhage( 2 cases ), liver decompensation( 4 cases ), diaphragmatic hernia ( 2 cases ), bile leak ( 1 case ), and pleural effusion (2 cases). One death was encountered, and mortality rate was 0. 3% ( 1/391 ). Conclusions MWA as a therapeutic technique for hepatic malignant tumor is a safe and well-tolerated with less complication method. The safety of the treatment can be raised by selecting patients properly and adopting assistant approach reasonably.
  • 摘要：目的 探讨组织多普勒(TDI)测定糖尿病肾病患者左心室及右心室Tei指数在评价心室功能方面的临床应用价值.方法 将189例患者分成健康对照组60例、慢性肾功能衰竭中非糖尿病肾病组69例及糖尿病肾病组60例,分别测量3组左、右心室常规超声心动图参数,并应用TDI技术测算左、右心室Tei指数并进行比较研究.结果 慢性肾功能衰竭患者非糖尿病肾病组患者左、右心室的Tei指数分别为0.45±0.11,0.36±0.10;糖尿病肾病组患者左、右心室Tei指数分别为0.48±0.11,0.40±0.09;健康对照组的Tei指数分别为0.43±0.08,0.33±0.09,3组中非糖尿病肾病组和糖尿病肾病组患者分别与健康对照组Tei指数比较差异有统计学意义(Tei左心室:t1=1.994,t2=2.109,Tei右心室:t1=1.292、t2=2.414,P均＜0.05),且糖尿病肾病组患者的Tei指数较非糖尿病肾病组患者显著增大(Tei左心室:t3=2.277,Tei右心室:t3=2.364,P均<0.05),临床表现为舒张功能障碍.结论 采用TDI技术测量Tei指数更加简便、敏感且能有效和综合评价糖尿病肾病患者左、右心室功能障碍.对其心室整体功能的评价是一个较好的指标.%Objective To evaluate the ventricular function in patients with diabetic nephropathy by tissue Doppler imaging( TDI ) with left and right ventricular Tei index. Methods A total of 60 patients with diabetic nephropathy ( DN ), 69 patients with non-diabetic nephropathy and 60 healthy subjects were studied. The common ultrasonic indices in all subjects were measured and TDI-Tei index of ventricular was calculated. Results Compared with the healthy group, the left and right ventricular Tei index increased in all patients with nephropathy( the left ventricular Tei index: 0.45 ±0.11,0.48 ±0. 11,0.43 ±0.08,^ =1.994t2 = 2. 109, the right ventricularTei indexrO. 36 ±0. 10,0.40 ±0.09,0.33 ±0.09,t2 = 1. 292^2 = 2. 414, all P< 0. 05 ). The Tei index in patients with DN significantly increased compared with that in patients with non-diabetic nephropathy( the left ventricular Tei index:t3 = 2. 277,the right ventricular Tei index: t3 = 2. 364,all P <0. 05 ),and the diastolic function was damaged obviously. Conclusion The ventricular Tei index measured by TDI can be served as a simple, sensitive and comprehensive index in evaluating the left and the right ventricular function of patients with DN.
  • 摘要：目的 探讨小儿孟氏骨折桡神经损伤的超声声像图特征.方法 对18例临床诊断孟氏骨折桡神经损伤的患儿行桡神经超声检查,以上臂中1/2、上臂中下1/3、肘关节及前臂上1/4作为A、B、C、D 4个观察平面,对比健侧与患侧桡神经内部回声变化及周围组织结构改变,并测量和比较4个平面上健侧和患侧桡神经的横截面积(CSA)及神经主干(RN-S)、浅支(RNS-S)、深支(RND-S)至皮肤的最短距离测值.对其中8例桡神经损伤患儿超声、肌电图和手术探查结果进行对比分析.结果 超声显示18例孟氏骨折患儿的桡神经损伤侧神经增粗,内部回声减低,伴有创伤性神经瘤(2例)和神经周围瘢痕粘连(6例);健侧A、B平面桡神经主干及C、D平面桡神经浅支、深支CSA分别为(6.32±1.05)mm2、(7.05±1.12)mm2、(3.07±0.42)mm2、(3.21±0.45)mm2、(2.87±0.92)mm2、(3.01±0.77)mm2,患侧神经CSA相应测值分别为(6.53±0.79)mm2、(9.31±2.39)mm2、(4.21±0.45)mm2、(5.64±1.16)mm2、(4.39±0.67)mm2、(3.61±1.24)mm2,患侧与健侧相比,A平面桡神经主干以及D平面桡神经深支的CSA超声测值差异均无统计学意义(P＞0.05);B和C平面患侧桡神经主干、桡神经浅支和深支以及D平面患侧桡神经浅支的CSA超声测值均大于健侧,差异有统计学意义(t=3.20、6.92、7.33、4.99,P＜0.05).健侧A、B平面RN-S及C、D平面RNS-S、RND-S分别为(15.42±2.60)mm、(9.96±1.22)mm、(10.03±2.85)mm、(11.21±2.94)mm、(10.27±2.52)mm、(11.31±2.71)mm,患侧相应测值分别为(15.92±1.29)mm、(7.65±1.07)mm、(3.66±1.83)mm、(4.47±1.22)mm、(9.94±3.32)mm、(10.20±2.42)mm,A平面健侧与患侧RN-S及D平面健侧与患侧RNS-S、RND-S测值比较差异均无统计学意义(P>0.05);B平面患侧RN-S及C平面患侧RNS-S、RND-S均小于健侧,差异有统计学意义(t=4.31、7.24、8.62,P<0.05).对8例患儿行桡神经手术探查,显示桡神经主干、浅支及深支损伤均为8支,与术前超声诊断结果一致,超声诊断桡神经损伤优于肌电图(仅检出桡神经主干损伤2支、浅支损伤2支、深支损伤7支),并能检出创伤性神经瘤(2例均检出)及神经周围瘢痕(7例检出6例).结论 超声可清晰显示小儿孟氏骨折桡神经损伤后神经肿胀和移位,能准确定位桡神经损伤后形成的创伤性神经瘤及神经周围瘢痕.%Objective To assess the features of radial nerve injury resulting from pediatric Monteggia fracture by ultrasonography. Methods Ultrasonography examination was performed in 18 pediatric patients who were diagnosed as radial nerve injury caused by Monteggia fracture. Four ultrasonographic planes were defined: A, midway in the upper arm; B, in lower one-third of the upper arm; C, articulatio cubiti; D,in upper one-forth of the forearm. The ultrasonic measurement of cross-sectional area ( cross-sectional area,CSA ) and the distances among the trunk, superficial branch and deep branch of radial nerve and skin ( distance between the radial nerve and skin, RN-S; distance between the superficial branch of the radial nerve and skin, RNS-S; distance between the deep branch of the radial nerve and skin,RND-S ) were achieved from both the affected sides and the normal side in the four planes. The diagnostic coincidence rate of radial nerve injury and the detectable rate of traumatic neuroma and encasing scar by ultrasonography were calculated. Results The injured radial nerves were appeared as swelling and hypoechoic nerves partly with traumatic neuroma and encasing scar. The CSAs of the normal radial nerve in plane A, B, C and D were (6.32±1.05)mm2,(7.05 ± 1. 12 )mm2,( 3. 07 ±0. 42 )mm2,( 3. 21 ±0.45 )mm2, ( 2. 87 ± 0. 92 )mm2 and( 3. 01 ± 0. 77 )mm2, respectively. The CSAs of the affected radial nerve in plane A, B, C and D were ( 6. 53 ±0. 79 )mm2,( 9. 31 ± 2. 39 )mm2, (4.21 ±0.45 )mm2,(5.64 ±1. 16)mm2,(4. 39 ± 0. 67 )mm2 and( 3. 61 ±1.24) mm , respectively. No significant difference of CSA was found between the normal side and the affected side of radial nerve in plane A ( P >0. 05 ). The CSA of radial nerve trunk, deep branch of the radial nerve and superficial branch of the radial nerve in affected side were thickener than the normal side in plane B and C( t =3. 20,6. 92, 7. 33,4.99,P <0.05 ). In plane D,the superficial branch of the radial nerve in affected side was thickener than the normal side ( P < 0. 05 ), while the deep branch of the radial nerve was not thickener than the normal side ( P <0. 05 ). The RN-S,RNS-S and RND-S of the normal side in plane A,B,C and D were( 15.42 ±2. 60 )mm,( 9. 96 ± 1.22 )mm,( 10. 03 ±2. 85 )mm,( 11. 21 ±2. 94 )mm,( 10. 27 ±2. 52 )mm and ( 11. 31 ±2. 71 )mm,respectively. The RN-S,RNS-S and RND - S of the affected side in plane A,B,C and D were( 15. 92 ± 1. 29 )mm,( 7. 65 ± 1. 07 )mm,( 3. 66 ± 1. 83 ) mm,( 4.47 ± 1. 22 )mm,( 9. 94 ± 3. 32 )mm and( 10. 20 ± 2. 42 )mm, respectively. There was no difference between the normal and the affected side of RN-S in plane Aas well as RNS-S and RND-S in plane D ( P >0.05 ). The RN-S in plane B and the nerves in plane C were smaller in the affected side than the normal side( t = 4. 31, 7. 24,8. 62,P < 0. 05 ). The coincidence rate of ultrasonography in diagnosing radial nerve injury was higher than electromyogram examination. The detectable rate of traumatic neuroma and encasing scar by ultrasonography were 2/2 and 6/7. Conclusion Ultrasonography could clearly demonstrate the swelling and shifting of the injured radial nerve, and detect the traumatic neuroma and encasing the scar sensitively caused by pediatric monteggia fracture.
  • 摘要：Objective To explore the correlation between the mitral valve coaptation index and echocardiographic parameters of left heart and mitral apparatus. Methods Thirty consecutive patients were registered in this study. Two-dimensional transthoracic echocardiography and real-time three-dimensional transesophageal echocardiography ( RT-3D-TEE ) were performed in all patients. The correlation of mitral valve coaptation index and echocardiographic parameters of left heart and mitral valve apparatus, including left atrium anterior-posterior dimension( Lad ), left ventricular end-diastolic dimension( LVEDd ), left ventricular end-systolic dimension( LVESd ), volume of the leaflets tent( Vtent ), maximal tenting height( Htent ), perimeter of mitral annulus( C3D ),area of annulus in projection plane( A2D ),annulus height( H ),anterior to posterior diameter of annulus ( DAP ), anterolateral to posteromedial diameter of annulus( DAlPm ), exposed length of A2( L3 DE A2 ), and exposed length of P2( L3 DE P2 ), mitral valve coaptation area, mitral valve coaptation index, were analyzed. Results Of all 30 patients, the Lad, LVEDd, LVESd, LVEF, Vtent, Htent, C3 D, A2D, H, DAP, DAlPm,L3DE P2,L3DE A2,mitral valve coaptation area,and mitral valve coaptation index were ( 38. 8 ±5. 2 )mm,( 48. 8 ±4. 5 )mm,( 31.7 ±4.5 )mm,(63.6 ±6.0)% , ( 1. 7 ±0. 8 )mL,( 5. 7 ± 1. 9 )mm,( 106. 1 ±9. 7 )mm,( 780. 0 ± 148. 6 )mm2,( 6. 1 ± 1.4)mm,(27.8 ±3. 9 )mm,( 33.2 ±4. 1 )mm,( 13.5 ±2.5 )mm,( 18.8 ±2. 9 )mm, ( 325. 9 ± 161. 5 ) mm2,( 26. 7 ± 8. 0 )% respectively. There was significant positive correlation between mitral valve coaptation index and mitral valve coaptation area ( r = 0. 883, P = 0. 000 ). There was negative correlation between mitral valve coaptation index and A2D ( r = - 0. 370, P = 0. 044 ). There was negative correlation between L3DE A2 and mitral valve coaptation index as well ( r = - 0. 464, P = 0. 010 ). There were no correlation between mitral valve coaptation index and the size of Lad, LVEDd, LVESd,Vtent,Htent,C3D,H,DAP,DAlPm,L3DE P2( r = -0.192,0.007, -0.023, - 0.082, - 0.225, - 0.255,0. 082,0. 258, - 0. 224, - 0. 157, P > 0. 05 ). Multiple linear regression analysis demonstrated that mitral valve coaptation area,A2D and L3DE A2 were associated factors of mitral valve coaptation index. The regression equation was expressed as: F( mitral valve coaptation index ) = 0. 323 + 0. 893Xt( mitral valve coaptation area ) - 0. 395Z2( A2D ) - 0. 09Z3( L3DE A2 ). Conclusions The mitral valve coaptation index is associated with the mitral valve coaptation area and is an important predictive factor for the degree of mitral valve coaptation. L3DE A2 reservesfor mitral valve coaptation index. The function of mitral annular contraction plays an important role in the degree of mitral valve coaptation.%目的 分析二尖瓣对合指数与左心和二尖瓣瓣器结构超声参数之间的关系.方法 连续选取30例行经胸二维超声心动图检查和经食管实时三维超声心动图检查的患者,测量左心房大小(Lad)、左心室舒张末期内径(LVEDd)、左心室收缩末期内径(LVESd)、二尖瓣穹窿容积(Vtent)、二尖瓣穹窿高度(Htent)、二尖瓣瓣环周长(C3D)、二尖瓣瓣环投影面积(A2D)、二尖瓣瓣环高度(H)、二尖瓣瓣环前后径(DAP)、二尖瓣瓣环左右径(DAlPm)、二尖瓣P2区收缩末期瓣根至对合线的长度(L3DE P2)、二尖瓣A2区收缩末期瓣根至对合线的长度(L3DE A2),测量并计算二尖瓣对合面积、二尖瓣对合指数,分析各参数之间的相关性.结果 30例患者的Lad为(38.8±5.2)mm,LVEDd为(48.8±4.5)mm,LVESd为(31.7±4.5)mm,LVEF为(63.6±6.0)%,Vtent为(1.7±0.8) mL,Htent为(5.7±1.9)mm,C3D为(106.1±9.7)mm,A2D为(780.0±148.6) mm2,H为(6.1±1.4)mm,DAP为(27.8±3.9)mm,DAlPm为 (33.2±4.1)mm,L3DE P2为(13.5±2.5)mm,L3DE A2为(18.8±2.9)mm,二尖瓣对合面积为(325.9±161.5) mm2,二尖瓣对合指数为(26.7± 8.0)%.二尖瓣对合指数与二尖瓣对合面积显著正相关(r=0.883,P=0.000),与A2D、L3DE A2呈负相关(r=-0.370,P=0.044;r=-0.464,P= 0.010);与Lad、LVEDd、LVESd、Vtent、Htent、C3D、H、DAP、DAlPm、L3DE P2均无相关性(r=-0.192、0.007、-0.023、-0.082、-0.225、-0.255、0.082、0.258、-0.224、-0.157,P均＞0.05).多元线性回归分析显示二尖瓣对合面积、A2D和L3DE A2是二尖瓣对合指数的影响因素,回归方程为:Y(二尖瓣对合指数)= 0.323+0.893X1(二尖瓣对合面积)-0.395X2(A2D)-0.09X3(L3DE A2).结论 二尖瓣对合指数与二尖瓣对合面积密切相关,是反映二尖瓣瓣叶对合程度的可靠指标.L3DE A2对瓣叶对合面积影响较大,具有功能储备作用.二尖瓣瓣环收缩功能对二尖瓣对合程度有重要影响.
  • 摘要：Objective To assess the early changes in left ventricular systolic synchrony and cardiac function by real-time three-dimensional echocardiography ( RT3DE )in patients with coronary heart disease after percutaneous coronary intervention ( PCI ). Methods Thirty-five subjects were selected and underwent RT3DE and two-dimensional echocardiography( 2DE )l day before treatment,3 days and one month after treatment. We measured left ventricular ejection fraction( LVEF ), left ventricular end-diastolic internal diameter( LVIDd ), left ventricular end-systolic inlernal diameter ( LVIDs ),peak early( E )and late( A ) trans-mitral Doppler velocities,and E/A ratio. The left ventricular volume-time curves ( VTC ), the left ventricular end-diastolic volume( EDV ), end-systolic volume( ESV ), left ventricular ejection fraction( LVEF ), peak ejection rate( PER ), peak early filling rate( PFR ), PERt = PER/EDV, PFRt = PFR/EDV,the time to minimal systolic volume of 16-segmental standard deviation and the maximum difference as a ratio of R-R interval ( Tmsvl6-SD% and Tmsv 16-Dif% ) of RT3DE were obtained. Results RT3DE parameters: EDV of patients pre-treatment, 3 days and one month after PCI were( 115. 74 ±22. 27 )mL,( 110. 51 ±20.44 )mL and ( 110. 26 ±27. 55 )mL respectively. The difference among the three groups was not statistically significant F =0.59,P >0. 05 );ESV were( 53. 57 ±22. 63 )mL,( 44. 28 ± 14. 34 )mL and( 44. 00 ± 15. 08 )mL, LVEF were( 56. 48 ± 10. 12 )% ,( 60. 45 ± 7. 91 )% and( 61. 77 ± 6. 63 )% ,PERt were 3. 10 ± 0. 80,3. 37 ± 0. 47 and 3. 43 ± 0.52 ,PFRt were 2.01 ± 0.51,2.16 ± 0.39 and 2.34 ± 0.44 ,Tmsvl6-SD% were 2. 33 ±2.32,1.61 ±0.83 and 1. 22 ± 0. 87, Tmsvl6-Dif% were 9.84 ±3.20,6.34 ±3.49 and 4. 07 ± 2. 62. The differences were all statistically significant F -2. 63,3. 80, 2. 80,4. 55 ,4. 88,5. 95,P < 0. 05 ); LVEF, PERt , PFRt of 3 days after PCI treatment were larger than those before PCI, but the differences were not statistically significant ( P > 0. 05 ); ESV, Tmsvl6-SD% , Tmsvl6-Dif% of 3 days after PCI treatment were lower than those before treatment. The differences were all statistically significant t = 1. 98,2. 00,1. 98, P < 0. 05 ). ESV, Tmsvl6-SD% , Tmsvl6-Dif% of one month after PCI treatment were significantly lower than those before treatment t = 2.02,3.08,3.44, P <0.05 ),LVEF,PER! ,PFRt of one month after PCI treatment were significantly larger than those before treatment t = -2. 65, -2.21, - 3. 02 ,P <0.05 ). 2DE parameters: LVIDd of patients pre-treatment, 3 days and one month after PCI treatment were (51.28 ±4.46)mm,(50. 60±5.40)mm and( 49. 82 ±3. 69 )mm respectively,E were ( 51.28 ±4.46 )cm/s,( 50.60 ±5.40 )cm/s,and( 49. 82 ±3. 69 )cm/s, A were( 0. 72 ± 0. 18)cm/s,(0. 76 ±0. 17 )cm/s and( 0. 73 ±0.23 )cm/s,E/A were 1.06 ±0.47, 1.03 ±0.41 and 1.21 ±0.47. The differences were all statistically significant F =0. 89,1.31,0.36,1. 61,P>0. 05);LVIDs were( 35. 02 ±4. 89 )mm,( 32. 51 ±5.40) mm and( 32. 54 ± 4. 28 )mm, LVEF were( 59. 37 ± 8. 67 )% ,( 62. 60 ± 8. 07 )% and ( 65. 29 ± 6. 86 )% . The differences were statistically significant F = 3. 06,5. 35 ,P < 0.05 );LVIDs of 3 days and one month after PCI treatment were significantly lower than that before treatment t = 2.16,2.13 ,P <0.05 ). LVEF of 3 days after PCI treatment was larger than that before treatment. The difference was not statistically significant P > 0. 05 );LVEF of one month after PCI treatment was significantly larger than that before PCI( t = -3.19,P <0.05 ). Conclusions Left ventricular systolic synchrony and systolic and diastolic function were significantly improved after PCI. RT3DE is a promising approach to evaluate the changes in left ventricular systolic synchrony and cardiac function in the patients with coronary heart disease after PCI.%目的 应用实时三维超声心动图评价冠心病患者经皮冠状动脉介入(PCI)治疗后左心室收缩同步性及心功能的早期改变.方法 对35例行PCI治疗的冠心病患者于术前及术后3 d、1个月进行经胸二维和实时三维超声心动图检查,二维超声获得左心室射血分数(LVEF)、左心室舒张末内径(LVIDd)、左心室收缩末内径(LVIDs)、二尖瓣口舒张早期峰值流速(E)和舒张晚期峰值流速(A)及其比值(E/A);三维超声获得左心室容积时间曲线,计算或采集左心室舒张末容积(EDV)、左心室收缩末容积(ESV)、左心室射血分数(LVEF)、峰值射血率(PER)和峰值充盈率(PFR)及其容积校正值PER1和PFR1、校正的16节段不同步指数Tmsv16-SD%和Tmsv16-Dif%.结果 三维超声参数:冠心病患者术前、术后3 d、1个月EDV分别为(115.74±22.27)、(110.51±20.44)、(110.26±27.55)mL,组间比较差异无统计学意义(F=0.59,P>0.05);ESV分别为(53.57±22.63)、(44.28±14.34)、(44.00±15.08)mL,LVEF分别为(56.48±10.12)%、(60.45±7.91)%、(61.77±6.63)%,PER1分别为(3.10±0.80)、(3.37±0.47)、(3.43±0.52),PFR1分别为(2.01±0.51)、(2.16±0.39)、(2.34±0.44),Tmsv16-SD%分别为(2.33±2.32)、(1.61±0.83)、(1.22±0.87),Tmsv16-Dif%分别为 (9.84±3.20)、(6.34±3.49)、(4.07±2.62),组间比较差异均有统计学意义(F=2.63、3.80、2.80、4.55、4.88、5.95,P均＜0.05);冠心病患者术后3 d LVEF、PER1、PFR1较术前均升高,但差异均无统计学意义(P均>0.05);冠心病患者术后3 d ESV、Tmsv16-SD%、Tmsv16-Dif%较术前均降低,差异均有统计学意义 (t=1.98、2.00、1.98,P均＜0.05);冠心病患者术后1个月ESV、Tmsv16-SD%、Tmsv16-Dif%较术前均降低,LVEF、PER1、PFR1较术前均升高,差异均有统计学意义(t=2.02、3.08、3.44、-2.65、-2.21、-3.02,P均＜0.05).二维超声参数:冠心病患者术前、术后3 d、1个月LVIDd分别为(51.28±4.46)、(50.60±5.40)、(49.82±3.69)mm,E分别为(51.28±4.46)、(50.60±5.40)、(49.82±3.69)cm/s,A分别为(0.72±0.18)、(0.76±0.17)、(0.73±0.23)cm/s,E/A分别为(1.06±0.47)、(1.03±0.41)、(1.21±0.47),组间比较差异均无统计学意义(F=0.89、1.31、0.36、1.61,P均>0.05);LVIDs分别为(35.02±4.89)、(32.51±5.40)、(32.54±4.28)mm,LVEF分别为(59.37±8.67)%、(62.60±8.07)%、(65.29±6.86)%,组间比较差异均有统计学意义(F=3.06、5.35,P均＜0.05);冠心病患者术后3 d、术后1个月LVIDs均较术前降低,差异均有统计学意义(t=2.16、2.13,P均＜0.05).冠心病患者术后3 d LVEF较术前升高,差异无统计学意义(P＞0.05);术后1个月LVEF较术前也升高,但差异有统计学意义(t=-3.19,P＜0.05).结论 PCI术后早期,患者左心室收缩同步性及收缩和舒张功能均得到明显改善,实时三维超声心动图可较客观的评价PCI术后左心室壁收缩同步性及心功能的早期变化.
  • 摘要：@@ 创伤导致的软组织异物为临床常见的急诊,金属异物大多由X线检查确诊,而非金属异物,尤其是透X线的异物诊断困难,容易漏诊.近年随着超声诊断技术的普及和高分辨力彩色多普勒超声的应用,使非金属异物的诊断变得快捷、简便.本研究对我院近8年来超声检查诊断并经手术证实的39例非金属异物患者的声像图进行分析,总结报道如下.
  • 摘要：@@ 患者女,30岁,因慢性上腹不适就诊,超声检查发现肝左外叶一直径13 cm×12 cm单房囊肿,左外叶肝实质完全消失,囊肿右侧壁紧邻左肝管远段,其余部分囊壁周围无肝组织覆盖(图1),肝内外胆管无扩张,对其行超声引导下无水乙醇硬化治疗.
  • 摘要：@@ 患者男,36岁,因反复镜下血尿1年余入院.专科检查:无阳性体征.实验室检查:尿常规:尿蛋白(+),潜血(+++),血白细胞计数10个/UL,红细胞计数180个/UL.静脉肾盂造影:膀胱右后壁可见不规则充盈缺损影,范围约3.2 cm×1.6 cm,膀胱下缘见弧形压迹.盆腔CT平扫及增强扫描提示:膀胱右后壁见宽基底软组织团块影,范围约4.2 cm×1.9 cm,未见钙化或坏死,增强后较明显强化,病灶与邻近小肠肠管分界不清楚,CT诊断:膀胱右后壁占位性病变,符合膀胱癌表现,病灶与邻近小肠肠管分界不清,不除外癌侵犯.
  • 摘要：@@ 孕妇,26岁,孕32+5周,平素月经规律,孕期无放射线及毒物接触史.孕15周超声检查显示胎儿左肾盂前后径0.45 cm,右肾盂前后径0.4 cm,膀胱大小2.0 cm×0.8 cm,呈长袋状,其上缘达脐水平.孕24周超声检查显示左肾盂前后径1.2 cm,未进行胎儿生殖器的检查.孕32周超声检查显示左肾盂前后径2.3 cm,同时左侧输尿管迂曲状增宽,起始段宽2.2 cm,余最宽处0.7 cm(图1,2),胎儿生殖器形态失常,阴茎短小,部分位于阴囊中间,阴茎阴囊声像图"花瓣"状,呈"郁金香征"(图3~6),超声提示:左肾积水伴输尿管扩张、生殖器畸形.脐血穿刺证实胎儿染色体核型为(46,XY).

    中华医学超声杂志（电子版）的期刊信息

    • 曾用名：
    • 创刊时间：2004
    • 地区：CN
    • 语言：中文
    • 热门主题：中华医学会
    • 学科分类： 临床医学;

    中华医学超声杂志（电子版）的获奖情况

    中华医学超声杂志（电子版）的收录情况

    • 中国·北大核心期刊（2023版）
    • 中国·北大核心期刊（2020版）
    • 中国·北大核心期刊（2017版）
    • 中国·中国科技核心期刊
    • 中国·中国科学引文数据库-核心（2023-2024）
    • 中国·中国科学引文数据库-核心（2021-2022）
    • 中国·中国科学引文数据库-核心（2019-2020）
    • 中国·中国科学引文数据库-核心（2017-2018）
    • 中国·中国科学引文数据库-扩展（2015-2016）
    • 日本·日本科学技术振兴机构数据库

    中华医学超声杂志（电子版）的投稿信息

    • 投稿方式：
    • 投稿须知：点击查看
    • 期刊官方网站：点击前往
    • 版面费：
    • 审稿费：元
    • 通讯地址：北京东河沿街69号616室
    • 邮编：100052
    • 联系电话：010-51322622
    • 邮箱：csbjb@cma.org.cn
    • 期刊栏目：专家论坛；述评；基础研究；临床研究；论文摘要；经验交流；综述；病例报告
    免费订阅本刊

    客服邮箱：kefu@zhangqiaokeyan.com

    京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有 出版物经营许可证

    • 客服微信

    • 服务号