ObjectiveTo investigate the methods and significances of the breast ultrasonographic breast imaging reporting and data system (BI-RADS) category 4 lesions divided into category 4a, 4b, and 4c, and to assess the risk of malig-nancy of lesions with BI-RADS category 4 in order to improve the accuracy of diagnosis. MethodsTwo hundred and eighty-eight breast lesions with BI-RADS category 4 confirmed by histopathology were collected. The ultrasonographic characteristics of benign and malignant lesions, containing the shape, aspect ration, margin, calcification, changes of the surrounding tissue, boundary, blood flow characteristics, internal echo, rear echo of the lesions, were comparatively anal-yzed, and the lesions with BI-RADS-US category 4 were divided into 4a, 4b, 4c according to these ultrasonographic charac-teristics and analyzed by statistics. ResultsThere were 192 malignant lesions and 96 benign lesions in the 288 breast lesions. There were statistical significances in the benign and malignant lesions with the shape, aspect ratio, margin, calci-fication, change of surrounding tissue, and boundary (P < 0.05), in other words, the proportion of these ultrasonographic characteristics were higher in the malignant lesions as compared with the benign lesions. But there were no significant differences of internal echo, rear echo, and blood flow characteristics between two lesions (P > 0.05). The positive predictive value of malignant tumor with BI-RADS category 4a, 4b, and 4c were 21.74%, 58.90%, and 91.78%, respectively, and there was significant difference (χ2=106.09, P=0.000). ConclusionsThe classification of breast lesions with BI-RADS category 4 is refined, it could more accurately assess the risk of benign and malignant breast masses. At the same time, it has an important clinical significance for diagnosis and treatment of benign and malignant breast masses.
ObjectiveTo evaluate the diagnostic value of ultrasound for gallbladder carcinoma (GA), in order to improve the ability of early ultrasonic and clinical diagnosis of GA. MethodsWe analyzed and compared the clinical data and ultrasonic results of 42 GA cases confirmed by surgery and pathology between January 2008 and December 2013, and summarized the classification, ultrasonographic features, and diagnosis of GA. ResultsAmong the 42 cases, 25 were correctly diagnosed by ultrasound (59.5%), among which 9 were thick-wall type, 11 were protrusion type and 5 were solid type. Seventeen cases were misdiagnosed (40.5%). Pathological results showed 14 cases of highly-differentiated adenocarcinoma, 16 of moderately differentiaed adenocarcinoma, 9 of poorly-differentiated adenocarcinoma, 2 of squamous adenocarcinoma and 1 of neuroendocrine carcinoma. ConclusionUltrasound is the preferred method for the diagnosis of GA because of its convenience, although the diagnostic accuracy is still not good and more efforts should be done.
【摘要】 目的 总结胆囊壁隆起样病变超声及病理特点，以提高此类疾病的鉴别诊断水平。 方法 回顾性分析2008-2009年222例经手术和病理证实的胆囊隆起样病变患者的临床资料，对其超声特点及病理学结果进行分析。 结果 胆固醇沉积症（包括附壁型37例和息肉型138例）175例（78.8%），炎性息肉（增生性息肉）3例（1.4%），腺瘤14例（6.3%），有7例腺瘤伴非典性增生，腺肌增生症1例（0.5%），单纯胆囊炎29例（13.1%）。 结论 超声对胆囊隆起样病变的诊断敏感性极高，能清晰显示其大小、数目、回声情况、病变形态和边界情况及局部胆囊壁的变化，有无合并结石等，还可方便地行随访观察，了解其动态变化，是简便可靠的诊断方法。【Abstract】 Objective To Summarize the common sonographical and pathological characteristics of apophysis lesions of the gallbladder, so as to improve the level of diagnosis and differential diagnosis. Methods Sonographical appearance and pathological characteristics of 222 patients from 2008 to 2009 with apophysis lesions of the gallbladder which were confirmed by pathologic diagnosis and operation were reviewed retrospectively. Results One hundred and seventy-five (78.8%) of the patients had gallbladder cholesterol lipoidosis and 138 (62.2%) of them had gallbladder cholesterol polyps;3 patients (1.4%) had gallbladder inflammatory polyp;14 patients (6.3%) had gallbladder adenomatoid polyps and 7 of them were accompanied with dyplasis and atypical hyperplasia; 1 (0.5%) patients (0.5%) had cholecystic adenomyosis. Tenty-nine patients (13.1%) had cholecystitis only. Conclusion Ultrasonography is quilt sensitive to this disease and can disply the size, number, echo, shape of the lesions and can show that if complicate with cholecystolithiasis.Ultrasonography is also accomplished in follow-up and can be one of the most dependable examination methods.
【摘要】 目的 通过对早期妊娠卵黄囊的观察，探讨其在早孕超声诊断中的临床价值。 方法 2008年5月-2009年1月应用阴道超声诊断仪观察536例早孕患者卵黄囊的形态、大小及卵黄囊的数目，根据结果分为卵黄囊正常及异常组，比较卵黄囊的增长情况与妊娠预后的关系。 结果 504例正常组中，501例正常妊娠结局的卵黄囊大小从孕5~11周持续增长，此后逐渐缩小，孕12周后消失；另3例为宫外孕而中止妊娠。卵黄囊异常组32例。正常组和异常组的卵黄囊大小及形态有统计学意义（Plt;0.05）。 结论 卵黄囊超声影像学改变可作为诊断早孕及预测妊娠发展和转归的可靠手段。【Abstract】 Objective To evaluate the clinical value of yolk sac in the diagnosis of early pregnancy by observing the change of yolk sac. Methods The yolk sacs in 536 pregnant women were measured by ultrasonogaphy from May 2008 to January 2009, and the correlation of the growth condition of the normal or abnormal yolk sac with pregnancy outcome were observed. Results In the normal group (504 patients), the yolk sac size of 501 patients continued to grow from five to 11 weeks of pregnancy, then gradually reduced and disappeared after 12 weeks of pregnancy. The other three patients terminated pregnancy because of ectopic pregnancy. Thirty-two cases of abnormal yolk sac were found. The results showed the size and shape of yolk sacs were significantly different between normal and abnormal groups (Plt;0.05). Conclusion The change of yolk sacs by ultrasonography during early pregnancy can be used as a good measure to diagnosis early pregnancy and predict the development and prognosis of pregnancy.
ObjectiveTo evaluate the value of preoperative risk assessment of papillary thyroid carcinoma with ultrasound for clinic diagnosis and treatment.MethodsThe data of 400 patients with papillary thyroid carcinoma received operative treatment in 2017 were retrospectively analyzed. Recorded and analyzed the ultrasonic risk assessment and postoperative grading of clinic risk assessment, to evaluate coherence and correlation between them.ResultsThere were 400 lesions with an average size of (12.8±8.5) mm. Among 400 lesions, diameter of 214 lesions less than 10 mm, diameter of 178 lesions were between 10 mm and 40 mm, and diameter of 8 lesions were larger than 40 mm. A total of 242 cases had lymph node metastasis and 309 cases had capsule invasion. Clinical and ultrasoud risk assessment was performed on 400 lesions. There were 224 lesions with low risk of clinical risk stratification vs. 111 lesions with low ultrasonic risk, 148 lesions with intermediate risk of clinical risk stratification vs. 270 lesions with intermediate ultrasonic risk, and 28 lesions with high risk of clinical risk stratification vs. 19 lesions with high ultrasonic risk. The consistency of postoperative recurrence risk stratification and preoperative ultrasound recurrence risk stratification was moderate (κ=0.414, P<0.01). In addition, the consistency between ultrasound examination and clinical lymph node metastasis was poor (κ=0.291, P<0.05), and the consistency of invasion of the capsule was moderate (κ=0.402, P<0.05).ConclusionPre- operative evaluation of recurrence risk grading before thyroid ultrasound, focusing on individualized preoperative assessment, the assessment is more detailed and detailed, and is helpful for follow-up treatment and early screening for recurrence risk.
目的：探讨超声诊断对异位妊娠的诊断及临床价值。方法：回顾性总结分析85例经临床确诊的异位妊娠。结果：输卵管壶腹部、峡部及伞部妊娠75例，符合率95.8%；间质部妊娠2例，符合率100%；卵巢妊娠1例，为误诊；宫角妊娠2例，符合率100%；宫颈妊娠5例，符合率100%；未破裂型异位妊娠51例，不典型34例。结论：超声检查对异位妊娠能作出较准确的定位诊断，对临床治疗提供了有力证据，具有较高的临床诊断价值。
【摘要】 目的 探讨超声检查对阴道斜隔综合征的诊断价值，分析超声图像特点，提高诊断率，为临床选用最佳的手术方式提供依据。 方法 回顾性分析2008年1月-2010年6月经手术确诊为阴道斜隔综合征的15例患者的临床资料及超声检查结果，总结阴道斜隔综合征的声像图特点。 结果 15例经临床确诊为阴道斜隔综合征的患者，超声诊断14例，均表现为双子宫、双宫颈、阴道或宫颈积液/血，9例左肾缺如，5例右肾缺如。误诊1例，为单子宫伴一侧附件巨大囊肿。 结论 超声具有诊断准确、简便、无创、重复性好、价格实惠等优点，对于临床诊断生殖系统畸形具有十分重要的意义，应列为首选检查方式。【Abstract】 Objective To investigate the diagnostic value of ultrasonography in examining oblique vaginal septum syndrome, analyze the characteristics of ultrasound image to improve the ultrasound diagnosis rate, in order to provide guidance for clinical surgeries. Methods We retrospectively analyzed the clinical data and ultrasound examination results of 15 patients diagnosed to have oblique vaginal septum syndrome in our hospital, and summarized their ultrasonographic characteristics. Results Among the 15 patients, 14 were diagnosed to have the disease by ultrasound examination. The ultrasound image showed a double uterus, double cervix, and vaginal or cervical fluid or blood for all the patients among whom 9 had absent left kidney, and 5 had absent right kidney. One patient was misdiagnosed to have single uterus with giant cysts on one side. Conclusions Ultrasound diagnosis is simple, noninvasive, reproducible, affordable and accurate in diagnosing. It is very useful in clinical diagnosis of reproductive system abnormalities and should be listed as the preferred way of examinations.
目的：通过超声对185例肾上腺肿瘤诊断及漏诊、误诊病例分析，寻找影响肾上腺肿瘤超声漏诊及误诊的因素。 方法：本文回顾性分析185例肾上腺肿瘤超声与病理的资料，对超声漏诊和误诊原因进行了分类、归纳和总结。结果：通过185例肾上腺肿瘤的超声检查，超声诊断出肾上腺病变122例，诊断正确率65.95%，明显低于相关文献报道，漏诊57例，误诊6例。漏误诊率(34.05%)，明显高于相关文献报道，综合分析其病理及影像学资料，将漏误诊原因归纳为五种：①左侧肾上腺肿瘤；②小于2.0 cm的肿瘤；③混合性回声的肿瘤；④临床及超声医师对肾上腺肿瘤认识不足；⑤误诊的主要原因是由于肿瘤巨大，造成定位困难。结论：通过对肾上腺肿瘤漏诊及误诊分析，可以提高超声诊断的准确性，降低漏误诊率。