【摘要】目的探讨乳腺囊性肿块的临床特点及诊治经验。方法对我院1988年4月至2003年5月期间收治的220例乳腺囊性肿块患者的临床资料进行回顾性分析。结果经均手术切除及病理学检查，本组病例中乳腺囊性上皮增生症162例，积乳性乳腺囊肿26例，单纯性乳腺囊肿23例，乳腺叶状囊肉瘤5例，大导管内乳头状瘤4例。结论乳腺囊性肿块具有一定的共性和个性特点，术前B超检查和诊断性穿刺对乳腺囊性肿块的诊断和鉴别诊断有一定价值，但确诊有赖于病理学检查，手术可以明确诊断和治愈疾病。
Lung segmentation is the premise of the computer aided diagnosis of lung cancer. The traditional segmentation method based on local low-level features can not get the correct result when a tumor is connected with pleura due to their similar computed tomography (CT) values. Moreover, because the big size of tumor leads to the loss of a large part of lung area, the traditional segmentation methods of lung with juxta-pleural nodule whose diameter is less than 3 cm are not suitable. Acitve shape model (ASM) combined with prior shape and low level features might be appropriate. But the search steps in conventional ASM is an optimization method based on the least square, which is sensitive to outlier marker points, and it makes profile update to the transition area of normal lung tissue and tumor rather than a true lung contour. To solve the problem, we proposed an improved ASM algorithm. Firstly, we identified these outlier marker points by distance, and then gave the different searching functions to the abnormal and normal marker points. And the search processing should be limited in volume of interesting (VOI). We selected 30 lung images with juxta-pleural tumors, and got the overlap rate with the gold standard as 93.6%. The experimental results showed that the improved ASM could get good segmentation results for the lungs with juxta-pleural tumors, and the running time of the algorithm could be tolerated in clinical.
【摘要】 目的 探讨多层螺旋CT血管造影（MSCTA）对腹部巨大肿块定位定性的诊断价值。 方法 收集2005年6月-2009年12月98例腹部巨大肿块，作MSCTA检查，观察供血动脉来源和肿块与血管关系。 结果 98例肿块发现有主要供血动脉76例，其中恶性肿块69例，血管受侵改变51例。 结论 由于MSCTA快捷、无创、经济、方便、空间分辨率高等优点，对腹部巨大肿块定位定性有较高诊断价值。【Abstract】 Objective To investigate the diagnostic value of multislice CT angiography (MSCTA) to abdominal huge mass from June 2005 to December 2009. The relation among blood vessel and supply origin and tumor was analyzed. Methods MSCTA was performed in 98 cases with abdomenial huge mass. Results The feeding artery of mass was discovered in 76 cases, in which malignant tumors were confirmed in 69 cases, the vessels were encroached on in 51 cases. Conclusion MSCTA may be of high value to diagnose abdominal huge mass because of noninvasiveness, convenience, and high resolution.
目的 探讨胰头部肿块型慢性胰腺炎的诊断要点与个体化术式的选择原则。方法 回顾性分析2000年4月至2011年9月期间我院收治的10例胰头部肿块型慢性胰腺炎患者的临床资料。结果 本组平均发病年龄47.3岁，平均病程69.1d，平均总胆红素99.4µmol/L，CA19-9 55～78U/ml。10例B超检查示肝内胆管及胆总管扩张，5例CT检查报告胰头部占位性病变伴主胰管不规则扩张或钙化灶，2例MRCP检查诊断胆总管下段占位。3例术中多点穿刺快速活检后行胆胰管引流术，7例术前误诊为胰头癌或壶腹癌均行胰十二指肠切除，术后出现并发症8例，死亡1例，9例平均随访44.2个月无复发和癌变。结论 把握发病年龄、病程、波动性黄疸等临床特征和CA19-9水平及CT、MRCP等影像检查要点是胰头部肿块型慢性胰腺炎与胰头癌鉴别诊断的关键，用个体化术式合理实施胰十二指肠切除、胆胰管内外引流术是胰头部肿块型慢性胰腺炎外科处理明智的选择。
【摘要】 目的 探讨隐蔽切口行乳腺肿块切除的经验。 方法 将1990年5月-2008年6月收治844例乳腺肿块患者随机设为观察组564例，采用乳晕缘切口，280例同期采用传统放射状切口的患者作为对照组，比较二者治疗效果。 结果 术后随访2～12个月，乳晕缘切口患者效果良好，切口瘢痕不显且保持了乳房的圆润外形；采用传统放射状切口的患者，乳房瘢痕宽大、明显。 结论 在熟悉乳房解剖及外科基本操作技术的基础上，开展乳晕缘切口行乳房肿块切除术是安全可行的，既达到了治疗目的，又符合美学要求，值得临床推广应用。【Abstract】Objective To explore the method of breast phymas via periaeoral incisions. Methods From May 1990 to June 2008, 844 patients with breast phyma were divided into the investigation group (564 patients) and the control group (280 cases). Incision around areola mammae was performed on the former group, the traditional radial incision was performed on the latter group，and then the results of the treatment were compared between the two groups. Results Follow-up visit ranged from two months to 1 year, all patients resulted in good effects, concealed scars, and remaining smooth shapes in the investigation group, and periareolar incisions was simpler and with less complication. Conclusion It is both safe and practicable to perform breast phyma excision via periareolar incision, on the basis of good understanding to breast anatomy and skillful operation.It can achieve the goal of treatment and meet the requirements of aesthetics as well, and hence is worthy of being recommended in clinical practice.
【Abstract】Objective To estimate the value of the infra-red light scanning and the colored ultrasonic Doppler in diagnosis of breast masses. Methods Two hundred and seventy nine patients with breast mass were examined with the infrared light scanning and the colored ultrasonic Doppler in our hospital.Following the two examinations the masses were resected and pathologically examined as a control. Results The conformity of the infra-red light scanning with pathologic diagnosis was 94.0% in 182 hyperplasia masses, while that of the ultrasonic Doppler was 84.6%(P＜0.01). The conformity of the infra-red light scanning with pathology was 91.7% and that of the colored ultrasonic Doppler was 83.3%(Pgt;0.05). The colored ultrasonic Doppler was seemingly more effective than infrared light scanning in diagnosing 9 galactocele and 5 intraductal papilloma, but there is no significant difference(Pgt;0.05). The conformity of the two exams with pathology in 59 fibroadenoma was almost the same.Conclusion The infra-red light scanning is more effective than the colored ultrasonic Doppler in diagnosing the hyperplasia masses, there is no significant difference in diagnosing the breast cancer and the fibroadenoma between the two exams. Combined use of this two exams would increase the accurase of the breast masses.
ObjectiveTo investigate the relationship between primary pulmonary mucinous adenocarcinoma (PPMA) mass type and pneumonia type and their difference in malignant degree, and to analyze the role of clinical manifestations and CT features in the diagnosis of this disease. MethodsThe clinical data of PPMA patients admitted in the First Affiliated Hospital of Xiamen University from May 2011 to March 2022 were retrospectively analyzed. According to CT features, they were divided into a mass type group and a pneumonia type group. The clinical manifestations, CT features and the degree of malignancy between the two groups were analyzed and compared. ResultsA total of 57 PPMA patients were enrolled. There were 17 males and 40 females, with an average age of (53.82±10.65) years, and 28 (49%) patients had reversed hato-like sign. There were 42 patients in the mass type group and 15 patients in the pneumonia type group. PPMA often occurs in both lower lungs, with clinical manifestations mainly of coughing and expectorating white mucoid sputum. There were statistical differences between the two groups in the maximum diameter of tumor (P<0.001), boundary condition (P<0.001) and pleural indentation sign (P=0.019). There was no statistical difference between the two groups in Ki-67 index (P>0.05). ConclusionThere is no statistical difference in the degree of malignancy between the two types of PPMA. Considering their clinical manifestations and differences in imaging features, it is supported that the pneumonia type is just a progression of the mass type. CT can present various manifestations, among which the reversed hato-like sign is expected to become an important imaging feature. Combined with a high proportion of solid components, pleural indentation sign, and vacuole sign, reversed hato-like sign can play a significant role in the diagnosis of PPMA.
目的 总结彩色多普勒超声（彩超）结合钼靶X线摄片标记定位对无临床体征乳腺肿块的定位诊断价值。 方法 2010年3月－2011年10月对48例彩超和钼靶X线检查发现可疑病灶而无任何临床体征的患者，在彩超引导下穿刺病灶金属导丝标记定位，并结合钼靶X线检查切除病灶，同时快速冰冻活检明确诊断。 结果 48倒中有11例确诊为乳腺癌（浸润性导管癌7例，导管内癌4例），37例为良性病变（纤维瘤5例，导管内乳头状瘤4例，乳腺腺病28例）。冰冻切片病理检查与术后石蜡病检结果一致。 结论 彩超引导下穿刺钢丝标记定位活检结合钼靶X线摄片，有效地解决了乳腺细小钙化和微小病灶活检术中精确定位和完整切除的难题，对无临床体征的微小乳腺肿块的诊断准确、可靠、实用。
Objective To explore the value of pathologic diagnosis for pancreatic head mass by using recise Tru-cut biopsy under intraoperative ultrasound guided. Methods Twenty-eight patients with solid pancreatic masses in People’s Hospital of Suqian，Affiliated Hospital Xuzhou Medical College from August 2010 to August 2011 were performed precise Tru-cut biopsy under intraoperative ultrasound guided. In all patients of 28 cases, male 20 cases and female 8 cases, the male-to-female ratio was 5∶2. The patients’ age was 34-78 years old（mean age： 64 years old）. Twenty-eight patients were divided into three groups based upon the greatest dimension of the masses as follows：equal or less than 1.5 cm （group S, 5 cases）, 1.5-3.0cm （group M, 7 cases）, and greater than 3.0cm （group L, 16 cases）. Three needlepasses in each mass were performed. The results of postoperative pathologic findings were compared with specimens in paraffin sections. Results In all cases of 28, the diagnostic coincidence rate was 100%, there were no false positive finding and false negative. The coincidence ratio for pathological diagnosis of tissues with only 1 strip sample （1/3）, only 2 strip samples （2/3）, and with 3 strip samples （3/3） were 3/5, 2/5, and 0/0, respectivly in S group, 0/0, 5/7, and 2/7, respectivly in M group, and 0/0, 4/16, and 12/16, respectivly in L group. The false negative rate of single strip sample in S group and M group was higher than that in L group （χ2=9.833，P=0.002）. There was false negative finding with master single test in small focus of infection. Conclusion Precise Tru-cut biopsy under intraoperative ultrasound guided is a safe and highly accurate method for pathological diagnosis of patients with solid pancreatic lesions, especially in small lesions，it is worthy of clinical application..
Objective To review the development of endoscopic techniques in breast surgery, focusing on their use in benign breast lump resection and breast-conserving surgery for cancer, and also summarize the development and application of these techniques in China, highlighting promotion and homogenization challenges and future directions. Methods A systematic review of relevant literature was conducted to trace the historical evolution, clinical applications, and related research of endoscopic techniques in breast surgery, emphasizing their advantages and disadvantages of endoscopic benign breast lump resection and breast-conserving surgery for cancer. Results Endoscopic benign breast lump resection and breast-conserving surgery for cancer have improved patients’ postoperative psychological health and quality of life, particularly in scar-free surgery. However, challenges such as limited intraoperative visibility and prolonged surgery time lead to controversy in clinical practice. Conclusion Despite significant advancements, endoscopic techniques in breast surgery also face challenges. Future efforts should focus on technological improvements and clinical research to address these issues, promoting widespread application and standardization. The key to future development lies in the promotion and homogenization of these technologies.