【摘要】 目的 用高频超声对正常女性乳腺健康体检，探讨其在临床及乳腺普查方面的应用价值。 方法 对2006年1月－2009年12月间7 532例健康女性乳腺体检声像图进行分析，并对各年龄段的乳腺病变超声结果分布情况进行统计。 结果 共检出乳腺病变2 861例（37.98%），正常者4 671例（62.02%）。所有受检者中，囊性病变1 904例（25.28%），实性病变944 例（12.53%），混合性病变13例（0.17%），伴有副乳者692例。囊性病变及实性病变单侧多于双侧，混合性病变均为单侧。常见病中，囊性病变多于实性病变，发病年龄分布在20～30岁及31～40岁年龄段。 结论 高频超声作为女性乳腺疾病的一种常规检查，能对乳腺占位性疾病提供较为准确的诊断，对乳腺癌早期发现、早期诊断、早期治疗提供一种科学依据。【Abstract】 Objective To explore the clinical value of high-frequency sonography for normal clinical breast examination in breast screening. Methods From January 2006 to December 2009, 7 532 healthy women underwent breast sonography. The results of sonography in the individuals with different ages were statistically analyzed. Results Breast lesions were found in 2 861 cases (37.98%) and the other 4 671 were healthy. Among all of the individuals, 1 904 cases (25.28%) had cystic lesions, 944 (12.53%) had solid lesions and 13 (0.17%) had mixed lesions. There were 692 cases of accessory mammary tissue. Unilateral cystic nodules and solid nodules were more common than bilateral ones, whereas mixed nodules were usually sunilaterally. Cystic nodules were more common than solid nodules. Most common onset of breast lesions is in the individuals with the age of 20-30 and 31-40 years. Conclusion High-frequency sonography, as an examination for normal clinical breast screening provides more accurate diagnosis and early detection of breast lesions, which can provide scientific evidence for early detection, diagnosis and treatment for breast cancer.
ObjectiveTo analyze the feasibility and effectiveness of elastic intramedullary nail fixation for the fifth metacarpal neck fracture under the guidance of high frequency ultrasound.MethodsThe clinical data of 30 patients with the fifth metacarpal neck fractures who were treated with elastic intramedullary nails fixation under the guidance of high frequency ultrasound and met the selection criteria between May 2013 and September 2017 were retrospectively analysed. There were 24 males and 6 females, the age ranged from 18 to 58 years, with an average of 31.4 years. The head-shaft angle of the fifth metacarpal was (55.6±11.3)°. The time from injury to operation was 12 hours to 8 days, with an average of 2.4 days. The operation time, number of intraoperative fluoroscopy, fracture reduction, complications, and fracture healing time were recorded. The head-shaft angle of the fifth metacarpal on the affected side after fracture healing were measured and compared with the healthy side. At last follow-up, the active range of motion of the fifth metacarpophalangeal joint of both sides were measured, and the function was evaluated by using the total active movement (TAM) evaluation standard of the Hand Surgery Association of Chinese Medical Association.ResultsThe operation time was 22-40 minutes, with an average of 32.4 minutes; the intraoperative fluoroscopy was performed once; ultrasound images and X-ray fluoroscopy showed that the fracture was well reduced and no adjustment was required. The incisions healed well after operation, without tendon adhesion or local numbness. All 30 patients were followed up 8-16 months, with an average of 11.7 months. The fracture healing time was 4-8 weeks, with an average of 5.6 weeks. The head-shaft angle of the fifth metacarpal was (13.2±1.4)°, which was significantly improved when compared with preoperative value (t=−20.02, P=0.00); and there was no significant difference (t=1.94, P=0.06) when compared with the healthy side [(12.6±1.0)°]. At last follow-up, the active range of motion of the fifth metacarpophalangeal joint on the affected side was (89.4±2.4)°, showing no significant difference (t=−1.58, P=0.13) when compared with the healthy side [(90.3±2.0)°]. According to the TAM evaluation standard of the Hand Surgery Association of Chinese Medical Association, all patients were considered to be excellent.ConclusionThe effectiveness of elastic intramedullary nail fixation for the fifth metacarpal neck fracture under the guidance of high frequency ultrasound is definite. It can dynamically observe the fracture reduction from different angles, reduce ionizing radiation and postoperative complications.
目的 分析经病理证实的颈部无痛性肿大淋巴结的声像图特点，比较良、恶性疾病中异常淋巴结的声像图特征，为临床医师的鉴别提供可靠的诊断依据。 方法 将2007年7月－2009年12月以颈部无痛性肿大淋巴结就医、并经病理证实的良、恶性疾病的97例患者作为研究对象，其中男56例，女41例；共检出淋巴结365个，依据病理诊断结果将研究对象分为良性组（98个）和恶性组（267个）。 结果 ① 大多数良性淋巴结：L/S＞2，形态接近椭圆形、门部回声规则无移位、皮质较薄、髓质形态规则，居中； 大多数恶性淋巴结短径相对增大，L/S≤2，形态趋于类圆形，包膜不完整，门部大多数偏离中心，皮质不均匀增厚，髓质变形移位或消失。② 良性淋巴结多表现为无血流型或门部规则血流型；恶性淋巴结多表现为周边血流或混合血流型。③ 大多数良性淋巴结血流阻力指数偏低，RI＜0.60；大多数恶性淋巴结血流阻力指数偏高，RI＞0.70。 结论 高频超声在颈部无痛性淋巴结肿大的良恶性鉴别中能够提供重要的诊断信息。
ObjectiveTo observe the accuracy of location and operation of traditional blind acupotomy lysis in the treatment of scapulohumeral periarthritis by using the high-frequency ultrasound.MethodsForty-two patients with scapulohumeral periarthritis diagnosed in the First Affiliated Hospital of Xinjiang Medical University and Urumqi Hospital of Traditional Chinese Medicine from February to April 2018 were selected. Four common sites of needle knife in the treatment of scapulohumeral periarthritis were operated blindly, and the process of the needle insertion points location and needle perform were both observed by high-frequency ultrasound.ResultsUsing high-frequency ultrasound to observe and confirm the bare-handed positioning point and needle-knife operating point, we found that the accuracy rate of bare-handed positioning needle-point was 100.0% (42/42). In the process of needling, the accuracies of needle insertion at the point of small tubercle of humerus and the point of bursa of deltoid muscle were high, which was 95.2% (40/42) and 100.0% (42/42), respectively. However, because of the deviation of the needle depth and direction, the accuracies of needle insertion at the coracoid point and the sulcus point between the humeral tubercles were low, which was 45.2% (19/42) and 4.8% (2/42), respectively.ConclusionsTraditional acupotomy lysis is a commonly used method of needle knife treatment. Using high-frequency ultrasound, it is found that even by experienced needle knife doctors, there may still be positioning deviation when using blind method to insert needles. Because the visualization of clinical needle knife is difficult to be carried out universally due to the limitations of time and technology, it is suggested that high-frequency ultrasound could be used as a visualization teaching tool in the training of needle knife operation to assist the training of blind needle knife operation technology, which may improve the accuracy of blind needle knife operation.
目的 探讨经腹部彩色多普勒超声（腹部超声）联合高频超声诊断良性胆囊息肉样病变的价值。 方法 回顾性分析2008年1月－2011年11月121例腹部超声联合高频超声检查提示为良性胆囊息肉样病变、且有手术病理检查结果的患者资料进行对照，以此评价经腹部超声联合高频超声对良性胆囊息肉样病变的诊断准确性。 结果 121例术前经腹部超声联合高频超声诊断为良性胆囊息肉样病变的患者，手术后病理检查结果示胆固醇息肉62例（51.24%），炎性息肉27例（22.31%），腺瘤6例（4.96%），腺癌3例（2.48%），胆囊结石14例（11.57%），腺肌症3例（2.48%），囊壁腺体结构紊乱3例（2.48%），黏膜下层软结节3例（2.48%）。经腹部超声联合高频超声与手术后病理对比检查，其诊断符合率为78.51%（95/121），误诊率为21.49%（26/121）。 结论 经腹部超声联合高频超声检查对良性胆囊息肉样病变诊断准确性较高，可为临床预防胆囊癌前病变提供依据。Objective To investigate the value of abdominal color Doppler ultrasonography (CDU) combined with high-frequency ultrasonography (HFU) diagnosing benign polypoid lesion of gallbladder (B-PLG). Methods A total of 121 patients with B-PLG diagnosed by CDU combined with HFU between January 2008 and November 2011 were randomly selected. All of the patients underwent the surgery and had the record of surgical pathological examination results, which were compared with the results of the ultrasonography in order to evaluate the diagnostic accuracy of CDU combined with HFU for B-PLG. Results In 121 patients with B-PLG diagnosed by CDU combined with HFU before the surgery, cholesterol polyp was found in 62 (51.24%), infective polyp was found in 27 (22.31%), adenoma was found in 6 (4.96%), adenocarcinoma was found in 3 (2.48%), gallstones was found in 14 (11.57%), adenomyosis was found in 3 (2.48%), the wall structure gland disorder was found in 3 (2.48%), and submucosal soft nodules was found in 3 (2.48%) after the surgical pathological examination. Coincidence rate between CDU combined with HFU diagnosis and surgical pathological diagnosiswas 78.51% (95/121), and the misdiagnosis rate of CDU combined with HFU was 21.49% (26/121). Conclusion The accuracy of CDU combined with HFU diagnosing B-PLG is high, which can help to prevent precancerous lesion of gallbladder cancer.