ObjectiveTo evaluate the value of ultrasound in the differential diagnosis of thickened bowel wall at the lower quadrant of abdomen. MethodsThe ultrasonic and clinical data of 416 cases of bowel wall thickening at the lower quadrant of abdomen were retrospectively analyzed between January 2009 and April 2013 in Meishan Traditional Chinese Medicine Hospital, Meishan Chinese Railway Hospital and West China Hospital of Sichuan University. The diseases included appendicitis, periappendiceal abscess, Meckel's diverticulum, intestinal duplication, Crohn's disease and intestinal tuberculosis. Misdiagnoses were also analyzed. ResultsAmong the 416 patients, there were 304 cases of inflammation, 90 of tumors, and 22 of congenital diseases. On ultrasound images, they manifested as cystic mass in 19 cases, mixed solid and cystic mass in 77 cases, and solid mass in 320 cases. Of all the cases, there were 56 cases of diffused changes, 54 of multiple-segment changes, and 306 of focal changes. ConclusionUltrasound is a valuable diagnostic imaging tool in the differential diagnosis of bowel thickening diseases at the lower quadrant of abdomen.
ObjectiveTo observe ocular ischemic appearance (OIA) associated with carotid artery stenosis and its effects on the hemodynamics of central retinal artery (CRA) and ophthalmic artery (OA). MethodsA total of 30 normal persons and 60 patients with carotid artery stenosis diagnosed by color Doppler flow imaging (CDFI) and digital subtraction angiography (DSA) were enrolled in this prospective study.Sixty patients were randomly divided into 2 groups:30 patients with the carotid artery stenosis degree < 60% and 30 cases with the carotid artery stenosis degree≥60%. Thirty normal persons were enrolled in the normal control group. All patients underwent a comprehensive eye examination to determine if OIA exists. The Doppler spectral patterns of CRA and OA were observed by CDFI. The peak systolic velocity (PSV), end diastolic velocity (EDV), blood vessel diameter (BVD) and resistance index (RI) of CRA and OA were measured. ResultsIn the group of the carotid artery stenosis degree≥60%, 24/30 patients (80.0%) had the ophthalmic symptoms and 9/30 patients (30.0%) had ophthalmic signs. In the group of the carotid artery stenosis degree < 60%, 9/30 patients (30.0%) had the ophthalmic symptoms and 3/30 patients (10.0%) had ophthalmic signs. For patients with≥60% stenosis, CDFI revealed a bread-like waveform of CRA, and single peak of OA instead of the typical 3-peak/2-notch waveform. For patients with < 60% stenosis, CDFI revealed a normal pattern of CRA and OA (3-peak/2-notch). The PSV(t=5.255, P=0.007) and EDV(t=4.949, P=0.005) of CRA in the stenosis≥60% group were statistically decreased compared to the normal control group, but the BVD(t=0.457, P > 0.05)and RI(t=0.213, P > 0.05)were normal. The PSV, EDV, BVD and RI of CRA in the stenosis < 60% group were normal(P > 0.05). The PSV(t=4.457, P=0.010)and EDV(t=4.588, P=0.009)of CRA in the stenosis≥60% group were statistically decreased compared to the stenosis < 60% group, but the BVD and RI were the same between these 2 groups. ConclusionPatients with carotid stenosis≥60% had a higher OIA incidence, reduced PSV, EDV of their CRA, while had no significant changes of OA hemodynamics.