目的 探讨超声弹性成像联合高频超声在甲状腺乳头状癌诊断中的应用价值。方法 2022年1月—2023年6月选择在中国人民解放军联勤保障部队第九九〇医院诊治的疑似甲状腺乳头状癌患者82例,所有患者均给予超声弹性成像联合高频超声检查,记录超声特征。所有患者均行病理检查,并以病理检查作为判断的金标准。结果 在82例患者中,病理诊断为甲状腺乳头状癌48例（癌性组）,占比58.54%;甲状腺良性结节34例（良性组）,占比41.46%。癌性组的形态异常、后方回声衰减、钙化、晕环征、边界不清晰、内部低回声等超声征象占比为81.25%、83.33%、83.33%、83.33%、81.25%、81.25%,高于良性组的52.94%、47.06%、47.06%、41.18%、47.06%、52.94%（P<0.05）。癌性组的收缩期最高流速低于良性组（P<0.05）,阻力指数、搏动指数与良性组相比有提高（P<0.05）。癌性组的弹性成像评分多为3~4分,良性组多为2分,两组比较差异有统计学意义（P<0.05）。超声弹性成像联合高频超声判断为甲状腺乳头状癌47例,诊断中的灵敏度与特异度分别为97.92%（47/48）和100.00%（34/34）。结论 甲状腺乳头状癌在超声上多表现为血流信号异常、钙化、后方回声衰减、晕环征等特征,超声弹性成像评分多为3~4分,超声弹性成像联合高频超声在其诊断中具有较高的应用价值。

Objective To explore the application value of ultrasound elastography combined with high-frequency ultrasound in the diagnosis of papillary thyroid cancer（PTC）．Methods From January 2022 to June 2023,82 patients with suspected PTC were treated at Chinese People’s Liberation Army Joint Logistics Force 990 Hospital．All patients were given ultrasound elastography combined with high-frequency ultrasound examination to record ultrasound features．All cases were given pathological examination,and the pathological examination were used as the gold standard for diagnosis．Results Among the 82 patients,48 were PTC（cancerous group）,accounting for 58.54%;and the other 34 were benign thyroid nodules（benign group）,accounting for 41.46%．The proportion of morphological abnormalities,posterior echo attenuation,calcification,halo ring signs,unclear boundary and internal hypoechoics in cancerous group were 81.25%,83.33%,83.33%,83.33%,81.25% and 81.25%,which were significantly higher than 52.94%,47.06%,47.06%,41.18%,47.06% and 52.94% in the benign group（P<0.05）．The highest systolic flow velocity in the cancerous group was significantly less than that in the benign group（P<0.05）,and the resistance index and pulse index were also significantly higher compared with the benign group（P<0.05）．The elastography score were mostly 3~4 in the cancerous group and 2 in the benign group,with a significant difference between the two groups（P<0.05）．Forty-seven cases of PTC were diagnosed by ultrasound elastography combined with high frequency ultrasonography,and the sensitivity and specificity in diagnosis were 97.92%（47/48）and 100.00%（34/34）,respectively．Conclusions PTC is often characterized by abnormal blood flow signals,calcification,posterior echo attenuation,halo sign and so on．The ultrasound elastography score is usually 3~4 points．Ultrasonic elastography combined with high frequency ultrasound has high value in diagnosis of PTC．

目的 应用高频超声观察眼轮匝肌的解剖信息和动态特征,探究肉毒毒素注射前超声评估的可行性,为个体化、精准化的治疗提供可能,以实现更加安全、更加高效的治疗效果。方法 采用高频超声获取40名20~30岁健康志愿者的双侧80条眼轮匝肌的长轴、短轴切面声像图,观察其全程形态、内部回声,并测量外眦水平眼轮匝肌最外侧缘与外眦之间的距离、外眦水平眼轮匝肌最厚处的前后径、外眦水平眼轮匝肌最厚处与表皮之间的距离,并对数据进行统计学分析。结果 高频超声可以清晰地显示眼轮匝肌全程的走形和整体肌束结构。微笑时可见外眦外侧的眼轮匝肌向内收缩,并出现不同程度的增厚。男性和女性外眦水平眼轮匝肌最外侧缘与外眦之间的距离分别为左侧（27.50±2.58）（25.32±2.17）mm,右侧（27.35±2.15）（25.11±2.08）mm;外眦水平眼轮匝肌最厚处的前后径分别为左侧（1.055±0.209）（0.770±0.172）mm,右侧（1.010±0.171）（0.775±0.162）mm;外眦水平眼轮匝肌最厚处与表皮之间的距离分别为左侧（2.450±0.274）（2.860±0.375）mm,右侧（2.430±0.252）（2.825±0.424）mm。上述3种指标在左右侧对比差异无统计学意义（P>0.05）。与男性对比,女性外眦水平皮下组织较厚、眼轮匝肌较薄,其最外侧缘与外眦之间的距离较短（P<0.05）。结论 高频超声为观察青年人群眼轮匝肌结构的有效影像学工具,可用于肉毒毒素注射前的面部评估。

Objective To observe the anatomical information and dynamic characteristics of the orbicularis oculi muscle by high-frequency ultrasound,to explor the feasibility of ultrasound evaluation before botulinum toxin injection,and to provide the possibility for personalized and precise treatment to achieve safer and more efficient therapeutic effects．Methods High frequency ultrasound was used to obtain long axis and short axis sectional ultrasound images of 80 bilateral orbicularis oculi muscles from 40 healthy volunteers aged 20-30．The overall morphology and internal echoes were observed,and the distance between the outermost edge of the orbicularis oculi muscle and the outer canthus,the anterior posterior diameter of the thickest part of the orbicularis oculi muscle at the outer canthus level,and the distance between the thickest part of the orbicularis oculi muscle and the epidermis at the outer canthus level were measured．Statistical analysis was performed on the data．Results High frequency ultrasound can clearly display the entire course of the orbicularis oculi muscle and the overall muscle bundle structure．When smiling,the orbicularis oculi muscle on the outer side of the outer canthus can be seen to contract inward and show varying degrees of thickening．The distance between the outermost edge of the orbicularis oculi muscle and the outer canthus of males and females were（27.50±2.58）（25.32±2.17）mm on the left side and（27.35±2.15）（25.11±2.08）mm on the right side,respectively．The anterior posterior diameters of the thickest part of the orbicularis oculi muscle at the level of the outer canthus were left（1.055±0.209）（0.770±0.172）mm and right（1.010±0.171）（0.775±0.162）mm,respectively．The distance between the thickest part of the orbicularis oculi muscle at the level of the outer canthus and the epidermis were（2.450±0.274）（2.860±0.375）mm on the left side and（2.430±0.252）（2.825±0.424）mm on the right side．There was no statistically significant difference in the comparison of the above three indicators on the left and right sides（P>0.05）,while there was a statistically significant difference in the mean values of both males and females（P<0.05）．Compared with males aged 20-30,females had thicker subcutaneous tissue at the level of the outer canthus and thinner orbicularis oculi muscle,with a shorter distance between the outermost edge and the outer canthus． Conclusions High frequency ultrasound is an effective imaging tool for observing the structure of the orbicularis oculi muscle in young population,and can be used for facial assessment before botulinum toxin injection．

目的 探讨与分析高频超声联合超微血流成像对肱三头肌肌腱断裂伴骨化性肌炎的诊断价值。方法 选择2020年7月—2022年5月在本院诊治的84例肱三头肌肌腱断裂患者作为研究对象,所有患者均行关节镜及超声检查,超声检查包括高频超声、超微血流成像,记录超声特征并判断诊断价值,根据关节镜检查结果分为骨化性肌炎组和非骨化性肌炎组。结果 84例患者中,经关节镜检查判断为合并骨化性肌炎24例（骨化性肌炎组）,占比28.6%。骨化性肌炎组超声表现为肱三头肌肌腱纤维呈连续性中断,含稍强回声的非均质等回声,近侧断端肌腱有回缩并增厚。非骨化性肌炎组（60例）超声表现为肱三头肌肌腱纤维呈连续性中断,局限性边界清晰非均质性稍低回声,两断端中间呈不均质低回声。骨化性肌炎组的骨质破坏、软组织肿胀与关节积液等占比分别为75.0%、79.2%、79.2%,均高于非骨化性肌炎组的20.0%、25.0%、35.0%（P<0.05）。骨化性肌炎组的肌腱面积、肌腱厚度、血管条数均比非骨化性肌炎组更高（P<0.05）。84例患者中,高频超声、超微血流成像与两者联合诊断为肱三头肌肌腱断裂伴骨化性肌炎分别为18例、23例、24例,高频超声、超微血流成像与两者联合诊断肱三头肌肌腱断裂伴骨化性肌炎的灵敏度为70.8%（17/24）、91.7%（22/24）、100.0%（24/24）,特异度为98.3%（59/60）、98.3%（59/60）、100.0%（60/60）。结论 肱三头肌肌腱断裂伴骨化性肌炎比较常见,高频超声联合超微血流成像在肱三头肌肌腱断裂伴骨化性肌炎的应用可有效反映病灶形态特征与血流特征,在诊断上具有很高的灵敏度与特异度。

Objective To explore and analyze the diagnostic values of high-frequency ultrasound combined with superb microvascular imaging（SMI）in triceps brachii tendon rupture with ossifying myositis．Methods From July 2020 to May 2022,84 cases of patients with triceps brachii tendon rupture who were diagnosed and treated in our hospital were selected as research subjects．All patients underwent arthroscopy and ultrasonography,ultrasonography including high-frequency ultrasound and SMI,to record ultrasound characteristics and determine diagnostic value,and patients were divided into ossifying myositis group and non-ossifying myositis group according to the results of the arthroscopic examination．Results In 84 patients,there were 24 patients（28.6%）diagnosed as ossifying myositis by arthroscopy（ossifying myositis group）．The ultrasound findings of the ossifying myositis group were interruption of the triceps brachii muscle tendon fibers with slightly strong echogenicity and heterogeneous isoechogenicity．The proximal severed tendon had retraction and thickening．In the non-ossifying myositis group（n=60）,the ultrasound findings showed a interruption of the triceps brachii muscle tendon fibers,with clear localized boundaries and slightly heterogeneous hypoechogenicity,and there was an uneven hypoechogenicity between the two broken ends．The proportions of bone destruction,soft tissue swelling and joint effusion in the myositis group were 75.0%,79.2% and 79.2%,which were significantly increased compared to 20.0%,25.0% and 35.0% in the non-ossifying myositis group（P<0.05）．The tendon area,tendon thickness and vascular number in the ossifying myositis group were significantly higher than those in the non-ossifying myositis group（P<0.05）．In the 84 patients,there were 18 cases,23 cases and 24 cases diagnosed of triceps tendon rupture with ossifying myositis by high-frequency ultrasound,SMI and their combination．The sensitivity of high-frequency ultrasound,SMI and their combination in the diagnosis of triceps tendon rupture with ossifying myositis were 70.8%（17/24）,91.7%（22/24） and 100.0%（24/24）,with specificity of 98.3%（59/60）,98.3%（59/60） and 100.0%（60/60）．Conclusions Triceps brachii tendon rupture with ossifying myositis is relatively common．The application of high-frequency ultrasound combined with SMI in triceps brachii tendon rupture with ossifying myositis can effectively reflect the morphological and blood flow characteristics of the lesion,with high sensitivity and specificity in diagnosis．

目的 探讨健康成人颈段气管的体外高频超声影像特点,为开展体外超声在检测颈段气管病变应用作前期研究。方法 应用体外高频超声观察120例健康成人颈段气管结构的声像表现,并对气管环T1-T4的内外横径、气管环厚度、相邻气管环间距进行测量和统计学分析。结果 120例志愿者均获得了颈段气管前、侧壁声像图,以及气管环T1-T4内外横径、气管环厚度、相邻气管环间距测值。结论 体外高频超声可以清晰显示气管形态和细微支撑结构,并进行部分径线测量,有望成为评估颈段气管病变的一种有价值的辅助手段。

Objective We investigated features of the healthy adult cervical tracheas in order to studying cervical tracheal lesions by extracorporeal high-frequency ultrasound EHFUS. Methods EHFUS examination of the trachea was performed in 120 asymptomatic adult volunteers. We observed imaging features of the healthy adult cervical tracheas, and measured TRID, TRED, TRTh and TRAS to analysis. Results The cervical tracheal anterior and side wall ultrasonograms, and measurements were obtained in all subjects. Conclusion The cervical tracheal shape and the fine structure of support can be seen in EHFUS, and partly of diameter measurements were obtained. Thus EHFUS may be a valuable assistant method to assess cervical tracheal lesions of support structure.

目的 探讨急性阑尾炎(acute appendicitis, AA)及急性感染性肠炎(acute infectious enteritis, AIE)患儿的阑尾高频超声影像特点及其显像敏感性。方法 回顾性分析临床确诊为急性阑尾炎患儿120例,急性感染性肠炎患儿160例,并对其行高频超声检查,另设120例正常儿童为对照组。分析高频超声阑尾显示率,阑尾外径,阑尾周围系膜炎性变化以及阑尾的位置等情况。结果 AA组、AIE组、对照组阑尾的显示率分别为96.7%、80.6%、68.3%,差异有统计学意义(P<0.05)。三组超声显示的阑尾外径分别为(8.5±2.2)mm、(4.3±0.8)mm、(3.5±0.7)mm,相互间差异亦均有统计学意义(P<0.05)。AA组所有的阑尾周围系膜炎症改变均可探及,但AIE组的阑尾周围系膜无变化。结论 小儿急性阑尾炎高频超声显像敏感性高,旨在为临床对AA早期诊断、早期治疗提供较准确全面的影像学依据。

Objective Use high-frequency ultrasound to determine the frequency of visualization and image feature of the appendix in children with acute appendicitis (acute appendicitis, AA) and with acute infectious enteritis (acute infectious enteritis, AIE). Methods The ultrasonic features of 120 children with AA, 160 children with AIE, and 120 randomly selected asymptomatic children were analyzed retrospectively. And their visualization rate, outer appendiceal diameter, presence or absence of inflamed periphery appendiceal mesenterium, and location of the appendix were recorded. Results The visualization rates of the appendix were 96.7%, 80.6%, and 68.3% for AA groups, AIE groups, and the control, respectively(P<0.05). The outer appendiceal diameters for the 3 groups were (8.5±2.2)mm, (4.3±0.8)mm, and (3.5±0.7)mm. Difference among the 3 groups was statistically significant also. Periphery appendiceal inflamed mesenterium was detected in all AA cases, but in none of the AIE cases. Conclusion High ultrasound imaging sensitivity of puerile acute appendicitis provided relatively accurate comprehensive imaging basis for clinical early diagnosis and early treatment.