目的 探讨个体化低速率对比剂注射方案联合低管电压扫描在低体质量指数(body mass index,BMI)受检者头颈部CT血管成像的可行性。方法 选取我科2020年1月—2020年11月低BMI受检者头颈部CTA检查90例进行研究,随机分成三组,每组30例。A组80 kV扫描,低流速、低总量注射方案; B组120 kV扫描,高流速、低总量注射方案;C组为120kV扫描条件,高流速、高总量注射方案。对比各组注射流速、注射总量、辐射剂量长度乘积(dose legth product,DLP),评价各组图像的主动脉弓、颈总动脉、基底动脉、胸锁乳突肌中段的CT值、信噪比及对比信噪比,由两名有经验的放射科医生对各组图像质量进行主观评价。结果 图像质量主观评价A、B两组图像评分集中在4分段,C组图像评分集中在3分段,A、B组与C组主观评分比较差异有统计学意义(P<0.05)。A组对比剂注射流速和DLP比B、C组分别下降27.75%、47.10%;A、B组对比剂注射总量较C组下降39.87%,差异有统计学意义(P<0.05)。A组各血管CT值对应比B、C组数值稍高,除主动脉弓CT值外其余血管客观参数对比均有差异(P<0.05)。结论 低BMI受检者头颈部CT血管个体化低流速精准对比剂注射方案联合低管电压扫描技术在获得满足诊断要求图像质量的前提下,既能降低受检者对比剂注射速率和注射风险,又能降低辐射剂量,值得推广应用。

Objective To explore the feasibility of individualized low rate contrast agent injection scheme combined with low tube voltage scanning in CTA imaging of low body mass index(BMI) subjects' head and neck. Methods Ninety cases of head and neck CTA examination of low BMI subjects in our department from January 2020 to November 2020 were selected for the study, and randomly divided into three groups with 30 cases in each group. Group A applied 80 kV scanning, low flow rate and low total volume injection scheme. Group B applied 120 kV scanning, high flow rate, low total volume injection scheme. Group C applied 120 kV scanning, high flow rate and high total volume injection scheme. The injection velocity, injection volume, radiation dose length product (DLP) among three groups were compared. In each image of the aortic arch, common carotid artery, basilar artery and the central part of sternocleidomastoid, the CT value, the signal-to-noise ratio and contrast-to-noise ratio were evaluated. Two experienced radiologists performed image quality evaluation. Results Image quality in group A and B by subjective evaluation got 4 points out of 4, and group C got 3 points out of 4, and there was statistical difference between group A, B and C in subjective evaluation of image quality (P<0.05). The injection velocity and DLP of contrast agent in group A were 27.75% and 47.10% lower than those in group B and C, respectively. The total amount of contrast agent injection in groups A and B was decreased by 39.87% compared with group C, with statistical difference (P<0.05). The corresponding CT values of each vessel in group A were slightly higher than those in group B and C, and there were statistically significant differences in the Objective parameters of other vessels except for aortic arch (P<0.05). Conclusion The combination of individualized low flow rate and precise contrast agent injection scheme with low tube voltage scanning technology for low BMI subject could not only reduce the injection rate and risk of contrast agent, but also reduce radiation dose, on the premise of meeting the diagnostic requirements of image quality. It is worthy of popularization and application.

目的 应用斑点追踪显像定量评价阻塞性睡眠呼吸暂停综合征患者的左心房功能,并进行对比研究。方法 OSAS患者60例,根据睡眠呼吸暂停低通气指数(AHI)分为3组,轻度组,中度组,重度组,每组20人;另选择20名健康正常人作为正常对照组。采用二维斑点追踪成像技术测量各组左心房相关应变参数:收缩期应变(Ss),舒张早期应变(Se),舒张晚期应变(Sa),左心房收缩期应变率(SRs),左心房舒张早期应变率(SRe),左心房舒张晚期应变率(SRa),分析并比较各组间参数的差异性。结果 随着疾病严重程度的增加Ss、SRs、Se、SRe呈逐渐减低的趋势,而Sa、SRa先升高后减低,差异有统计学意义(P<0.05)。结论 应用斑点追踪成像技术可在OSAS患者发生左心房重构前检测出心房功能的变化。

Objective The left atrial function of patients with obstructive sleep apnea syndrome was quantitatively evaluated by speckle tracing imaging and compared. Methods Sixty patients with OSAS were divided into three groups according to the sleep apnea hypopnea index(AHI),including the mild group, the moderate group and the severe group, with 20 patients in each group. Another 20 healthy people were selected as the normal control group. Left atrial correlation strain parameters:systolic strain(Ss), early diastolic strain(Se), late diastolic strain(Sa), left atrial systolic strain rate(SRs), early diastolic strain rate(SRe), left atrium left atrium late diastolic strain rate(SRa) were measured by two dimensional speckle tracking imaging technology, and the differences of parameters between groups were compared. Results With the increase of disease severity, Ss, SRs, Se and SRe showed a trend of gradual decrease, while Sa and SRa increased first and then decreased, and the difference was statistically significant(P<0.05). Conclusion Changes in atrial function may be detected in OSAS patients prior to left atrial remodeling using speckle tracking imaging.

目的 基于防控要求,快速建立临时隔离病区,合理优化影像学检查,更好的加强病区的管理工作,控制新型肺炎、防止交叉感染。方法 基于我院现有条件、人员、检查设备,结合抗击SARS经验,合理调整病区布局,建立有效的就诊,分诊,转运机制,明确工作职责,优化检查流程,放射检查防控等。结果 自新型肺炎临时病区建立以来,无1例医护人员感染和院内交叉感染。结论 思想重视,认真落实分诊,就诊;转运措施得当,科学防控,一站式,一体化,快速有效的检查方式,快速建立临时隔离病区,防止交叉感染的发生。在防控COVID-19新型肺炎中可以发挥巨大作用。

Objective Based on prevention and control requirements, to establish temporary isolation of ward quickly, rationally optimize medical imaging examinations and strengthen the management of ward to control the novel pneumonia, and prevent cross infection. Methods Based on the existing materials conditions, personnels, and examination equipments of our hospital, combined with the experiences of fighting against SARS, we rationally adjust the layout of the ward, establish an effective consultation, triage, and transfer mechanism, clarify job responsibilities, optimize examination procedures, and take strict prevention and control measures of medical imaging examinations. Results Since the establishment of the COVID-19 temporary ward, there was no cases of medical staff infection and nosocomial infection. Conclusion Highly valued opinion, conscientiously implements triage-visit-transportation measures, scientific prevention and control, one-stop-integrated fast and effective examination procedures and quickly establishement of a temporary isolation ward have played a huge role in preventing and controlling COVID-19.

目的 探讨经阴道三维容积超声成像在诊断子宫肌瘤FIGO分类的临床应用价值。方法 对本院收治的手术病理结果证实的219例子宫肌瘤,回顾临床资料分组,99例以经阴道三维容积超声成像作为观察组,120例以经阴道二维彩超检查作为对照组。评估经阴道三维容积超声成像在诊断子宫肌瘤FIGO分类的诊断符合率。结果 两组子宫肌瘤FIGO分类诊断符合率分别为:观察组97.93%,对照组78.33%;经阴道三维容积超声成像检查诊断符合率显著高于二维彩超,差异有统计学意义。结论 经阴道三维容积超声成像较二维彩超能获得更为丰富的诊断信息,诊断子宫肌瘤FIGO分类较二维彩超优势显著,有利于提高诊断准确率,为指导临床个性化治疗提供可靠的理论依据,值得临床推广应用。

Objective To investigate the clinical value of transvaginal three-dimensional volumetric ultrasound imaging in the diagnosis of the FIGO classification of hysteromyoma. Methods To retrospectively analysis data of 219 cases hysteromyoma confirmed by the surgical pathological findings in this hospital. 99 cases treated with transvaginal 3D ultrasound were as the observation group, and 120 cases treated with vaginal 2D ultrasound as the control group. To evaluate the diagnostic coincidence rate of transvaginal three-dimensional volumetric ultrasound imaging in the diagnosis of FIGO classification of hysteromyoma. Results The coincidence rates of FIGO classification of hysteromyoma in the two groups were 97.93% in the observation group and 78.33% in the control group; the diagnostic coincidence rate of transvaginal three-dimensional volumetric ultrasound imaging was higher than that of two-dimensional color Doppler ultrasound, and the difference was statistically significant. Conclusion Transvaginal three-dimensional volumetric ultrasound imaging can obtain richer diagnostic information than two-dimensional color Doppler ultrasound. In the FIGO classification of hysteromyoma, it has significant advantages than two-dimensional color Doppler ultrasound, which is conducive to improving the diagnostic accuracy and providing a reliable theory for guiding clinical personalized treatment. The basis is worthy of clinical promotion and application.

目的 探讨产前超声联合磁共振诊断胎儿部分性胼胝体发育不全的价值。方法 收集产前超声联合磁共振诊断为部分性胼胝体发育不全的胎儿15例,对比出生或引产后的检查结果,分析产前超声特征。结果 产前超声直接征象:胼胝体正中矢状切面相应部位缺失12例(12/15,80.0%)。间接征象:透明隔腔形态异常(80.0%)、侧脑室扩张(73.3%)、大脑纵裂池分离(73.3%)、脑中线丘脑后方囊性包块(26.7%)、侧脑室“泪滴状改变”(26.7%)、胼周动脉走行异常(26.7%),合并颅内或其他系统畸形6例。对比出生或引产后随访结果,诊断准确率:产前超声80.0%,产前磁共振93.3%。结论 超声可以诊断胎儿部分性胼胝体发育不全,更精确的诊断建议结合产前胎儿头颅磁共振检查。

Objective To explore the value of prenatal ultrasound in diagnosis of fetal partial agenesis of corpus callosum. Methods 15 fetuses diagnosed as partial agenesis of corpus callosum by prenatal ultrasound combined with magnetic resonance imaging (MRI) were collected. Results of examination after birth or induction of labor were compared to analyze the characteristics of prenatal ultrasound. Results Direct signs were observed in the prenatal sonographic features: 12 cases (12/15, 80.0%) were missing corresponding parts in the midsagittal section of corpus callosum. Indirect signs: transparent partition morphological abnormalities (80.0%), lateral ventricle expansion (73.3%), separation of longitudinal crack on the brain pool(73.3%), posterior thalamic midline cystic mass (26.7%), “teardrop change” of the lateral ventricle (26.7%), abnormal course of pericallosal artery (26.7%), with intracranial and other system deformity in 6 cases, including multiple anomalies. Compared with the follow-up results after birth or induction of labor, the diagnostic accuracy was 80.0% of prenatal ultrasound and 93.3% of prenatal MRI. Conclusion Ultrasonography may diagnose fetal partial agenesis of corpus callosum properly, and more accurate diagnosis could be finished combining with prenatal fetal cranial MRI.

目的 分析2019新型冠状病毒(COVID-19)肺炎的肺部影像表现,提高对该病的影像学诊断认识。方法 回顾性分析2020年1月20日—2020年2月20日在我院就诊并最终经临床确诊的COVID-19肺炎患者的影像学及临床资料,所有患者均在入院后三天内行胸部X线检查或高分辨率CT平扫,分别记录每位患者两种影像检查方式的影像学表现,包括病灶累及的肺叶、磨玻璃影(GGO)、实变影、铺路石征、纤维索条及小叶间隔增厚等征象。结果 共22例确诊为COVID-19肺炎,其中男:女为1:1,年龄范围20~82岁;平均年龄为(52.9±16.2)岁。21例行胸部X线检查,其中有3例患者同时行肺部CT平扫检查;1例患者仅行胸部CT平扫检查。21例X线检查中16例(76%)胸片表现为斑片状、絮状致密影,余5例(24%)检查双肺未见异常征象。4例CT扫描患者中均可以见到病灶(100%),其中有3例(75%)累及5个肺叶,1例(25%)仅累及1个肺叶;均表现为胸膜下磨玻璃影、斑片状实变影、铺路石征、小叶间隔增厚、小血管增粗及支气管气象;其中1例(25%)出现淋巴结肿大;2例(50%)出现纤维索条影。结论 影像学检查对COVID-19的诊断和病情评估具有重要价值,其中X线检查对于部分病灶显示欠佳, 胸部CT平扫对于病变的检查较为准确,可作为COVID-19首选的影像学检查方法,为临床上早期诊断及治疗提供依据。

Objective To analyzed the pulmonary imaging manifestations of 2019 novel coronavirus (COVID-19) pneumonia, in order to improve the imaging diagnosis of the disease. Methods Retrospective analysis of the imaging and clinical data of 22 patients infected with the 2019 Novel Coronavirus (COVID-19) were reviewed, which all the patients took the X-ray or CT scan, and to record the images in the two types of inspection for each patient, including the involvement of the consolidation of the lung, ground-glass opacification, consolidation, paving stone chippings, fiber cable and interlobular septal thickening and so on. Results A total of 22 patients were diagnosed with COVID-19, and the ratio of male to female was 1:1, age range is 20~82, mean age is (52.9±16.2.21) patients received chest X-ray examination, including 3 patients received the non-contrast CT examination at the same time; 1 patient received chest CT plain examination only. 16 (76%) among the 21 patients with X-ray showed patchy and flocculent dense shadows, while the remaining 5 patients (24%) showed no abnormal signs in both lungs. 4 patients with CT scan can find the lesions. Among the 4 patients with detect CT scan, 3 patients (75%) involved 5 pulmonary lobes, and 1 patient (25%) only involved 1 pulmonary lobe. All of them showed subpleural ground-glass opacification, consolidation, paving stone chippings, fiber cable and interlobular septal thickening, including lymph node enlargement occurred in 1 case (25%), fiber strip shadows were observed in 2 cases (50%). Conclusion The imaging examination is of great value for the diagnosis and disease evaluation of COVID-19, among which X-ray examination is not good for some lesions, and CT plain scan is relatively accurate for the examination of lesions, which can be used as the preferred imaging method of COVID-19, providing further theoretical basis for early clinical diagnosis and treatment.

目的 分析毕节地区新型冠状病毒(2019-nCoV)肺炎(novel coronavirus pneumonia,NCP)胸部CT影像学表现,探讨对NCP的临床诊断的价值。方法 回顾性分析毕节市第三人民医院2020年1月14日至2月18日收治的13例NCP患者的流行病学特征及胸部CT影像学特征。结果 13例患者中2例为长期居住在武汉来毕;1例由从上海到湖北宜昌逗留3天返毕;1例直接与武汉当地人接触;3例为与确诊病人的密切接触者;5例是聚集性发病,均与从浙江省台州市返毕确诊病人密切接触;1例无流行病学史。胸部CT影像学以双肺或一侧肺散在斑片状、磨玻璃状高密度影,密度不均,边界不清,肺野外带显著为特征。重型患者短期内肺部CT影像学变化明显。结论 确诊NCP普通型患者胸部CT影像学大多以典型表现为特征;重型NCP患者短时间内可出现实变及肺纤维化。

Objective To analyze the novel coronavirus (2019-nCoV) novel coronavirus pneumonia (NCP) chest CT imaging findings in Bijie area, and to explore the clinical diagnostic value of NCP. Methods The epidemiological characteristics and chest CT features of 13 NCP patients admitted to The Third People's Hospital of Bijie from January 14 to February 18, 2020 were analyzed retrospectively. Results Among the 13 patients, 2 lived in Wuhan for a long time, 1 stayed for 3 days from Shanghai to Yichang, Hubei, and returned home; 1 directly contacted with the local people in Wuhan; 3 closely contacted with the confirmed patients; 5 were clustered diseases, all closely contacted with the confirmed patients returning from Taizhou, Zhejiang province; 1 had no epidemiological history. CT imaging of the chest is characterized by patchy, ground glass high-density shadows scattered in two or one side of the lung, with uneven density, unclear boundary and significant lung field zone. Conclusion Most of the chest CT images of the patients with NCP were characterized by typical manifestations, while consolidation and pulmonary fibrosis were found in the patients with severe NCP in a short period of time.

目的 应用三维斑点追踪成像(3D-STI)技术评价睡眠呼吸暂停综合征患者左、右心室整体收缩功能。方法 OSAS患者60例,根据睡眠呼吸暂停低通气指数(AHI)分为3组,轻度组,中度组,重度组,每组20人;另选择20名健康正常人作为正常对照组。用三维斑点追踪成像技术测量各组左心室整体纵向应变(LVGLS)、圆周应变(LVGCS)、径向应变(LVGRS)、面积应变(LVGAS)以及右心室整体纵向应变(RVGLS)、圆周应变(RVGCS)、径向应变(RVGRS),并比较各组间参数的差异。结果 与轻度OSAS组比较,中、重度OSAS组LVGLS、LVGAS降低,差异有统计学意义(P<0.05);与中度OSAS组相比较,重度组LVGLS、LVGCS、LVGRS以及LVGAS均降低,差异有统计学意义(P<0.05);右心室部分应变参数变化早于左心室。结论 应用3D-STI技术能够在患者左心室射血分数(LVEF)发生改变之前发现早期左、右心室功能收缩障碍,为临床早期诊断及干预提供可靠的依据。

Objective To evaluate left and right ventricular systolic function of patients with obstructive sleep apnea syndrome (OSAS) by using three-dimensional speckle tracking imaging(3D-STI). Methods Sixty patients with OSAS were divided into three groups according to the sleep apnea hypopnea index (AHI), the mild group, the moderate group and the severe group, with 20 patients in each group. Another 20 healthy people were selected as the normal control group. The left ventricle global longitudinal strain (LVGLS), left ventricle global circumferential strain (LVGCS), left ventricle global radial strain (LVGRS), left ventricle global area strain (LVGAS) and right ventricle global longitudinal strain (RVGLS), right ventricle global circumferential strain (RVGCS) and right ventricle global radial strain (RVGRS) were measured by three-dimensional speckle tracking imaging technology, and the differences of parameters between groups were compared. Results Compared with mild OSAS group, LVGLS and LVGAS were decreased in moderate and severe OSAS groups, and the difference was statistically significant (P<0.05). Compared with the moderate OSAS group, LVGLS, LVGCS, LVGRS and LVGAS in the severe group all decreased, and the difference was statistically significant (P<0.05). Some of right ventricle strain parameters were earlier than that of left ventricle. Conclusion The application of 3D-STI technology can detect early left and right ventricular dysfunction before left ventricular ejection fraction(LVEF)changes, provide a reliable basis for early clinical diagnosis and intervention.

目的 分析应用蓝激光成像技术(BLI)联合内镜智能分光比色技术(FICE)诊断早期食管癌的临床意义。方法 收集本院及下级医院2016年1月—2018年6月在普通内镜下发现的108例食管可疑病变患者,分别给予白光、FICE和BLI不同模式进行观察诊断,再结合放大模式对病变部位的上皮乳头内毛细血管袢(IPCL)进行观察、分型、判断性质。最后取活检送病理学检查。内镜数据和病理数据采用Kappa一致性检验方法、Spearman相关性分析,统计每种内镜检查模式诊断的准确性,分析各方法下IPCL分型与病理诊断之间的相关性。结果 Kappa一致性检验显示,白光内镜、FICE、BLI以及FICE+BLI等模式诊断早期食管癌的准确度、敏感度、特异度、阳性预测、阴性预测及Kappa值呈逐步升高;Spearman相关性分析显示,FICE、BLI以及BLI与FICE联合诊断时,IPCL分型与早期食管癌的诊断均呈正相关,且BLI联合FICE的相关性强于BLI或FICE单独诊断。结论 BLI联合FICE可显著提高早期食管癌的诊断率,结合放大内镜下IPCL分型可判断早期食管癌病理分型。

Objective To analyze the clinical significance of blue laser imaging (BLI)technology combined with Fuji intelligent chromo endoscopy (FICE)in the diagnosis of early esophageal cancer. Methods 108 cases of patients with esophageal suspicious lesions admitted to our hospital from January 2016 to June 2018 were enrolled in the study. They were given different modes of white light, FICE and BLI for observation and diagnosis, and the magnifying endoscopy model was combined to observe the intraepithelial papillary capillary loop (IPCL)at lesions sites for IPCL typing. After complete endoscopic examinations, the lesions were taken for pathological examination. The accuracy, sensitivity, specificity, positive predictive value, negative predictive value and Kappa value of each method were tested by Kappa consistency test. Spearman correlation analysis was used to analyze the correlation between IPCL classification and pathological diagnosis under each method. Results Kappa consistency test showed that the accuracy, sensitivity, specificity, positive predictive value, negative predictive value and Kappa value of white light endoscopy, FICE, BLI and FICE+BLI were increased in the diagnosis of early esophageal cancer. IPCL classification under combined magnifying endoscopy showed that type IV was mainly early esophageal cancer, and types I-III were mainly precancerous lesions. Spearman correlation analysis showed that through FICE, BLI and BLI combined with FICE for diagnosis, IPCL classification was positively correlated with early esophageal cancer, and the correlation of BLI combined with FICE was stronger than that of BLI or FICE. Conclusions BLI combined with FICE can greatly improve the diagnosis rate of early esophageal cancer. Combined with magnifying endoscopy, IPCL classification can judge the pathological types of early esophageal cancer.

目的 探讨二维斑点追踪成像技术（Two-dimensional speckle tracking imaging,2D-STI）检测心肌肥厚患者左心室短轴收缩功能变化的效果。方法 选择2016年1月—2018年6月我院接诊的心肌肥厚100例为观察组,选取同期在我院行健康体检的健康者100例,均接受2D-STI检查,比较两组左心室短轴收缩期圆周应变与最大径向应变参数。结果 观察组前侧壁、前壁、下壁、后侧壁、前间隔、后间隔左心室短轴收缩期最大圆周应变均低于对照组,差异有统计学意义（P<0.05）;观察组前侧壁、前壁、下壁、后侧壁、前间隔、后间隔左心室短轴收缩期最大径向应变均低于对照组,差异有统计学意义（P<0.05）。结论 2D-STI可测量心机肥厚患者左心室短轴收缩功能,准确评价其心室局部运动,值得临床推广。

Objective To investigate the effect of two-dimensional speckle tracking imaging （2D-STI） on the changes of left ventricular short-axis systolic function in patients with cardiac hypertrophy. Methods 100 cases of cardiac hypertrophy received from our hospital from January 2016 to June 2018 were selected as observation group. 100 healthy subjects who underwent physical examination in our hospital during the same period were examined by 2D-STI. The left ventricle was compared between the two groups. Short-axis systolic circumferential strain and maximum radial strain parameters were compared . Results The maximum circumferential strain of the anterior wall of the anterior wall, anterior wall, inferior wall, posterior wall, anterior septum and posterior septum of the left ventricle was lower than that of the control group, and the difference was statistically significant （P<0.05）. The maximum radial strain of the anterior wall, anterior wall, inferior wall, posterior wall, anterior septum and posterior septal left ventricle was lower than the control group, and the difference was statistically significant （P<0.05）. Conclusion 2D-STI can measure the left ventricular short-axis systolic function in patients with cardiac hypertrophy and accurately evaluate the local ventricular motion, which is worthy of clinical promotion.