目的 比较锝[???Tc]甲氧基异丁基异腈单光子发射计算机断层扫描/计算机断层扫描（???Tc-MIBI SPECT/CT）双时相显像与颈部超声在继发性甲状旁腺功能亢进症（SHPT）患者术前定位中的诊断价值。方法 回顾性纳入2025年5月至2026年4月于黔东南苗族侗族自治州人民医院行两种影像学检查的疑似SHPT患者54例。以手术病理结果为金标准，计算超声与SPECT/CT在区域层面（共216个区域）的敏感性、特异性、准确性，并比较不同解剖区域的病灶检出率。结果 54例中确诊SHPT 45例（83.33%）。超声诊断敏感性、特异性、准确性分别为70.89%（112/158）、86.21%（50/58）、75.00%（162/216）；SPECT/CT分别为92.41%（146/158）、94.83%（55/58）、93.06%（201/216）。SPECT/CT的敏感性和准确性均高于超声（P均<0.001）。SPECT/CT在左上、左下、右上三个区域的检出率均高于超声（P<0.05）。结论 99mTc-MIBI SPECT/CT双时相显像在SHPT术前定位中的敏感性和准确性优于颈部超声，尤其对左上、左下、右上区域病灶检出优势明显，可作为SHPT患者术前定位的重要补充或首选影像学方法。

       目的   探讨孕中晚期口腔二维轴向切面超声在产前诊断胎儿唇腭裂中的应用价值，评估其对唇裂、唇腭裂及继发腭裂的检出率和准确性。方法   本研究为前瞻性研究，共纳入2020年3月—2023年12月在我院超声科行产前超声诊断的3 666例孕中晚期胎儿，其中经超声检查诊断出111例唇腭裂，这些病例归为唇腭裂组，其余3 555例归入正常对照组。所有受试者均通过口腔二维轴向切面超声进行评估，诊断结果经产后随访确认。结果   在正常对照组中，上唇及上牙槽突的评估成功率为100%，软硬腭分界线显示率为99%，软腭显示率为85%。在唇腭裂组中，超声对唇裂、唇腭裂及继发腭裂的检出率分别为45%、48%和7%，且超声诊断的灵敏度、特异度和预测值均超过98%。结论   孕中晚期口腔二维轴向切面超声在产前诊断胎儿唇腭裂中具有较高的准确性和可靠性，为早期干预和临床管理提供了重要的影像学依据。

       Objective  To explore the application value of two-dimensional axial section ultrasound in prenatal diagnosis of fetal cleft lip and palate in the second and third trimesters of pregnancy，and to evaluate its detection rate and accuracy for cleft lip，cleft lip and palate，and secondary cleft palate．Methods  This study is a prospective study that included 3 666 fetuses in the second and third trimesters of pregnancy．Among them，111 cases of cleft lip and palate were diagnosed by ultrasound examination．These cases were classified as the cleft lip and palate group，and the remaining 3 555 cases were classified as the normal control group．All subjects were evaluated by oral two-dimensional axial section ultrasound，and the diagnostic  results were confirmed by postpartum follow-up．Results  In the normal control group，the success rates of evaluating the upper lip and upper alveolar process were 100%．The present rate of the soft hard palate boundary was 99%，and the present rate of the soft palate was 85%．In the cleft lip and palate group，the detection rates of cleft lip，cleft lip and palate，and secondary cleft palate by ultrasound were 45%，48% and 7% respectively，and the sensitivity，specificity，and predictive value of ultrasound diagnosis exceeded 98%．Conclusions  Two dimensional axial section ultrasound of the oral cavity in second and third trimesters of pregnancy has high accuracy and reliability in prenatal diagnosis of fetal cleft lip and palate，providing strong imaging evidence for early intervention and clinical management．

目的 探讨超声评分法在体表高分化脂肪肉瘤(WDLPS)和良性脂肪瘤(LP)鉴别诊断中的价值,为两者的鉴别诊断和治疗方式选择提供依据。方法 回顾性分析经病理证实的 14 例(共15个肿块)体表WDLPS和 37 例(共40个肿块)LP临床资料及超声声像图特征,比较2组患者的发病年龄、性别、发病部位、肿块长径、短/长径比、肿块形态、边界、有无包膜、内部回声、回声分布、位置及血流分级等指标。筛选出有统计学差异指标,绘制ROC曲线,计算评分系统的诊断效能。结果 WDLPS和 LP患者在年龄、肿块长径、短/长径比值、有无包膜、位置以及血流分级6个指标有统计学差异(P＜0.05),对以上6个指标赋予0或1分建立病灶评分系统,总分0～6分。计算不同分值对WDLPS的诊断效能,以总分≥3分时诊断效能最高,灵敏度86.7%,特异度77.5%,正确率80%,阳性预测值59.1%,阴性预测值93.9%。结论 基于超声图像特征的评分方法在总分≥3分时,对术前鉴别WDLPS和LP具有较好的诊断效能,能够为临床治疗方案选择提供重要参考依据,值得推广应用。

Objective To evaluate the value of ultrasonography scoring system in differential diagnosis of well-differentiated liposarcomas (WDLPS) and benign lipoma (LP), and to provide evidence for the differential diagnosis and treatment choice. Methods Fourteen WDLPS cases (total of 15 masses) and 37 LP cases (total of 40 masses) were diagnosed by surgical histopathology, which clinical data and the ultrasound images were analyzed retrospectively. The parameters including age, gender, region, mass length, length/width ratio, shape, margin, envelope echoes, echogenicity, texture, location, blood flow were compared between the groups above. A scoring system was established by analyzing the parameters with statistical differences, and the ROC curve was plotted to calculate the best cut-off value and evaluate the diagnostic efficiency of the scoring system. Results There were statistically significant differences between two groups in the following six parameters: age, mass length, length/width ratio, envelope echoes, location, blood flow(P＜0.05). The scoring system was established by assigning 0 or 1 point to each factor, and the total score was 0～6 points. The highest diagnostic efficiency of WDLPS was observed at the cut-off value ≥ 3. The sensitivity, specificity, accuracy, the positive predictive value and the negative predictive value was 86.7%, 77.5%, 80%, 59.1%, 93.9% respectively. Conclusions The ultrasonography-based scoring system has a better diagnostic efficacy in differentiating WDLPS and LP, which can provide an important reference basis for the selection of clinical treatment, and is worthy of promotion and application.

目的 探究超声检查对于甲状腺囊性结节随访中的作用和临床价值,探讨其临床应用意义。方法 以2018年1月—2019年1月在本院就诊,经过临床金标准诊断为甲状腺囊实性结节的83名患者作为研究对象,采用历史性队列研究方法对患者进行为期18个月的随访观察,对患者在随访期内,使用超声检查所得知的甲状腺囊实性结节的大小、形态、边界、内部回声、钙化及血流信号等特征进行记录,并与患者初次就诊时的记录进行对比分析。结果 根据随访记录得知,83例患有甲状腺囊实性结节的患者当中,75例患者在随访后发现具有甲状腺恶性结节症,其余8例患者不具有甲状腺恶性结节特征。随访后83例患者的甲状腺囊实性结节均呈现好转,主要表现为:甲状腺囊实性结节出现不同程度的吸收;结节体积减小,个数无变化;结节吸收后在超声下显示在同一部位的结节表现为低或极低回声结节;囊性液体成分明显减少,部分原结节较小的患者,囊性成分出现消失。根据对随访前后患者甲状腺囊实性结节的平均体积对比有统计学差异(P<0.05),随访后的结节半径明显小于随访前。甲状腺囊实性结节体积有效缩小率为68%～88%。结论 通过对甲状腺囊实性结节定期进行超声复查可以实现对甲状腺结节的动态观察,有助于对患者的病情进行掌握,且由于甲状腺囊实性结节患者在后期结节吸收过程中常常出现恶性结节特征。通过使用超声检查对患者进行长期随访不仅可起到早期诊断甲状腺恶性肿瘤的意义,还可以避免,因过度诊断为甲状腺恶性结节,而使用细胞穿刺检查等有创检查对患者造成的不便。

目的 探讨健康儿童的个体因素对超声测量下腔静脉内径的影响。方法 使用超声测量210例健康儿童的下腔静脉呼气末内径及腹主动脉内径,并记录他们的个体特征,包括性别、年龄、身高、体质量、腰围、体表面积等,进行相关与回归分析。结果 年龄、身高、体质量、腰围、体表面积与下腔静脉和腹主动脉内径呈正相关。年龄是女性儿童下腔静脉内径唯一的独立影响因素,身高是男性儿童下腔静脉内径唯一的独立影响因素。无论男性或女性,年龄是儿童腹主动脉内径的独立影响因素,而下腔静脉和腹主动脉内径的比值不受这些个体因素的影响。结论 下腔静脉和腹主动脉内径易受个体因素影响,而它们的比值不易受个体因素影响,可以更好的用于预测儿童的容量特征。

Objective To explore the impact of individual characteristics on inferior vena cava diameter ( IVC ) in healthy children. Methods IVC_max and abdominal aorta (AO) diameters were measured by ultrasound in 210 healthy children. The individual characteristics including gender, age,height,weight, waist circumference of each child were recorded. Then the surface area(BSA) and IVC_max/AO were calculated to discuss the relationship between them with multivariate analysis. Results Age, height, weight,waist circumference, and BSA were positively correlated with IVC_max and AO. Multivariate linear regression showed that age was the only independent variable for IVC_max in female children, height was the only independent variable for IVC_max in male children, and age was the only independent variable for AO in both females and males. IVC_max/AO was not significantly influenced by the subjects' characteristics. Conclusion IVC_max and AO were more susceptible to subjects' characteristics than IVC_max/AO. IVC_max/AO could be a reliable and practical parameter in children as it was independent of age, height, and weight.

目的 探讨急性脑卒中患者颈动脉粥样硬化斑块的超声形态学表现以及探讨不同超声形态学表现的诊断价值。方法 对所有入选受检者进行多层螺旋CT或磁共振(MRI)检查、常规颈动脉超声检查、彩色多普勒血流显像(CDFI)、超声造影技术(CEUS)的影像学资料进行回顾性分析;所入选病例组患者在发病2天内完成上述影像学检查,对照组受检者也在2天内完成上述影像学检查。结果 常规超声发现病例组颈动脉斑块45处、对照组11处;CDFI发现病例组颈动脉斑块远端血流频谱改变35例、对照组11例;超声造影发现颈动脉斑粥样硬化斑块处毛细血管现象病例组15例、对照组2例。斑块表面形态以及内部回声分布情况两项结果与对照组比较差异有统计学意义。结论 脑卒中患者与无症状颈动脉硬化受检者的斑块超声声像图中,斑块表面形态以及内部回声分布两项指标具有明显的鉴别诊断意义。提示表面不光整、内部回声分布不均匀的斑块导致急性脑卒中的可能性较大。

目的 研究超声内镜(EUS)对结直肠癌(CRC)术前分期和指导手术方案的应用价值。方法 选取我院2014年11月—2015年11月结直肠外科收治的52例CRC患者,均接受根治性切除术治疗并经术中病理观察确诊,并以手术病理TNM分期结果作为金标准。术前对入选患者行超声内镜检查,参考金标准回顾性分析超声内镜的TNM分期诊断效果。结果 该52例CRC患者EUS诊断结果显示肿瘤侵犯浸润T分期(T1～T4)准确率分别为87.50%、80.00%、94.12%、83.33%,较手术病理金标准无差异(P>0.05);EUS诊断淋巴结转移N分期(N0～N2)准确率分别为76.92%、79.17%、86.67%,其中N0、N2准确率较金标准无差异(P>0.05),但N1分期准确率较金标准偏低(P<0.05)。结论 虽然ENS对淋巴结转移程度尤其是N1的诊断准确度存在一定误差,但从整体来看EUS能较好的观察CRC患者肿瘤侵犯浸润深度和判断淋巴结转移情况,术前结合EUS诊断结果有利于患者术前病理分期,并为选择合适的手术方案提供参考依据。

Objective To study the application value of endoscopic ultrasonography (EUS) in preoperative staging of colorectal cancer (CRC) and guidance of surgical procedures. Methods 52 cases of patients with CRC who were admitted in the department of colorectal surgery of our hospital from November 2014 and November 2015 were selected. All of them underwent radical resection and were confirmed by surgical and pathological observation. Surgical and pathological TNM staging results were taken as golden standard. Before surgery, endoscopic ultrasonography was performed in the selected patients. Referring to the gold standard, TNM staging diagnostic effects of endoscopic ultrasonography were retrospectively analyzed. Results The EUS diagnostic results of 52 patients with CRC showed that the accuracy rates of tumor invasion T stage (T1-T4) were 87.50%, 80.00%, 94.12% and 83.33% respectively. There was no significant difference, compared with surgical and pathological golden standard (P>0.05); The accuracy rates of EUS in diagnosis of lymph node metastasis N stage (N0-N2) were 76.92%, 79.17% and 86.67%, respectively. There was no significant difference in accuracy rate in N0 and N2, compared with the gold standard (P>0.05), but the accuracy in N1 stage was lower than that of gold standard (P<0.05). Conclusion Although ENS has some errors in the diagnosis of degree of lymph node metastasis, especially N1, on the whole, EUS can be better to observe the depth of tumor invasion and lymph node metastasis in patients with CRC. The diagnosis combining with EUS before surgery is helpful to the preoperative pathological staging, and provide reference for the selection of appropriate surgical procedures.

目的 探讨二维超声联合三维超声检测不同孕期胎儿肢体畸形的临床价值。方法 回顾性分析我科2013年1月—2015年1月超声筛查的1352名孕15~34周的孕妇,运用二维及三维超声,采用连续顺序追踪超声法检测胎儿四肢,将产前诊断结果与引产或引产结果对照。结果 1352名孕妇胎儿畸形46例(3.40%,46/1352),总涉及肢体73处(近端肢体畸形65处,远端肢体畸形8处),其中四肢短小9例(骨发育不全2例,单纯四肢短小畸形5例,成骨发育不全2例),漏诊2例;足畸形16例34处,漏诊1例,残肢畸形15例;手畸形6例,漏诊1例。结论 孕中期二维连续顺序追踪超声法联合三维超声胎儿肢体畸形检出率高,对及早发现胎儿肢体畸形有一定的诊断价值。