二维高频结合彩色多谱勒超声诊断乳腺肿块180例分析

目的通过观察乳腺肿块的声像图特征,探讨二维高频结合彩色多谱勒超声对乳腺肿块鉴别诊断的价值。方法本文对180例经手术及病理证实的乳腺肿块的二维声像图特征及彩色多谱勒血流显像特点与病理学诊断进行回顾性对照分析。结果 180例乳腺肿块,良性肿块121例,占67.2%;乳腺癌52例,占28.9%;诊断符合率96.1%。误诊7例,误诊率3.9%,其中1例浆细胞性乳腺炎误诊为乳腺癌,1例异物性肉芽肿误诊为脂肪瘤,1例早期乳腺癌误诊为乳腺增生结节,1例纤维腺瘤误诊为浆细胞性乳腺炎,1例积乳囊肿误诊为乳腺癌,1例乳腺癌误诊为增生区,1例导管内乳头状瘤误诊为导管癌。结论应用二维高频超声加彩色多普勒对乳腺肿块进行检测,能明显提高诊断符合率,对肿块良恶性的鉴别诊断具有重要临床应用价值。     

乳晕入路切除乳腺良性肿块的疗效分析

目的为了保持女性乳腺良性肿块切除术后乳房的完美造型,探讨乳晕入路切除术的临床应用价值,特别是当肿块>2cm应用mammotome微创旋切技术无法切除时,此方法更具优越性,既经济、美观又彻底清除肿块。方法选择乳晕切口,用低脓度麻醉药注射到乳腺浅筋膜层,钝性分离到达肿块周围切除乳腺良性肿块,共计162例,术后不放置引流,切口用可吸收线做皮内连续缝合。结果本组162例临床追踪观察1～3年,术后乳房恢复完好如初,不但保留乳头原有功能且几乎看不到手术痕迹。     

浸润性乳腺导管癌的彩色多普勒超声诊断体会

目的分析浸润性乳腺导管癌的超声声像学特征,评价其诊断价值。方法36例经手术、病理证实的浸润性乳腺导管癌,分析其术前的二维及彩色多普勒超声声像学表现,根据肿块的回声强度、均匀性、边界、纵横径比值及CDFI血流信号情况。结果35例的乳腺癌回声强度表现为低回声;32例的乳腺癌表现为内部回声不均,边界不规整呈蟹足状;乳腺肿块纵横比≥1诊断恶性肿瘤的特异性最高(100%);肿块内有多发性微小钙化灶和远场衰减者分别为12和26例;皮肤组织浸润26例;彩色多普勒显示癌肿内部和周边血流丰富者28例。结论综合声像判断对浸润性乳腺癌有较高的诊断价值。     

浅表超声对乳腺微小钙化的观察与分析

目的:观察与分析浅表超声对乳腺微小钙化的检出情况.方法:回顾性分析124例乳腺肿块患者的临床资料,所有患者均经手术病理诊断和浅表超声检查,分析浅表超声对乳腺微小钙化的检出情况、良恶性病变的诊断符合率、检出乳腺微小钙化的病理类型.结果:124例乳腺肿块患者的乳腺微小钙化检出32例;其中良性病变4例,占7.14%;恶性病变28例,占41.18%;经χ2检验,乳腺肿块良性病变与恶性病变患者的乳腺微小钙化检出率差异具有统计学意义(P<0.05);浅表超声与手术病理诊断相符110例,占88.71%;其中良性病变符合率为87.50%(49/56),恶性病变符合率为89.71%(61/68);使用7.5MHz超声探头扫查,均能检出乳腺微小钙化病灶.结论:浅表超声对乳腺微小钙化的检出效果显著,钙化灶后不伴有声影作为诊断乳腺肿块恶性病变的重要依据.     

乳腺导管造影钼靶拍片对导管内乳头状肿瘤诊断的意义

目的探讨乳腺导管内乳头状肿瘤的临床表现、乳腺导管造影钼靶拍片影像学表现、病理类型与治疗方法。方法回顾分析209例女性乳腺导管内乳头状肿瘤病例,探讨其临床表现、影像学表现、病理类型及治疗方法,分析它们之间的关系。结果209例患者的临床表现:乳头溢血最常见,占60.2%(126/209);单纯乳房肿块者,占28.7%(60/209);同时有乳头溢血和乳房肿块者,占11.0%(23/209)。病理结果:导管内乳头状瘤165例(78.9%),导管内乳头状肿瘤伴上皮细胞不典型增生13例(6.2%),导管内乳头状癌及浸润性乳头状癌31例(14.8%)。年龄>50岁的导管瘤病例,恶性占49.3%(35/71);病变位于二级以下导管者,恶性占39.0%(41/105);钼靶片提示伴有钙化的,恶性占48%(37/76);乳头血性溢液伴临床可触及肿块者,恶性占52.1%(12/23),均有统计学意义。结论乳腺导管造影钼靶拍片对于导管内乳头状肿瘤的诊断有着很重要的价值。     

高频超声联合彩色多普勒在乳腺肿块诊断中的价值

目的探讨二维超声及彩色多普勒超声在乳腺肿块鉴别诊断方面的临床应用价值。方法对125例经手术病理证实的乳腺肿块病例对照二维声像图特征、周边及内部血流、进行回顾性观察和分析。结果乳腺良、恶性肿块在肿瘤形态、边界、边缘回声、内部回声、衰减、钙化、血流分布方面具有显著差异性。结论乳腺肿块的超声诊断应以二维声像图为基础,同时结合彩色多普勒血流丰富程度,两者联合应用可提高超声对乳腺肿块的诊断符合率。     

乳腺导管内原位癌与乳腺导管内乳头状瘤超声鉴别诊断logistic回归分析

目的讨论常规超声对乳腺导管内原位癌及乳腺导管内乳头状瘤是否有鉴别诊断意义方法回顾性分析华中科技大学协和深圳医院100例经病理诊断确诊为乳腺导管内原位癌(50例)及乳腺导管内乳头状瘤(50例)的乳腺超声声像图并对其进行对比有无相关性。其中观察的指标包括年龄(P0.05)、病变内部回声(P0.05)、病变最大直径(P0.05)、病变边界(P0.05)、病变形态(P0.05)、病变内微钙化(P0.05)、病变距乳头距离(P0.05)、病变血流情况(P0.05)同侧腋窝淋巴结情况(P0.05)。结论超声检查对于乳腺导管内原位癌及乳腺导管内乳头状瘤是有一定鉴别诊断意义的。     

超声与钼靶X线检查在乳腺恶性肿瘤中的诊断价值

目的探讨超声检查和钼靶X线检查以及联合两种检查方法在乳腺恶性肿瘤诊断中的价值。方法对116例经手术与病理证实的乳腺恶性肿瘤,对比分析患者术前的超声及钼靶X线的诊断。结果116例(其中2例为双侧乳腺恶性肿瘤)乳腺恶性肿瘤的超声诊断敏感性为84.7%,钼靶诊断的敏感性为87.3%,差异无统计学意义(P>0.017)。联合两种检查法对乳腺恶性肿瘤的诊断敏感性率为94.9%,高于单用超声检查(P<0.017),也高于单用钼靶X线检查(P<0.017)。结论超声检查和钼靶X线检查对乳腺恶性肿瘤的诊断与鉴别诊断有重要的价值,而联合应用两种检查法可提高乳腺恶性病变的检出率,以早期发现乳腺恶性肿瘤。     

空芯针穿刺活检术在乳腺肿块中的临床应用

目的探讨对乳腺肿块患者行空芯针穿刺活检术的临床价值。方法 2005年1月至2010年6月间,德宏州医疗集团人民医院普外科收治的55例以发现乳腺肿块(肿块直径>5cm)而就诊的女性患者,行空芯针穿刺抽取3～5条长约2cm的乳腺组织行病理学检查。结果 55个乳腺肿块行空芯针穿刺活检术后均获得病理学诊断,其中10例证实为乳腺良性疾病,45例证实为乳腺癌。10例乳腺良性疾病患者经手术而治愈,45例乳腺癌患者经新辅助化疗而获得降期。结论对乳腺肿块患者行空芯针穿刺活检术是一种安全、简单、准确、实用的方法,能够使患者术前获得病理组织学诊断,具有较大的临床应用价值。     

阴道超声对子宫内膜癌的诊断分析

目的 探讨阴道超声对子宫内膜癌诊断的意叉及价值.方法 收集29例经手术后病理证实为子宫内膜癌患者,对其术前超声检查结果及术后病理结果进行分析比较.结果 本组29例经术后病与术前超声检查结果对照,符合例数为26例,准确率为89.7%.讨论阴道彩色多普勒超声能清晰显示子宫内膜病灶回声特点,肌层浸润深度,病灶和周围肌层的血供情况,具有广泛的临床应用价售.     

彩色超声多普勒对45例乳腺包块分析

目的：总结彩色超声对乳腺包块病变诊断价值，提高诊断水平。方法：采用philips iE33, philips i u22彩色多普勒超声诊断仪，对乳腺包块患者扫查包块部位、观察血流特征，分析经病理证实的乳腺癌和良性乳腺包块的超声表现和特点。结果：良性病变20例，恶性肿瘤25例，其表现边界不清，呈“蟹足样”改变，血流较丰富，阻力指数平均0.71。结论：彩色多普勒超声对乳腺包块的诊断及鉴别有重大帮助意义。     

98例乳腺癌的钼靶X线分析

目的总结乳腺癌的钼靶X线表现,提高诊断水平。方法回顾性分析经手术病理证实的98例乳腺癌的钼靶X线表现。结果浸润性导管癌90例,髓样癌5例,其它3例。X表现为肿块90例,肿块伴腋窝淋巴结肿大21例,无肿块仅腋窝淋巴结肿大2例,仅肿块但无腋窝淋巴结转移67例,钙化32例。结论肿块是乳腺癌的最常见征象,钙化是乳腺癌的基本X线征象,腋窝淋巴结肿大是不可忽视的重要征象。使用点压技术是提高X线诊断率的重要手段。     

高频彩超对乳腺小结节的诊断价值

目的探讨高频彩超对乳腺小结节的诊断价值。方法对37例乳腺小结节进行高频彩色多普勒超声检查,并将其超声图像与术后病理结果进行回顾性分析。结果彩色多普勒超声对良恶性结节的诊断符合率分别为93.3%、85.7%。良性结节多表现为外形规则、边界清晰、内部回声均匀、后方回声无衰减,彩色多普勒血流分级多为0～Ⅰ级,阻力指数RI<0.7;而恶性结节多表现为外形欠规则、边界不清、毛刺征、内部回欠均匀、微钙化,后方可有衰减,彩色多普勒血流分级多为Ⅱ～III级,RI>0.7。结论高频彩超对乳腺小结节具有重要诊断价值。     

B超在小儿急性阑尾炎诊断中的应用价值研究

目的：对B型超声在小儿急性阑尾炎诊断中的价值进行研究分析。方法：随机选取临床病例100人作为研究对象,其中男62例,女38例;年龄（4～14）岁,平均（8.1±0.8）岁,病发至就诊时间（1.5～8.0） h,平均（3.4±0.2）h,且所有患儿均经B超检查诊断并且最终经手术证实。结果：32例患儿阑尾轻度肿大（直径≥6m m,阑尾壁厚≥3m m）,43例患儿阑尾肿大明显（直径≥8m m,阑尾黏膜下层增厚明显）,15例患儿阑尾肿大明显,呈现不归则低回声区;10例患儿阑尾管壁四周仅呈现不对称性管壁增厚,（其中3例患儿右下腹B超显示呈现低回声或无回声,腔内可见气体。）。结论：B超检查对少儿急性阑尾炎的诊断和鉴别诊断具有重要价值,它能够提高阑尾炎的诊断准确率。     

微创内固定治疗老年股骨粗隆间骨折的临床观察(附120例报告)

目的观察微创内固定治疗老年患者股骨粗隆间骨折的疗效。方法回顾性分析1996年1月至2008年12月采用微创动力髋螺钉内固定(DHS)术治疗老年股骨粗隆间骨折120例患者的临床资料。结果手术时间平均54.5min,术中出血85.6mL,手术平均4.7cm。经6个月以上的随访,骨折全部愈合,2例轻度髋内翻,但活动功能好;2例出现延迟愈合,约6个月愈合。疗效,优84例、良31例、差5例,优良率为95.8%(115/120)。结论DHS治疗老年股骨粗隆间骨折创伤小、出血少、手术时间短、固定相对牢固,能够早期活动,是比较理想的方法。     

Coexistence of Granular Cell Tumor and Invasive Ductal Breast Cancer in Contralateral Breasts: A Case Report

Granular cell tumor (GCT) is a benign tumor of the breast that can mimic, on breast imaging, invasive carcinomas. Biological evolution of mammary GCT is unknown, especially if it is associated with an invasive carcinoma in the same or contralateral breast. This report details the morphological features of these synchronous lesions highlighting their biological characteristics and suggesting an appropriate follow up.     

微创手术治疗输尿管结石的临床分析

目的 分析微创治疗输尿管结石方法的临床疗效。方法 回顾分析我院收治的160例输尿管结石患者,分析输尿管镜取石法、经皮微创肾输尿管镜取石法2种不同方法的临床效果。结果 2组患者输尿管结石全部取出,术后无石率均达到100%,术后无并发症的发生。结论 输尿管镜取石法、经皮微创肾输尿管镜取石法在治疗输尿管结石上疗效相当,但其适用证不同。     

Gold nanocages covered with thermally-responsive polymers for controlled release by high-intensity focused ultrasound

This paper describes the use of Au nanocages covered with smart, thermally-responsive polymers for controlled release with high-intensity focused ultrasound (HIFU). HIFU is a highly precise medical procedure that uses focused ultrasound to heat and destroy pathogenic tissue rapidly and locally in a non-invasive or minimally invasive manner. The released dosage could be remotely controlled by manipulating the power of HIFU and/or the duration of exposure. We demonstrated localized release within the focal volume of HIFU by using gelatin phantom samples containing dye-loaded Au nanocages. By placing chicken breast tissues on top of the phantoms, we further demonstrated the feasibility of this system for controlled release at depths up to 30 mm. Because it can penetrate more deeply into soft tissues than near-infrared light, HIFU is a potentially more effective external stimulus for rapid, on-demand drug release.     

A Step Forward in Breast Cancer Research: From a Natural-Like Experimental Model to a Preliminary Photothermal Approach

Breast cancer is one of the most frequently diagnosed malignancies and common causes of cancer death in women. Recent studies suggest that environmental exposures to certain chemicals, such as 7,12-Dimethylbenzanthracene (DMBA), a chemical present in tobacco, may increase the risk of developing breast cancer later in life. The first-line treatments for breast cancer (surgery, chemotherapy or a combination of both) are generally invasive and frequently associated with severe side effects and high comorbidity. Consequently, novel approaches are strongly required to find more natural-like experimental models that better reflect the tumors’ etiology, physiopathology and response to treatments, as well as to find more targeted, efficient and minimally invasive treatments. This study proposes the development and an in deep biological characterization of an experimental model using DMBA-tumor-induction in Sprague-Dawley female rats. Moreover, a photothermal therapy approach using a near-infrared laser coupled with gold nanoparticles was preliminarily assessed. The gold nanoparticles were functionalized with Epidermal Growth Factor, and their physicochemical properties and in vitro effects were characterized. DMBA proved to be a very good and selective inductor of breast cancer, with 100% incidence and inducing an average of 4.7 tumors per animal. Epigenetic analysis showed that tumors classified with worst prognosis were hypomethylated. The tumor-induced rats were then subjected to a preliminary treatment using functionalized gold nanoparticles and its activation by laser (650–900 nm). The treatment outcomes presented very promising alterations in terms of tumor histology, confirming the presence of necrosis in most of the cases. Although this study revealed encouraging results as a breast cancer therapy, it is important to define tumor eligibility and specific efficiency criteria to further assess its application in breast cancer treatment on other species.