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1.
Ultrasonography(US) and the new applications US elastography(USE) and contrast-enhanced US(CEUS) are used in the screening of thyroid nodules,for which fine-needle aspiration biopsy(FNAB) is the best single diagnostic test.The aim of the study was to compare the sensitivity,specificity,positive predictive value(PPV),and accuracy of the four examinations in nodules with cytological and histological diagnoses.The study used data from US,FNAB,USE(elasticity(ELX 2/1) index),and CEUS(Peak index and time to peak(TTP) index) evaluated in 73 thyroid nodules in 63 consecutive patients likely to undergo surgery.Cytological-histological correlation was available for 38 nodules.No correlation emerged between nodule size and cytological results.A significant(P=0.03) positive correlation between cumulative US findings and cytological results was found.In addition,significant correlations between cumulative US findings and cytology(P=0.02) and between cumulative US findings and histology(P<0.0001) were found.US showed the best specificity and PPV,and FNAB the best sensitivity.There was no significant difference in the ELX 2/1 index,Peak index,or TTP index among nodules subdivided according to cytological scores.No significant correlation was found between ELX 2/1 index,Peak index,and TTP index,on the one hand,and nodule size,US cumulative findings,cytology,and histology on the other hand.The sensitivity of the ELX 2/1 index was high,but its specificity was very low.The accuracy and PPV of USE were lower than those of the other procedures.Only the correlation between Peak index and cumulative US findings reached a value close to significance.Our ultimate aim is to minimise unnecessary thyroidectomy.US and FNAB continue to play a central diagnostic role.The use of a US score showed high specificity and PPV.The specificity of FNAB was low in this selected series because of the numbers of indeterminate cytological responses.USE and CEUS are innovative techniques that need to be standardized.The ELX 2/1 index,Peak index,and TTP index seem to be unrelated to histology.The best statistical data on USE and CEUS concerned their sensitivity and PPV,respectively.At present,USE and CEUS are too time-consuming and of limited utility in selecting patients for surgery.  相似文献   

2.
The coexistence of thyroid diseases with primary hyperparathyroidism （PHPT） can present a challenge in the clinical diagnosis and management for these patients. This study aims to determine the frequency of coexisting thyroid gland lesions in a consecutive series patients with PHPT, and to analyze the clinical features, diagnosis and treatment of these patients. Twenty-two cases of a total of 52 PHPT patients who had synchronous thyroid and parathyroid pathology were surgically managed in this study Thirteen patients had ipsilateral thyroid nodules, and 9 patients had thyroid nodules in contralateral or bilateral side. Seven patients underwent direct parathyroidectomy and hemithyroidectomy via a mini-incision （about 3 cm）, while other 15 procedures were converted to Kocher incision. Seventeen nodular goiter （32.7%）, 2 thyroiditis （3.8%）, 2 thyroid adenoma （3.8%） and 1 thyroid carcinoma （1.9%） coexisting with parathyroid adenoma were pathologically diagnosed. The sensitivity of preoperative ultra- sonography （US） and methoxy-isobutyl-isonitrile （MIBI） scintigraphy for parathyroid lesions was 63.6% and 85.7%; and the overall positive predictive values for MIBI and US were 100% and 95.5% respectively. A high incidence of thyroid diseases that coexisted with PHPT in literatures was briefly reviewed. Our study illustrated the need for clinical awareness of concomitant PHPT and thyroid disease. A combination of US, computed tomography （CT） and MIBI scintigraphy would be recommended for preoperative localization of enlarged parathyroid adenoma and for evaluation of thyroid lesions. Synchronous treatment of associated thyroid abnormalities is desirable, and open minimally invasive surgical approach with additional resection of isolated ipsilateral thyroid nodules is possible in some of these patients.  相似文献   

3.
TCT检测及巴氏涂片细胞学检测在宫颈癌筛查中的对比研究   总被引：2，自引：0，他引：2  
目的：对液基薄层细胞检测系统Thinprep Cytology Test（TCT）及The Bethesda System（TBS）细胞学分类法在宫颈癌筛查中的应用价值进行综合评价。方法：采用液基薄层细胞检测系统检测宫颈细胞并进行TBS细胞学分类诊断,将诊断意义不明的不典型鳞状细胞（ASCUS）以上病变均列为阳性病例,病例均在阴道镜下行活检,将细胞学检测结果与活检结果作对比分析。结果：对223例行TCT及阴道镜下活检与组织病理学诊断：鳞状细胞癌（SCC）100%（12/12）;高度病变88.23%（15/17）;低度病变88.44%（38/45）。结论：TCT技术应用于宫颈细胞涂片筛查,与传统的巴氏图片相比明显提高了涂片的满意率及宫颈异常细胞检出率。TBS报告方式内容直观、易懂、具体、客观,TCT检查异常的病例配合阴道镜病理检查进行诊断,能及早发现宫颈早期病变,尽可能防治宫颈癌发生。  相似文献   

4.
目的探讨高危型人乳头瘤病毒（HPV）在宫颈病变筛查中的临床价值。方法利用宫颈液基细胞学（TCT）检测4类宫颈病变病人，包括ASC-US，LSIL，ASC-H和HSIL，运用DNA基因捕获技术（HC2）检测上述4类病人的HPV值，并分析HPV值与各类宫颈病变病人的关系。结果4类宫颈病变病人中，HPV阳性检出率平均为38％，其中HSIL病人中，HPV阳性检出率最高，同时HPV阳性值最高。结论宫颈液基细胞学联合HPV—DNA检测在宫颈癌癌前病变筛查中具有重要的临床应用价值。  相似文献   

5.
目的：研究乳腺肿瘤组织印片细胞学检查与组织病理学定性诊断符合率,探讨印片细胞学检查在临床病理学诊断中的应用价值。方法：回顾性分析2004-01—2008-01月采用印片法观察123例新鲜离体乳腺包块,与组织病理切片诊断结果对照分析。结果：总体定性诊断符合率95．93％（118／123）,其中恶性肿瘤96．3％,良性肿瘤为95．2％,误诊率为2．44％。结论：组织印片细胞学检查是组织病理学诊断一种有效的补充,也是对术中切除组织筛检定性的一种快捷方法。  相似文献   

6.
The cytology of 130 indeterminate nodules (Thy 3) was retrospectively reviewed according to the British Thyroid Association 2014 classification. Nodules were divided into Thy 3a (atypical features) and Thy 3f (follicular lesion) categories. Histology was available as a reference for 97 nodules. Pre-surgical evaluations comprised biochemical tests, color-Doppler ultrasonography (US), semi-quantitative elastography-US (USE), contrast-enhanced US (CEUS), and mutation analysis from cytological slides. Thyroid malignancy was the final diagnosis for 19% of surgically-treated nodules. No statistically significant difference in the risk of malignancy was found between Thy 3a (26%) and Thy 3f (14%) nodules. Histology of the Thy 3a and Thy 3f nodules showed a higher incidence of Hurtle cell adenomas in Thy 3f (29%) than in Thy 3a (3%) nodules (P=0.01). The only pre-surgical difference concerned the BRAF V600E mutation, which was positive in some Thy 3a but not in any Thy 3f nodules (P=0.04). Receiver-operating characteristic (ROC) analysis was used to obtain cut-off values from US (score), USE (ELX 2/1 strain index), and CEUS (time-topeak index and peak index) data. The cut-off values were similar for Thy 3a and Thy 3f nodules. Data showed that malignancy can be suspected if the US score is >2, ELX 1/2 strain index >1, time-to-peak index >1, and peak index <1. In a sub-group of 24 revised nodules (12 Thy 3a and 12 Thy 3f) with histology as a reference, the diagnostic power of cumulative pre-surgical analysis by means of US, USE, and CEUS showed high positive and negative predictive values (83% and 100%, respectively) for the presence of malignancy in Thy 3a and Thy 3f nodules. In conclusion, in our series of revised Thy 3 nodules, malignancy was low and displayed no significant differences between Thy 3a and Thy 3f categories. The use of cut-offs based on histology as a reference could reduce surgery. Our data support the conviction that, in mutation-negative Thy 3a and Thy 3f nodules, observation should be the first choice when not all instrumental results are suspect.  相似文献   

7.
Objective: The diagnoses of patients with duodenal protruding lesions are difficult when using conventional examinations such as computed tomography (CT) and conventional endoscope etc. Thus, we investigated the clinical value of endoscopic ultrasonography (EUS) with miniature ultrasonic probes on the diagnosis and treatment of duodenal protruding lesions. Methods: Patients with duodenal protruding lesions who were indicated for EUS were examined by EUS with 12-15 MHz miniature ultrasonic probes and double-cavity electronic endoscope. According to diagnosis of EUS, those patients were indicated for biopsy and treatment received biopsy, endoscopic resection or surgical excision. The postoperative histological results were compared with the preoperative diagnosis of EUS. Those patients without endoscopic resection or surgical excision were periodically followed up with EUS. Results: A total of 169 patients with duodenal protruding lesions were examined by EUS, of which 40 were diagnosed with cysts, 36 with inflammatory protruding or polyp, 25 with Brunner's gland adenoma, 19 with ectopic pancreas, 17 with gastrointestinal stromal tumor, 12 with extrinsic compression, 12 with minor papilla, 6 with lipoma, 1 with adenocarcinoma and 1 with lymphoma. After EUS examinations, 75 patients received biopsy, endoscopic resection or surgical excision respectively. The postoperative histological results of 70 patients were completely consistent with the preoperative diagnosis of EUS, with 93.33% diagnostic accuracy. The results of follow-up with EUS indicated that duodenal cyst, Brunner's gland adenoma, ectopic pancreas, gastrointestinal stromal tumor and lipoma remained unchanged within 1-3 years. No related complications occurred among all patients that received EUS examinations. Conclusion: EUS is an effective and reliable diagnostic method for duodenal protruding lesions.  相似文献   

8.
Primary fallopian tube carcinoma (PFTC) is a rare malignant carcinoma among all genital tract malignancies. It occurs most commonly in postmenopausal women and is similar to ovarian malignancy historically and clinically. Because of its insidious onset and silent course, the diagnosis is made usually postoperatively. Liquid-based cytology (LBC) is a type of method for cervical cancer screening, but sometimes it may aid in making PFTC diagnosis. We report a 47-year-old woman with PFTC, whose diagnosis was made with the aid of LBC.   相似文献   

9.
Primary fallopian tube carcinoma (PFTC) is a rare malignant carcinoma among all genital tract malignancies. It occurs most commonly in postmenopausal women and is similar to ovarian malignancy historically and clinically. Because of its insidious onset and silent course, the diagnosis is made usually postoperatively. Liquid-based cytology (LBC) is a type of method for cervical cancer screening, but sometimes it may aid in making PFTC diagnosis. We report a 47-year-old woman with PFTC, whose diagnosis was made with the aid of LBC.  相似文献   

10.
Surgical results of pars plana vitrectomy combined with phacoemulsification   总被引：2，自引：0，他引：2  
INTRODUCTION Cataract is frequently associated with vitreo-retinal pathology such as vitreous hemorrhage,retinal detachment,proliferative vitreoretinal disease,espe-cially in patients with diabetes mellitus,ocular trauma and elderly population(Vatavuk and Pentz,2004;Vatavuk et al.,2005).The cataract can be removed together with vitrectomy or later on in a separate surgical procedure(Tyagi et al.,1998;Lam et al.,1998).The primary indication for the primary re-moval of cataract and vitrect…  相似文献   

11.
ObjectiveTo determine if US child physical abuse and neglect injury rates changed from 2006 to 2014, whether definitive diagnoses of physical abuse and neglect were used more often over time, and what patient factors influenced definitive physical maltreatment diagnoses.MethodsNationally estimated rates of definitive and suggestive physical abuse and neglect injuries for children <10 years were generated using the Nationwide Emergency Department Sample, the National Inpatient Sample, and census estimates. Trends over time were evaluated, including the trend in the proportion of definitive diagnoses to all diagnoses (definitive plus suggestive). Logistic regression was used to evaluate whether patient characteristics and hospital patient volumes were associated with definitive versus suggestive diagnoses.ResultsThe population rates of child physical maltreatment medically treated injuries were unchanged from 2006 to 2014; the trends were not statistically significant for ED or hospitalized patients. Over time, physician definitive diagnoses as a proportion of all physical maltreatment diagnoses (definitive plus suggestive) increased in admitted children from 17.6% in 2006 to 22.0% in 2014 (p = 0.02). Older age, white race, lower income by zip code, and public insurance as well as larger patient volumes increased the odds of definitive rather than suggestive diagnoses of physical abuse and neglect injuries.ConclusionsDefinitive diagnoses of physical abuse and neglect increased over the study period and were associated with hospital volume and patient characteristics which may reflect provider experience and possible bias. The use of electronic medical records may have influenced the coding of definitive diagnoses.  相似文献   

12.
目的分析分化型甲状腺癌术后~(131)I治疗患者应用协同模式对其心理状况及生活质量的影响。方法选取2018年10月~2020年10月在我院收治的甲状腺癌术后~(131)I治疗患者100例,采用随机数字表法将其分为两组,各50例。对照组患者采用常规模式干预,研究组采用协同护理模式,比较两组情绪、生活质量等改善情况。结果研究组干预后SAS评分,SDS评分,与对照组各评分比较差异明显(P<0.05)。干预后两组患者的自我效能评分均提升,且研究组干预后自我效能评分改善情况优于对照组(P<0.05)。两组干预后自护能力均较干预前改善,且研究组干预后自护能力总分及各项目评分均高于对照组(P<0.05)。研究组干预后癌因性评分低于对照组,组间差异明显(P<0.05)。且研究组干预后生活质量各维度评分高于对照组,研究组护理满意度为96.00%,与对照组的80.00%比较明显较高,P<0.05,差异有统计学意义。结论分化型甲状腺癌术后~(131)I治疗患者中应用协同护理模式,能够有效改善患者心理状况,减轻患者癌因性疲乏,增强患者自我效能感,从而提升患者自护能力,改善患者生活质量及满意度,在临床具有较高的应用价值。  相似文献   

13.
目的探讨肝脏局灶性结节增生(focal nodular hyperplasia,FNH)的影像学诊断价值.方法回顾性分析经病理证实的肝脏局灶性结节增生18例22个病灶的US、CT和MR影像资料.结果US、CT和MR非造影检出率:US13个,占59.1%(13/22);CT检出16个,占72.7%(16/22);MR显示全部病灶,占100%(22/22).US、CT和MR造影检出率:US共检出17个,占77.3%(17/22);CT共检出19个,占86.4%(19/22);MR全部检出,占100%(22/22).正确诊断:US27.3%(6/22),CT40.9%(9/22),MR68.2%(15/22).影像综合正确诊断:90.9%(20/22).结论影像学综合检查能够正确诊断大部分肝脏局灶性结节增生,MRI诊断准确性明显优于CT和US.  相似文献   

14.
目的:通过对门诊628例尿常规检查结果的分析,说明尿常规检查做到细致准确的必要性以及实际体会。方法:尿常规检查采用手工标准化方法结合干化学试带法,使结果更加准确可靠。结果:尿糖阳性的病人尿液中真菌检出率为11.8％。而尿糖阴性的病人尿液中真菌检出率为0.5％(P<0.01);肉眼血尿病人尿液脱落细胞检查可以为临床提供泌尿系肿瘤的信息;尿沉渣中红细胞达满视野/高倍,随蛋白尿加重,出现的频率增多,且红细胞形态呈非均一性比率增大(P<0.01)。结论:尿常规检查不但要做准,而且要求做得更细,真正为临床提供及时可靠的诊疗依据。  相似文献   

15.
INTRODUCTIONThetermpolypoidgallbladder(PLG)isusedgenericallytodescribeanymucosalprojectionintothelumen .Itmaybeclassifiedaseithernon neoplasticlesions,whichcomprise 95 %ofallgallbladderpolyps,orneoplasticlesions,ofwhichadenomascomprisethevastmajority .Anu…  相似文献   

16.
OBJECTIVE: The research was conducted to determine the relationship between violent trauma, child abuse history, and dissociative symptoms in a Russian population. METHOD: Three hundred and one undergraduate students from Moscow State Linguistics University participated in the study and completed the Dissociation Continuum Scale, the Violence History Questionnaire, the Traumatic Events Survey (TES), and a demographic measure. RESULTS: Scores on dissociation and its subfactors were significantly higher in the Russian sample compared to the normative US group. The best predictors for dissociation were experiencing a violent trauma, child abuse history, and/or the experience of a fearful event. Those participants with a prior child abuse history were more symptomatic after adult trauma than those with no such history. CONCLUSIONS: The relationship between trauma/abuse and dissociation is unlikely to be a result of suggestion by therapists or media exposure, since the correlation appears in a Russian population who are relatively unexposed to these suggestive sources. The validity, reliability, and structure of the dissociation measure were relatively similar in American and Russian samples.  相似文献   

17.
Until recently the majority of research undertaken into dyslexia focused on English‐speaking dyslexics, who tend to make significantly more phonological than visual errors. This led to a major assumption about the possible cause of dyslexia being a lack of phonological awareness. According to the phonological deficit theory, the level of phonological consistency of a language determines not only the reading speed but also the amount and types of reading and spelling errors made by dyslexic people. This theory has been seriously challenged by the results of a number of studies in more phonologically consistent languages, such as Greek, Italian and Japanese, where morphology seemed to play a more crucial role than the phonological structure of a language per se. The 116 dyslexic people who took part in this experiment were matched on age, sex, IQ and psycho‐educational performance. A total of 58 US English‐speaking dyslexic people were compared to 58 Greek dyslexic people. Both groups met the diagnostic criteria. Results demonstrated that Greek dyslexics were found to make significantly fewer phonological errors (11.0%) than the US dyslexics (85.5%, p < .000), but comparatively more visual (66.8% to US 14.0%, P < .000) and grammatical errors (22.2% to US 0.1%, p < .000) than their English‐speaking counterparts. These data showed highly significant quantitative and qualitative spelling differences. Greek dyslexics could be accurately differentiated from the US English dyslexics based on the three types of spelling errors.  相似文献   

18.
Objective: To study the relationship between cholecystolithiasis and polypoid gallbladder(PLG), 260 patients with polypoid gallbladder were investigated. The patients were divided into 2 groups: group A (PLG combined with cholecystolithiasis) and group B (without cholecystolithiasis). The clinical pathological characteristics were analyzed. The intestinal epithelium metaplasia and atypical hyperplasia of the gallbladder mucosa were observed under light microscope. Results: Intestinal epithelium metaplasia and atypical hyperplasia of gallbladder mucosa were found in 47 of the 260 cases. The pathological lesions included 16 gallbladder carcinoma, 11 adenomatosis polyp, 5 myoadenoma, 7 cholesterol polyp, 4 inflammatory polyp and 4 adenomatosis hyperplasia, which occurred in 26 and 21 patients in group A and group B, i. e. 44.0% and 10.3% respectively. The difference between group A and group B was statistically significant (P<0.01). Conclusion: Cholecystolithiasis and the succeeding inflammatory reaction is a risk-factor for the polypoid gallbladder to develop tumour. Project (No. 2002ZXO19) supported by the Zhejiang Province Health Bureau, China  相似文献   

19.
Background： The purpose of this study was to describe our experiences and analyze the benefits of video-assisted thoracoscopic surgery （VATS） combined with positron emitted tomography （PET）-computed tomography （CT） in the diagnosis of patients with early （Stage 1） sarcoidosis. Methods： From 1995 to 2006, seven patients （two males, five females）, with ages ranging from 26 to 58 years, were impressed with Stage 1 sarcoidosis （mediastinal or hilar lymph nodes involvements without lung involvement） by histological examination of intrathoracic lymph nodes （LNs） and/or lung parenchyma taken＇from VATS biopsy. Three of them received PET or PET-CT evaluation. VATS was approached from the right and left side in one and six patients, respectively, according to the locations of their lesions. Results： All the VATS biopsied LNs or lung specimens were adequate for establishing diagnosis. Mediastinal LNs were taken from Groups 3, 4 in four, Group 7 in two, and Groups 5, 6 in one of them. Hilar LNs biopsies were performed in four cases. Lung biopsy was performed in all but two cases. All of them were expressed pathologically or radiologically as Stage 1 sarcoidosis. PET-CT revealed high emission signals over these affected LNs. These patients received oral steroid treatment or follow up only. All of them were followed up from 5 months to 11 years with satisfactory results. Conclusion： VATS biopsy is a minimally invasive, safe and effective procedure. It can be used as a diagnostic altermative of transbronchial lung biopsy （TBLB）, and can harvest larger and more areas of specimens than mediastinoscopy for staging patients with sarcoidosis. PET-CT can provide us more accurate information about the characteristics and localization of these lesions before biopsy. VATS combined with PET-CT can provide more accurate and earlier diagnosis of patients with unknown intrathoracic lesions, including the sarcoidosis.  相似文献   

20.
Objective: To assess the diagnostic efficiency of OMOM capsule endoscopy (CE) in a group of patients with different indications. Methods: Data from 89 consecutive patients (49 males, 40 females) with suspected small bowel disease who under- went OMOM CE (Jinshan Science and Technology Company, Chongqing, China) examination were obtained by retrospective review. The patients’ indications of the disease consisted of the following: obscure gastrointestinal bleeding (OGIB), abdominal pain or diarrhea, partial i...  相似文献   

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