代谢相关性脂肪肝病(MAFLD)是一种正在全球范围流行的慢性肝病,曾用名非酒精性脂肪肝病(NAFLD)。肝纤维化是MAFLD病情进展中的重要阶段,随着肝纤维化的发展有极大风险进展为肝硬化、肝癌。对MAFLD患者进行肝纤维化评估可以达到早期干预和改善预后的目的,剪切波弹性成像(SWE)是一种肝纤维化诊断的非侵入性技术,以其简便、快捷、高效的检查特点在临床得到了广泛的应用。本文旨在对当前SWE在MAFLD肝纤维化诊断中的应用进展进行综述。Metabolic-associated fatty liver disease (MAFLD) is a chronic liver disease that is becoming endemic worldwide, formerly known as non-alcoholic fatty liver disease (NAFLD). Liver fibrosis is an important stage in the progression of MAFLD, and with the development of liver fibrosis, there is a great risk of progression to liver cirrhosis and liver cancer. Shear wave elastography (SWE) is a non-invasive technique for the diagnosis of liver fibrosis, which has been widely used in clinical practice due to its simple, fast and efficient examination characteristics. This article is to review the current progress in the application of SWE in the diagnosis of liver fibrosis in MAFLD.
帕金森病是常见的神经退行性疾病,早期症状不典型,而临床诊断又主要依靠症状与体征,不仅诊断困难,因帕金森病的临床异质性大,也难以与其他神经退行性病相鉴别。经颅超声检查提示中脑黑质高回声是诊断帕金森病的一个辅助诊断指标,这一回声特性对帕金森疾病患者的某些疾病特征具有提示作用,目前关于经颅聚焦超声应用于帕金森病治疗的研究也开始崭露头角。因此本文就经颅超声在帕金森病诊断及治疗中的研究进展进行综述。Parkinson’s disease is a widely recognized neurodegenerative disorder, yet its early symptoms often present atypically. The clinical diagnosis relies heavily on identifying these symptoms and signs, which makes accurate diagnosis challenging. Moreover, the significant clinical variability of Parkinson’s disease adds to the difficulty of distinguishing it from other neurodegenerative diseases. Transcranial ultrasound can reveal increased echogenicity in the substantia nigra of the midbrain, serving as a critical auxiliary diagnostic marker for Parkinson’s disease. This echogenicity provides valuable insights into specific characteristics of the disease in affected patients. Currently, research on the application of transcranial focused ultrasound in the treatment of Parkinson’s disease is beginning to emerge. Therefore, this paper reviews the research progress of transcranial ultrasound in the diagnosis and treatment of Parkinson’s disease.
目的评价连续低强度脉冲式超声(LIPUS)联合微泡(MB)的空化治疗(以下简称超声空化治疗)促进小鼠缺血后肢微循环灌注的效果,初步探讨该治疗方式对肢体动脉缺血性损伤的无创治疗潜力。方法构建小鼠左后肢缺血模型,按照不同治疗方法将小鼠随机分为4组(每组16只):模型组、MB组、LIPUS组和超声空化治疗组(LIPUS+MB组)。模型组小鼠经尾静脉注射0.1 mL生理盐水,MB组小鼠经尾静脉注射0.1 mL MB,LIPUS组小鼠在经尾静脉注射0.1 mL生理盐水的同时采用LIPUS对缺血后肢进行治疗,LIPUS+MB组小鼠在经尾静脉注射0.1 mL MB的同时采用LIPUS对缺血后肢进行治疗;各组均每天注射1次,共7 d。在治疗的第1、4、7天,通过超声造影评价小鼠缺血后肢的微循环灌注情况,并结合小鼠后肢腓肠肌组织H-E染色和CD31免疫组织化学染色,评估不同治疗对小鼠缺血后肢微循环灌注的促进效果。结果小鼠左后肢缺血模型构建成功,所有的模型小鼠均表现出明显的缺血微循环灌注障碍,模型稳定性良好。治疗第7天结束后,LIPUS+MB组小鼠缺血后肢微循环灌注水平升高,其缺血侧与非缺血侧微血管流量比值高于LIPUS组[(94.33±4.51)%vs(70.33±2.09)%,P<0.05];H-E染色结果显示,LIPUS+MB组腓肠肌组织新生毛细血管和肌成纤维细胞数量增加,肌肉结构修复优于LIPUS组,而模型组和MB组则表现为肌细胞坏死、肌束排列紊乱及毛细血管稀疏;CD31免疫组织化学分析进一步证实,超声空化治疗在促进缺血骨骼肌微循环灌注、微血管新生和组织修复方面显著优于单纯LIPUS治疗(CD31相对表达水平5.03±0.33 vs 3.57±0.21,P<0.01)。结论与单纯LIPUS治疗相比,连续超声空化治疗在促进小鼠缺血后肢的微循环灌注方面表现出更加显著的效果,为外周动脉缺血性疾病所致肢体骨骼肌微循环灌注障碍提供了新的治疗策略。
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