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      • KCI등재

        Urethral configuration and mobility during urine leaking described using real-time transperineal ultrasonography

        Baihua Zhao,Lieming Wen,Dan Liu,Huang Shanya 대한초음파의학회 2022 ULTRASONOGRAPHY Vol.41 No.1

        Purpose: The aim of this study was to explore differences in the bladder neck configuration and segmental urethral mobility during the cough stress test (CST) in the supine and standing positions between women with and without stress urinary incontinence (SUI). Methods: This prospective study included 100 control women and 100 incontinent women who had a CST with transperineal ultrasonography. The bladder neck configuration and urethral mobility were described in terms of urethral funneling, bladder neck descent (BND), retrovesical angle (RVA), urethral rotation angle, and urethral mobility at six points along the urethra (vectors 1 to 6). The two groups’ ultrasound findings in the two positions were compared. Results: Valid data were collected from 78 control women and 90 women with SUI. Significant differences were found in age and body mass index between the two groups (P<0.01). Urethral funneling was found in 33 women (36.7%) with SUI and five continent women (6.4%) and altered little in the standing position. In the standing position, the mean RVA significantly increased (160° to 179°, P<0.001) in the SUI group; The mean vector of points 1 to 6 significantly increased in the control group (all P<0.001). The RVA, BND, and vectors 1 to 4 were significantly greater (all P≤0.01) in women with SUI than without, in both positions. Conclusion: Urethral funneling was an intrinsic anatomical characteristic relative to SUI. Weak upper- and mid-urethral support and an unstable connection between the trigone and proximal urethra were the anatomical signs of SUI. Purpose: The aim of this study was to explore differences in the bladder neck configuration and segmental urethral mobility during the cough stress test (CST) in the supine and standing positions between women with and without stress urinary incontinence (SUI).Methods: This prospective study included 100 control women and 100 incontinent women who had a CST with transperineal ultrasonography. The bladder neck configuration and urethral mobility were described in terms of urethral funneling, bladder neck descent (BND), retrovesical angle (RVA), urethral rotation angle, and urethral mobility at six points along the urethra (vectors 1 to 6). The two groups’ ultrasound findings in the two positions were compared.Results: Valid data were collected from 78 control women and 90 women with SUI. Significant differences were found in age and body mass index between the two groups (P<0.01). Urethral funneling was found in 33 women (36.7%) with SUI and five continent women (6.4%) and altered little in the standing position. In the standing position, the mean RVA significantly increased (160° to 179°, P<0.001) in the SUI group; The mean vector of points 1 to 6 significantly increased in the control group (all P<0.001). The RVA, BND, and vectors 1 to 4 were significantly greater (all P≤0.01) in women with SUI than without, in both positions.Conclusion: Urethral funneling was an intrinsic anatomical characteristic relative to SUI. Weak upper- and mid-urethral support and an unstable connection between the trigone and proximal urethra were the anatomical signs of SUI.

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        A comparison of the diagnostic performance of the O-RADS, RMI4, IOTA LR2, and IOTA SR systems by senior and junior doctors

        Yuyang Guo,Baihua Zhao,Shan Zhou,Lieming Wen,Liu Jieyu,Yaqian Fu,Fang Xu,Minghui Liu 대한초음파의학회 2022 ULTRASONOGRAPHY Vol.41 No.3

        Purpose: This study compared the diagnostic performance of the Ovarian-Adnexal Reporting and Data System (O-RADS), the Risk of Malignancy Index 4 (RMI4), the International Ovarian of Tumor Analysis Logistic Regression Model 2 (IOTA LR2), and the IOTA Simple Rules (IOTA SR) in predicting the malignancy of adnexal masses (AMs).Methods: This retrospective study included 575 women with AMs between 2017 and 2020. All clinical messages, ultrasound images, and pathological findings were collected. Two senior doctors (group I) and two junior doctors (group II) used the four systems to classify AMs. The postoperative pathological diagnosis was used as the gold standard to evaluate the diagnostic efficiency. A receiver operating characteristic curve was used to test the diagnostic performance. The interrater agreement between the two groups was tested using kappa values.Results: Of all 592 AMs, 447 (75.5%) were benign, 123 (20.8%) were malignant, and 22 (3.7%) were borderline. The intergroup consistency test yielded kappa values of 0.71, 0.92, 0.68, and 0.77 for the O-RADS, RMI4, IOTA LR2, and IOTA SR, respectively. To predict malignant lesions, the areas under the curve of the O-RADS, RMI4, IOTA LR2, and IOTA SR systems were 0.90, 0.89, 0.90, and 0.86 for group I and 0.89, 0.87, 0.88, and 0.84 for group II, respectively. The O-RADS had the highest sensitivity (91.0% in group I and 84.8% in group II).Conclusion: The four diagnostic systems could compensate for junior doctors’ inexperience in predicting malignant adnexal lesions. The O-RADS performed best and showed the highest sensitivity.

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        The learning curve and difficult points of the O-RADS ultrasound risk stratification system in 54 trainees

        Shan Zhou,Yuyang Guo,Lieming Wen,Baihua Zhao,Minghui Liu 대한초음파의학회 2022 ULTRASONOGRAPHY Vol.41 No.2

        Purpose: This study aimed to evaluate the learning curve and explore the difficult points of the Ovarian-Adnexal Reporting and Data System (O-RADS) ultrasound risk stratification system.Methods: One hundred adnexal masses (AMs) were randomly selected for five tests as training data. Two experienced trainers had an inter-rater agreement of 0.95 for the O-RADS scores. Fifty-four trainees (26 level I practitioners [group 1], 17 level II practitioners [group 2], and 11 experienced level II practitioners [group 3]) attended the training. Every trainee received assessment and feedback after 20 scored cases. The outcomes of the five tests were compared among the three groups using repeated-measurements analysis of variance.Results: Of the 100 AMs, 52 were pathologically benign and 48 were malignant; the O-RADS scores were 2, 3, 4, and 5 in 22, 11, 48, and 19 AMs, respectively. The between-subjects effects test showed no significant differences between groups 1, 2, and 3 for the five tests (P=0.501). For each group, the differences among the five tests were significant (P<0.001, P=0.006, and P=0.044 for groups 1, 2, and 3, respectively). Test 2 was the worst. In 23 cases, more than 40% of trainees gave incorrect answers, which mainly related to classic benign lesions, the color flow score, and solid-appearing masses.Conclusion: After training, junior doctors at different levels can reach a coincident O-RADS ultrasound risk stratification. The difficulties primarily related to subjective judgments of classic benign lesions, the color flow score, and solid-appearing masses. More experience is needed to improve the applicability of the system.

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