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Objective:To explore the predictive value of various ultrasonic signs for papillary thyroid microcarcinoma (PTMC) .Methods:The ultrasonic data of of 603 micronodular goiter (MNG) in 396 cases and 640 PTMC in 539 cases, which were confirmed by pathology from Jan. 2013 to Dec. 2016, were retrospectively analyzed. According to the different inspection time, all nodules were divided into model group (2013-2014 years) and test group (2015-2016 years) . The tumor morphology, internal echo, microcalcification, and aspect ratio (A/T) were observed. Chi-square test and multivariate Logistic regression analysis were used to analyze the distribution differences of the four ultrasound features in PTMC and MNG, and their diagnostic value was evaluated.Results:There were statistical difference between model group and test group in ultrasonic signs including tumors shape, internal echo, microcalcification and aspect ratio according single factor analysis (chi square value was 283.540 and 298.119, 63.130 and 87.400, 26.342 and 50.152, 169.918 and 181.405; P<0.05) ;Multivariable Logistic regression analysis showed that irregular shape, hypoecho, A/T>1 and microcalcification were more common in PTMC ( P< 0.05) . OR values were 18.410 and 19.231, 2.560 and 6.380, 9.379 and 6.724, 3.102 and 8.830, and AUC prediction probability values were 0.916 and 0.911 respectively. Conclusions:Irregular shape, internal hypoechoic, microcalcification and A/T>1 are stable important ultrasonographic signs in predicting PTMC. Comprehensive analysis of various ultrasonic signs can improve the diagnostic efficiency.
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Objective To evaluate the practical value of the method of contrast enhanced ultrasoundguided reduced-fine needle aspiration (CEUS-FNA) in decreasing the complications of prostate nodule puncture.Methods Nine hundred patients with suspected prostate cancer(PCa) who underwent traditional 10-point blind transperineal prostate nodule puncture(n =548) or CEUS-FNA(n =352) were collected retrospectively and classfied into normal group or CEUS group,respectively.The ratio of prostate cancer diagnosis,number of punctur and compliations were observed in both groups.Results Altogether 362 PCa were diagnosed from 900 patients.Among these cases the diagnosis ratio of normal group was 38.0％ (208/548) and that of CEUS group was 43.8 ％ (154/352).There was no significant difference in diagnosis ratio between two groups (x2 =2.992,P =0.084).The puncture number of normal group were more than that of CEUS group(P ＜0.01).There were 134 cases occurred infection and other complications in tradition group and 56 cases in CEUS group.The complication rate in normal group was higher than that in CEUS group (24.5 ％ vs 15.9 ％),with significant differences between the two groups (x2 =9.393,P =0.002).Conclusions CEUS-FNA could reduce puncture number,but not decrease the PCa diagnsis rate.And also that could reduce the complication rate of prostate puncture.
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ObjectiveTo investigate the value of the automated breast volume scanner (ABVS) in the diagnosis of ductal carcinomain situ(DCIS).MethodsSixty-seven patients who were diagnosed as DCIS by histopathology from December, 2010 to December, 2012 were retrospectively analyzed. Their image results and detection rates of mammography, conventional ultrasound and ABVS were analyzed and compared by Nonparametric Cochran'sQ test, and the further comparison were performed between groups by McNemar test.ResultsThe cases diagnosed as mass (with or without microcalcifications) by mammography, conventional ultrasound and ABVS were 13 (19%), 22 (33%) and 25 (37%), respectively. The detection rates of conventional ultrasound and ABVS were higher than mammography, and the differences were statistically significant (χ2=7.11, 10.08, bothP0.05). The cases diagnosed as simple microcalcification or associated with microcalcification by mammography, conventional ultrasound and ABVS were 42 (63%), 30 (45%) and 39 (58%), respectively. The detection rates of simple microcalcification or associated with microcalcifications by mammography and ABVS were higher than conventional ultrasound, and the differences were statistically significant (χ2=8.64, 5.82, bothP0.05). The detection rates of DCIS by mammography, conventional ultrasound and ABVS were 84%, 70% and 91%. The detection rates of DCIS by mammography and ABVS were higher than conventional ultrasound, and the differences were statistically significant. But the rate between mammography and ABVS showed no statistical significance.ConclusionsABVS can improve the ultronic detection rate of breast DCIS. Its detection rate is similar with mammography performance.
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Objective To compare the values of automated breast volume scanner(ABVS) and conventional ultrasound(US) in the diagnosis of breast microcalcifications.Methods Sixty-eight cases of patients with breast microcalcifications 71 lesions were found by mammography,which were also examined by ABVS and US.The detection rate of microcalcifications under different background which have masses or not by the two methods were compared respectively,and the detection rate in the different pathological types of breast were also compared.All the cases were confirmed with histopathology.Results Sixty-five cases with breast microcalcifications were detected by ABVS and 55 cases detected by US,respectively.The detection rate of ABVS was significantly higher than that of US (91.5％ vs 77.5％,x2 =5.379,P =0.020).Forty-four cases of microcalcifications were found within the masses,but the other 27 cases without mass.The detection rate of microcalcifications within the masses had no siginificant difference between ABVS and US (97.7％ vs 93.2％,x2 =0.262,P =0.609),but ABVS was significantly higher than US (81.5％ vs 51.9％,x2 =5.333,P =0.021) in the detection rate of microcalcifications without the masses.The detection rate of ABVS in microcalcifications for those patients with invasive ductal carcinoma,were found the same as US (both 100％).However,the detection rate of microcalcifications by ABVS was much higher than US (94.1 ％ vs 58.8％,P =0.039) in patients with ductal carcinoma in situ.Conclusions ABVS can improve the detection rate of microcalcifications,especially without mass.The microcalcifications distribution can be observed in the coronal plane of ABVS,which increases the detection rate of ultrasound in the diagnosis of ductal carcinoma in situ.
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Objective To evaluate the correlation between quantitative parameters of contrastenhanced ultrasound(CEUS) and microvessel density (MVD) of rabbit atherosclerotic plaques.Methods Twenty-six male New Zealand rabbits were damaged abdominal aortic by balloon expanded,fed with high fat 12 weeks later.Thirty two plaques were detected using conventional ultrasound examination.The maximum area,luminal area stenosis rate and the maximum thickness of each plaque were recorded.CEUS was performed on 32 plaques and enhancement images were offline analyzed quantitatively by ACQ software and the parameters such as arrival time(AT),time to peak(TTP),basic intensity(BI),and peak intensity(PI) were acquired.Enhanced intensity (EI) was calculated according to the formula:EI =PI- BI.Then the experimentalrabbitswerekilledforpathologicalexaminationandCD34monoclonalantibody immunohistochemical detection.MVD was counted under the microscope.The correlation between the parameters of CEUS and MVD was analyzed.Based on pathological findings,the plaques were divided into vulnerable plaques and stable plaques.ResultsEI and MVD of vulnerable plaques group were significantly higher than that of stable plaques group [EI:(26.36 ± 1.44) dB vs (23.90 ± 2.92)dB,t =- 3.243,P =0.001 ；MVD:(5.23 ± 1.16)/mm2 vs (2.47 ± 1.12)/mm2,Z =- 4.378,P ＜0.001].The maximum area,luminal area stenosis rate,the maximum thickness and PI,AT,TTP had no significant difference between two groups( P ＞0.05).The value of EI showed significant positive correlation with MVD ( r =0.676,P ＜0.001).ConclusionsEI can accurately evaluate the angiogenesis of rabbit atherosclerotic plaques,which can be regarded as a useful index to distinguish between vulnerable and stable plaques.
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Objective To explore the value of abdominal aorta strain reserve(SR) of rabbits during the period of early atherosclerosis using velocity vector imaging(VVI) techniques combined with nitroglycerin (NTG) vasodilation experiment.Methods Fifty-two male New Zealand White rabbits were used in this experiment.Group A(n=12) was the normal control group.Forty rabbits were made into atherosclerosis models.The SR of abdominal aortas of all rabbits were analyzed in short axis views using VVI and NTG vasodilation experiment at the forth week and the eighth week after feeding.The period of atherosclerosis into endothelial injury stage(group B) and intima thickening stage(group C) were divided.Results There were eighteen rabbits at the endothelial injury stage in group B and thirteen at the intima thickening stage in group C.Compared with control group,arterial SR values of group B and group C were significantly decreased in turn [4.13±1.21＞2.31±0.89＞1.22±0.77,Z=-2.978,P=0.003;Z=1.959,P=0.001],IMT of group C was significantly higher than that of group A(Z=-3.108,P=0.002),strain of group C was significantly lower than that of group A(Z=-2.415,P=0.016),the strain and IMT had no significant difference among three groups except group A and group C (P>0.05).A cut-off value was 3.67 of SR for diagnosing the endothelial injury aretary had a sensitivity of 70% and spectificity of 92.3% respectively obtained by the area under the ROC curve.The agreement of this diagnosis was very good.Conclusions The variable of the SR could stand for the variable of the vascular elasticity during the period of the early atherosclerosis.VVI and NTG vasodilation experiment could quantitatively assess SR of abdominal aortas of rabbits.
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Objective To explore the value of biomechanics parameter of rabbit abdominal aortic atheroma using velocity vector imaging(VVI).Methods Ten of 45 male New Zealand rabbits were chosen as normal control group randomly,the rest experimental rabbits were made atheromatous plaque model.The rabbits were examined by two-dimensional ultrasound and VVI respectively.The intima-media thickness(IMT) or thickness of plaques of abdominal aorta 1 cm from right renal artery branch were recorded.Maximum tangential velocity,strain and strain rate of IMT or plaques were measured using VVI.Then the rabbits were killed for pathological and immuno-histochemical examination.Results Based on pathology,the rabbites were divided into 4 groups:control group(group A,n=10),group of pathological endometrial thickening(group B,n=9),group of thick fibrous cap atheromatous plaques (group C,n=15) and group of thin fibrous cap atheromatous plaques (group D,n=11).The difference of plaques thickness and biochemical indicators had no statistically significant between group B and C(P>0.05),both bigger than group A and B (P0.46×10-2 cm/s,Smax>0.37%,SRmax>1.415×10-2 s-1 to find the vulnerable plaques,the sensitivity were 75.0%,84.4%,84.4% respectively,specificity were 70.8%,91.7%,83.3% respectively.Conclusions VVI can identify plaque biomechanics parameter of different progression periods,which is expected to be a reliable method to find vulnerable plaques earlier in clinic.
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Objective To evaluate the change of elasticity of rabbit liver following portal inflow vessels occlusion using acoustic radiation force impulse (ARFI). Methods Twelve Japanese white big ear rabbits were used to establish total hepatic vascular exclusion animal models by occluding the portal inflow vessels. The elasticity of rabbits' right liver was detected during the stages of baseline(T0), 5 min(T1),20min(T2) ,30min (T3)after occluding the portal inflow vessels using ARFI respectively. The elasticity of rabbit liver, levels of serum's aspartate aminotransferase (AST), alanine aminotransferase (ALT) and historical results of hepatic tissue during different stage were compared. Results Shear wave velocity(Vs)of rabbits' right livers in T2 was significantly higher than that in T0 ( P ＜0.05) and Vs of rabbits' right livers in T3 was significantly higher than that in T2 ( P ＜0.05). No significant differences of serum's AST,ALT levels between T2 and T0 were found,while the Vs of rabbit live in T2 was slightly higher than that in T0 (P＞0.05), serum's AST, ALT levels in T3 were significantly higher than that in T2 ( P ＜0.05).Historical changes of liver ischemia and injury were observed in T2 and T3 with light microscopy. Conclusions The liver ischemia and injury severity can be accurately and objectively evaluated using ARFI.