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Objective:To explore the diagnostic value of contrast-enhanced ultrasound combined with fine-needle aspiration biopsy and BRAF gene detection for TI-RADS category 4 nodules.Methods:The clinical datas of 80 patients who underwent surgery in the First Affiliated Hospital, Zhejiang University School of Medicine and Lishui People′s Hospital and diagnosed with TI-RADS 4 thyroid nodules from January 2019 to January 2020 were retrospectively analyzed. All patients received contrast-enhanced ultrasound combined fine-needle aspiration biopsy and BRAF gene detection, the ROC curves were plotted, the area under the ROC curve(AUC) and the best diagnostic cut-off values were calculated, and the application value of ultrasound-enhanced contrast, fine-needle aspiration biopsy and BRAF gene detection were compared.Results:Based on the results of pathological diagnosis, in diagnosing TI-RADS 4 thyroid nodules, the sensitivity, specificity and accuracy were 77.61%, 70.97% and 75.51% for contrast-enhanced ultrasound, respectively; 80.60%, 74.19%, and 78.57% for ultrasound-guided fine-needle aspiration biopsy, respectively; 79.10%, 96.77%, and 84.69% for the BRAF gene test, respectively; and 98.51%, 70.97% and 89.80% for the combined diagnosis, respectively. The AUC was 0.790 for contrast-enhanced ultrasound, and 0.774 for ultrasound-guided fine-needle aspiration biopsy, 0.799 for BRAF genetic testing, and 0.847 for combined testing. The diagnostic value of combined diagnosis was significantly higher than other diagnostic methods ( P<0.05). Conclusions:Contrast-enhanced ultrasound combined with fine-needle aspiration biopsy and BRAF gene detection is valuable for the diagnosis of TI-RADS 4 class thyroid nodules and improves the preperative diagnosis.
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Objective To explore the application value of B -ultrasound examination in gynecological acute abdomen.Methods From October 2015 to October 2017,150 patients with suspected gynecological acute abdomen were selected in the People's Hospital of Lishui.The effect of B-ultrasound examination in diagnosis of gynecological acute abdomen was analyzed.Results The sensitivity,specificity and total accuracy of abdominal ultrasound in the diagnosis of gynecological acute abdomen were 75.00%( 99／132),44.44%(8／18) and 71.33%(107／150), respectively.The sensitivity,specificity and total accuracy of transvaginal ultrasound in the diagnosis of gynecological acute abdomen were 87.12%(115／132),72.22%(13／18) and 85.33%(128／150),respectively.The sensitivity, specificity and total accuracy of abdominal combined with transvaginal ultrasonography in the diagnosis of gynecological acute abdomen were 98.48%(130／132),94.44%(17／18) and 98.00%(147／150),respectively.The sensitivity, specificity and total accuracy of abdominal combined with transvaginal ultrasound in the diagnosis of gynecological acute abdomen were significantly higher than those of abdominal ultrasound and transvaginal ultrasound (χ2 ＝8.658, 10.699,9.075,all P＜0.05).The diagnosis of acute pelvic inflammation ,ectopic pregnancy ,rupture of luteal cyst and torsion of ovarian cyst by abdominal combined with transvaginal ultrasound was better than abdominal ultrasound (χ2 ＝13.748,5.984,13.524,6.874,all P＜0.05).Conclusion Abdominal ultrasound and transvaginal ultrasound can be used to diagnose gynecological acute abdomen.However,abdominal combined with vaginal ultrasound is more effective in the diagnosis of gynecological acute abdomen ,and it can effectively improve the accuracy of diagnosis.
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Objective:To explore the application value of B-mode ultrasound combined with real-time color doppler ultrasound in percutaneous nephrolithotomy and provide guidance for clinical application.Methods:A total of 150 patients underwent percutaneous nephrolithotomy from December 2015 to December 2017 in the People's Hospital of Lishui were selected.According to different ultrasound guidance methods, the patients were divided into two groups.The single group(70 cases) received B-guided puncture.In the combined group(80 cases), B-ultrasound combined with real-time color doppler ultrasound-guided puncture was applied.The incidence of complications and the success rate of lithotomy were compared between the two groups.The changes in renal artery blood flow parameters[end diastolic velocity(EDV), peak systolic velocity(PSV) and resistance index(RI)] before and after surgery in the combined group were observed.Results:The incidence of complications in the combined group was 2.50%(2/80), which was lower than that in the single group[14.29%(10/70)](χ 2=7.046, P<0.05). The success rate of stone extraction in the combined group was 98.75%(79/80), which was higher than that in the single group[85.71%(60/70)](χ 2=9.336, P<0.01). The EDV and PSV of the renal interlobar arteries of the combined group before and after surgery had statistically significant differences ( t=3.794, 5.385, all P<0.05), but the RI had no statistically significant difference ( P>0.05). The EDV and PSV of renal segment arteries in the combined group before and after surgery had statistically significant differences ( t=4.535, 4.884, all P<0.05), while the RI had no statistically significant difference ( P>0.05). The EDV and PSV of renal aorta of the combined group before and after surgery showed no statistically significant differences (all P>0.05), while the RI showed statistically significant difference ( t=4.360, P<0.05). Conclusion:B-mode ultrasound combined with real-time color doppler ultrasound guidance for percutaneous nephrolithotomy can help reduce the incidence of complications and improve the success rate of stone extraction to a certain extent.
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Objective@#To explore the application value of B-mode ultrasound combined with real-time color doppler ultrasound in percutaneous nephrolithotomy and provide guidance for clinical application.@*Methods@#A total of 150 patients underwent percutaneous nephrolithotomy from December 2015 to December 2017 in the People's Hospital of Lishui were selected.According to different ultrasound guidance methods, the patients were divided into two groups.The single group(70 cases) received B-guided puncture.In the combined group(80 cases), B-ultrasound combined with real-time color doppler ultrasound-guided puncture was applied.The incidence of complications and the success rate of lithotomy were compared between the two groups.The changes in renal artery blood flow parameters[end diastolic velocity(EDV), peak systolic velocity(PSV) and resistance index(RI)] before and after surgery in the combined group were observed.@*Results@#The incidence of complications in the combined group was 2.50%(2/80), which was lower than that in the single group[14.29%(10/70)](χ2=7.046, P<0.05). The success rate of stone extraction in the combined group was 98.75%(79/80), which was higher than that in the single group[85.71%(60/70)](χ2=9.336, P<0.01). The EDV and PSV of the renal interlobar arteries of the combined group before and after surgery had statistically significant differences (t=3.794, 5.385, all P<0.05), but the RI had no statistically significant difference (P>0.05). The EDV and PSV of renal segment arteries in the combined group before and after surgery had statistically significant differences (t=4.535, 4.884, all P<0.05), while the RI had no statistically significant difference (P>0.05). The EDV and PSV of renal aorta of the combined group before and after surgery showed no statistically significant differences (all P>0.05), while the RI showed statistically significant difference (t=4.360, P<0.05).@*Conclusion@#B-mode ultrasound combined with real-time color doppler ultrasound guidance for percutaneous nephrolithotomy can help reduce the incidence of complications and improve the success rate of stone extraction to a certain extent.
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Objective@#To explore the application value of B-ultrasound examination in gynecological acute abdomen.@*Methods@#From October 2015 to October 2017, 150 patients with suspected gynecological acute abdomen were selected in the People's Hospital of Lishui.The effect of B-ultrasound examination in diagnosis of gynecological acute abdomen was analyzed.@*Results@#The sensitivity, specificity and total accuracy of abdominal ultrasound in the diagnosis of gynecological acute abdomen were 75.00%(99/132), 44.44%(8/18) and 71.33%(107/150), respectively.The sensitivity, specificity and total accuracy of transvaginal ultrasound in the diagnosis of gynecological acute abdomen were 87.12%(115/132), 72.22%(13/18) and 85.33%(128/150), respectively.The sensitivity, specificity and total accuracy of abdominal combined with transvaginal ultrasonography in the diagnosis of gynecological acute abdomen were 98.48%(130/132), 94.44%(17/18) and 98.00%(147/150), respectively.The sensitivity, specificity and total accuracy of abdominal combined with transvaginal ultrasound in the diagnosis of gynecological acute abdomen were significantly higher than those of abdominal ultrasound and transvaginal ultrasound(χ2=8.658, 10.699, 9.075, all P<0.05). The diagnosis of acute pelvic inflammation, ectopic pregnancy, rupture of luteal cyst and torsion of ovarian cyst by abdominal combined with transvaginal ultrasound was better than abdominal ultrasound(χ2=13.748, 5.984, 13.524, 6.874, all P<0.05).@*Conclusion@#Abdominal ultrasound and transvaginal ultrasound can be used to diagnose gynecological acute abdomen.However, abdominal combined with vaginal ultrasound is more effective in the diagnosis of gynecological acute abdomen, and it can effectively improve the accuracy of diagnosis.