ABSTRACT
Objective:To investigate the reference range of the length and thickness of the fetal vomer-palate diameters at 11-13 + 6 weeks, and their role in the diagnosis of cleft lip and palate(CLP). Methods:From May 2020 to August 2021, 1 559 pregnant women who underwent ultrasound examination at 11-13 + 6 weeks in Guangdong Women and Children Hospital were selected, and the fetal vomer-palate in the median sagittal plane of the face was observed. The length and thickness diameters of the fetal were measured separately to establish the reference value range of normal fetal.The reference range was compared with the vomer-palate data of fetuses with confirmed CLP. Results:The 1 518 normal fetuses were divided into 11-13 + 6 weeks, 12-12 + 6 weeks and 13-13 + 6 weeks. The reference values of the long diameter of fetal vomer-palatine were 4.3-5.9 mm, 5.0-6.8 mm, 5.4-7.7 mm, and the reference values of the thick diameter were 2.0-2.9 mm, 2.2-3.4 mm, and 2.5-3.8 mm, respectively. The length and thickness of the fetal vomer-palatine were significantly positively correlated with the Crown-rump length ( rs=0.733, 0.634; all P<0.001). In the 1 559 fetals, 25 cases were diagnosed and confirmed with CLP, and the vomer-palate thickness diameters were smaller than the reference values in all cases, meanwhile, the vomer-palate length diameters of 22(88.0)% cases were smaller than the reference values. Conclusions:The reference range of fetal vomer-palate length and thickness at 11-13 + 6 weeks of gestation is valuable for the screening of fetal CLP.
ABSTRACT
Objective:To explore the value of high frequency ultrasound combined with serum alpha-fetoprotein (AFP) in the accurate qualitative diagnosis of pediatric testicular tumors.Methods:The ultrasound characteristics (physical properties, calcification, alder blood flow classification) and AFP levels of 47 testicular tumors confirmed by operation and pathology were analyzed retrospectively. The tumors were further divided into two ways: malignant tumor group and benign tumor group, yolk sac tumor group and non yolk sac tumor group. The characteristics of ultrasound and the accurate qualitative diagnosis efficiency of AFP in testicular tumors were analyzed by receiver operating characteristic curve (ROC).Results:18 cases of yolk sac tumor showed solid or almost solid mass, which may be accompanied by several small anechoic areas without calcification. The Alder blood flow grade were grade 3. 29 cases of nonyolk sac tumor showed cystic, solid or mixed mass, most of them have calcification and some of them showed honeycomb echo. Alder blood flow grade were 0-3 grade. ROC curve analysis showed that the area under the curve, sensitivity and specificity of the ultrasound characteristics and AFP in the diagnosis of pediatric testicular malignancies were: solid or almost solid mass (0.894, 83.3%, 95.5%), and no calcification (0.904, 94.4%, 86.4%), Alder blood flow level 3 (0.941, 88.9%, 95.5%), AFP by best cut-off value 18.8 ng/ml (0.972, 100%, 95.5%), ultrasound features combined with AFP (0.992, 100%, 90.9%). All the testicular malignancies, such as yolk sac tumor, immature teratoma, teratoma combined with yolk sac tumor, can be identified by ultrasound features combined with AFP. Further analysis showed that the sensitivity and specificity of the diagnosis of yolk sac tumor with combined solid or almost solid and no calcification were both 100.0%, which can accurately distinguish all cases of yolk sac tumor.Conclusions:Pediatric testicular yolk sac tumor has specific ultrasound performance, high-frequency ultrasound can make a relatively accurate diagnosis, combined with serum AFP can further make a relatively accurate qualitative diagnosis of other malignant tumors of the testis in children.
ABSTRACT
Objective:To explore the effects of different approaches for second-trimester multifetal pregnancy reduction on pregnancy outcome in women with dichorionic triamniotic (DCTA) triplet.Methods:A retrospective study was performed on 51 women with DCTA triplet pregnancies who were referred to Guangdong Women and Children Hospital for second-trimester multifetal pregnancy reduction from January 2014 to January 2020. All participants were divided into either preventive group ( n=39) or treatment group ( n=12) according to the indication for multifetal pregnancy reduction, and they were further allocated to three subgroups based on different reduction methods, which were reduction to dichorionic twin by radiofrequency ablation (RFA) (RFA subgroup), reduction to monochorionic singleton (KCl-singleton subgroup) or monochorionic twin (KCl-twin subgroup) by cardiac injection of potassium chloride. Pregnancy loss rate, neonatal birth weight, gestational age at delivery, incidence of intrauterine death, and neonatal death were compared and analyzed between different groups using t-test, analysis of variance, Chi-square test, Fisher's exact test and Bonferroni correction. Results:(1) The mean gestational week at operation in the treatment group was significantly later than that in the preventive group [(18.5±3.1) vs (15.0±2.3) weeks, t=-4.209, P<0.001]. In the preventive group, the mean gestational week at operation in the RFA subgroup was later than the KCl-singleton and KCl-twin subgroup[(17.2±1.6) vs (13.8±1.5) and (12.7±1.0) weeks, t=6.630 and 3.875, respectively, both P<0.05]. (2) The postoperative pregnancy loss rate in the preventive group was decreased compared with the treatment group [10.3%(4/39) vs 5/12, Fisher's exact test, P<0.05], and the live birth ratio was increased [ 85.7%(48/56) vs 10/18, χ2=5.640, P=0.018]. No live birth infants with birth weight <1 500 g was reported in the KCl-singleton subgroup in preventive group, and the statistical significance was observed in the intra-group differences ( P<0.05) rather than the pairwise comparison differences in the preventive group. For the proportion of live births, there was a statistically significant difference in the intra-group comparison in the treatment group, which was higher in the RFA subgroup than that in the KCl-twin subgroup (6/6 vs 1/6, P=0.045). No significant difference was revealed among pregnancy loss rate, gestational weeks at delivery, the mean birth weight, premature delivery <32 gestational weeks, and full-term birth rate among three different approaches within the two groups. (3) No monochorionic twin complications or perinatal death occurred in any RFA or KCl-singleton subgroups in the two groups. In the KCl-twin subgroups including five cases with ten fetuses, including three live birth, four miscarriage, three intrauterine death occured, while no neonatal death was reported. One case with selective fetal uterine growth restriction in the preventive group delivered two live births, and one case with twin-to-twin transfusion syndrome in the treatment group had intrauterine death in one fetus and one survival neonate. Conclusions:The pregnancy outcome of multifetal pregnancy reduction to dichorionic diamniotic twins by RFA or reduction to singleton by cardiac injection of potassium chloride are comparative in women with DCTA triplet, regardless of whether it is a preventive or therapeutic reduction.
ABSTRACT
Objective:To investigate the application value of high-frequency linear array probe in prenatal ultrasound diagnosis of fetal kidney fusion anomalies.Methods:A senior sonographer for prenatal diagnosis used a convex array probe and a high-frequency linear array probe to obtain and store renal images of the transverse section, sagittal and coronal plane and ectopic kidney of 27 fetuses with suspected or diagnosed fetal renal fossa emptiness, abnormal renal position and abnormal renal contour in Guangdong Women and Children Hospital from December 2018 to October 2019. The images were analyzed to judge the possibility of kidney fusions by another senior sonographer (subject 1) and a junior sonographer (subject 2) separately. Then, ROC curves were plotted and statistically analyzed based on postnatal follow-up results. The Kappa coefficient between the two subjects was calculated.Results:Areas under the two ROC curves were 0.969 and 0.756 when using a convex array probe, but 1.000 and 1.000 with a high-frequency linear array probe by two subjects separately. Subject 1 had no significant difference using two kinds of probes ( P>0.05), however, subject 2 had higher diagnostic accuracy when using high frequency linear array probes ( P<0.05). The diagnostic consistence of high-frequency linear array probe between subjects was higher than convex array probe, the Kappa coefficients were 1.000 and 0.516, respectively. Conclusions:The application of high-frequency linear array probe in prenatal diagnosis of fetal kidney fusion anomalies is feasible, and can improve the confidence and diagnostic accuracy for fetal kidney fusion anomalies.
ABSTRACT
Objective To observe the features of fetus unilateral pulmonary agenesis in antenatal ultrasonography and analyse the causes of misdiagnosed,so that fetus unilateral pulmonary agenesis can be known more deeply.Methods From January 2012 to October 2017,8 fetuses underwent prenatal ultrasound examination of fetal system in Guangdong Maternal and Child Health Hospital.The prenatal ultrasound data and postnatal clinical data were retrospectively analyzed.Results Among 8 cases of unilateral pulmonary agenesis,there were 4 males and 4 females,5 cases involving right lung,3 cases involving left lung,3 cases of single lung absence,and 5 cases combined with other deformities.There were 4 cases of induced labor,and 4 cases of surviving children were confirmed unilateral pulmonary agenesis by chest computed tomography (CT) examination.2 cases of missed prenatal diagnosis were left pulmonary agenesis,including 1 case only found left pulmonary artery absence and 1 case only found left axis deviation and cardiac enlargement before delivery.Conclusions Cardiac displacement and absence of left or right pulmonary artery are important clues for prenatal ultrasound diagnosis of fetal unilateral pulmonary absence.Prenatal ultrasound is the preferred method to detect and diagnose fetal unilateral pulmonary absence.
ABSTRACT
Objective To analyze the characteristics of lung ultrasound (LUS) in congenital pulmonary airway malformation (CPAM),and to compare the difference of image characteristics between LUS and chest X-ray(CXR) and evaluate the value of neonate LUS in CPAM.Methods From June 2017 to October 2018,the characteristics of LUS and CXR of 32 neonates who were diagnosed with CPAM by prenatal ultrasound and postnatal chest CT were analyzed retrospectively,and the difference of their direct signs and indirect signs were compared.Results Among 32 CPAM cases,10 cases (31.25％) showed a single large cystic lesions and 3 cases with consolidation,4 cases (12.5％) characterized by multiple hypoechoic lesions and 3 cases with consolidation,16 cases (50％) showed consolidation with or without intensiveaerated bronchus sign or dendritic air-filled bronchi,2 cases (6.25 ％) only characterized by dense B-line.The non-characteristic sonographic findings including pleural line was not smooth and not clear;A-line decreased or disappeared,dense B-lines were observed.The ability of LUS in measuring the size of CPAM was limited.Among 32 CPAM cases,10 cases (31.25 ％) showed large cystic hypoechoic lesions and 22 cases (68.75％) showed small cystic hypoechoic lesions by CT scan.In this group,there were 11 cases (34.4％) with normal CXR.There was no significant differences of the direct signs (including single large cystic lesions and multiple hypoechoic lesions) between LUS and CXR (P =0.80),however the indirect signs of LUS were more obvious than CXR,with significant difference(P =0.001).Conclusions The neonatal LUS findings of CPAM is multiple,it can be used as a preliminary qualitative screening method.The diagnosis value of indirect sign of LUS is superior to CXR.
ABSTRACT
Objective@#To analyze the characteristics of lung ultrasound (LUS) in congenital pulmonary airway malformation (CPAM), and to compare the difference of image characteristics between LUS and chest X-ray(CXR) and evaluate the value of neonate LUS in CPAM.@*Methods@#From June 2017 to October 2018, the characteristics of LUS and CXR of 32 neonates who were diagnosed with CPAM by prenatal ultrasound and postnatal chest CT were analyzed retrospectively, and the difference of their direct signs and indirect signs were compared.@*Results@#Among 32 CPAM cases, 10 cases (31.25%) showed a single large cystic lesions and 3 cases with consolidation, 4 cases (12.5%) characterized by multiple hypoechoic lesions and 3 cases with consolidation, 16 cases (50%) showed consolidation with or without intensiveaerated bronchus sign or dendritic air-filled bronchi, 2 cases (6.25%) only characterized by dense B-line. The non-characteristic sonographic findings including pleural line was not smooth and not clear; A-line decreased or disappeared, dense B-lines were observed. The ability of LUS in measuring the size of CPAM was limited.Among 32 CPAM cases, 10 cases (31.25%) showed large cystic hypoechoic lesions and 22 cases (68.75%) showed small cystic hypoechoic lesions by CT scan. In this group, there were 11 cases(34.4%) with normal CXR. There was no significant differences of the direct signs (including single large cystic lesions and multiple hypoechoic lesions) between LUS and CXR (P=0.80), however the indirect signs of LUS were more obvious than CXR, with significant difference(P=0.001).@*Conclusions@#The neonatal LUS findings of CPAM is multiple, it can be used as a preliminary qualitative screening method.The diagnosis value of indirect sign of LUS is superior to CXR.
ABSTRACT
Objective To discuss the diagnostic value of 3D-ultrasound for cord entanglement in monoam-niotic twins. Methods From November 2013 to March 2016,a total of 65 monoamniotic twinsunderwent routine obstetric ultrasonography to screen fetal abnormalities in our hospital. The cord was meticulously observedusing a systematic continuous sequence approach. Fetuses who showed cord entanglement by 2-D ultrasound or 3-D flow Doppler were all recruited. The gestational weeks,fetal malformation,ultrasonic image feature of cord entangle-ment,and clinicaloutcome were recorded and analyzed retrospectively. Results 4 monoamniotic twins showed cord entanglement. Three-dimensional color Doppler clearly delineated thefeatures of entanglement. At following-up of 8 fetuses,3 fetuses were found intrauterine fetal death and 3 fetuses with structural abnormalities except for 2 well infants.Conclusion Cord entanglement may threaten the safety of fetusesin monoamniotic pregnancies.In aid of 2-D ultrasound or 3-D flow Doppler in monoamniotic twins can help to find it in time ,monitor it carefully and provide evidence for obstetric treatment .
ABSTRACT
Objective To investigate the value of prenatal ultrasound in prognosis assessment of congenital diaphragmatic hernia.Methods The ultrasonographic features of 65 fetuses with congenital diaphragmatic hernia were analyzed,which were confirmed by after birth surgery or examination.The lung-to-head ratio (LHR) of unaffected side and O/E LHR (LHR compared to normal fetuses on same gestational weeks) were obtained,and then the relationship with the prognosis of neonates were analyzed.Results In 65 cases,45 fetuses survived and 8 fetuses died after surgery,while 12 cases did not undergo surgery and death promptly.Overall mortality was 30.77％ (20/65).In 12 hepatic intrathoracic type of diaphragmatic hernia cases,the mortality rate was 66.67 ％ (8/12).In 53 hepatic intra-abdominal type of diaphragmatic hernia cases,the mortality rate was 22.64 ％ (12/53).In 9 cases combined with other structural abnormalities,there were 8 cases were dead and 6 cases (6/8) with abnormal chest structure.LHR values were from 0.40 to 2.72,the average value was 1.59±0.69.It showed statistical difference on the mortality rate in fetus of congenital diaphragmatic hernia with different LHR (x2 =19.360,P＜0.001),The mortality rate in fetal of congenital diaphragmatic hernia with LHR 1.0 or less was higher than that with LHR ＞1.0.O/E LHR measurement values were from 23％ to 90％ and the average value was (58.25±17.61) ％.It showed statistical difference on the mortality rate in fetus of congenital diaphragmatic hernia with different O/E LHR (x2 15.261,P=0.002).The mortality rate in fetal of congenital diaphragmatic hernia with O/E LHR ≤45 ％ was higher than that with O/E LHR＞45 ％.Conclusion The prenatal ultrasound can be used to diagnose congenital diaphragmatic hernia,and to assess the development of unaffected lung and prognosis.
ABSTRACT
Objective To investigate the diagnostic criteria of thyroid solid nodules by high-frequency ultrasound,elastography and ultrasound contrast.Methods Totally 87 patients with thyroid solid nodules underwent high-frequency ultrasound,elastography and ultrasound contrast before surgery,distinguishing benign from malignant lesions was executed based on pathological results,and according to the pathological character the image features by the three measures were compared.There were 40 patients divided into a control group going through the examination by high-frequency ultrasound,and 47 ones into an observation group with the examinations by the three measures.Pathological results were used as gold standard,and the two groups were compared on diagnostic sensitivity.Results High-frequency ultrasound showed significant differences of benign and malignant nodules in equal echo,very low echo,irregular peripheral halo,rates of clear nodule boundary and aspect ratio higher than as well as microcalcification (x2--4.603,17.394,5.833,14.832,10.107 and 27.392,and all Pvalues were less than 0.05).There were 85％ benign nodules gained grade Ⅰ and Ⅱ elastography images,81.82％malignant nodules had grade Ⅲ and ⅣV elastography images,and there were significant differences between benign and malignant nodules (x2=53.42,P=0.00).Ultrasound contrast found annular enhancement in most of benign nodules (x2=39.16,P＜0.01) while uneven enhancement in most of malignant nodules (x2=40.28,P＜0.01),and the nodule ranges increasedsignificantly after contrast (t=2.19,P＜0.05).The observation group had the sensitivity being 82.86％,which was statisticallyhigher than 59.38％ in the control group (x2=4.537,P--0.033).Conclusion High-frequency ultrasound,elastography and ultrasound contrast all show the manifestations of thyroid solid nodules,and the comprehensive application of the above three measures contributes to determining the nature of the nodules.
ABSTRACT
Objective To investigate the diagnostic criteria of thyroid solid nodules by high-frequency ultrasound,elastography and ultrasound contrast.Methods Totally 87 patients with thyroid solid nodules underwent high-frequency ultrasound,elastography and ultrasound contrast before surgery,distinguishing benign from malignant lesions was executed based on pathological results,and according to the pathological character the image features by the three measures were compared.There were 40 patients divided into a control group going through the examination by high-frequency ultrasound,and 47 ones into an observation group with the examinations by the three measures.Pathological results were used as gold standard,and the two groups were compared on diagnostic sensitivity.Results High-frequency ultrasound showed significant differences of benign and malignant nodules in equal echo,very low echo,irregular peripheral halo,rates of clear nodule boundary and aspect ratio higher than as well as microcalcification (x2--4.603,17.394,5.833,14.832,10.107 and 27.392,and all Pvalues were less than 0.05).There were 85％ benign nodules gained grade Ⅰ and Ⅱ elastography images,81.82％malignant nodules had grade Ⅲ and ⅣV elastography images,and there were significant differences between benign and malignant nodules (x2=53.42,P=0.00).Ultrasound contrast found annular enhancement in most of benign nodules (x2=39.16,P＜0.01) while uneven enhancement in most of malignant nodules (x2=40.28,P＜0.01),and the nodule ranges increasedsignificantly after contrast (t=2.19,P＜0.05).The observation group had the sensitivity being 82.86％,which was statisticallyhigher than 59.38％ in the control group (x2=4.537,P--0.033).Conclusion High-frequency ultrasound,elastography and ultrasound contrast all show the manifestations of thyroid solid nodules,and the comprehensive application of the above three measures contributes to determining the nature of the nodules.
ABSTRACT
ObjectiveTo explore the ultrasound characteristics of coronary artery fistula to improve its prenatal diagnosis.MethodsImaging data for 12 fetuses with coronary artery fistula who underwent fetal echocardiography at our hospital from June 2005 to December 2013 were retrospectively analyzed to summarize the ultrasound characteristics of coronary artery fistula.ResultsOf the 12 fetuses, 7 were confirmed with coronary artery fistula by echocardiography after birth, and the remaining 5 were aborted due to other cardiac abnormalities (since an autopsy was not performed, the diagnosis of coronary artery fistula could not be confirmed). Of the 7 confirmed cases, 1 had left coronary artery-to-right atrium fistula, 3 had left coronary artery-to-right ventricle fistula, and 3 had right coronary artery-to-right ventricle fistula; 1 had left coronary artery-to-right ventricle fistula with muscular ventricular septal defect, and 6 had simple coronary fistula. Two-dimensional ultrasound examination revealed that coronary arteries were displayed in all cases, and the diameter ranged from 1.8 to 4.0 mm. Color Doppler ultrasound clearly showed the fistula size, course and the situation fistulas drained into heart chambers. Diastolic regurgitation signal could be detected in the ascending aorta and aortic arch.ConclusionCoronary artery fistula can be diagnosed by color Doppler ultrasound combined with spectral Doppler ultrasound when the fetal coronary artery expands.
ABSTRACT
<p><b>BACKGROUND</b>The difference between renal oncocytomas (RO) and renal clear cell carcinomas (RCCs) presents the greatest diagnostic challenge. The aim of this study was to retrospectively determine if RO and RCCs could be differentiated on computed tomography (CT) images on the basis of their enhancement patterns with a new enhancement correcting method.</p><p><b>METHODS</b>Forty-six patients with a solitary renal mass who underwent total or partial nephrectomy were included in this study. Fourteen of those were RO and 32 were RCCs. All patients were examined with contrast-enhanced CT. The pattern and degree of enhancement were evaluated. We selected the area that demonstrated the greatest degree of enhancement of the renal lesion in the corticomedullary nephrographic and excretory phase images. Regions of interest (ROI) were also placed in adjacent normal renal cortex for normalization. We used the values of the normal renal cortex that were measured at the same time as divisors. The ratios of lesion-to-renal cortex enhancement were calculated for all three phases. The Student's t-test and Pearson's Chi-square test were used for statistical analyses.</p><p><b>RESULTS</b>All RCCs masses showed contrast that appeared to be better enhanced than RO on all contrast-enhanced phases of CT imaging, but there was no significant difference in absolute attenuation values between these two diseases (P > 0.05). The ratio of lesion-to-cortex attenuation in the corticomedullary phase showed significantly different values between RO and RCCs. The degree of contrast enhancement in RCCs was equal to or greater than that of the normal renal cortex, but it was less than that of the normal cortex in RO in the corticomedullary phase. The ratio of lesion-to-cortex attenuation in the corticomedullary phase was higher than the cut off value of 1.0 in most RCCs (84%, 27/32) and lower than 1.0 in most RO (93%, 13/14) (P < 0.05). In the nephrographic phase, the ratio of lesion-to-cortex attenuation was higher than that in the corticomedullary phase in most RO (71%, 10/14), showing a prolonged enhancement pattern; and was lower than that in most RCCs (97%, 31/32), showing an early washout pattern (P < 0.05). In the differentiation of RO from RCCs, the sensitivity was 93%, specificity 84%, positive predictive value 72%, negative predictive value 84%, and accuracy for RO was 87, if the ratio of lesion-to-cortex attenuation in a cortex phase was lower than the cutoff value of 1.0. The sensitivity was 71%, specificity was 97%, positive predictive value was 91%, negative predictive value was 91%, and accuracy for RO was 89%, if the ratio of lesion-to-cortex attenuation in nephrographic phase was higher than that in the corticomedullary phase.</p><p><b>CONCLUSIONS</b>The ratios of renal lesion-to-cortex attenuation ratios may be helpful in differentiating RO from RCCs.</p>
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Adenoma, Oxyphilic , Diagnosis , Diagnostic Imaging , Carcinoma, Renal Cell , Diagnosis , Diagnostic Imaging , Kidney Neoplasms , Diagnosis , Diagnostic Imaging , Tomography, X-Ray ComputedABSTRACT
Objective To discuss the diagnosis and early intervention treatment of fetal congenital broncho-genic cysts based on the cases reviewed. Methods The clinical features of 7 infants presenting bronchogenic cysts diagnosed antenatally from January 2013 to May 2014 in Guangdong Women and Children's Hospital and Health In-stitute were reviewed retrospectively. Pathology,the prenatal diagnosis and treatment of bronchogenic cysts experience were summarized combined with CT after birth and surgery. Results Based on the prenatal diagnosis of fetal and postnatal CT and surgical pathology,a total of 7 cases with congenital bronchial cysts were diagnosed. Of which 4 ca-ses were suggestive of congenital cystsic adenomatoid malformation by prenatal diagnosis,and the other 3 cases had fetal bronchial cysts by prenatal diagnosis,antenatal diagnosis was accurate in 42. 9%(3 / 7 cases). CT examinations were taken in 7 cases after birth,and the cyst excision was performed on them with surgery thoracic approach;the average age at surgery was(5. 3 ± 1. 7)months. Four cases had simple bronchial cystss,2 cases with congenital cystsic adenomatoid malformation,1 case with congenital pulmonary sequestration. The accuracy of CT diagnosis was 85. 7%(6 / 7 cases). All surgical treatment was effective. Conclusions Fetal bronchial cysts is always associated with the other presence of lung congenital malformations. Prenatal diagnosis of congenital bronchial cysts is difficult. Prenatal diagnosis is difficult to exclude congenital cystsic adenomatoid malformation. To avoid symptoms like oppres-sion,infection,prenatal diagnosis combined with CT examination after birth and early treatment are necessary and reliable clinically.
ABSTRACT
Objective To investigate the correlation factors of neonatal lenticulostriate vasculopathy. Method Four hundred and forty-seven newborns from Guangdong Women and Children Hospital were enrolled in this study. Clinical data of the newborns were obtained . Brain ultrasound studies of lenticulostriate artery were performed on the newborns. The logistic regression was performed for screening the correlation factors of neonatal lenticulostriate vasculopathy (P < 0.05). Results Results of the univariate logistic regression reveal the correlation factors tcontributing to LSV include congenital cytomegalovirus infection、neonatal asphyxia、congenital heart disease (CHD),hypertensive disorder in pregnancy (P < 0.05, respectively). Multivariate logistic regression analysis was performed on these factors. The congenital cytomegalovirus infection, neonatal asphyxia, CHD,hypertensive disorder in pregnancy were significantly associated with LSV (P < 0.05). Conclusion The congenital cytomegalovirus infection,neonatal asphyxia,CHD,hypertensive disorder in pregnancy are the correlation factors of neonatal lenticulostriate vasculopathy. LSV could be a predictive marker for the future development of neuropsychiatric disorders. The brain ultrasound studies of lenticulostriate artery is suggested to be performed on all infants with the correlation factors.
ABSTRACT
Objective To investigate the ultrasound characteristics of congenital cystic adenomatoid malformation (CCAM). Methods The ultrasonographic features of 21 cases of fetal CCAM confirmed by prenatal ultrasound were analyzed. And ultrasound ifndings were compared with the postnatal thoracic computed tomography (CT), surgical result and follow-up data. Results (1) Prenatal ultrasonographic ifndings:2 cases of CCAM typeⅠ(10%, 2/21), 13 cases of typeⅡ(62%, 13/21), and 6 cases of typeⅢ(28%, 6/21). Of them, 95%(20/21) lesions were located in unilateral thorax, while 5%(1/21) in bilateral thorax. CCAM was ifrst detected at 18th-25th gestational week with a median of 22nd week. The CVR was1.6 in 16 (76%, 16/21) and 5 (24%, 5/21) cases respectively. After reaching the maximum volume, the size of mass remained stable in 8 cases and regressed in 13 cases with even complete remission in 5 cases. There were mediastinal shift in 19 fetuses (90%, 19/21), polyhydramnios in 6, and concomitant structural abnormalities in 3 cases such as pulmonary sequestration, diaphragmatic hernia and fetal hydrops. (2) Clinical outcomes:15 newborns were conifrmed as CCAM by CT, in which 9 cases underwent surgical resection. One case was conifrmed by autopsy. Nineteen cases showed good prognosis. Whereas 1 pregnancy with fetal hydrops was terminated, and 1 fetus with diaphragmatic hernia died after birth. Conclusions Dynamic prenatal ultrasound assessment is the key factor in prognosis prediction of fetal CCAM. CCAM without other structural abnormalities has a good outcome.
ABSTRACT
Objective To investigate the relationship between obesity parameters and obstructive sleep apnea-hypopnea syndrome (OSAHS) in aircrew. Methods A questionnaire survey in aircrew members was performed. Outcome measurement included body height, body weight, neck circumference ( NC), waist circumference (WC), and body mass index (BMI). Those with snoring during sleep and/or Epworth sleepiness scale (ESS)score ≥ 9 were screened with pulse oxygen saturation test during overnight sleep. Those with oxygen saturation decrease index ≥ 10 times/h and suspected OSAHS were tested by polysomnography (PSG). The objects were then assigned to three groups: the OSAHS group,the snore group and the normal group. The relationship between obesity parameters and OSAHS was analyzed. Results There were 399 ( 37. 54% ) overweight, 36 ( 3. 39% ) obesity, 130 ( 12. 23% ) increased NC, and 354 (33.30%)increased WC in 1063 aircrew members (OSAHS group ＞ snore group ＞ normal group; P＜O. 05). The mean value of BMI, NC and WC in the three groups were dittos. Multiple logistic regression analysis showed that overweight, obesity and increased WC were significantly associated with snoring (P ＜0.05) and snoring enlarged NC was significantly correlated with OSAHS (P＜ 0.05). Conclusion Increased BMI, NC and WC may be risk factors of OSAHS among aircrew. Effective prevention and treatment of OSAHS should be needed.
ABSTRACT
<p><b>OBJECTIVE</b>To evaluate the clinical values of spiral CT imaging postprocessing techniques.</p><p><b>METHODS</b>Totally 167 patients with known or suspected abnormalities of thorax (including small pulmonary emboli, primary and metastatic tumours, diffuse lung diseases, bronchiectasis and emphysema) underwent spiral CT of their thorax. We reconstructed images by using different postprocessing techniques (MPR, MIP, SSD, VR, STS and VE). Images after postprocessing were reviewed in conjunction with axial CT scans by three readers with specific focus on their diagnostic and therapeutic efficiency. Judgement was reached by consensus.</p><p><b>RESULTS</b>Compared with axial CT scans, image presentation after postprocessing (a) corrected interpretive errors in 15 cases; (b) raised diagnostic confidence by providing supplemental diagnostic and/or morphologic information in 57 cases; (c) assisted the accurate location of complicated sites in 9 cases; (d) played a major role in therapy planning in 75 cases; and (e) was not associated with diagnostic superiority in 11 cases.</p><p><b>CONCLUSION</b>Postprocessing of spiral CT data can represent a useful complement to axial CT in most patients with thoracic diseases and should be a routine part of radiological practice.</p>
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Image Processing, Computer-Assisted , Imaging, Three-Dimensional , Lung Neoplasms , Diagnostic Imaging , Mediastinal Neoplasms , Diagnostic Imaging , Radiographic Image Enhancement , Tomography, Spiral Computed , MethodsABSTRACT
3 cm)and small lesions(diameter≤3 cm)were 80.6%(79/98)and 67.2% (45/67),respectively(P
ABSTRACT
OBJECTIVE To study the clinical characteristics of invasive pulmonary aspergillosis(IPA).METHODS Based on the clinical data from 14 IPA cases identified by pathologic examination in the 454th Hospital,the characteristics of IPA were discussed,including the underlying diseases,symptoms,X-ray,CT,the treatment methods and the curative effect.The related literatures were also reviewed.RESULTS All of the 14 patients had underlying diseases.From them 5 were with pulmonary cancer(35.7%),3 with chronic obstructive pulmonary disease(21.4%),2 with pulmonary abscess(14.3%),2 were after chemotherapy for leukemia(14.3%),1 with pulmonary tuberculosis(7.1%)and 1 with diabetes(7.1%).The common symptoms of the 14 cases were febricity,productive cough and hemoptysis.Some of them also suffered with short of breath,night sweat,fatigue,chest pain and losing weight.The air crescent sign showed on X-ray and CT.Soft tissue masses with halo-sign on the margin,dense shadow of small masses within the alveoli,and multi-nodular shadows were also observed.Among 10 patients treated by antifungal medications,only 4 treated otherwise with operation were cured,4 patients died,and 2 patients did not complete the treatment scheme.CONCLUSIONS The patients with immunodeficiency are susceptible to IPA.The clinical manifestations of IPA are non-specific.The final diagnosis depends on the pathologic examination.The only medication is not sufficient for IPA patients.Pulmonary resection should be considered if the prolonged illness or frequent hemoptysis exist.