Verification and comparisons of different ultrasound risk-stratification systems in the evaluation of thyroid nodules / 中华超声影像学杂志

Objective To verify and compare the TI-RADS developed by Kwak et al .( Kwak TI-RADS ) ,2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer ( ATA Guideline Classification) ,2017 TI-RADS released by the American College of Radiology (ACR TI-RADS) and TI-RADS developed by Zhou et al .(Zhou TI-RADS) in the evaluation of thyroid nodules . Methods The ultrasound images of 339 thyroid nodules in 273 patients were analyzed by retrospective study . The thyroid nodules were categorized into aforementioned four stratified systems . Based on the pathological findings considered the "gold standard",the receiver operating characteristic( ROC ) curve was created to compare the clinical application value of aforementioned four stratified systems . Results The percentage of nodules that could not be categorized were 1 .2％ ,17 .5％ ,0 and 1 .2％ for the Kwak TI-RADS ,ATA guidelines ,ACR TI-RADS ,and Zhou TI-RADS ,respectively and the area under the ROC curve ( AUC) was 0 .899 ,0 .879 ,0 .876 ,and 0 .918 ,respectively . The sensitivity of Kwak TI-RADS ,ATA guidelines classification ,and ACR TI-RADS were higher than that of Zhou TI-RADS (all P < 0 .05) ,whereas the specificity of Zhou TI-RADS was the highest (all P < 0 .05) . As for the accuracy ,no statistically significant differences were observed between any two of Kwak TI-RADS ,ATA guidelines ,ACR TI-RADS ,and Zhou TI-RADS systems ( all P > 0 .05) . Conclusions Four thyroid risk stratification systems provide effective risk assessment for thyroid nodules ,Zhou TI-RADS has relatively lower sensitivity ,but its specificity and AUC value are the highest among the four evaluated systems . In addition ,ACR TI-RADS can classify the most nodules ,while the number of nodules that can′t be categorized by ATA guideline is maximum .

Ultrasound-guided laser thermal ablation for treatment of small liver cancer at high-risk sites / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the clinical value of ultrasound-guided laser thermal ablation (LTA) in the treatment of small liver cancer at high-risk sites.</p><p><b>METHODS</b>A total of 73 lesions ablated with LTA in 68 patients with small liver cancer. After the operation, the rates of complete ablation were compared between patients with lesions of different sizes and at different sites using contrast-enhanced ultrasound and the complications were recorded during the follow-up.</p><p><b>RESULTS</b>The complete ablation rates for carcinomas ≤1 cm, 1-2 cm, and 2-3 cm were 100%, 86.4%, and 82.7%, respectively, showing no significant differences among them (P>0.05). The complete ablation rates of lesions were similar between the high-risk and low-risk groups (85.7% vs 92.1%; P>0.05). The two groups showed no significant difference in the incidence of complications (9.1% vs 5.7%; P>0.05).</p><p><b>CONCLUSION</b>Ultrasound-guided LTA can be a good option for treatment of small liver cancers at high-risk sites.</p>

Contrastive study on conventional ultrasound, compression elastography and acoustic radiation force impulse imaging in the differential diagnosis of benign and malignant breast tumors / 中南大学学报(医学版)

Objective: To evaluate the diagnostic performance of conventional ultrasound, compression elastography (CE) and acoustic radiation force impulse imaging (ARFI) in diff erential diagnosis of benign and malignant breast tumors. Methods: A total of 98 patients with liver lesions were included in the study. The images of conventional ultrasound, CE and the values of virtual touch tissue quantiifcation (VTQ) of breast lesions were obtained. hTe diagnostic performance of conventional ultrasound, CE and ARFI were assessed by using pathology as the gold standard, and then evaluate the diagnosis effciency of these three approaches in differential diagnosing benign and malignant breast tumors. Results: The specificity, sensitivity and accuracy in the diagnosis of malignant breast tumors for conventional ultrasound were 80.0%, 81.1% and 81.7%, respectively, whereas for CE elastic score were 85.7%, 86.7% and 86.3%, respectively. With a cutoff value of 3.71 for the SR, the sensitivity, speciifcity, accuracy in diagnosis of malignant breast tumors were 97.1%, 83.3% and 88.4%, respectively. With a cutoff value of 3.78 m/s for VTQ, the sensitivity, speciifcity, accuracy in diagnosis of malignant breast tumors were 94.3%, 91.7% and 92.6%, respectively. The difference in diagnosis efficiency among ARFI, CE and conventional ultrasound in differential diagnosis of benign and malignant breast tumors was signiifcant (P<0.05). Conclusion: Conventional ultrasound, CE and ARFI are all useful for the differential diagnosis of benign and malignant breast tumors. But the diagnosis effciency of ARFI is superior to CE and conventional ultrasound. The three approaches can help each other in differential diagnosis of benign and malignant breast tumors.

Clinical value of inferior vena caval filter insertion under color Doppler flow imaging guidance through the right internal jugular vein / 南方医科大学学报

<p><b>OBJECTIVE</b>To explore the efficacy and feasibility of color Doppler flow imaging (CDFI)-guided inferior vena caval filter (IVCF) insertion through the right internal jugular vein for prevention of pulmonary embolism in patients with deep venous thrombosis (DVT).</p><p><b>METHODS</b>Thirty-eight patients with lower extremity DVT confirmed by clinical and CDFI examinations underwent IVCF insertion through the right internal jugular vein under guidance of CDFI for prevention of pulmonary embolism. The shape and position of IVCF were monitored by CDFI regularly. After 32 to 45 days, the retrievable filters were removed under CDFI guidance via the right internal jugular vein. All patients were followed up to monitor the occurrence of filter complications and pulmonary embolism PE.</p><p><b>RESULTS</b>Preoperative CDFI clearly displayed the locations of the right internal jugular vein, inferior vena caval (IVC), bifurcation of the common iliac vein, and the bilateral renal veins in all the 38 patients. All the veins were free of anatomical variations or embolism. Under CDFI guidance, 23 retrievable IVCF and 15 permanent IVCF were placed without technical difficulty via the right internal jugular vein. Follow-up examination with CDFI and abdominal plain X-ray film showed that all the filters were placed in right positions with complete opening. The 23 retrievable filters were retrieved via the right internal jugular vein after 32-45 days. IVCF captured venous emboli in 14 cases (36.5%). None of the patients had filter displacement, tilting, or fracture or showed IVC perforation or the occurrence of pulmonary embolism.</p><p><b>CONCLUSION</b>CDFI-guided IVCF insertion via the jugular vein is safe and feasible. Compared with X-ray guidance, CDFI guidance is convenient and substantially reduces the procedural cost and avoids the risk of radiation exposure.</p>

Contrast-enhanced ultrasonographic evaluation on blood supply of rabbit liver VX2 tumor in early stage / 中国医学影像技术

Objective To observe the value of contrast-enhanced ultrasonography (CEUS) in quantitatively evaluating the evolution of the blood supply of rabbit liver VX2 tumor models in early stage. Methods Eighteen liver VX2 tumor models of rabbits were divided into 3 groups randomly (each n=6). CEUS was performed on the 10th, 15th and 20th day group after establishemnt, resepectively. Time intensity curve (TIC) was plotted, the rabbits' liver tumor and surrounding normal liver tissue were resected for immuno-histochemistry and microvessel density (MVD) count. Results CEUS showed that the rabbit liver VX2 tumor present a typical malignant tumor imaging fast-in and fast-out in early stage. TIC showed that the time to peak (TTP) of hepatic tumor is shorter than that of surrounding normal liver tissue in all three groups (P＜0.01), no statistical difference of tumor's TTP was detected among three groups (P>0.05). Absolute enhanced intensity (AEI) and MVD reduced in turn of 10th, 15th and 20th day group. MVD of tumor was higher in 10thday group than surrounding normal liver tissue (P＜0.01), while was equal in 15th day group (P>0.05) and lower in 20th day group (P＜0.01). AEI of liver tumor had positive correlation with MVD (r=0.83, P＜0.05). Conclusion AEI of TIC can be used to quantitatively assess the evolution of the blood supply in rabbit liver VX2 tumor models. The blood supply in early stage of rabbit liver VX2 tumor models shows a gradual descent process from abundant blood supply to medium blood supply and then low blood supply.

Ultrasound-guided renal intracapsular injection of methylprednisolone for primary glomerulonephritis / 中南大学学报(医学版)

OBJECTIVE@#To evaluate ultrasound-guided renal intracapsular injection of methylprednisolone for primary glomerulonephritis.@*METHODS@#Thirty patients with primary glomerulonephritis were performed intra-renal adipose capsule injection therapy under ultrasound guidance. The 24 hour urinary protein, plasma total protein, plasma albumin, urine volume, and serum creatinine were measured before and after the treatment.@*RESULTS@#The injection success rate was 96.3% (314/326) in patients whose width of perinephric adipose capsule was >or= 5 mm. The injection success rate was 77.4% (212/274) in patients whose width of perinephric adipose capsule was 0.05).@*CONCLUSION@#Intra-renal adipose capsule injection under ultrasound guidance has a high success rate and good effect, and is effective to treat primary glomerulonephritis with glucocorticoid.