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Objective:To analyze the factors of missed diagnosis and misdiagnosis of gallbladder adenomyomatosis(GBA) by ultrasonography according to the contrast between ultrasonography and pathology.Methods:Four hundred and forty-six cases of patients with pathological diagnosis of GBA and complete preoperative case informations were retrospectively collected from January 2010 to November 2018 in the PLA General Hospital, and the preoperative ultrasound diagnosis, clinical symptoms, pathological classification were analyzed. The coincidence rate and missed diagnosis rate of GBA by ultrasound were calculated. The ultrasonic diagnosis of GBA missed diagnosis and misdiagnosis factors were analyzed according to the multiple factors and single factor Logistic regression.Results:The coincidence rate of ultrasonic diagnosis was 46.9%(200/426), the missed diagnosis rate was 35.2%(150/426), and the misdiagnosis rate was 17.8%(76/426). Misdiagnosed cases included 65 cases (85.5%) of gallbladder occupation, 7 cases (9.2%) of gallbladder stones, and 4 cases (5.3%) of chronic cholecystitis. The results of multi-fact OR Logistics regression analysis showed that gallbladder stones ( OR=5.112, P<0.001), chronic cholecystitis ( OR=4.613, P<0.001), gallbladder occupation ( OR=6.565, P<0.001) and cholesterol crystals ( OR=8.634, P<0.001) were independent influencing factors for accurate diagnosis of GBA by ultrasound. Conclusions:Ultrasound has a high rate of missed diagnosis and misdiagnosis for GBA operation group at present. Since most cases are complicated with other gallbladder diseases, it is important to scan carefully for GBA besides the diagnosis of a single gallbladder disease.
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<p><b>OBJECTIVE</b>To assess the stiffness and thickness of the plantar fascia using shear wave elastography (SWE) in healthy volunteers of different ages and in patients with plantar fasciitis.</p><p><b>METHODS</b>The bilateral feet of 30 healthy volunteers and 23 patients with plantar fasciitis were examined with SWE. The plantar fascia thickness and elasticity modulus value were measured at the insertion of the calcaneus and at 1 cm from the insertion.</p><p><b>RESULTS</b>The elderly volunteers had a significantly greater plantar fascia thickness measured using conventional ultrasound (P=0.005) and a significantly lower elasticity modulus value than the young volunteers (P=0.000). The patients with fasciitis had a significantly greater plantar fascia thickness (P=0.001) and a lower elasticity modulus value than the elderly volunteers (P=0.000). The elasticity modulus value was significantly lower at the calcaneus insertion than at 1 cm from the insertion in patients with fasciitis (P=0.000) but showed no significantly difference between the two points in the elderly or young volunteers (P=0.172, P=0.126).</p><p><b>CONCLUSION</b>SWE allows quantitative assessment of the stiffness of the plantar fascia, which decreases with aging and in patients with plantar fasciitis.</p>
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Case-Control Studies , Elasticity Imaging Techniques , Fascia , Diagnostic Imaging , Fasciitis, Plantar , Diagnostic ImagingABSTRACT
Purpose To investigate the prognosis and influencing factor of hematoma complicated from ultrasonography-guided EnCor vacuum-assisted breast biopsy system in minimally invasive surgery for breast lesions, and to provide reference for clinical treatment. Materials and Methods 280 female patients with 486 benign breast lesions underwent minimally invasive excision using a ultrasonography-guided EnCor vacuum-assisted device, occurrence and the inlfuence factors of hematoma complicated from the operation was observed. Results All the 486 lesions were completely excised with EnCor system, hematoma (≥1cm) were found in 47 cases after 24 hours and almost disappeared in 6 months. After analysis of the occurrence of hematoma, it was found that the following situations would lead to a higher incidence of hematoma, which included lumps ≥ 2.5 cm, more than two lesions removed at one time, lumps locating deep inside the areola or the edge of breasts, bigger and less dense breasts, operation in menstrual period, pressure bandaging after operation less than 12 hours and operation without using adrenaline (P<0.05 or P<0.01). Conclusion Benign lesions breast can be effectively excised using ultrasonography-guided EnCor vacuum device, and the factors listed below could affect the occurance of hematoma complicated from the surgery, including the size, location and number of the resected nodules, breast shape, surgery during menstrual period, postoperative pressure bandaging and the use of hemostatics.
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Objective To evaluate the value of supersonic shear wave elastrography(SWE) in the diagnosis of benign and malignant breast lesions.Methods SWE was performed on 134 breast lesions of 123 female patients and 74 normal breast glands to determine the values of overall elastic modulus and dispersion,and ROC curves were used to assess the diagnosis boundary value of two kinds of data respectively.Results According to the diagnostic gold standard-histopathology,the values of overall elastic modulus and dispersion were statistically significant when comparing benign lesions and malignant lesions with normal glands.ROC curve displayed that,when the Youden index reached to maximum,the diagnosis boundary value of overall elastic modulus was 41.01 kPa,the sensitivity and specificity of the value were 68.5％ and 83.8％ respectively; the diagnosis boundary value of dispersion was 12.25 kPa,the sensitivity and specificity of the value were 87.0％ and 88.7％ respectively.Conclusions The values of overall elastic modulus and dispersion for solid breast lesions can be used to reflect the elastic characteristics of lesions quantificationally,which is useful to diagnose benign and malignant breast lesions in clinical.