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Objective:To investigate the reference value of ultrasonography (US) image features, elastography and serum thyroid stimulating hormone (TSH) levels in preoperative diagnosis of differentiated thyroid carcinoma (DTC).Methods:Retrospective analysis was conducted to collect clinical data of patients undergoing thyroid surgery in the Fourth Affiliated Hospital of Harbin Medical University from September 2018 to January 2020. All patients underwent conventional ultrasound, elastography examination and serum TSH level measurement before surgery; patients were divided into benign group and DTC group according to the results of pathological results of the operation, and the US image features and elasticity score were analyzed by chi-square test and multivariate logistic regression to evaluate the causes of DTC; a multivariate logistic regression model was established and the receiver operating characteristic curve (ROC) was drawn with the regression model, by analyzing the area under the ROC curve (AUC), sensitivity, specificity and accuracy, the reference value of US image features, elastography and serum TSH levels in the preoperative diagnosis of DTC were judged.Results:Clinical data of 81 patients were collected, including 17 men and 64 women, aged (48.72 ± 10.58) years. In benign group, there were 37 cases, including 10 men and 27 women, with age of (53.24 ± 9.59) years; there were 44 patients in DTC group, including 7 men and 37 women, with age of (44.91 ± 9.95) years old, the age difference between benign group and DTC group was significant ( t = 3.822, P < 0.05), while the gender difference was not statistically significant (χ 2 = 1.498, P > 0.05). There were significant differences in the number, size, echo level, microcalcification, aspect ratio and elasticity score between benign group and DTC group (χ 2 = 49.000, 4.457, 32.111, 5.444, 4.457, 49.926, P < 0.05); multivariate logistic analysis showed that hypoecho, microcalcification, aspect ratio > 1 and elasticity score were risk factors for DTC ( OR = 8.042, 4.787, 4.160, 2.380, P < 0.05), the ROC curve of the multivariate logistic regression model showed that the AUC was 0.841 (95% CI = 0.743 - 0.939), sensitivity was 90.91%, specificity was 72.97%, and accuracy was 82.72%; the AUC of serum TSH level prediction of DTC showed that the AUC was 0.721 ( P < 0.05), sensitivity was 72.70%, specificity was 64.90%, accuracy was 54.30%, and TSH best cut-off value was 2.215 μU/ml. Conclusion:In the preoperative diagnosis of DTC, US image features, elastography and serum TSH levels are of important clinical reference value for diagnosis of DTC, and the establishment of multivariate logistic regression model is conducive in improving the clinicians prediction of the occurrence of DTC.
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Objective:To investigate the adult thyroid structural abnormalities and epidemiological characteristics in different regions of Heilongjiang Province.Methods:From December 2017 to November 2018, 30 survey sites were selected in 13 prefecture-level cities under the jurisdiction of Heilongjiang Province by the population probability sampling (PPS) method, and 120 local residents aged 20 to 70 who lived for more than 1 year in the local area were selected from each survey site for thyroid ultrasound examination. The occurrence of thyroid structural abnormalities in different genders, ages and regions were analyzed.Results:A total of 3 870 residents were investigated, including 1 248 males and 2 622 females, aged (48.3 ± 12.6) years; 2 075 urban residents and 1 795 rural residents. A total of 2 144 cases of thyroid structural abnormalities were detected, with a total detection rate of 55.40% (2 144/3 870); among them, 1 476 cases of thyroid focal nodular lesions, 359 cases of diffuse lesions, and 309 cases of diffuse lesions with focal nodules, the detection rates were 38.14%, 9.28%, and 7.98%, respectively. The detection rate of thyroid structural abnormalities was 61.25% (1 606/2 622) in women and 43.11% (538/1 248) in men, the difference was statistically significant (χ 2=111.899, P < 0.01). There was significant difference in the total detection rate of thyroid structural abnormalities among different age groups (χ 2=185.959, P < 0.01); and with the increase of age, the total detection rate of thyroid structural abnormalities showed an upward trend (χ 2trend=173.576, P < 0.01). There was significant difference in the total detection rate of thyroid structural abnormalities in adults among different prefecture-level cities (χ 2=108.487, P < 0.01); but there was no significant difference in the total detection rate of thyroid structural abnormalities between urban and rural (χ 2=0.103, P > 0.05). Conclusions:The main thyroid structural abnormalities in Heilongjiang Province are focal nodular lesions. The detection rate of women is higher than that of men, and the older the age, the higher the detection rate. There are differences in the detection rate of thyroid structural abnormalities in adults of different prefecture-level cities, but there is no significant difference between urban and rural.
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Objective:To investigate the prevalence of thyroid nodule in middle-aged and elderly people in Heilongjiang Province, and to analyze its epidemiological characteristics and influencing factors.Methods:From December 2017 to December 2018, middle-aged and elderly people aged 40-70 years old were recruited through probability proportional sampling (PPS) method for a cross-sectional survey. The respondents were stratified by age (40-49, 50-59, 60-70 years old), urine samples were collected at random once during the day, and urinary iodine was detected by arsenic-cerium catalytic spectrophotometry (WS/T 107.1-2016). At the same time, questionnaire surveys and thyroid ultrasound examinations were conducted on the respondents. Logistic regression was used to analyze the relationship between the related investigation factors and the thyroid nodule.Results:A total of 2 771 middle-aged and elderly people were included, and their age was (54.32 ± 8.24) years old. The median of urinary iodine was 157.04 μg/L, which was an iodine appropriate level. The prevalence of thyroid nodule was 43.63% (1 209/2 771), and the prevalence increased with age(χ 2trend=49.400, P < 0.01). The prevalence of thyroid nodule in females [46.98% (917/1 952)] was significantly higher than that in males [35.65% (292/819), χ 2=30.082, P < 0.01]. In patients with thyroid nodule, small nodule accounted for 57.65% (697/1 209), large nodule accounted for 42.35% (512/1 209), and the proportion of large nodule increased with age (χ 2trend=18.751, P<0.01). Solitary nodule accounted for 42.76% (517/1 209), multiple nodule accounted for 57.24% (692/1 209), and the proportion of multiple nodule increased with age(χ 2trend=18.437, P<0.01). Cystic-solid nodule was the most common[47.97%(580/1 209)], followed by solid nodule [44.25% (535/1 209)], and cystic nodule was the least common [7.78% (94/1 209)]. Logistic regression analysis showed female [odds ratio ( OR)=1.868, 95% confidence interval ( CI): 1.538-2.269, P < 0.01], age (50-59 years old: OR=1.258, 95% CI: 1.020-1.550, P < 0.05; 60-70 years old: OR=1.762, 95% CI: 1.407-2.207, P < 0.01), overweight ( OR=1.303, 95% CI: 1.078-1.574, P < 0.01), hypertension ( OR=1.332, 95% CI: 1.037-1.712, P < 0.05), and diabetes ( OR=1.604, 95% CI: 1.077-2.387, P < 0.05) were independent risk factors affecting the occurrence of thyroid nodule in middle-aged and elderly people. Conclusions:The epidemiological characteristics of thyroid nodule in middle-aged and elderly people in Heilongjiang Province have obvious age trends and gender differences. The proportion of large nodule and multiple nodule increase with age. Early screening and attention to the prognosis of women, older, overweight, hypertension and diabetes people should be strengthened.
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Objective:To investigate the application value of shear wave elastography (SWE) and real-time tissue elastography (RTE) in differential diagnosis of thyroid Amereican College Radiology (ACR) TR5 nodules.Methods:Patients who underwent ultrasound examination at the Fourth Affiliated Hospital of Harbin Medical University from August 2018 to June 2019 diagnosed as ACR TR5 nodules were surveyed, and received SWE and RTE examinations to evaluate the nodules hardness. The receiver operating characteristic curve (ROC curve) was drawn to obtain the best diagnostic cutoff value for the Young's modulus maximum (Emax) of the benign and malignant thyroid ACR TR5 nodules using SWE technique; using the 5-point method, the elasticity score (ES) was used to evaluate the benign and malignant ACR TR5 nodules by RTE technology, and the pathological results were regarded as "gold standard". The accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of SWE, RTE and two elastography techniques in differential diagnosis of benign and malignant thyroid ACR TR5 nodules were compared.Results:A total of 65 patients were enrolled, with a total of 73 ACR TR5 nodules. The optimal Emax threshold for differential diagnosis of ACR TR5 nodules by SWE technology was 41.8 kPa, and 32 malignant nodules and 41 benign ones were determined. Of the 73 ACR TR5 nodules using RTE technology, 38 had ES scores of 1 to 3 and 35 had ES scores of ≥4. Pathological results showed that among 73 thyroid ACR TR5 nodules, benign nodules accounted for 45.21% (33/73), malignant nodules accounted for 54.79% (40/73). The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of SWE, RTE and two elastography techniques for differential diagnosis of benign and malignant thyroid ACR TR5 nodules were 72.50%, 77.50%, 87.50%; 90.91%, 87.88%, 87.88%; 80.82%, 82.19%, 87.67%; 90.63%, 88.57%, 89.24% and 73.17%, 76.32%, 85.29%.Conclusions:Ultrasound elastography of two different imaging principles of SWE and RTE is an effective method for differential diagnosis of benign and malignant thyroid ACR TR5 nodules. The combination of the two is more advantageous.
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Objective To investigate the relationship between changes in thyroid ultrasound parameters and thyroid function during pregnancy. Methods With prospective design, from December 2015 to December 2016, healthy women at childbearing age at the Obstetrics Clinic of the Fourth Affiliated Hospital of Harbin Medical University were observed using a self-control method in pre-pregnancy, early pregnancy, mid-pregnancy and late pregnancy. Thyroid ultra-sonography was performed to measure thyroid volume, systolic blood flow velocity (PSV), and resistance index (RI) during the four phases. At the same time, venous blood was drawn at the four stages and electrochemiluminescence immunoassay was performed. Serum free triiodothyronine (FT3), free thyroxine (FT4), and thyroid stimulating hormone (TSH) were examined to analyze the relationship between changes in thyroid ultrasound parameters and thyroid function. Results A total of two hundred and two pregnant women of childbearing age were selected, twenty-two of them were excluded based on inclusion criteria, one hundred and sixty-nine were successfully conceived. Thyroid volume (cm3) was significantly different (F = 4.77, P < 0.01) between pre-pregnancy (8.10 ± 1.41), early pregnancy (11.16 ± 4.07), mid-pregnancy (10.31 ± 2.59), and late pregnancy (9.98 ± 2.02). Among them, there were statistically significant differences (P<0.05) between early pregnancy and mid-pregnancy compared with pre-pregnancy, mid-pregnancy and late pregnancy with early pregnancy. Left and right PSV ( cm/s ) were significantly different (F=2.95, 2.41,P<0.05) between pre-pregnancy (13.63 ± 1.58, 14.12 ± 1.92), early pregnancy (16.12 ± 2.58, 15.93 ± 3.45), mid-pregnancy (14.54 ± 2.86, 14.61 ± 3.23), and late pregnancy (13.23 ± 2.85, 13.54 ± 2.13). Among them, there were statistically significant differences (P < 0.05) between pre-pregnancy and late pregnancy compared with early pregnancy, mid-pregnancy with late pregnancy. The differences between FT3, FT4 and TSH groups were statistically significant (χ2 = 41.46, 25.09, 9.29, P < 0.01 or < 0.05). FT3 (pmol/L) was significantly different (P < 0.05) between pre-pregnancy (3.84) and mid-pregnancy (4.41) and late pregnancy (4.08) compared with early pregnancy (4.85). FT4 (pmol/L) was significantly different (P < 0.05) between early pregnancy (16.08) compared with mid-pregnancy (14.40), pre-pregnancy (13.42) and late pregnancy (12.80), pre-pregnancy compared with mid-pregnancy. TSH (mU/L) was significantly different (P<0.05) between early pregnancy (1.05) compared with pre-pregnancy (1.65) and late pregnancy (1.72). Thyroid volume, PSV and RI changes were not significantly associated with thyroid function FT3, FT4, and TSH (r<0.3, P>0.05). Conclusion Pregnancy can lead to changes in thyroid ultrasound parameters and thyroid function in pregnant women, but there is no correlation between them.
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Objective:To investigate the safety and efficacy of ultrasound-guided transvaginal radiofrequency ablation in the treat ment of symptomatic uterine fibroid.Methods:39 patients with symptomatic uterine fibroid underwent transvaginal radiofrequency ablation therapy were selected Before treatment,the fibroid size and volume were measured using ultrasound.The fibroid-related symptom severity and quality of life were scored using uterine fibroid symptom and quality of life survey.The fibroid volume reduction rate,improvement in clinical symptom and quality of life,and ovarian function of patients were observed before treatment and at three,six,nine and 12 months after treatment.Results:The average operation time of radiofrequency ablation was 25 minutes.There was no clear intraand postoperative complication.Preoperative fibroid volume was 65.2± 49.3cm3,which was reduced to 32.2± 27.6 cm3,21.2± 18.2 cm3,15.3± 12.1 cm3 and 10.3± 9.8 cm3 at 3,6,9 and 12 months after treatment,respectively(P＜0.05).The symptom severity score (SSS) was 60.23± 13.2 before treatment,and gradually decreased to 42.2± 11.4,21.1± 10.2,15.4± 10.3 and 12.2± 9.7 at 3,6,9 and 12 months after treatment(P＜0.05).The quality of life (QOL) score gradually increased from 58.24± 16.24 before treatment to 70.3± 20.3,81.4± 8.6,86.3± 7.6 and 88.2± 9.1 at 3,6,9 and 12 months after treatment (P＜0.05).The levels of follicle stimulating hormone,luteinizing hormone and estradiol at 3,6,9 and 12 months after treatment showed no difference compared with these before treatment (P＞0.05).Conclusions:Ultrasound-guided transvaginal radiofrequency therapy was a minimally invasive,safe,and effective therapy for symptomatic uterine fibroid.
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Objective:To investigate the application value of real-time ultrasound elastography in the treatment of fibroids radiofrequency ablation (RFA).Methods:Transvaginal ultrasonography,Real-time ultrasound elastography (RTE) and contrast-enhanced ultrasonography (CEUS) were performed on 34 patients with a total of 38 uterine fibroids who had the treatment of RFA before,1 hour and 3 months after the treatment of RFA.Detected the diameters of the lesions with the three methods of CEUS,RTE and 2D.Analysed the elastic image features and divided into groups,Measured the elastic strain ratio and compared the E/E0 in and between the group.The difference of lesion diameter between 2D,RTE and CEUS was compared.When the image of lesions showed blue and green was taken as the cirterion of incomplete ablation after RFA,conpared with CEUS,analysed the consistency of RTE and CEUS in evaluating the degree of ablation.Results:The lesions were divided into 3 groups according to the preoperative elastic image,with 8 (21.1％) in the blue group,20 (52.6％) in blue-based and 10 (26.3％) in green-based group.The difference was obvious in E/E0 between the 3 groups before RFA.There was no significant difference in E/E0 between 1 hour and 3 months after RFA (P ＞ 0.05).In each group the E/E0 of lesions were significantly increased at 1 hour and 3 months after the treatment of FRA,and the hardness of 3 months after RFA was harder than that of 1 hour after RFA(P＜0.05).The diameter measured by RTE was larger than that by 2D and CEUS before RFA(P＞0.05).The diameter measured by 2D was larger than that by RTE and CEUS at 1 hour after RFA (P＜0.05).No statistically significant difference was found in the lesion diameters among the three methods of2D,RTE and CEUS at 3 months after the treatment ofRFA (P＞0.05).CEUS and RTE had the basic consistent in the evaluation of lesions ablation degree at 1 hour (kappa=0.46) and 3 months (kappa=0.54) after the treatment of RFA.Conclusions:After RFA,the myoma gradually hardens,and RTE can reflect the change of the hardness,RTE can clearly show the boundary of uterine ftbroids especially after the treatment of RFA,can be used in the prediction of lesions ablation degree,so there was a certain application value of RTE used in RFA.
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Objective To explore the value ofspatio-temporal image correlation (STIC) technique in diagnosis of fetal ductus arteriosus aneurysm (DAA).Methods A total of 67 pregnant women,diagnosed with fetal ductus arteriosus aneurysm,were selected from the Fourth Affiliated Hospital of Harbin Medical University,between September 2014 and September 2016.2DE and STIC techniques were used to observe the form of fetal ductus arteriosus aneurysm.STIC technique was used to measure the maximum diameter,minimum diameter,systolic peak velocity,and diastolic velocity of ductus arteriosus aneurysm in 40 cases caused by ductus arteriosus stenosis.Pearson linear correlation analysis was applied to analyze the correlation between the maximum diameter and the minimum diameter,systolic peak velocity and diastolic velocity.The maximum diameters of 67 ductus arteriosus aneurysm were measured by 2DE and STIC techniques,and the above measurements were repeated one week later.ICC was used to analyze the consistency between 2DE and STIC technique,and internal consistency of 2DE and STIC technique,respectively.Results Pearson linear correlation analysis showed that the maximum diameter of the DAA was negatively correlated with the minimum diameter (r=-0.755,P ＜ 0.001) significantly,and positively correlated with the systolic peak velocity (r=0.779,P ＜ 0.001) significantly.The internal consistency of STIC technique was the best of the three,followed by the consistency between 2DE and STIC techniques,with the 2DE,illustrating the lowest consistency.Conclusions STIC technique provides with more comprehensive and accurate volume data than 2DE in the diagnosis of fetal ductus arteriosus aneurysm.Thus,this technique is conducive to the early detection of ductus arterious stenosis,observation of hemodynamic changes,closely monitoring of relevant indicators to guide clinical timely intervention,and to improve the quality of life of children.
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Objective To explore the application value of ultrasound elasticity index ratio and elasticity index methods in differential diagnosis of different sizes of benign and malignant thyroid nodules.Methods Clinical examination data of patients who were hospitalized for thyroid nodules were collected and were retrospectively analyzed in the Fourth Affiliated Hospital of Harbin Medical University from January 2015 to January 2016.The elasticity index ratio and elasticity index were used to diagnose benign and malignant thyroid nodules,and the results were compared with pathological diagnosis.The thyroid nodules were fell into three groups according to the maximum long diameter:＜ 1,1-2,and ＞ 2 cm.Using the above two methods,the sensitivity,specificity and accuracy were analyzed in benign and malignant thyroid nodules with different sizes.And the receiver operating characteristic curve (ROC) was drawn.Results A total of 90 patients (108 nodules) were enrolled in the study and they were from thyroid nodular surgery,28 male cases,62 female cases,mean age (44.1 ± 11.5) years,and ranged from 20 to 69 years old.Seventy benign nodules and 38 malignant nodules were diagnosed with pathology.Sixtythree benign nodules and 45 malignant nodules were diagnosed via the ultrasound elasticity index ratio method.Compared with the pathological diagnosis,13 were misdiagnosed and 6 were omission diagnosed in malignant thyroid nodules.Sixty-three benign nodules and 45 malignant nodules were diagnosed via the ultrasound elasticity index method.Compared with the pathological diagnosis,16 were misdiagnosed and 9 were omission diagnosed in malignant thyroid nodules.Sensitivities of elasticity index ratio method in ＜ 1,1-2,and ＞ 2 cm groups were 91.7％,86.0％,and 75.0％;specificities were 88.9％,78.6％,and 79.2％,and accuracies were 90.0％,81.0％,and 77.8％;and differences in sensitivity and accuracy of the two methods were statistically significant (x2 =76.4,70.8,P ＜ 0.05).Sensitivities of elasticity index method in ＜ 1,1-2,and ＞ 2 cm were 83.3％,78.6％,and 66.7％;specificities were 83.3％,75.0％,and 75.0％,and accuracies were 83.3％,76.0％,and 72.2％.Differences in sensitivity and accuracy of the two methods were statistically significant (x2 =82.8,74.5,P ＜ 0.05).The area under the ROC curve of elasticity index ratio and of elasticity index was 0.814 and 0.766,respectively,and the difference was statistically significant (Z =0.896.P ＜ 0.05).Conclusions In the differential diagnosis of different sizes of benign and malignant thyroid nodules,the elasticity index ratio method is better than the elasticity index method.The diagnostic value on ≤ 2 cm nodules is higher.
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Objective To investigate the value of real-time elastography (RTE) in evaluating the characteristics and elasticity index (E-index) changes at different echo level of uterine fibroids before and after radiofrequency ablation (RFA).Methods A total of 43 patients (with 55 lesions) accepted RFA under ultrasound guidance in the Fourth Affiliated Hospital of Harbin Medical University from September 2013 to January 2015.All lesions were confirmed to have no perfusion through ultrasonography 1 h after RFA.The diameter of lesions ranging from 1.0 cm to 3.0 cm (with an average of 1.9± 1.2 cm).Preoperative lesions were classified into 3 groups for comparison based on ultrasonic echo type,group A:hypo echo (n=30);group B:hyper echo (n=12);and group C:mixed echo (n=12).Measured elasticity index E-index and internal uniformity (△ E) were analyzed.Comparisons of E value and△ E value were performed with repeated measures.RTE images features using x2 test of Fisher inspection comparison at the same time differences between groups.Results (1) Before RFA,RTE images showed blue alternating with green with green being dominated accounting for 70％ (21/30).50％ of RTE images in group B were completely covered in blue (6/12),while group C exhibited 53.9％ blue alternating with green with blue being dominated (7/13).There were statistically significant characteristics of RTE images among 3 groups (P ＜ 0.01).1 h after RFA,74.5％ lesions exhibited with blue being dominated (41/55).However,83.6％ (41/55) exhibited with blue 3 months after RFA.The difference in characteristics of RTE among 3 groups displayed no statistical significance (P ＞ 0.05).(2) The comparison of E-index revealed that before RFA,the E value was the lowest in the group A and the highest in the group B,while the group C was between them.There was significant difference between group A and B (F=19.25,P ＜ 0.01).E-index elevated in all the three groups and significant differences were found 1 h,3 month after RFA in comparison with that before RFA in the group A (F=386.75,294.68,both P ＜ 0.01).In addition,significant differences were also found 1 h,3 month after RFA in comparison with the treatment in the group B (F=29.98,45.88,both P ＜ 0.01).As for the group C,there were significant differences in E-index 1 h,3 month after RFA compared with before RFA (F=120.29,139.64,both P ＜ 0.01).3 months after RFA,E-index further elevated in the three groups and no significant inter-group difference was found at the same time points (P ＞ 0.05).(3)Before RFA,the△ E value was lower in group A and group B,while higher in the group C,group C presenting significant difference from group A and B (F=484.68,344.15,both P ＜ 0.01).At 1 h after RFA,△ E value was higher in group A and group C,while lower in group B,with group B showing significant difference from the low and mixed echo groups (F=53.58,94.79,both P ＜ 0.01).Significant difference was observed 1 h after surgery compared to before RFA in group A (F=154.35,P ＜ 0.01).Significant difference was also found 1 h after RFA compared to 3 month after RFA in group A (F=266.85,P ＜ 0.01).As for group C,there were also significant differences in△ E-index before treatment and 1 h after RFA compared with 3 month after RFA (F=103.24,76.53,both P ＜ 0.01).At 3 months after RFA,△ E-index decreased in all three groups.No significant inter-group difference was found at the same time points (all P ＞ 0.05).Conclusions RTE characteristics and the elasticity index are distinctly different among uterine fibroid at various echo intensities.RTE contributes to judging changes in hardness before and after RFA.The application of RTE for quantitative comparison of lesion hardness and uniformity can be served as the foundation for evaluating therapeutic effects of RFA.
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ObjectiveTo explore changes of immune factors in serum before and after ultrasound-guided (US-guided ) interventional treatment of ovarian endometrial cyst.MethodsNine patients with ovarian endometrial cyst were selected between December 2011 and December 2013 in the fourth affiliated hospital of Harbin Medical University. All patients performed US-guided interventional treatment, the serum specimens were collected before and after three months of treatment respectively. NimbleGen genome microarray of serum specimens were performed to analysis the gene function and gene pathways of related factors of ovarian endometrial cyst and to find out factors with significant expression differences before and after treatment. The relevance between factors with significant expression differences and the pathogenesis of ovarian endometrial cyst were analyzed.ResultsThe expression of CD36, NR4A1and HES1 were found to be down-regulated after US-guided interventional treatment of ovarian endometrial cyst by NimbleGen genome microarray. The gene function of CD36, NR4A1 and HES1participating in angiogenesis, chemotaxis, cell adhesion was relevant to the pathogenesis of the ovarian endometrial cyst, and played roles through Adipocytokine signaling pathway, MAPK signalig pathway, Maturity onset diabetes of the young signaling pathways.ConclusionSerum CD36, NR4A1 and HES1of ovarian endometrial cyst were down-regulated after US-guided ethanol sclerotherapy , and involved in the pathogenesis of ovarian endometrial cyst .
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Objective To evaluate the features of ultrasound and elastography of chronic lymphocytic thyroiditis (CLT) with different thyroid functions,analyze the course of the disease and provide a basis for clinical treatment.Methods A total of 77 patients with CLT were retrospectively analyzed in the Department of Ultrasound,Fourth Affiliated Hospital of Harbin Medical University from September 2013 to September 2014.The patients were divided into four groups based on thyroid function,including 20 patients with hyperthyroidism,18 patients with hypothyroidism,20 patients with subclinical hypothyroidism,and 19 patients with euthyroidism.According to 6 indicators consisted of the thyroid size (volume,thickness of the lateral lobe,thickness of the isthmic portion),flow classification(0,Ⅰ,Ⅱ,Ⅲ),the peak systolic velocity (PSV) of the superior thyroid artery(STA),resistance index (RI) of the STA,echo types (diffuse,localized) and ultrasound elastic rate (E2/E1),the features of ultrasound and elastography of CLT were analyzed.According to the thyroid echo types and different thyroid functions,the change of E2/E1 was analyzed and the relationship between E2/E1 in different thyroid function and thyroid function (thyroid stimulating hormone,TSH) was compared.Results The volume,thickness of the lateral lobe of hypothyroidism,subclinical hypothyroidism,hyperthyroidism and euthyroidism groups were respectively as follows:(14.25 ± 4.15),(11.79 ± 3.22),(9.84 ± 2.63),(5.61 ± 1.35) ml and (2.35 ± 0.27),(2.15 ± 0.24),(1.97 ± 0.16),(1.62 ± 0.22) cm,and the differences between different groups were statistically significant (F =27.77,35.56,all P ＜ 0.05).The thickness of the isthmic portion was respectively as follows:(0.53 ± 0.09),(0.47 ± 0.06),(0.44 ± 0.06),(0.38 ± 0.06) cm,and the differences between different groups were not statistically significant (F =14.76,P ＞ 0.05).The PSVs were respectively as follows:(50.53 ± 10.61),(42.93 ± 7.81),(64.96 ± 12.20),(34.74 ± 6.05) cm/s,and the differences between different groups were statistically significant (F =36.06,P ＜ 0.05).The RIs were respectively as follows:0.59 ± 0.04,0.60 ± 0.02,0.63 ± 0.02,0.60 ± 0.02,and the differences between different groups were not statistically significant (F =7.66,P ＞ 0.05).Patients with euthyroidism had Color Doppler Flow Imaging (CDFI) pattern 0 (52.6％,10/19).Patients with subclinical hypothyroidism had CDFI pattern Ⅰ (60.0％,12/ 20).Patients with hypothyroidism had CDFI pattern Ⅱ (66.7％,12/18).Patients with hyperthyroidism had CDFI pattern Ⅲ (55.0％,11/20).The thyroid gland echo in CLT groups was mainly diffuse hypoechoic pattern (62.3％,48/ 77).Focal hypoechoic pattern and diffuse hypoechoic pattern without heterogeneous linear hypoechoic were mainly seen in the groups of hyperthyroidism and euthyroidism (66.7％,26/39).Diffuse hypoechoic pattern with heterogeneous linear hypoechoic and nodular changes were mainly seen in the groups of hypothyroidism and subclinical hypothyroidism (86.9％,33/38).The E2/E1 in focal hypoechoic pattern,diffuse hypoechoic pattern without heterogeneous linear hypoechoic pattern,diffuse hypoechoic pattern with heterogeneous linear hypoechoic and nodular changes were by turns:1.30 ± 0.48,1.68 ± 0.38,1.97 ± 0.55,2.27 ± 0.63,and the differences between different groups were statistically significant (F =32.47,P ＜ 0.05).The E2/E1 in hyperthyroidism,euthyroidism,subclinical hypothyroidism,and hypothyroidism were by turns:1.12 ± 0.50,1.69 ± 0.12,2.21 ± 0.20,2.45 ± 0.32,and the differences between different groups were statistically significant (F =64.54,P ＜ 0.05).The correlation coefficient between E2/E1 and serum TSH was 0.742,which was significant (P ＜ 0.01) in different thyroid function groups.Conclusions CLT with different thyroid functions has different features of ultrasound and elastography.E2/E1 can reflect the hardness of the thyroid parenchyma to a certain extent,and assess the thyroid function and the course of the disease,can prevent the occurrence of hypothyroidism early.
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Objective To investigate the current situation of thyroid disease by analyzing retrospectively the color poppler ultrasonography data of neck discomfort in Heilongjiang Province.Methods A total of 13 020 cases (18-93 years old) of thyroid ultrasound examination data collected from September 2009 to October 2012 at the Department of Ultrasound,Fourth Affiliated Hospital of Harbin Medical University,were retrospectively analyzed.According to the sonographic features of thyroid (thyroid morphology,size,echo characteristics,blood flow,nodular location,number,calcification,etc),combined with ultrasound diagnosis,the relationships between gender and disease,age and disease,ultrasound diagnosis and disease classification,gender,number of nodules and benign and malignant were analyzed.Results Among the 13 020 cases,524 cases was excluded.There were 2 291 male cases; abnormalities were detected in 1 679 cases,and the abnormal ratio was 73.29％; there were 10 205 female cases; 7 946 cases were abnormal,and the abnormal ratio was 77.86％.The proportion of abnormal thyroid cases of the total number of female was higher than that of male,and the ratio of male and female was 1.00 ∶ 4.73 (1 679∶7 946); gender differences were statistically significant(x2 =18.476,P ＜ 0.01).There were nodular type 5 018 cases,diffuse type 2 012 cases and mixed type 2 603 cases in sonographic findings.The nodular type on ultrasound images showed mainly nodular goiter(79.21％,3 975/5 018).The diffuse type on ultrasonic images showed mainly Hashimoto Thyroiditis(59.24％,1 192/2 012).The mixed cases on ultrasound images showed mainly nodular goiter (89.83％,2 331/2 595).Ultrasound diagnostic results showed that nodular goiter accounted for 65.52％ (6 306/9 625) and Hashimoto Thyroiditis accounted for 17.97％ (1 730/9 625).Proportion of thyroid disease increased gradually with age,reached a peak [29.93％(2 557/8 544) and 28.84％ (2 464/8 544)] between the ages of 41-50 and 51-60 years old.The proportion gradually decreased into[14.17％(1 211/8 544),7.26％(620/8 544)] between the age of 61-71 and ＞ 71 years old.The incidence differences of malignant nodules between different age groups were statistically significant (x2 =407.796,P ＜ 0.01).Among malignant nodules,solitary nodule accounted for 95.76％ (113/118) ; multiple nodules accounted for 4.24％ (5/118),and there were more solitary nodule than multiple nodules(x2 =15.286,P ＜ 0.01).About malignant solitary nodules,women accounted for 87.61％(99/113); men accounted for 12.39％ (14/113),and women's were significantly higher than man's(x2 =360.960,P ＜ 0.01).Correlation analysis showed that the results of ultrasounddiagnosisofvarious thyroid diseases were highly correlated with the ultrasonic types of diseases(r =0.139 99,P ＜ 0.01).Conclusions Nodular goiter and Hashimoto Thyroiditis are the most common adult neck discomfort diagnosed by ultrasound in Heilongjiang Province.The high-risk age of thyroid disease is between 41-60 years old.Thyroid malignant is more common in single nodular,and the number of female patients is significantly higher than that of men.
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Objective To investigate the diagnostic value of contrast enhanced ultrasound in breast cancer. Methods Thirty-six cases including 51 typical and 22 atypical breast cancer were examined with injecting contrast agent before operation. The enhanced charaters of perfusion pattern, enhanced level, and modes were observed and reanalyzed when pathology was got. Results There was no statistical meanings in perfusion pattern, enhanced level and mode between typical and atypical breast cancer. They all enhanced like branch or annulus with high lever and there were 3 enhanced modes:"fast in slow out"(48% ,35/73) ,"lastly fast in slow out"(44% ,32/73) and "same in same out"(8% ,6/73). Conclusions The enhanced modes of breast cancer showed "fast in slow out" , "lastly fast in slow out"and "same in same out", enhanced like "branch or annulus" and high level enhanced. Contrast enhanced ultrasound can increase the diagnostic accuracy in the early stage of breast cancer.
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Objective To evaluate the application of pure brilliance imaging(PB1) in diagnosis of benign and malignant breast neoplasms. Methods Ninty-seven breast neoplasms were respectively examined by high frequency ultrasound and PBI before operation,then correlated with pathological results. Results The accuracy of high frequency ultrasound for breast neoplasms was 73.2% with the sensitivity 77.8% ,specificity 69.2%. The detectable rate of spiculate margin, halo,calcification were much higher in PBI than those in high frequency ultrasound(P<0.05). And the accuracy,sensitivity and specificity of PBI were 86.6%, 91.1%, 82.6%. Conclusions PBI can significantly increase the detectable rate of ultrasonographie marginal features of breast neoplasms which were also helpful to the differential diagnosis.
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With the combined interruption of the superior mesenteric vein, the splenic artery and vein and the portal vein, we successfully separated the adhesion between the collum pancreatis and the portal vein which is difficult to separate in 8 cases During the separation, the portal vein was damaged in 2～5 parts, and the size of wounds of vein were of 2～6mm in length, but the amount of bleeding was small and the bleeding speed was slow All the wounds were easily repaired under direct vision We consider that the mothod of the combined interruption is safe and effective for the separation of the adhesion between the collum pancreatis and the portal vein, and is helpful to increasing the success rate of removing carcinoma of the head of pancreases The interruption is safe for 20～25 minutes under normothermia