Construction of undergraduate teaching method of standardized ultrasound skill operation video and evaluation of its teaching effect / 中华医学教育探索杂志

This study evaluated the standardized ultrasound operation skill video courseware recording and online teaching of undergraduate clinical internship course in the direction of medical imaging ultrasound technology in West China Clinical Medical College of Sichuan University. Through the systematic teaching plan preparation of ultrasound skill operation teaching video, script writing, post production, recording and implementation of teaching, the results showed that 116 students (81.69%) thought knowledge points of skill operation video course were reasonably divided, 128 ones (90.14%) thought the explanation was clear, 118 ones (83.10%) thought the video duration was appropriate, 121 ones (85.21%) thought the degree of difficulty was moderate, 119 ones (83.09%) thought the ultrasonic image was consistent with the anatomical image, and 124 ones (87.32%) thought it was helpful to improve the level of clinical operation skills. Standardized ultrasound skill operation video online teaching has the advantages of no time and place restrictions and good repeatability, which can exercise students' self-study ability, improve their learning enthusiasm, help students master operation skills more comprehensively, and is of great significance to the implementation and promotion of ultrasound clinical skill training video online teaching.

Establishment of layered training system of ultrasound medicine based on physician and sonographer collaboration / 中华医学教育探索杂志

In order to meet the social demand for ultrasound talents, a layered training system of ultrasound medical talents suitable for China's national conditions has been explored. The department of ultrasound of West China Hospital of Sichuan University has formulated and implemented a "three-layers" ultrasound education and training system in combination with its own reality. The first layer mainly refers mastering the basic ultrasound examination ability mainly through relevant ultrasound theoretical knowledge and basic operation skills training. The second layer is based on the first level to further master the ability of ultrasound diagnosis and differential diagnosis of common and frequently occurring diseases in various systems, and to be capable of engaging in basic ultrasound teaching and scientific research. The third layer means mastering the ability of ultrasound diagnosis, evaluation and interventional diagnosis and treatment of difficult and specialized diseases, grasping the latest development direction of the sub-specialty, and having the ability to engage in ultrasound teaching and clinical research. The results show that the "three-layers" ultrasound education and training system conforms to China's national conditions and is worthy of reference and promotion.

A multicenter study to confirm further diagnostic value of strain ratio method giving to 5-point scoring by elastography for differentiation of breast lesions / 中华超声影像学杂志

Objective To confirm whether strain ratio should be added after evaluation of lesions with 5-point elasticity scoring for differentiating breast lesions on ultrasonic elastography(UE).Methods Eight hundred and forty-six consecutive female patients with 1 071 breast lesions were recruited into a multicenter retrospective study,which involved 8 centers across China.All the patients underwent the UE procedure and the strain ratios were calculated.The sensitivity,specificity,accuracy,PPV and NPV were calculated for each of the two evaluation systems and the areas under the ROC curve were compared.Results The strain ratios of 559 benign lesions(2.7±1.4)and 512 malignant lesions(8.1±5.9)were significantly different (P<0.001).When the cutoff point was 3.03,strain ratio method had 81.6% sensitivity,89.7% specificity,81.7% accuracy,80.2% PPV and 84.2% NPV.The areas under the ROC curve with the strain ratio method and 5-point scoring method were 0.865 and 0.862,respectively(P =0.622).For the lesions with elasticity score 3 and 4,the areas under the ROC curve of the two Methods were 0.71 1 and 0.629, respectively(P = 0.020).Conclusions Although the two UE Methods have similar diagnostic performance,separate calculation of the strain ratios seems compulsory,especially for the lesions with elasticity score 3 and 4.

Ultrasonic diagnosis and pathological comparison of pancreatic serous and mucinous cystadenoma / 重庆医学

Objective To explore the value of ultrasound in diagnosis and differential diagnosis of pancreatic mucinous cystade‐noma and serous cystadenoma .Methods Data of tumor features of sixty seven cases of pancreatic cystadenoma ultrasonographic was retrospectively analyzed .The tumor location ,tumor size ,tumor boundary ,tumor shape ,cavity number and calcification were re‐corded .Then all the data was statistically analyzed .Results Pancreatic cystadenoma occured mostly in middle‐aged women ,there was no significant difference between pancreatic mucinous cystadenoma and serous cystadenoma of the pancreas in age ,gender ,le‐sion location ,lesion size ,shape ,boundary ,cystic wall ,cystic wall nodules(P>0 .05) ,while there were significant differences in with and without clinical symptoms ,cavity number ,diameter of the largest cyst and calcification(P<0 .05) .Conclusion Ultrasonic man‐ifestations of pancreatic cystadenoma has certain characteristics ,when there are clinical symptoms ,cavity number is less than 6 , maximum sac diameter is bigger than 2 cm and there is marginal calcification ,it tends to mucinous cystadenoma;when there is no clinical symptoms ,cavity number is equal to or more than 6 ,maximum sac diameter is equal to or smaller than 2 cm and there is cen‐tral calcification ,it tends to serous cystadenoma .

A detailed criterion of BI-RADS assessment category based on US-BI-RADS: a preliminary study / 中华超声影像学杂志

Objective To set up an objective criterion for BI-RADS assessment.Methods The breast sonograms of 1 938 female cases were retrospectively studied which had been confirmed by pathology from January to September 2011 and 2012 January.1 660 cases during 2011 were model cases,and the importance of each single feature in distinguishing between benign and malignant was obtained with Chi square and OR value.A detailed criterion of BI-RADS assessment category was set up based on US-BI-RADS.Results Eighteen of 24 lexicons were statistically significant distinguished between benign and malignant breast masses(P ＜ 0.05).The lexicons were divided into major suspicious signs,middle ones and minor ones assigned 3 points,2 points and 1 point,and a scoring model was established as follows:Score =3 * (X1 + X2 + … + X6) + 2 * (X7 + X8 + … + X12) + (X9 + X10 + … + X18).Based on BI-RADS,the positive predictive value of model cases was 1.5％,6.9％,22.1％,62.5％,96.1％ followed by category 3,4A,4B,4C and 5,and it was 1.4％,3.4％,21.1％,69.4％,92.7％ in test cases.Conclusions The scoring model could be useful for BI-RADS final assessment more objectively,and could make it more convenient to predict the risk of breast cancer.

The performance of conventional and elasticity ultrasonography of papillary thyroid microcarcinoma under different background / 中华超声影像学杂志

Objective To investigate the conventional ultrasonic and elastographic characteristics of papillary thyroid micro-carcinomas(PTMC) suffered in normal and Hashimoto's thyroiditis(HT).Methods A total of 227 patients with 249 nodules that were confirmed by surgery or biopsy were included in this study.The cases were divided into normal group and HT group.All patients underwent conventional ultrasound and elastography (static pressure).The sonographic characteristics and strain ratio (SR) value were evaluated.Results In the normal group,the ratio between male and female was 1 ∶ 2.9,while in HT group,it was 1 ∶ 11,which was significant different between the two group (P =0.002).Sonographic characteristics that had no significant difference between the two groups (P ＞0.05) include:boundary,shape,vertical and horizontal ratio,halo,echogenicity,calcification,posterior shadowing,vascularity on color Doppler ultrasonography.The strain ratio value was statistically different between the two groups (P =0.034),with 3.44 ± 1.03 in normal group and 3.13 ± 1.13 in HT group.Conclusions The conventional ultrasonographic features of PTMC were similar in both normal thyroid and HT.However,females suffering HT were more susceptible to PTMC,and the strain ratio value of PTMC concomitant HT decreased.

Sonography of male breast lesions and the pathological diagnosis: a retrospective study of 10 years and literature review / 生物医学工程学杂志

The sonographic features of male breast lesions, which underwent ultrasound examination in our hospital for the past 10 years, were retrospectively analyzed. Sonographic features of these lesions were standardized as BI RADS image lexicon. The differences in ultrasonic malignant signs were assessed between the benign and the malig nant diseases. Between the two groups, incomplete boundary was statistically different. The specificity was above 95% within the two groups in terms of speculated margin, echogenic halo, calcification, axillary lymphadenopathy, thickening of skin and eccentric of mass to the nipple. High-frequency sonographic examination has a high level of differential diagnosis for male breast lesions.

The anxiety level of the patients who will have ultrasound-guided puncture biopsy: a survey study / 生物医学工程学杂志

In order to fully understand the anxiety level of the patients who will have ultrasound-guided puncture biopsy, and the survey results will guide the future clinical care to reduce the anxiety score of the patients, and to im-prove the satisfaction of them, which reflects the quality of care, we used Zung Self-rating Anxiety Scale (SAS) to investigate outpatients who will have ultrasound-guided puncture biopsy in a upper first-class hospital by convenience sampling way. The results showed that the SAS standard score of the patients was higher than the Chinese normal population's, and there is significant difference between the patients and the normal population's score (t = 47.12, P < 0.001). So for reducing the patients' anxiety level we should give health education and care intervention to the patients before the operation. This reflects the Patient-centered Culture and Excellent-quality Care in China.

Validation for access recirculation and access flow rate measurement by contrast-enhanced ultrasonography during hemodialysis / 生物医学工程学杂志

To evaluate the feasibility and accuracy of contrast-enhanced ultrasonography (CEUS) for the measurement of hemodialysis access recirculation (AR) and access flow rate (Qa), a two pump system was used to simulate access and dialyzer flow. AR and Qa under different conditions, such as reversal connection of dialysis lines and the needle orientation, were compared with each other. The value of access flow and recirculation flow were calculated based on the formulas introduced in this paper, and the correlation and consistency between true flow rate and calculated values were analyzed. The measured R correlated well with true value of flow rate (r = 0.57, P = 0.038, Qa > Qb; r = 0.95, P = 0.001, Qa < Qb). The Bland-altman test showed good agreement between the calculated value based on CEUS and true values. The CEUS can be used as a new advanced technology for AR and Qa measurement.

On the segmentation of malignant halo in ultrasound images of breast tumor / 生物医学工程学杂志

The method for segmenting malignant halo of malignant breast tumor in ultrasound image is useful in providing evidence for the differential diagnosis of breast tumor. In this respect, we adopt an improved anisotropic diffusion filtering method to preprocess the breast tumor ultrasound image, and then apply an improved LBF model with combination of Otsu and morphology methods to extract internal and external contours for obtaining malignant halo based on LBF model proposed by Li. We compare our data of malignant halo with doctor's manual-sketched malignant halo, and make quantitative analysis. The result shows that the malignant halo segmented by the proposed methods in this paper is in accordance with the manual-sketched malignant halo.

A preliminary study on data mining techniques for utilizing the breast ultrasound database / 生物医学工程学杂志

Based on the breast ultrasound database of West China Hospital from January 1, 2002 to December 31, 2007, a study of data mining techniques for utilizing the diagnostic information of breast ultrasound and breast pathology was carried out. An innovative computerized retrieval system was invented. With the visual user interface of the system, the data of benignancy or malignancy diagnosed by ultrasound and pathologic examination, and the data on the diagnostic correlation of ultrasound and pathology were obtained, respectively. The qualities of data mining were 99. 98%-100%. By means of the retrieval system, the users can secure numerous data from the breast ultrasound database rapidly and accurately; so it contributes to the rational utilization of information from medical database for serving various medical studies. This method may also be helpful for doctors to utilize ultrasound database in other fields.

Ultrasonographic diagnosis of dermatofibrosarcoma protuberans / 中国医学影像技术

Objective To explore the ultrasonographic appearance of dermatofibrosarcoma protuberans. Methods Clinical data, sonographic features and color Doppler flow imaging characteristics of 12 patients surgically and pathologically confirmed dermatofibrosarcoma protuberans were retrospectively analyzed.Results Single mass was detected in 11 patients (11/12, 91.67%) with the diameter ranged 0.9-8.0 cm. The tumors distributed in the trunk (8/12, 66.67%), proximal limbs (2/12, 16.67%) or face and neck (2/12, 16.67%). Most of the tumors (10/12, 83.33%) developed from skin and subcutaneous fat layer of the trunk and limbs and were hypoechoic and heterogeneous (11/12, 91.67%), some (8/12,66.67%) with distinct boundary and regular shape without liquification, calcification nor regional lymph node metastasis. Affluent color Doppler flow signals of tumor were found in 11 patients (91.67%).Conclusion Ultrasonographic characteristics of dermatofibrosarcoma protuberans include distinct boundary, regular shape, heterogeneous hypoechogenicity and rich color Doppler flow signals without regional lymph node metastasis.

Ultrasonography diagnosis of cystic renal cell carcinoma / 中国医学影像技术

Objective To observe the ultrasonic features of cystic renal cell carcinoma. Methods Ultrasonic features of 18 patients of cystic renal cell carcinoma confirmed with operation and pathology were analyzed retrospectively.Results Among 18 patients, 7 were clear-cell carcinoma of cystis degeneration, 5 were cystic renal cell carcinoma (clear cell type), 3 were multilocular renal cell carcinoma, 1 was corpora mammillaria renal cell carcinoma, and one clear-cell carcinoma was on capsule wall of cyst and 1 was nephroblastoma. Ultrasound diagnosed 15 patients and misdiagnosed 3 with a diagnostic rate of 83.33%.Conclusion Cystic renal cell carcinoma has specific ultrasonic characteristics, and having an intimate knowledge of these characteristics may be helpful to diagnosis.

Tumor size assessment with ultrasound as a prognostic factor for patients with liver transplantation for hepatocellular carcinoma / 中华超声影像学杂志

Objective To evaluate the assessment of tumor's size with ultrasound in research of prognosis of liver transplantation for hepatocellular carcinoma (HCC). Methods Clinical data of 148 patients with HCC who underwent liver transplantation were analyzed retrospectively. Results One-, 2-,3-,and 5-year overall actuarial survival were 73.3% ,45.6% ,35.4% ,and 32.1%,respectively. One-,2-,3-,and 5-year overall recurrence-free survival were 70.7 %, 44.3 %, 38. 5%, and 34. 5%, respectively. The overall tumor recurrence rate was 43.2%. Univariate analysis indicates that (the Kaplan-Meier method with the Log-Rank test) the total tumor burden (TTB) (χ2=15.098,P=0.001) was found to be significantly affecting the actuarial survival. While TTB (χ2=29. 038, P<0.001) was for recurrence-free survival. In multivariate analysis (with the multivariate Cox proportional hazards model), TTB (R2=1.610, P =0. 008) was found to be an independent predictor of actuarial survival. On the other hand, TTB (R2 =2. 206, P<0.001) was identified as the prognostic factor independently related to recurrence-free survival. Conclusions TTB is an independent prognostic factor for patients with liver transplantation for HCC. Assessment of tumor size with ultrasound is beneficial to the evaluation of indication for liver transplantation when patients with HCC were concerned.

The recognition of breast tumor based on ultrasonic image contour features / 生物医学工程学杂志

The purpose of this article is to evaluate the role of quantitative margin features in the computer-aided diagnosis of malignant and benign solid breast masses using sonographic imaging. The tumour was seperated by the expert. Three contour features circurity (C), area ratio (A) and length width ratio (LWR) was caculated from the tumour contour. Then back-propagation (BP) neural network with contour features was used to classify tumors into benign and malignant. Results from 119 ultrasonic images have been applied in this experiment. BP neural network yielded the following results: 89.7% and 73.5% respectively. The methods applied in this paper are helpful to raise the correctance of breast cancer diagnosis.

Fast edge extraction for ultrasound image of breast tumor based on fuzzy number / 生物医学工程学杂志

An accurate edge extraction method for the ultrasound breast tumor image is useful for classifying tumors as benign or malignant. This paper refers to a fast technique to extract edge of breast tumor from ultrasound image. This method uses the triangular fuzzy number to build up a fuzzy number plane whose basic unit is the marching square. It is possible to visualize at once the results obtained using different presumption levels. Experiments of benign and malignant breast tumor in ultrasound images have shown that our method can extract the breast tumor edge faster than many conventional methods can do separately, and the results are reliable and credible. Our experiments demonstrate that it can be efficiently used to extract the edge of breast tumor from the ultrasound image.

Clinical application value of ultrasonography in excising breast mass with Mammotome / 中华超声影像学杂志

Objective To investigate the clinical application value of ultrasonography in excising breast mass with Mammotome vacuum assisted biopsy device and a stereotactic unit(MMT).Methods Guided by ultrasonography,breast masses were biopsy and excised with MMT.The property of masses were identified by pathology.The effects were followed up with ultrasonography.Results Sixty one masses of breast in 34 cases were excised.Pathology showed that 54 were fibroadenoma and 7 were fibroadenosis.The patients had little discomfort in operation and few complications post operation.There were no relapses during short interviews.Conclusions MMT can biopsy and excise the breast mass guided by ultrasonography.The operation has little wound and few complications.It is a useful minimally invasive method which does not influence the appearance of breast.Ultrasonography can insure operation safety and precision.The effects are evaluated immediately.

Ultrasonographic diagnosis of galactostasis in lactation / 中华超声影像学杂志

Objective To study the value of ultrasonographic diagnosis of galactostasis in lactation.MethodsPatients in lactation and post-lactation were examined by color Doppler ultrasonography.Combined puncture,operation and pathology,the imaging features of different stage were summarized.Results The type of galactostasis included ductal ectasia,galactocele,infection and consolidation.The ultrasonographic examination with imaging features can determine the diagnosis and judge the type and the course of disease.Conclusions Ultrasonography is a first choice in diagnosing galactostasis in lactation.

Comparative study of ultrasonographical and pathological manifestations of juvenile macromastia / 中华超声影像学杂志

Objective To expatiate the ultrasonographical and pathological manifestations of breasts with juvenile macromastia.Methods Four patients with juvenile macromastia were examined by high frequency ultrasonography.The sonographical and pathological images were observed and reported.Results The sonographical characteristics of the breasts with juvenile macromastia were similar: the anatomical structures of the breasts were obscure,which were characterized by cystic formation,reticular structure,patched hypoechoic or hyperechoic regions and distorted gland structure.One patient had fibroadenoma and dermatic erythema.The results of pathological examination showed marked cystic proliferation of glands accompanied with ductal epithelial hyperplasia,irregular ductal distribution,no lobules formation or proliferation of fat tissue,fibrocyte and fibroblast.Conclusions The abnormalities of juvenile macromastia may not only be the huge volume,but also may include abnormal ultrasonographical and pathological manifestations,awaiting more follow-up studies.