Prenatal diagnosis of Pierre Robin sequence by ultrasound / 中华超声影像学杂志

Objective:To explore the characteristics and diagnostic methods of Pierre Robin sequence in prenatal ultrasonography.Methods:The ultrasonographic features and pregnancy outcome were analyzed in 12 cases of fetuses with Pierre Robin sequence who were diagnosed by ultrasound prenatally in Shenzhen Maternity & Child Healthcare Hospital from 2017 January to 2020 January, and chromosome examination results were collected.Results:Prenatal ultrasonographic features of 12 cases of Pierre Robin sequence were characterized by micrognathia, incomplete cleft palate and tongue posture, among which 4 cases were isolated Pierre Robin sequence, 8 cases were combined with associated malformations, and 1 case of isolated Pierre Robin sequence was misdiagnosed.Conclusions:Fetus with Pierre Robin sequence has characteristic features in prenatal ultrasound, the facial median sagittal plane and oblique coronal plane of palate through oral cleft are contributive to its diagnosis.

Screening of nucleic acid aptamer of lung cancer cells based on cell exponential enrichment ligand system evolution and its application in tumor diagnosis and treatment / 生物医学工程学杂志

Nucleic acid aptamer is an oligonucleotide sequence screened by the exponential enrichment ligand system evolution technology (SELEX). Previous studies have shown that nucleic acid aptamer has a good application prospect in tumor diagnosis and treatment. Therefore, we reviewed the selection and identification of nucleic acid aptamer of lung cancer cells in recent years, and discussed the effect of aptamer as targeting drugs and targeting vectors on the diagnosis of tumors, which provide a new idea for early diagnosis and treatment of tumor.

The new approach in the location of the fetal conus medullaris and its application in tethered cord syndrome / 中华超声影像学杂志

Objective To evaluate the position of the fetal conus medullaris during pregnancy and its value in detecting tethered cord syndrome(TCS). Methods Nine hundred and seventy-four normal fetuses and 46 fetuses with TCS between 15 and 41 weeks gestation were involved in the study.Parameters D 1 (the distance between the end of the conus medullaris and the caudal edge of last vertebral body ossification center) and D2 (the distance from the end of the conus medullaris to the caudal skin namely the intersection point of the extending line of D1 and the skin) were measured in the caudal midsagittal plane of the spine. Sixty normal fetuses were chosed randomly for interobserver variability.Correlation analysis between these two parameters and gestational age(GA) were conducted and the normal reference value of these parameters were calculated in normal group. The ratios of growth parameters ( Biparietal diameter, Head circumference,Abdominal circumference,Femur length) to D1 and D2 were calculated separately to observe the difference of the ratios between two groups. All the parameters and ratios of normal fetuses were compared with that of TCS cases.Results There was no significant difference in D1 and D2 between two observers.A significant linear correlation between the parameters and GA was found in normal group,linear regression equations were D1=0.251 GA -2.265 cm (R2=0.926,P <0.01) and D2=0.267 GA -1.812 cm(R2=0.928,P <0.01),respectively.D1 and D2 were much lower in normal group than in abnormal group (all P <0.01). The ratios of the growth parameters to D1 and D2 were relatively stable and had statistically differences between two groups in different gestational age. Conclusions The methods that determination of D1 and D2 are simple and feasible,and could help to the prenatal diagnosis of TCS.

Calcified and non-calcified ductal carcinoma in situ differences in sonographic and pathologic features / 中华超声影像学杂志

Objective To compare the sonographic and pathologic features of calcified and non-calcified ductal carcinoma in situ DCIS Methods A total of 83 lesions in 82 consecutive patients with pathologically confirmed pure DCIS were recruited One patient had bilateral lesions All lesions were divided into calcified DCIS and non-calcified DCIS according to the presence of calcifications on mammography Their sonographic features and pathologic reports for all patients with DCIS were retrospectively reviewed Statistical comparisons were performed using the chi-square test Results 1 Calcified DCIS showed positive ultrasound US findings in 80% 44 55 of cases The most common US finding was nonmass lesions 43 6% 24 55 Nine cases had pure ductal dilatations 16 4% 9 55 Non-calcified DCIS showed positive US findings in 96 4% 27 28 of cases The most common US finding was mass 89 2% 25 28 Two cases had pure ductal dilatations 7 1 % 2 28 No significant difference was found in the shape margin orientation posterior feature of a mass between the calcified and non-calcified groups P >0 05 Significant difference was observed in the size boundary echogenicity on ultrasound of the two groups P <0 05 2 At histopathology the pathological scores high nuclear grade positive ER status positive PR status positive Ki67 status and the presence of Her-2 neu oncogene were more common in the calcified group than in the non-calcified group Conclusions Calcified and non-calcified pure DCIS have different pathologic and sonographic features Calcified DCIS has more aggressive histological features than non-calcified DCIS.

Evaluation of fetal cardiac function by brain natriuretic peptide and velocity vector imaging in congenital heart disease / 中华医学超声杂志（电子版）

Objective To investigate the clinical value of evaluation of fetal cardiac function in congenital heart disease by brain natriuretic peptide (BNP) and velocity vector imaging (VVI). Methods Fetuses who came from Shenzhen Maternity & Child healthcare Hospital were divided into the congenital heart disease group and the control group. At the same time we collected amniotic fluid and assayed BNP concentration. Using the VVI software, the velocity, strain and strain rate of the global and segmental of the left ventricle were measured. Comparison and correlation were made between the two groups. Results There was significantly difference of BNP concentrations in amniotic fluid between two groups. The gestational age had significant positive correlation with BNP concentrations in disease group. The comparison of global velocity, strain and strain rate of left ventricle between the two groups showed significant differences. All of the left ventricular dynamic parameters in disease group were lower than those of the control group. Conclusions Compared with the control group, the disease group had a high level of BNP in amniotic fluid and a lower level of dynamic parameters of left ventricular. There was a positive correlation between BNP concentration and gestational age in disease group. So we can conclude that theBNP concentration can be a biological parameter for evaluating the latent impairments of fetal cardiac function.

Preliminary study of acoustic radiation force impulse in the placental function of normal population and patients with severe preeclampsia / 中华超声影像学杂志

Objective To investigate the clinical value of acoustic radiation forcs impulse (ARFI)in quantitative evaluating placental elasticity.Methods The study population included 487 normal pregnant women,and ARFI generated shear wave velocity (SWV)was measured.On the basis of gestational ages, placental sites and sampling depths in region of interest (ROI),the normal population was divided into different groups.One-way analysis of variance was used to compare the discrepancy on the SWV values amomg the nomal placental sites or the sampling depths in ROI.Pearson correlation coefficient were used to assess the possible relationships between the normal placental SWV values and the different gestational ages or the placental grades.A total of 5 1 cases were diagnosed with severe preeclampsia,among them 25 cases were categorized as severe preeclampsia with fetal growth restriction (FGR).The placental SWV values were measured and compared with those of the normal population.The pathological examinations were performed on 50 normal and 5 1 abnormal placentas.Results Basing on the placental sites,the normal population were divided into three groups:anterior wall,lateral wall and posterior wall groups.Compared with the posterior wall group,the placental SWV values in the anterior wall or lateral wall group significantly decreased (P <0.05).No statistical significant difference was found between the anterior wall group and the lateral wall group.Basing on the distance from the sampling depths to the probe (range from 2 to 7.99 cm,and each additional 1 cm corresponding a group),the normal population were divided into six groups.There was statistical significant difference for the placental SWV values between the two groups of distance in the range of 2.0 to 5.99 cm and 6.0 to 7.99 cm (P <0.05).There was no statistical significant difference between the other two groups.The mean SWV value was (0.78±0.08 m/s)in the normal group. No significant relationships were found between the placental SWV values and the gestational ages of the normal population.However the placental SWV values were significantly related to the placental grades.For the placental SWV values,there was statistical significant difference between the normal group and the abnormal group (P <0.05).No statistical significant difference was found between the severe preeclampsia group and the severe preeclampsia with FGR group.The pathological examinations also showed significant changes in the abnormal group.Conclusions ARFI may quantitatively analyze the placental elasticity and make a difference between nomal and abnormal placenta.

Study of ultrasound BI-RADS for small solid breast masses / 中华超声影像学杂志

Objective To evaluate the clinical value of ultrasound breast imaging reporting and data system (BI‐RADS) in small solid breast masses with diameter ≤1 cm. Methods The ultrasound features of 230 solid breast masses with diameter ≤ 1 cm were described by ultrasound BI‐RADS, the relationship between ultrasound features, BI‐RADS final assesment and pathology were analyzed. Results Of these 230 masses, 72 (31 3.% ) were pathologically confirmed to be malignant and 158 (68 7.% ) to be benign. The ultrasound BI‐RADS features of mass shape, margin, orientation, posterior acoustic features, and microcalcificaition were significantly different between malignant and benign masses( P < 0.05). Irregular shape, noncircumscribed, nonparallel orientation, postrior shadowing, microcalcifications were regarded as malignant ultrasound features, their positive predictive values(PPV), sensitivity, specificity and accuracy for malignancy were 53 3.% -100%, 2 8.% -75 0.%, 82 3.% -100%, 69 6.% -80 9.%, respectively. One hundred and fifty‐two(66.1% ), 62(27 0.% ), 16(7 0.% ) masses were classified into grade 3, 4, and 5, respectively. The PPV for grade 3, 4 and 5 were 10 5.%, 64 5.%, 100% respectively. Among BI‐RADS grade 3 cases, 87 5.%malignant masses were intraductal carcinoma in situ and special type of invasive cancer, among pathological benign BI‐RADS grade 4 masses, 90 9.% were hyperplasia and intraductal papilloma. Conclusions In small breast masses with diameter ≤ 1 cm, due to the sensitivity of malignant signs are not high, the overlap between signs of benign and malignant lesions, pathological type and other factors, the positive predictive value of BI‐RADS grade 3 is higher than criteria of American College of Radiology, so BI‐RADS classification requires further detailed study.

Prenatal ultrasound diagnosis of Cantrell's syndrome and image analysis / 中华医学超声杂志（电子版）

ObjectiveTo summarize prenatal ultrasound image features of Cantrell′s syndrome (Cantrell′s pentalogy).MethodsFrom January 2007 to December 2013 in Shenzhen Maternity & Child Healthcare Hospital, there were twenty cases diagnosed and conifrmed by postmortem as Cantrell′s syndrome. The prenatal ultrasound image features and outcomes were analyzed.ResultsAmong the twenty cases, eighteen were singleton and two were twins with the other normal fetus. Prenatal ultrasound image: two obvious ultrasound image features of ectopic heart and hight omphalocele (seventeen cases) or gastroschisis (three cases) were appeared in prenatal ultrasound of twenty cases. Fourteen cases were complete ectopic heart (Ectopic heart was located within the omphalocele in one case, ectopic heart was completely exposed in amniotic lfuid in thirteen cases), six cases were incomplete ectopic heart, three cases were ventricular septal defect in which one was associated with pulmonary stenosis, two cases were single atrium and single ventricle in which one was associated with a single arterial trunk, one case was tetralogy of Fallot, and six cases were without signiifcant heart abnormalities. Associated with other abnormalities: seventeen cases were associated with other abnormalities in twenty cases, in which eleven cases were spinal abnormalities, nine cases were umbilical cord abnormalities (short umbilical cord in six cases, single umbilical artery in two cases, short umbilical cord associated with single umbilical artery in one case), ifve cases were neurological abnormalities (exencephalia in four cases, encephalocele in one case), four cases were limb abnormalities, three cases were cheilopalatognathus, one case was giant bladder. Three cases weren′t associated with other abnormalities. Nuchal Translucency: in eight cases, nuchal translucency were measured in early pregnancy. Nuchal translucency of ifve cases were thick, one case was cervical hygroma in one of the two twins. Chromosome examination results: only three cases had chromosome examination in twenty cases, in which one case was trisomy 21, another two were chromosome normal. Fetal outcome and examination results: in twenty cases, one of the two twins can′t survive after birth, and the other one of two twins was reduced in intrauterine, so the specimen could not be obtained. Eighteen cases of singleton underwent labor induction. The results of postmortem appearance (nineteen cases) and autopsies (ifve cases) were all consistent with prenatal ultrasound scan.ConclusionsEctopic heart and hight omphalocele or gastroschisis appearing at the same time was the characteristic of Cantrell′s syndrome in prenatal ultrasound and other abnormalities may be part of the Cantrell′s syndrome spectrum. It is beneift to detect and diagnose Cantrell′s syndrome by prenatal ultrasound in the ifrst trimester.

Correlation of ultrasonographic and pathological features in mucinous cancer of the breast / 中华超声影像学杂志

Objective To investigate ultrasonographic (US) features of mucinous breast carcinoma with pathological correlation and to improve the early diagnosis for the mucinous breast carcinoma.Methods Twenty-two patients with 23 focuses mucinous carcinoma of the breast confirmed by pathology were included in this study,retrospectively evaluate sonographic features according to the American College of Radiology(ACR) Breast Imaging Reporting and Data System(BI-RADS) Lexicon,all cases were classified by BI-RADS before operation.Histological type of mucinous breast carcinoma included mixed and pure two forms,the latter was classified into cellular variants and hypocellular variants.The correlation between the ultrasonographic findings of mucinous carcinoma and histologic features in different types were analysed.Results On US examination,all 22 cases presented as solid mass.In pure form,they showed well-defined margins with no pseudocapsule and isoechogenic or hypoechoic internal echo pattern relative to that of subcutaneous fat in 86.7％ (13/15) focuses which histological type were pure type.93.3％ (14/15) of pure type focuses had posterior enhancement.All pure type focuses demonstrated that the orientation of the mass is parallel to the skin line.75.0％ (6/8) of mixed type focuses and 13.3％ (2/15) of pure type focuses,however,demonstrated ill-defined and or spiculated margins with more hypoechogenic structure (P ＜0.01).Mixed type focuses have more aggressive malignant features.65.2％ (15/23) of cases being classified as BI-RADS 4 or 5 were suspected as malignancy,which included 6 mixed type focuses and 9 pure type respectively accounting for 75.0％ (6/8) and 60.0％ (6/15) of each type focuses.Conclusions Mucinous breast carcinoma especial pure type did not have the typical malignant breast masses sonographic features,which showed some benign masses sonographic features except no pseudocapsule benign feature.Mixed type mucinous carcinomas tumors have more aggressive margin imaging characteristics.It is suggested that mucinous breast carcinoma should be classified category 4 by BI-RADS to avoid diagnosis delay.

Ultrasonographic clues and methods for fetal anomalies of the aortic arch / 中华超声影像学杂志

Objective To study the ultrasonographic clues and methods for fetal anomalies of the aorta arch and improve prenatal detection of anomalies of the aorta arch.Methods One thousand four hundred and seventy-two cases fetus who were carried out detailed scan and whose results were confirmed were chose as study objects.Every routine fetal echocardiography included four chamber and left and right outflow tract and three-vessel trachea view(3VT).The more views which included longitudinal and coronary view of the aorta arch and coronary view of the trachea and main bronchus were obtained when the abnormality of aorta arch was suspected.Results One hundred and forty-eight cases with anomalies of aorta arch were diagnosed by ultrasonography.One case was misdiagnosed.Ninety-two fetus with anomalies of aorta arch which included 28 aortic coarctation(CoA) and 10 interrupted aortic arch (IAA) and 52 right-side aortic arch and abnormal aortic branch and 2 double aortic arch were confirmed by postmortem or postnatal echocardiography and surgery.Of the 92 confirmed cases,24 had prenatally diagnosed additional complex intracardiac anomalies.All cases with CoA and IAA presented ventricular and/or great arterial disproportion with smaller left ventricle and aorta diameter on four chamber view and 3VT.Right aortic arch (RAA) and abnormal aortic branch(AAB) displayed aortic arch located on the right side of the trachea and increased distance between the aortic arch and arterial duct and abnormal aortic arch branch-subclavian artery originating from the beginning section of the descend aorta which coursed behind the trachea with U-shaped appearance on the 3VT plane.The display rate of the transverse and longitudinal and coronary view of the aorta arch was 98.4%,90.0%,81.9%,respectively.Conclusions Disproportional ventricular and /or great arterial with smaller left ventricle and aorta diameter are the clues for CoA and IAA.Increased distance between the aortic arch and arterial duct is the clue for RSA.The transverse view of the aortic arch 3VT is the most sensitive for detecting the anomalies of the aortic arch and the most easily be obtained.The longitudinal and coronary view of the aorta arch and coronary view of the trachea and main bronchus are helpful in differentiating the anomalies of the aortic arch.

Prenatal sonographic diagnosis on agenesis of fetal corpus callosum / 中华超声影像学杂志

Objective To assess the value of prenatal sonographic diagnosis on fetal agenesis of corpus callosum(ACC). Methods A retrospective study was on prenatal sonographic findings of 10 cases with ACC malformation and their abnormalities in central nervous system (CNS) or extra-CNS.Results The special sonographic findings established the diagnosis of ACC malformation in all 10 cases,with 7cases diagnosed absence agenesis. Among all patients with ACC,6 cases were accompanied with abnormalities in extra-CNS,8 in CNS and 5 in both. Conclusions Prenatal ultrasonography plays a vital role in accurate diagnosis on fetal ACC. Attentions should be paid to the indirect encephalic features and complicated abnormalities so as to make accurate and prompt diagnosis.

Prenatal ultrasonographic diagnosis and outcome of congenital lung abnormal lesion / 中华超声影像学杂志

Objective To determine sonographic features and outcome of fetal lung abnormal lesions. Methods Blood supply of the lesion, fetus hydrops and other extra-lung anomalies should be evaluated by color Doppler flow image(CDFI) when abnormal lesion was detected in fetus lung during routine scanning. The fetus with lung abnormal lesion without hydrops at the first time scanning should be monitored by ultrasound in every four to six weeks. Results Forty cases fetus presented lung abnormal lesions, which included 21 cases with hyperechogenic solid masses,15 cases with cystic-solid mixture masses,4 cases with cystic masses. Lesions of 8 cases were demonstrated systemic arterial blood supply arising from the aorta on CDFI and the diagnosis of pulmonary sequestration (PS) were suggested. Seventeen cases lesion that had small size or decreased or disappeared or remained stable in size with gestational age developing had normal neonate. Conclusions CDFI is very useful in detecting abnormal lesion of the fetal lung and differentiating pathology and evaluating the prognosis. The outcome of isolated lung lesion without hydrops and mediastinal shift that decreased or disappeared or remained stable in size had a good prognosis.

Prenatal ultrasonographic evaluation of fetal micrognathia / 中华超声影像学杂志

Objective To review the prenatal ultrasound features and clinical value of fetal micrognathia.Methods All 13 500 cases were scanned for fetal faces with routine transverse,coronal and sagittal planes during prenatal ultrasonography.Results Thirteen cases with micrognathia were detected by prenatal ultrasonography.Midsagittal and coronal scans of all fetuses with micrognathia demonstrated small mandible and receding chin and the lower lip reside posterior to the upper lip.All prenatal diagnosed fetuses micrognathia were confirmed by autopsy.Conclusions Prenatal ultrasonic diagnosis of fetal micrognathia relied on subjective evaluation of fetal profile on a midline sagittal and a coronal scan of fetal face.Micrognathia may be a clue or marker of chromosomal anomalies and syndrome.Prenatal detecting of micrognathia has important clinical value.

Comparative diagnosis of malformations of forearm and crus by prenatal and fetus in vitro ultrasonography / 第三军医大学学报

Objective To assess the value of prenatal ultrasonography on fetal forearm and crus malformations by studying the ultrasonographic characteristic in relation to methods of examination. Methods All fetus were evaluated by using a systematic continuous sequence approach (SCSA) with ultrasonography. A close attention was paid on shapes, structures and movement of fetal forearm and crus, and fetus specimens after induced labor were rescanned by ultrasonography under the condition of mimic intra-uterus. Results Thirty of 33 cases (90.9%) with fetal forearm and crus malformations (totally 48 of 54 limb anormalies, 88.9%) were correctly diagnosed by prenatal ultrasonography. Six limb malformations of 3 cases were missed. Conclusion Our study demonstrates that the malformations of forearm and crus detected with prenatal ultrasonography are highly accordant with the malformations revealed in fetus in vitro. It is important to abide by the SCSA in ultrasonographic diagnosis of fetal forearm and crus malformation.

Prenatal ultrasound diagnosis of fetal radial ray abnormalities / 中华超声影像学杂志

Objective To investigate prenatal ultrasound diagnosis of radial ray abnormalities and its clinical value. Methods All the fetus that entered usual prenatal ultrasound diagnosis were scanned each limb using a systematic continuous sequence approach (SCSA) with Acuson Sequoia 512 and GE Logiq 400 equipments. All the artificial aborted fetal radius malformation also had ultrasound examination in a simulating intrauterine estate and /or X-ray examination. Results Correctly diagnosis was made in 13 cases fetal radial ray abnormalities by prenatal ultrasonography following SCSA through the scaning course. All the fetal radial ray abnormalities had radius absence(only one skeleton in the forearm) or radius dysplasia and characteristic radial club hand. Ray abnormalities can be classifyied into three types on ultrasonography: type Ⅰ, radius absence; type Ⅱ,radius part absence; type Ⅲ,radius dysplasia.Conclusions Mastering characteristic radial club hand and SCSA are the keys to diagnose fetal radial ray abnormalities by prenatal ultrasonography.

Prenatal ultrasonographic evaluation of fetal facial anatomy and fetal facial malformations / 中华超声影像学杂志

Objective To review the ultrasonographic evaluation on fetal facial anatomy and malformations in prenatal diagnosis. Methods Continuous 4 200 prenatal ultrasonographic evaluation during gestation age 14 40 weeks from August 2000 through June 2002 entered the present study. Routine coronal, sagittal and transverse planes were applied to scan the fetal facial structures after the fetal position was confirmed and/or adjusted. Results Superficial facial anatomic structures as well as the deep bony structures of the fetal faces were clearly displayed and correctly recognized on the three routine planes in 4 184 cases ( 99.62 %), but not the palate. Seventy eight facial malformations of 29 fetuses were correctly diagnosed. Whereas 9 malformations of 7 fetuses were missed to recognize, and 2 suspected cleft palate were demonstrated normal after delivery. The diagnoses were confirmed after subsequent labor or induced labor. The total detection rate reached 89.66 %. The false negative rate was 10.34 %, and the false positive rate was 0.05 %. The sensitivity, specificity, accuracy, positive and negative predictive values were 85.29 %, 99.95 %, 99.83 %, 93.55 % and 99.88 % respectively. Conclusions The majority of fetal facial superficial and deep structures is clearly demonstrated on prenatal ultrasonic imaging on the 3 routine scanning planes. Prenatal ultrasonographic evaluation of the fetal face is a reliable and accurate diagnostic modality so far as the skills become more sophisticated.

Prenatal ultrasound diagnosis of clubfoot / 中华超声影像学杂志

Objective To investigate prenatal ultrasound diagnosis of clubfoot and its clinical value.Methods Three thousands pregants ranging gestational age from 12 through 40 weeks were checked using Ascuson Sequoia 512 equipment.The diagnosis of clubfoot was made prospectively at the time of the scan by the following criteria: the ball of foot had to be visible in the same plane as the longitudinal section of bones of the lower leg,unchanging with fetal activity and reproducible for several images.All prenatal ultrasonographic dignoses of clubfoot were proved by autopsy or newborn physical examination.Results A total of 17 cases clubfoot fetuses were prenatal diagnosed by ultrasonography.Fourteen of 17 clubfoot fetuses had associated with complex abnormalities,three of them were isolated clubfoot.Fourteen of 17 cases with clubfoot prenatal diagnosed by ultrasound were proved by autopsy.Another three cases with clubfoot were proved by newborn physical examination,two of them were false positive diagnosis.Conclusions Prenatal diagnosis of clubfoot is reliable by ultrasound.It is helpful in diagnosis with other structural abnormalities associated with clubfoot.It can also provide direction for clinical obstetrical management.