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Objective:To evaluate the value of contrast-enhanced ultrasound (CEUS) in the diagnosis and differential diagnosis of bladder urothelial carcinoma(BUC).Methods:A comparative analysis of 138 patients with bladder lesions (123 cases of BUC and 15 cases of other benign lesions) who were hospitalized in Union Hospital, Fujian Medical University from January 2019 to May 2021 were confirmed by pathology. All patients underwent two-dimensional ultrasound, color Doppler ultrasound, CEUS examination, the time intensity curve (TIC) of the region of interest(ROI) before operation was drawn, the ultrasound examination results with the pathological diagnosis results were compared and its diagnostic efficiency was analyzed.Results:Among the 138 cases of bladder lesions, 98 cases were single lesions and 40 cases were multiple lesions. In all single lesions, 95 cases were found by two-dimensional ultrasound and 3 cases were missed, while in all multiple lesions, 24 cases were found by two-dimensional ultrasound and 16 cases were missed, but all cases could be shown by CEUS. The sensitivity of CEUS to multiple bladder lesions was higher than that of two-dimensional ultrasound ( P<0.05). Besides, the differences between BUC and benign lesions in color blood flow distribution intensity and CEUS performance were significant (both P<0.05). Malignant lesions were mostly "less- to -rich" blood flow signals, and benign lesions were mainly "less- to- no" blood flow signals.In addition, in the CEUS examination, 83.7% (103/123) of BUC were high enhancement, and only 33.3% (5/15) of benign lesions were high enhancement. The diagnostic accuracy, specificity and negative predictive value of CEUS(89.9%, 46.7%, 53.8%) were higher than that of two-dimensional ultrasound(67.4%, 13.3%, 13.3%). The area under the curve, the rising slope and the peak intensity of BUC were all higher than those of benign lesions, and the differences were significant(all P<0.05), but none of them was independent risk factor for BUC ( P>0.05). Conclusions:CEUS can significantly improve the diagnostic sensitivity of bladder multiple lesions and help to improve the diagnostic accuracy of BUC, while the area under the curve, the rising slope and the peak intensity of TIC were not the independent risk factors for BUC.
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Objective:To investigate the feasibility of shear wave elastography (SWE) to evaluate the protective effect of testicular compartment decompression on spermatogenesis after testicular torsion reduction.Methods:Thirty-two rabbits were randomly divided into 4 groups: control group (S group), testicular torsion simple reduction group (I group), and testicular torsion reduction+ compartment decompression group (T group: T1 group, T2 group), 8 rabbits per group. After the complete testicular torsion model was established in the I and T groups, the I group was simply reperfused, and the T group was reperfused before decompression of the compartment. Rabbits in each group were kept for 30 days after successful modeling. Each group of rabbits underwent testicular fascia intracompartment pressure measurement and SWE examination before operation, after successful complete torsion modeling, after reperfusion and 30 days later. After the experiment, the surgical side testicles were taken for pathological examination.Results:After testicular torsion, the pressure of testicular fascia and the average Young′s modulus (Emean) of testicular tissue in each experimental group increased (all P<0.05), and further increased with the extension of torsion time (all P<0.05). After reperfusion, the testicular fascial compartment pressure and testicular tissue Emean value in group I further increased (all P<0.05), while the testicular fascial compartment pressure and testicular tissue Emean value in group T decreased (all P<0.05). Thirty days later, testicular fascial compartment pressure and testicular tissue Emean value in group I were higher than those in group T (all P<0.05), while Johnsen′s score of testicular tissue was lower than that in group T ( P<0.05), and testicular tissue apoptosis index and malondialdehyde content were higher than those in group T Group T (all P<0.05). Conclusions:Decompression of the testicular compartment has a protective effect on spermatogenesis after testicular torsion reduction. SWE can indirectly evaluate the severity of testicular compartment syndrome after testicular torsion and reduction, and the protective effect of compartment decompression on spermatogenesis.
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Objective:To construct preliminarily the malignant risk classification system for the cervical lymph node.Methods:A total of 301 patients with cervical lymphadenopathy were collected in this prospective study from Union Hospital, Fujian Medical University from July 2018 to December 2019. The ultrasonographic features(including the short diameter, ratio of long to short diameters(L/S), margin, border, matting, echogenic hilum, echogenicity, gross necrosis, microcalcification, hyperechoic area, flow type, vascular distribution), history of malignancy, inflammation performance of the neck and history of tuberculosis were analyzed. A score was assigned for each significant index related to benign/malignant lymph nodes by a Logistic regression analysis. The classification of the malignant risk was determined on the basis of the scores.Results:The factors significantly associated with the malignant lymph nodes were enlargement of the short diameter, L/S<2, microcalcification, hyperechoic area, irregular margin, matting, abnormal flow pattern, malignancy history. While the factors related to the benign were the inflammation performance and the fuzzy boundary. The risk of malignancy increased as the score of lymph node increased. The malignant risk of lymph node according to the classification system was as follows: category 1, 7.30%; category 2a, 35.00%; category 2b, 69.30%; category 2c, 91.50%; and category 3, 99.05%. The area under the ROC curve of the system was 0.913.Conclusions:The system has great potential of clinical application to assess the risk of malignancy in cervical lymph nodes.
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Objective:To explore the value of contrast-enhanced ultrasound and its quantitative analysis technology in the evaluation of testicular microvascular injury caused by chronic alcoholism, as well as its relationship with the morphological changes of testicular spermatogenic cells.Methods:Seventy-two New Zealand white rabbits were randomly divided into control group (S group), low-dose alcohol group (L group), medium-dose alcohol group (M group), and high-dose alcohol group (H group). Then, the rabbits were subdivided into the groups of S1, S2, S3, L1, L2, L3, M1, M2, M3, H1, H2, H3 according to different time points (30 d, 60 d, 90 d). The rabbits in each group were examined by routine ultrasound before the experiment, followed by contrast-enhanced ultrasound examination. Testicular tissues were taken for pathological examination under light and electron microscope.Results:①The peak intensity and area under the curve of ultrasound contrast parameters gradually decreased with the increase of dosage and duration of alcohol feeding (all P<0.05), and the curvature also gradually decreased (all P<0.05). The differences of peak time, mean transit time, and peak half-time were not statistically significant (all P>0.05). ②With the increase of alcohol dosage and duration under the light microscope, the seminiferous tubule epithelium gradually became thinner, and the sperm in the cavity gradually decreased or no sperm was produced. The Johnsen′s score of testicular tissue decreased with the increase of alcohol dosage and duration (all P<0.05). The cytoplasmic mitochondria of the microvascular endothelial cells were vacuolated under the electron microscope. With the dosage and duration of alcohol feeding, the endothelial cells were vacuolated and even shed, and the basement membrane was interrupted. Conclusions:Alcohol could damage the testicular microvessels and spermatogenic cells in a dose-effect and time-effect relationship. Contrast-enhanced ultrasound can be used to evaluate the microvessel damage of testis caused by chronic alcoholism and indirectly reflect the morphological changes of spermatogenic cells.
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Objective:To investigate the diagnostic value of multimodal transvaginal contrast-enhanced ultrasound combined with fallopian tubal patency.Methods:From November 2017 to November 2019, 212 patients with infertility were treated in the outpatient clinic of the Union Hospital of Fujian Medical University. Multimodal contrast-enhanced ultrasonography was used to analyze the diagnostic efficiency differences of four-dimensional transvaginal contrast-enhanced hysterosalpinx (TVS 4D-HyCoSy, 4D), three-dimensional contrast-enhanced hysterosalpingography (TVS 3D-HyCoSy 3D), two-dimensional contrast-enhanced hysterosalpingography (TVS 2D-HyCoSy 2D), and transvaginal harmonic imaging (TVS harmonic imaging, HI) individually and in different combinations. The diagnostic efficiency of tubal patency was compared between the high seniority group and the low seniority group.Results:Two patients gave up the examination because of pain. A total of 420 salpingography in 210 patients were successful, of which 375 were unobstructed and 45 were blocked (13 on the right, 18 on the left, and 7 on both sides). In high seniority group and low seniority group, the diagnostic efficiencies of different mode combinations on fallopian tubal patency were significantly different ( P<0.01). There were significant differences( P<0.05) between 4D+ 3D+ 2D+ HI group and 4D+ 3D+ 2D group, 4D+ 3D+ 2D group and 4D+ 3D group, 4D+ 3D group and 4D group. There was no significant difference ( P>0.05) in the diagnostic efficiency of fallopian tubal patency between high seniority group and low seniority group. Conclusions:The diagnostic efficiency of multimodal transvaginal contrast-enhanced ultrasound combined is higher than that of single mode, and ultrasound doctors in both high and low seniority groups can effectively diagnose fallopian tubal patency, which has important clinical value in the diagnosis of fallopian tube patency.
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Objective:To investigate the value of real-time shear wave elastography (SWE) in the diagnosis of acute testicular torsion.Methods:A total of 30 rabbits were randomly divided into 3 groups including control group (Group S), complete torsion group (Group C) and incomplete torsion group (Group U), and corresponding animal models were built. Rabbits in each group were examined by gray scale and color Doppler ultrasound, SWE and contrast-enhanced ultrasound(CEUS) before and after operation. Mean values of elasticity modulus (Emean) of testicular capsule area, parenehyma testis, spermatic cord torsion section, torsion lower section and contrast-enhanced ultrasound parameters were recorded and then pathological examinations were performed.Results:There was no significant difference for Emean values of each group in all parts before operation( P>0.05). There was no significant difference for Emean value of S group at each period after operation( P>0.05). Emean value of postoperative testicular capsule area in U group increased obviously and rapidly compared with C group, yellow or red "hard ring signs" appeared within four to six hours after operation, there was significant difference of Emean value difference at various periods after operation in group U and C, and at 1 h, 1.5 h, 2 h, 2.5 h, 3 h and 3.5 h postoperatively between group U and C( P<0.05). Postoperative Emean value of parenchyma testis in group C and U increased about 5 kPa, expression of SWE was consistent blue. Postoperative Emean value of spermatic cord torsion section in group C increased more obviously compared with U group, a large patch of red signals appeared within five to six hours after operation, there was significant difference of Emean value at various periods after operation in group C and U, and at each period except instant, 2 h, and 3 h postoperatively between group C and U( P<0.05). Postoperative Emean value in spermatic cord torsion lower section in group U and C increased slowly ( P<0.05), expression of SWE changed from blue to blue green and green from original blue. CEUS showed blood pefusion in testis was "in and out slowly " in group U, pathological feature showed the testicular spermatogenic cells were in disorder with interstitial edema, distinct expansion of microvascular lumen, hyperemia and congestion and lots of erythrocyte leakage. CEUS showed postoperative contrast agent was not filling in testicular in group C, pathological feature showed the testicular spermatogenic cells were in disorder with interstitial edema, slight expansion of microvascular lumen, congestion and part erythrocyte leakage. Conclusions:The image changes of SWE after acute testicular torsion are related with the degree and time of torsion, the changes of testicular capsule area and spermatic cord torsion section are most significant. The use of SWE helps to get accurate hardness information of focus with effective clinical value for the diagnosis testicular torsion.
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Objective:To investigate the value of three-dimensional transvaginal sonography(3D-TVS) in the diagnosis of intrauterine adhesions(IUA) and to analyze the causes of the missed diagnosis.Methods:Forty-seven patients with IUA were examined by three-dimensional transvaginal sonography(3D-TVS), 3D volume imaging (Render imaging) and tomographic ultrasound imaging(TUI imaging) in the Union Hospital of Fujian Medical University from January 2017 to July 2019. The abnormal echo data of the endometrium were recorded and analyzed, and the ultrasound diagnosis and hysteroscopic diagnosis were compared.Results:3D-TVS correctly diagnosed IUA was accurate in the 39 cases whose ultrasound imaging showed an uneven thickness of endometrial echo with the uterine cavity line having different degrees of echo continuity interruption. The diagnostic accuracy rate was 83.0%(39/47). In the Render imaging, 7 cases showed endometrial echo with honeycomb change, 28 cases showed partial echo loss with irregular low echo zone or low echo, and 4 cases showed corneal disappearance of one side. In TUI imaging, the endometrium was partly thinned in varying degrees where echo continuity was interrupted with hypoechoic band-like changes in all 39 cases. Three of the 8 missed IUA cases showed slender endometrium with filiform or membranous adhesions, and the other 5 were patients with uterine endometrial polyps.Conclusions:3D-TVS, Render imaging and TUI imaging technology can display stereo images, which contributes to the better preoperative diagnosis and postoperative follow-up. Care should be taken to avoid missed diagnosis and to improve the diagnostic accuracy for IUA by the techniques.
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Objective:To investigate the value of transrectal ultrasonography(TRUS) in the preoperative diagnosis and tumor T-staging of anorectal malignant melanoma(ARMM).Methods:The clinical and ultrasound data of 19 patients(22 lesions) with ARMM confirmed by pathology from February 2008 to Apirl 2019 in Fujian Medical University Affiliated Union Hospital were collected. TRUS was performed within one week before pathological examination. The sonographic features were summarized, ultrasonic typing was performed according to the lesion size and growth pattern, and the accuracies of preoperative ultrasound diagnosis and tumor staging were analyzed.Results:Among the 22 lesions, 63.64%(14/22) were with a distance of ≤3 cm between the anal verge and the lower margin of tumor, 68.18%(15/22) with regular shape, 81.82%(18/22) with clear boundary, and 63.64%(14/22) with Adler blood flow grading from Ⅱ to Ⅲ. The preoperative TRUS diagnostic coincidence rate was 73.68%(14/19), and the tumor T-staging accuracy was 75%(12/16), respectively.Conclusions:TRUS exhibits certain sonographic characteristics, with high preoperative diagnosis rate and tumor T-staging accuracy in anorectal malignant melanoma, which is of great guiding significance for clinical diagnosis and treatment.
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Objective@#To investigate the value of transrectal ultrasonography(TRUS) in the preoperative diagnosis and tumor T-staging of anorectal malignant melanoma(ARMM).@*Methods@#The clinical and ultrasound data of 19 patients(22 lesions) with ARMM confirmed by pathology from February 2008 to Apirl 2019 in Fujian Medical University Affiliated Union Hospital were collected. TRUS was performed within one week before pathological examination. The sonographic features were summarized, ultrasonic typing was performed according to the lesion size and growth pattern, and the accuracies of preoperative ultrasound diagnosis and tumor staging were analyzed.@*Results@#Among the 22 lesions, 63.64%(14/22) were with a distance of ≤3 cm between the anal verge and the lower margin of tumor, 68.18%(15/22) with regular shape, 81.82%(18/22) with clear boundary, and 63.64%(14/22) with Adler blood flow grading from Ⅱ to Ⅲ. The preoperative TRUS diagnostic coincidence rate was 73.68%(14/19), and the tumor T-staging accuracy was 75%(12/16), respectively.@*Conclusions@#TRUS exhibits certain sonographic characteristics, with high preoperative diagnosis rate and tumor T-staging accuracy in anorectal malignant melanoma, which is of great guiding significance for clinical diagnosis and treatment.
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Objective@#To investigate the ultrasonographic features of fibrocystic breast change (FBC) and improve the ultrasonographic diagnosis and differential diagnosis of FBC.@*Methods@#Fifty-five patients of FBC with 60 lesions and 39 patients of invasive ductal carcinoma (IDC) with 42 lesions, which were confirmed by pathology after operation in the Affiliated Union Hospital of Fujian Medical University from January 2014 to February 2019 were enrolled. The preoperative sonographic findings of FBC and IDC were retrospectively analyzed and compared.@*Results@#There was no significant difference between the two groups in the rates of showing irregular shape, which were 86.7% in FBC group and 88.1% in IDC group, respectively (P>0.05), but the rate of showing crab feet or burrs on the edge of lesions in FBC group was lower than that in IDC group(P<0.05). The occurrence rates of posterior echo enhancement and cystic degeneration in FBC group were 81.7% and 71.7% respectively, which were significantly higher than those in IDC group (38.1% and 16.7%)(P<0.001). In addition, the FBC group showed fewer features such as hyperechoic halo and more features such as hypovascular supply than that of IDC group (all P<0.001).@*Conclusions@#In terms of ultrasonic features, including irregular shape or even crab feet and burrs, FBC can be easily misdiagnosed as malignant tumors. However, posterior echo enhancement, interior scattered small cysts, lack of blood supply and rare hyperechoic halo may be the characteristics of FBC, which can be differentiated from malignant tumors.
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Objective To investigate the ultrasonographic features of fibrocystic breast change ( FBC) and improve the ultrasonographic diagnosis and differential diagnosis of FBC . Methods Fifty‐five patients of FBC with 60 lesions and 39 patients of invasive ductal carcinoma ( IDC ) with 42 lesions ,which were confirmed by pathology after operation in the Affiliated Union Hospital of Fujian M edical University from January 2014 to February 2019 were enrolled . T he preoperative sonographic findings of FBC and IDC were retrospectively analyzed and compared . Results T here was no significant difference between the two groups in the rates of showing irregular shape ,which were 86 .7% in FBC group and 88 .1% in IDC group , respectively ( P ＞0 .05) ,but the rate of showing crab feet or burrs on the edge of lesions in FBC group was lower than that in IDC group( P ＜0 .05 ) . T he occurrence rates of posterior echo enhancement and cystic degeneration in FBC group were 81 .7% and 71 .7% respectively ,w hich were significantly higher than those in IDC group ( 38 .1% and 16 .7% ) ( P ＜0 .001) . In addition ,the FBC group showed fewer features such as hyperechoic halo and more features such as hypovascular supply than that of IDC group ( all P ＜0 .001 ) . Conclusions In terms of ultrasonic features ,including irregular shape or even crab feet and burrs ,FBC can be easily misdiagnosed as malignant tumors . However ,posterior echo enhancement ,interior scattered small cysts ,lack of blood supply and rare hyperechoic halo may be the characteristics of FBC ,w hich can be differentiated from malignant tumors .
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Objective@#To explore the sonographic features of primary testicular lymphoma(PLT).@*Methods@#The sonographic features of 16 PLT patients confirmed by surgery and pathology were retrospectively analyzed.@*Results@#Sixteen PLT patients were typed into 3 ultrasonic patterns: ①The diffuse homogeneous echo type: 2 cases, the ultrasonic features were homogeneous sieve-like hypoechoic echo, the blood flow signal was rich and radially distributed, with interstisial fibrosis inapparently under-microscope. ②The diffuse uneven homogeneous echo type: 9 cases, the ultrasonic features lobulated or map-like heterogeneous hypoechoic features, the blood flow signal was rich in linear distribution, and interstisial fibrosis proliferated to form fibrous septa under-microscope. ③The focal nodular pattern echo type: 5 cases, the ultrasonic features were homogeneous hypoechoic nodules, the blood flow signal was few, interstisial fibrosis hyperplasia surrounding the tumor under-microscope.@*Conclusions@#Ultrasonic appearances of primary testicular lymphoma are closely related to its pathologic characteristics, the recognization of their relations contributes to improve the diagnostic value of ultrasound.
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Objective To explore the sonographic features of primary testicular lymphoma(PLT).Methods The sonographic features of 16 PLT patients confirmed by surgery and pathology were retrospectively analyzed.Results Sixteen PLT patients were typed into 3 ultrasonic patterns:①The diffuse homogeneous echo type:2 cases,the ultrasonic features were homogeneous sieve-like hypoechoic echo,the blood flow signal was rich and radially distributed,with interstisial fibrosis inapparently under-microscope.②The diffuse uneven homogeneous echo type:9 cases,the ultrasonic features lobulated or map-like heterogeneous hypoechoic features,the blood flow signal was rich in linear distribution,and interstisial fibrosis proliferated to form fibrous septa under-microscope.③The focal nodular pattern echo type:5 cases,the ultrasonic features were homogeneous hypoechoic nodules,the blood flow signal was few,interstisial fibrosis hyperplasia surrounding the tumor under-microscope.Conclusions Ultrasonic appearances of primary testicular lymphoma are closely related to its pathologic characteristics,the recognization of their relations contributes to improve the diagnostic value of ultrasound.
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To discuss the value of color Doppler ultrasonography in the diagnosis and differential diagnosis of ureteral polyps ( U P) . Methods Ninety‐five cases with pathologically proven U P and 104 cases with pathological confirmed urinary tract urothelial carcinoma ( U T UC) were enrolled in the study . T heir positive rate of color Doppler ultrasonography exam preoperatively were retrospectively analyzed and compared with pathological findings . Results Compared with pathological diagnosis , the accordance rate of color Doppler ultrasonography localization were 82 .1% ( 78/95) and 80 .8% ( 84/104) for U P and U T UC respectively ,the accordance rate of qualitative diagnosis were 69 .2% ( 54/78 ) and 90 .5%( 76/84) . Color Doppler ultrasonographic features of U P displayed a clear demarcation between the pipe wall of ureter and surrounding tissue .However ,such clear demarcation could not be found in U T UC . T he accordance rate between two groups has statistically significant difference ( P ＝0 .000 6 ) . Color Doppler ultrasonographic image showed no blood flow in the ureteral polyps ,while mainly minor or medium amount of blood stream signals were found in most tumors of U T UC . According to Adler blood flow grading and the blood flow detective rate ,the two groups demonstrated statistically significant difference ( P ＜0 .05 ) . Conclusions With high resolution color Doppler ultrasonography and flexible operation technique ,it can clearly observe the internal structure of ureter at obstruction end as well as boundary conditions of peripheral tissue ,w hich will play a profound role in preoperative diagnosis and differential diagnosis of U P .
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Objective To investigate the value of high frequency ultrasound combined with color Doppler flow imaging in diagnosis and classification of trauma of penis on the clinical treatment . Methods T he sonographic features of 48 cases with penile trauma were analyzed and compared with treatment outcomes . Results T he ultrasonic findings of penile trauma ranged from penis contusion to penis fracture . According to the sonographic features ,the trauma of penis was grouped as follow s :Type 1 ,penis bruise ( 7 cases) presented with images of continuous penis skin and tunica albuginea ,inhomogeneous echoes of subcutaneous tissue . Type 2 ,corpora cavernosa bruise ( 4 cases ) showed images of continuous tunica albuginea ,inhomogeneous internal echoes of corpora cavernosa without abnormal flow signal . T he corpora cavernosa swelling into honeycomb‐like ,anechoic area of cavernosa with high‐speed artery Doppler signals w hen accompanied by cavernous artery injury . Four cases were treated conservatively . Type 3 ,the skin and subcutaneous tissue contusion ( 6 cases) manifested images of incontinuous and inhomogeneous echoes of skin and subcutaneous tissue but homogeneous echoes of corpora cavernosa and tunica albuginea . Six cases of patients underwent debridement and sutured by local anesthesia . Type 4 ,rupture of tunica albuginea( 26 cases) revealed images of incontinuous and irregular local tunica albuginea ,a hematoma seen between the tunica albuginea and subcutaneous tissue . Type 5 , penile fracture ( 5 cases ) revealed mostly or fully disconnected skin and corpora cavernosa ,tearing of blood vessels . T he patients of type 4 and 5 were all treated surgically . Conclusions Color Doppler ultrasonography could provide accurate assessment and classification for trauma of penis ,w hich is helpful to offer a reliable basis for clinical treatment scheme .
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Objective To investigate the correlation between the features of conventional ultrasound& shear wave elasticity and axillary lymph node involvement in breast cancer . Methods A total of 169 breast cancers patients were divided into lymph node metastasis group( n = 115) and non metastasis group ( n = 54 ) according to the postoperative pathological results . Preoperative conventional ultrasonographic features and preoperative shear wave elastography quantitative parameters ( E values ) of the two groups breast lessons were analyzed by single factor analysis to screen out statistically significant factors ,then Logistic regression analysis was performed to analyze the relationship between above factors and lymph node involvement . Results Single factor analysis showed the microcalcification and hyperechoic halo detection rates of lymph node metastasis group [ 81 .7％ ( 94/115) and 71 .3％ ( 82/115 ) ,respectively] were higher than those in non metastasis group [ 61 .1％ (33/54) and 50 .0％ ( 27/54) ,respectively] . The elastography maximum value( Emax) of lymph node involvement group was ( 182 .2 ± 74 .0) kPa ,which was larger than that in non metastasis group′s ( 153 .3 ± 76 .9) kPa ( P < 0 .05) . Multivariate Logistic regression analysis showed the microcalcification( OR = 2 .498 , P = 0 .022) ,the hyperechoic halo( OR = 2 .482 , P = 0 .013) and the Emax value( OR = 1 .007 , P = 0 .007) were risk factors of axillary lymph node metastasis in breast cancer . Conclusions Breast cancer with microcalcification ,hyperechoic signs and high Emax value is more likely to develop axillary lymph node metastasis .
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Objective To investigate the value of color Doppler ultrasonography in mammary ductal ectasia( MDE). Methods Preoperative sonograms of 54 MDE,135 invasive ductal carcinoma( IDC) and 68 ductal carcinoma in situ ( DCIS ) patients were retrospectively analyzed and further confirmed by histopathology. Results MDE showed 88.9% (48/54) mass type and 11.1% (6/54) ductal type.The average age of patients in MDE was younger than that in IDC( P ＜0.05). The number of MDE located around the areola was more than that of IDC( P ＜0.05). Mean maximum diameter of MDE was smaller than that of DCIS ( P ＜0.05). Compared to DCIS and IDC,MDE in mass type showed higher detection rate of liquidity area and mammary ductal ectasia( all P ＜0.05),while lower detection rate of hyperecho, peripheral hyperechoic zone,posterior echo attenuation or blood flow richness( all P ＜0.001). Compared to IDC,MDE in mass type showed higher detection rate of inside ductal echolocation,while showed lower detection rate of irregular shape,spiculate margin or axillary lymph node enlargement. Compared to DCIS, MDE showed higher detection rate of large aspect ratios( ≥0.7). Less MDE in ductal type with hyperecho were found than DCIS in ductal type ( P ＜ 0.001 ). The coincidence rate of ultrasonic diagnosis and postoperative histopathhology results in 54 MDE patientis was 13.0% ( 7/54 ). Conclusions The sonographic findings of MDE has diverse manifestations. It shows important value of ultrasonography for MDE in its diagnosis and differential diagnosis with breast cancer.
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Objective To explore novel lipid microbubbles with matrix metalloproteinase-9(TMB-9) targeting in the radiography evaluation of the protective effects of doxycycline on testicular ischemia-reperfusion injury by contrast-enhanced ultrasound(CEUS). Methods Thirty-six rabbits were randomly divided into control groups (group S1 and group S2),ischemia reperfusion groups (group R1 and group R2) and doxy intervention groups (group D1 and group D2).In the control groups,threading without ligation was performed after the exposure of the spermatic cord.The establishment of ischemia-reperfusion model was performed in ischemia reperfusion groups and doxy intervention groups,followed by 1-day feeding for group R1 and D1 as well as 4-day feeding for group R2 and D2.Group D1,group D2 and group S1 were given intraperitoneal injection of doxy 20 mg· kg -1· d-1.Group R1,group R2 and group S2 were given intraperitoneal injection of equivalent normal saline.MB and TMB-9 CEUS were undertook preoperative and postoperative respectively in each group.And the changes of the contrast parameters were analyzed, including PI,TP,Slope,MTT,DT/2 and AUC.The testes were taken for pathological examination after operation.Results TMB-9 contrast parameters of the group D1 including PI and AUC were significantly decreased,MTT and DT/2 decreased( P < 0.05),compared with Group R1.While compared with MB, TMB-9 contrast parameters of group D1 including PI and AUC were increased,MTT and DT/2 prolonged (P<0.05).TMB-9 contrast parameters of Group D2 including PI and AUC were significantly decreased, MTT and DT/2 decreased( P <0.01),compared with Group R2.TMB-9 contrast parameters of Group D2 only PI increased( P <0.01),while compared with MB.Compared with the ischemia reperfusion group,the expression of MMP-9 in the vascular basement membrane of doxy intervention groups was significantly decreased ( P < 0.01).Conclusions TMB-9 can sensitively and objectively evaluate testicular ischemia-reperfusion injury of testicular microvasculature at different reperfusion times before and after doxy intervention.
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Objective To explore the relationship between ultrasonic appearances of epididymal spermatic granuloma and its pathologic characteristics. Methods The sonographic features of 32 cases of epididymal spermatic granuloma confirmed by pathology were retrospectively analyzed. Results A total of 34 epididymal spermatic granuloma nodules in 32 cases included 4 located in caput epididymidis and 30 located in cauda epididymidis,and maximum diameter of nodules were about 0.5-2.3 cm.Sonographic and pathologic appearances of nodules were: ① mostly low echo type,21 nodules mostly showed the obscure boundary and quite abundant blood flow signals,early granulomas formed with interstitial fibrosis inapparently under-microscope; ② inhomogeneous echo type,12 nodules mostly showed the barely clear boundary and blood flow signals from small amount to abundant amount,granulomas of different maturites distributed dispersedly with interstitial fibrosis of varying degrees under-microscope or single giant lesions formed;③mostly high echo type,1 nodule showed the obscure boundary and inapparent blood flow signals, center of the nodules distributed by a large amount of dense fibrous tissue under-microscope. Anechoic ethmoid sinus seen in 29 nodules was section of dilated epididymal ductus.Dotted strong echoes seen in 6 nodules were calcification of sperms in dilated epididymal ductus and necrotic tissue. Conclusions Ultrasonic appearances of epididymal spermatic granuloma are closely related to its pathologic characteristics.To recognize both relations contributes to improve the diagnostic value of ultrasound.
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Objective To analyze the ultrasonic features of papillary thyroid microcarcinoma (PTMC) with different size and location,and to investigate the relationship of aspect transverse ratio (A/T) and capsule invasion in PTMC.Methods Totally 407 patients of PTMC with 495 nodules confirmed by pathology were enrolled.The nodules were divided into largest diameter≤0.5 cm group and largest diameter＞0.5 cm group.The ultrasonic signs of nodules were observed,and the relationship between A/T and thyroid capsule invasion was analyzed.Results The differences of blood type,relationship with capsule,calcification,morphology and A/T were statistically significant between the two groups (all P＜0.05).In nodules closed to capsule and A/T≥1,the rate of capsule invasion in diameter＞0.5 cm group (117/185,63.24％) was higher than that in diameter≤0.5 cm group (25/61,40.98％,P＜0.01).Taking A/T≥1 as the standard,the sensitivity of A/T in estimating capsule invasion of nodules closed to capsule in diameter≤0.5 cm group and diameter＞ 0.5 cm group was 89.29％ and 73.58％,the specificity was 29.41％ and 37.61％,respectively.In nodules adjacent to capsule and broken through capsule,the difference of capsule invasion rate was not significant between nodules with A/T≥1 and A/T＜1 (both P＞0.05).In nodules that contact capsule,the capsule invasion rate of A/T≥1 nodules (46/67,68.66％) was higher than that of A/T＜1 (10/27,37.04％).Taking A/T≥1 as the standard,the sensitivity of A/T in estimating capsule invasion of nodules touched capsule was 82.14％,and the specificity was 44.74％.Conclusion Ultrasonography can show the size,A/T and relationship with capsule in PTMC,which can provide diagnostic evidences in judging capsule invasion of PTMC.