ABSTRACT
Objective:To evaluate the application value of three-dimensional shear wave elastography(3D-SWE) with quantitative parameters and qualitative analysis of stiff rim sign in differentiating benign and malignant breast masses.Methods:One hundred and seventeen female patients (121 breast masses) admitted to the First Affiliated Hospital of Soochow University from January 2020 to February 2021 were examined by conventional ultrasound, two-dimensional shear wave elastography (2D-SWE) and 3D-SWE. Surgical or puncture pathology were used as the gold standard, the ROC curves of 2D-SWE and 3D-SWE were drawn to obtain the optimal qualitative and quantitative indicators. Afterwards, BI-RADS category was adjusted according to the optimal indicators, which could be used to evaluate the diagnostic value in differentiating benign and malignant breast masses.Results:The area under ROC curve (AUC) of BI-RADS category was 0.846, the sensitivity and specificity were 89.6% and 79.6%, respectively. The AUC value of mass-to-fat elasticity ratio(Eratio) of coronal plane was 0.869, which was the highest among all quantitative parameters and was significantly higher than that of 2D-SWE ( P<0.05). In addition, the AUC value of stiff rim sign of coronal plane was significantly higher than those of 2D-SWE, sagittal plane and transverse plane (All P<0.05). The AUC of combination of stiff rim sign of coronal plane and conventional US was 0.901, which was significantly higher than that using conventional ultrasound alone( P<0.05). Conclusions:Compared with 2D-SWE, Eratio and stiff rim sign of coronal plane of 3D-SWE yield better diagnostic efficiency.Adjusting stiff rim sign coronal plane to BI-RADS category can effectively improve the diagnostic efficiency.
ABSTRACT
Objective:To investigate the difference of accuracy between magnetic induction Freehand-3D ultrasound and two-dimensional ultrasound in measuring the volume of thyroid model.Methods:Forty thyroid models were established using porcine liver, and the Archimedes procedure was set as gold standard in the measurement of the volume of each model. The accuracy of measurement of the porcine thyroid model volume between two-dimensional ultrasound and magnetic induction Freehand-3D ultrasound were compared.Results:There were no significant differences in the accuracy of measurements of thyroid model volume among two-dimensional ultrasound, magnetic induction Freehand-3D ultrasound and Archimedes procedure (all P>0.05). Compared with the Archimedes procedure, magnetic induction Freehand-3D ultrasonic method showed higher correlation coefficient of the measurement of thyroid model volume ( r=0.998). Bland-Altman analysis showed the lower measure error with a relative error of 3.42% and range of -9.57% to 12.07%. And the limits of agreement were (-1.253, 0.999) in the magnetic induction Freehand-3D ultrasonic measurement. Conclusions:Compared with two-dimensional ultrasound, the magnetic induction Freehand-3D ultrasound show higher accuracy in the measurement of the volume of the thyroid model.
ABSTRACT
Objective@#To explore the clinical value of contrast-enhanced ultrasound combined with modified labeled method in labeling sentinel lymph nodes of breast cancer in comparison with nano-carbon stained method.@*Methods@#Eighty female breast cancer patients who underwent surgery in the First Affiliated Hospital of Soochow University between July 2017 and April 2019 were enrolled. Sentinel lymph nodes in all patients were labeled by contrast-enhanced ultrasound combined with modified labeled method and nano-carbon stained method, respectively. The consistency of first lymph node labeled by the two methods was judged, the number of SLNs labeled by two methods was counted, and the pathology of the labeled SLN was compared with that after axillary dissection.@*Results@#The two methods have good consistency in locating sentinel lymph nodes of breast cancer(Kappa=0.749, P=0.000). The number of SLNs labeled by modified labeling method was significantly less than that labeled by stained method(Z=-7.434, P=0.000). The pathology of lymph nodes labeled by both the modified labeling method and stained method coincided well with that of axillary dissection(Kappa=0.941, 0.943; P=0.000, 0.000), and diagnostic efficiency was comparable(AUC=0.964, 0.967).@*Conclusions@#Contrast-enhanced ultrasound combined with modified labeling method is simple and accurate in labeling sentinel lymph nodes of breast cancer. Accurate assessment of axillary lymph node staging can be made by precise biopsy of 1-2 SLNs.
ABSTRACT
Objective To explore the clinical value of contrast-enhanced ultrasound combined with modified labeled method in labeling sentinel lymph nodes of breast cancer in comparison with nano-carbon stained method.Methods Eighty female breast cancer patients who underwent surgery in the First Affiliated Hospital of Soochow University between July 2017 and April 2019 were enrolled.Sentinel lymph nodes in all patients were labeled by contrast-enhanced ultrasound combined with modified labeled method and nano-carbon stained method,respectively.The consistency of first lymph node labeled by the two methods was j udged,the number of SLNs labeled by two methods was counted,and the pathology of the labeled SLN was compared with that after axillary dissection.Results The two methods have good consistency in locating sentinel lymph nodes of breast cancer(Kappa=0.749,P =0.000).The number of SLNs labeled by modified labeling method was significantly less than that labeled by stained method(Z =-7.434,P =0.000).The pathology of lymph nodes labeled by both the modified labeling method and stained method coincided well with that of axillary dissection(Kappa=0.941,0.943;P =0.000,0.000), and diagnostic efficiency was comparable(AUC = 0.964,0.967).Conclusions Contrast-enhanced ultrasound combined with modified labeling method is simple and accurate in labeling sentinel lymph nodes of breast cancer.Accurate assessment of axillary lymph node staging can be made by precise biopsy of 1-2 SLNs.
ABSTRACT
Purpose To investigate the relationship between ultrasonic manifestations in prostate cancer (PCa) and Gleason score,and improve the clinical value of transrectal ultrasound (TRUS) examination of PCa.Materials and Methods 362 patients with PCa treated in the First Affiliated Hospital of Soochow University from September 2009 to January 2015 were analyzed retrospectively,according to TRUS examination,the ultrasonic manifestations of PCa were divided into the localized type,diffuse type and negative type.Gleason score of pathological tissue divided the risk factor of PCa into low risk (＜7 points),medium risk (=7 points),and high risk (＞7 points).The relationship between ultrasonic manifestations of PCa and risk factor was analyzed.Results Ultrasonic results showed that,for the 362 patients with PCa,patients with ultrasonic negative manifestations accounted for 32.9％ (119/362) and those with ultrasonic positive manifestations accounted for 67.1％ (243/362),including 38.7％ (140/362) localized type and 28.4％ (103/362) diffuse type.In localized and diffuse PCa,the number of patients in high risk group was significantly more than the low risk group,and the difference among the high risk,medium risk and low risk groups was statistically significant (P＜0.05);in the low risk group,the ultrasonic negative manifestations were more than the positive manifestations,and the difference was statistically significant (P＜0.05);in high risk group,the localized and diffuse manifestations were more than the negative manifestations and the difference was statistically significant (P＜0.05).Conclusion TRUS shows more clinical values in the diagnosis and treatment of PCa,and the ultrasonic positive manifestations can preliminarily evaluate the risk factor of PCa.
ABSTRACT
Objective To evaluate the diagnostic value of prostate imaging reporting and data system version 1 (PI-RADS V1) and version 2 (PI-RADS V2) for detection of prostate cancer (PCa) in the transition zone (TZ).Methods Seventy-seven patients with suspicious lesions in TZ on mpMRI were scored according to the PI-RADS system (V1 and V2) before MR-TRUS fusion guided biopsy prospectively.In all of the patients with suspicious tumors,respectively at least one lesion with a PI-RADS V1 assessment category of ≥3,was selected for biopsy.Independent sample t test was used to compare scores of PI-RADS V1 and V2 between PCa and benign prostatic hyperplasia (BPH).The diagnostic performance of PI-RADS V 1 and V2 for detection of PCa in the transition zone was compared by analyzing ROC basing on the results of MR-TRUS fusion guided biopsy.Results A cohort of 77 patients was performed including 31 cases of PCa (32 cores) and 46 cases of BPH (51 cores).PCa (V1:1 1.50±2.79;V2:4.28±0.99) had significantly higher scores of both PI-RADS V1 and PI-RADS V2 than BPH(V1:7.51± 1.63;V2∶2.61 ±0.67) (P＜0.05).Using a PI-RADS V1 score cut-off ≥ 11,sensitivity and specificity in group PCa and BPH were calculated,which were 68.8％(22/32) and 96.1％(49/51) with a area under curve of 0.869;using a PI-RADS V2 score cut-off ≥4,which were 75.0％ (24/32) and 90.2％ (46/51) with a area under curve of 0.888,respectively.Conclusions PI-RADS system can indicate the likelihood of PCa of suspicious lesions in TZ on Mp-MRI.PI-RADS V2 perform better than V 1 for the assessment of prostate cancer in TZ.
ABSTRACT
Objective To evaluate the method of ultrasonic imaging to confirm endotracheal tube location in adult patients.Methods A certified sonographer identified the location of the trachea tube with ultrasound machine and then put it to optimum place.Correct trachea tube location confirmed by fiberoptic bronchoscopy (FOB) was used to evaluate the accuracy of ultrasonography for detecting endotracheal tube location.Results Several relevant structures,including anterior wall of trachea,the edge of balloon and the superior edge of the aorta (DGA) would be successfully visualized by sonographic examination.Among 48patients underwent ultrasound-guided tracheal intubation,there were 44 successful cases.2 intubatedmalposition cases and 2 failed-to-guide cases.The locating accuracy rate was 91.7％.Conclusions Ultrasound examination can identify the position of trachea tube in adult patients accurately,and it is a noninvasive,convenient and radiation free method for patients undergoing airway management.
ABSTRACT
Objective To investigate the efficacy and safety of balloon-assisted catheter directed thrombolysis (CDT) for acute lower extremity deep vein thrombosis (DVT).Methods From September 2008 to February 2011,94 patients with acute lower extremity DVT were admitted.The cases in early stage were treated by CDT (Group A,n =50),and the cases in late stage were treated by balloon-assisted CDT ( Group B,n =44).The clinical data of these patients were retrospectively analyzed.The circumference difference between normal and affected limbs,scores of venous patency,and rates of venous patency were recorded for judging the efficacy.The total dose of urokinase and retention time of infusion catheter was compared between the two groups.The incidence of pulmonary embolism and bleeding were used to judge the safety of treatment.The venous patency was followed up by ultrasound or/and venography.Measurement data with normal distribution was described by mean + standard,and was analyzed using T test.Measurement data with non-normal distribution was described by M ( QL,QU ),QL =P25,QU =P75,and was analyzed using Wilcoxon' s test.Categorical variable data was analyzed using Chi-Square test Results The prior treatment circunfference difference between normal and affectéd limbs were (5.37 ±1.97) cm (thigh) & (4.14 ± 1.57) cm (calf) in Group A and (5.41±2.22) cm (thigh) & (4.05 ±1.61) cm (calf) in Group B ; and the difference between the groups was insignificant ( thigh:t =- 0.113,P=0.910; calf:t =0.288,P =0.774).The post treatment correspondences were:(2.96 ± 1.10) cm (thigh) & ( 1.93 ± 0.84 ) cm (calf) in Group A and ( 1.78 ± 1.40) cm ( thigh ) & ( 1.41± 1.17 ) cm (calf) in Group B; the difference between the groups was significant (thigh:t =4.66,P ＜0.0001; calf:t =2.548,P =0.012 ).The prior treatment score of venous patency was 9 (8,10) in Group A and 8.3(7,10) in Group B without significant difference (Z =- 1.5172,P =0.1292).The post treatment score of venous patency was 3.5 ( 2,5 ) in Group A and 0 ( 0,1) in Group B with significant difference ( Z =-5.7702,P ＜0.01).The rate of venous patency after the treatment was 55.0％ (42.3％,72.4％ ) in Group A and 100％ (88.5％,100％ ) in Group B,with significant difference ( Z =4.9148,P ＜ 0.01).The total dose of urokinase used in the treatment was 5.950 ( 5.525,7.225 ) × 106U in Group A and 4.100 (3.600,5.050) × 106U in Group B with significant difference (Z =-6.0133,P ＜ 0.01).The retention time of perfusion catheter was 10 (9,12) d in Group A and 6 (5,7) d in Group B with significant difference ( Z =- 8.0358,P ＜ 0.01).No symptomatic pulmonary embolism occurred in both groups during the treatment and follow-up period.The rate of bleeding complication was 38.0％ (19/50) in Group A and 22.3％ (10/44) in Group B,without significant difference (x2 =2.5590,P =0.1097 ).The removal rate of optional filter was 88.37％ (38/43) in Group A and 100％ (39/39) in Group B,with significant difference ( x2 =4.829,P =0.028 ).The rate of venous patency at the last follow-up point was 50.0％ (44.4％,59.2％ ) in Group A,and 95.4％ (83.6％,100％ ) in Group B,with significant difference (Z =- 3.2721,P =0.0011).Conclusions Balloon-assisted CDT was a promising treatment for acute lower-extremity DVT.It improved the effect of thrombolysis and reduced the dosage of urokinase,and did not increase the risk of pulmonary embolism.
ABSTRACT
Objective To establish VX2 hepatic carcinoma model in rabbits by implanting the tumor fragment into the liver through percutaneous puncture under ultrasound guidance and to observe its growing and metastatic characteristics, to determine the optimal time for interventional experiment study with the model. Methods Inoculation of VX2 carcinoma fragment was performed in 28 New Zealand white rabbits. PET/CT and ultrasonography (US) examinations were carried out in the second, third and forth week after the inoculation, and each time two tumor-bearing rabbits were sacrificed for pathologic study. Results The successful rate of model establishment was 89.28% (25/28). On PET or CT scans, single lesion in the liver was demonstrated in 25 rabbits. Two, three and four weeks after the inoculation, the maximum diameter of the tumor was (4.82±0.80) mm, (16.05±2.89) mm and (30.08±5.38) mm respectively, while the metastasis rates was 0% (0/25), 13.04% (3/23), 76.19% (16/21) respectively. No significant necrosis was found in the second week after inoculation, only tiny coagulation necrosis was revealed in the third week, and massive necrosis was seen in the forth week. Conclusion Percutaneous inoculation of the tumor fragment into the liver under ultrasonographic guidance is a simple method to establish VX2 hepatic carcinoma in rabbits with a high successful rate. The third week after inoculation is the suitable time for making interventional experiment study.