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Objective:To analyze the correlation between the muscle thickness (MT) and echo intensity (EI) of the medial head of gastrocnemius and muscle mass, strength and functional parameters, and to evaluate the diagnostic efficacy of MT and EI for decreased muscle mass.Methods:Fifty-two subjects who visited the Department of Ultrasound Medicine of the Second Affiliated Hospital of Fujian Medical University from March to December 2021 were collected.MT of the medial head of gastrocnemius was measured by two-dimensional ultrasound, and EI values in the region of interest were analyzed using Image J software. Twenty of the subjects were selected to assess the intra-observer and inter-observer agreements in measuring MT and EI values using the intraclass correlation coefficient (ICC) and Altman-Bland analysis was performed. The subjects were divided into healthy control group (30 cases) and decreased muscle mass group (22 cases) according to 2019 Asian Sarcopenia Working Group (AWGS) diagnostic criteria, the differences in MT and EI values between the two groups were compared, and the correlation between MT, EI values and muscle mass, strength, function were analyzed using Pearson correlation analysis. The diagnostic cutoff values of MT and EI values for decreased muscle mass were obtained using ROC curves, and the diagnostic efficacy was compared.Results:①The ICC of MT and EI in medial head of gastrocnemius detected by the same physician and different physicians were greater than 0.97, and the retest reliability was good. ②Compared with the healthy control group, the MT value in medial head of gastrocnemius decreased and the EI value increased in the decreased muscle mass group ( t=4.759, -3.789; all P<0.001). ③The MT value in medial head of gastrocnemius was positively correlated with appendicular skeletal muscle mass (ASM), appendicular skeletal muscle mass index (ASMI), lower limb skeletal muscle mass (LLSM), grip strength, and gait speed ( r=0.579, 0.568, 0.585, 0.495, 0.415; all P<0.001), of which, the correlation with LLSM was the best; ④EI in medial head of gastrocnemius was negatively correlated with ASM and ASMI, LLSM, grip strength, and gait speed, ( r=-0.583, -0.591, -0.590, -0.537, -0.455; all P<0.001), and among which the correlation with ASMI was the best. ⑤The medial head of gastrocnemius MT and EI were 14.33 mm and 58.85 for predicting decreased muscle mass, respectively, and there was no significant difference in the diagnostic performance of the two for decreased muscle mass ( Z=0.734 3, P>0.05). Conclusions:The MT and EI values of the medial head of gastrocnemius can accurately assess muscle mass and can be used in the evaluation of patients with decreased muscle mass.
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Objective:To evaluate the value of improved pulmonary ultrasonography in the follow-up assessment of lung damage in patients who recovered from corona virus disease 2019(COVID-19).Methods:Twenty-two patients who were cured of COVID-19 in Quanzhou First Hospital from January to May 2020 were randomly selected and divided into 7 mild cases, 12 moderate cases and 3 severe cases according to the first high-resolution CT (HRCT) at admission. Six months after recovery, modified lung ultrasonography and HRCT were used prospectively to assess the lung damage and evaluate the correlation and consistency between the two techniques.Results:①There were significant differences in lung damage between the mild group and the moderate group, severe group (all P<0.05), while there was no significant difference between the moderate group and severe group ( P>0.05). ②There was good consistency between the improved lung ultrasound examination and HRCT (Kappa=0.776, P<0.001). ③There was a positive correlation between the score of improved pulmonary ultrasound examination and HRCT Warrick score ( r=0.755, P<0.001). Conclusions:Improved pulmonary ultrasonography can be used as a priority in the evaluation of pulmonary damage follow-up in patients with COVID-19 recovery, reducing the use of CT, and providing favorable evidence for further clinical management.
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Objective:To explore the safety and clinical value of ultrasound-guided percutaneous core needle biopsy in the diagnosis of cardiac intermural tumors and pericardial tumors.Methods:Seven patients who underwent ultrasound-guided percutaneous cardiac tumors needle biopsy in Fujian Provincial Hospital from January 2012 to December 2019 were selected for this study. The locations and sizes of the lesions were recorded preoperatively by echocardiography and the operation time was recorded by conventional ultrasonography. The postoperative complications was followed up, and the satisfaction of pathological materials was used as the evaluation standard to comprehensively analyze the safety and clinical application value of ultrasound-guided percutaneous biopsy in the diagnosis of cardiac tumors.Results:Ultrasound-guided percutaneous biopsy was performed successfully in all the 7 cases, 3 of them were intermural tumors and 4 of them were pericardial tumors. Except for 2 patients with diffuse pericardial space, the maximum diameter of the remaining 5 patients was (58.6±23.5)mm. Six cases were punctured from the apex of the heart, and 1 case from the left parasternal through third intercostal space toward the bottom of the heart as the needle pathway. The satisfaction of pathological material was 100%, and the time of procedure was (15.1±3.3)min. There were no postoperative complications such as bleeding, infection or arrhythmia.Conclusions:Ultrasound-guided percutaneous transthoracic needle biopsy is safe and feasible, which provides a simple and easy method for the biopsy of cardiac intramural tumors and pericardial tumors.
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Objective:To evaluate the diagnostic value of refined transthoracic lung ultrasound(TLUS) scoring method in interstitial lung diseases(ILD).Methods:The TLUS was performed in 39 ILD patients in respiratory department and immunology department of the Second Affiliated Hospital of Fujian Medical University from March 2019 to February 2020. The ultrasonic recordings were evaluated by Buda ultrasound scoring method and refined ultrasound scoring method. The diagnostic efficacies of the refined ultrasound scoring method, Buda ultrasound scoring method and high resolution computed tomography(HRCT) scoring method for ILD were analyzed. The correlations between refined ultrasound score and Buda ultrasound score/HRCT score were evaluated. The difference of diagnostic efficacy between refined ultrasound scoring method and Buda ultrasound scoring method were analyzed in different severity of ILD. Then, the HRCT Warrick scoring method was used as the criterion to judge the severity of ILD, and the receiver operator characteristic (ROC) curve was plotted to predict the cutoff values of the fefined ultrasound score for different degrees of ILD.Results:①The sensitivity of the refined ultrasound scoring method in diagnosing ILD was 92.3%, specificity was 92.3%, area under ROC curve(AUC)=0.978, 95% CI=0.941-1.000. The sensitivity of Buda ultrasound scoring method in diagnosing ILD was 87.2%, specificity was 87.2%, AUC=0.950, 95% CI=0.892-1.000. The sensitivity of HRCT scoring method in diagnosing ILD was 97.4%, specificity was 97.4%, AUC=0.999, 95% CI=0.994-1.000. ②The correlations between the refined ultrasound score, the HRCT Warrick score and the Buda ultrasound score were high ( r=0.929, 0.920, 0.862 respectively, P<0.001). ③The values of refined ultrasound scoring method and Buda ultrasound scoring method consistently and significantly increased with the increasing severity of ILD. With regards to the former one, there were significant differences among mild group, moderate group and severe group ( P<0.05). ④The ROC curve confirmed that refined ultrasound score cut-off points for predicting mild and severe interstitial lung diseases, were 34 [sensitivity of 100%, specificity of 87.5% respectively, AUC=0.891, 95% CI=0.686-1.000] and 64.5 [sensitivity of 91.3%, specificity of 87.5% respectively, AUC=0.954, 95% CI=0.877-1.000]. Conclusions:The severity of the interstitial lung diseases could be evaluated by the refined ultrasound scoring method, which is useful in the semi-quantitative evaluation of ILD.
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Objective:To explore ultrasonographic diagnostic characteristics of ovarian epithelial tumors and establish prediction models.Methods:The ultrasonographic images of 427 cases from multicenter with ovarian epithelial tumors confirmed by pathology from January 2015 to July 2019 were retrospectively analyzed according to the International Ovarian Tumor Analysis (IOTA). Ultrasonographic signs with distinguishing significance were obtained through univariate analysis and included into multivariate Logistic regression analysis to obtain important ultrasonagraphic indicators for distinguishing borderline, benign and malignant ovarian tumors, and to establish prediction models.Results:The microcystic pattern of papillary projections and solid components was the diagnostic characteristic between borderline and benign, malignant ovarian epithelial tumors( OR value 10.97 and 19.22, respectively). Irregular morphology, septa thickness, solid lesions, rich blood supply and ascites were diagnostic characteristics between benign and malignant tumors, with the irregular morphology having the highest value. Irregular morphology, large papillary, septa thickness and rich blood supply could be used to identify borderline and malignant tumors. At the same time, irregular morphology was the valuable sign to distinguish borderline and benign tumors. In this study, the total coincidence rate of the proposed model was 72.4%, among which the predicted coincidence rate of the borderline model was 57.2%, 78.6% for benign, and 80.7% for malignant. Conclusions:The microcystic pattern of papillary projections and solid components are the specific sonographic characteristics of borderline ovarian tumors. Irregularity, solid lesions, rich blood supply and ascites have important value in differentiating ovarian epithelial tumors. The prediction models of benign, malignant and borderline ovarian tumors in this study have higher diagnostic efficacy.
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Objective To evaluate the efficacy of the combination of gynecologic imaging reporting and data system (GI-RADS) uhrasonographic stratification and 3D contrast-enhanced ultrasonography (3D-CEUS) in identifying malignant lesions from benign ovarian masses.Methods Both of 2D ultrasound (2D-US) and 3D-CEUS were performed on 102 patients with ovarian masses.The perfusion characteristics of ovarian masses were observed with 3D-CEUS,and the 2D-US features of ovarian masses were analyzed based on GI-RADS.Simple and multiple Logistic regression analysis were used to investigate whether the independent risk predictors in differential diagnosis of benign and malignant ovarian could be confirmed.In addition,ROC curves were drawn.The diagnostic efficacy of GI-RADS combined with 3D-CEUS scoring system was evaluated and compared with that of only GI-RADS.Results Simple and multiple Logistic regression analysis confirmed that there were 8 independent predictors of malignant masses,including large papillary projections (≥7 mm),separated or wall thickness ≥3 mm,central blood flow,the proportion of solid part ≥50％,combination of ascites,high level enhancement,uneven distribution of contrast media in enhanced solid part and the vascular with characteristics as dense,tortuous and anfractuous.When using 4 points as the cut-off,the area under the curve (AUC) of GI-RADS combined with 3D-CEUS scoring system in identifying malignant ovarian masses was 0.969,higher than that of only GI-RADS (0.839;Z=1.64,P=0.029).Furthermore,the scoring system showed higher sensitivity,specificity,positive predictive value,negative predictive value and accuracy (all P＜0.001).Conclusion The combination of GI-RADS with 3D-CEUS can be more effective to distinguish malignant lesions from benign ovarian masses.
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Objective To investigate the value of prenatally quantitative sonography in diagnosing clubfoot.Methods By routine sonography totally 32 feet diagnosed doubtfully with clubfoot were chosen as case group,and 414 normal feet between 16 and 38 weeks'gestation were enrolled in control group stochastically.The length of foot(FL)and width of the foot(FW)in both group were measured,and then the length-to-width ratio(FL、FW)was calculated.On the basis of the research of Glotzbecker,the angle that the long-axis of the foot made with the long-axis of the lower leg was measured and classified into mild, moderate,severe degree in control group.The length and width of the foot and the length-to-width ratio in both groups were compared.After birth,the fetuses of case group were followed up and Dimeglio score was recorded.The FL、FW and the angle that the long-axis of the foot made with the long-axis of the lower leg were subjected to the correlation analysis with Dimeglio score,respectively.Results Twenty-six of the 32 feet with prenatal diagnosis had a clubfoot documented at birth(false positive equals to 18.8%).According to Glotzbecker's classification,13,13 and 5 of 32 feet respectively were classified as mild,moderate,severe degree.The FL and FL、FW in case group were smaller than those in the other group(FL:Z=-2.10,P <0.05;FL、FW:Z=-8.46,P <0.001),and the foot width was wider(Z=-2.06,P <0.05).Significant negative correlation was identified between the FL、FW and the Dimeglio score(r =-0.600,P <0.01) and significant positive correlation was identified between the angle that the long-axis of the foot made with the long-axis of the lower leg and the Dimeglio score(r=0.764,P <0.01).Conclusions The angle that the long-axis of the foot made with the long-axis of the lower leg,FL,FW and FL、FW can provide more information for prenatally sonography in diagnosing clubfoot without more section of the examination.
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Objective To compare the value of ultrasound International Ovarian of Tumor Analysis (IOTA) simple rules and gynecologic imaging reporting and data system (GI-RADS) ultrasonographie stratification in the diagnosis of adnexal masses.Methods A total of 463 patients with adnexal masses were classified according to IOTA simple rules by senior doctor.The benign and malignant masses were enrolled in the study.Then the masses were judged according to GI-RADS classification and IOTA simple rules by senior and junior doctors.And junior doctorn in diagnosis of adnexal masses with IOTA was group A1,senior doctor in diagnosis of adnexal masses with IOTA was group B1,junior doctor in diagnosis of adnexal masses with GI-RADS was A2,senior doctor in diagnosis of adnexal masses with GI-RADS was B2.The efficacy of the two methods were compared.Results Among the 463 cases,there were 411 cases (411/463,88.77％) of benign mass and malignant mass by IOTA and 52 cases (52/463,11.23 ％) of uncertain mass.The specificity,positive predictive value,diagnostic accuracy had statistical differences between groups A2 and B2,A1 and A2 (all P＜0.05),and sensitivity and negative predictive value had no statistical differences (all P＞0.05).Diagnostic efficacy index had no statistial signifi cance between group A1 and B1,B1 and B2 (all P＞0.05).Conclusion The diagnostic efficacy of IOTA simple rules and GI-RADS is high and similar in diagnosis of benign and malignant adnexal masse.IOTA simple rules do not depend on experience,but they are not suitable for the diagnosis of all adnexal masses.
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Objective To select the ultrasonic appearances which effect the benign and malignant of thyroid lesions,and to explore the establishment and applications of supersonic evaluation system for thyroid imaging reporting and data system (TI-RADS) classification.Methods The ultrasound images of 1 080 thyroid nodule cases were retrospectively analyzed by Logistic equation,and the ultrasonic appearances were screened to identify benign and malignant of thyroid lesions.All appearances were obtained weights.The TI-RADS classification analysis software was assigned,which was used to analyze 332 patients with thyroid diseases and to verify the diagnostic performance of the TI-RADS classification system.Results Five ultrasonic features were selected into the regression model,including aspect ratio (odds ratio [OR]=3.61),margins (OR=3.83),composition (OR=11.46),echogenicity (OR=14.12),microcalcification foci (OR =48.82).Using objective evaluation system for TI-RADS classification in ultrasound in diagnosing 332 cases,the area under the ROC curve was 0.91 (P＜0.05).Conclusion Relatively the weight and formation of malignant indicators should be more concern than the number of ultrasonic malignant thyroid lesions indicators.The objective evaluation system for TI-RADS classification in ultrasound has relatively high diagnosis capability which established by the methods of Logistic equation.
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Objective To evaluate the diagnostic value of virtual touch imaging quantification (VTIQ) technique in the differential diagnosis between benign and malignant breast lesions.Methods From September to December 2015, the imaging data of 115 breast lesions in 100 patients confirmed by pathology on conventional ultrasound (2DUS) and VTIQ were retrospectively analyzed. The breast nodules were examined by 2DUS firstly and then the lesions were classified by breast imaging reporting and data system (BI-RADS). The maximum, minimum and average of shear wave velocity (SWV) values were obtained from multiple SWV measurement under the VTIQ speed mode. According to the pathology results, receiver operating characteristic (ROC) curve were plotted to determine the most accurate SWV value and the cut-off value for differential diagnosis. And the diagnosis efficiency was compared between 2DUS and VTIQ.Results There were 38 malignant nodules and 77 benign nodules in 115 breast nodules. BI-RADS grading≥4b level was set as the malignant nodules and grading≤ 4a level as the benign nodules. The SWVmax, SWVmin, and SWVmean on VTIQ of benign and malignant breast nodules were (5.11±1.61) m/s, (2.90±0.86) m/s, (3.73±1.02) m/s, and (7.22±0.94) m/s, (4.33±1.31) m/s, (5.73±1.11) m/s. There were significant differences between malignant and benign breast nodules in SWVmax, SWVmin, and SWVmean on VTIQ (t=-7.442,-7.047,-9.356, allP<0.001). Based on the area under curve of ROC, the SWVmean value in the nodule was the best value in comparison with other SWV values. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of diagnose malignant lesion conducted by 2DUS were 89.5％, 85.7％, 87.0％, 0.63 and 0.84, respectively. The cut-off value of VTIQ mean was 4.34 m/s. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value for the diagnosis of malignant lesion conducted by VTIQ were 89.5％, 85.7％, 87.0％, 0.76 and 0.95, respectively. The diagnosis efficiency of VTIQ was better than 2DUS.Conclusion The study proved that the VTIQ SWVmean is the best parameter for differential diagnosis and VTIQ plays an important role in differential diagnosis of breast nodules.
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Objective To evaluate the effects of gestational exposure to mobile phone radiation on astrocytes in parietal cortex of rat offspring.Methods Nine male Sprague Dawley rats were mated with nine female rats at the age of 12 weeks.Pregnant rats were randomly divided into three groups including control group,short-term gestational exposure group (STE group) and long-term gestational exposure group (LTE group) with three in each group.From day 2 to day 18 of pregnancy,rats in STE and LTE groups were exposed to a mobile phone in talking mode for 6 h and 24 h per day,respectively.Meanwhile,the mobile phone used in control group was kept in standby mode.Morphology and ultrastructure of cells in parietal cortex of 1 month-old offspring rat were studied by Nissle staining and electron microscope,respectively.Cells positive for glial fibrillary acidic protein (GFAP) and expression of GFAP in parietal cortex were detected by immunohistochemistry and Western bloting.One-way ANOVA,followed by SNK post hoc tests,were used for statistical analysis.Results (1) No significant difference in the morphology of cells in parietal cortex of rat offspring was observed among the three groups by Nissle staining.These cells were regularly arranged with intact cell membrane,clear nuclear membrane,evenly distributed chromatin and distinct nucleoli.(2) Neurons with normal morphology and intact synapse were observed in rat offspring in both control and STE groups.But condensation and migration of nuclear chromatin in neurons and blurred and widened synaptic clefts were observed in LTE group.(3) In offspring of control and STE groups,there were few GFAP-positive cells with small cell body and short processes in parietal cortex.But in LTE group,more GFAP-positive cells with large body and long processes were found.Moreover,long-term exposure to mobile phone during pregnancy resulted in enhanced GFAP expression in parietal cortex (0.79±0.04) as compared with control group (0.37±0.03) and STE group (0.41 ±0.04) (F=147.059,P＜0.001).Conclusions Long-term gestational exposure to mobile phone radiation might lead to activation of astrocytes,increased expression of GFAP and changes in the ultrastructure of neurons in parietal cortex of rat offspring.
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Objective To evaluate the value of fetal dual Doppler ultrasonography in the diagnosis of fetal arrhythmias.Methods 77 53 1 fetuses were examined by echocardiography.If fetal arrhythmias were found,information of pulsed wave Doppler signals in hepatic vein(HV) and descending aorta(DAo) using dual Doppler were collected simultaneously.Results On dual Doppler examination,13 1 of the fetuses showed signals of cardiac dysrhythmias,including 60 fetuses with irregular fetal heart rhythm but having normal heart rate,45 with tachyarrhythmias and 26 with bradyarrhythmias.Sixteen and 2 with tachy- or bradyarrhythmias fetuses complicated fetal malformation or severely maternal systemic diseases.Eighteen and 3 with tachy- or bradyarrhythmias fetuses revealed intrauterine death or intermediate pregnancy induction.The three main kinds of fetal arrhythmias had statistical differences in complicating with fetal malformation,maternal diseases,intrauterine fetal demise or intermediate pregnancy induction(all P <0.05).There was a significant difference in the accuracy of diagnosing rhythm abnormalities in the fetus between conventional ultrasonography and dual Doppler ultrasonography(k = 0.562,P < 0.05).Sixty cases of irregular fetal heart rhythm,42 cases of fetal tachyarrhythmias,and 8 cases of fetal bradyarrhythmias were changed to normal rhythm at the third-pregnancy or prenatal period through appropriate treatment.All surviving fetuses were examined by echocardiography within 3 days,without any combination of congenital heart disease,and 1 months after the delivery,the ECG were shown as sinus rhythm.Conclusions Dual Doppler ultrasonography is a precise and rapid method of assessing various types of fetal arrhythmias.Different types of fetal arrhythmias have different fetal prognosis.
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Objective To evaluate the application value of three‐dimensional ultrasonography OmniView technology in diagnosis of fetal cleft lip/palate . Methods Three‐dimensional volume data was acquired from 100 normal singleton fetuses and 18 cleft lip/palate fetuses ,and was analysed by OmniView technology . Two‐dimensional ultrasonography and three‐dimensional OmniView technology were compared in the displaying rate of different planes of the lip and palate and the diagnosis accordance rate of cleft lip/palate.Results ①ThedisplayingrateofthelipandpalateofOmniViewtechnologywashigherthanthatof two‐dimensional ultrasonography ( the displaying rates were 64% -88% and 30% -65% ,respectively , P 0 .05) . Conclusions Three‐dimentional ultrasonography OmniView technology can improve the displaying rate of the hard and soft palate .The application of this technology in the fetuses who has a high risk of cleft palate may be beneficial to the diagnosis of cleft palate .
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Objective To establish the ranges of normal reference values of fetal brainstem-vermis angle (BVA)and brainstem-tentorium angle (BTA)in normal fetuses at different gestational weeks,and to evaluate their clinical values in the diagnosis of mega cisterna magna.Methods Totally 320 normal singleton fetuses between 1 8 and 40 weeks of gestation were enrolled in this study.Three-dimensional ultrasound (3DUS)with volume contrast imaging (VCI)was used to measure their BVA and BTA,the correlations of BVA and BTA with gestational age were analyzed.The BVA and BTA of 24 fetuses with mega cisterna magna were also measured and were compared with those of the normal fetuses.Results In these normal fetuses,the BVA and BTA showed no correlations with gestational age (r=-0.05,0.04,both P >0.05);the ranges of normal reference values of BVA and BTA were 2.23°-19.30°and 18.53°-48.13°, respectively.The BVA and BTA of 24 fetuses with mega cisterna magna were 4.23°-17.42°and 20.41°-40.89°,respectively,which were not significantly different from those of normal fetuses (t =-0.55,0.92, both P >0.05).Conclusions 3DUS with VCI is feasible for measuring the BVA and BTA of fetuses,and the measured values can be used as the reference standards for BVA and BTA measurement in China.