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Objective:To explore the characteristics of vocal cord polyps and to study the application value of high-frequency ultrasound in the diagnosis of vocal cord polyps.Methods:A total of 169 patients diagnosed with vocal cord polyps ( 176 polyps in total ) by pathology in the Second Affiliated Hospital of Xi′an Jiaotong University from December 2016 to September 2021 were collected, the ultrasonic image characteristics of vocal cord polyps were summarized, and the characteristics of thyroid cartilage calcification at glottic level and the influence of the calcification range of thyroid cartilage at glottic level on the display of vocal cord polyps were observed.Results:The sonogram images of all vocal cord polyps showed the localized uniform low echo between the upper cortex and the ligament layer, the morphology could be circular and flat, and all polyps could be divided into high tension type and low tension type, no blood flow signal was found in 96.8% of the polyps. Round polyps were more easier to be detected by ultrasound than flat polyps, but there was no significant difference( P>0.05). The incidence of thyroid cartilage calcification at glottis level was higher in men than in women, and the difference was statistically significant( P<0.05). The range of thyroid cartilage calcification at the glottic level affects the display rate of vocal cord polyps.With the increase of calcification range, the display rate of vocal cord polyps gradually decreased. There was significant difference in the display rate of vocal cord polyps between non calcification group and moderate calcification group, non calcification group and severe calcification group(all P<0.05). Conclusions:Vocal cord polyps have typical sonographic appearance. High-frequency ultrasound can identify the morphology, location and size of vocal cord polyps. Especially for patients with no or mild calcification of thyroid cartilage at glottic level, ultrasound can meet the requirements of accurate diagnosis. It is expected to become an effective supplement to laryngoscopy, and apply for to the preliminary screening of vocal cord polyps and postoperative review.
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Objective:To explore the effect of virtual reality (VR) on the emergency management of pediatric anesthesia.Methods:Four kinds of perioperative critical events were selected as VR training content, and the training objects were 60 residents who took part in the standardized residency training in Ninth People's Hospital of Shanghai Jiao Tong University School of Medicine. Through theoretical examination and questionnaire survey, the training effect and the anxiety of residents after critical events were evaluated. The data were input into Graphpad Prism 5 software, and the quantitative data conforming to normal distribution were expressed as (mean ± standard deviation), and compared by nonparametric test and t test of two independent samples between groups. Qualitative data were expressed in terms of rate, and the 2× k trend chi-square test was used to compare the scores of the two groups. Results:All the residents took part in the theoretical assessment of the management of pediatric anesthesia emergencies. Compared with the offline theoretical teaching, the average scores of the students who underwent VR training were higher, and the incidence of anxiety was significantly reduced.Conclusion:VR simulation teaching in the department of anesthesiology can fully arouse the enthusiasm of residents and make them overcome the fear of dealing with pediatric anesthesia emergencies.
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Objective:To compare the effect of case-based Learning (CBL) and problem-based Learning (PBL) in clinical education in anesthesiology.Methods:A total of 39 residents who received airway management training in 2018 and 2019 were included in this study. Nineteen residents received training of airway management by PBL in 2018 (PBL group), and 20 residents received training of airway management by CBL in 2019 (CBL group). Students in both groups received assessment and questionnaires at the end of training.Results:The scores of theoretical examination and students' teacher satisfaction degree in the CBL group were higher than those in the PBL group ( P<0.05). However, there was no statistical difference in clinical operation assessment between the two groups ( P>0.05). The chi-square test, and t-test analyses were performed using SPSS 19.0. Conclusion:In the standardized training of airway management, CBL teaching method is better than PBL teaching mode, which enable the trainees to master the relevant knowledge and improve their acceptances of teaching procedures.
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Objective To evaluate and compare the consistency and repeatability of three-dimensional ultrasound (3D-US) virtual organ computer-aided analysis (VOCAL) technique and two-dimensional ultrasound (2D-US) in the measurement of thyroid volume.Methods The thyroid volume of 50 healthy female adults aged 18 to 68 years were measured by 2D-US and 3D-US.The 2D-US was used to measure the three diameter lines (L,H,W) of the largest thyroid section,and the thyroid volume was calculated by the classical ellipsoid formula V=0.523×L×H×W.The 3D-US VOCAL technique was used to acquire the thyroid three-dimensional data,and VOCAL software was used to measure the thyroid volume.The two methods of measurement were also compared and analyzed.Results The coefficient of variation in the intra-assay was 0.738％ and 1.59％ respectively for the 3D-US VOCAL technology and traditional 2D-US measurement of thyroid volume,and the 95％ limit of agreement in the intra-assay was (-0.26 cm3,0.22 cm3) and (-0.32 cm3,0.46 cm3).In addition,the correlation coefficient in the inter-assay were 0.970xx and 0.942xx,and the 95％ limit of agreement were (-0.36 cm3,0.37 cm3) and (-0.75 cm3,0.64 cm3).To compare the two methods of measuring thyroid volume,the 3D-US VOCAL had a lower variation coefficient in the intra-assay,a higher correlation coefficient in the inter-assay and a narrower 95％ limit of agreement,which showed that the repeatability of the 3D-US VOCAL technique measuring was better than the traditional 2D-US in measuring thyroid volume.Conclusions The 3D-US VOCAL technique shows a higher repeatability in measuring thyroid than traditional 2D-US.As a safe,simple and feasible precise measurement method,it provides a reliable and effective new method for clinical measurement of irregular organ volume.
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Objective To investigate the reason for misdiagnosis of real-time contrast-enhanced ultrasound (CEUS) in identifying benign and malignant thyroid nodules and the impact of nodule size and calcification on CEUS result.Methods Retrospective analysis were carried out in 331 cases of thyroid disease patients with 421 nodules.All the nodules were performed CEUS and confirmed by pathology.Results In the total of 421 nodules,33 nodular goiters were misdiagnosed as thyroid carcinoma.8 nodular goiters were misdiagnosed as thyroid adenoma.8 thyroid carcinomas were misdiagnosed as nodular goiter,2 thyroid carcinomas were misdiagnosed as thyroid adenoma.The accuracy of diagnosis for thyroid benign and malignant lesions by CEUS was 87.89％,and the misdiagnosis rate was 12.11％.The size of the thyroid nodule and the form of calcification had influence on diagnosis.In the group with diameter of the nodule less than 10 mm,the misdiagnosis rate was higher compared with the other two groups,and the difference was statistically significant (P＜0.05).In addition,the misdiagnosis rate in the group with bulky calcification was higher than microcalcifications group,and the difference was statistically significant (P＜0.05).Conclusion The size of the thyroid nodule and the form of calcification have some impact on diagnosis of CEUS.To make clear the reason for misdiagnosis is beneficial to improve the diagnostic level of thyroid diseases.
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Objective To investigate the potential association between SEPS1 variants and Hashimoto's thyroiditis (HT)in the Chinese Han population and evaulate the effects of SEPS1 haplotypes on the susceptibility to immunity-mediated diseases.Methods We analyzed 7 SNPs with minor allele frequency (MAF)≥0.05 in a cohort of 1013 HT patients and 2998 healthy controls from genetically independent Han Chinese individuals.Single SNP,haplotype and gender-specific associations were performed. Results We found that rs28665122 was significantly associated with HT,and SNP was associated with HT in females.Further haplotypic analysis indicated that a haplotype block (rs2009895-rs28665122)spanning the promoter of SEPS1 gene was highly associated with HT. Additionally,the haplotype CA in the block had an almost 1.5-fold increase in these cases,which remained significantly associated with HT in females.Conclusion SEPS1 plays a role in the pathogenesis and etiology of HT.
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Objective To investigate the value of contrast-enhanced ultrasound(CEUS) to diagnose thyroid nodules with different calcifications,and analyze its correlation with age and gender.Methods The image characteristics of high frequency ultrasound and pathological results of 522 patients with calcified thyroid nodules were analyzed retrospectively.CEUS enhancement patterns of different age and gender were observed and compared.Results There were no malignant nodules in patients under the age of 10.In the group of male and female,malignant nodules patients constituted the highest proportion between 40-49years old and a minimal proportion between 10-19 years old.The CEUS for weak enhancement with micro calcifications were mostly malignant nodules;the high or equal enhancement with macrocalcifications were mostly benign nodules.But a part of micro calcifications in young women patients (20 to 29 years old) with high or equal enhancement were mostly malignant nodules.Conclusions The CEUS for weak enhancement with microcalcifications are mostly malignant nodules,but a part of microcalcifications in young women patients (20 to 29 years old) with high or equal enhancement are mostly malignant nodules.
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ABSTRACT:Objective To construct a recombinant adenovirus vector harboring fusion gene NT4p53(C22)Ant and study its killing effect on HepG2 tumor cells.Methods Using molecular cloning technology,the rAVV-NT4p53(C22)Ant was produced by homologous recombination.Then we collected virus supernatant and measured its titer after it was amplified by PCR.The effect of this fusion gene on HepG2 tumor cells was evaluated by IHC, MTT assay,PI staining and flow cytometry.Results The recombinant adenovirus was successfully constructed. The p53 expression rate in rAAV-NT4p53(C22)Ant group was (44.88±2.45)%.MTT assay showed that rAAV-NT4p53(C22)Ant could strongly suppress the growth of HepG2 tumor cells.Flow cytometry showed that rAAV-NT4p53(C22)Ant could induce obvious apoptosis of HepG2 tumor cells.Conclusion The recombinant adenovirus vector encoding gene NT4p53(C22)Ant has been successfully constructed and expressed in this experiment,and it can inhibit proliferation and induce apoptosis of HepG2 tumor cells.
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Objective To study the correlation between single point pulse wave velocity (PWVβ)of different peripheral arteries and coronary artery stenosis quantity obtained by coronary arteriongraphy so as to explore the diagnostic value of PWVβin coronary heart disease.Methods We made a retrospective analysis of 183 patients receiving coronary arteriongraphy in our hospital from October 2013 to May 2014.Based on stenosis quantity of coronary artery,the patients were divided into one-vessel lesion group,double-vessel lesion group,multi-vessel lesion group,and nonstenosis as control group.Clinical data of all the patients were collected before coronary arteriongraphy.Different peripheral artery PWVβwas measured with vascular echo tracking (ET)technology for statistical analysis.Results As the lesion vessel number increased,PWVβandβvalues in three peripheral arteries presented a rising tendency.Correlation analysis indicated that PWVβvalues in the three peripheral arteries showed a positive correlation with coronary artery involvement degree.The correlation between PWVβvalue of the common carotid artery and coronary artery involvement degree was most obvious,followed by the femoral artery and the popliteal artery.The sensitivity,specificity,positive predictive value,negative predictive value and Youden index of the common carotid artery PWVβvalue to diagnose coronary heart disease were 91.2%,84.5%,92.7%,81.7 and 0.76,respectively.Non-conditional multi-factor Logistic regression analysis was implemented by choosing age, sex,smoking history,hypertension history,diabetes history,hyperlipemia,BMI,HDL-C,LDL-C,TC,TG,GLU,SBP,DBP,UA,Cr,and PWVβ value as independent variables,and the degree of coronary artery disease as dependent variable.The results revealed that age,hypertension history,diabetes history,and PWVβ value were independent risk factors for coronary heart disease.Conclusion PWVβ value can be regarded as one index for observing artherosclerosis lesion degree and predicting early lesion.PWVβvalue of the common carotid artery can be an important index for dynamically observing the occurrence and development of artherosclerosis.
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Objective To analyze the misdiagnosed cases of the nodular goiter (NG)in real-time contrast-enhanced ultrasound(CEUS),in order to improve the diagnostic accuracy of NG.Methods Two-hundred and sixty-five cases of NG CEUS images,especially the 48 nodules in 44 misdiagnosis cases,were retrospectively analyzed to find out the main reasons of the misdiagnosis.In addition,the factors which effected the results of CEUS such as size,number and calcification of NG nodules were summarized.Results There were 42 nodules misdiagnosed as thyroid cancer,5 nodules misdiagnosed as thyroid adenoma and 1 nodular goiter misdiagnosed as subacute thyroiditis in 874 nodular goiter cases.The misdiagnosis rate of nodular goiter was 5.49% (48/874)by the diagnostic criterion of homogeneous enhancement in CEUS.The differences size and calcification of nodules had a significant impact on CEUS.The misdiagnosis rate of the NG nodules with major diameter less than 10 mm was much higher than that of more than 10 mm,the misdiagnosis rate of NG nodules with coarse calcification was much higher than the situation of microcalcification(P <0.05).Conclusions Major diameter less than 10mm and coarse calcifications of NG nodular are the main factors which influence the results of CEUS.
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<p><b>OBJECTIVE</b>To evaluate the diagnostic value of contrast-enhanced ultrasound(CEUS) in calcified thyroid nodules.</p><p><b>METHODS</b>A total of 179 cases with calcified thyroid nodules between February 2009 and September 2012 underwent CEUS by injection of microbubbles via superficial vein was included in the study. Pathological diagnosis as a gold standard, the sensitivity, specificity, positive predictive, negative predictive and diagnostic coincidence rate of CEUS were evaluated.</p><p><b>RESULTS</b>Among 110 cases of benign nodules, 62 cases were nodular goiter (46 cases with macrocalcification and 16 cases with microcalcification); 29 cases were adenoma (28 cases with macrocalcification and 1 case with microcalcification); 17 cases were Hashimoto's thyroid (13 cases with macrocalcification and 4 cases with microcalcification); and 2 cases were granuloma with microcalcification. Among 69 cases of malignant nodules (t = 14.33, P < 0.05), 68 cases were papillary carcinoma (60 cases with microcalcification and 8 cases with macrocalcification), and 1 case of medullary carcinoma with microcalcification. Malignant nodules mainly showed weak inhomogeneous enhancement, with the mean; peak intensity (51.38 ± 14.33)dB that was lower than that (92.37 ± 33.36)dB in benign nodules, and benign nodules showed isoenhancement or hyperenhancement, with significant differences compared to malignant nodules (t = 14.33, P < 0.05) , however, there were significant differences in the enhanced time and the time to peak between benign and malignant nodules. The sensitivity, specificity, positive predictive, negative predictive and diagnostic coincidence rate of CEUS for the diagnoses of thyroid nodules were 92.75%, 90.91%, 86.49%, 95.24% and 91.62%, respectively.</p><p><b>CONCLUSION</b>CEUS has high value in differential diagnosis of benign and malignant calcified thyroid nodules.</p>
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Humans , Contrast Media , Goiter, Nodular , Microbubbles , Thyroid Nodule , Diagnostic Imaging , UltrasonographyABSTRACT
<p><b>OBJECTIVE</b>To evaluate the contrast-enhanced ultrasound(CEUS) and ultrasonic elastography (UE) in diagnosis of thyroid nodules by a binary Logistic regression model.</p><p><b>METHODS</b>A total 149 cases with thyroid nodules were examed by CEUS and UE and were confirmed by surgical pathology. A Logistic model was obtained on the basis of ultrasonographic features. Receiver operator characteris(ROC) curve was constructed to assess the performance of the Logistic model.</p><p><b>RESULTS</b>Four ultrasonographic features including calcification, enhancement degree, biggest perfusion strength and elastic score were finally entered into the Logistic model. The percentage of correct prediction was 91.90%.</p><p><b>CONCLUSION</b>Both CEUS and UE have high value in differential diagnosis of thyroid nodules and the Logistic regression model has high diagnostic rate.</p>
Subject(s)
Humans , Calcinosis , Contrast Media , Diagnosis, Differential , Elasticity Imaging Techniques , Logistic Models , ROC Curve , Thyroid Nodule , Diagnosis , Diagnostic Imaging , UltrasonicsABSTRACT
Objective To explore the sensitivity of contrast-enhanced ultrasound (CEUS) and ultrasonic elastography(UE) in detecting different sizes of thyroid papillary carcinoma.Methods 64 cases of thyroid papillary carcinoma were divided into two groups according to the diameter size(group 1,≤1 cm;group 2,＞ 1 cm) and examined by the contrast-enhanced ultrasound and elastography,then the features were analyzed and the sensitivity for detecting of the two methods in different groups were compared.Results The sensitivity for detecting in CEUS was higher than in UE,which had significant difference between two methods.CEUS and UE were valuable for detecting and they had no difference in sensitivity for detecting in group 1.There was a significant difference in sensitivity for detecting between two methods in group 2.Conclusions Both CEUS and UE were valuable in diagnosis of thyroid papillary carcinoma and the sensitivity for detecting in CEUS is higher than in UE in group 2.
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Objective To evaluate the diagnostic value of conventional ultrasound and contrastenhanced ultrasound(CEUS) in calcified thyroid nodules.Methods 122 cases of calcified thyroid nodules confirmed by pathology were underwent conventional ultrasound and CEUS.The sensitivity,specificity,positive predictive,negative predictive and diagnostic coincidence rate of conventional ultrasound and CEUS were evaluated.Receiver operating characteristic (ROC) curve was constructed to assess the differential diagnosis value of conventional ultrasound and CEUS in calcified thyroid nodules.Results There were 73 benign and 49 malignant nodules among 122 calcified thyroid nodules.The sensitivity,specificity,positive predictive,negative predictive and diagnostic coincidence rate of conventional ultrasound were 49.98％,76.71％,58.54％,69.14％ and 65.57％,while for CEUS were 89.80％,91.78％,88.00％,93.06％ and 90.98％,respectively.There was statistical difference for each index between the two methods (all P ＜0.05).The area under ROC curve of CEUS was 0.908,which was bigger than conventional ultrasound.Conclusions Compared with conventional ultrasound,CEUS has higher value in differential diagnosis of benign and malignant calcified thyroid nodules.
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Objective To evaluate the value of the differential diagnosis of benign and malignant thyroid nodules under the background of Hashimoto' s thyroiditis (HT) using contrast-enhanced ultrasonography (CEUS).Methods Ninety-three single thyroid nodules with HT confirmed by operations and pathology were given CEUS examination,and time-intensity curves were drawn by using TomTec analyzing software.The parameters as follows:rise time (RT),time to peak (TTP),mean transit time (mTT) and maximum intensity(IMAX) were compared by independent-samples t test,and the diagnostic value of parameters were analyzed by receiver operating characteristic (ROC) curve.Results In 93nodules,there were 56 benign thyroid nodules,and 37 malignant thyroid nodules.(1) After injection of contrast media,the enhancement and wash-out in benign nodules were mostly the same with peripheral gland,as well as the enhance intensity.Malignant nodules presented lower enhancement,with later rise time and earlier wash-out compared to peripheral gland.(2) mTT was longer,while IMAX was higher in benign nodules than those in malignant nodules (P ＜0.05).But there were no significant differences in RT or TTP between the two groups.(3) The cut-off value in diagnosis of benign and malignant thyroid nodules with HT assessed by ROC curve were mTT 21.70 s,IMAX 86.41％.When mTT,IMAX,and combination of the two parameters were used for the diagnosis of malignant thyroid nodules with HT,the sensitivity were 86.5 ％,83.8 ％,97.3 ％ and the specificity were 69.6 ％,75.0 ％,48.2 ％,respectively.Conclusions CEUS is helpful to identify the benign and malignant thyroid nodules under the background of HT.
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Objective To evaluate the diagnostic value of thyroid microcarcinoma using contrastenhanced ultrasound(CEUS).Methods The CEUS characteristics of 31 lesions in patients with thyroid microcarcinoma which were confirmed by surgery and pathology were retrospectively analyzed.[Results]The enhancement features of 31 lesions were hypoenhancement,morphological irregularity,and lack of a complete envelope.The time intensity curve showed late washed in and late washed out.The start-time of the lesions was later than that of normal thyroid tissue.The enhancement intensities of the lesions were lower than that of normal thyroid tissue.Conclusions The contrast enhancement patternshypoenhancement,suggested that the CEUS might provide a useful,quantitative analysis method for the diagnosis of thyroid microcarcinoma,which can improve diagnostic confidence in thyroid microcarcinoma.
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Objective To investigate the different roles of two-dimensional,color Doppler ultrasound and real-time ultrasound elastography in the diagnosis of Hashimoto's thyroiditis(HT).Methods One hundred and forty-one patients clinically diagnosed as HT underwent traditional ultrasound and elastography.The patients were classified into three groups,the hyperthyroidism group,the hypothyroidism group and the euthyroidism group.One hundred and eight volunteers with normal thyroid functions were enrolled as control group.Ultrasonic characteristics (size,echo,accompanied nodules,blood flow distribution of thyroid) and thyroid elastic parameters were recorded and analyzed.Results ①Focal hypoechoic pattern was mainly seen in the group of HT hyperthyroidim,diffuse hypoechoic pattern was mainly seen in the groups of HT euthyroidism,diffuse hypoechoic pattern with heterogeneous linear hyperechoic and nodular changes were mainly seen in the HT hypothyroidism group.②Blood flow reduced according to the order by the hyperthyroidim group,euthyroidism group and hypothyroidism group.③Patients with HT hyperthyroidism had elastic image pattern Ⅰ.Patients with HT euthyroidism had pattern Ⅰ and pattern Ⅱ.Patients with HT hypothyroidism had pattern Ⅱ and pattern Ⅲ.④There were significant differences (P＜0.05) between the mean elastic strain and the ratio of the blue area in each group.Conclusions Real-time ultrasound elastography is helpful for the diagnosis of HT.
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<p><b>OBJECTIVE</b>To assess the value of color Doppler ultrasonography, contrast-enhanced ultrasound and detection of serum CA-125 levels in the differential diagnosis of ovarian masses.</p><p><b>METHODS</b>The findings of color Doppler ultrasonography, contrast-enhanced ultrasound and the serum levels of CA-125 were comparatively analyzed in 65 patients with ovarian masses, and the diagnostic accuracy of the 3 methods was estimated.</p><p><b>RESULTS</b>Of the 65 cases of ovarian masses, 21 of the 35 patients with benign ovarian masses had serum CA-125 levels below 35 U/ml , and 28 of the 30 patients with malignant masses showed CA-125 levels over 35 U/ml. Color Doppler ultrasonography identified 30 benign and 22 malignant cases, but failed to produce definite results in 13 cases (including 5 with benign and 8 with malignant masses). By contrast-enhanced ultrasound, benign masses were found in 34 cases and malignant masses in 29 cases, and misdiagnosis occurred in 2 cases (including 1 case of thecoma and 1 of ovarian borderline tumor). With serum CA-125 detection, color Doppler ultrasonography and contrast-enhanced ultrasound, the diagnostic sensitivity for ovarian masses was 66.7%, 73.3%, and 96.7%, and the specificity was 60.0%, 85.7%, and 97.1%, respectively.</p><p><b>CONCLUSIONS</b>Detection of serum CA-125 level and ultrasound examinations help in the diagnosis and differential diagnosis of benign and malignant ovarian masses. Compared with serum CA-125 detection and color Doppler ultrasonography, contrast-enhanced ultrasound is more informative on perfusion patterns of the ovarian masses to result in higher accuracy in early and differential diagnosis of the ovarian masses.</p>
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Adult , Female , Humans , Middle Aged , Young Adult , CA-125 Antigen , Blood , Contrast Media , Diagnosis, Differential , Image Enhancement , Methods , Ovarian Neoplasms , Diagnosis , Diagnostic Imaging , Ultrasonography, Doppler, Color , MethodsABSTRACT
Objective To study the clinic imaging features and the clinic applications of the contrastenhanced ultrasound(CEUS) in the diagnosis of gallbladder carcinoma.Methods The characteristics of CEUS were reviewed in 24 patients with gallbladder carcinoma proven pathologically. Results After injection of SonoVue, all gallbladder carcinoma of 24 cases showed enhancement and these lesions looked clearer than those in conventional ultrasound.The analysis of time-intensity curve indicated the upslope of curve was steep in the lesions,which was flat in normal liver parenchyma around.In 10 cases of thick wall of gallbladder carcinoma, quick and obvious enhancement was seen in 9 cases, 1 case showed poor enhancement during scanning,but thick and tortile blood vessels could be seen in the thickening wall.Quick and uneven enhancement was been seen in both 8 cases of soft-tissue mass and 6 cases of nodules within gallbladder.Five cases of gallbladder carcinoma with liver metastasis revealed more liver metastasis depend on CEUS.Conclusions CEUS plays an important role in diagnosis and improving the diagnostic accuracy for gallbladder carcinoma.