Value of Thermal Tomography in Early Diagnosis of Breast Cancer in Animal Models / 中国医学科学院学报

To obtain ultrasound and thermal tomography images of breast cancer during its growth and to assess the value of thermal tomography in detecting breast cancer. Breast cancer models were established with NOD/SCID mice and SD rats. These animal models were examined by thermal tomography,plain ultrasound,and contrast-enhanced ultrasound. Tumor tissues were stained with CD34 to explore the relationship between tumor heat production and vascular pathology. Thermal tomography detected breast cancer 2-4 days earlier than ultrasound. The expression of CD34 in tumor tissues was increased,along with thickened,increased,and irregular blood vessels. Thermal tomography can detect early breast cancer and is a promising tool for screening breast cancer.

Comparison of Elasticity Imaging and Virtual Touch Tissue Imaging and Quantification in the Diagnosis of Thyroid Nodules / 中国医学科学院学报

Objective To compare the values of elasticity imaging(EI)and Virtual Touch tissue imaging and quantification(VTIQ)in diagnosing thyroid nodules and explore the factors influencing the accuracy of these two techniques.Methods Totally 62 patients who were planned to receive surgery for thyroid nodules underwent conventional ultrasound,EI,and VTIQ examinations.EI patterns were scored according to the degree and distribution of strain,the strain of nodule and surrounding normal reference tissue were measured,and then strain index was calculated.Shear wave velocity in nodules were obtained under VTIQ mode.Results The nodules were malignant in 40 patients and benign in 22 patients.When the strain score of 3 was regarded as malignant,the diagnostic sensitivity,specificity,and accuracy of EI in detecting thyroid nodules were 90.00%,31.82%,and 69.32%,respectively.Receiver operating characteristic curve results showed that the area under curves of EI-SI and VTIQ methods for diagnosing thyroid nodules was 77.8%(95%:0.64-0.91)(=0.000)and 74.3%(95%:0.62-0.87)(=0.002),respectively.Thyroid nodules' characteristics location(=0.04)and size(=0.02)were correlated with the diagnostic accuracy of EI.The accuracy of SI and VTIQ were not affected by thyroid nodules' characteristics(>0.05).Conclusions The diagnostic accuracy of EI for thyroid nodules is related to nodules' characteristics.EI combined with semi-quantitative SI and quantitative VTIQ can effectively improve the diagnostic capability for thyroid nodules.

Molecular Mechanisms of Breast Nodule Stiffness / 中国医学科学院学报

The texture of breast nodules has always the focus of clinical palpation,and the stiffness of breast nodules has been a hot research topic of ultrasound elastography. Both texture and stiffness are based on the principle that malignant tissue is stiffer than benign tissues,but the underlying mechanisms of breast nodule stiffness is not yet confirmed. Breast nodule stiffness is affected by both substance and mesenchyme,and the latter is an important factor. Collagen,as the major composition of the extra cell matrix,plays an important role in breast nodule stiffness. This review summarizes the molecular mechanisms of intracellular and extracellular changes in the formation of breast nodules.

Construction of Nude Mouse Model of Triple Negative Breast Cancer and Value of Thermal Tomography / 中国医学科学院学报

<p><b>OBJECTIVE</b>To explore the early detection of breast cancer by ultrasonic imaging and thermal tomography of luciferase or green fluorescent protein (GFP)-labeled MDA-MB-231 breast cancer cell line-xenografts in nude mice.</p><p><b>METHODS</b>Fluorescence-tagged lentiviral vectors were transfected into the triple-negative breast cancer cell line MDA-MB-231. These cells were implanted either subcutaneously under the right breast pad or intravenously into the tail vein of nude BALB/C mice. Thermal tomography and ultrasound imaging were used to detect tumor formation and to monitor tumor growth and metastasis in vivo.</p><p><b>RESULTS</b>Triple negative breast cancer cell line-xenografts were used to successfully construct an orthotopic nude mice model of breast cancer metastasis in the peritoneum. Thermal tomography and ultrasound imaging were used together to detect small tumors. Thermal tomography imaging detected small tumors earlier than ultrasound imaging.</p><p><b>CONCLUSIONS</b>Thermal tomography can be used to monitor changes in tumor growth and detect abnormal tissue. Therefore, it can serve as a convenient,rapid,sensitive, and reliable technique for early screening of human breast cancer.</p>

Percutaneous Removal of Benign Breast Lesions with an Ultrasound-guided Vacuum-assisted System: Influence Factors in the Hematoma Formation / 中国医学科学杂志(英文版)

Objective To explore the influence factors in hematoma formation after removing benign breast lesions with an ultrasound-guided vacuum-assisted system.Methods A total of 232 females with 312 benign breast masses received excisional biopsy with ultrasound- guided vacuum-assisted system. The pathology of patients, Results of hematoma development and outcome, influence factors for hematoma occurrence (nodule size, nodule location, number of nodule, breast shape, menstrual period, efficacy time of bandage, and application of hemostatic agents during the procedure) were recorded.Results Pathologic examination revealed fibroadenomas in 138 lesions, fibroadenosis in 127 lesions, intraductal papillomas in 39 lesions, inflammatory change in 4 lesions, retention cyst of the breast in 3 lesions, and benign phyllodes tumor in 1 lesion. Thirty hematomas were observed in patients (9.6%). Finally, 97.0% hematomas were absorbed completely within 6 months follow-up. The incidence rates of hematoma were increased by 24.7%, 10.0%, 63.2%, 13.9% in the nodule diameter larger or equal to 25 mm group, removal of larger or equal to two nodules once time from one patient group, menstrual period group, and larger and loose breast group, respectively (all P<0.05). However, the incidences were decreased by 60.6% in the bandage performed for 12-24 hours or beyond 24 hours group (P<0.05). The multiple logistic regression models revealed that nodule size (χ=15.227, P<0.001), number of nodule (χ=7.767, P=0.005), menstrual period (χ=24.530, P<0.001), and breast shape (χ=9.559, P=0.002) were independent risk factors associated with hematoma occurrence, but efficacy time of bandage was a protective factor associated with hematoma occurrence.Conclusion The occurrence of hematoma after the minimally invasive operation was associated with nodule size, number of nodule, menstrual period, breast shape, and efficacy time of bandage.

Performance of Ultrasonic Shear Wave Elastography in Assessing Benign and Malignant Breast Lesions / 中国医学科学院学报

<p><b>OBJECTIVE</b>To determine the best shear wave elastography (SWE) quantitative parameters including the maximum elasticity (Emax), mean elasticity(Emean), minimum elasticity, standard deviation and ratio of Emean (Eratio) in assessing benign and malignant breast lesions.</p><p><b>METHODS</b>Totally 302 breast lesions underwent conventional ultrasound and SWE. Each lesion was classified according to ultrasound Breast Imaging Reporting and Data System (BI-RADS). The receiver operating characteristic(ROC) curves were used to determine the cut-off values of SWE quantitative parameters and to suggest breast lesions as benign or malignant. The sensitivity,specificity and the Youden index (sum of sensitivity and specificity minus 1) of SWE quantitative parameters were compared,and then the sensitivity,specificity and the Youden index of the combinations of each SWE parameters in assessing breast lesions were compared.</p><p><b>RESULTS</b>The sensitivity,specificity and the Youden index of the Emax were 0.87,0.97 and 0.84,which were higher than other SWE parameters (all P<0.01). The sensitivity, specificity and the Youden index of Emax combined with ultrasound BI-RADS were 0.86,0.97 and 0.83, which were higher than other combinations (all P<0.01).</p><p><b>CONCLUSIONS</b>Compared with other parameters, Emax has the best performance in assessing breast lesions. It can be used as an important quantitative indicator for the evaluation of benign and malignant breast lesions.</p>

The value of age-adjusted D-dimer cut-off value in diagnosing deep vein thrombosis in elderly patients / 中华心血管病杂志

<p><b>OBJECTIVE</b>To validate the value of age-adjusted D-dimer combined with clinical probability to confirm or exclude deep vein thrombosis (DVT) in elderly patients.</p><p><b>METHOD</b>Elderly patients ( ≥ 65 years) suspected with DVT were evaluated by Wells score and D-dimer test. All patients underwent ultrasonography examination except for patients with Wells score < 2 and negative D-dimer test results. Conventional cut-off value is 500 µg/L, while age-adjusted cut-off value is set as patient's age×10 µg/L. We compared the sensitivity and specificity using the 2 cut-off values in confirming or excluding the diagnoses of DVT.</p><p><b>RESULTS</b>The study population consisted of 624 patients [mean age(76.4 ± 19.3) years], DVT was confirmed in 192 (30.8%) patients. Using Wells score model, 326 patients (52.2%) were scored as unlikely DVT and DVT was confirmed by ultrasonography in 44 patients (13.5%), and 298 patients as likely DVT patients and DVT was confirmed in 148 patients (55.0%). The sensitivity, specificity, positive predictive value, and negative predictive value by conventional and age-adjusted D-dimer cut-off value for diagnosing DVT in low-risk patients evaluated by Wells score model were 95.5%, 40.4%, 20.0%, 98.3% and 95.5%, 61.0%, 27.6%, 87.1%, respectively, and which were 89.9%, 67.3%, 73.1%, 87.1% and 89.2%, 89.3%, 89.2%, 89.3%, respectively, in high-risk patients evaluated by Wells score model. Thus, specificity increased about 20% using age-adjusted D-dimer cut-off value compared with conventional D-dimer cut-off value.</p><p><b>CONCLUSION</b>The age-adjusted D-dimer cut-off value combined with clinical probability evaluation could increase diagnosing specificity of DVT in elderly patients.</p>

Clinical value of contrast-enhanced ultrasound in the diagnosis of Budd-Chiari syndrome with inferior vena cava obstruction / 中国医学科学院学报

<p><b>OBJECTIVE</b>To explore the clinical value of contrast-enhanced ultrasound (CEUS) in the diagnosis of Budd-Chiari syndrome with inferior vena cava (IVC) obstruction.</p><p><b>METHOD</b>A total of 38 patients with Budd-Chiari syndrome with IVC obstruction were examined by CEUS before and after vascular interventional management, and the results were compared with angiographic findings.</p><p><b>RESULTS</b>The location and degree of IVC obstruction were clearly showed on CEUS. Enhancement was found in the occlusion site, and blood flow was narrowed at the stenosis site. The arrival time was earlier after treatment in the IVC obstruction, and it was positively correlated with the pressure of IVC( P< 0.05).</p><p><b>CONCLUSION</b>The location and type of the occlusion and stenosis in IVC can be accurately determined by CEUS. Therefore, CEUS can provide useful information for the selection of surgical procedures and post-operative effectiveness.</p>

Study on diagnostic accuracy of ultrasound-guided core needle breast biopsy / 中华病理学杂志

<p><b>OBJECTIVE</b>to evaluate the diagnostic accuracy of ultrasound-guided core needle biopsy of breast tumors.</p><p><b>METHODS</b>six hundred and sixty-seven cases of core needle biopsy of breast encountered during the period from January, 2004 to June, 2007 were retrieved from the archival file and retrospectively reviewed. The core needle biopsy diagnoses were correlated with the histologic findings of the subsequent surgical excision specimens. The discrepancies were further analyzed.</p><p><b>RESULTS</b>three hundred and eighty-two patients had core needle biopsy diagnosis followed by local excision, breast conservation surgery or mastectomy. Two hundred and eighty-one cases were confirmed to have malignancy in the surgical specimens. Review of the corresponding core needle biopsies showed 4 false-negative cases, no false-positive cases, 28 cases with underestimation and 2 cases with overestimation. The false-negative rate was 1.4% (4/281). The rate of underestimation for ductal carcinoma-in-situ was 6/11. The diagnostic accuracy of core needle biopsy was 94.7% (266/281).</p><p><b>CONCLUSION</b>in order to improve the diagnostic accuracy of core needle biopsy of breast tumors, recognition of the limitation of the procedure, application of immunohistochemistry and awareness of potentially rare entities are important.</p>

A preliminary study of contrast-enhanced ultrasound in benign prostatic hyperplasia / 中华男科学杂志

<p><b>OBJECTIVE</b>To analyze and evaluate the characteristics of benign prostatic hyperplasia (BPH) on contrast-enhanced ultrasound.</p><p><b>METHODS</b>Forty-eight BPH patients confirmed by transrectal ultrasound-guided biopsy underwent contrast-enhanced ultrasound. Contrast pulse sequencing technique (CPS) and quantitative software-ACQ were used, and the parameters of beginning enhancement time, disappearing and transit time and peak intensity (PI) of the inner gland and outer gland were recorded and analyzed.</p><p><b>RESULTS</b>The prostate was rich with blood and enhanced significantly on contrast-enhanced ultrasound. The beginning enhancement time of the prostatic inner gland, especially the area around the urethra, was much earlier than that of the outer gland, (26.68 +/- 3.76) and (31.24 +/- 5.33) s, respectively (P = 0.000). The contrast disappeared later in the inner gland than in the outer gland, (200.68 +/- 59.40) and (157.56 +/- 50.66) s, respectively (P = 0.000). The transit time of the contrast in the inner gland was much longer than in the outer gland, (173.94 +/- 60.14) and (129.21 +/- 56.91) s, respectively (P = 0.000). PI of the inner gland was much higher than that of the outer gland, (90.45 +/- 42.19) and (65.32 +/- 25.15) dB, respectively (P = 0.000).</p><p><b>CONCLUSION</b>Contrast-enhanced ultrasound makes it possible to continuously observe the blood perfusion process of BPH, and promises to be an effective means for observing the blood supply in BPH.</p>

Quantitative morphometry of hyperplastic hypoechoic nodules in the prostatic outer gland / 中华男科学杂志

<p><b>OBJECTIVE</b>To explore the morphotic characteristics of hypoechoic nodules in the outer gland of the prostate with benign</p><p><b>METHODS</b>Twenty-two hyperplastic hypoechoic nodules in the prostatic outer gland were biopsied guided by prostatic hyperplasia. transrectal ultrasound. The hematoxylin-eosin (HE) staining and immunohistochemistry combined with computer assisted quantitative image analyses were adopted to examine the mean percentages of the area densities of stroma, epithelium, glandular lumen and smooth muscle cells.</p><p><b>RESULTS</b>The area densities of stroma, epithelium, glandular lumen and smooth muscle cells were (72.52 +/- 13.14)%, (20.57 +/- 9.01)%, (6.85 +/- 4.51)% and (24.14 +/- 6.31)%, respectively.</p><p><b>CONCLUSION</b>Hyperplastic hypoechoic nodules may develop in the outer gland as well as in the inner gland of the prostate, but the mean percentages of the components are different between the two kinds of nodules.</p>