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Objective@#To investigate the initial clinical value of shear wave elastography (SWE) combined with shear wave dispersion (SWD) in preoperatively differentiating diagnosis of focal liver lesions (FLLs).@*Methods@#Eighty-three patients diagnosed as FLLs were prospectively enrolled from January to April 2018 in Zhongshan Hospital of Fudan University. Measurements of SWD and SWE both inner FLLs and surrounding liver parenchyma 2 cm away from the board lines of lesions were performed. ROIs were placed within the lesions and surrounding parenchyma 2 cm away from the lesions. In each ROI, measurements were performed 13 times. Histopathological results after operation were regarded as gold standard, and the values of viscoelasticity in differentiating diagnosis of FLLs were analyzed.@*Results@#The final histopathological results showed that of all 83 cases, 20 cases were diagnosed as benign lesions (5 cases of focal nodular hyperplasia, 15 cases of hemangioma), and 63 cases as malignant lesions (12 cases of liver metastases, 51 cases of hepatocellular carcinoma). The SWE of benign lesions and malignant lesions were (9.94±8.22)kPa, and (13.68±7.80)kPa(P<0.05). The SWD of benign lesions and malignant lesions were (13.47±2.76)(m/s)/kHz, and (15.00±3.82)(m/s)/kHz(P<0.05). The SWE ratio and SWD ratio of benign lesions to surrounding liver parenchyma were higher than those of malignant lesions(all P<0.05). The SWE ratio of benign and malignant lesions were 2.60±2.65, and 1.40±1.40, respectively (P<0.05). The SWD ratio of benign and malignant lesions were 0.92±0.44, and 0.80±0.51, respectively(P<0.05).@*Conclusions@#With the advantages of effectiveness, convenience, non-invasiveness and repeatability, combined measurement of SWE and SWD has a potential value in differentiating diagnosis of liver lesions.
ABSTRACT
Objective To investigate the initial clinical value of shear wave elastography ( SWE ) combined with shear wave dispersion ( SWD) in preoperatively differentiating diagnosis of focal liver lesions ( FLLs) . Methods Eighty‐three patients diagnosed as FLLs were prospectively enrolled from January to April 2018 in Zhongshan Hospital of Fudan University . M easurements of SWD and SWE both inner FLLs and surrounding liver parenchyma 2 cm away from the board lines of lesions were performed . ROIs were placed within the lesions and surrounding parenchyma 2 cm away from the lesions . In each ROI , measurements were performed 13 times . Histopathological results after operation were regarded as gold standard ,and the values of viscoelasticity in differentiating diagnosis of FLLs were analyzed . Results The final histopathological results showed that of all 83 cases ,20 cases were diagnosed as benign lesions ( 5 cases of focal nodular hyperplasia ,15 cases of hemangioma) ,and 63 cases as malignant lesions ( 12 cases of liver metastases ,51 cases of hepatocellular carcinoma) . T he SWE of benign lesions and malignant lesions were ( 9 .94 ± 8 .22) kPa ,and ( 13 .68 ± 7 .80) kPa( P ＜0 .05 ) . T he SWD of benign lesions and malignant lesions were ( 13 .47 ± 2 .76 ) ( m/s)/kHz ,and ( 15 .00 ± 3 .82 ) ( m/s)/kHz ( P ＜0 .05 ) . T he SWE ratio and SWD ratio of benign lesions to surrounding liver parenchyma were higher than those of malignant lesions( all P ＜
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Objective To investigate the value of contrast‐enhanced ultrasound ( CEUS ) in the differential diagnosis of pancreatic neoplasia ( SPN ) before operation . Methods Forty‐six cases of SPN confirmed by operation and histopathological results from January 2012 to June 2018 were enrolled in the study . According to the European Ultrasound Association ( EFSUMB) guidelines for CEUS in 2018 ,the enhancement pattern of pancreatic lesion with normal surrounding pancreatic parenchyma was used for reference . T he enhancement pattern of SPN were observed during the arterial phase ,venous phase and delayed phase . CEUS pattern of 16 cases with pancreatic ductal adenocarcinoma ( PDAC ) with cystic changes proved by histopathology were observed and compared with SPN . Results T he mean size of 46 cases of SPN was ( 32 .72 ± 25 .51) mm . Fifteen SPN lesions located in the head of pancreas ,31 cases located in the body and tail of the pancreas . Most of SPN were solidcystic lesions with thin separation on conventional B mode ultrasoud ,without communication with the main pancreatic duct . Color flow signals could be detected in 78 .3% ( 36/46) SPN lesions . After the injection of 2 .4 ml ultrasound contrast agent , the substantial part of all SPN showed hyperenhancement ( n＝ 44 ,99 .7% ) or isoenhancement ( n ＝ 2 , 4 .3% ) during the arterial phase ,venous phase and late phase . However ,93 .8% ( 15/16 ) of the PDAC lesion with cystic changes showed consistent hypo enhancement throughout the arterial ,venous and late phase ( P ＜0 .05) . T he accuracy of preoperative diagnosis of CEUS was 95 .6% . Conclusions Depending on its unique advantages such as real‐time observation ,high‐resolution imaging ,and no radiation ,CEUS is helpful for early detection ,accurate localization and preoperative diagnosis of SPN . CEUS has potential role for clinical decision‐making before treatment .
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Objective To investigate the effect of medical student involvement on the quality of actual cardiopulmonary resuscitation (CPR).Methods A digital video-recording system was used to record and analyze CPR procedures for adult patients from March 2011 to September 2012.Results Twenty-six student-involved and 40 non-student-involved cases were studied.The chest compression rate in the studentinvolved group was significantly higher than that in the non-student-involved group (P ＜ 0.01).The proportion of compressions atabove 110 cpm was higher in the student-involved group (P =0.021),whereas the proportion at 90 ～ 110 cpm was lower in the student-involved group (P =0.015).The ratio of hands-off time to total manual compression time was significantly lower in the student-involved group than in the non-student-involved group (P ＜ 0.05).In contrast,the student-involved group delivered a higher ventilation rate compared with the non-student-involved group (P ＜ 0.05).The observed time delay to first compression and first ventilation was very similar between the groups.There were no significant differences between groups in either return of spontaneous circulation or time from survival to discharge.Conclusions Student-involved resuscitation teams were able to perform good CPR,with higher compression rates and fewer interruptions.However,the supervision from medical staff is still needed to ensure appropriate chest compression and ventilation rate in student-involved actual CPR in the emergency department.