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Objective To develop a logistic regression model for differential diagnosis of the malignant ovarian tumor by combining transvaginal conventional ultrasonography and 3D power Doppler ultrasound(3D-PDUS) techniques. Methods The transvaginal ultrasonography and 3D-PDUS data were collected from 291 patients with ovarian tumors received clinical pathological diagnosis.According to the pathological resuts,the 291 patients were divided in to benign group(GB) and borderline/malignant group (GM). Univariate and multivariate logistic regression analyses were applied to establish models for predicting malignant tumor. Results ① Within the 291 ovarian tumor patients,175 (60.14% ) were classified as the GB and 116 (39.86% ) were considered as the GM,the number for postmenopausal cases and the serum CA125 level in GB group were significantly lower than those in GM group ( P <0.001); ②The tansvaginal conventional ultrasound analysis suggested that borderline/malignant tumor often presented as larger volume,more irregular shape,and higher incidence in the blood flow within a solid papillary projection and ascites (P< 0.05,compared with GB group);In 3D-PDSU data,the vascularization index (VI) was lower than that in GB group( P <0.001,compared with GM group),but there was no significant difference between GB group and GM group in flow index (FI) and vascularization-flow index (VFI) ( P =0.559,0.454); ③ Multivariate logistic regression analysis showed that postmenopausal status,serum CA125 levels,tumor echo,papillary with blood flow,ascites and 3D-PDUS VI parameters were independent risk factors for the progression of borderline/malignant tumor.The ROC curve showed that the established regression model accuracy was 92.0%,sensitivity was 86.2%,specificity was 95.7%,positive predictive value was 92.6% and negative predictive value was 91.7%. Conclusions Combining multi-model transvaginal conventional ultrasound and 3D-PDUS analyses is a useful non-invasive technique for the differential diagnosis of ovarian tumor.
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Objective To explore the clinical value of real‐time elastography in evaluating rabbit carotid vulnerable plaque . Methods Thirty male New Zealand rabbits ( weighted from 2 .0 to 3 .0 kg) were all fed with high cholesterol diet for one week before balloon injury of their right common carotid arteries . Then they were categorized randomly into two groups which were continued fed by high cholesterol diet for 6 and 12 weeks ,respectively . Ultrasound and real‐time elastography of their right common carotid arteries were applied after their anesthesia by ear marginal vein . Strains of the carotid plaques were measured and analyzed statistically by two independent experienced sonographers . All the rabbits were sacrificed by air embolism method after all the examinations . The atherosclerotic rabbit common carotid lesions were dissected ,fixed for pathologic examination , and graded according to the standard of American Heart Association ( AHA) ,which were compared with the real‐time elastography findings . Results Real‐time elastography had well repeatability between different operators . Consistency between elastography and the AHA pathology was quite good ,with the Cohen′s kappa= 0 .803 (95% CI 0 .669 to 0 .938) . Strains of different regions in a plaque had statistically significant difference ( P <0 .000 1) . By using strain higher than 0 .37% ,the sensitivity and specificity of detecting a lipid core were 88 .0% and 81 .6% ,and area under ROC curve was 0 .902 (95% CI 0 .810 -0 .959 , P < 0 .0001) . Conclusions Real‐time elastography can display the inner elastic characteristics of the rabbit carotid plaques ,and may help evaluate the grading of a plaque . The strain value may help detect a necrotic core ,thereby help evaluate the stability of a plaque .
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Purpose To compare the mammography and ultrasound imaging features of triple-negative breast cancer (TNBC) and non-triple-negative breast cancer (NTNBC), and to improve TNBC diagnosis. Materials and Methods Using immunohistochemical staining technique, 387 patients with pathologically conifrmed breast cancer were divided into TNBC group (n=54) and NTNBC group (n=333). Mammography and ultrasound ifndings as well as pathological data were retrospectively reviewed. Results TNBC was associated with higher tumor grades. There were signiifcantly more grade III inifltrating ductal carcinomas and axillary lymph node involvement in TNBC group than in NTNBC group (χ2=47.009, P<0.001;χ2=4.658, P<0.05). On mammography, TNBC most frequently presented with a mass (n=37, 69.8%) and was less associated with microcalciifcations (n=10, 18.9%). TNBC masses were mostly round or oval (n=28, 62.2%) with circumscribed margin (n=16, 35.6%). Spiculated margins were rare (n=5, 11.1%). NTNBC most frequently presented as a mass with calciifcations (n=138, 42.1%), and was more irregular in shape (n=119, 46.5%). Spiculated margins were common (n=77, 30.1%). There was statistically signiifcant difference between these two groups in mass, microcalcification, shape and margin (χ2=24.618, 19.889, 32.605 and 21.102, P<0.001). On ultrasonograhy, TNBC most frequently presented as a mass (n=52, 96.3%) with less microcalciifcations (n=5, 9.3%). TNBC masses were more frequently round or oval (n=27, 51.9%) with circumscribed margins (n=25, 48.1%). Spiculated margins were rare (n=3, 5.8%). TNBC was less likely to show attenuating posterior echoes (n=5, 9.6%);NTNBC most frequently presented as a mass (n=318, 96.1%) with microcalcifications (n=135, 40.8%). NTNBC masses were more frequently irregular in shape (n=243, 76.4%) with spiculated margins (n=76, 23.9%). NTNBC was more likely to show attenuating posterior echoes (n=78, 24.5%). There was statistically signiifcant difference between these two groups in microcalciifcation, shape, margin and posterior echo (χ2=19.006 and 18.339, P<0.001;χ2=16.170 and 8.429, P<0.05). Conclusion TNBC demonstrates round or oval mass with circumscribed margin and is less likely to show attenuating posterior echoes on mammography and ultrasound with benign imaging features. NTNBC frequently presents as irregular mass with spiculated margin, and is more associated with microcalciifcations. These imaging ifndings are useful in early diagnosis of TNBC.
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Objective To evaluate the clinical value of tomography ultrasonic imaging (TUI) in staging carcinomas of the cervix.Methods Eighty-seven patients with biopsy proven cervical cancer who underwent transvaginal TUI examination were enrolled.Clinical and ultrasonic staging were based on the FIGO staging system.Surgical-pathological or MR results was taken as golden standard.Ultrasonic staging were compared with clinical staging.Tumor sizes of 38 cases of cervical cancers measured by TUI were recorded and compared with the pathological results.Results The overall accuracy of preoperative TUI staging was higher than that of preoperative clinical staging (91.95 ％ vs 81.60 ％,P ＜0.01).Mean size of the 38 malignant tumors was 2.5 cm×2.1 cm×2.2 cm by TUI and 2.6 cm×2.1 cm×2.3 cm by pathological samples (P ＞ 0.05).Conclusions TUI technology may be useful in the noninvasive examination of preoperative staging of carcinoma cervix.
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Objective To evaluate the clinical value of three-dimensional power Doppler ultrasound (3D PDUS) in diagnosing cervical cancers.Methods 162 patients with cervical lesions were enrolled.All the cases were confirmed by autopsy or surgery.Vascularization index (VI),flow index (FI) and vascularization flow index(VFI) were all measured and compared.The pathological findings was taken as golden standard.ROC curve was used to find the best cut-off value.Results 3D PDUS indices of benign and malignant lesions were statistically different (P ＜0.0001).The best cut-off value of VI was 4.63 using ROC curves,the area under the curve (AUC) was 0.94,the sensitivity and specificity were 89.10％ and 86.30％,respectively.The best cut-off value of FI was 34.39 using ROC curves,AUC was 0.76,the sensitivity and specificity were 73.40％ and 76.70％,respectively.The best cut-off value of VFI was 1.60 using ROC curves,AUC was 0.93,the sensitivity and specificity were 87.50 ％ and 86.30 ％,respectively.Conclusions 3D PDUS was a new and noninvasive way for the clinical to differentiate benign and malignant cervical lesions.
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Objective To investigate the clinical value of strain ratio in differential diagnosis of thyroid tumors,compared with the evaluation based on elastography scores.Methods Elastography examinations were performed in 67 patients with 92 thyroid tumors.Ultrasonic elastograms were evaluated according to the four- and five-score system respectively.Strain ratio of the tumor and the surrounding tissue was also calculated.Clinical value of the three evaluations was compared with pathological findings as the reference standard.Results The area under the curve:0.885 for the four-score,0.904 for the five-score,0.961 for the strain ratio.When a cutoff point of 3 was used,four-score and five-score showed a sensitivity of 78.0%,a specificity of 86.3%,an accuracy of 82.6% and a sensitivity of 80.5%,a specificity of 88.2%,an accuracy of 84.8%,respectively.When a cutoff point of 3.57 was introduced,the strain ratio had 92.7% sensitivity,92.2% specificity,92.4% accuracy.Conclusions Strain ratio was more helpful in diagnostic performance of thyroid tumors as a new semi-quantitative method than elastography scores.
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ObjectiveTo investigate the clinical value of transvaginal elastography in diagnosing cervical cancers.MethodsTotally,124 patients of cervical lesions with definite pathological results were enrolled.Elastograms were collected and the strain ratios of the benign and malignant lesions were record and compared.ROC curve was used to find the best cut-off point.ResultsElastography was useful in differentiating benign and malignant lesions by different color.Values of strain ratio of different pathological lesions were statistically different ( P ＜0.01).The mean value of strain ratio was 2.71 ± 1.56 for benign lesions and 8.32 ± 4.11 for malignant ones.The best cut-off point was 4.99 basing on the ROC curve.The sensitivity and specificity were 80.7％ and 89.6％,respectively.ConclusionsReal-time transvaginal elastography was a new way in differential diagnosing cervical cancers from benign lesions of the cervix.
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Objective To summarize the characters of the elastograms of different pathological nodules, and to observe the value of elastography in differentiating benign from malignant thyroid solid nodules. Methods One hundred and sixteen patients with thyroid nodules were enrolled in the study and 122 nodules were detected in total. All of them were examined by elastography and conventional ultrasound. Five sonographers were invited to evaluate the nodules double blinded basing on the images and the four-point system proposed by Fukunari. The interobserver agreement was evaluated by Kappa coefficient. Diagnostic performances of the five readers were compared by the ROC curves. Distributions of elastography scores of different pathological nodules were compared by one-way ANOVA. Results Interobserver agreements on scoring the nodules were moderate. Mean value of benign nodules was obvious lower than that of the malignant ones. The mean score of nodular goiters was 2.67 ± 0.89, range from 1 to 3. Most of the adenomas got score of 2, but the score of thyroiditis was quite high. No significant differences were found between the comparison of thyroiditis and thyroid cancers. Areas under the ROC curve (AUC) of the five readers were 0.82,0.81,0.79,0.73 and 0.83 respectively. When 3.5 was choosen as the cut-off point, the sensitivity of elastography was 82.4%, and specificity was 71.6%. Conclusions Elastography was really a useful technique for it can provide a new index for the differential diagnosis of thyroid nodules. However, the 4-point score system is not comprehensive enough.
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Protein arginine methyltransferase 5 (PRMT5) has been implicated as an important regulator of many cellular processes and signaling pathways,including chromatin remodeling,RNA splicing,DNA transcription,and cell proliferation.Therefore,structural and functional studies on PRMT5 are quite important.The full length ofPRMT5 gene was cloned into vector pGEX-4T-1,resulting in only low expression levels in Escherichia coli (E.colO.Here,it was showed that the several N-terminal amino acids deletions could result in a significant increase in the amount of soluble ft"action,while one of them did not affect the protein-arginine methyltransferase activity.And it was also found that the N-terminal 15 amino acids region of PRMT5 may be important for the catalytic activity.
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Objective To analyze right ventrieular diastolic dysfunction in essential hypertension by quantitative tissue velocity imaging(QTVI). Methods Twenty normotensives and forty-five hypertensives underwent standard Doppler echocardiography and QTVI of right ventricular lateral tricuspid annulus. By QTVI,diastolic measurements were obtained. According to WHO standard, the patients with hypertension were classified into three groups, grade Ⅰ (group Ⅰ) 15 cases, grade Ⅱ(group Ⅱ) 15 cases, grade Ⅲ (group Ⅲ) 15 cases. Results Pulsed Doppler eehocardiography showed impaired Doppler diastolic indexes in hypertensives, without changes among the eases groups. In all hypertension groups, QTVI showed reduction of right ventricular Ea, increase of Aa and Ea/Aa<1 comparison with controls. IVRT of Ⅱ, Ⅲgroups was longer than normal. Conclusions Right ventricular diastolic function with essential hypertension decreased according to the degree of staging. QTVI has a greater predictive value than conventional imaging, and is useful for evaluating right ventricular function in patients with essential hypertension.
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Objective To assess the value of high-frequency color Doppler ultrasound technique combined with hemorheology in detecting early atherosclerosis and monitoring its progression.Methods Twenty-four white big ear rabbits were divided into two groups randomly.Group A (6 rabbits) was fed normal rabbit chow,while group B (18 rabbits) was fed high cholesterol diet and was divided into three subgroups: B1(6 rabbits) with high cholesterol diet for 4 weeks,B2(6 rabbits) for 8 weeks,B3(6 rabbits) for 12 weeks.Intima-media thickness (IMT),diameter of common carotid artery and hemorheology index were observed dynamically and compared with the findings of histological examination.Results IMT of common carotid artery increased gradually in group B at different phases of atherosclerosis.Diameter compensationally enlarged at the early stage,and then stenosed with the progression of atherosclerosis.RBC deformation index of group B began reducing in the second week,but blood viscosity,plasma viscosity,RBC aggregation index and rigidity index gradually increased from the fourth week( P