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OBJECTIVE: To study the diagnostic efficiency of the fine needle aspiration biopsy(FNA) and contrastenhanced ultrasound(CEUS) in differentiation of solid thyroid nodules coexisting Hashimoto's thyroiditis, and to determine whether combined use of both methods is helpful. METHODS: A total of 68 thyroid nodules in 62 patients were observed with CEUS and FNA before surgical excision. The diagnostic performances of FNA, CEUS and CEUS combined with FNA were compared. RESULTS: There was no significant difference in sensitivity, accuracy, positive predictive value and negative predictive value among the three methods(P>0.05). The specificity was significant high in FNA group(P<0.05). CONCLUSION: FNA has high specificity in the diagnosis of Hashimoto's thyroiditis with nodule.FNA combined with CEUS could not improve the diagnostic accuracy for thyroid nodules coexisting Hashimoto's thyroiditis.
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<p><b>OBJECTIVE</b>To evaluate the clinical value of radial endorectal ultrasound (ERUS) in the assessment of preoperative staging of rectal carcinoma.</p><p><b>METHODS</b>One hundred and ten patients with rectal cancer underwent preoperative endorectal ultrasound (ERUS) examination in our hospital from February 2010 to September 2011. ERUS was performed using a Hitachi 900, Hitachi HI Vision Preirus US scanner, with a 5 - 10 MHz rigid rotating radial transducer and a focal length of 2 - 5 cm. The size, shape, echo pattern, infiltration depth, degree of circumferential involvement, extra-rectal invasion of the lesions and lymph node involvement were observed. The results of ERUS staging were compared with histopathological findings of the surgical specimens.</p><p><b>RESULTS</b>The accuracy of ERUS for T staging was 91.4%. The accuracy of ERUS in diagnosing stage T1, T2, T3, T4 cancers was 92.7%, 88.2%, 88.2% and 96.4%, respectively. The sensitivity of ERUS in diagnosing stage T1, T2, T3, T4 cancers was 92.3%, 72.7%, 85.4% and 71.4%, respectively. The specificity of ERUS in diagnosing stage T1, T2, T3, T4 cancer was 92.9%, 92.0%, 90.3% and 100.0%, respectively. Comparing the consistency of preoperative T-staging and postoperative pathological results, the Kappa value was 0.75, with a considerable consistency. The sensitivity, specificity, and accuracy of ERUS in the assessment of lymph node metastasis were 74.2%, 89.9% and 85.5%, respectively. Comparing the consistency of preoperative N-staging and postoperative pathological results, the Kappa value was 0.64, with a considerable consistency.</p><p><b>CONCLUSIONS</b>ERUS is a practical and accurate tool in assessment of preoperative staging of rectal tumors in regard to tumor invasion depth (T) and regional lymph node status (N), with advantages of simple operation, less pain, and high accuracy.</p>
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Endosonography , Methods , Lymphatic Metastasis , Neoplasm Staging , Preoperative Period , Rectal Neoplasms , Diagnostic Imaging , Pathology , General Surgery , Rectum , Diagnostic Imaging , Pathology , General SurgeryABSTRACT
Objective To investigate the clinical value of double contrast-enhanced ultrasonography (DCUS) in the macroscopic classification of rectal carcinoma. Methods Seventy-one patients with rectal carcinoma were examined by ultrasound after intrarectal infusion and intravenous bolus injection of SonoVue preoperatively. And three types were divided according to the shape of the tumor:protruding type, ulcerative type and invasive type. After surgery, DCUS and perfusion contrast-enhanced ultrasonography (PCUS) were compared with final pathologic results respectively, and the relationship between general tumor type and TN staging were analyzed.Results The accuracy of DCUS [88.7%(63/71) ] in macroscopic classification of rectal carcinoma was significantly higher than that of PCUS [73.2%(52/71) ](χ2=5.534,P<0.05). For the invasion depth into the intestinal wall, the protruding type was mainly in T1, T2 and T3 stages while ulcerative and invasive type in T2, T3 and T4 stages (χ2=12.322, P<0.05 ). For the stage of lymph node, the protruding type was mainly in N0 and N1 while ulcerative and invasive type in N1 and N2(χ2=6.733,P < 0.05 ). Conclusions DCUS, with its high accuracy, is a new valuable method for macroscopic classification of rectal carcinoma.In the aspect of intestinal wall invasion and the lymph node, protruding type is less severe than ulcerative type and invasive type.
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<p><b>OBJECTIVE</b>To compare the accuracy of preoperative T staging of gastric cancer by oral and intravenous contrast-enhanced gastric ultrasonography.</p><p><b>METHODS</b>One hundred and forty three patients who had been diagnosed as gastric cancer by endoscopic biopsy and confirmed by pathology after operation were examined by oral and intravenous contrast-enhanced gastric ultrasonography, and they were divided into satisfied group and non-satisfied group according to the 2-D image quality of lesion. The results were compared with postoperative pathologic findings.</p><p><b>RESULTS</b>All the patients with gastric cancer presented regional gastric wall thickening. Among them, 117 cases were clearly presented with good image quality. The remaining 26 cases were presented with vague profile, the ulcerative surface of lesion was filled with hyperechogenicity combined with rear shadow. The accuracy of oral contrast-enhanced ultrasonography in determining the T stage of gastric cancer was 74.1%. The accuracy in satisfied group and non-satisfied group was 78.6% and 53.8%, respectively. The enhancement pattern of 143 cases was showed as hyperenhancement during the arterial phase and hypoenhancement during the portal phase in DCUS. The accuracy of double contrast-enhanced ultrasongraphy in determining the T stage of gastric cancer was 86.7%, but the accuracy in satisfied group and non-satisfied group was 88.9% and 76.9%, respectively. There was a significant difference between the two methods (χ(2) = 9.031, P < 0.01).</p><p><b>CONCLUSION</b>DCUS is more accurate than oral contrast-enhanced ultrasonography as a useful diagnostic method for preoperative T staging of gastric cancer.</p>
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Adult , Aged , Female , Humans , Male , Middle Aged , Contrast Media , Neoplasm Staging , Methods , Preoperative Period , Stomach Neoplasms , Diagnostic Imaging , Pathology , Ultrasonography , MethodsABSTRACT
<p><b>OBJECTIVE</b>To investigate the diagnostic value of contrast-enhanced ultrasonography (CEUS) in preoperative T-staging of gastric cancer.</p><p><b>METHODS</b>A sulfur hexafluoride-filled microbubble ultrasound contrast agent and a continuous real-time imaging technique of contrast pulse sequencing were used. Normal gastric wall was examined by CEUS in 8 healthy volunteers and the results were compared with the findings on multislice computed tomography. Sixty-two patients with gastric cancer proved by biopsies who received preoperative CEUS examination were involved in this study, and the CEUS result was compared with postoperative pathological findings.</p><p><b>RESULTS</b>The normal gastric wall presented a one-layer structure in the portal venous phase and a three-layer structure in the arterial and equilibrium phase including a slightly hyper-enhanced inner layer, a hypo-enhanced intermediate layer, and a markedly hyper-enhanced outer layer, which corresponded histologically to the mucosal, submucosal, and muscular-serosal layer, respectively. The accuracy of transabdominal ultrasonography and CEUS in determining the T stage of gastric cancer was 72.9% and 88.1% respectively, and the difference was statistically significant (chi(2)=4.37, P=0.036).</p><p><b>CONCLUSIONS</b>CEUS shows the normal gastric wall as a one- or a three-layer structure, which provides a theory base for CEUS in preoperative T-staging of gastric cancer. CEUS is a useful diagnostic method for preoperative T-staging of gastric cancer.</p>
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Contrast Media , Neoplasm Staging , Methods , Stomach Neoplasms , Diagnostic Imaging , Pathology , Sulfur Hexafluoride , Ultrasonography , MethodsABSTRACT
<p><b>OBJECTIVE</b>To evaluate the measurement of intravesical prostatic protrusion (IPP) by transabdominal ultrasonography (TAUS) in the diagnosis of benign prostatic obstruction (BPO).</p><p><b>METHODS</b>We studied the clinical data of 109 BPH patients referred for lower urinary tract symptoms (LUTS) from April 2005 to December 2006. IPP was measured by TAUS, urodynamic parameters such as Qmax and PdetQmax obtained by urodynamic studies and AG values calculated. The patients were divided into an obstruction and a non-obstruction group according to their AG values.</p><p><b>RESULTS</b>IPP was found statistically different between the obstruction and non-obstruction groups (P<0.001) and positively correlated with the AG value (r=0.729, P=0.001). With the cutoff at IPP > or = 10 mm for the diagnosis of BPO, the sensitivity, specificity and accuracy of the diagnosis were 89.9%, 97.5% and 92.7%, respectively.</p><p><b>CONCLUSION</b>The measurement of IPP by TAUS offers a valuable help for the diagnosis of BPO.</p>