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Objective:To investigate the application value of shear wave elastography (SWE) and real-time tissue elastography (RTE) in differential diagnosis of thyroid Amereican College Radiology (ACR) TR5 nodules.Methods:Patients who underwent ultrasound examination at the Fourth Affiliated Hospital of Harbin Medical University from August 2018 to June 2019 diagnosed as ACR TR5 nodules were surveyed, and received SWE and RTE examinations to evaluate the nodules hardness. The receiver operating characteristic curve (ROC curve) was drawn to obtain the best diagnostic cutoff value for the Young's modulus maximum (Emax) of the benign and malignant thyroid ACR TR5 nodules using SWE technique; using the 5-point method, the elasticity score (ES) was used to evaluate the benign and malignant ACR TR5 nodules by RTE technology, and the pathological results were regarded as "gold standard". The accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of SWE, RTE and two elastography techniques in differential diagnosis of benign and malignant thyroid ACR TR5 nodules were compared.Results:A total of 65 patients were enrolled, with a total of 73 ACR TR5 nodules. The optimal Emax threshold for differential diagnosis of ACR TR5 nodules by SWE technology was 41.8 kPa, and 32 malignant nodules and 41 benign ones were determined. Of the 73 ACR TR5 nodules using RTE technology, 38 had ES scores of 1 to 3 and 35 had ES scores of ≥4. Pathological results showed that among 73 thyroid ACR TR5 nodules, benign nodules accounted for 45.21% (33/73), malignant nodules accounted for 54.79% (40/73). The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of SWE, RTE and two elastography techniques for differential diagnosis of benign and malignant thyroid ACR TR5 nodules were 72.50%, 77.50%, 87.50%; 90.91%, 87.88%, 87.88%; 80.82%, 82.19%, 87.67%; 90.63%, 88.57%, 89.24% and 73.17%, 76.32%, 85.29%.Conclusions:Ultrasound elastography of two different imaging principles of SWE and RTE is an effective method for differential diagnosis of benign and malignant thyroid ACR TR5 nodules. The combination of the two is more advantageous.
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Objective:To investigate the application value of real-time ultrasound elastography in the treatment of fibroids radiofrequency ablation (RFA).Methods:Transvaginal ultrasonography,Real-time ultrasound elastography (RTE) and contrast-enhanced ultrasonography (CEUS) were performed on 34 patients with a total of 38 uterine fibroids who had the treatment of RFA before,1 hour and 3 months after the treatment of RFA.Detected the diameters of the lesions with the three methods of CEUS,RTE and 2D.Analysed the elastic image features and divided into groups,Measured the elastic strain ratio and compared the E/E0 in and between the group.The difference of lesion diameter between 2D,RTE and CEUS was compared.When the image of lesions showed blue and green was taken as the cirterion of incomplete ablation after RFA,conpared with CEUS,analysed the consistency of RTE and CEUS in evaluating the degree of ablation.Results:The lesions were divided into 3 groups according to the preoperative elastic image,with 8 (21.1％) in the blue group,20 (52.6％) in blue-based and 10 (26.3％) in green-based group.The difference was obvious in E/E0 between the 3 groups before RFA.There was no significant difference in E/E0 between 1 hour and 3 months after RFA (P ＞ 0.05).In each group the E/E0 of lesions were significantly increased at 1 hour and 3 months after the treatment of FRA,and the hardness of 3 months after RFA was harder than that of 1 hour after RFA(P＜0.05).The diameter measured by RTE was larger than that by 2D and CEUS before RFA(P＞0.05).The diameter measured by 2D was larger than that by RTE and CEUS at 1 hour after RFA (P＜0.05).No statistically significant difference was found in the lesion diameters among the three methods of2D,RTE and CEUS at 3 months after the treatment ofRFA (P＞0.05).CEUS and RTE had the basic consistent in the evaluation of lesions ablation degree at 1 hour (kappa=0.46) and 3 months (kappa=0.54) after the treatment of RFA.Conclusions:After RFA,the myoma gradually hardens,and RTE can reflect the change of the hardness,RTE can clearly show the boundary of uterine ftbroids especially after the treatment of RFA,can be used in the prediction of lesions ablation degree,so there was a certain application value of RTE used in RFA.
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Objective To investigate the value of real-time elastography (RTE) in evaluating the characteristics and elasticity index (E-index) changes at different echo level of uterine fibroids before and after radiofrequency ablation (RFA).Methods A total of 43 patients (with 55 lesions) accepted RFA under ultrasound guidance in the Fourth Affiliated Hospital of Harbin Medical University from September 2013 to January 2015.All lesions were confirmed to have no perfusion through ultrasonography 1 h after RFA.The diameter of lesions ranging from 1.0 cm to 3.0 cm (with an average of 1.9± 1.2 cm).Preoperative lesions were classified into 3 groups for comparison based on ultrasonic echo type,group A:hypo echo (n=30);group B:hyper echo (n=12);and group C:mixed echo (n=12).Measured elasticity index E-index and internal uniformity (△ E) were analyzed.Comparisons of E value and△ E value were performed with repeated measures.RTE images features using x2 test of Fisher inspection comparison at the same time differences between groups.Results (1) Before RFA,RTE images showed blue alternating with green with green being dominated accounting for 70％ (21/30).50％ of RTE images in group B were completely covered in blue (6/12),while group C exhibited 53.9％ blue alternating with green with blue being dominated (7/13).There were statistically significant characteristics of RTE images among 3 groups (P ＜ 0.01).1 h after RFA,74.5％ lesions exhibited with blue being dominated (41/55).However,83.6％ (41/55) exhibited with blue 3 months after RFA.The difference in characteristics of RTE among 3 groups displayed no statistical significance (P ＞ 0.05).(2) The comparison of E-index revealed that before RFA,the E value was the lowest in the group A and the highest in the group B,while the group C was between them.There was significant difference between group A and B (F=19.25,P ＜ 0.01).E-index elevated in all the three groups and significant differences were found 1 h,3 month after RFA in comparison with that before RFA in the group A (F=386.75,294.68,both P ＜ 0.01).In addition,significant differences were also found 1 h,3 month after RFA in comparison with the treatment in the group B (F=29.98,45.88,both P ＜ 0.01).As for the group C,there were significant differences in E-index 1 h,3 month after RFA compared with before RFA (F=120.29,139.64,both P ＜ 0.01).3 months after RFA,E-index further elevated in the three groups and no significant inter-group difference was found at the same time points (P ＞ 0.05).(3)Before RFA,the△ E value was lower in group A and group B,while higher in the group C,group C presenting significant difference from group A and B (F=484.68,344.15,both P ＜ 0.01).At 1 h after RFA,△ E value was higher in group A and group C,while lower in group B,with group B showing significant difference from the low and mixed echo groups (F=53.58,94.79,both P ＜ 0.01).Significant difference was observed 1 h after surgery compared to before RFA in group A (F=154.35,P ＜ 0.01).Significant difference was also found 1 h after RFA compared to 3 month after RFA in group A (F=266.85,P ＜ 0.01).As for group C,there were also significant differences in△ E-index before treatment and 1 h after RFA compared with 3 month after RFA (F=103.24,76.53,both P ＜ 0.01).At 3 months after RFA,△ E-index decreased in all three groups.No significant inter-group difference was found at the same time points (all P ＞ 0.05).Conclusions RTE characteristics and the elasticity index are distinctly different among uterine fibroid at various echo intensities.RTE contributes to judging changes in hardness before and after RFA.The application of RTE for quantitative comparison of lesion hardness and uniformity can be served as the foundation for evaluating therapeutic effects of RFA.
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ObjectiveTo explore changes of immune factors in serum before and after ultrasound-guided (US-guided ) interventional treatment of ovarian endometrial cyst.MethodsNine patients with ovarian endometrial cyst were selected between December 2011 and December 2013 in the fourth affiliated hospital of Harbin Medical University. All patients performed US-guided interventional treatment, the serum specimens were collected before and after three months of treatment respectively. NimbleGen genome microarray of serum specimens were performed to analysis the gene function and gene pathways of related factors of ovarian endometrial cyst and to find out factors with significant expression differences before and after treatment. The relevance between factors with significant expression differences and the pathogenesis of ovarian endometrial cyst were analyzed.ResultsThe expression of CD36, NR4A1and HES1 were found to be down-regulated after US-guided interventional treatment of ovarian endometrial cyst by NimbleGen genome microarray. The gene function of CD36, NR4A1 and HES1participating in angiogenesis, chemotaxis, cell adhesion was relevant to the pathogenesis of the ovarian endometrial cyst, and played roles through Adipocytokine signaling pathway, MAPK signalig pathway, Maturity onset diabetes of the young signaling pathways.ConclusionSerum CD36, NR4A1 and HES1of ovarian endometrial cyst were down-regulated after US-guided ethanol sclerotherapy , and involved in the pathogenesis of ovarian endometrial cyst .
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Objective To investigate the current situation of thyroid disease by analyzing retrospectively the color poppler ultrasonography data of neck discomfort in Heilongjiang Province.Methods A total of 13 020 cases (18-93 years old) of thyroid ultrasound examination data collected from September 2009 to October 2012 at the Department of Ultrasound,Fourth Affiliated Hospital of Harbin Medical University,were retrospectively analyzed.According to the sonographic features of thyroid (thyroid morphology,size,echo characteristics,blood flow,nodular location,number,calcification,etc),combined with ultrasound diagnosis,the relationships between gender and disease,age and disease,ultrasound diagnosis and disease classification,gender,number of nodules and benign and malignant were analyzed.Results Among the 13 020 cases,524 cases was excluded.There were 2 291 male cases; abnormalities were detected in 1 679 cases,and the abnormal ratio was 73.29％; there were 10 205 female cases; 7 946 cases were abnormal,and the abnormal ratio was 77.86％.The proportion of abnormal thyroid cases of the total number of female was higher than that of male,and the ratio of male and female was 1.00 ∶ 4.73 (1 679∶7 946); gender differences were statistically significant(x2 =18.476,P ＜ 0.01).There were nodular type 5 018 cases,diffuse type 2 012 cases and mixed type 2 603 cases in sonographic findings.The nodular type on ultrasound images showed mainly nodular goiter(79.21％,3 975/5 018).The diffuse type on ultrasonic images showed mainly Hashimoto Thyroiditis(59.24％,1 192/2 012).The mixed cases on ultrasound images showed mainly nodular goiter (89.83％,2 331/2 595).Ultrasound diagnostic results showed that nodular goiter accounted for 65.52％ (6 306/9 625) and Hashimoto Thyroiditis accounted for 17.97％ (1 730/9 625).Proportion of thyroid disease increased gradually with age,reached a peak [29.93％(2 557/8 544) and 28.84％ (2 464/8 544)] between the ages of 41-50 and 51-60 years old.The proportion gradually decreased into[14.17％(1 211/8 544),7.26％(620/8 544)] between the age of 61-71 and ＞ 71 years old.The incidence differences of malignant nodules between different age groups were statistically significant (x2 =407.796,P ＜ 0.01).Among malignant nodules,solitary nodule accounted for 95.76％ (113/118) ; multiple nodules accounted for 4.24％ (5/118),and there were more solitary nodule than multiple nodules(x2 =15.286,P ＜ 0.01).About malignant solitary nodules,women accounted for 87.61％(99/113); men accounted for 12.39％ (14/113),and women's were significantly higher than man's(x2 =360.960,P ＜ 0.01).Correlation analysis showed that the results of ultrasounddiagnosisofvarious thyroid diseases were highly correlated with the ultrasonic types of diseases(r =0.139 99,P ＜ 0.01).Conclusions Nodular goiter and Hashimoto Thyroiditis are the most common adult neck discomfort diagnosed by ultrasound in Heilongjiang Province.The high-risk age of thyroid disease is between 41-60 years old.Thyroid malignant is more common in single nodular,and the number of female patients is significantly higher than that of men.
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Objective To investigate the diagnostic value of contrast enhanced ultrasound in breast cancer. Methods Thirty-six cases including 51 typical and 22 atypical breast cancer were examined with injecting contrast agent before operation. The enhanced charaters of perfusion pattern, enhanced level, and modes were observed and reanalyzed when pathology was got. Results There was no statistical meanings in perfusion pattern, enhanced level and mode between typical and atypical breast cancer. They all enhanced like branch or annulus with high lever and there were 3 enhanced modes:"fast in slow out"(48% ,35/73) ,"lastly fast in slow out"(44% ,32/73) and "same in same out"(8% ,6/73). Conclusions The enhanced modes of breast cancer showed "fast in slow out" , "lastly fast in slow out"and "same in same out", enhanced like "branch or annulus" and high level enhanced. Contrast enhanced ultrasound can increase the diagnostic accuracy in the early stage of breast cancer.
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Objective To evaluate the application of pure brilliance imaging(PB1) in diagnosis of benign and malignant breast neoplasms. Methods Ninty-seven breast neoplasms were respectively examined by high frequency ultrasound and PBI before operation,then correlated with pathological results. Results The accuracy of high frequency ultrasound for breast neoplasms was 73.2% with the sensitivity 77.8% ,specificity 69.2%. The detectable rate of spiculate margin, halo,calcification were much higher in PBI than those in high frequency ultrasound(P<0.05). And the accuracy,sensitivity and specificity of PBI were 86.6%, 91.1%, 82.6%. Conclusions PBI can significantly increase the detectable rate of ultrasonographie marginal features of breast neoplasms which were also helpful to the differential diagnosis.