Exploration of CT imaging features of cystic pulmonary nodules and establishment of a prediction model for benign and malignant pulmonary nodules / 中国胸心血管外科临床杂志

@#Objective To explore the CT imaging features and independent risk factors for cystic pulmonary nodules and establish a malignant probability prediction model. Methods The patients with cystic pulmonary nodules admitted to the Department of Thoracic Surgery of the First People's Hospital of Neijiang from January 2017 to February 2022 were retrospectively enrolled. They were divided into a malignant group and a benign group according to the pathological results. The clinical data and preoperative chest CT imaging features of the two groups were collected, and the independent risk factors for malignant cystic pulmonary nodules were screened out by logistic regression analysis, so as to establish a prediction model for benign and malignant cystic pulmonary nodules. Results A total of 107 patients were enrolled. There were 76 patients in the malignant group, including 36 males and 40 females, with an average age of 59.65±11.74 years. There were 31 patients in the benign group, including 16 males and 15 females, with an average age of 58.96±13.91 years. Multivariate logistic analysis showed that the special CT imaging features such as cystic wall nodules [OR=3.538, 95%CI (1.231, 10.164), P=0.019], short burrs [OR=4.106, 95%CI (1.454, 11.598), P=0.008], cystic wall morphology [OR=6.978, 95%CI (2.374, 20.505), P<0.001], and the number of cysts [OR=4.179, 95%CI (1.438, 12.146), P=0.009] were independent risk factors for cystic lung cancer. A prediction model was established: P=ex/(1+ex), X=–2.453+1.264×cystic wall nodules+1.412×short burrs+1.943×cystic wall morphology+1.430×the number of cysts. The area under the receiver operating charateristic curve was 0.830, the sensitivity was 82.9%, and the specificity was 74.2%. Conclusion Cystic wall nodules, short burrs, cystic wall morphology, and the number of cysts are the independent risk factors for cystic lung cancer, and the established prediction model can be used as a screening method for cystic pulmonary nodules.

Establishment and Verification of Benign and Malignant Prediction Model of Subcentimeter Pulmonary Ground Glass Nodules Based on HRCT / 中国肺癌杂志

BACKGROUND@#Pre-operative accuracy of subcentimeter ground glass nodules (SGGNs) is a difficult problem in clinical practice, but there are few clinical studies on the benign and malignant prediction model of SGGNs. The aim of this study was to help identify benign and malignant lesions of SGGNs based on the imaging features of high resolution computed tomography (HRCT) and the general clinical data of patients, and to build a risk prediction model.@*METHODS@#This study retrospectively analyzed the clinical data of 483 patients with SGGNs who underwent surgical resection and were confirmed by histology from the First Affiliated Hospital of University of Science and Technology of China from August 2020 to December 2021. The patients were divided into the training set (n=338) and the validation set (n=145) according to 7:3 random assignment. According to the postoperative histology, they were divided into adenocarcinoma group and benign lesion group. The independent risk factors and models were analyzed by univariate analysis and multivariate Logistic regression. The receiver operator characteristic (ROC) curve was constructed to evaluate the model differentiation, and the calibration curve was used to evaluate the model consistency. The clinical application value of the decision curve analysis (DCA) evaluation model was drawn, and the validation set data was substituted for external verification.@*RESULTS@#Multivariate Logistic analysis screened out patients' age, vascular sign, lobular sign, nodule volume and mean-CT value as independent risk factors for SGGNs. Based on the results of multivariate analysis, Nomogram prediction model was constructed, and the area under ROC curve was 0.836 (95%CI: 0.794-0.879). The critical value corresponding to the maximum approximate entry index was 0.483. The sensitivity was 76.6%, and the specificity was 80.1%. The positive predictive value was 86.5%, and the negative predictive value was 68.7%. The benign and malignant risk of SGGNs predicted by the calibration curve was highly consistent with the actual occurrence risk after sampling 1,000 times using Bootstrap method. DCA showed that patients showed a positive net benefit when the predictive probability of the predicted model probability was 0.2 to 0.9.@*CONCLUSIONS@#Based on preoperative medical history and preoperative HRCT examination indicators, the benign and malignant risk prediction model of SGGNs was established to have good predictive efficacy and clinical application value. The visualization of Nomogram can help to screen out high-risk groups of SGGNs, providing support for clinical decision-making.

Value of CT texture analysis parameters in differential diagnosis of benign and malignant thyroid nodules in Hashimoto’s thyroiditis / 中华内分泌外科杂志

Objective:To study the value of CT texture analysis (CTTA) parameters in differential diagnosis of benign and malignant thyroid nodules in Hashimoto’s thyroiditis.Methods:From May. 2020 to Oct. 2021, 110 patients with thyroid nodules in the background of Hashimoto’s thyroiditis in the Radiology Department of Nanjing Integrated Hospital of Traditional Chinese and Western Medicine were selected, and CTTA was performed. CTTA parameters (entropy value, peak state and skewness) were counted. The pathological diagnosis results were taken as the "gold standard". Statistical pathological examination results were used to compare the general clinical characteristics and CTTA parameters of benign and malignant thyroid nodules. The receiver operating characteristic (ROC) was used to analyze the diagnostic value of CTTA parameters for thyroid nodules.Results:According to the clinicopathological examination, 43 of 110 patients with Hashimoto’s thyroiditis were malignant, accounting for 39.09%. Among them, 22 were papillary carcinoma, 13 were follicular carcinoma, 6 were medullary carcinoma, and 2 were malignant lymphoma; 67 cases were benign, accounting for 60.91%, including 32 nodular goiters, 20 Hashimoto’s nodules, 8 thyroid adenomas, and 7 focal inflammation. The levels of TSH, irregular shape, blurry border and calcification in patients with malignant thyroid nodules were higher than those in patients with benign thyroid nodules ( t/ χ2=13.167, 18.364, 20.180,17.621, P<0.001). In the background of Hashimoto’s thyroiditis, there was no significant difference in the peak and skewness of CTTA parameters between benign and malignant thyroid nodules ( t=1.633, 1.382, P=0.105, 0.170). The entropy value of patients with malignant thyroid nodules was higher than that of patients with benign thyroid nodules, and the difference was statistically significant ( t=9.862, P<0.001). ROC analysis showed that the cut-off value of entropy value for diagnosing benign and malignant thyroid nodules was 6.28, AUC value was 0.909, 95% CI was 0.839-0.955, sensitivity was 86.05% (37/43), and specificity was 88.06% (69/67) . Conclusion:CTTA parameters in Hashimoto’s thyroiditis patients with benign and malignant thyroid nodules are different, and CTTA parameters have certain diagnostic value for benign and malignant thyroid nodules.

Value of cell paraffin block immunohistochemistry and pleural effusion CRKL and MIC-1 in the diagnosis of malignant pleural effusion / 国际肿瘤学杂志

Objective:To study the value of cell paraffin block immunohistochemistry and pleural fluid Crk like protein (CRKL) and macrophage inhibitory cytokine-1 (MIC-1) in the diagnosis of malignant pleural effusion.Methods:A total of 98 patients with pleural effusion treated in Shantou Central Hospital from February 2020 to February 2021 were retrospectively selected as the research objects, including 58 benign cases and 40 malignant cases. The levels of CRKL and MIC-1 in pleural effusion were detected by enzyme-linked immunosorbent assay. The pleural effusion was analyzed by cell paraffin block immunohistochemistry. The levels of various indexes in benign group and malignant group were compared. The diagnostic value of cell paraffin block immunohistochemistry and pleural effusion CRKL and MIC-1 for benign and malignant pleural effusion was analyzed by receiver operating characteristic (ROC) curve.Results:With pathological results as the gold standard, 54 cases of benign and 44 cases of malignant were diagnosed by cell paraffin block immunohistochemistry. The diagnostic accuracy was 75.5% (74/98) , and the sensitivity and specificity were 75.0% (30/40) and 75.9% (44/58) respectively. The levels of pleural effusion CRKL [2.84 (2.17, 3.98) ng/ml vs. 1.88 (0.94, 2.62) ng/ml], MIC-1 [2.28 (1.67, 2.98) ng/ml vs. 1.76 (1.22, 2.32) ] ng/ml] in the malignant group were higher than those in the benign group, with statistically significant differences ( Z=-4.57, P<0.001; Z=-3.09, P<0.001) . The optimal critical value of CRKL in pleural effusion for the diagnosis of malignant pleural effusion was 2.33 ng/ml, the area under the curve (AUC) was 0.76 (95% CI: 0.66-0.85) , and the sensitivity and specificity were 67.5% (27 /40) , 74.1% (43/58) . The optimal critical value of MIC-1 in pleural effusion for the diagnosis of malignant pleural effusion was 2.10 ng/ml, the AUC was 0.74 (95% CI: 0.64-0.85) , and the sensitivity and specificity were 60.0% (24/40) , 82.8% (48/58) . The AUC of MIC-1 and CRKL in pleural effusion combined with cell paraffin block immunohistochemistry for the diagnosis of malignant pleural effusion was 0.83 (95% CI: 0.75-0.91) , and the sensitivity and specificity were 85.0% (34/40) and 70.7% (41/58) . The sensitivity and AUC of combined diagnosis were significantly higher than those of CRKL and MIC-1 alone (sensitivity: χ2=4.26, P=0.046; χ2=6.27, P=0.012; AUC: Z=3.53, P<0.001; Z=4.14, P<0.001) . Conclusion:CRKL and MIC-1 in pleural effusion of patients with malignant pleural effusion are highly expressed, which can be used as indicators for the diagnosis of malignant pleural effusion. Detection combined with cell paraffin block immunohistochemistry can improve the diagnostic value of malignant pleural effusion.

Establishment and verification of a mathematical prediction model for benignancy and malignancy in subsolid pulmonary nodules / 中国胸心血管外科临床杂志

@#Objective    To explore the independent risk factors for benign and malignant subsolid pulmonary nodules and establish a malignant probability prediction model. Methods    A retrospective analysis was performed in 443 patients with subsolid pulmonary nodules admitted to Subei People's Hospital of Jiangsu Province from 2014 to 2018 with definite pathological findings. The patients were randomly divided into a modeling group and a validation group. There were 296 patients in the modeling group, including 125 males and 171 females, with an average age of 55.9±11.1 years. There were 147 patients in the verification group, including 68 males and 79 females, with an average age of 56.9±11.6 years. Univariate and multivariate analysis was used to screen the independent risk factors for benign and malignant lesions of subsolid pulmonary nodules, and then a prediction model was established. Based on the validation data, the model of this study was compared and validated with Mayo, VA, Brock and PKUPH models. Results    Univariate and multivariate analysis showed that gender, consolidation/tumor ratio (CTR), boundary, spiculation, lobulation and carcinoembryonic antigen (CEA) were independent risk factors for the diagnosis of benign and malignant subsolid pulmonary nodules. The prediction model formula for malignant probability was: P=ex/(1+ex). X=0.018+(1.436× gender)+(2.068×CTR)+(−1.976×boundary)+ (2.082×spiculation)+(1.277×lobulation)+(2.296×CEA). In this study, the area under the curve was 0.856, the sensitivity was 81.6%, the specificity was 75.6%, the positive predictive value was 95.4%, and the negative predictive value was 39.8%. Compared with the traditional model, the predictive value of this model was significantly better than that of Mayo, VA, Brock and PKUPH models. Conclusion    Compared with Mayo, VA, Brock and PKUPH models, the predictive value of the model is more ideal and has greater clinical application value, which can be used for early screening of subsolid nodules.

Evaluation of Serum Prostate Specific Antigen in Benign and Malignant Enlargements of Prostate

Prostatic enlargement is a common cause of bladder outlet obstruction among men in India. The enlargement usually leads to lower urinary tract symptoms, irrespective of whether it is benign or malignant. Methods: Forty six patients attending surgical outpatient department of Hi-Tech Medical College, Rourkela with symptoms of bladder outflow obstruction and prostate enlargement were studied. Results: The maximum numbers of patient recruited in the study were in the age range of 56–65 years and 66–75 years, having 14 (30.4%) and 11 (23.9%) cases, respectively. Out of 31 cases which were categorized as malignant on the basis of the serum PSA levels, 27 were confirmed by histopathology & 4 cases which were diagnosed as malignant by serum PSA levels were confirmed as benign by histopathology. Categorization of the Prostatic lesions on the basis of the Sr P.S.A. levels, which were confirmed by CytoHPE the accuracy for BPH was 50% and 67.4 % for malignant lesions. Conclusion: Patients with symptomatic prostate enlargement, serum PSA should be seen as a continuum with increasing risk of prostate malignancy.

Pathologic basis and application progress of ultrasound elasticity imaging technique in differential diagnosis of benign and malignant breast lesions / 上海交通大学学报（医学版）

At present, breast cancer has become the most common female malignancy badly threatening health around the world, which suggests that early diagnosis and treatment are crucial. As a new ultrasound technique, ultrasonic elastography (UE) has developed rapidly and been applied widely. UE provides more significant information about tissue elasticity characteristics on the basis of B-mode ultrasound, and elasticity imagings show stiffness distribution of tissues directly. At the same time, tissue elasticity characteristics are closely associated with pathological component. Therefore, UE provides an important basis for clinical differential diagnosis of breast lesions. This paper reviews pathologic basis and application progress of UE in differential diagnosis of benign and malignant breast lesions.

Benign and malignant classification of renal occupancy lesions CT images using convolutional neural networks / 国际生物医学工程杂志

Objective To investigate the feasibility and application value of the benign and malignant classificational methods of renal occupying CT images based on convolutional neural networks (CNN). Methods An image omics method that can automatically learn the image features and classify CT images was used. Firstly, the CNN model obtained by large-scale natural image training was used to migrate the characteristics of the renal occupancy lesions CT images, and then the fine-tuning of the full connection layer was used to realize the benign and malignant classification of the images. Results The evaluation indexes of the VGG19 model were lower than ResNet50 and Inception V3, and the training result showed obvious overfitting. The accuracy, sensitivity and negative prediction values of the Inception V3 model was 93.8％, 99.5％ and 99.1％, respectively, which were higher than that of the ResNet50 model. Conclusions The benign and malignant classification of renal occupancy lesions CT images using CNN is a reasonable and feasible method, and the fine-tuned Inception V3 model has a better classification performance.

Clinical and pathological features of corneal neoplasm / 眼科新进展

Objective To analyze the clinical features and pathological classification of corneal neoplasms.Methods The clinical data of 135 patients (136 eyes) of corneal neoplasm between January 2002 and June 2016 in Tianjin Eye Hospital were reviewed retrospectively,and the pathological features were analyzed.Results Together 118 patients (87.41％) with benign neoplasms were found,including 100 patients with corneal dermoid neoplasms,8 patients with epithelium cell proliferation,6 patients with corneal nevus pigmentation,2 patients with squamous papilloma,1 patient with epithelial cyst,1 patient with proliferation of granulation tissue.And 17 patients (12.59％)with premalignant or malignant neoplasms were found,including 5 patients with actinic keratosis,5 patients with squamous cell carcinoma,4 patients with carcinoma in situ,3patients with atypical hyperplasia.In 5 cases of squamous cell carcinoma patients,there were 2 cases of patients with papillary squamous cell carcinoma and 3 with invasive squamous cell carcinoma.The incidence of benign corneal neoplasms was highest in patients aged 0 to 17 years,and the prevalence of precancerous lesions and malignancies was highest in patients over 60 years of age.Conclusion In patients with corneal neoplasm,corneal dermoid neoplasm is the most common benign tumor of the cornea,and actinic keratosis and squamous cell carcinoma are the most common corneal precancerous lesions and malignancies accordingly in our study.

The analysis of chest,abdominal and pelvic primary occupying lesions by whole-body PET-like imaging / 实用放射学杂志

Objective To study the application value of 1.5T MRI whole-body PET-like imaging in the chest,abdominal and pelvic primary occupying lesions.Methods Whole-body PET-like imaging were performed in 5 7 patients with chest,abdominal and pelvic primary occupying lesions.The detection rate of whole-body PET-like in chest,abdominal and pelvis primary occupying lesions were compared.Apparent diffusion coefficient (ADC)values for benign and malignant lesions were compared and analyzed.Results (1) All of 71 cases of chest,abdominal and pelvic primary occupying lesions,67 lesions (94.4%)were diagnosed by whole-body PET-like imaging. Among them,31(93.9%)of malignant lesions were detected and 36(94.7%)benign lesions were detected.There was not statistically significant of detection rate between benign and malignant lesions(P>0.05).(2)The range of ADC value:malignant tumor was (0.83-1.57)× 10-3mm2/s,among which 27 lesions ADC value less than 1.1×10-3mm2/s,accounting for 87.1%;The benign lesion was (1.41-3.16)× 10-3mm2/s,among which the total 32 lesion ADC values of liver cyst(13),hepatic hemangioma(9)and renal cyst(10)were greater than 2.0×10-3mm2/s,accounting for 88.9%.There was significantly different of ADC values between benign and malignant lesions (P<0.05).Conclusion There is higher detection rate on primary chest,abdominal and pelvic space occupying lesions for whole-body PET-like imaging,which is suitable for tumor screening in healthy population.It is helpful to differentiate benign and malignant tumors by quantitative analysis of ADC value.

Diagnosis of Bening and Malignant Breast Solid Lesions Using Shear Ware Elastography and Color Image Scoring / 昆明医科大学学报

Objective To investigate the value of color image scoring with shear wave elastography in the diagnosis of benign and malignant breast solid lesions.Methods From February 2016 to February 2017 , 125 patients with breast lesions were given shear wave elastography score, by type of image scoring method, image color method for differential diagnosis between benign and malignant lesions. Results Among all the 125 patients with breast solid lesions, 175 were solid lesions, of which 85 cases (119) were benign lesions, accounting for 68%, and 40 (56) were malignant lesions, accounting for 32%. The difference of type and color score between benign breast lesions and malignant lesions was statistically significant (P＜0.05) . A positive correlation was fourd between color image type score and color score of benign and malignant breast lesion,using shear wave elastography (P＜0.05) . The pathological findings were used as a gold standard, and the difference in the area under ROC curves of benign and malignant lesions of the breast was statistically significant by using type and color scoring method (P＜0.05) . Type scoring method and color scoring method have higher diagnostic efficacy when the diagnostic value is above 2 points. Conclusion The shear wave elastography color image scoring method is of high clinical value in the diagnosis of benign and malignant breast solid lesions, and it is of high accuracy for the diagnosis of benign breast solid lesions.

The correlation of pulmonary ground-glass opacity imaging features and benign,malignant lesions / 实用放射学杂志

Objective To analyze the imaging features of ground-glass opacity (GGO) and provide advice for early diagnosis and treatment of malignant lung lesions.Methods The imaging findings of 56 GGOs scanned by MSCT on thin layer scanning were analyzed by χ2 test.Multivariate Logistic regression analysis was performed of the statistically significant variables for univariate analysis.Results Smoothness of the boundary, uniformity of the internal density, and spiculated margin of the GGO lesions were closely related to the diagnosis of malignant lesions.However,size,shape and distribution of the lesions were limited.Conclusion The distribution of GGO(internal, middle and outer band), border, internal density and spiculation are playing important role in early diagnosis of benign and malignant GGO.

Clinical study on diagnosis value of serum and ascites tumor markers in benign and malignant ascites / 国际检验医学杂志

Objective To analyze the clinical value of serum and ascites tumor markers in the diagnosis of benign and malignant ascites ,and to provide reference for clinical diagnosis and treatment of ascites .Methods A total of 168 patients with ascites in Third Affiliated Hospital of Liaoning University of Chinese Medicine from November 2015 to June 2016 were selected .All patients were collected abdominal paracentesis ascites ,analysis of ascites tumor markers .Vein blood sample were collected ,centrifuged up-per serum and detected tumor markers including CA153 ,BXTM and CEA ,all patients underwent pathological test for diagnosis of benign and malignant ascites .The normal distribution method was used to determine the standard of judging malignant ascites and serum ,with the pathological diagnosis as the gold standard ,the four grid diagnosis table was used to calculate the sensitivity and specificity of different combination of ascites tumor markers and serum tumor markers in diagnosis of benign and malignant ascites . Results Among 168 cases ,56 cases were diagnosed with malignant ascites ,112 cases with benign ascites by pathological test .Com-bined detection results of three tumor markers in ascites :57 cases were malignant ,111 were benign .Combined detection results of three tumor markers in serum :64 cases were malignant ,104 cases were benign .The sensitivity and specificity of three tumor mark-ers in ascites were 85 .71% and 91 .96% respectively ,which were higher than 82 .41% and 83 .93% of the three tumor markers in serum .Conclusion The sensitivity and specificity of three tumor markers in ascites for diagnosis of benign and malignant ascites were superior ,which could be used as an important auxiliary means for diagnosis on the overall condition of patients with ascites , and provides an important reference for the subsequent selection other inspection methods .

Clinical study on diagnosis value of serum and ascites tumor markers in benign and malignant ascites / 国际检验医学杂志

Objective To analyze the clinical value of serum and ascites tumor markers in the diagnosis of benign and malignant ascites ,and to provide reference for clinical diagnosis and treatment of ascites .Methods A total of 168 patients with ascites in Third Affiliated Hospital of Liaoning University of Chinese Medicine from November 2015 to June 2016 were selected .All patients were collected abdominal paracentesis ascites ,analysis of ascites tumor markers .Vein blood sample were collected ,centrifuged up-per serum and detected tumor markers including CA153 ,BXTM and CEA ,all patients underwent pathological test for diagnosis of benign and malignant ascites .The normal distribution method was used to determine the standard of judging malignant ascites and serum ,with the pathological diagnosis as the gold standard ,the four grid diagnosis table was used to calculate the sensitivity and specificity of different combination of ascites tumor markers and serum tumor markers in diagnosis of benign and malignant ascites . Results Among 168 cases ,56 cases were diagnosed with malignant ascites ,112 cases with benign ascites by pathological test .Com-bined detection results of three tumor markers in ascites :57 cases were malignant ,111 were benign .Combined detection results of three tumor markers in serum :64 cases were malignant ,104 cases were benign .The sensitivity and specificity of three tumor mark-ers in ascites were 85 .71% and 91 .96% respectively ,which were higher than 82 .41% and 83 .93% of the three tumor markers in serum .Conclusion The sensitivity and specificity of three tumor markers in ascites for diagnosis of benign and malignant ascites were superior ,which could be used as an important auxiliary means for diagnosis on the overall condition of patients with ascites , and provides an important reference for the subsequent selection other inspection methods .

The research on MRI for differential diagnosis of benign and malignant lesions of SPN / 中国医学装备

Objective:To investigate the clinical value of magnetic resonance imaging (MRI) in differential diagnosis for benign and malignant lesions of solitary pulmonary nodules (SPN).Methods: 120 patients with SPN were enrolled in the retrospective analysis, and all of them underwent scan of MR including MRI, DCE-MR and diffusion weighted imaging (DWI) before their surgery. All of patients received detection of pathology or histopathological examination after their surgery, and the ADC values under different b values of dispersion sensitivity factor (300 s/mm2, 500 s/mm2 and 800 s/mm2) were compared.Results:Under the conditions both of 300 s/mm2 and 800 s/mm2, the differences of ADC value between benign nodule and malignant nodule were not statistically significant (t=1.195,P>0.05). And under the condition of 500 s/mm2, the ADC value of benign nodule was significantly higher than that of malignant nodule (t=4.313,P<0.05), and at this time, the sensitivity, specificity, rate of missed diagnosis and misdiagnosis rate of the differential diagnosis for benign and malignant lesions of SPN by using MR were 85.71％, 74％, 14.9％ and 26％, respectively.Conclusion: MR examination has higher sensitivity in differential diagnosis for benign and malignant lesions of SPN, and it has a certain clinical value when it is used as early detecting method.

Comparison of elasticity imaging and conventional ultrasound applied to diagnosis of benign and malignant breast tumors / 医疗卫生装备

Objective To compare elasticity imaging and conventional ultrasound when applied to the diagnosis of benign and malignant breast tumors.Methods Totally 124 breast tumor patients (140 lesions) from some hospital were analyzed retrospectively,who were divided into a control group and an observation group according to ultrasound examination ways.The control group involved in 60 patients with 66 lesions undergoing conventional ultrasound examination,and the observation group had 64 patients with 74 lesions undergoing elasticity imaging.Pathological findings were considered as gold standard,and the two groups were compared on accuracy,specificity and sensitivity.Results Pathological detection found the accuracy,specificity and sensitivity of the malignant tumor in the control group were 85.00％,84.78％ and 84.85％ respectively,and the ones of the malignant tumor in the observation group were 95.83％,96.00％ and 95.95％ respectively.The two groups had significant differences between the accuracies,specificities and sensitivities (P＜0.05).Conclusion Elasticity imaging describes the size,shape,number,margin and etc of the breast tumor,and thus can enhance the accuracy,specificity and sensitivity for diagnosing breast tumors.

Diagnostic Value of Contrast-enhanced Ultrasonography in Differentiating Benign and Malignant Tumor of Pelvic Cavity / 昆明医科大学学报

Objective To discuss the diagnostic value of contrast-enhanced ultrasonography in differentiating benign and malignant tumor of pelvic cavity.Methods From October 2014 to January 2016,abdominal ultrasonography or trans-vaginal ultrasonography were performed among outpatients and inpatients in the First Affiliated Hospital of Kunming Medical University.We found 62 cases with pelvic cavity tumors with 64 lumps,which were detected at cystic mass,cystic-solid mass,and solid mass in conventional ultrasonography.We made the diagnosis of all the lumps by performing contrast-enhanced ultrasonography,observing the infusion process and analyzing perfusion pattern,the intensity of perfusion and time intensity curve.By contrasting the diagnosis and the pathologic and long-term follow-up results,we classified the tumors into two groups,benign and malignant.Then we analyzed the time intensity curve and imaging parameters of the two groups.Restlts Among the total 64 lumps,43 was found in the group of benign tumor and 21 in the group of malignant tumor.Sixty-two were proved by pathologic results and 2 were proved by long-term follow-up results.Benign tumors showed that the infusion flowed from the peripheral to the center and enhanced equably and the vessels were regularly shaped.Malignant tumor showed that the infusion infiltrated from the center to the peripheral and enhanced quickly and unequally,and vessels were distorted.In the time intensity curve,group of benign tumors presented a gently slow raise and fall type,and group of malignant tumors showed a quickly raise and fall type.Rise time (RT) of malignant group (7.70 ± 2.56s) was shorter than benign group (11.40 ± 6.77s) (P＜0.05).Peak intensity (PI) of malignant group (16.30 ± 7.41dB) was higher than benign group (12.12 ± 6.70dB) (P＜0.05).Area Under the Curve (AUC) of malignant group (981.65 ± 548.04 dB s) was bigger than benign group (715.22 ± 651.04dB s) (P＜ 0.05).No difference was found between two groups in Time to Peak (TP) and Mean Transit Time (MTF) (P＞ 0.05).The sensitivity,specificity,positive and negative predictive value of contrast-enhanced ultrasonography were 95.2％,93.0％,86.9％,and 97.5％ respectively.Conclusion Contrast-enhanced ultrasonography ean show an eligible blood perfusion and vascularity of lumps.Analyzing perfusion pattern,time intensity curve,and other parameters can improve capacity of diagnosing and differentiating benign tumor and malignant tumor of pelvic cavity.

Research on clinical significance of meningioma diagnosis in radiological expression of CT and MRI / 中国医学装备

Objective:To study CT and MRI radiological expression of benign and malignant meningiomas to provide a reliable evidence for clinical surgery scheme determination. Methods: The radiological and pathological data of 40 cases with meningiomas undergoing surgery in hospital were analyzed, and the benign and malignant lesions of meningiomas were judged according to imaging features such as meningioma shape, edge, signal or density, peritumorous edema, intratumorous calcification, multiple tumors, tumor brain interface status etc.Results: (1)Tumor signal or density: T1 signal inhomogeneous in 6 cases(15.0%), T2 signal inhomogeneous in 8 cases(20.0%), the signal homogeneous in 26 cases (65.0%), CT density is inhomogeneous in 15 cases(37.5%), CT density is homogeneous in 25 cases(62.5%); (2)Tumor edge: regular in 27 cases(67.5%), coarse, irregular, lobulated, with mural nodules in 13 cases(32.5%); (3)Dural tail sign in 36 cases (90.0%); (4)Skull invasion in 6 cases(15.0%); (5)Calcification within the tumor in 7 cases(17.5%); (6)Peritumoral edema in 14 cases(35.0%); (7)Multiple tumors in 6 cases(15.0%); (8)Enhance performance: Obvious homogeneous enhancement in 27 cases(67.5%), Obvious inhomogeneous enhancement in 13 cases(32.5%).Conclusion: Benign and malignant meningiomas with a certain radiological feature, the curative effect and prognosis may be properly evaluated by the radiological expression of meningiomas.

The value of DCE-MRI quantitative parameters in the differential diagnosis of hepatocellular carcinoma from benign liver tumors / 实用放射学杂志

Objective To study the values of quantitative parameters of DCE-MRI in diagnosis of benign and malignant liver tumors and to explore its diagnostic efficacy.Methods Consecutive 25 patients with benign or malignant liver tumors underwent plain scanning and dynamic contrast-enhanced MRI,and total 28 lesions were confirmed by pathology or follow-up.The DCE-MRI quantitative parameters (Ktrans ,Kep ,Ve and iAUC)of the lesions and the surrounding normal liver tissue were acquired.The inde-pendent sample t test was used to compare the quantitative parameters between different tumors.The optimal parameters values of benign and malignant liver tumors were determined by plotting ROC curves.Results The mean quantitative parameters of HCC and benign lesions were larger than those of the surrounding normal liver tissue.Ktrans ,Kep and iAUC between HCC and surrounding nor-mal liver tissue had significant differences (P <0.05),Ktrans and iAUC between benign lesions and surrounding normal liver tissue had a significant difference (P <0.05).Ktrans ,Kep and iAUC between HCC and benign lesions had significant differences (P <0.05). The diagnostic effectiveness of Ktrans = 0.21 5 min-1 ,with sensitivity of 81.3% and specificity of 66.7%,was greater than that of Kep =0.477 and iAUC=24.706.Conclusion The DCE-MRI quantitative analysis can provide a reference for the differential diagnosis of HCC from benign liver tumors.

Research status and progressions of benign and malignant evaluation of solitary pulmonary nodule / 国际外科学杂志

Despite solitary pulmonary nodule (SPN) is a common medical problem in the clinic,the managements can be quite complex.The aetiological agent is largely unknown.Making a definitive diagnosis for SPNs before the operation has been a clinical challenge.A major problem for clinicians and radiologists were to identify the nature of benign and malignant SPNs at an early stage,and let the patients receive therapies timely and effectively.At present,many clinical features and detect methods of SPNs have been applied for differentiating the nodules,but these are not fully to distinguish it.Recently,some progressions had brought qualitative improvements to the diagnosis and treatment of SPNs.Therefore,in this paper,the research status and progresses of SPNs were reviewed.