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Objective:To explore the applicational value of identifying different types of echogenic foci and distinguishing the lesions between benign and malignant lesions in histopathology classification.Methods:The detailed clinical data of 223 patients (264 thyroid nodules) with echogenic foci in preoperative ultrasound from October 2018 to December 2019 in the Sir Run Run Shaw Hospital of Zhejiang University School of Medicine were retrospectively analyzed. The echogenic foci were categorized as big comet-tail artifact, small comet-tail artifact, microcalcification, coarse calcification, peripheral calcification and eggshell calcification. At the same time, other ultrasonographic features were included in order to comparatively analyze with postoperative pathological findings. Independent samples t test and univariate chi-square test were performed to obtain meaningful information of sex, age, body mass index (BMI), thyroid stimulating hormone (TSH), serum free triiodothyronine (FT 3), serum free thyroxine (FT 4), aspect ratio, composition, margin, echo type, echogenic foci; Logistic regression analysis was performed to screen out the independent influence factors in order to forecast malignant lesions. Spearman correlation analysis was performed to determine the ralationships between the clinical indicators and the pathologic results of thyroid lesions. Results:Among the 264 lesions, there were 219(83.0%) malignant nodules and 45(17.0%) benign nodules. For malignant lesions, except for big comet-tail artifact, other types of echogenic foci were all founded, including 152(69.4%) microcalcification, 41(18.7%) small comet-tail artifact, 17(7.8%) coarse calcification, 7(3.2%) peripheral calcification, 2(0.9%) eggshell calcification. While in benign lesions, there were 13(28.9%) microcalcification, 9(20.0%) coarse calcification, 8(17.8%) peripheral calcification, 6(13.3%) small comet-tail artifact, 6(13.3%) big comet-tail artifact, 3(6.7%) eggshell calcification with all echogenic foci types included. Univariate analysis showed that differences between benign and malignant lesions regarding age, serum FT 4, aspect ratio, composition, margin, echo type, echogenic foci were statistically significant (all P<0.05), Logistic regression analysis indicated that age, serum FT 4, hypoechoic, solid, small comet-tail artifact and microcalcification were independent influence factors for malignancy( OR=0.946, 0.026, 47.656, 9.032, 7.925, 12.767; all P<0.05), age and serum FT 4 were correlated with the pathologic results of thyroid lesions ( rs=-0.259, -0.156; all P<0.05). Conclusions:It is highly suggestive of malignancy when the thyroid lesions are solid, hypoechoic, and echogenic foci type is small comet-tail artifact or microcalcification.
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Objective To investigate the differential diagnosis value of ultrasound elastography in Hashimoto's thyroiditis with benign and malignant nodules. Methods From January 2013 to December 2015, 21 patients (25 nodules) with Hashimoto's thyroiditis and malignant nodules and 52 patients(76 nodules) with benign nodules in Jiangshan Hospital of Traditional Chinese Medicine were studied. All nodules were detected by color Doppler ultrasound and ultrasound elastography. Results The proportion of boundaries clear,morphological rules,non-low-echo,no calcification or coarse calcifications,RI value <0. 70,blood flow grade 0 -Ⅰin patients with malignant nodules(32. 0％,24. 0％,12. 0％,40. 0％,32. 0％,24. 0％) were lower than those of the benign group(80. 3％, 51. 3％,47. 4％,97. 4％,60. 5％,51. 3％)(χ2 =20. 245,5. 682,9. 928,44. 228,6. 153,5. 682,P=0. 000,0. 017, 0. 002,0. 000,0. 013,0. 017). The sensitivity,specificity and diagnostic accuracy of two-dimensional color Doppler ultrasound in diagnosing Hashimoto's thyroiditis with malignant and benign nodules were 68. 0％, 75. 0％ and 73. 2％,respectively. The ultrasound elastography ≥Ⅲ grade level was as the predictor of malignant nodules, the sensitivity,specificity and diagnostic accuracy of ultrasound elastography in diagnosing Hashimoto's thyroiditis with benign and malignant nodules were 88. 0％,69. 7％ and 74. 3％,respectively. The ultrasound elastography strain rate ratio=5. 13 was the cut-off point,the ultrasound elastography strain rate ratio in diagnosing Hashimoto's thyroiditis with benign and malignant nodules,the sensitivity was 76. 0％,the specificity was 92. 1％,the diagnostic accuracy was 88. 1％. Conclusion Ultrasound elastography grading and ultrasound elastography strain rate have certain value in the differential diagnosis of Hashimoto's thyroiditis with malignant and benign nodule.
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Objective To evaluate the feasibility and efficacy of the ultrasonic technology,digital subtraction angiography(DSA) combined guide line of liver abscess drainage tube.Methods 70 patients with liver abscess received ultrasonic technology,DSA joint drainage tube after treatment.Using ultrasound technology and DSA of complementary advantages,enhancement in the operation was good,especially the liver abscess of abdominal pneumatosis was more and more room,enhancement effect was better than that of pure guided by ultrasound.Results 70 patients were all successful puncture and catheter,development was good,all 70 cases cured,without any serious complication.Conclusion Ultrasound technology,DSA joint guided puncture catheter drainage is a safe,minimally invasive treatment,has significant efficacy and important clinical value.
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Objective To explore the qualitative evaluation of contrast-enhanced ultrasound (CEUS) in the differential diagnosis between benign and malignant thyroid nodules (TNs).Methods Totally 110 outpatients with 132 TNs underwent CEUS were enrolled in this study in Jinling Hospitall Medical School of Nanjing University (Nanjing General Hospital of Nanjing Military).Nanjing General Hospital of Nanjing Military All the nodules underwent ultrasound guided fine needle aspiration biopsy (FNAB).113 TNs were histologically diagnosed,the characteristics of enhancement for each noudle were scored.The characteristicsof enhancement between benign and malignant TNs were compared by chi-square test.The receiver operating characteristic (ROC) curve analysis were conducted to determine the diagnostic values of thyroid CEUS.Results Contrast-enhanced patterns were significantly different between benign and malignant TNs in the degree,homogeneity of enhancement,enhanced ring and boundary,shape and size of the enhanced lesions (x2=23.85,P ＜ 0.001;x2=7.43,P=0.04;x2=34.54,P ＜ 0.001;x2=25.7,P ＜ 0.001;x2=53.10,P ＜ 0.001;x2=22.78,P ＜ 0.001;x2=30.90,P ＜ 0.001).Contrast-enhanced patterns were not significantly different between benign and malignant TNs in the process and completeness of enhancement.Malignant lesions had concentric (79.5％),inhomogeneous (89.0％) and low (71.1％) enhanced with irregular (79.5％) and unclear (64.4％) boundary and bigger size (63.0％).The typical CEUS feature of benign nodules was peripheral ring hyperenhancement (34.7％).According to ROC curve,the cut off value was 3.5 points.The area under the ROC curve (AUC) for CEUS was 0.862 (95％CI:0.797-0.927).The sensitivity,specificity and accuracy for CEUS were 80.8％,79.6％,80.3％ respectively.Conclusion The pattem of CEUS may assist in differential diagnosis of benign and malignant TNs.
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Objective To explore the effect of air pressure wave on the prevention of lower limb deep venous thrombosis in patients with cerebral stroke and the application value of color Doppler ultrasound (CDUS).Methods 72 stroke patients were randomly divided into experimental group (n =37) and control group (n =35) by random digits table.The control group received routine nursing,conventional and rehabilitation therapy.The experimental group was treated by the air pressure wave for 15 days on the basis of the control group.DVT formation of lower extremities and hemodynamic changes before and after treatment was observed by CDUS,and the results were compared with the X-ray phlebography examination results.Results CDUS displayed the incidence rate of DVT in the experimental group was significantly lower than that in the control group (2.7％ vs 20.0％,x2 =5.449,P ＜0.05).The changes of blood flow velocity and the average reflux time of femoral,popliteal vein in the experimental group had significant differences between before and after treatment (t =8.503,4.254,8.587,2.062,all P ＜ 0.05) ;and in the control group,only popliteal vein blood flow velocity had statistically significant difference (t =6.895,2.116,4.169,all P ＜ 0.05).Compared with the X-ray angiography,8 cases of DVT diagnosed by CDUS were consistent,but 1 case of DVT in the control group was missed diagnosis.Conclusion Air pressure wave can effectively reduce the occurrence of DVT in patients with cerebral stroke.CDUS can accurately diagnose the DVT formation,and can help to understand the hemodynamic change,it has important clinical value for monitoring the preventive effect of DVT.
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Objective To measure the parameters of ealeaneal quantitative ultrasound(QUS)in nomal Hubei Yichang subjects.which were compared between different age groups after standardization by body mass index(BMI).Methods Calcaneal parameters were measured by UBIS5000 in 2912 normal Hubei Yichang subjects,from 20 to 82 years old women 1450,men 1462).Results The peak values of broadband ultrasound attenuation(BUA)and stiffness(STI)of the calcaneal were both in 45-49 year group for women.The peak value of BUA was in 50-54 year group for men.Standardized by BMI,the peak value of BUA、STI and sound of speed(SOS)were both in 20-24 year groups for women and men.Conclusion BUA、SOS and STI of the calcaneal may change with age.After the influence of body mass is eliminated,the change still exists obviously,and the parameters may gradually reduce with increasing age.
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ObjectiveTo evaluate ultrasound diagnosis of occult inguinal hernia in children. MethodsThe contralateral site of 132 established unilateral inguinal hernia cases was checked by ultrasound and 33 outpatient suspected occult inguinal hernia cases underwent B-mode ultrasonography. [WT5”HZ]Results Occult inguinal hernia was diagnosed in 15 cases (11.4%) in the 132 children,and diagnosis of occult inguinal hernia was founded by ultrasound in 17 out of the 33 outpatient cases. No opposite inguinal hernia developed in the ultrasound negative 117 patients during follow up of 2 to 12 months,and hernia developed in one out of the 16 outpatient cases initially judged as negative by ultrasound. ConclusionUltrasonography is useful for the diagnosis of occult inguinal hernia in children.
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Objective To compare the effect of inhibiting neointimal hyperplasia between domestic sirolimus eluting stent(Firebird TM stent)and the TaxusTM stent by IVUS.Methods From May 2003 to June 2007,168 patients with 236 native lesions underwent DES implantation,of which,108 patients(147 lesions)were implanted with the FirebirdTM stents and the other 60 patients(89 lesions)were implanted with the TaxusTM stent.Quantitative angiography(QCA)and intravascular ultrasound(IVUS)analysis were performed at one-year follow-up.Results The baseline clinical and angiographic characteristics between the two groups were similar.There were less in-stent late loss(0.17?0.29 mm vs 0.43?0.51 mm,P0.05).But the Absolute and relative measwements of intimal hyperplasia including manifested as intimal hyperplasia area(0.35?0.58 mm2 vs 1.29?1.26 mm2),percentage of intimal hyperplasia area(5.45%?9.26% vs 17.38%?13.75%),percentage of maximal intimal hyperplasia area(9.41%?14.15% vs 31.56%?20.99%),intimal hyperplasia volume(2.09?5.46 mm3 vs 13.43?18.59 mm3)and percentage of intimal hyperplasia volume(1.68%?5.84% vs 8.62%?9.90%)were lower in the Firebird stent group than those in the Taxus stent group(all P