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Objective To analyze and compare the ultrasound elastography (UE) features of various types of cervical tuberculous lymphadenopathy (CTL), and to investigate the value and limitation of UE in diagnosis of CTL. Methods A total of 70 CTL patients confirmed by pathology or diagnostic treatment who were admitted to Shanghai Pulmonary Hospital affiliated to Tongji University from Jul. 2017 to Mar. 2018 were enrolled, and the images of conventional ultrasound and UE of the largest lymph nodes in each patient were retrospectively analyzed. According to the conventional ultrasound classification criteria of tuberculous lymphadenopathy, the lesions were divided into acute inflammatory type (type), caseous necrotic type (typeⅡ), cold abscess type (type III) and healing calcification type (type ). The elasticity score and strain ratio of various types of CTL lesions were summarized and compared. Results There were 24 (34.29%) typeCTL lesions, 28 (40.00%) typeⅡ, 12 (17.14%) type III, and 6 (8.57%) type . The hardness of CTL lesions of typeand typeⅡ was high, with the elastic score being 3-4 (47/52, 90.38%) and the strain ratio being 3-5; the hardness of type III was the lowest, with the elastic score being 1-2 (10/12, 83.33%) and the strain ratio2; the hardness of type was the highest, with the elastic score being 4-5 (6/6, 100.00%) and the strain ratio5. There were significant differences in elastic score and strain ratio among the four type CTL lesions (H＝30.756, F＝23.177; both P0.001). Pairwise comparison showed that except for the differences between typeand typeⅡ lesions, there were significant differences in elastic scores and strain ratios between the four type CTL lesions (P0.05). Conclusion The value of UE in the diagnosis of CTL is limited. It may play some roles in determining whether there is an obvious granuloma formation in typelesions and the tension of type III lesions.
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Objective To explore the role of real-time ultrasound elastography (RUE) in the staging of rectal cancer.Methods We retrospectively analyzed 41 cases of rectal cancer by both double plane transrectal conventional ultrasonography (CU) and RUE and comparatively assessed elasticity scores and strain ratios (SR) of the tumor along with postoperative pathological staging results.Results The accuracy of CU for preoperative staging of rectal tumors was 80.49％.There were significant differences between the elasticity scores and strain ratios of the T1 stage and T2,T3,and T4 stages,and also in elasticity scores and strain ratios of the T4 stage and T2 and T3 stages of rectal cancer by using RUE (P ＜ 0.05).Taking the elasticity score of 3 points as the optimal ritical value in the diagnosis of the T1 stage of rectal cancer,the sensitivity,specificity,positive predictive value,and negative predictive value were 66.67％,96.88％,85.71％,and 91.18％ respectively.Condusion Endorectal RUE can assess the elastic stiffness of rectal cancer,and it helps in the preoperative staging of rectal cancer.
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Objective To confirm whether strain ratio should be added after evaluation of lesions with 5-point elasticity scoring for differentiating breast lesions on ultrasonic elastography(UE).Methods Eight hundred and forty-six consecutive female patients with 1 071 breast lesions were recruited into a multicenter retrospective study,which involved 8 centers across China.All the patients underwent the UE procedure and the strain ratios were calculated.The sensitivity,specificity,accuracy,PPV and NPV were calculated for each of the two evaluation systems and the areas under the ROC curve were compared.Results The strain ratios of 559 benign lesions(2.7±1.4)and 512 malignant lesions(8.1±5.9)were significantly different (P<0.001).When the cutoff point was 3.03,strain ratio method had 81.6% sensitivity,89.7% specificity,81.7% accuracy,80.2% PPV and 84.2% NPV.The areas under the ROC curve with the strain ratio method and 5-point scoring method were 0.865 and 0.862,respectively(P =0.622).For the lesions with elasticity score 3 and 4,the areas under the ROC curve of the two Methods were 0.71 1 and 0.629, respectively(P = 0.020).Conclusions Although the two UE Methods have similar diagnostic performance,separate calculation of the strain ratios seems compulsory,especially for the lesions with elasticity score 3 and 4.