Relationship between UE and CEUS indexes and the expression of invasion genes and proliferation genes in differentiated thyroid cancer tissue / 中华内分泌外科杂志

Objective:To study the diagnostic value of ultrasonic elastography (UE) CEUS in differentiated thyroid cancer (DTC) and its correlation with invasive gene and proliferative gene expression in DTC tissue.Methods:100 DTC patients who were treated in the Ultrasound Department of Zhuji People’s Hospital of Zhejiang Province from Jan. 2019 to Jan. 2022 were retrospectively selected and included in the TC group, and 100 thyroid adenoma patients who were treated during the same period were included in the thyroid adenoma group. UE and CEUS tests were performed on all patients, and the expression levels of proliferative and invasive genes in tumor tissues were measured. Time to peak (TTP) , average time of contrast medium passage (MTT) and peak intensity (PI) were recorded. DTC patients were divided into groups according to the blue area ratio, elastic ratio of lesions, optimal ROC truncation value of TTP, MTT and PI, that is, elastic value > 1.66, blue area ratio > 51.21%, PI≤17.11dB, MTT≤36.39s, TTP≤18.90s were group A, and vice president was Group B. SPSS 19.0 was used for data analysis, and P < 0.05 was considered to be statistically significant. Results:The blue area ratio and elastic ratio of lesions in TC group were higher than those in thyroid adenoma group ( P < 0.05) , while TTP, MTT and PI in TC group were lower than those in thyroid adenoma group ( P < 0.05) . There were statistically significant differences in blue area ratio, elastic ratio of lesions, TTP, MTT and PI among TC groups with different clinical stages, capsule invasion and lymph node metastasis ( P<0.05) . ROC curve was drawn. The AUC of DTC combined with blue area ratio, elastic ratio of lesions, TTP, MTT and PI was the highest, the specificity of combined detection was 86.37%, and the detection sensitivity was 80.16%. Compared with thyroid adenoma group, Xklp2 target protein (TPX2) , chemokine receptor 4, CXCR4) and polymetalloproteinase-9 (ADAM9) gene expression levels were higher, but TDCD4 gene expression levels were lower ( P<0.05) . The expression levels of TPX2, CXCR4 and ADAM9 genes in group A were higher than those in group B ( P<0.05) , and the programmed death factor 4 (PDCD4) gene in group A was lower than that in group B ( P<0.05) . According to Pearson linear analysis, the blue area ratio and elastic ratio of lesions were positively correlated with the expression levels of TPX2, ADAM9 and CXCR4 genes in DTC tissues, and inversely correlated with the expression levels of PDCD4 genes in DTC tissues ( P<0.05) . The expression levels of TPX2, ADAM9 and CXCR4 genes in TTP, MTT and PI were inversely proportional to the expression levels of PDCD4 genes in DTC patients ( P<0.05) . Conclusion:The combination of blue area ratio, elastic ratio of lesions, TTP, MTT and PI has good diagnostic value for DTC, and the blue area ratio, elastic ratio of lesions, TTP, MTT and PI are correlated with the expression levels of invasive genes and proliferating genes in tumor tissues.

Effect of the location and size of thyroid nodules on the diagnostic performance of ultrasound elastography: A retrospective analysis

OBJECTIVES: Ultrasound-guided fine-needle aspiration biopsies are recommended for the detection of suspicious thyroid nodules. However, the best approach regarding suspicious ultrasound features for thyroid nodules is still unclear. This study aimed to evaluate the effect of location and size of thyroid nodules on the diagnostic performance of strain ultrasound elastography. In addition, this study evaluated whether ultrasound elastography predicts malignancy in thyroid nodules. METHODS: Data regarding the size, depth, and distance from the carotid artery of nodules, the elasticity contrast index, and the nature of nodules were analyzed. RESULTS: There was no significant difference in the depth (p=0.092) and the distance from the carotid artery (p=0.061) between benign and suspicious nodules. Suspicious nodules were smaller than benign nodules (p<0.0001, q=23.84) and had a higher elasticity contrast index (p<0.0001, q=21.05). The depth of nodules and the size of the nodule were not associated with the correct value of the elasticity contrast index (p>0.05 for both). The diagnostic performance of ultrasound elastography was not affected by the distance of the nodules from the carotid artery if they were located ≥15 mm from the carotid artery (p=0.5960). However, if the suspicious nodules were located <15 mm from the carotid artery, the diagnostic accuracy was hampered (p=0.006). CONCLUSIONS: The strain ultrasound elastography should be carefully evaluated when small thyroid nodules are located near the carotid artery.

Use of strain ultrasound elastography versus fine-needle aspiration cytology for the differential diagnosis of thyroid nodules: a retrospective analysis

OBJECTIVE: Fine-needle aspiration cytology is the risk stratification tool for thyroid nodules, and ultrasound elastography is not routinely used for the differential diagnosis of thyroid cancer. The current study aimed to compare the diagnostic parameters of ultrasound elastography and fine-needle aspiration cytology, using surgical pathology as the reference standard. METHODS: In total, 205 patients with abnormal thyroid function test results underwent ultrasound-guided fine-needle aspiration cytology on the basis of the American College of Radiology Thyroid Imaging-Reporting and Data System classification and strain ultrasound elastography according to the ASTERIA criteria. Histopathological examination of the surgical specimens was performed according to the 2017 World Health Organization classification system. Moreover, a beneficial score analysis for each modality was conducted. RESULTS: Of 265 nodules, 212 measured ≥1 cm. The strain index value increased from benign to malignant nodules, and the presence of autoimmune thyroid diseases did not affect the results (p>0.05 for all categories). The sensitivities of histopathological examination, ultrasound elastography, and fine-needle aspiration cytology for detection of nodules measuring ≥1 cm were 1, 1, and 0.97, respectively. The working area for detecting nodule(s) in a single image was similar between strain ultrasound elastography and fine-needle aspiration cytology for highly and moderately suspicious nodules. However, for mildly suspicious, unsuspicious, and benign nodules, the working area for detecting nodule(s) in a single image was higher in strain ultrasound elastography than in fine-needle aspiration cytology. CONCLUSION: Strain ultrasound elastography for highly and moderately suspicious nodules facilitated the detection of mildly suspicious, unsuspicious, and benign nodules.

Application of Ultrasound Elastography in Quantitative Evaluation for Spasticity of Forearm Flexor Muscles after Stroke / 中国康复理论与实践

Objective:To apply the ultrasound elastography in quantitative evaluation for spasticity of forearm flexor muscles after stroke, and observe its characteristics. Methods:From January to October, 2019, 30 inpatients with stroke were recruited, followning spasticity of wrist and finger flexor muscles. They were measured the shear wave velocity (SWV) of flexor carpi ulnaris (FCU), flexor digitorum superficialis (FDS), flexor digitorum profundus (FDP) and flexor carpi radialis (FCR) with ultrasound elastography, and assessed the tension of wrist and finger flexors with modified Ashworth Scale (MAS). Results:The SWV of all the muscles were more in stretching position than in relaxation position in both sides (|Z| > 3.844， P < 0.001). The SWV of all the muscles were more in the affected side than in the unaffected side in stretching position (|Z| > 3.593， P < 0.001). The differences of SWV between stretching and relaxation were more in all the muscles in the affected side than in the unaffected side (t > 3.199, P < 0.01). The mean SWV of all the muscles significantly correlated with the MAS score of wrist (r = 0.605, P < 0.001), while the mean SWV of FDS and FDP correlated with the MAS score of finger (r = 0.540, P < 0.01). Conclusion:Ultrasound elastography is useful to quantitatively evaluate the spasticity of each muscle of forearm flexors after stroke.

Application of Ultrasound Shear Wave Elastography in Rehabilitaion Assessment of Triceps Surae and Achilles Tendon after Stroke / 中国康复理论与实践

Objective:To apply the ultrasonic shear wave elastography to evaluate triceps surae and Achilles tendon for patients with lower extremity dyskinesia after stroke. Methods:Thirty-two inpatients during 2018 and 2019 with unilateral lower extremity dyskinesia after stroke were studied with 2-D ultrasound and shear wave elastography on the bilateral triceps surae and Achilles tendons before and after rehabilitation. Shear wave velocity (SWV) of the triceps surae and the Achilles tendons, the length and thickness of Achilles tendon (soleus tendon) were measured. Results:Before rehabilitation, the SWV of the Achilles tendons and the triceps surae increased more in the affected side than in the unaffected side (t > 2.426, P < 0.05), as well as the length of the Achilles tendons (t = 11.801, P < 0.001). After rehabilitation, the SWV of the triceps surae decreased (t > 2.447, P < 0.05), as well as the length of the Achilles tendons (t = 8.577, P < 0.001). Conclusion:Ultrasound shear wave elastography can be used to evaluate the elastic characteristics of the Achilles tendon and the triceps surae, to guide the rehabilitation for stroke patients.

Research progress of new ultrasound technology for carotid atherosclerotic artery evaluation / 中国脑血管病杂志

Carotid atherosclerotic plaque is closely related to the occurrence of ischemic stroke and coronary artery disease. Studies have shown that the vulnerability of carotid atherosclerotic plaque is one of the main causes of cardiovascular and cerebrovascular diseases, and its vulnerability is closely associated with the core of lipid necrosis, thin fibrous cap, high levels of macrophages, and intraplaque hemorrhage. With the advantages of easy operation, low cost, high safety and time -saving, ultrasound is more suitable than other imaging methods to become the routine screening method for the vulnerability of carotid atherosclerotic plaque. The article mainly introduces several emerging ultrasound technologies and their convenience and effectiveness, which are expected to detect the vulnerability of carotid atherosclerotic plaques in clinical practice.

Diagnostic role of ultrasound elastography on lymph node metastases in patients with head and neck cancer / Papel diagnóstico da elastografia ultrassonográfica nas metástases de linfonodos em pacientes com câncer de cabeça e pescoço

Abstract Introduction: Ultrasonography is the easiest non-invasive method to diagnose lymph node metastases in patients with head and neck cancer. However, since CT scans are often preferred in the evaluation of primary tumours of these patients, information about lymphatic metastases may also available in these patients. Therefore, ultrasound is not routinely employed in the evaluation of these patients. However, elastography technique, a recent development in ultrasound technology, could make use of ultrasonography in these patients even more widespread, even though it is still not widely used today. Objectives: The aim of this study was to evaluate the role of sonographic elastography in the diagnosis of lymph node metastasis of head and neck cancer. Methods: Twenty-three patients diagnosed with head and neck cancer and scheduled for surgical treatment including neck dissection were included in the study. All patients underwent neck examination by palpation, ultrasound elastography and computerized tomography with contrast. To compare the diagnostic performance of palpation, ultrasound elastography and computerized tomography, the findings of each examination method were compared with the histopathological examination results of neck specimens. Results: 15 (65.2%) patients had a primary tumour in the larynx; 7 (30.4%) in the oral cavity; and 1 (4.3%) in the parotid. 7 (30.4%) out of 23 patients underwent bilateral neck dissection. In total, 30 neck dissections were hereby taken into account during study. Ultrasound elastography showed higher accuracy (83.3%) and higher sensitivity (82.4%) than palpation and computerized tomography, but the specificity of ultrasound elastography was lower (84.6%) than palpation and computerized tomography. Conclusions: Ultrasound elastography is helpful for the diagnosis of lymph node metastases in patients with head and neck cancer. Due to its non-invasive character, it can be used safety in combination with other radiological techniques to support or improve their diagnostic performance.

Resumo Introdução: A ultrassonografia é o método mais fácil e não invasivo para diagnosticar metástases em linfonodos em pacientes com câncer de cabeça e pescoço. No entanto, como as tomografias computadorizadas são frequentemente preferidas na avaliação de tumores primários desses pacientes, as informações sobre metástases linfáticas também se tornam disponíveis. Portanto, a ultrassonografia não faz parte da avaliação de rotina desses pacientes. Entretanto, a técnica de elastografia, um desenvolvimento mais recente na tecnologia de ultrassom, poderia tornar o uso da ultrassonografia mais difundido nesses pacientes, embora atualmente ainda não seja amplamente usado. Objetivo: Avaliar o papel da elastografia ultrassonográfica no diagnóstico de metástases em linfonodos em casos de câncer de cabeça e pescoço. Método: Foram incluídos no estudo 23 pacientes diagnosticados com câncer de cabeça e pescoço e com tratamento cirúrgico programado, inclusive esvaziamento cervical. Todos os pacientes foram submetidos a exame cervical por palpação, elastografia ultrassonográfica e tomografia computadorizada com contraste. Para comparar o desempenho diagnóstico da palpação, elastografia ultrassonográfica e tomografia computadorizada, os achados de cada método de exame foram comparados com os resultados do exame histopatológico de amostras obtidas do pescoço. Resultados: Dos pacientes, 15 (65,2%) apresentaram tumor primário na laringe; sete (30,4%) na cavidade oral; e um (4,3%) na parótida. Sete (30,4%) dos 23 pacientes foram submetidos a esvaziamento cervical bilateral. Foram considerados durante o estudo 30 pescoços. A elastografia ultrassonográfica mostrou maior acurácia (83,3%) e maior sensibilidade (82,4%) do que a palpação e a tomografia computadorizada, mas a especificidade da elastografia ultrassonográfica foi menor (84,6%) do que a palpação e a tomografia computadorizada. Conclusões: A elastografia ultrassonográfica é útil para o diagnóstico de metástases de linfonodos em pacientes com câncer de cabeça e pescoço. Graças ao seu caráter não invasivo, pode ser usada com segurança em combinação com outras técnicas radiológicas para apoiar ou melhorar o desempenho diagnóstico.

Elastography evaluation of normal thyroid gland and its comparison with diffuse non nodular enlarged thyroid gland using strain ultrasound elastography

Background: The thyroid gland is located in the anterior part of neck, spanning between C5 and T1 vertebra and is located anterior to the thyroid and cricoids cartilage of larynx and first three tracheal rings. Ultrasonography has been widely used for diagnosis of thyroid disease it is highly regarded for its ease of use, real-time capability, portability and low cost.Methods: The current observational study was conducted in Department of Radiology, Dr. BRAM Hospital, Pt. JNM Medical College, Raipur, India. Consecutive sampling method was used for the study. All the cases coming to radiology department during the study period were taken as study subjects.Results: Of the normal subjects, author found 107 normal thyroid subjects and 53 patients were categorized into cases with diffuse non-nodular thyroid swelling groups. Of the diffuse thyroid swelling group about 85% of the study population is between 20-50 years of age group, 13.2% were <20 years of age and one patient is >50 years of age. Females to male ratio for diffuse thyroid disease is 3.4:1.Conclusions: Ultrasound elastography (USE) is a newly developed non-invasive method to evaluate and compare the elasticity of the thyroid gland and other organs like liver, prostate, parotid, breast pathologies. Its use is based on the principle that pathological changes in a tissue also changes its elasticity.

Role Of Strain Elastography In The Characterization Of Benign And Malignant Nature Of The Thyroid Nodules.

Elastography is an imaging technique to measure the stiffness of tissues. Images are acquired before and after soft compression of tissues and the deformation is evaluated. Strain ratio -calculated as the ratio of stiffness between nodular tissue and surrounding normal thyroid tissue. With prior verbal and written consent patients were examined on gray-scale ultrasound on transverse images and then using elastographic ultrasonography technique. patients were followed up by fnac findings & postoperative histopathology report in cases of inconclusive FNAC reports. This is prospective study conducted on 200 subjects at Government Medical College, Department of RADIO-DIAGNOSIS, Nagpur from November 2016 to 2018. Regarding sonoelastograph, relation between elastograph scores and thyroid malignancies showing sensitivity, specificity and p value is calculated. The most accurate strain ratio cutoff value among studies calculated. RESULTS: Ultrasound Strain elastography is a promising imaging technique that is useful in the differentiating between benign and malignant thyroid nodules. Further improvements in the technique and the diagnostic criteria are necessary for this examination to provide a useful contribution to diagnosis. The use of Real Time ultrasound strain elastography would lead to low thyroid FNAC’s because of the high elasticity of being strongly associated with a benign cytology.

Could semiquantitative analysis of real-time ultrasound elastography distinguish more liver parenchyma alterations of nonalcoholic fatty liver disease in patients with polycystic ovary syndrome?

ABSTRACT Objective: Nonalcoholic fatty liver disease is the commonest diffuse liver disease, of which women with polycystic ovary syndrome are at an increased risk. The aim of the present study was to assess the diagnostic value of the semiquantitative strain parameters of real-time ultrasound elastography for nonalcoholic fatty liver disease in patients with polycystic ovary syndrome. Subjects and methods: Thirty-five polycystic ovary syndrome patients with nonalcoholic fatty liver disease, 70 polycystic ovary syndrome patients without nonalcoholic fatty liver disease, and 70 healthy female controls of reproductive age were included. All participants underwent ultrasonic examination and semiquantitative analysis of real-time ultrasound elastography of the liver. Results: Main semi quantitative strain parameters, such as average strain value, differed significantly among groups polycystic ovary syndrome with nonalcoholic fatty liver disease, polycystic ovary syndrome without nonalcoholic fatty liver disease, and control (87.02 ± 10.16 vs. 96.31 ± 11.44 vs. 104.49 ± 7.28, p < 0.001). Clinical and laboratory parameters differed significantly between the two subgroups with low or high average strain value. For diagnostic value of average strain value for elevated aminotransferase, the area under the curve was 0.808 (range 0.721-0.895). In multiple linear regression analysis, polycystic ovary syndrome, waist circumference, and metabolic syndrome were stand-alone independent factors associated with average strain value among subjects without nonalcoholic fatty liver disease. Conclusion: Semiquantitative real-time ultrasound elastography analysis could distinguish liver parenchyma alterations in patients with polycystic ovary syndrome more sensitively. The diagnostic value of the proposed method for nonalcoholic fatty liver disease need further research.

Inter-platform reproducibility of liver stiffness measured with two different point shear wave elastography techniques and 2-dimensional shear wave elastography using the comb-push technique

PURPOSE: The purpose of this study was to compare the technical success rate and reliability of measurements made using three shear wave elastography (SWE) techniques and to assess the inter-platform reproducibility of the resultant liver stiffness measurements. METHODS: This prospective study included 54 patients with liver disease. Liver stiffness (LS) measurements were obtained using 2-point SWE techniques (Virtual Touch Quantification and S-Shearwave) and 2-dimensional (2D) SWE, with transient elastography (TE) serving as the reference standard. The technical success rates and measurement reliability of the three techniques were compared. LS values measured using the three SWE techniques and TE were compared using Spearman correlation coefficients and 95% Bland-Altman limits of agreement. Intra-class correlation coefficients (ICC) were used to analyze the inter-platform reproducibility of LS measurements. RESULTS: The three SWE techniques and TE showed similar technical success rates (P=0.682) but demonstrated significant differences in the reliability of LS measurements (P=0.006) and mean LS measurements (P<0.001). Despite strong correlations (r=0.73-0.94) between SWE systems, various degrees of inter-platform reproducibility (ICC, 0.58-0.92) were observed for the three SWE techniques. The best agreement was observed between S-Shearwave and TE (ICC, 0.92), and the worst agreement was observed between 2D-SWE and TE (ICC, 0.58). In the Bland-Altman analysis, a tendency toward lower LS values with the three SWE techniques than with TE in patients with F3 and F4 disease was observed. CONCLUSION: Significant inter-system variability was observed in LS measurements made using the three SWE techniques. Therefore, LS values measured using different SWE techniques should not be used interchangeably for longitudinal follow-up.

Semi-quantitative strain elastography may facilitate pre-surgical prediction of mandibular lymph nodes malignancy in dogs

Evaluation of mandibular lymph nodes in a patient with head and neck cancer is important for stage determination and prognosis development, and, in human medicine, the use of sonoelastography for differentiating between non-metastatic and metastatic lymph nodes has been reported. Our prospective, cross-sectional study aimed to evaluate the diagnostic performance of strain elastography and to determine elastographic cut-off values for predicting malignancy. Sixty-six mandibular lymph nodes were included (clinical healthy, n = 45; non-metastatic, n = 8; and metastatic, n = 13). Elastographic images were evaluated qualitatively (elastographic pattern) and semi-quantitatively (mean hue histogram and stiffness area ratios). Elastographic patterns were classified as grades 1 to 4, according to the percentage of high elasticity determined by visualization. The mean hue histogram was defined based on as the mean pixel color values within the lymph node. Stiffness area ratios were determined by computer program analysis of the stiff area. Among the criteria, receiver operating characteristic curve analyses revealed cut-off values for the prediction of malignancy of 92.26 for mean hue histogram (sensitivity: 100%, specificity: 92%), and 0.17 for stiffness area ratios (sensitivity: 86%, specificity of 100%). Reproducibility and repeatability were excellent. In conclusion, semi-quantitative evaluation via strain elastography holds potential for predicting lymph node malignancy.

The study of diffusion kurtosis imaging value for assessing liver fibrosis and comparison with ultrasound elastography / 中华放射学杂志

Objective To explore the efficacy difference of diffusion kurtosis imaging (DKI) and ultrasound elastography (UE) in the diagnosis of liver fibrosis. Methods Thirty-five patients whose serological examination showed hepatitis B or hepatitis C virus infection, disease course≥ 1 year, and finally liver biopsy confirmed pathological fibrosis grade in Tianjin Second People's Hospital from December 2015 to April 2017 were prospectively enrolled as patient group. During the same period, twenty healthy volunteers who matched the age, sex and BMI with patient group and showed normal liver function within the last month were enrolled as control group. All of the subjects underwent DKI experiment, and subjects in patient group underwent UE experiment in addition. Liver mean apparent diffusion (MD) and mean kurtosis (MK) were obtained in all subjects and liver stiffness measurement (LSM) was obtained in patient group. The patient group was staged for hepatic fibrosis based on liver biopsy results (S0 to S4). Differences in liver MD and MK values between control and patient groups were tested using independent sample t test (normal distribution) or Mann-Whitney U test (skewed distribution). Differences in liver MD, MK, and LSM between patients with different fibrosis stages were tested using One-way ANOVA (normal distribution) or Kruskal-Wallis test (skewed distribution). The correlation between liver MD, MK and LSM values with fibrosis stages were analyzed using Pearson correlation test. The diagnostic performance in staging fibrosis was analyzed using ROC analysis. Results Liver MD in patient group was lower than that in control group, and the difference was statistically significant (P<0.01). There was no significant difference in liver MK between the two groups (P>0.05). The AUC value for the diagnosis of liver fibrosis by MD was 0.950 (95％CI:0.855 to 0.990). Of the 35 patients, 15 were S1 (mild fibrosis), 13 were S2 (moderate fibrosis), 4 were S3, 3 were S4 (S3+S4 were severe fibrosis). The difference of MD and LSM between different stages of liver fibrosis was statistically significant (P<0.05), and there was no significant difference in MK (P>0.05). Liver fibrosis stages was highly correlated with MD (r=-0.757, P<0.01), and had no correlation with MK (r=-0.010, P=0.956), and moderately correlated with LSM (r=0.440, P<0.01). The AUC values of liver MD and LSM for characterization of ≥S2 stage liver fibrosis were 0.867 and 0.800, respectively, without statistically significant difference (P=0.486). The AUC values for characterization of≥S3 stage liver fibrosis were 0.918 and 0.653, respectively, with a statistically significant difference (P=0.032). Conclusion MD derived from DKI can be used for noninvasive assessment of liver fibrosis, and it is superior to LSM in distinguishing different fibrosis stages and detecting severe fibrosis.

Endobronchial ultrasound elastography in diagnosis of mediastinal lymph nodes / 中国内镜杂志

Objective To evaluate the value of endobronchial ultrasound elastography in diagnosis of mediastinal lymph nodes by measuring the parameters of endobronchial ultrasound elastography. Methods Between 2016 and 2017, 46 patients with 63 lesions underwent EBUS-TBNA examination were included. Conventional ultrasound and ultrasound elastography were performed respectively to examine 63 lymph nodes before aspiration. Then various features of conventional ultrasound and parameters of ultrasound elastography were analyzed and recorded. Then evaluate the value of ultrasound elastography by pathological results and three-month follow-up data. Result The diagnostic value of ultrasound elastography image type, elasticity score, strain ratio and blue area ratio for malignant lymph nodes were higher than that of conventional ultrasound features in accuracy, sensitivity and specificity (P < 0.05); The accuracy of the boundary was the highest in the diagnosis of malignant lymph nodes. In the ultrasound elastography parameters, the accuracy of the elasticity score was the highest, and the blue area ratio had the largest area under the curve. When the boundary was used as the joint index to judge malignant lymph nodes with elasticity score and area ratio respectively, significantly higher than the diagnostic accuracy of conventional ultrasound and ultrasound elastography alone (P < 0.05). Conclusion The value of ultrasound elastography parameter in mediastinal lymph nodes diagnosis is higher than the conventional ultrasound features and a combination of both applications can improve discrimination accuracy of benign and malignant lymph nodes.

Predictive value of quantitative regression model based on ultrasound elastography in neoadjuvant chemo-therapy for breast cancer / 实用医学杂志

Objective To construct a model to predict the clinical efficacy of neoadjuvant chemotherapy for breast cancer based on ultrasound elastography,and to investigate the value of the model. Methods A total of 102 patients with breast cancer treated with surgery after neoadjuvant chemotherapy were enrolled. According to Miller&Payne classification,they were divided into effective group and ineffective group. Ultrasound elastography was performed before the chemotherapy,2 cycles after the chemotherapy,and at the end of the chemotherapy, then the predictive model of the curative effect was established and verified. Results The chemotherapy was effec-tive in 82 cases out of the 102 patients. After 2 cycles of the chemotherapy,the maximum tumor diameter,systolic peak velocity in tumor(PSV),arterial resistance index in RI(RI),and lesion side shear wave velocity to contra-lateral side shear wave velocity ratio(SWVr)of the effective group were significantly less than those of ineffective group(P<0.05). PSV and SWVr after 2 cycles of the chemotherapy were independent predictors of the prognosis in patients(P<0.05). The area under the ROC curve for predicting the efficacy by the regression model made by PSV and SWVr after 2 cycles of the chemotherapy was 0.913. Conclusion PSV and SWVr after 2 cycles of the chemotherapy can predict the efficacy of neoadjuvant chemotherapy in patients with breast cancer.

Intra- and Inter-rater Reliability of Shear Wave Elastic Imaging Technique for Elastic Modulus Measurements of Muscle and Tendon / 中国康复理论与实践

@#Objective To explore the intra- and inter-rater reliability of shear wave elastography (SWE) for the patellar tendon and quadriceps femoris stiffness.Methods From October to November, 2017, the stiffness of the patellar tendon and quadriceps femoris of 20 healthy men was measured by SWE, and measured again five days later. The results were evaluated with interclass correlation coefficient (ICC).Results For patellar tendon, ICC=0.79 in intra-rater and inter-rater; for rectus femoris, ICC=0.71 in intra-rater and 0.73 in inter-rater; for vastus lateralis muscle, ICC=0.84 in intra-rater and 0.74 in inter-rater; for vastus medialis,ICC=0.95 in intra-rater and 0.94 in inter-rater.Conclusion It is a reliable and repeatable method to measure the stiffness of patellar tendon and quadriceps femoris by SWE.

Effects of Inner Heating Dry Needle Therapy on Nonspecific Chronic Neck Pain: A Ultrasound Elastography Study / 中国康复理论与实践

@#Objective To explore the clinical effect of inner heating dry needle therapy on nonspecific chronic neck pain (NCNP). Methods From October, 2017 to March, 2018, 60 patients with NCNP were randomly divided into needle group (n=30) and magner group (n=30). The needle group received inner heating dry needle therapy, and the magner group received hot magner therapy. They were measured the strain ratio (SR) of bilateral trapezius muscles, scalp clamp muscles, cephalospinal muscles, semispinalis muscles and multifidus muscles with ultrasound elastography before, and one week and one month after treatment, respectively, while they were assessed with Visual Analogue Scale (VAS) of pain and Neck Disability Index (NDI). Results The scores of VAS and NDI decreased in both groups one week and one month after treatment (t>2.693, P<0.05), and decreased more in the needle group than in the magner group (F>8.048, P<0.001). SR of all the muscles decreased in the needle group one week and one month after treatment (F>6.22, P<0.01), and only decreased in the right cephalospinal muscles in the magner group (F=4.35, P<0.05).Conclusion Inner heating dry needle therapy could recover the neck muscle elasticity to relieve pain and improve ceivical function in patients with NCNP.

Advance in Ultrasound Elastography for Evaluation of Spasticity (review) / 中国康复理论与实践

@#Spasticity is one of common manifestations of upper motor neuron injury, and often evaluated with semi-quantitative scales. Ultrasound elastography (UE) can provide elastic information for muscle tissue, and can be used for the evaluation of muscle tension after cerebral palsy and stroke, as well as the efficacy of treatment. It correlates well with clinical spasm rating scales. However, UE may also be used for assessment of spasticity after spinal cord injury and multiple sclerosis, etc.

Effect of ultrasonic elastography combined with serum carbohydrate antigen 15-3, C keratin 19 fragment antigen 21-1 and prostate specific antigen levels detection on the sensitivity and accuracy of breast cancer diagonsis / 中国医师进修杂志

Objective To investigate the effect of ultrasound elastography combined with serum carbohydrate antigen 15-3(CA15-3 C), C keratin 19 fragment antigen 21-1(CYFRA21-1)and prostate specific antigen (PSA) levels detection on the sensitivity and accuracy of breast cancer diagnosis. Methods Sixty cases of breast cancer from December 2015 to January 2017 were selected as study group, and all cases were diagnosed as breast cancer by pathological examination.They were divided into groups according to the TNM classification criteria of breast cancer, stageⅠ22 cases, stageⅡ17 cases, stage Ⅲ14 cases, stageⅣ7 cases.Fifty-three cases of benign breast diseases were selected as control group. The levels of serum CA15-3, CYFRA21-1 and PSA were compared among two groups and the study group at different stages. The correlations between serums CA15-3, CYFRA21-1 and PSA expression level and breast cancer staging were analyzed. The results of pathological examination were regarded as "gold standard". Serum CA15-3, CYFRA21-1, PSA levels, single detection of ultrasound elastography and combined detection of breast cancer results were compared. Results The levels of serum CA15-3, CYFRA21-1 and PSA in study group were higher than those in control group:(37.98 ± 4.71)kU/L vs.(8.58 ± 3.04) kU/L,(5.41 ± 3.24)μg/L vs.(1.42 ± 0.47)μg/L,(0.39 ± 0.11)μg/L vs. (0.16 ± 0.04) μg/L, and there were significant differences (P<0.01). The levels of serum CA15-3, CYFRA21-1 and PSA in patients with stageⅢandⅣof breast cancer were higher than those of patients with stageⅠandⅡof breast cancer,and there were significant difference(P<0.01).Spearman correlation analysis showed that serum CA15-3, CYFRA21-1 expression levels and breast cancer staging was positively correlated (P < 0.05). There was a negative correlation between serum PSA expression and breast cancer staging(P<0.05).The sensitivity 98.33%(59/60), specificity 96.23%(51/53)and accuracy rate 97.35%(110/113) of breast cancer detected by serum CA15-3, CYFRA21-1, PSA levels and ultrasonic elastography was higher than that of single dectction, and the difference was statistically significant (P < 0.05). Conclusions The levels of serum CA15-3, CYFRA21-1 and PSA are closely related to the occurrence and progression of breast cancer.The combination of serum CA15-3, CYFRA21-1 and PSA levels with ultrasonic elastography can improve the specificity, sensitivity and accuracy of diagnosis of breast cancer.

Application value of ultrasound elasticity index ratio and elasticity index methods in differential diagnosis of benign and malignant thyroid nodules / 中华地方病学杂志

Objective To explore the application value of ultrasound elasticity index ratio and elasticity index methods in differential diagnosis of different sizes of benign and malignant thyroid nodules.Methods Clinical examination data of patients who were hospitalized for thyroid nodules were collected and were retrospectively analyzed in the Fourth Affiliated Hospital of Harbin Medical University from January 2015 to January 2016.The elasticity index ratio and elasticity index were used to diagnose benign and malignant thyroid nodules,and the results were compared with pathological diagnosis.The thyroid nodules were fell into three groups according to the maximum long diameter:＜ 1,1-2,and ＞ 2 cm.Using the above two methods,the sensitivity,specificity and accuracy were analyzed in benign and malignant thyroid nodules with different sizes.And the receiver operating characteristic curve (ROC) was drawn.Results A total of 90 patients (108 nodules) were enrolled in the study and they were from thyroid nodular surgery,28 male cases,62 female cases,mean age (44.1 ± 11.5) years,and ranged from 20 to 69 years old.Seventy benign nodules and 38 malignant nodules were diagnosed with pathology.Sixtythree benign nodules and 45 malignant nodules were diagnosed via the ultrasound elasticity index ratio method.Compared with the pathological diagnosis,13 were misdiagnosed and 6 were omission diagnosed in malignant thyroid nodules.Sixty-three benign nodules and 45 malignant nodules were diagnosed via the ultrasound elasticity index method.Compared with the pathological diagnosis,16 were misdiagnosed and 9 were omission diagnosed in malignant thyroid nodules.Sensitivities of elasticity index ratio method in ＜ 1,1-2,and ＞ 2 cm groups were 91.7％,86.0％,and 75.0％;specificities were 88.9％,78.6％,and 79.2％,and accuracies were 90.0％,81.0％,and 77.8％;and differences in sensitivity and accuracy of the two methods were statistically significant (x2 =76.4,70.8,P ＜ 0.05).Sensitivities of elasticity index method in ＜ 1,1-2,and ＞ 2 cm were 83.3％,78.6％,and 66.7％;specificities were 83.3％,75.0％,and 75.0％,and accuracies were 83.3％,76.0％,and 72.2％.Differences in sensitivity and accuracy of the two methods were statistically significant (x2 =82.8,74.5,P ＜ 0.05).The area under the ROC curve of elasticity index ratio and of elasticity index was 0.814 and 0.766,respectively,and the difference was statistically significant (Z =0.896.P ＜ 0.05).Conclusions In the differential diagnosis of different sizes of benign and malignant thyroid nodules,the elasticity index ratio method is better than the elasticity index method.The diagnostic value on ≤ 2 cm nodules is higher.