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Abstract Fetal thyroid complications in pregnancy are uncommon, and are commonly related to the passage of substances through the placenta. The excessive iodine intake during the pregnancy is a well-known mechanism of fetal thyroid enlargement or goiter, and invasive procedures have been proposed for the treatment of fetal thyroid pathologies. In the present report, we demonstrate two cases from different centers of prenatal diagnosis of fetal thyroid enlargement and/or goiter in three fetuses (one pair of twins, wherein both fetuses were affected, and one singleton pregnancy). The anamnesis revealed the ingestion of iodine by the patients, prescribed from inadequate vitamin supplementation. In both cases, the cessation of iodine supplement intake resulted in a marked reduction of the volume of the fetal thyroid glands, demonstrating that conservative treatmentmay be an option in those cases. Also, clinicians must be aware that patients may be exposed to harmful dosages or substances during pregnancy.
Resumo As complicações fetais da tireoide na gravidez são incomuns e são comumente relacionadas à passagem de substâncias pela placenta. A ingestão excessiva de iodo durante a gravidez é um mecanismo bem conhecido de aumento da tireoide ou bócio fetal, e procedimentos invasivos foram propostos para o tratamento de patologias da tireoide fetal. No presente relato de caso, demonstramos dois casos de diferentes centros de diagnóstico pré-natal de aumento da tireoide fetal e/ou bócio em três fetos (um par de gêmeos, em que ambos os fetos foram afetados, e uma gravidez única). A anamnese revelou a ingestão de iodo pelos pacientes prescrita por suplementação inadequada de vitaminas. Nos dois casos, a interrupção da ingestão de suplemento de iodo resultou em uma redução acentuada do volume das glândulas tireoides fetais, demonstrando que o tratamento conservador pode ser uma opção nestes casos. Além disso, os médicos devem estar cientes de que as pacientes podem ser expostas a doses ou substâncias nocivas durante a gravidez.
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Humans , Female , Pregnancy , Adult , Prenatal Care/methods , Dietary Supplements/adverse effects , Goiter/etiology , Iodine/adverse effects , Self Care/adverse effects , Magnetic Resonance Imaging , Ultrasonography, Prenatal , Imaging, Three-Dimensional , Diseases in Twins/etiology , Diseases in Twins/diagnostic imaging , Fetal Diseases/etiology , Fetal Diseases/diagnostic imaging , Goiter/diagnostic imaging , Iodine/administration & dosageABSTRACT
Objective:To explore the accuracy and clinical application value of a Multi-Agent Reinforcement Learning framework (MARL framework) in three-dimensional ultrasound to automatically locate the coronal plane of the uterus.Methods:A total of 144 female patients who underwent routine gynecological examinations in Luohu People′s Hospital during May 2020 were selected as the experimental subjects. The three-dimensional volume data of the uterus of all the experimental subjects were collected by using the Resona-8 high-end color Doppler ultrasound system. A sonographer with more than 5 years of clinical experience manually locate the coronal plane of the uterus in all collected data, and at the same time automatically locate the coronal plane of the uterus MARL framework. The coronal plane images of the uterus obtained by the two methods were saved, and the operation time of the two methods was recorded. The coronal plane uterine images obtained by the two methods were mixed together, and the images were scored 0-1 by two senior ultrasound experts in a double-blind manner. The average score greater than or equal to 0.6 points was considered qualified.Results:①In 144 volunteers, among the coronal planes of the uterus located by the two methods, 131 were qualified by the manual method, and 137 were qualified by the automatic method.There was no statistical difference between the manual and automatic coronal plane images of the uterus (χ 2=1.934, P=0.164) by the chi-square test. ②Using interquartile range analysis, the median and interquartile range of the image score of the automatic group was 0.80(0.75, 0.90), while the median and interquartile range of the image score of the manual group was 0.80(0.75, 0.90). The Wilcoxon signed rank test was used to analyze the quality of the coronal plane images obtained by manual and automatic methods, and the difference was not statistically significant ( Z=1.241, P=0.215). ③The paired t test was used to compare the time required to locate the coronal surface of the uterus, by manual method (63.65±10.182)s, by automatic method (3.25±0.294)s, the difference between the two methods was statistically significant ( t=19.52, P<0.001). Conclusions:The method based on MARL framework has a high correlation with the manual locating of the coronal plane of uterus in three-dimensional ultrasound, and greatly reduces the operation time. It can be effectively applied in clinical practice and lays a foundation for the automatic diagnosis of uterine related diseases.
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3D printing technology has achieved good results in the diagnosis and guidance of congenital heart disease(CHD). Computed tomography (CT) and magnetic resonance imaging (MRI) are used as data sources to establish a three-dimensional model of the heart, which has been used clinically.The use of non-invasive techniques such as three-dimensional ultrasound to obtain data sources for 3D printing models can bring about changes in the diagnosis and treatment of CHD.This paper reviews the research progress of 3D printing technology in CHD with CT, MRI and 3D ultrasound.
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Objective@#To evaluate the clinical value of three-dimensional ultrasound VOCAL technique in evaluating gastric emptying function in children with functional dyspepsia (FD).@*Methods@#Seventy-one children with FD who were treated in Wenzhou Integrated Traditional Chinese and Western Medicine Hospital Affiliated to Zhejiang University of Traditional Chinese Medicine from January 2018 to June 2018 were enrolled as the study subjects (observation group), and 71 normal children without FD were selected as controls (control group). The gastric emptying, antral pyloric systolic contraction frequency and distal gastric contraction movement in different time groups were analyzed, and GET1/2 and 2h gastric residual situation before and after treatment in the observation group were compared.@*Results@#The GET1/2 of the observation group was (60.2±12.69)min, and the gastric emptying rate of the observation group was (61.9±12.2)min and (72.0±12.3)min at 90min and 120min, which were significantly better than those of the control group, and the differences were statistically significant (t=19.092, 15.092, 14.882, P=0.016, 0.024, 0.033). The frequency of antral pyloric systolic contraction, gastric antrum contraction frequency and gastric antrum contraction amplitude were (1.1±0.7)times/min, (2.9±0.8)times/min, (1.0±0.6)cm, respectively.Compared with the control group, the differences were statistically significant (t=16.092, 21.224, 8.092, all P<0.05). In the observation group of 71 children: GET1/2 before treatment and after treatment were (68.1±11.8)min, (54.2±9.8)min, respectively.The gastric residual at 2h after treatment was (31.2±8.0)%, (22.1±7.0)%, respectively.The GET1/2 and 2h gastric residual rate of the children were significantly lower than before treatment, and the differences were statistically significant (t=18.983, 21.004, all P<0.05).@*Conclusion@#Three-dimensional ultrasound VOCAL technology can be used as an evaluation standard for FD in children.
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Transvaginal ultrasound is the preferred imaging method for the diagnosis of adenomyosis.The ultrasonographic features of adenomyosis are closely related to its histopathological features.The main sonographic features include spherical enlargement of uterus,asymmetric thickening of anterior and posterior walls,uneven echo of myometrium,linear streaks or island nodules under endometrium,unclear demarcation of endometrium-myometrium,thickening,irregular or interrupted junction zone(JZ),fence-like shadow,intramyometrial cysts,CDFI showing increased blood flow signals in the affected area of myometrium,translesional vascularity and so on.Advanced ultrasound technology,such as cline clips and three-dimensional ultrasound,can complement the shortcomings of conventional ultrasound and improve the diagnostic efficacy of ultrasound for adenomyosis.
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Objective To evaluate the clinical value of three-dimensional ultrasound VOCAL technique in evaluating gastric emptying function in children with functional dyspepsia ( FD).Methods Seventy-one children with FD who were treated in Wenzhou Integrated Traditional Chinese and Western Medicine Hospital Affiliated to Zhejiang University of Traditional Chinese Medicine from January 2018 to June 2018 were enrolled as the study subjects (observation group), and 71 normal children without FD were selected as controls ( control group). The gastric emptying,antral pyloric systolic contraction frequency and distal gastric contraction movement in different time groups were analyzed,and GET1/2 and 2h gastric residual situation before and after treatment in the observation group were compared.Results The GET1/2 of the observation group was (60.2 ± 12.69) min,and the gastric emptying rate of the observation group was (61.9 ± 12.2) min and (72.0 ± 12.3) min at 90min and 120min,which were significantly better than those of the control group, and the differences were statistically significant ( t =19.092, 15.092,14.882, P =0.016,0.024,0.033 ). The frequency of antral pyloric systolic contraction, gastric antrum contraction frequency and gastric antrum contraction amplitude were (1.1 ± 0.7)times/min,(2.9 ± 0.8)times/min, (1.0 ± 0.6) cm, respectively. Compared with the control group,the differences were statistically significant ( t =16.092,21.224,8.092,all P＜0.05).In the observation group of 71 children:GET1/2 before treatment and after treatment were (68.1 ± 11.8) min,(54.2 ± 9.8) min,respectively.The gastric residual at 2h after treatment was (31.2 ± 8.0)%, (22.1 ± 7.0)%, respectively. The GET1/2 and 2h gastric residual rate of the children were significantly lower than before treatment,and the differences were statistically significant (t=18.983,21.004,all P＜0.05).Conclusion Three-dimensional ultrasound VOCAL technology can be used as an evaluation standard for FD in children.
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Objective An improved method for obtaining pseudo-computed tomography (CT ps) based on ultrasound deformation field.Methods The three-dimensional image data of computed tomography and ultrasound for three postoperative cervical cancer patients were selected,including the CT (CTsim) and ultrasound (USsim) images obtained during the simulated positioning stage,and the cone beam CT (CBCT) and ultrasound images obtained during the positioning verification stage of the treatment one week later.Binary masks of the OROI and OROW were created and applied in ultrasound image registration;thus,the deformation field was obtained.The deformation field was applied to CTsim images and different pseudo-CT images were obtained.Similarities between these pseudo-CT images and those of CBCT were compared,and registration accuracies between pseudo-CT images under different binary masks and CTsim were discussed.Results The averages of the correlation coefficient between pseudo-CT based on OROI,OROW,no binary mask and CBCT were 0.95,0.82 and 0.64 respectively.The average of the normalized mean square Error were 0.12,0.42 and 0.57 respectively.Conclusion The pseudo-CT based on OROI binary mask matches the best with CTsim and achieves the highest similarity with CBCT.
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Objective To evaluate and compare the consistency and repeatability of three-dimensional ultrasound (3D-US) virtual organ computer-aided analysis (VOCAL) technique and two-dimensional ultrasound (2D-US) in the measurement of thyroid volume.Methods The thyroid volume of 50 healthy female adults aged 18 to 68 years were measured by 2D-US and 3D-US.The 2D-US was used to measure the three diameter lines (L,H,W) of the largest thyroid section,and the thyroid volume was calculated by the classical ellipsoid formula V=0.523×L×H×W.The 3D-US VOCAL technique was used to acquire the thyroid three-dimensional data,and VOCAL software was used to measure the thyroid volume.The two methods of measurement were also compared and analyzed.Results The coefficient of variation in the intra-assay was 0.738％ and 1.59％ respectively for the 3D-US VOCAL technology and traditional 2D-US measurement of thyroid volume,and the 95％ limit of agreement in the intra-assay was (-0.26 cm3,0.22 cm3) and (-0.32 cm3,0.46 cm3).In addition,the correlation coefficient in the inter-assay were 0.970xx and 0.942xx,and the 95％ limit of agreement were (-0.36 cm3,0.37 cm3) and (-0.75 cm3,0.64 cm3).To compare the two methods of measuring thyroid volume,the 3D-US VOCAL had a lower variation coefficient in the intra-assay,a higher correlation coefficient in the inter-assay and a narrower 95％ limit of agreement,which showed that the repeatability of the 3D-US VOCAL technique measuring was better than the traditional 2D-US in measuring thyroid volume.Conclusions The 3D-US VOCAL technique shows a higher repeatability in measuring thyroid than traditional 2D-US.As a safe,simple and feasible precise measurement method,it provides a reliable and effective new method for clinical measurement of irregular organ volume.
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Objective To investigate the effect of different delivery methods on the levator ani muscle of the pelvic floor by transperineal three-dimensional ultrasound and TUI imaging. Methods 200 cases of pregnant women from August2014 to August 2016 in our hospital were divided into selective cesarean section group (n = 85) and vaginal delivery group (n= 115). The vaginal group, according to the intraoperative lateral segmentation, was further divided into vaginal lateral incision group (n = 65) and vaginal delivery without lateral incision group (n = 50). At the same time, select 80 cases of nulliparous women (volunteers) as control group, relevant indicators by three-dimensional imaging and TUI imaging technique. Results The vaginal delivery without lateral incision group, lateral incision group vaginal delivery and cesarean section group levator hiatus diameter, anteroposterior diameter, perimeter and area were significantly higher than the control group(P＜0.05), and vaginal delivery side cut was significantly higher than the other three groups (P＜0.05), vaginal delivery in two sub-group and cesarean section group of levator ani muscle thickness were significantly lower than the control group(P＜0.05), vaginal delivery in two sub groups were significantly lower than that in the cesarean section group (P＜0. 05); vaginal delivery group of levator ani muscle injury rate was significantly higher than that in the cesarean section group (P＜0. 05); There was no significant difference in the rate of levator ani muscle injury in vaginal delivery group (P＞0.05). Conclusion Compared with cesarean section, vaginal delivery is more obvious in changing the morphology and integrity of levator ani muscle, and vaginal delivery is more obvious than that of vaginal incision.
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Objective To investigate the value of three-dimension (3D) ultrasound in identification of benign or malignant gastric ulceration. Methods A total of 88 patients with gastric ulcer were collected in Tianjin Nankai Hospital from March 2014 to May 2015, including 36 malignant cases and 52 benign cases confirmed by pathological results. Results of 2D ultrasound, 3D ultrasound and gastroscope diagnosis were compared, and the diagnostic values of the three methods were evaluated by the gold standard of pathologic results. Receiver operating characteristic (ROC) curves were plotted for the main measurement indicators (ulcer surface width, ulcer surface depth and thickness of stomach wall) of 3D ultrasound. The best cut-off value was determined. Results The positive rate of malignant gastric ulcer diagnosed by 3D ultrasound was significantly higher than that of 2D ultrasound (P=0.002), but there was no significant difference between 3D ultrasound and gastroscope detection (P=0.453). The diagnostic sensitivities of malignant gastric ulcer were 86.11%, 58.33%and 91.67%for 3D ultrasound, 2D ultrasound and gastroscope detection respectively. The diagnostic specificities were 100%, 100%and 96.15% respectively. The areas under the ROC curves measured by 3D ultrasound were 0.750, 0.940 and 0.977 for ulcer surface width, ulcer surface depth and thickness of stomach wall. And the best cut-off values of the three indicators were 16.55 mm, 8.05 mm and 9.90 mm. Conclusion The 3D ultrasound can show the form and structure of gastric ulcer more clearly and intuitively, which is valuable for the differential diagnosis of benign gastric ulcer and malignant gastric ulcer, and may be used for screening malignant gastric ulcer.
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[Objective] To evaluate the value of cardiac screening in the first trimester by using three-dimensional ultrasound with spatiotemporal image correlation (STIC) and to analyze the value of different views for cardiac assessment.[Methods] This study retrospectively reviewed the eighty-seven fetuses with congenital heart diseases which were diagnosed in our institution between January 4th 2013 and June 30th 2016.We compared the detection rate of prenatal ultrasound screening with STIC in the first trimester and the results of postnatal echocardiography or autopsy.In addition,the detection rates of the different planes,including four-chamber view (4CV),outlet of the left ventricle (OLV),outlet of the right ventricle (ORV) and three vessels-trachea view (3VT) were analyzed.[Results] Severe cardiac anomalies were identified in 62 fetuses (71.3％) and non-severe cardiac anomalies were identified in 25 fetuses (28.7％).Seventy-eight cases (89.7％,78/87) with congenital heart diseases could be detected by using three-dimensional ultrasound with STIC.The detection ratesfor 4CV,4CV+OLV,4CV+ORV,4CV+3VT,4CV+OLV+ORV and 4CV+OLV+ORV+3VT were 48.3％,64.4％,66.7％,79.3％,69.0％ and 89.7％ respectively.[Conclusions] Three-dimensional ultrasound with STIC could detect congenital heart disease in the first trinester.The four-chamber view plus outlet of the left ventricle,outlet of the right ventricle and three vessels-trachea view could increase the detection rates of congenital heart diseases.
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Objective To discuss the diagnostic value of 3D-ultrasound for cord entanglement in monoam-niotic twins. Methods From November 2013 to March 2016,a total of 65 monoamniotic twinsunderwent routine obstetric ultrasonography to screen fetal abnormalities in our hospital. The cord was meticulously observedusing a systematic continuous sequence approach. Fetuses who showed cord entanglement by 2-D ultrasound or 3-D flow Doppler were all recruited. The gestational weeks,fetal malformation,ultrasonic image feature of cord entangle-ment,and clinicaloutcome were recorded and analyzed retrospectively. Results 4 monoamniotic twins showed cord entanglement. Three-dimensional color Doppler clearly delineated thefeatures of entanglement. At following-up of 8 fetuses,3 fetuses were found intrauterine fetal death and 3 fetuses with structural abnormalities except for 2 well infants.Conclusion Cord entanglement may threaten the safety of fetusesin monoamniotic pregnancies.In aid of 2-D ultrasound or 3-D flow Doppler in monoamniotic twins can help to find it in time ,monitor it carefully and provide evidence for obstetric treatment .
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Objective To analyze the diagnostic value of transvaginal three-dimensional ultrasound in intrauterine adhesion.Methods The data in 75 patients with intrauterine adhesion confirmed by hysteroscopy surgery and conducting transvaginal twodimensional and three-dimensional ultrasound examination in this hospital from November 2014 to November 2016 were retrospectively analyzed.Results The diagnostic accuracy rate of the three-dimensional transvaginal ultrasound for diagnosing intrauterine adhesion reached 87.7 ％,which of two-dimensional ultrasound reached 69.2 ％;the accuracy rates of transvaginal two-dimensional ultrasound for detecting mild,middle and severe intrauterine adhesion were 56.7％,76.9％ and 88.9％ respectively,while which of transvaginal three-dimensional ultrasound were 76.7 ％,96.2 ％ and 100.0 ％ respectively;the accuracy rates of transvaginal two-dimensional ultrasound for detecting peripheral,central and mixed intrauterine adhesion were 66.7％,76.7％ and 54.5％ respectively,while which of transvaginal three-dimensional ultrasound were 83.3％,88.7％ and 100.0％ respectively;the accuracy rate of three-dimensional transvaginal ultrasound was significantly superior to that of transvaginal two-dimensional ultrasound,the difference was statistically significant (P＜0.05).Conclusion Compared with transvaginal two-dimensional ultrasound,transvaginal three-dimensional ultrasound is more accuracy in diagnosing intrauterine adhesion and can provide more information for clinical doctors.
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Objective To evaluate the value of transvaginal two-dimensional and three-dimensional ultrasound in diagnosis of cesarean scar pregnancy (incision area pregnancy ) after cesarean section .Methods Thirty cases of cesarean incision pregnancy at lower section of uterine anterior wall diagnosed by transvaginal two-dimensional ultrasound during 2015-2016 were retrospectively analyzed .On this basis ,all cases conducted transvaginal three-dimensional ultrasound and were verified by magnetic resonance(MR) examination .Then the values of transvaginal two-dimensional and three-dimensional ultrasound in diagnosis of incision area preg-nancy were analyzed .Results One case was diagnosed as the incision site and partial implantation of pregnant capsule by transvagi-nal two-dimensional ultrasound ,and then diagnosed as the complete implantation of pregnant capsule at incision site ,the other types were consistent to the diagnosis by the three-dimensional ultrasound .The MR examination results were consistent to the those by three-dimensional ultrasound .The diagnosis typing coincidence rate had no statistical difference among the three methods ( P>0 .05) .Conclusion Transvaginal three-dimensional can more intuitively display the lesion′s position ,range ,incision involvement sit-uation ,while transvaginal two-dimensional ultrasound has more plentiful diagnostic information .
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Abstract Lissencephaly is a genetic heterogeneous autosomal recessive disorder characterized by the classical triad: brain malformations, eye anomalies, and congenital muscular dystrophy. Prenatal diagnosis is feasible by demonstrating abnormal development of sulci and gyri. Magnetic resonance imaging (MRI) may enhance detection of developmental cortical disorders as well as ocular anomalies. We describe a case of early diagnosis of lissencephaly type 2 detected at the time of routine second trimester scan by three-dimensional ultrasound and fetal MRI. Gross pathology confirmed the accuracy of the prenatal diagnosis while histology showed the typical feature of cobblestone cortex. As the disease is associated with poor perinatal prognosis, early and accurate prenatal diagnosis is important for genetic counseling and antenatal care.
Resumo Lissencefalia são doenças genéticas autossômicas recessivas heterogêneas caracterizadas pela tríade clássica: malformações do cérebro, anomalias oculares e distrofia muscular congênita. Diagnóstico pré-natal é factível pela demonstração do desenvolvimento anormal de sulcos e giros. Ressonância magnética ( RM ) melhora a detecção de distúrbios do desenvolvimento cortical, bem como as anomalias oculares. Descrevemos um caso de diagnóstico precoce de lisencefalia tipo 2 detectado no momento do ultrassom morfológico de segundo trimestre pela ultrassonografia tridimensional e RM fetal. A macroscopia confirmou a acurácia do diagnóstico pré-natal, enquanto que a microscopia mostrou a típica característica de córtex em cobblestone. Como a doença está associada à um pobre prognóstico perinatal, o precoce e acurado diagnóstico pré-natal é importante para o aconselhamento genético e seguimento da gestação.
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Humans , Female , Pregnancy , Adult , Cobblestone Lissencephaly/diagnostic imaging , Prenatal Diagnosis , Imaging, Three-Dimensional , Magnetic Resonance Imaging , Prenatal Diagnosis/methods , Ultrasonography, PrenatalABSTRACT
Objective To analyze the stability and accuracy of the equipment for three-dimensional ultrasound-based image-guided radiation therapy (3DUS-IGRT) in daily practice, and to provide a basis for clinical application of radiotherapy for soft tissue tumors.Methods A specific calibration phantom was used for continuous calibration and quality control of the 3DUS-IGRT equipment in a year.The method for daily quality control of ultrasound-guided equipment was explored, and its stability and accuracy were monitored.Results The phantom position errors in both Sim and Guide stations of the 3DUS-IGRT equipment were within 1 mm.Conclusions The 3DUS-IGRT equipment has a stable performance with the support of a complete set of stringent and accurate calibration and quality control, which provides a new image-guided method for precise radiotherapy for soft tissue tumors.
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Objective To explore the diagnostic value of transvaginal three-dimensional ultrasound in uterus abnormal bleeding caused by uterine incision diverticulum after cesarean section. Methods We collected 480 cases with cesarean section patients from January 2011 to July 2015 in our hospital. A retrospective analysis of the cases was performed by transvaginal ultrasound , if the incision diverticulum was found , for measuring and recording the depth , length , width and assessing the residual muscle layer thickness and the shape and volume of the diverticulum with vaginal bleeding in the following up. Results 118 cases were found incision diverticu-lum by ultrasound in 480 patients , including 70 cases of triangular , 33 cases of semicircle , 15 cases of other shapes , of which 56 patients of uterine abnormal bleeding were significantly correlated with the volume and depth of the diverticulum. While menstruation PBAC scores were higher , the greater probability associated with abnormal uterine bleeding , but bleeding did not associate with the shape and length and width of diverticula; In this study we also found that OR value (OR = 15.809) of the diverticulum volume maximum was the key factors leading to the abnormal uterine bleeding in uterine incision diverticulum. Conclusion Transvaginal three-dimen-sional ultrasound can be convenient , fast and accurate diagnosis of uterine abnormal bleeding caused by incision diverticulum , and is of important significance for guiding clinical medication and surgical treatment.
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Objective To measure volume of breast cancer , calculate tumor volume doubling time (TVDT), and analyze the correlated factors affecting TVDT using three-dimensional ultrasound (3D-US). Methods We applied 3D-US to measure the volume of breast cancer of BI-RADS-US 4A classified by conventional ultrasound. The breast cancer case scanned by 3D-US at least twice (the interval is 3 months at least) without any medical intervention were included in the study. We calculated TVDT according to the formula, and analyzed the affecting factors of TVDT using multiple linear regression. Results Sixty-nine cases were enrolled in the study. The TVDT of breast cancer were from 66 to 521 days , in an average of 185 ± 126 days and the median time of 164 days. We found that: ① there were no statistics significances in TVDT between different breast cancer pattern , smoothing border lines , speculated sign , hyperechoic halo , microcalcification and different rear echo (P > 0.05). ② TVDT of different age groups, lymph node metastasis, pathological grade and NPI score were significantly different (P 0.05). ③ TVDT of patients with different expression of ER, PR and Ki-67, molecular typing showed statistically difference (P 0.05). ④ multi-factor analysis showed that the NPI score, lymph node metastasis, Ki-67 and molecular typing of breast cancer were relative factors in TVDT (P < 0.05). Conclusions The NPI score , lymph node metastasis , Ki-67 and molecular typing significantly correlate with TVDT of breast cancer. Triple-negative breast cancer in molecular typing has the fastest growth rate.
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We present a case of a fetal adrenal hemorrhage, a rare disease in fetal life, detected prenatally at 36 weeks' gestation by ultrasound. Routine ultrasound examination at 36 weeks' gestation by primary obstetrician showed a cyst on the fetal suprarenal area. Initially, the suspected diagnosis was a fetal adrenal hemorrhage, but we should diagnose differently from neuroblastoma. Subsequent ultrasound examination at 38 and 39 weeks' gestation showed increase of the cyst in size. A 3.34-kg-male neonate was born by spontaneous vaginal delivery at 39 weeks' gestation. The diagnosis of adrenal hemorrhage was confirmed by postnatal follow-up sonograms and magnetic resonance imaging. Course and sonographic signs were typical for adrenal hemorrhage and the neonate was therefore managed without surgical exploration.
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Humans , Infant, Newborn , Pregnancy , Diagnosis , Follow-Up Studies , Hemorrhage , Magnetic Resonance Imaging , Neuroblastoma , Prenatal Diagnosis , Rare Diseases , UltrasonographyABSTRACT
Objective To investigate the accuracy of three-dimensional ultrasound volumetric measurements for children's bladder. Methods The bladder volumes of 238 children aged 9 months to 16 years (male:106;female:132) in Shenzhen Children's Hospital underwent real-time three-dimensional ultrasound for volume measurements. These cases were divided into six groups according to the body surface area:(0.36~0.60) m2 (27 cases), (0.61~0.78) m2 (66 cases), (0.79~0.89) m2 (52 cases), (0.90~1.05) m2 (33 cases), (1.06~1.20) m2 (30 cases) and (1.21~1.78) m2 (30 cases). The bladder volume measured by GE Voluson E8 and Philips iU22 were compared with the actual volumes of discharge urine. The relation between bladder volume measurements and the actual volume of discharge urine was analyzed. Results Children's bladder volume increasesd with the body surface area (F=33.53, P<0.05) and showed positive correlations with the body surface area (r=0.679, P <0.05). Compared with the actual volume of discharge urine, each group's bladder volume measurements obtained by three-dimensional ultrasound were lower and the results were as follows:[(47.80±30.33) ml vs (82.24±49.63) ml, (77.20±39.72) ml vs (139.98±79.03) ml, (95.96±50.79) ml vs (175.96±101.70) ml, (117.46±54.17) ml vs (206.62±86.22) ml, (145.53±73.60) ml vs (253.33±135.09) ml and (220.27±110.34) ml vs (327.42±165.45) ml]. The differences between children's bladder volume measurements and the actual volume of discharge urine were statistically significant (t=3.19, 5.53, 5.08, 4.49, 3.84 and 3.00, all P <0.05), but children's bladder volume showed positive correlations with the actual urine volume (r=0.881, P<0.05). The bladder volume measurements by spheroid formula based on two-dimensional ultrasound are lower than the actual volume of discharge urine, and the results were as follows:[(50.38±36.94) ml vs (82.24±49.63) ml, (86.77±62.34) ml vs (139.98±79.03) ml, (102.69±60.21) ml vs (175.96±101.70) ml, (107.94±55.14) ml vs (206.62±86.22) ml, (145.31±66.01) ml vs (253.33±135.09) ml and (222.77±132.59) ml vs (327.42±165.45) ml]. The differences were statistically significant (t=3.03, 4.01, 4.47, 4.95, 3.94 and 2.75, all P <0.05), but children's bladder volume showed positive correlations with actual urine volume (r=0.326, P <0.05). Conclusions Three-dimensional ultrasound volumetric measurements for children's bladder is feasible and in clinical application, the factors of children's growth should be take into account. Combing regression equation, children's bladder volume can be more accurately quantified.