Résumé
Objective To evaluate the value of GE′s Q-analysis real-time ultrasonic elastography quantitative analysis software in the diagnosis of breast diseases and explore the best cutoff point of the breast diseases diagnosis.Methods The elastograms of 71 breast lesions(66 patients)were evaluated by using the GE LOGIQ E9 with the Q-analysis software.All the 71 lesions were diagnosed as malignant and benign lesions by surgery or biopsy.The receiver operating characteristic (ROC)curves of the entirety elasticity rate and local elasticity rate was performed.We compared the areas under ROC curves ( AUC) of the two modalities and confirmed the best cutoff point of the breast diseases diagnosis .We also assessed the sensitivity and specificity of the two modalities .Lastly we assessed the ROC curves with Z test to determine whether the difference between the two modalities was significant .Results Among the 71 leisions (66 patients),there were 37 benign lesions and 34 malignant ones.The elastograms of the leisions showed that the elasticity of 37 benign leisions was good ,the hardness value was low and the texture was even .As for the 34 malignant leisions,the elasticity was bad,the hardness value was high and the texture was uneven .The AUC of the local modality was 0.899 ( >0.5).The AUC of the entire modality,was 0.985 ( >0.5).Both modalities were accurate for the diagnosis of breast diseases .When the cutoff point of entirety elasticity rate was set as 3.60,the sensitiveness was 82.4%and the specificity was 86.5%.When the cutoff point of local elasticity rate was set as 2.60,the sensitiveness was 97.1% and the specificity was 91.9%.The difference between the two modalities was significant (Z =2.621,P=0.0088).Conclusions Q-analysis real-time ultrasonic elastography quantitative analysis is able to evaluate the rigidity and texture of tissue and is valuable to distinguish benign breast lesions between malignant breast lesions .The sensitiveness and specificity of local modality are higher than that of entirety modality .
Résumé
<p><b>BACKGROUND</b>Carotid artery intima-media thickness (CIMT) and brachial artery flow-mediated dilation percentage (FMD%) are common parameters used for detecting subclinical atherosclerosis. This study compared subclinical atherosclerosis of the carotid and brachial arteries in rheumatoid arthritis (RA) patients and healthy controls using high resolution ultrasonography. We also investigated their correlation with clinical factors and the association between FMD% and CIMT.</p><p><b>METHODS</b>One hundred and two RA patients and 46 age-gender matched healthy controls were included in the study. FMD of the brachial artery and CIMT were measured ultrasonographically. Patients with diabetes mellitus, hypertension, renal failure, history of cardiovascular or cerebrovascular disease were excluded. Subjects who were receiving or used high dose steroids were also excluded.</p><p><b>RESULTS</b>The CIMT was significantly higher in patients than that in the control group ((0.697±0.053) vs. (0.554±0.051) mm, P<0.001), whereas brachial artery FMD% was lower in patients than that in the controls ((5.454±2.653)% vs. (8.477±2.851)%, P<0.001). CIMT was related to age, disease duration, tender and swollen joint score, C-reactive protein, systolic blood pressure and high-density lipoprotein. However, FMD% was only association with systolic blood pressure. There was no significant correlation between CIMT and FMD%.</p><p><b>CONCLUSIONS</b>Compared with the healthy control subjects, RA patients without clinically evident cardiovascular disease had subclinical atherosclerosis in terms of impaired FMD% and increased CIMT. FMD% and CIMT may measure a different stage of subclinical atherosclerosis in RA patients.</p>