Diagnostic value of computed tomography (CT) histogram analysis in thyroid benign solitary coarse calcification nodules / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

This study was to investigate the diagnostic value of the computed tomography (CT) histogram in thyroid benign solitary coarse calcification nodules (BSCNs). A total of 89 thyroid solitary coarse calcification nodules (coarse calcification ≥5 mm, no definite soft tissue around calcification) confirmed either by surgery or histopathological examination in 86 cases enrolled from January 2009 to December 2015 were evaluated. These included 56 BSCNs and 33 malignant solitary coarse calcification nodules (MSCNs). Overall, 27 cut-off values were calculated by N (4≤N≤30) times of 50 Hounsfield units (HU) in the range of 200 to 1500 HU, and each cut-off value and the differences in the corresponding area percentages in the CT histogram were recorded for BSCN and MSCN. The optimal cut-off value and the corresponding area percentage were established by receiver operating characteristic (ROC) curve analysis. In the 19 groups with an ROC area under curve (AUC) of more than 0.7, at a cut-off value of 800 HU and at an area percentage of no more than 93.8%, the ROC AUC reached the maximum of 0.79, and the accuracy, sensitivity, and specificity were 75.3%, 80.4%, and 66.7%, respectively. At a cut-off value of 1050 HU and at an area percentage of no more than 93.6%, the accuracy, sensitivity, and specificity were 71.9%, 60.7%, and 90.9%, respectively. At a cut-off of 1150 HU and area of no more than 98.4%, the accuracy, sensitivity, and specificity were 70.8%, 57.1%, and 93.9%, respectively. At a cut-off of 600 HU and area of no more than 12.1%, the accuracy, sensitivity, and specificity were 61.8%, 39.3%, and 100.0%, respectively. Compared with the cut-off value of 800 HU and an area percentage of no more than 93.8%, the sensitivity of cut-off values and minimum areas of 1050 HU and 93.6%, of 1150 HU and 98.4%, and of 600 HU and 12.1%, was gradually decreasing; however, their specificity was gradually increasing. This can provide an important basis for reducing the misdiagnosis and unnecessary surgical trauma.

The DSA findings and embolization treatment of broncho-costoarterial pulmonary circulation fistula / 介入放射学杂志

Objective To discuss digital subtraction angiography(DSA)findings and interventional treatment of broncho-costoarterial pulmonary circulation fistula(BPF).Methods Fifty one patients with massive hemoptysis were undergone DSA showing 19 cases with BPF.All BPF were cmbolized with 500～700?PVA, silk particles and segments,and steel coil;separately or in combination according to shunt orifice size and blood flow velocity.Results There were 4 types of BPF demonstrated by DSA according to feeding and drainage vessels,including 13 cases of bronchial artery-pulmonary artery shunt(AAS),2 cases of bronchial artery-pulmonary venous shunt(AVS),3 cases of intercostal artery-pulmonary artery shunt(IAPS)and 1 case of bronchial arteriovenous malformatoin(B-AVM).All patients were followed up for 1～4 years,with 18 cases of complete symptomless during 7 days postoperatively obtaining,the effective rate of 94.7%.There were 3 recurrent cases within 1 year with the recurrent rate of 15.79%.Conlusions BPF is the main factor for inducing and aggrevating pulmonary hemoptysis and interventional embolization serves as a safe and effective treatment.The method could be used repeatedly for recurrent cases and furthermore emphasis should be put on treating the primary pulmonary diseases simultaneously.(J Intervent Radiol,2007,16:84-87)