Résumé
Objective To explore the application value of virtual touch tissue quantification(VTQ) technique in differentiating small solid thyroid nodules.Methods The patients with suspiciously malignant thyroid nodules(solitary,size range 5-15 mm),homogeneous and normal color Doppler flow imaging in the rest of thyroid parenchyma,were enrolled in this study.Five repeated measurements were performed on both nodules and extra-nodular tissues using VTQ.A receiver-operating characteristic (ROC) curve was drew according to shear wave velocity(Vs).Results 62 patients with a total of 67 lesions were included in this study,turned out to be 39 malignant and 28 benign.The Vs of malignant group nodules,malignant group extra-nodular tissues,benign group nodules and benign group extra-nodular tissues were (3.91 ±1.85) m/s,(2.03 ± 0.42)m/s,(2.29 ± 0.56)m/s,(1.84 ± 0.45)m/s,respectively.The Vs difference between malignant and benign nodules was statistically significant (P =0.000),while the Vs difference between malignant and benign extra-nodular tissues had no statistical significance (P =0.07).The best cutoff Vs value for distinguishing malignant from benign nodules was 2.78 m/s,with the sensitivity,specificity and accuracy of 76.9％,78.6％ and 80.6％ respectively.The area under ROC curve was 0.84.Conclusions VTQ could evaluate the elasticity of thyroid nodules,and was helpful in the diagnostic work-up of thyroid nodules.
Résumé
Objective To investigate the correlations of extracellular matrix and hepatic ultramicrostructural changes with clinical manifestations in patients with mild chronic hepatitis B (CHB).Methods Patients with chronic HBV infections were enrolled and were divided into mild CHB group (n=66) and HBV carrier group (n=10).Serum samples were collected from patients, and serum HBV markers, HBV DNA load and liver fibrosis indexes were measured.All subjects received liver biopsy, and the tissue samples were observed by light microscope and electron microscope.T test and χ2 test were performed for measurement data and enumeration data, respectively.Spearman test was used for ranked data.Results The differences on ALT and AST levels between mild CHB group and HBV carrier group were significant (t=12.42, 7.06, P＜0.05), but there was no significant difference on HBV DNA load between two groups (t=0.24, P ＞ 0.05).Serum liver fibrosis indexes (hyaluronic acid, type Ⅲ collagen,type Ⅳ collagen and laminin protein) in mild CHB group were not significantly higher than those in HBV carrier group (t=0.45, 0.95, 0.76 and 1.21, P ＞0.05).In mild CHB group, there were 33 patients with ≥G2 and ≥S2, but in HBV carrier group were only 2 patients (χ2=4.17, P ＜ 0.05).Seventeen patients in mild CHB group were with S3-4, while that was not observed in HBV carrier group (χ2=4.75, P ＜0.05).In mild CHB group, hepatic ultramicrostrutural changes on fat storing cell, collagen protein and portal area were correlated with fibrosis grades, and the correlation coefficients were 0.351, 0.675 and 0.301, respectively (P=0.004, 0.000 and 0.014).Conclusion Electron microscope is of higher sensitivity than light microscope in observing hepatic ultramicrostructural changes, which is effective in evaluating the severity of mild CHB.