Ultrasound image analysis of partially cystic thyroid nodules / 中国医师杂志

Objective:To investigate the diagnostic value of high frequency ultrasound in benign and malignant thyroid partially cystic nodules.Methods:The preoperative ultrasound features of 159 thyroid cystic and solid nodules confirmed by surgery and pathology in Shenzhen Longgang Central Hospital from June 2017 to January 2021 were retrospectively analyzed. According to the ultrasonic manifestations, it can be divided into four types: type Ⅰ, band separation or flocculent echo in the interior; type Ⅱ, the small papillary middle echo process was seen on the wall; type Ⅲ, with band separation or flocculent echo and papillary medium echo process; type Ⅳ, the internal was mainly solid echo, and the inner part was irregular small piece echo and fissure echo free echo. The coincidence rate of ultrasonic diagnosis and pathological results of all types was observed.Results:Among 159 cystic and solid thyroid nodules, 22 were malignant and 137 were benign. The coincidence rate of ultrasonic diagnosis and pathological results of type Ⅰ, Ⅱ, Ⅲ and Ⅳ cystic solid thyroid nodules were 97%(61/63), 80%(45/56), 90%(9/10) and 67%(20/30), respectively. Type Ⅰ, type Ⅱ, type Ⅲ were mainly cystic components, with cystic components ≥ 50%; In type Ⅳ, solid component was the main component and cystic component was less than 50%.Conclusions:The internal zonal separation or flocculent echo was the characteristic ultrasonic manifestation of benign cystic solid nodules; It is easy to be misdiagnosed because of the lowest coincidence rate of ultrasound diagnosis for cystic and solid thyroid nodules with internal solid echo, irregular small piece like and fissure like anechoic. Careful observation of the characteristics can improve the accuracy of ultrasound diagnosis.

Application of multimodal neuroendoscopy combined with microsurgery in the surgical treatment of cystic and solid brain tumors / 中国医师进修杂志

Objective To investigate the value of multi-modal neuroendoscopy combined with microscopy in the treatment of solid cystic brain tumors. Methods Fifty patients with cystic solid tumors admitted to Wuzhou Worker′s Hospital(the Seventh Affiliated Hospital of Guangxi Medical University) from February 2016 to February 2019 were enrolled. The patients were divided into two groups by random number table method. The patients in control group (25 cases) received microsurgery, and the patients in observation group (25 cases) received microsurgery combined with neuroendoscopy. All patients underwent CT or MRI. The differences in tumor resection rate between the two groups were observed and compared. The postoperative complications and Glasgow Outcome Scale (GOS) scores were compared between the two groups. All patients were followed up for 12 months after surgery. The tumor recurrence rate and mortality rate of the two groups were compared. Results The total resection rate of the tumor in observation group was 80.00%(20/25), and in control group was 48.00%(12/25), and there was significant difference (P<0.05). The postoperative GOS score of observation group was higher than that of control group: (4.52 ± 1.73) scores vs. (3.65 ± 1.15) scores, t=2.094, P=0.041. The incidence of postoperative complications, tumor recurrence rate and the mortality rate between two groups had no significant difference (P>0.05). Conclusions Multi-modal neuroendoscopy combined with microscopy can significantly improve the total resection rate of cystic brain tumors and improve the prognosis without increasing the risk of surgery.

Total pancreatic head resection with duodenum and bile duct preserving: a report of 31 patients / 中华肝胆外科杂志

Objective To investigates the role of duodenum and bile duct preserving pancreatic head resection (DBPPHR) in treatment of benign or low-grade malignant diseases located in the head of pancreas.Methods The clinical data of 31 patients who underwent DBPPHR between April 2012 to May 2016 in Zhejiang Provincial People's Hospital and Zhangzhou Municipal Hospital of Fujian Province were analyzed retrospectively.Results Of the 31 patients,4 patients underwent laparoscopic DBPPHR.One patient in the open group was converted to pancreaticoduodenectomy.For the open group,the mean operation time was (165.3 ±63.6) min;the mean estimated blood loss was (258.1 ± 156.9) ml;and the mean postoperative stay was (11.7 ± 6.3) days.The postoperative complications included 1 reoperation due to postoperative bleeding,1 bile leakage and 13 patients developed grade A pancreatic fistula (48.2％).For the laparoscopic group,the mean operation time was 350.0 (280.0 ～ 450.0) min;the mean estimated blood loss was 425.0 (250.0 ～600.0) ml;and the mean postoperative stay was 14 days.Three patients developed postoperative pancreatic fistula (grade A).The pathological diagnosis were:12 patients with pancreatolithiasis,8 patients with serous cystadenoma,4 patients with branched intraductal papillary mucinous neoplasm,5 patients with neuroendocrine tumor and 2 patients with mucinous cystadenoma.The follow-up period was 1 ～ 48 month,and there was no patient with diabetes or diarrhea.Conclusions DBPPHR was safe and efficacious.It is less invasive to treat benign or low-grade malignant diseases located in the head of pancreas.

Tumor sólido quístico pseudopapilar del páncreas: reporte del primer caso en Cuba / First clinical report from Cuba of solid-pseudopapillary tumors of the pancreas

Se presenta el caso de una paciente de 21 años de edad, portadora de un tumor sólido quístico pseudopapilar del páncreas. Se hace una revisión de los aspectos clínicos, diagnósticos y terapéuticos de esta rara neoplasia; al mismo tiempo, se hace énfasis en la anatomía patológica y en su diagnóstico diferencial. Esta es una entidad propia de mujeres jóvenes, sin embargo, en la actualidad ha incrementado su frecuencia, con variación en los aspectos clásicos del comportamiento clínico.

The case of a 21-year female patient with a solid-pseudopapillary tumor of the Pancreas is presented. Clinical, histopathological, diagnostic and therapeutic features of this rare tumor are presented and discussed with emphasis on pathology and differential diagnosis. This rare entity most frequently affects young women, but its incidence has increasing, and there have been changes its clinical behavior from those classically reported.

Multidetector CT and high magnetic field MRI in evaluation of small cystic-solid renal mass / 上海第二医科大学学报

Objective To evaluate the role of multidetector CT(MDCT) and high magnetic field MRI in diagnosis of small cystic-solid renal mass. Methods Fifty-two cases with small renal cystic-solid mass(≤3 cm) were consecutively collected,including small cystic-solid renal cell carcinoma(n=25),carcinoid(n=1),complex cysts(n=16),small angiomyolipoma(n=7) and benign cystic nephroma(n=3).All were examined by both 1.5T MRI and multidetector CT at intervals between 3 days and 2 months. Results All cases were proved by pathology.Multi-planar reconstruction techniques were useful for MDCT in differentiating small cystic-solid renal mass,with the sensitivity of 98.1%,which was as high as MRI.However,the accuracy for MDCT was 71.2%,significantly lower than that of MRI(90.4%)(P=0.001).MRI helped to identify the components and structure of renal masses,and behaved better in the detection of pseudo-capsule of renal cell carcinoma(57.7%).Conclusion High magnetic field MRI may play an important role in the diagnosis of small renal cystic-solid masses,and it may be feasible as a noninvasive examination when CT can not make the ultimate determination.