Combination of S-Detect and strain elastography in the conventional ultrasonic diagnosis of breast tumors / 中国综合临床

Objective:To explore the value of s-detect combined with elastography in the differential diagnosis of benign and malignant breast tumors.Methods:The ultrasound diagnosis data of 136 patients with breast mass examined by ultrasound in the First Affiliated Hospital of Shantou University Medical College from April 2018 to January 2020 were retrospectively analyzed. The breast lesions diagnosed as BI-RADS 3 or above were analyzed by conventional ultrasound, strain elastic imaging strain ratio (SR) and S-Detect Computer-aided Diagnosis (CAD) technology successively and were used for cross-sectional study. The corresponding benign and malignant judgment results were obtained, and the efficacy of individual diagnosis and combined diagnosis were compared and analyzed.Results:Conventional ultrasound, SR, S-Detect alone and conventional ultrasound+SR, conventional ultrasound+S-detect, conventional ultrasound + S-detect +SR combined diagnosis of breast tumors, the area under the receiver operating curve (AREA under the receiver operating curve) Characteristic curve, AUC) were 0.776, 0.839, 0.802, 0.861, 0.832 and 0.870, respectively. SR, S-Detect, conventional ultrasound +SR, conventional ultrasound + S-detect and conventional ultrasound +SR+ S-detect were compared with conventional ultrasound group, Z values were 1.49, 0.70, 2.76, 2.52, 2.96, respectively, and P values were 0.137, 0.484, 0.006, 0.012 and 0.003, respectively. The difference was statistically significant. The accuracy of conventional ultrasound +S-Detect+SR was the highest (84.1%), compared with pathological results, its Kappa value was 0.687, showing the strongest consistency. Conclusion:S-detect combined with strain elastography assisted by conventional ultrasound can significantly improve the diagnostic efficiency of benign and malignant breast tumors.

Application values of double contrast enhanced ultrasonography in the diagnosis of micro vessel formation on gastric cancer / 中国医师杂志

Objective To discuss the application of double contrast enhanced ultrasonography in the diagnosis of micro vessel formation on gastric cancer.Methods 52 cases of patients with gastric cancer who scheduled for elective tumor resection on our hospital from August 2015 to October 2017 were enrolled in the study.Oral ultrasonic contrast agent,and intravenous contrast agent were used to assess the preoperative condition.The image feature of gastric ultrasound imaging was observed,and the time-intensity curve (TIC) parameters of gastric lesions and normal gastric were recorded,the relationship of gastric carcinoma TIC parameters and the expression of micro vessel density (MVD),vascular endothelial growth factor (VEGF) expression were analyzed.Results Comparison of gastric lesions and normal gastric tissue,there were statistically significant difference on the basic strength (BI),enhanced intensity (EI),peak intensity (PI),perfusion time (WIT) (P ＜ 0.05);Correlation analysis showed that EI,PI were positively correlated with MVD,BI,WIT was negatively correlated with MVD (P ＜ 0.05);EI,PI were positively correlated with VEGF,BI was negatively correlated with VEGF (P ＜ 0.05).Conclusions Gastric ultrasound imaging technology can accurately assess the blood perfusion characteristics of gastric carcinoma,with a certain value on the gastric cancer angiogenesis evaluation.

Preliminary clinical study of left ventricular systolic dyssynchrony in patients with coronary heart disease by real-time three-dimensional echocardiography / 中国基层医药

Objective To figure out the preliminary clinical value of real-time three-dimensional echocardiography(RT-3DE) in evaluating the systolic dyssynchrony in patients with coronary artery heart disease(CAD).Methods Eighty patients who were suspected as CAD were included in this study.RT-3DE was performed first.After the analysis,we got the data:ejection fraction (EF),16 segments systolic dyssynchronic index (SDI 16).All subjects should take the coronary angiography.According to coronary angiography results,the patients with the vascular stenosis rate ≥50% were defined as the CAD group,and the patients with the vascular stenosis rate 0.05).However,SDI 16 had significant difference between the control group[(3.72±2.68)%]and the CAD group[(7.14±3.10)%],the same between coronary atherosclerosis group[(5.12±3.46)%]and the CAD group[(7.14±3.10)%](t=-3.71,-2.34,all P5.49% has a higher value in evaluating systolic dyssynchrony in patients with CAD with RT-3D of Siemens Acuson SC2000 ultrasonic diagnostic instrument.

The quantitative assessment of left ventricular local myocardial systolic function in patients with coronary heart disease by velocity vector imaging / 中国医师杂志

Objective To explore the preliminarily clinical value of strain rate parameters using velocity vector imaging (VVI) evaluating left ventricular regional endocardial systolic function in patients with coronary artery heart disease (CAD).Methods A total of eight six inner subjects who were suspected as CAD was enrolled in the study.Patients with the vascular stenosis rate ≥ 50％ were defined as the CAD group,patients with the vascular stenosis rate ＜ 50％ were defined as the coronary atherosclerosis group,and patients with the completely normal angiographic results were included in the control group,according to the results of angiography.The left ventricular endocardial systolic strain rate parameters of VVI were obtained in standard long axis views (apical two,three,and four-chamber view) and short axis views (at the level of the mitral valve,papillary muscles,and apex).The strain rate parameters were global longitudinal endocardial systolic strain rate in the apical two,three,and four-chamber views (A2-GLSRs,A3-GLSRs,and A4-GLSRs),global radial endocardial systolic strain rate in short axis view of the mitral valve level,papillary muscles,and apex (MV-GRSRs,PM-GRSRs,and AP-GRSRs),and global circumferential endocardial systolic strain rate in short axis view of the mitral valve level,papillary muscles,and apex (MV-GCSRs,PM-GCSRs,and AP-GCSRs).The parametric differences were compared among three groups.Results All the subjects included in the present study had normal left ventricular ejection fraction (LVEF) and there was no significant difference in LVEF across three groups.Compared to other groups,the control group had significantly higher E/A ratio.The LV endocardial systolic strain rate parameters were all significantly reduced in the CAD group compared to the control group and the coronary atherosclerosis group (all P ＜ 0.05).Compared to the control group[(-1.37 ± 0.25)/s],the coronary atherosclerosis group [(-1.12 ± 0.42)/s] had significantly lower MV-GCSRs (P ＜0.01).Conclusions VVI is useful for quantitative assessment of the left ventricular systolic function in CAD.MV-GCSRs might have the potential to predict early left ventricle (LV) systolic dysfunction in subjects with coronary artery stenosis ＜ 50％.

The clinical diagnostic value of anatomic M -mode echocardiography in coronary artery diseases / 中国基层医药

Objective To investigate the clinical value of anatomic M-mode echocardiography (AMM)for pristine diagnosis of myocardial ischemia in patients with coronary heart diseases (CAD).Methods 44 inner patients who were suspected as CAD were detected.Ordinary ultrasound was performed first.The ventricular segmental wall thickness and amplitude were measured by AMM.Then,we got the ventricular wall thickening fractions.All subjects should take the coronary angiography after the ultrasound examination in 1 -3 days.Patients with the vascular stenosis rate≥50% were defined as the CAD group,patients with the completely normal angiographic results were included in the normal control group according to the results of angiography.The parametric differences between the patients and the normal control subjects were compared.Results In the normal control subjects,the ventricular segmental wall amplitude >5mm accounted for 78.67%,the ventricular wall thickening fractions >30% accounted for 99.13%.But in CAD group,the ventricular segmental wall amplitude <4mm accounted for 61.14%,<5mm accounted for 93.47%,the abnormal ventricular wall thickening fractions <30% accounted for 88.43%.The sensitivity, specificity,accuracy of AMM were 77.47%,90.00%,77.39% respectively.Conclusion The ventricular wall thickening fractions of AMMhas quite significant correlation with morbid blood vessel in patients with CAD,they are effective reference indicators to evaluate the left ventricular wall motion quantitatively.

Value of acoustic radiation force impulse imaging in the differential diagnosis of the superficial lymphadenopathy / 中华医学超声杂志（电子版）

Objective To investigate the application value of virtual touch tissue image technology (VTI) and virtual touch tissue quantification technique (VTQ) in the differential diagnosis of benign and malignant superficial lymph nodes. Methods Fifty superficial lymph nodes were obtained, including 23 for nonspecific inflammatory, 2 for tuberculosis, 5 for lymphoma and 20 for metastasis. All lymph nodes were confirmed by biopsy pathology or follow-up after anti-inflammatory treatments and scanned by traditional ultrasound, VTI and VTQ before resections or treatments. Receiver operating characteristic curve of traditional ultrasound, VTI and VTQ was made to determine the optional cut-off point in the differential diagnosis of benign and malignant superficial lymph nodes and calculate the sensitivity, specificity, accuracy, positive predictive value and negative predictive value. Final diagnosis was defined as the golden standard. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value were calculated by the combined application of traditional ultrasound with VTI and VTQ technology. Results Nine (evaluation value) was taken as the critical value which was scanned by both two-dimensional ultrasound and color Doppler. The ROC curve indicated that the sensitivity, specificity, accuracy, positive predictive value and negative predictive value of conventional two-dimensional ultrasound of benign and malignant lymph nodes were 76.0%, 84.0%, 80.0%, 82.6%, and 77.8%. Taking three (critical value) as the cut-off point, the sensitivity, specificity, accuracy, positive predictive value and negative predictive value of VTI in the diagnosis of benign and malignant lymph nodes were 88.0%, 64.0%, 76.0%, 71.0%and 84.2%. Taking 2.755 m/s (shear wave velocity) as the cut-off value, the sensitivity, specificity, accuracy, positive predictive value and negative predictive value of VTQ in the differentiation of benign and malignant superficial lymph nodes were 80%, 92.0%, 86.0%, 90.9%and 82.1%. Defined“traditional ultrasound +VTI+VTQ series method” as using conventional ultrasound, VTI, VTQ simultaneously, superficial lymph nodes could be diagnosed with malignant or benign if each method confirmed the same diagnosis. Defined“traditional ultrasound+VTI+VTQ parallel method”as using conventional ultrasound, VTI, VTQ simultaneously, superficial lymph nodes could be diagnosed with malignant if any one method indicated malignancy, otherwise benign. Specificity of‘traditional ultrasound+VTI+VTQ series method’ was consistent with VTQ, which was 92.0%, while the sensitivity and accuracy decreased significantly, which was 64.0%and 78.0%, respectively;the sensitivity and negative predictive value increased significantly by using “traditional ultrasound +VTI+VTQ parallel method” when compared with traditional ultrasound, VTI or VTQ, almost near 100%, but declined significantly in specificity and accuracy, which was 64.0%and 82.0%, respectively. Conclusions Traditional ultrasound, VTI and VTQ have certain clinical value for differential diagnosis of benign and malignant superficial lymph nodes. Combined application of traditional ultrasound, VTI and VTQ can improve the accuracy in the diagnosis of benign and malignant lymph nodes effectively.

Clinical application of interventional treatment for uterine scar pregnancy by vaginal color Doppler ultrasound guidance / 中国基层医药

Objective To investigate the efficiency of interventional treatment and intramuscular injection of methotrexate for the treatment uterine scar pregnancy.Methods 22 patients with uterine scar pregnancy were divided into two groups,group A (n =12),transvaginal color Doppler ultrasound to guide percutaneous interventional treatment;group B( n =10) intramuscular injection of methotrexate treatment.Mass size and β-HCG preoperation and 4 days,7 days,1 month postoperation were evalutaed respectively.Results The cure rate of interventional treatment and intramuscular injection of methotrexate for the treatment uterine scar pregnancy were 83.3％ and 40.0％ respectively.And the difference was statistically significant ( P ＜ 0.05 ).Conclusion Compared with intramuscular methotrexate treatment of uterine scar pregnancy,guided by vaginal ultrasonography involved the injection of methotrexate is more effective and have important clinical significance.