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Background & objectives: Recently, there has been a surge to develop new devices and techniques for the diagnosis of peripheral pulmonary lesions such as the combination of LungPoint navigation and endobronchial ultrasound with a guide sheath (EBUS-GS). The present study aimed to explore the diagnostic value of LungPoint navigation in combination with EBUS-GS and rapid on-site evaluation (ROSE) particularly for peripheral pulmonary nodules. Methods: Patients (n=108) with pulmonary nodules (10 mm ? nodal diameter ?30 mm) presenting to Henan Provincial People’s Hospital were detected using chest computed tomographic (CT) scanning and bronchoscopy. All patients were evaluated using LungPoint navigation, EBUS-GS and ROSE techniques to evaluate the positive rate of combined diagnosis using the three methods. Results: A total of 108 patients participated in this study and successfully underwent all the three procedures. Of these, 82 patients were accurately diagnosed, making the overall diagnostic rate of 75.9 per cent for combined LungPoint navigation, EBUS-GS, and ROSE analyses. Further subgroup analysis of the diagnostic rate of the three combined techniques were conducted based on the size of the nodules which showed a diagnostic rate of 65.3 per cent for 10 mm ? nodule diameter ?20 mm and 85.7 per cent for 20 mm ? nodal diameter ?30 mm. Of the 108 patients, 85 had solid nodules and 23 had ground-glass nodules; the positive rate of diagnosis of solid nodules was the highest. The patients ultimately were diagnosed with lung cancer with a positive rate of 83.5 per cent. The sensitivity, specificity and positive and negative predicted values for ROSE were 90.3, 78.3, 84.8 and 83.6 per cent, respectively. Interpretation & conclusions: The combined use of the three techniques can effectively shorten the duration of the total diagnosis period and improve the safety of diagnosis without affecting the detection rate.
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Objective To investigate the difference in texture features on diffusion weighted imaging (DWI) images between breast benign and malignant tumors.Methods Patients including 56 with mass-like breast cancer, 16 with breast fibroadenoma, and 4 with intraductal papilloma of breast treated in the Hainan Hospital of Chinese PLA General Hospital were retrospectively enrolled in this study, and allocated to the benign group (20 patients) and the malignant group (56 patients) according to the post-surgically pathological results. Texture analysis was performed on axial DWI images, and five characteristic parameters including Angular Second Moment (ASM), Contrast, Correlation, Inverse Difference Moment (IDM), and Entropy were calculated. Independent sample t-test and Mann-Whitney U test were performed for intergroup comparison. Regression model was established by using Binary Logistic regression analysis, and receiver operating characteristic curve (ROC) analysis was carried out to evaluate the diagnostic efficiency.Results The texture features ASM, Contrast, Correlation and Entropy showed significant differences between the benign and malignant breast tumor groups (P=0.014, P=0.019, P=0.010, P=0.007). The area under the ROC curve was 0.685, 0.681, 0.754, and 0.683 respectively for the positive texture variables mentioned above, and that for the combined variables (ASM, Contrast, and Entropy) was 0.802 in the model of Logistic regression. Binary Logistic regression analysis demonstrated that ASM, Contrast and Entropy were considered as the specific imaging variables for the differential diagnosis of breast benign and malignant tumors.Conclusions The texture analysis of DWI may be a simple and effective tool in the differential diagnosis between breast benign and malignant tumors.
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Adulto , Feminino , Humanos , Pessoa de Meia-Idade , Mama , Diagnóstico por Imagem , Diagnóstico Diferencial , Imagem de Difusão por Ressonância Magnética , Fibroadenoma , Diagnóstico por Imagem , Estudos RetrospectivosRESUMO
Conventional contrast-enhanced T1WI is a useful tool for evaluating the choroid but can not be used to evaluate the retina due to its small blood supply. Contrast-enhanced T2 fluid-attenuated inversion recovery imaging(CE-T2FLAIR)is sensitive to low-concentration MRI contrast;however,its role in the diagnosis of macular edema has not been described. A patient with macular edema caused by retinal vein occlusion was diagnosed by CE-T2FLAIR in the Hainan Branch of Chinese PLA General Hospital from July 20,2017 to August 4,2017,and our findings confirmed that CE-T2FLAIR could provide valuable imaging evidence for the diagnosis and evaluation of macular edema.
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To compare the clinical effect of phacoemulsification and middle incision extracapsular cataract extraction ( Ml-ECCE) . METHODS: One hundred and eighty - five eyes of phacoemulsification (137 cases) and 185 eyes of 139 cases for Ml-ECCE from January 2011 to May 2013 were involved in this study. And the ratio posterior capsular rupture during surgery, visual acuity, corneal edema, corneal astigmatism and intraocular pressure post operation were followed up.RESULTS: On 1d after surgery, uncorrected visual acuity in the group of Ml-ECCE was better than that of phacoemulsification group, while from 3d; 1 and 3mo after surgery, no significant difference was found from the above two groups. On 1d postoperation, corneal edema ratio in phacoemulsification group ( 45 eyes ) was higher than that in Ml-ECCE group(20 eyes) ( X2=11. 665, P=0. 0006 ) . No significant difference was found for the ratio of posterior capsule rupture during surgery in these two surgical technique groups(X2=0. 094,P=0. 759). On 1wk;1 and 3mo after surgery, significant difference was found for the average of surgical induced corneal astigmatism between two groups (u=6. 661, 6. 880, 4. 187, P = 0. 00, respectively ). During following up, no significant difference was found for the intraocular pressure between two groups ( u=1. 858, 0. 963, 0. 471, 1. 349, 1. 388; P= 0. 063, 0. 335, 0. 638, 0. 177, 0. 165). lntraocular pressure on 1d postoperation in phacoemulsification and Ml-ECCE groups was higher than before operation ( u = 19. 86, 19. 39, P = 0. 00, respectively). And on 1wk; 1 and 3mo postoperation, intraocular pressure in the operated eyes in both groups was lower than before operation for 2~3mmHg.CONCLUSlON: Although phacoemulsification and Ml-ECCE could both get good visual rehabilitation, with similar visual outcome, no significant effect for intraocular pressure, and no severe complications, the latter one owns the advantage that easier maneuver, quicker recovery, and cheaper instruments needed, which is suitable for the hard nuclei cataract in local hospitals. Ml-ECCE is a safe, effective and easy manipulation for local hospital for large batch of cataract surgeries.