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Objective:To explore the application value of dual contrast-enhanced ultrasound in the differential diagnosis of renal cystic lesions.Methods:Eighty-four cases with renal cysts who were diagnosed by routine ultrasound in Zhejiang Cancer Hospital and Zhejiang Xiaoshan Hospital from January 2019 to October 2020 were included in the study. Intravenous contrast-enhanced ultrasound and enhanced MRI were performed to differentiate benign and malignant cysts. Patients with benign cysts underuent intravenous pyelography and intracapsular contrast-enhanced ultrasound. Before sclerotheraphy to exclude renal pelvic cysts. The diagnostic results of dual radiography were compared with MRI and intravenous pyelography.Results:Among 84 patients with suspected renal cysts, the diagnostic accuracy of enhanced MRI for cystic renal cancer was 97.62%, and the sensitivity was 97.62%. The diagnostic accuracy of intravenous contrast-enhanced ultrasound was 98.81, the sensitivity was 100%, and the specificity was 98.73%. There was no statistically significant difference between the two groups (all P>0.05). 77 cases were diagnosed as benign renal cysts, the detection rate of intravenous pyelography was 9.1% (7/77), the detection rate of renal pelvic cysts by intracystic ultrasonography was 6.5% (5/77). With intravenous pyelography as the gold standard, the diagnostic accuracy of intracapsular contrast-enhanced ultrasound was 97.4% (75/77), the sensitivity was 71.4% (5/7), and the specificity was 100% (70/70). Conclusions:Compared with enhanced magnetic resonance and intravenous pyelography before renal cyst sclerosing therapy, there is no difference in diagnostic efficiency of double contrast ultrasound for benign and malignant cysts. The diagnostic efficiency of renal pelvic cysts is high, and the operation is convenient. It can identify cystic renal cancer and cysts from the renal pelvis and improve the safety of sclerotherapy.
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Objective To explore the value of ultrasound gray scale ratio (UGSR) in the diagnosis and differential diagnosis of papillary thyroid carcinoma(PTC) with different sizes.Methods A retrospective study was made in 702 patients with 1107 nodules which were confirmed by surgery in the Department of Oncology or fineneedle aspiration of HangZhou First people's Hospital,Zhejiang University of medical school from Jan.2016 to Oct.2017.All the thyroid nodules were divided into three groups:D≤ 1 cm group,1＜D≤2 cm group and ＞2 cm group according to their sizes.The UGSR of the PTC and NG were obtained through the RAD info system.Their differences were analyzed and ROC was established to confirm the optimal threshold in the differential diagnosis between PTC and NG among the groups.Results There were 483 PTC and 624 NG in this study.The UGSR of D≤ 1 cm group,1＜D≤2 cm group and ＞2 cm group of PTC and NG were (0.48±0.12) vs (0.76±0.22)(t=33.21,P=0.00);(0.52±0.17) vs(0.80±0.21)(t=1.30,P=0.00) and (0.63±0.20) vs(0.89±0.24)(t=3.58,P=0.00) respectively.The area under the ROC of UGSR in the differentiation of PTC and NG in the three groups were 0.873,0.840 and 0.811 respectively.The Youden indexes were greatest (0.631,0.536 and 0.535 respectively),when the cut-offs of the UGSR were 0.682,0.652 and 0.831 respectively.The sensitivity and specificity to diagnose PTC were 94.8％ and 68.0％,75.0％ and 78.6％,80.3％ and 73.2％ respectively in the three groups.Conclusions The best UGSR value of PTC was variant in thyroid nodule with different size.Recognition of these differences accurately could improve the pre-operative diagnostic accuracy of PTC.Also the method is simple to operate and easy to apply.
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Objective To investigate the diagnostic value of computed tomography (CT) histogram analysis for thyroid malignant solitary coarse calcification nodules (MSCN).Methods 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 patients enrolled in this study from Jan.2009 to Dec.2015 were evaluated,including 33 MSCN from 32 patients and 56 benign solitary coarse calcification nodules (BSCN) from 56 patients.Overall,27 cut-off values were calculated by N (4 ≤ N ≤ 30) times of 50 Hounsfield units (HU) in the range of 200 HU to 1500 HU,and each cut-off value and the differences in the corresponding area percentages in the CT histogram were recorded for MSCN and BSCN.The optimal cut-off value and the corresponding area percentage were established by receiver operating characteristic (ROC) curve analysis.Results In the 24 groups with an ROC area under the curve (AUC) of more than 0.7,at a cut-off value of 1150 HU and at an area percentage of no less than 98.4％,the ROC AUC reached a maximum of 0.86,and the accuracy,sensitivity,and specificity were 70.8％,93.9％,and 57.1％,respectively.At a cut-off value of 450 HU and at an area percentage of no less than 46.3％,the accuracy,sensitivity,and specificity were 76.4％,48.5％,and 92.9％,respectively.At a cut-off value of 550 HU and at an area percentage of no less than 81.5％,the accuracy,sensitivity,and specificity were 75.3％,33.3％,and 100％,respectively.Conclusions In comparison with the cut-off value of 1150 HU with an area percentage of no less than 98.4％,the sensitivities for the cut-off value of 450 HU with an area percentage of no less than 46.3％ and for the cut-off value of 550 HU with an area percentage of no less than 81.5％ were lower;however,the specificities increased significantly,providing an important basis for reducing the misdiagnosis of MSCN.
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Objective@#To evaluate the differential diagnosis of idiopathic granulomatous mastitis (IGM) and invasive ductal carcinoma.@*Methods@#The ultrasonographic data of 37 IGM patients and 50 cases of IDC were analyzed retrospectively. The shape, growth direction, margin, internal echo, posterior echo, calcification, Adler blood flow classification, PSV(peak sestolic velocity), RI (resistance index)and elasticity scores were analyzed by χ2 test and independent sample t test. The optimal cutoff values of age, PSV and RI were calculated by receiver operating characteristic (ROC) curve. Logistic regression analysis was used to calculate the odds ratio (OR) of ultrasonic variates in the diagnosis of both diseases.@*Results@#There were no significant differences in the shape, margin, internal echo and blood flow grading between the two groups. The age, lesion growth direction, posterior echo, calcification, PSV, RI and elasticity were statistically different. The cut-of value of Age, PSV and RI were 38.5 years old, 13.20 cm/s, and 0.655. Logistic regression multi-variated analysis revealed that elastic score (OR=9.806) had the best value of the differential diagnosis, as well as calcification (OR=6.937), posterior echo decay (OR=4.613), RI (OR=3.257), lesion growth orientation (OR=3.198), and PSV (OR=1.202). Lesion shape, margin, internal echo, and Adler blood flow classification did not help in differential diagnosis.@*Conclusion@#Ultrasound multi-parameter analysis has high value in IGM and IDC differential diagnosis.
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Objective To analyze the influencing factors of hematoma complicated from ultrasound-guided minimally invasive surgery for benign breast masses.Methods Retrospective analysis was performed in 412 patients with a total of 516 masses underwent the ultrasound-guided minimally invasive surgery for benign breast masses from January 2011 to December 2015 in Xiaoshan Hospital. Theχ2 test was used to univariately analyze risk factors of hematoma formation after ultrasound-guided minimally invasive surgery for benign breast masses. Logistic regression analysis was used to multivariately analyze risk factors of hematoma formation.Results All masses were resected completely, however, hematomas with long diameter≥1.0 cm were formed in 43 masses one week after surgery, and all hematomas were completely absorbed after six months. There were significant differences in the incidence of hematoma between the groups of different needle sizes, numbers of needle cutting, masses sizes, blood flow grades, depth, resection numbers and effective compression time of postoperative bandages (χ2=16.917, 14.548, 39.971, 23.333, 29.137, 36.819 and 39.864, respectively, allP<0.001). The needle sizes, the numbers of needle cutting, the masses sizes, blood flow grades, depth, resection numbers and the effective compression time constituted the risk factors of hematoma formation after the minimally invasive surgery.Conclusions The risk factors of the hematoma formation after ultrasound-guided minimally invasive surgery for benign breast masses included the different size of the needle, the number of different cutting needles, different size of the masses, the grade of blood flow, the number of resection and the different effective compression time of postoperative bandages. We could prevent the occurrence of hematoma in advance by screening patients and take corresponding measures.
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Objective To investigate the diagnostic value of ultrasound elastography hardness score and area ratio to identify benign and malignant lesions.Methods 90 patients with breast lumps were selected and divided into the malignant and non -malignant group according to surgical pathology diagnosis,they were 40 cases (a total of 45 tumors)and 50 cases (a total of 57 tumors),two groups of patients were detected in ultrasound elastography,anal-ysis of imaging hardness ratings and area ratio and other information,to investigate the clinical diagnostic value. Results The ultrasound elastography of 50 cases with benign tumor were 0 -2 point,7 cases were 3 -4 point, 7 cases with malignant tumors were 0 -2 point,38 cases were 3 -4 point,the difference between the two groups were statistically significant (χ2 =28.55,P <0.05);The average area ratio of benign tumor was (1.01 ±0.27),malignant tumors was (2.28 ±1.68),the difference between the two groups was statistically significant(t =9.22,P =0.001);the sensitivity,specificity,accuracy of elastography hardness rating in diagnosis of malignant breast tumors were 87.72%,84.44%,86.27%,the area ratio method were 85.96%,86.67%,86.27%,joint inspection of the two groups were 96.49%,95.55%,96.08%,joint inspection had obvious advantages,the difference was statistically sig-nificant(χ2 =16.24,13.58,P <0.05).Conclusion Ultrasound elastography hardness rating combined area ratio has a higher accuracy rate for differentiating benign and malignant breast tumors.
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Objective To investigate the value of Color Doppler ultrasound in hemodynamic changes of non-alcoholic fatty liver disease.Methods 120 cases with non -alcoholic fatty liver disease were selected and divided into the mild group,moderate group and severe group.According to the degree of fatty infiltration of the liver taxono-my,40 cases in each group,hemodynamic changes of each group were detected in Color Doppler ultrasound equip-ment.Results Hepatic venous pulse waveform analysis and comparison constituted of the three groups and control group,the difference was statistically significant (χ2 =25.343,P <0.05).PPVV,MPVV,HARI of the three groups and control group were compared,the difference was statistically significant(F =34.67,51.03,31.06,all P <0.05).Conclusion Color Doppler ultrasound which is used to detect hemodynamic changes in non -alcoholic fatty liver disease had good clinical value,can assess disease progression in patients,can provide the basis for clinical treat-ment.