Evaluation of echogenic foci pattern of papillary thyroid carcinoma solitary nodule in lateral cervical lymph node metastasis / 中华超声影像学杂志

Objective:To study the correlation between echogenic foci pattern of papillary thyroid carcinoma(PTC) solitary nodule and lateral cervical lymph node metastasis.Methods:The clinical data of 475 patients with echogenic foci in preoperative ultrasound and pathologically confirmed PTC solitary nodule from January to December 2014 in Fudan University Shanghai Cancer Center were retrospectively analyzed, which was categorized into lateral cervical lymph node metastasis group and lateral cervical lymph node non-metastasis group. Echogenic foci was classified into five types: local punctate echogenic foci, diffused punctate echogenic foci, coarse echogenic foci, mixed echogenic foci, peripheral annular and eggshell echogenic foci. The related clinical characteristics and the ultrasonic features were also involved. Chi-Square test and Logistic regression analysis were performed to analyze the correlation.Results:Age, preoperative human thyroglobulin (HTG) level, maximum diameter, location and echogenic foci pattern distributed to lateral cervical lymph node metastasis of PTC solitary nodule in 475 cases, according to univariate analysis ( P<0.05). Multivariate Logistic regression analysis showed diffused punctate echogenic foci, age≤35 years old, maximum diameter >10 mm and upper part were risk factors of lateral cervical lymph node metastasis of PTC solitary nodule. Conclusions:Diffused punctate echogenic foci in PTC solitary nodule, patients younger than 35 years old, maximum diameter larger than 1 cm and nodule location at upper part of the thyroid promote to lateral cervical lymph node metastasis.

Risk factors of central neck lymph node metastasis following solitary papillary thyroid carcinoma / 中华超声影像学杂志

Objective To evaluate the risk factors in terms of clinical characteristics ,serological indicators and sonographic features regarding thyroid papillary carcinoma ( PTC) for the central neck lymph node metastasis . Methods One thousand one hundred and seventy‐four patients accepted thyroid cancer surgery at Fudan University Shanghai Cancer Center from January to September 2016 were enrolled . All patients were confirmed to be solitary PTC in paraffin wax pathology after thyroidectomy .M eanwhile ,the status of central neck lymph node metastasis was determined referring to postoperative pathology . All features of the PTC lesion in terms of clinical ,serological and sonographic features were evaluated for the association with central neck lymph node metastasis using univariate and multivariate logistic regression analysis . Meanwhile ,a nomogram model was established for the determined risk factors . Results Out of 1 174 patients ,469 patients ( 39 .9% ) presented central neck lymph node metastasis ,univariate analysis showed that age , gender , preoperative thyroglobulin ( Tg ) and thyroid peroxidase antibody ( T POAb ) , maximum diameter ,location ,close to the thyroid capsule ,AP/T R ,echo ,acoustic halo ,and presence of microcalcification were related with CLNM ( P ＜ 0 .05 ) . M ultivariate logistic regression analysis demonstrated that less than 55 years‐old , male , Tg higher than 20 eg/L , T POAb less than 1 kU/L , maximum diameter larger than 10 mm ,and presence of microcalcification were independent risk factors for CLNM . T he nomogram was established based on independent risk factors determined by the logistic regression with the AUC 0 .714 ,specificity 73 .1% ,and sensitivity 59 .7% . Conclusions For patients with single focal PTC lesion , younger age , male , higher Tg , lower T POAb , and larger lesions containing microcalcificatin on ultrasound are associated with central neck lymph node metastasis .

Ultrasonographic features of different pathological types of breast phyllodes tumors / 中华超声影像学杂志

Objective To investigate the ultrasonographic features of different pathological types of phyllodes tumors ( PT ) of breast . Methods T he clinical manifestations and sonographic findings were analyzed retrospectively in 132 patients with 136 different subtype PT s . Ultrasonographic features of benign ,borderline and malignant types were compared . Results All the lesions were classified into benign ( 46/136 ,33 .8% ) ,borderline ( 62/136 ,45 .6% ) and malignant ( 28/136 ,20 .6% ) . On sonography ,most tumors were show n as oval or lobulated ( 77 .9% ) ,well‐defined margins ( 70 .6% ) ,and posterior echo enhancement ( 72 .1% ) . Cystic areas were observed in 36 lesions ( 26 .5% ) . No significant difference was observed in age ,lesion shape ,echo patterns ,posterior acoustic features or cystic area ( P ＞ 0 .05 ) . Large size ,indistinct margins and grade Ⅱ － Ⅲ vascularity were more frequent in borderline and malignant tumors ( P ＝0 .002 , P ＝0 .028 , P ＜0 .001 ,respectively ) . Conclusions Phyllodes tumors of breast have certain characteristics on ultrasonography .Large size ,unclear margins and rich blood flow signals may indicate malignancy .

Risk factors of predicting lateral neck lymph node metastasis following solitary papillary thyroid carcinoma / 中华超声影像学杂志

Objective@#To evaluate the risk factors in terms of clinical characteristics and sonographic features regarding solitairy thyroid papillary carcinoma (PTC) for the lateral cervical lymph node metastasis(LLNM) and then to establish nomogram model.@*Methods@#All patients were confirmed to be solitary PTC in paraffin wax pathology after thyroidectomy in Fudan University Shanghai Cancer Center from January to September 2016. Meanwhile, the status of lateral cervical lymph node metastasis was determined referring to postoperative pathology. Clinical characteristics including gender, age, preoperative thyroid stimulating hormone (TSH), thyroglobulin (Tg), thyroglobulin antibody (TGAb), thyroid peroxidase antibody (TPOAb), central lymph node metastasis (CLNM) and sonographic features of the PTC lesion including maximum tumor diameter, location, aspect ratio, relation with thyroid capsule, echo, margin, acoustic halo, microcalcification were evaluated for the association with lateral cervical lymph node metastasis using univariate and multivariate logistic regression analyses. Then the nomogram model was established and its application value was evaluated using ROC.@*Results@#Out of 1 174 patients, 125 patients (10.6%) presented lateral neck lymph node metastasis and 10 patients presented skipping metastasis.Univariate analysis showed gender, preoperative Tg and TGAb, CLNM, maximum tumor diameter, location, close to the thyroid tumor capsule, echo, aspect ratio, acoustic halo, microcalcification were associated with LLNM(P<0.05). Binomial logistic regression analysis indicated CLNM, maximum tumor diameter of larger than 10 mm, superior or multiple location, microcalcification were independent risk factors of LLNM. The AUC of the nomogram model was 0.865, the sensitivity was 88.0%, the specificity was 75.2%, and the accuracy was 76.6%.@*Conclusions@#As for patients with single focal PTC, CLNM, larger lesions, microcalcification, superior location are associated with lateral neck lymph node metastasis. The nomogram model can be tried for clinical application.

Risk factors of predicting lateral neck lymph node metastasis following solitary papillary thyroid carcinoma / 中华超声影像学杂志

Objective To evaluate the risk factors in terms of clinical characteristics and sonographic features regarding solitairy thyroid papillary carcinoma (PTC) for the lateral cervical lymph node metastasis (LLNM) and then to establish nomogram model.Methods All patients were confirmed to be solitary PTC in paraffin wax pathology after thyroidectomy in Fudan University Shanghai Cancer Center from January to September 2016.Meanwhile,the status of lateral cervical lymph node metastasis was determined referring to postoperative pathology.Clinical characteristics including gender,age,preoperative thyroid stimulating hormone (TSH),thyroglobulin (Tg),thyroglobulin antibody (TGAb),thyroid peroxidase antibody (TPOAb),central lymph node metastasis (CLNM) and sonographic features of the PTC lesion including maximum tumor diameter,location,aspect ratio,relation with thyroid capsule,echo,margin,acoustic halo,microcalcification were evaluated for the association with lateral cervical lymph node metastasis using univariate and multivariate logistic regression analyses.Then the nomogram model was established and its application value was evaluated using ROC.Results Out of 1 174 patients,125 patients (10.6％) presented lateral neck lymph node metastasis and 10 patients presented skipping metastasis.Univariate analysis showed gender,preoperative Tg and TGAb,CLNM,maximum tumor diameter,location,close to the thyroid tumor capsule,echo,aspect ratio,acoustic halo,microcalcification were associated with LLNM (P ＜0.05).Binomial logistic regression analysis indicated CLNM,maximum tumor diameter of larger than 10 mm,superior or multiple location,microcalcification were independent risk factors of LLNM.The AUC of the nomogram model was 0.865,the sensitivity was 88.0％,the specificity was 75.2％,and the accuracy was 76.6％.Conclusions As for patients with single focal PTC,CLNM,larger lesions,microcalcification,superior location are associated with lateral neck lymph node metastasis.The nomogram model can be tried for clinical application.

Comparative study of the diagnostic value of ultrasonography and MRI in mucinous adenocarcinoma of breast / 中华超声影像学杂志

Objective@#To investigate ultrasonographic and magnetic resonance imaging features of pure mucinous adenocarcinoma of breast, and to discuss the diagnose value.@*Methods@#Eighty-eight patients with 92 breast lesions of pure mucinous adenocarcinoma had undergone ultrasonography and MRI. The imaging features were reviewed and the diagnostic values were compared between the two imaging examinations.@*Results@#On ultrasonography, tumors were mostly showed well-defined margins (77.2%), lobulated shape (60.9%), hypoechoic (51.1%), heterogeneous texture (63.0%), posterior echo enhancement (82.6%). Color Doppler imaging showed vascularity in 75% of these lesions.On magnetic resonance imaging, most tumors showed circumscribed mass with lobulated shape. Sixty-four lesions (69.6%) showed hypointensity on T1-wighted images.Hyperintensity and strongly hyperintensity on T2-weighted images were identified in 71 cases and 21 cases, respectively. After contrast, 54 cases showed rim enhancement and the other 38 cases showed heterogeneous enhancement. There was no significant difference in diagnostic accuracy between ultrasonography and MRI (72.8% vs 77.2%, P=0.481). Combined the two imaging examinations, the diagnostic accuracy was higher than that of ultrasonography (84.8% vs 72.8%, P=0.001) and MRI (84.8% vs 77.2%, P=0.016).@*Conclusions@#Pure mucinous adenocarcinoma of breast has some typical characteristics in ultrasonography and MRI, combination of the two imaging examinations can improve the diagnostic accuracy.

Comparison of ultrasonography and ultrasound-guided diffuse optical tomography in assessing treatment response of breast cancer to neoadjuvant chemotherapy / 中华超声影像学杂志

Objective To investigate the clinical value of conventional ultrasonographic ( US),US-guided diffuse optical tomography ( US-guided DOT ) and both combined to assess treatment response of breast cancer to neoadjuvant chemotherapy( NAC). Methods Eighty-eight breast cancer patients,totally 93 lesions were included in the study. Pre-and post-last chemotherapy,size,and total hemoglobin concentration ( THC) of each lesion were measured by conventional US and US-guided DOT before biopsy,the change of lesion Size( ΔSize) and the change of THC( ΔTHC) were calculated respectively.Based on the guidelines to evaluate the response to treatment in solid tumors,the responses to NAC were classified into complete response, partial response, static disease, progressive disease groups. The histological response to chemotherapy were categorised as partial pathological response and complete pathological response using Miller and Payne system. Results Of 93 breast cancers,the overall response rate was 81.7%,the cPR rate was 24.7%. According to ROC curve analysis,when ΔSize 42.6% and ΔTHC 23.9% as cutoff values to evaluate the complete response and partial response,the area under the curve ( AUC ) were 0.666 and 0.751,respectively,the AUC of US and US-guided DOT combined in parallel and in series were 0.680 and 0.737 respectively.When ΔSize 64.5% and ΔTHC 27.2% as cutoff values to evaluate complete pathologial response,the AUC were 0.690 and 0.728 respectively,the AUC of US and US-guided DOT combined in parallel and in series were 0.693 and 0.726 respectively. Conclusions US-guided DOT and US can be used to predict breast cancers response to NAC,US and US-guided DOT combined in parallel and in series can not improve response prediction comparing with US or US-guided DOT alone.

Screening for cryptococcal antigenemia and analyzsis of the related cryptococcal lesions in hospitalized human immunodeficiency virus infected patients / 中华传染病杂志

Objective To evaluate the prevalence of cryptococcal antigenemia and explore the related cryptococcal lesions in hospitalized human immunodeficiency virus ( HIV )-infected patients . Methods Medical records of 517 HIV-infected patients ,including patients'age ,sex ,clinical features , previous medical history ,laboratory tests ,chest CT ,treatment and the response to treatment ,in the Second Hospital of the Nanjing between January 2016 and February 2018 were retrospectively analyzed . The serum cryptococcal antigen (sCrAg) was detected by lateral flow immunoassay .The χ2 test or Fisherexact test was used to perform the statistical analysis .Results Among 517 HIV-infected cases ,51 were sCrAg positive ,of whom 96 .1％ (49 cases) were men .The cases with CD4+ T lymphocyte count <100 × 106 cells/L accounted for 66 .2％ (342 cases) ,while 90 .2％ (46 cases) in sCrAg-positive patients showed CD4+ T lymphocyte count < 100 × 106 cells/L with statistical significance (χ2 = 14 .6 , P< 0 .01 ) . Multivariable analysis revealed that CD4+ T lymphocyte count <100 × 106 cells/L was independent risk factor for cryptococcal antigenemia (OR= 4 .7;95％ CI:1 .8 -12 .5 , P< 0 .01) .Clinical cryptococcal diseases were found in 76 .4％ (39/51 ) of patients with cryptococcal antigenemia , and cryptococcal meningitis (CM) ,pulmonary cyptococcosis (PC) and cryptococcal septicemia were found in 56％ (28/50) ,52 .9％ (27/51) and 44 .4％ (16/36) of the patients ,respectively .Cryptoccal disease was not identified in 21 .6％ (11/51 ) of the patients with cryptococcal antigenemia (isolated cryptococcal antigenemia) .The median (range) sCrAg titers of the patients with and without CM were 1:1280 (1:10-1:2560) and 1 :15 (1:2-1:2560) ,respectively (P<0 .01) .The proportion of CM in patients with sCrAg titers ≤1:5 ,1:10 -1:320 and ≥1:640 were 0 (0/10) ,50％ (10/20) and 90％ (18/20) , respectively .When cryptococcal infection was restricted to the lung ,87 .5％ (7/8) of the patients had sCrAg titers ≤1:20 .30％ (3/10) of the patients with sCrAg titers ≤1:5 had PC .The median (range) sCrAg titers of the patients with cryptococcal septicemia and with isolated cryptococcal antigenemia were 1:1280 (1:10 -1:2560 ) and 1:5 (1:2 -1:320 ) , respectively . Conclusions T he prevalence of cryptococcal antigenmia is high in hospitalized HIV-infected patients . Most patients with cryptococcal antigenemia have developed cryptococcal diseases .The sCrAg titer in HIV patients may ,in some extend , predicts the condition of cryptococcal infection .sCrAg titers ≥ 1:640 are strongly suggestive of CM . Patients with sCrAg titers ≤1:5 seems unlikely to have CM or cryptococcal septicemia ,however ,clinician should still be alarmed of possible PC .

Anisotropy of shear wave elastography in breast lesions and its correlation with histopathology / 中华超声影像学杂志

Objective To retrospectively study the anisotropy of shear wave elastography (SWE)quantitative parameters of breast lesions,and the correlation with histopathology.Methods A total of 281 consecutive women with 281 breast lesions (179 malignant,102 benign) were included,who underwent conventional ultrasound (US) and 2D SWE before surgical excision.Three acquisitions each for transverse and longitudinal planes were obtained,and maximum elasticity (Emax),mean elasticity (Emean),standard deviation (Esd) of the whole lesion and ratio between the elasticity in the mass and the fatty tissue (Eratio)were recorded.Anisotropic difference (AD) and anisotropy factors (AF) were calculated,and correlation with histopathology was analyzed.Results The average Emax,Emean and Esd of transverse planes were significantly higher than those of longitudinal planes.AF showed positive correlation with quantitative elasticity (Emax,Emean,Esd and Eratio) (P =0.000),and was significantly higher in malignant lesions than that in benign besions (P =0.000).AUC of AF was significantly higher than that of AD (P ＜0.001).AF was significantly higher in invasive ductal carcinoma than that in ductal carcinoma in situ.Higher AF was associated with higher histopathological grades of invasive ductal carcinoma (P =0.000),and correlated with ER/PR(+).Conclusions Anisotropy of SWE is an indicator of malignancy of breast lesions,and is of predictive value for prognosis in breast cancer.

The correlation study between greyscale ultrasonography of invasive breast cancer and axillary lymph node involvement / 中华超声影像学杂志

Objective To investigate the relationship of greyscale ultrasonographic signs and clinical pathological characteristics with axillary lymph node metastasis in invasive breast cancer.Methods Three hundred and thirty-five patients with pathologically confirmed breast cancer were retrospectively analyzed,which categorized into 2 groups,including lymph node metastasis group and lymph node non-metastasis group.The clinical and pathological characteristics included age,primary tumor size,histological grade,and molecular subtypes.The ultrasonographic features were examined including orientation,shape,margin,echo pattern,posterior acoustic feature,and calcification.Chi-Square test and Logistic regression analysis were performed to analyze the relationship of clinical pathological characteristics and greyscale ultrasonographic signs with axillary lymph node metastasis.Results Age (＜45 years),primary tumor size (≥2 cm),histological grade(Ⅲ grade),molecular subtype (Luminal B),and number of margin angulation (＞ 10) contributed to axillary lymph node metastasis in 335 cases,according to univariate analysis (P ＜0.05).Multivariate Logistic regression analysis showed age (OR =0.573,P =0.019),the primary tumor size (OR=2.359,P =0.001),histological grade (OR=0.529,P =0.008),and number of marginangulation (OR =1.889,P =0.031) were risk factors of axillary lymph node metastasis in breast cancer.Conclusions Univariate and multivariate analyses show the correlation between ultrasonographic features and axillary lymph node involvement.Combining with clinical pathological data,it can provide a predictor of axillary lymph node metastasis.

Quantitative features and diagnostic value of 3-dimensional shear wave elastography in breast lesions / 中华超声影像学杂志

Objective To retrospectively study the quantitative features and diagnostic value of 3-dimensional shear wave elastography (3D-SWE) in breast lesions.Methods A total of 198 consecutive women with 198 breast lesions (125 malignant,73 benign) were included,who underwent conventional ultrasound (US) and 3D-SWE before surgical excision.Quantitative parameters of transverse planes,sagittal planes and coronal planes were calculated,including maximum elasticity (Emax-w),mean elasticity (Emean-w),standard deviation (Esd) of the whole lesion and ratio between the stiffest elasticity (Emean-s)in the lesion and the fatty tissue (Eratio).Area under ROC curve(AUC) for combination of quantitative parameters and US were calculated.Results The AUC,sensitivity and specificity for US were 0.919,88.0％ and 78.1 ％,respectively.In the total 198 lesions,Emax-w,Emean-w,Esd,Eratio and Emean s were significantly lower in coronal planes than those in transverse and sagittal planes (all P ＜0.001).AUC for combination of each quantitative parameter and US were significantly higher than those of US (all P ＜0.05),except Emean-w of transverse plane,while there was no significant difference among the three orthogonal plane (P＞0.05).Sensitivity significantly increased by combining US with Emean-s,Eratio (transverse,sagittal and coronal planes),Emean-w (coronal and sagittal planes) or Esd (coronal and transverse planes) (all P＜0.05).Combination of US and Emean w of coronal plane yielded significantly higher sensitivity than those of transverse and sagittal planes.Conclusions Combination of quantitative features of 3D-SWE and US can significantly increase diagnostic accuracy and sensitivity in breast lesions.Emean-w of coronal plane yields the highest sensitivity.

Prediction of clinical efficacy of breast cancer neoadjuvant chemotherapy using ultrasound-guided diffuse optical tomography / 中华超声影像学杂志

Objective To investigate the value of ultrasound-guided diffuse optical tomography (US-guided DOT) to predict clinical efficacy of breast cancer neoadjuvant chemotherapy (NAC).Methods Eighty-eight breast cancer patients with 93 lesions were included.Pre-and post-last chemotherapy,the size,total hemoglobin concentration (THC) of each lesion were measured by ultrasonography (US) and US-guided DOT.Based on the guidelines to evaluate the response to treatment in solid tumors,the lesions of treated breast cancer patients were divided into 4 types of responses to NAC:complete response (CR),partial response (PR),stable disease (SD),and progressive disease (PD).Efficient groups include CR and PR groups.Results As expected,no significant difference was found in size and THC for untreated lesions (all P ＞0.05).However,for the treated lesions(P =0.001),THC,pre-vs post-treatment size changes (△Size％) (P =0.002) and THC changes (△THC％) (P ＜0.001) were significantly varied among CR,PR,SD,PD groups.When compared with pre-treated,tumor sizes after treatment were changed significantly in all CR(P ＜0.001),PR(P ＜0.001),SD (P =0.023) and PD (P =0.001),while significant change of THC was only found in CR(P ＜0.001),PR(P ＜0.001) and SD (P =0.002).When △THC％ =23.9％ as the threshold for prediction of NAC efficiency,the area under the curve of ROC was 0.75,and the sensitivity was 73.7％,specificity was 76.5 ％,positive predictive value was 93.3 ％,negative predictive value was 39.4％,accuracy was 74.2％.Conclusions △size％ changes in consistent with △THC％ among the intergroups,but their changes levels are different,the highest change percent appears in CR,gradually decreased in PR,SD groups.△THC％ will contribute to predict preoperative clinical NAC efficacy.

Value of ultrasonography,mammography and magnetic resonance imaging in diagnosis of granulomatous lobular mastitis / 中华超声影像学杂志

Objective To evaluate the ultrasonographic ( US ) findings of granulomatous lobular mastitis( GLM ) ,and to compare the diagnostic accuracy among US ,mammographic ,and magnetic resonance imaging ( MRI) . Methods Imaging characteristics of 56 patients who were pathologically comfirmed as GLM were reviewed .All the lesions were assessed by BI‐RADS ( Breast Imaging Reporting and Data System) . Results Fifty‐eight lesions were found in 56 patients . Thirty ( 51 .7% ) were irregular ,20 (34 .5% ) were lobular and 8(13 .8% ) were round or oval in shape . Forty two lesions (72 .4% ) were hypoechoic ,14 (24 .1% ) were mixed echoic textur ,including 6 lesions (10 .3% ) with tubular connections and 8 lesions ( 13 .8% ) with irregular markly hypoechoic internal echoes . Two ( 3% ) were isoechoic .No calcification were found . Color Doppler signals were detected in 33 cases(56 .9% ) ,and the resistance index ( RI) ranged from 0 .61 to 0 .79 . Forty patients underwent mammography ,there were no distinct lesions in 6 cases(15% ) ,suspicious calcification in two(5% ) , asymmetric density in twenty(50% ) ,and solitary masses in twelve(30% ) . MRI was performed in 36 patients ,and revealed no abnormality in two patients(5 .6% ) , twenty nine lesions ( 80 .6% ) showed hypointensity on T1‐weighted images and hyperimensity on T2‐weighted images ,five lesions ( 13 .9% ) showed isointensity on T1‐weighted images and hyperimensity on T2‐weighted images ,and all the lesions showed heterogeneous enhancement after contrast .The diagnostic accuracy of ultrasonography , mammography and MRl was 63 .8% , 45% and 61 .1% , respectively . Conclusions There were no specific imaging characteristics of GLM ,the combination of ultrasonography , mammography and MRI might benefit the diagnosis of GLM .

The application of BI-RADS in the diagnosis of breast cystic-solid lesions / 中华超声影像学杂志

Objective To analyze the ultrasonographic characteristics of breast cystic-solid lesions and to investigate the diagnostic value of BI-RADS breast imaging reporting and data system in this kind of disease Methods Imaging characteristics of 105 breast cystic-solid lesions of 93 patients were analyzed All the lesions were assessed by BI-RADS Histopathologic examination was used as the reference standard Results Among 105 lesions 57 54 3% were benign and 48 45 7% were malignant Differences in orientation shape margin calcification and vascularity were statistically significant between the benign and malignant lesions P 0 05).There were 5 1 predominantly solid mass,which appeared as solid mass with little dispersed or centralized cystic regions or solid mass with surrounding cystic regions,including 33 benign lesions and 1 8 malignant lesions.The area under the curves of ROC was 0.956 in this type.There were 25 lesions predominantly cystic,which had regular or irregular thick walls or septa,or had nodules protruding to the cystic component,including 1 1 benign lesions and 14 malignant lesions.The area under the curves of ROC was 0.753.There were 29 mixed solid-cystic mass,in which the solid component equaled to the cystic,including 13 benign lesions and 16 malignant lesions.The area under the curves of ROC was 0.887.The area under curves of ROC was 0.873 for the all breast cystic-solid lesions.The rates of malignant cystic-solid lesions in the three types had no significant difference(P >0.05).Conclusions Ultrasound is a useful tool for diagnosing breast cystic-solid lesions.The proportion of the cystic component is not helpful to differentiate malignancy from benignancy.

Influence of size on sonographic characteristics of pure mucinous carcinoma of the breast and diagnostic ;accuracy / 中华超声影像学杂志

Objective To investigate the influence of breast pure mucinous carcinoma size on sonographic characteristics and diagnostic accuracy.Methods Sonographic characteristics of 101 breast pure mucinous carcinoma in 1 00 patients were analyzed retrospectively.All lesions were divided into three groups according to maximum diameter at ultrasound.These were group Ⅰ with lesions less than 20 mm,group Ⅱwith lesions greater than or equal 20 mm,less than 40 mm,and group Ⅲ with lesions greater than or equal 40 mm.The relationship between lesions size and ultrasound parameters were analyzed.Results There were 38 lesions in group Ⅰ,52 lesions in group Ⅱ and 1 1 lesions in group Ⅲ.The patients age in group Ⅲwere older than that in group Ⅰ(F=3.442,P =0.036).Among these sonographic appearances,only shape (χ2=9.813,P =0.005)and blood flow (χ2=27.952,P =0.000)indicated significant differences.The accuracy of ultrasound diagnosis of breast cancer was 85.1%,the smaller the lesions were,the higher misdiagnosis rate the lesions were.Conclusions With lesions size increased,the lobular and internal blood flow of pure mucinous carcinoma increased.More smaller the lesions were,more higher misdiagnosis rate of lesions were.

The value of shear wave elastography for differential diagnosis of benign and malignant thyroid nodules / 中华超声影像学杂志

Objective To investigate the value of shear wave elastography (SWE)for differential diagnosis of benign and malignant thyroid nodules.Methods A total of 1 56 patients referred for surgery of thyroid nodules underwent standard ultrasound as well as elastography.The following characteristics of all the nodules were assessed:location,size,shape,margin,echogenicity,calcification and blood flow.The SWE elasticity indices of maximum (Emax),mean (Emean),minimum (Emin),and standard deviation (Esd) were automatically calculated by the US system.Thresholds were calculated by receiver operating characteristic (ROC ) curve analysis.The diagnostic performance of conventional US and SWE were compared.Histopathologic examination was used as the reference standard.Results Among a total of 1 56 nodules,1 1 8 were malignant and 38 were benign.SWE elasticity indices were significantly higher in malignant than in benign nodules (P ≤0.001 ).Sensitivity and specificity for predicting malignancy were 83.9%,92.1 % respectively using Emean with a threshold of 32.1 kPa,the specificity was significantly higher than using conventional ultrasound (P 0.05).Conclusions SWE provides higher specificity for predicting malignancy without losing sensitivity.

Influence of Oxygen Inhalation on Latency and Amplitude of P300 / 中国康复理论与实践

@#Objective To observe the change of the latency and amplitude of auditory-evoked potential P300 after oxygen inhalation.Methods 27 healthy male academicians were included. They were divided into control group (n=12) and experiment group (n=15) according to the random numerical table, and they were blinded about groups. All subjects in the experiment group inhaled pure oxygen while air in the control group through a mask for 60 minutes. EEG was recorded when an auditory Oddball paradigm was performed during following 4 periods: before oxygen inhalation (pre0), inhale oxygen (air in control) for 20 minutes (Oxy20) and 50 minutes (Oxy50), 30 minutes after oxygen inhaled (post30). The latency and amplitude of P300 from target stimuli were calculated. Results The latency of P300 was longer at Oxy20 as (358.58±15.32) ms, Oxy50 as (353.42±9.41) ms and post30 as (354.10±10.42) ms than at pre0 as (335.91±15.40) ms in the control group (P<0.01). The latency of P300 was shorter at Oxy50 as (319.17±14.34) ms, and post30 as (318.50±13.87) ms than at pre0 as (332.98±14.63) ms in the experiment group (P<0.05). The latency was shorter in the experiment group than in the control group at Oxy20,Oxy50 and post30 (P<0.01). The amplitudes were stable in the control group (P<0.05). The amplitude was lower at post30 as (2.41±0.64) μV than at pre0 as (5.49±0.89) μV in the experiment group (P<0.05). Conclusion Oxygen inhalation shortens the latency of P300, and decreases the amplitude in the similar trend with the prolongation of oxygen inhalation.

Ultrasonographic characteristics of breast lymphoma and comparison with mammography and MRI / 中华超声影像学杂志

Objective To retrospectively study the value of ultrasonography in diagnosing breast lymphoma and compare with mammography and MRI. Methods Imaging characteristics of 26 patients who were pathologically comfirmed as breast lymphoma were reviewed, including ultrasonography,mammography and MRI, and compare the diagnostic accuracy among the three. Results Twenty-four patients underwent ultrasonography and 32 lesions were found, with longest diameters averaged 30 mm.Tumors were mostly hypoechoic or very hypoechoic (81.3％), some were lobular (25.0％) or oval (21.9 ％ ) in shape, the margins were most frequently circumcribed (62. 5 ％ ), and a few tumors showed an echogenic boundary (18.8 ％ ). Color Doppler imaging showed hypervascularity in most tumors (59.4 ％ ).Ninteen patients undewent mammography, 15 solitary lesions were identified in 12 patients, asymmetric density in five,punctate calcification in one,and no abnormality in one. Eleven lesions were identified in MRI of 10 patients, 10 lesions showed hypointensity on T1-weighted images and hyperintensity on T2-weighted images, and heterogeneous enhancement after contrast. The diagnostic accuracy of ultrasonography,mammography and MRI was 83％, 52％ and 100％, respectively. Conclusions The sonograms of breast lymphoma have some distinct features, the combination of ultrasonography and MRI might benefit the diagnosis of breast lymphoma.

Ultrasound evaluation of neoadjuvant chemotherapeutic response in breast cancer and its correlation with histopathology / 中华超声影像学杂志

Objective To study ultrasound features of breast cancer before and after neoadjuvant chemotherapy,and its correlation with histopathology. Methods One hundred and nine patients with breast cancer underwent paclitaxel plus carboplatin neoadjuvant chemotherapy, the change of the primary lesions and axillary lymph nodes were studied by ultrasound,and compared with histopathology. Results Seventeen patients achieved complete remission under ultrasound, the rest measurable lesions became significantly shortened in maximum diameter [ ( 22.46 ± 11.50) mm vs (34. 71 ± 13.67) mm, P ＜ 0. 001 ], and showed decrease both in longitudinal-transverse ratio (0. 80 ± 0. 23 vs 0. 86 ± 0. 22, P ＞0. 05) and grades of blood flow (0. 51 ± 0.80 vs 1.23± 1.05, P ＜0. 001 ). 44. 83% (44/92) of metastatic axillary lymph nodes disapeared after treatment. Comparing with histopathology, the sensitivity and specificity of ultrasound assessing complete remission were 57. 89 % ( 11 / 19) and 93.33 % (84/90), respectively. The moderate concord between ultrasound with histopathology might be attributed to the pathologic change of breast tissue and stroma after treatment, nevertheless grades of blood flow might be more meaningful. Conclusions Ultrasound assessment of neoadjuvant chemotherapeutic response might be of reference value,and studying corresponding ultrasonic manifestation of different kinds of pathological changes would help with better evaluation.

The Apllication of Statins in the Treatment of Acute Ischemic Stroke / 国际脑血管病杂志

Previous studies have proved that the effect of statins in both primary and secondary prevention of ischemic stroke, however, whether acute ischemic stroke needs to be treated with statins and the effect of statins pretreatment on acute ischemic stroke remain unclear. This article reviews the recent representative studies in this field, and analyzes the effects of the application of statins in the treatment of acute ischemic stroke on prognosis.