Application value of contrast-enhanced ultrasound in differential diagnosis of complex renal cysts and clear renal cell carcinoma with cystic change / 中华超声影像学杂志

Objective@#To investigate the value of contrast-enhanced ultrasound(CEUS) in differential diagnosis of complex renal cysts and clear renal cell carcinoma with cystic change(CRCCC).@*Methods@#The ultrasonographic datas of 82 lesions in 82 patients with complicated renal cysts or CRCCC confirmed by pathology were analyzed. The characteristics of conventional ultrasound and CEUS were observed and evaluated. The lesions were graded according to Bosniak classification criteria.@*Results@#Pathological examination showed that 36 cases were complicated renal cysts and 46 cases were CRCCC. Routine ultrasound showed there were 9 cases (25.0%) with cystic masses and 27 cases (75.0%) with solid and cystic masses in complex renal cysts, of which 14 cases (38.9%) could detect color flow signals. In CRCCC, 2 cases (4.3%) were with cystic masses and 44 cases (95.7%) were with solid and cystic masses, of which 33 cases (75.0%) could detect color flow signals. CEUS showed that only 18 cases (50.0%) of the complex renal cysts showed enhancement of cystic wall or septum, with equal or low enhancement at the peak, 9 cases (50.0%) accompanied by decrease of renal cortex, 35 cases (97.2%) had thin and regular cystic wall, no enhancement of cystic wall in all lesions, and 33 cases (91.7%) had septal thickness less than 1 mm. Forty-five cases (97.8%) of CRCCC showed enhancement of cystic wall or septum, 40 cases (88.9%) showed equal or high enhancement at peak, 30 cases (66.7%) were faster than the decrease of renal cortex, 37 cases (80.4%) showed uneven thickness of cystic wall, 24 cases (52.2%) showed enhancement of cystic wall nodules, and 28 cases (60.9%) showed uneven thickness of septum. After CEUS, 33 cases (91.7%) of complex renal cysts were classified as grade Ⅰ and Ⅱ, while 42 cases (91.3%) of CRCCC were classified as grade Ⅲ and Ⅳ.@*Conclusions@#The CEUS manifestations of complex renal cysts are different from those of CRCCC. The application of Bosniak criteria in CEUS is helpful for the differential diagnosis of complex renal cysts and CRCCC.

Application value of contrast-enhanced ultrasound in differential diagnosis of complex renal cysts and clear renal cell carcinoma with cystic change / 中华超声影像学杂志

Objective To investigate the value of contrast-enhanced ultrasound(CEUS)in differential diagnosis of complex renal cysts and clear renal cell carcinoma with cystic change(CRCCC).Methods The ultrasonographic datas of 82 lesions in 82 patients with complicated renal cysts or CRCCC confirmed by pathology were analyzed.The characteristics of conventional ultrasound and CEUS were observed and evaluated.The lesions were graded according to Bosniak classification criteria.Results Pathological examination showed that 36 cases were complicated renal cysts and 46 cases were CRCCC. Routine ultrasound showed there were 9 cases (25.0％) with cystic masses and 27 cases (75.0％) with solid and cystic masses in complex renal cysts,of which 14 cases (38.9％) could detect color flow signals.In CRCCC,2 cases(4.3％)were with cystic masses and 44 cases(95.7％)were with solid and cystic masses, of which 33 cases(75.0％)could detect color flow signals.CEUS showed that only 18 cases(50.0％)of the complex renal cysts showed enhancement of cystic wall or septum,with equal or low enhancement at the peak,9 cases(50.0％) accompanied by decrease of renal cortex,35 cases (97.2％) had thin and regular cystic wall,no enhancement of cystic wall in all lesions,and 33 cases(91.7％)had septal thickness less than 1 mm.Forty-five cases (97.8％) of CRCCC showed enhancement of cystic wall or septum,40 cases(88.9％)showed equal or high enhancement at peak,30 cases(66.7％)were faster than the decrease of renal cortex,37 cases (80.4％) showed uneven thickness of cystic wall,24 cases (52.2％) showed enhancement of cystic wall nodules,and 28 cases (60.9％) showed uneven thickness of septum.After CEUS,33 cases(91.7％)of complex renal cysts were classified as grade Ⅰ and Ⅱ,while 42 cases(91.3％) of CRCCC were classified as grade Ⅲ and Ⅳ.Conclusions The CEUS manifestations of complex renal cysts are different from those of CRCCC.The application of Bosniak criteria in CEUS is helpful for the differential diagnosis of complex renal cysts and CRCCC.

Comparative study of handheld ultrasound ,automated breast volume scanner and breast specific gamma imaging in the diagnosis of breast cancer / 中华超声影像学杂志

Objective To compare the efficiencies of handheld ultrasound ,automated breast volume scanner ( ABVS) and breast specific gamma imaging (BSGI) in the diagnosis of breast cancer . Methods A retrospective review was performed in 200 women ( 210 breast lesions) underwent handheld ultrasound , ABVS and BSGI before surgery . The results were verified with histological examination . Results There was no obvious difference among the three methods in the sensitivity for the diagnosis of breast cancer( P >0 .05) . There was no difference of specificity between handheld ultrasound and ABVS ,BSGI( P = 0 .393 , 0 .139) . Compared with BSGI ,ABVS was an imaging modality with highest specificity for the diagnosis of breast cancer( P = 0 .021) ,and there was no difference between handheld ultrasound and ABVS ,BSGI ( P =0 .07 ,0 .29) . The areas under the ROC curve of handheld ultrasound ,ABVS and BSGI were 0 .855 ,0 .894 and 0 .818 ,respectively . The difference was obvious between ABVS and BSGI ( P = 0 .02) . Conclusions The diagnostic efficacy of ABVS in diagnosis of breast malignant lesions is similar to that of handheld ultrasound . BSGI has certain clinical value in the diagnosis of breast cancer ,and it is an effective supplement for breast cancer ultrasound examination .

The image performance of mucinous breast carcinoma on automated breast volume scanner and its pathologic features / 中华超声影像学杂志

Objective To explore the image performance of mucinous breast carcinoma( MBC) on automated breast volume scanner ( ABVS ) and its pathologic features ,for the purpose of improving the recognition of this disease on ABVS ,as well as diagnostic ability . Methods Retrospectively analyzed the sonogram and pathological data of 17 patients with 18 MBC lesions that included 9 PMBC ( pure mucinous breast carcinoma) and 9 MMBC( mixed mucinous breast carcinoma) ,all patients were examined by ABVS before operation and confirmed by pathology . Results Luminal A was the main molecular subtype of MBC ,as well as rarely lymph node metastases;The image of the MBC on ABVS mainly showed a round like or irregular mass ,isoechoic or slightly lower with posterior acoustic enhancement ,and clearly edge with microlobulated or angular ;While on the coronal plane ,it might presented unsmoothed contour ,retraction phenomenon and expansive growth pattern like a spherical nodular;The image characteristics of the PMBC and MMBC lesions on ABVS had no statistical difference( P > 0 .05) ,but the PMBC often performed isoechoic mass with clearly marge ,in contrast , the MMBC usually performed hypoechoic mass with indistinct and angular edge ,and the malignant image features on the coronal plane . Conclusions The three vertical sections of ABVS are beneficial to observe the morphological features of MBC completely ,which can help to identify it from the benign lesions ,reduce misdiagnosis ,and provide some guidance for MBC surgical treatment in the early stage .

Clinical research of automated breast volume scanner and MRI in diagnosis of breast cancer / 中华超声影像学杂志

Objective To evaluate the effectiveness of automated breast volume scanner(ABVS) and magnetic resonance imaging(MRI) in the detection and diagnosis of breast cancer and to assess the value of these modalities as well as the joint use of the two.Methods In this study,a total of 50 breast lesions in 37 patients proved by surgery and pathology were included.Before operation,all patients were underwent both ABVS and dynamic contrast-enhanced (DCE-MRI) examinations,and classified into groups according to BI-RADS classification.Then the effectiveness of the two examinations were contrasted,the image features on the two techniques were analyzed,and their differential diagnosis in benign and malignant breast lesions were compared.Results The sensitivity,specificity,accuracy,positive predictive value (PPV) and negative predictive value(NPV) of ABVS and MRI for the diagnosis of breast cancer were 91.67％ and 95.83％,88.46％ and 80.77％,90.00％ and 88.00％,88.00％ and 82.14％,92.00％ and 95.45％,respectively,and there was no statistical difference between ABVS and MRI(P ＞0.05);The sensitivity and specificity of the combination of the two were 99.65％ and 97.78％,respectively.The difference of the ABVS coronal features and MRI dynamic enhancement curve types between malignant breast lesions and the benign were statistically significant (P ＜ 0.05).Conclusions Both ABVS and MRI are effective to diagnose breast cancer well,while the combination of the two can improve the diagnosis more accurately.

Correlation between retraction phenomenon on the coronal planes and biological behaviors of breast cancer / 中华超声影像学杂志

Objective To investigate the correlation between retraction phenomenon on the coronal planes obtained by an automated breast volume scanner ABVS and biological behaviors of breast cancer Methods Two hundred and eighty-eight female patients with 293 pathologically proven breast cancers were included in this study All of them underwent ABVS examinations before surgery Retraction phenomenon on the coronal planes was evaluated retrospectively Correlation between retraction phenomenon and hormone receptor HR human epidermal growth factor receptor 2 HER-2 Ki-67 molecular subtypes histologic type histologic grade lymph node status lesion size and patient age were evaluated by univariate logistic regression analysis Above significant variables were then enrolled in multivariate logistic regression analysis to select independent risk factors for retraction phenomenon Results By univariate logistic regression analysis Luminal A subtype odds radio OR =8 395 P <0 001 HR positive OR=4 876 P <0 001 HER-2 negative OR = 4 407 P < 0 001 lower expression of Ki-67 OR = 3 716 P <0 001 lower grade OR=3 574 P <0 001 lymph node invasion OR=2 053 P =0 004 and smaller lesion OR=1 762 P =0 033 were risk factors for retraction phenomenon while histologic type P =0 3 1 8 and patient age P = 0 612 were not By multivariate logistic regression analysis Luminal A subtype OR=9 877 P <0 001 lower grade OR=3 573 P <0 001 and lymph node invasion OR=2 730 P = 0 004 were independent risk factors for retraction phenomenon among which Luminal A subtype was the strongest one Conclusions Retraction phenomenon on the coronal planes obtained by ABVS is closely related with Luminal A subtype and may be an imaging feature of less aggressive behaviors of breast cancer.

Comparison of three different planes obtained by automated breast volume scanner for the observation of margin ;characteristics of breast masses / 中华超声影像学杂志

Objective To compare the application value of three different planes obtained by automated breast volume scanner for the observation of margin characteristics of breast masses.Methods Two hundred and eight women patients with 237 masses (120 benign and 1 1 7 malignant,confirmed by pathology)were included in this study.The detection rates of mass margin characteristics in three different planes were compared.The diagnostic performance of mass margin characteristics in differentiating benign and malignant breast masses in three different planes was compared by area under the ROC curve (AUC). Results The detection rate of angular margins for malignant masses in sagittal planes(41 .9%)was higher than that in coronal planes(22.2%)and axial planes(26.5%)with statistical difference (P =0.001 ,0.013);the detection rate of spiculated margins for malignant masses in coronal planes(42.7%)was higher than that in sagittal planes (1 1 .1 %)and axial planes (1 7.1 %)with statistical difference (both P < 0.001 ).No significant difference was found between any two of the three planes in the detection rates of margin characteristics for benign masses.The AUC of angular margins in sagittal planes (0.693)was higher than that in coronal planes (0.607)and axial planes (0.624);the AUC of spiculated margins in coronal planes (0.697)was higher than that in sagittal planes (0.55 1 )and axial planes (0.573 );the AUC of indistinct margins in axial planes(0.606)was higher than that in coronal planes (0.552)and sagittal planes (0.552);the AUC of microlobulated margins in axial planes (0.825)was higher than that in coronal planes (0.778) and sagittal planes (0.81 7).Conclusions Three different planes of ABVS have their own advantages for the observation of margin characteristics of breast masses.