Value of predictive liver metastasis in pancreatic neuroendocrine neoplasms based on ultrasonographic radiomics / 中华超声影像学杂志

Objective:To explore the predictive value of ultrasound-based radiomics for liver metastasis in pancreatic neuroendocrine tumors (pNEN).Methods:A retrospective analysis was conducted on clinical, pathological, and ultrasound data of 269 pNEN patients confirmed by pathology at Tianjin Medical University Cancer Institute and Hospital from January 2012 to June 2022, including 94 patients with liver metastasis and 175 without liver metastasis. The regions of interest (ROI) were delineated on the maximum diameter section of the tumor using ITKSNAP software, and radiomics features were extracted using Pyradiomics. Radiomics features with an intra-group correlation coefficient greater than 0.90 were retained, and the optimal features were selected using the maximum relevance minimum redundancy (MRMR) algorithm. The dataset was randomly divided into a training set and a validation set in a ratio of 7∶3, and the random forest algorithm (Rfs) was used to predict pNEN liver metastasis. Three models were constructed, including the clinical ultrasound model, the radiomics model, and the comprehensive model that combined clinical ultrasound and radiomics features. The predictive performance of different models for pNEN liver metastasis was analyzed using the ROC curve, and the predictive performance of different models was compared using the Delong test.Results:A total of 874 features were extracted from the ROI, and 12 highly robust radiomics features were retained for model construction based on inter- and intra-observer correlation grading and feature selection. The area under curve(AUC), sensitivity, specificity, and accuracy of the radiomics model, the clinical ultrasound model, and the comprehensive model for predicting liver metastasis in pNEN patients were 0.800, 0.574, 0.789, 0.714; 0.780, 0.596, 0.874, 0.777; and 0.890, 0.694, 0.874, 0.810, respectively. The Delong test showed that the comprehensive model had the best predictive performance, with an AUC superior to that of radiomics model ( Z=3.845, P=0.000 12) and clinical ultrasound model ( Z=3.506, P=0.000 45). Conclusions:The radiomics model based on ultrasound has good performance in predicting liver metastasis in pNEN, and the comprehensive model that combines clinical ultrasound and radiomics features can further improve the predictive performance of the model.

Analysis of the feasibility of measurements and characteristics of intraocular lens tilt using swept-source optical coherence tomography biometer / 中华实验眼科杂志

Objective:To evaluate the feasibility of measurement and characteristics of intraocular lens (IOL) tilt using the swept-source optical coherence tomography (SS-OCT) biometer (IOLMaster 700) and to explore its potentially relevant parameters.Methods:A cross-sectional study was conducted.Two hundred and forty-two eyes (119 right eyes, 123 left eyes) of 185 patients after phacoemulsification and IOL implantation were included in Beijing Tongren Hospital from July to September 2018.The IOL position, angle κ, angle α, corneal curvature, anterior chamber depth (ACD), pupil diameter (PD), and axial length (AL) were obtained by IOLMaster 700, and the IOL tilt direction and magnitude were calculated.The within-subject standard deviation and intraclass correlation coefficient were used to evaluate the repeatability of three IOL tilt measurements.Binocular symmetry of IOL tilt and the correlation between IOL tilt and different influencing factors were evaluated by Pearson linear correlation analysis or Spearman rank correlation analysis.Influencing factors for IOL tilt were assessed by multiple linear regression analysis.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of Beijing Tongren Hospital, Capital Medical University (No.TRECKY2018-049). Patients were informed of the purpose and methods of this study and signed the written informed consent.Results:The repeatability of IOL tilt measurements was excellent with a within-subject standard deviation of 5.16° for IOL tilt direction and 0.13° for IOL tilt magnitude.IOL tilt was mirror symmetric in both eyes.The IOL tilt direction in right eyes ranged from -89.60° to 87.53° with a mean of (18.85±29.65)°, and the tilt magnitude ranged from 1.32° to 7.05° with a mean of (4.16±1.26)°.The IOL tilt direction in left eyes ranged from -84.30° to 89.44° with a mean of (21.17±32.38)°, and the tilt magnitude ranged from 0.58° to 7.40° with a mean of (3.80±1.31)°.There were moderate and weak positive correlations of IOL tilt direction and tilt magnitude between both eyes ( r=0.473, P<0.001; r=0.335, P=0.011). IOL tilt magnitude was weakly positively correlated with angle α and IOL diopter ( rs=0.272, P=0.003; r=0.285, P=0.002), and was weakly negatively correlated with ACD, PD and AL ( r=-0.303, P=0.001; r=-0.233, P=0.011; rs=-0.331, P<0.001). In backward stepwise regression analysis, the regression equation of IOL tilt magnitude, angle α, ACD, PD, AL and IOL diopter in multiple linear regression analysis was as follows: IOL tilt magnitude=10.503+ 1.456×angle α-0.532×ACD-0.196×AL ( R2=0.400; F=8.588, P<0.001). Conclusions:The SS-OCT biometer can be an effective method to assess IOL tilt.IOL tilt is mirror symmetric between the right eyes and left eyes.

Association of pre-pregnancy body mass index and gestational weight gain with macrosomia / 中华健康管理学杂志

Objective:To analyze the association of pre-pregnancy body mass index (BMI) and gestational weight gain with macrosomia.Methods:In this retrospective cohort study, data of all puerperae and newborns in the Obstetrics Center of Peking Union Medical College Hospital from July 2020 to June 2021 were collected, including basic maternal information, pregnancy complications and neonatal conditions. A total of 2 422 pregnant women with full-term singleton live birth and their newborns were included in the analysis. The incidence of macrosomia (≥4 000 g) was calculated according to the birth weight of the newborns. Logistic regression and heat map were used to analyze the associations of pre-pregnancy BMI and gestational weight gain with macrosomia.Results:The incidence of macrosomia was 4.00% (97/2 422) in full-term singleton live birth newborns. Pre-pregnancy body weight, pre-pregnancy BMI, pre-pregnancy overweight/obesity rate, pre-delivery body weight, total weight gain during pregnancy, mean weekly weight gain during pregnancy, the proportion of excessive weight gain during pregnancy, duration of pregnancy, and the proportion of primiparity and education level of junior college or below were all significantly higher in the puerperae of the macrosomia group than those in the non-macrosomia group [(63.87±8.27) vs (58.14±7.86) kg, (23.33±2.97) vs (21.60±2.72) kg/m2, 35.1% vs 17.3%, (77.48±9.11) vs (70.02±8.79) kg, (13.61±4.56) vs (11.88±4.40) kg, (0.34±0.11) vs (0.30±0.11) kg, 58.8% vs 31.1%, (280.47±7.79) vs (276.14±7.83) d, 34.1% vs 23.7%, 18.6% vs 7.5%] (all P<0.05). Pre-pregnancy BMI ( OR=1.227, 95% CI: 1.145-1.314), mean weekly weight gain during the whole pregnancy ( OR=33.453, 95% CI: 5.172-217.947), duration of pregnancy ( OR=1.083, 95% CI: 1.055-1.112), primiparity ( OR=1.969, 95% CI: 1.232-3.101) and education level of junior college or below ( OR=2.525, 95% CI: 1.325-4.668) were all positively associated with occurrence of macrosomia (all P<0.05). The incidence of macrosomia increased with the pre-pregnancy body mass index and mean weekly weight gain during the whole pregnancy. Conclusions:High pre-pregnancy BMI and mean weekly weight gain during the whole pregnancy are associated with the increased risk of macrosomia. Appropriate weight management during pregnancy may help to reduce the incidence of adverse pregnancy outcomes.

Value of machine learning model based on 18F-FDG PET/CT radiomics features in differential diagnosis between gastric cancer and primary gastric lymphoma / 中华核医学与分子影像杂志

Objective:To investigate the value of machine learning model based on 18F-FDG PET/CT radiomics features in preoperative differential diagnosis of gastric cancer (GC) and primary gastric lymphoma (PGL). Methods:A total of 155 patients with GC (104 males, 51 females; age (59.3±12.8) years) and 82 patients with PGL (40 males, 42 females; age (56.8±14.6) years) who underwent 18F-FDG PET/CT imaging before treatment from January 2012 to December 2020 in Tianjin Medical University Cancer Institute and Hospital were included in this retrospective study. Patients were randomly divided into training set and test set by using Python3.7.1 software. Volumes of interest (VOIs) in PET and CT images were drawn and two-dimensional and three-dimensional radiomics features were extracted. Two machine learning models, including multi-layer perceptron (MLP) and support vector machine (SVM), were established based on CT radiomics features alone, PET radiomics features alone and PET/CT radiomics features to differentiate GC and PGL, respectively. The predictive performance of each model was evaluated by ROC curve analysis. Results:There were 166 patients in training set and 71 patients in test set. Generally, SVM machine learning model based on PET/CT radiomics features showed a trend to be superior to MLP machine learning model in the differential diagnosis of GC and PGL (PET-SVM: AUC=0.88, 95% CI: 0.83-0.94); PET/CT-MLP: AUC=0.80, 95% CI: 0.73-0.87; z=1.15, P=0.337). The AUC of PET/CT-SVM machine learning model was significantly higher than that of CT-SVM machine learning model (CT-SVM: AUC=0.74, 95% CI: 0.67-0.81; z=2.28, P=0.022). Conclusion:Machine learning model based on 18F-FDG PET/CT radiomics features is expected to be a non-invasive, effective tool for preoperative differential diagnosis of GC and PGL.

Predictive value of 18F-FDG PET/CT radiomic fusion features combined with XGBoost model for HER2 expression status in breast cancer / 中华核医学与分子影像杂志

Objective:To evaluate the value of radiomic fusion features combined with extreme gradient boosting (XGBoost) machine learning models based on 18F-FDG PET/CT images in the prediction of human epidermal growth factor receptor 2 (HER2) expression status in breast cancer. Methods:18F-FDG PET/CT images of 210 patients with primary breast cancer (all females; age 52(46, 60) years; 95 HER2-positive and 115 HER2-negative) in Tianjin Medical University Cancer Institute and Hospital between January 2012 and December 2019 were retrospectively analyzed. About 70% of the HER2-positive and HER2-negative groups were randomly selected using Python 3.7.1 software as a training set ( n=147; 67 HER2-positive and 80 HER2-negative, age: 52(46, 60) years vs 55(45, 62) years) and 30% as a test set ( n=63; 28 HER2-positive and 35 HER2-negative, age: 54(43, 65) years vs 52(45, 61) years). After tumor segmentation on CT and PET images being finished, CT and PET radiomic features were extracted respectively. PET/CT fusion features (including PET/CT splicing features and PET/CT mean features) were obtained through post-processing. The support vector machine (SVM) model and XGBoost model were established. The selected features were input to predict the expression status of HER2 in primary breast cancer lesions, and the prediction efficiency of the model was evaluated by ROC curve. The Delong test was used to compare the predictive effectiveness of different models and radiomic features, and the calibration curve of the machine learning model with the highest prediction efficiency was plotted. Results:Compared with SVM model, XGBoost model had better prediction performance ( z values: 2.26-3.54, P values: 0.016-0.040) when four kinds of radiomic features (CT features, PET features, PET/CT splicing features and PET/CT mean features) were input. ROC curve analysis showed that PET/CT mean features with XGBoost machine learning model had the best performance in predicting the expression status of HER2, and the maximum AUC was 0.83 (95% CI: 0.73-0.93), which was superior to CT features (0.75(95% CI: 0.63-0.88); z=3.57, P=0.027), PET features (0.73(95% CI: 0.60-0.86); z=2.64, P=0.034) and PET/CT splicing features (0.74(95% CI: 0.60-0.87); z=2.49, P=0.037). Conclusion:XGBoost machine learning model based on PET/CT radiomics fusion features is expected to predict HER2 expression status in patients with breast cancer.

Effect of posaconazole combined with proton pump inhibitors on blood concentrations and invasive fungal infec-tion in patients with malignant hematological disorders / 中国药房

OBJECTIVE To explore the effects of posaconazole combined with proton pump inhibitors （PPI） on the blood concentration and the risk of invasive fungal disease （IFD） in patients with malignant hematological disorder. METHODS In accordance with the random number table method， 40 patients with malignant hematological disorders who were admitted to the hematology department of our hospital between December 2020 and December 2021 were chosen and divided into control group （20 cases） and observation group （20 cases）. The control group received Posaconazole oral suspension alone， while the observation group received Posaconazole oral suspension combined with PPI. The incidence of IFD， attainment rate of blood concentration， the time from the start of prophylaxis to IFD onset， the fatality associated with IFD， treatment of infected patients， and blood concentrations of posaconazole on 7th， 14th， 21st， and 28th day after posaconazole application were compared between 2 groups； the occurrence of adverse events during drug administration in the two groups was recorded. RESULTS The study was stopped because 2 patients in the observation group and 9 patients in the control group received hospital departures after taking posaconazole for fewer than 7 days. The incidence of IFD in the observation group was significantly higher than control group， and the attainment rate of blood concentration in the observation group was significantly lower than control group （P＜0.05）. There was no significant difference in the time from the start of prophylaxis to IFD onset， the fatality associated with IFD， treatment of infected patients and the incidence of adverse events （P＞ 0.05）. The blood concentration of posaconazole in the observation group was significantly lower than control group on 7th day of medication （P＜0.05）； there was no significant in blood concentration of posaconazole between 2 groups on the 14th day of medication （P＞0.05）. CONCLUSIONS Posaconazole combined with PPI can reduce the blood concentration of patients with malignant hematological disorders， increase the risk of IFD. Clinical practice should try to avoid the combination of the two or use them under the guidance of therapeutic drug monitoring.

Research progress on material basis for neurotoxicity of traditional Chinese medicine and its mechanism / 中国药房

In recent years， neurotoxicity caused by traditional Chinese medicine （TCM） has frequently occurred and has become one of the important factors restricting the development and application of TCM. TCM contains active components and its dosage-effect relationship is the key to determine its pharmacological activity and toxic effects. Among them， the endogenous toxic components include alkaloids， glycosides， diterpenoids， animal and plant toxic proteins and heavy metals， and so on； exogenous toxic components mainly refer to some harmful elements and pesticide residues during the cultivation， processing， transportation and storage of medicinal materials that are not synthesized by themselves. Effect on the processes such as oxidative stress， inflammation， ion exchange， and energy metabolism may be important mechanisms of TCM-induced neurotoxicity. Neural cells， myelin cells， axons and neurotransmitter systems are common targets of TCM-induced neurotoxicity. In the future， we can use modern research methods and big data mining means to establish a safety evaluation mode of “toxic symptoms-poisoning dose-toxic original agent-detoxification scheme” with the basic component group of toxic substances as the core， so as to provide support for development and clinical intervention of neurotoxic traditional Chinese medicine.

Ultrasonographic features of adenoma of the nonpigmented ciliary epithelium / 中华眼底病杂志

Objective:To analyze the ultrasonographic features of adenoma of the nonpigmented ciliary epithelium (ANPCE).Methods:A retrospective series of case studies. From January 2014 to October 2021, 31 patients (31 eyes) with ANPCE (ANPCE group) were diagnosed in the eye center of Beijing Tongren Eye Center of Beijing Tongren Hospital, Capital Medical University, and 17 patients (17 eyes) with ciliary body melanoma (control group) diagnosed at the same time were selected as the control group. There was no significant difference in age ( t=-0.564) and sex composition ratio ( χ 2=0.182) between the two groups ( P=0.576, 0.670). All patients underwent ultrasound biomicroscopy to obtain the measurement parameters: tumor height, maximum basal diameter, maximum diameter, ratio of maximum diameter to basal diameter and ratio of maximum diameter to height; tumor location, shape, internal echogenicity intensity, echogenicity uniformity, degree of sound attenuation, invasion of iris, anterior displacement of the iris, lens subluxation were observed. The measurement parameters and observation indexes of the two groups were compared by independent sample t-test and χ 2 test. Receiver operating characteristic (ROC) curve was drawn, area under the ROC curve (AUC) was determined, and parameter indicators with differential diagnosis value were screened. Results:The maximum diameter, height, maximum basal diameter, ratio of the maximum diameter to the maximum basal diameter, and the ratio of the maximum diameter to the height of the tumors in the ANPCE group and the control group were 5.64±0.98 mm, 4.24±0.59 mm, 3.66±0.71 mm, 1.58±0.34, 1.34±0.19 and 7.82±2.03 mm, 4.47±2.44 mm, 7.02±1.96 mm, 1.13±0.16, 2.09±1.06. The maximum diameter, the maximum basal diameter, and the ratio of the maximum diameter to the height of the tumor in the ANPCE group were all smaller than those of the control group, and the ratio of the maximum diameter to the maximum basal diameter was greater than that of the control group, and the differences were statistically significant ( t=-4.159,-6.808, -2.924, 6.257; P<0.05). The tumors in the ANPCE group were mainly spherical (87.1%, 27/31), with no significant acoustic attenuation (77.4%, 24/31), less invading the root iris (77.4%, 24/31), and the tumors were mostly located in the ciliary body coronal (74.2%, 23/31); tumors in the control group were mainly hemispherical (47.1%, 8/17) or spherical (47.1%, 8/17), with significant sound attenuation (76.5%, 13/17), most of the tumors invaded the iris (70.6%, 12/17), and the tumors were mostly located from the pars plana to the coronal (76.5%, 13/17). There were statistically significant differences in the position, shape, sound attenuation degree, and whether it invaded the iris between the two groups of eyes ( χ 2=15.132, 19.767, 13.118, 10.581; P<0.05). The results of ROC curve analysis showed that the ratio of the largest diameter to the largest base diameter, the degree of sound attenuation and the AUC of whether the iris was violated were higher, which were 0.881, 0.769, and 0.740, respectively. Conclusions:Ultrasound biomicroscopy is helpful in the diagnosis and differential diagnosis of ANPCE and ciliary body melanoma. The ratio of maximum diameter to maximum basal diameter, the degree of sound attenuation and whether it invades the root iris are important parameters to distinguish the two tumors.

Analysis of ultrasonic diagnostic features of juxtapapillary capillary hemangioma / 中华超声影像学杂志

Objective:To discuss the characteristics of ultrasound diagnosis of optic disc capillary hemangioma.Methods:The study analyzed retrospectively 7 cases of optic disc capillary hemangioma diagnosed in the Beijing Tongren Hospital from 2015 to 2018. The size, morphology, internal echo, and secondary changes of the lesion were analyzed during ultrasound examination.Color Doppler flow imaging was used to check the blood flow in the lesion.Results:Pre-optic disc occupying lesions could be detected in the ultrasound images of the 7 cases. Lesion size: average base diameters (5.39±1.90)mm×(4.79±1.28)mm, average height (3.61±1.37)mm. Lesion morphology: 5 cases were round, and 2 cases were irregular. Echo within the lesion: 3 cases had medium echo inside the lesion, and 4 cases had high echo inside the lesion. Internal echo characteristics: 5 cases had uniform echo, and 2 cases had uneven echo. Secondary changes: 6 cases had secondary retinal detachment and vitreous opacity, and 1 cases was accompanied by retinal hemangioma in other parts. In all cases, blood flow signals could be detected inside the space-occupying lesions, which were in the form of branches, stripes or spots, and the blood flow spectrum showed a parallel spectrum of arteries and veins.Conclusions:Ultrasound examination of optic disc capillary hemangioma has certain characteristics, which can provide a valuable follow-up basis for clinical diagnosis.

Value of machine learning and 18F-FDG PET/CT radiomics features in lung adenocarcinoma EGFR mutation subtypes prediction / 中华核医学与分子影像杂志

Objective:To explore the predictive values for mutation subtypes of epidermal growth factor receptor (EGFR) in patients with lung adenocarcinoma (LUAD) based on machine learning and 18F-fluorodeoxyglucose (FDG) PET/CT images. Methods:18F-FDG PET/CT images and pathological data of 238 patients with LUAD (126 patients (54 males, 72 females, median age 62 years) with EGFR mutation; 112 patients (68 males, 44 females, median age 61 years) with wild-type EGFR)) were retrospectively collected at Tianjin Medical University Cancer Institute and Hospital between April 2016 and May 2020. Volumes of interest (VOI) of PET and CT images were delineated respectively and three-dimensional-based and two-dimensional-based radiomics features were extracted from VOIs. Three machine learning classifiers of K-nearest neighbor (KNN), support vector machine (SVM) and Adaboost were trained in training set with CT, PET and fusion PET/CT radiomics features respectively. Well trained classifiers were tested in test set. Each predictive model was evaluated by using the receiver operating characteristic (ROC) curve. Results:A total of 126 patients were EGFR mutation including 3 patients with 18 exon mutation, 6 patients with 20 exon mutation, 42 patients with 19 exon mutation, and 75 patients with 21 exon mutation. Finally, patients with 18 exon mutation and 20 exon mutation were removed due to the scale was too small to be trained adequately by machine learning classifiers. Predictive performance of mean PET/CT feature-based model (Adaboost: area under curve (AUC)=0.87, 95% CI: 0.75-0.99) in EGFR mutation subtypes was better than PET feature-based model (Adaboost: AUC=0.64, 95% CI: 0.46-0.83; z=2.04, P<0.05) and CT feature-based model (Adaboost: AUC=0.64, 95% CI: 0.45-0.83; z=2.06, P<0.05). There was no statistical difference between predictive performance of mean PET/CT feature-based model (SVM: AUC=0.76, 95% CI: 0.56-0.96) and PET/CT concatenation feature-based model (SVM: AUC=0.75, 95% CI: 0.59-0.92; z=1.14, P>0.05). Conclusion:Machine learning and 18F-FDG PET/CT radiomics features can provide predictive value for EGFR mutation subtypes in patients with LUAD.

Analysis of ultrasonic features of melanocytoma of optic disc / 中华超声影像学杂志

Objective:To investigate the ultrasonic features, contrast-enhanced ultrasound findings and long-term follow-up results of melanocytoma of the optic disc(MCOD).Methods:The data of 35 patients (35 eyes, 35 lesions) diagnosed with MCOD in Beijing Tongren Ophthalmic Center, Beijing Tongren Hospital from September 2012 to October 2020 were retrospectively analyzed. The B-mode ultrasonography and color Doppler flow imaging (CDFI) were performed on them. The size, morphology, internal echo and secondary changes of the lesions were analyzed. Contrast-enhanced ultrasound was performed on 13 patients. At the same time, 9 patients were followed up for long-term observation.Results:Six lesions (17.1%) showed hemispherical high echo, and 29 lesions (82.9%) showed limited uplift high echo. The largest base diameter of the lesions was (4.0±0.8)mm, average height was(1.9±0.4)mm. Internal echo characteristics: 8 lesions (22.9%) showed uniform echo and 27 lesions (77.1%) showed uneven echo.Lesion boundary: 35 lesions (100%) showed clear lesion boundary. Fifheen lesions (42.9%) showed secondary vitreous opacity. CDFI: blood flow signals could be detected inside the lesions in 19 lesions(54.3%), and not in 16 lesions(45.7%). Contrast-enhanced ultrasound showed 11 of the 13 lesions (84.6%) were completely filled with contrast agent.Conclusions:MCOD has certain ultrasonographic characteristics, which can provide a reliable basis for clinical diagnosis and differential diagnosis. There is no significant change in tumor size after long-term follow-up.

Perfusion characteristics analysis of contrast-enhanced ultrasound in choroidal metastasis and choroidal hemangioma / 中华超声影像学杂志

Objective:To analyze the perfusion characteristics of choroidal metastasis using contrast-enhanced ultrasound, and compare with choroidal hemangioma.Methods:This was a retrospective study.From January 2016 to February 2018 in Beijing Tongren Hospital, a total of 21 eyes from 21 patients who were clinically diagnosed as choroidal metastasis were included as the choroidal metastasis group and 46 eyes from 46 patients who were diagnosed as choroidal hemangioma during the same period were included as the choroidal hemangioma group. All patients underwent contrast-enhanced ultrasound examination, and Sonoliver was used to obtain the data on quantitative parameters of the tumor and the adjacent normal orbital tissues, including maximum of intensity (IMAX), rise time (RT), time to peak (TTP), and mean transit time (mTT). The quantitative parameters between choroidal metastasis and normal orbital tissues were compared. And the quantitative parameters between choroidal metastasis and choroidal hemangioma were compared. The receiver operating characteristic (ROC) curve analysis was performed to evaluate the diagnostic performance.Results:The IMAX of choroidal metastasis was significantly higher than that of normal orbital tissues, while RT, TTP and mTT were significantly shorter than these of normal orbital tissues (all P<0.01). The IMAX of choroidal metastasis was lower than that of choroidal hemangioma, and RT, TTP and mTT were shorter than choroidal hemangioma (all P<0.01). The ROC curve analysis showed that area under curves of the IMAX, RT, TTP and mTT were 0.775 (95% CI=0.666-0.884), 0.970 (95% CI=0.896-0.996), 0.729 (95% CI=0.607-0.831) and 0.992 (95% CI=0.931-1.000) respectively. The sensitivities were 71.7%, 95.7%, 76.1% and 95.7%, and the specificities were 85.7%, 90.5%, 66.7% and 95.2%, respectively. Conclusions:Contrast-enhanced ultrasound can reflect the differences in perfusion characteristics between choroidal metastasis and choroidal hemangioma. RT and mTT are useful parameters in differential diagnosis between the two types of tumors.

The value of color Doppler ultrasound in the detection of macular diseases in age-related cataract patients / 中华眼底病杂志

Objective To observe the application value with color Doppler flow imaging (CDFI) in the detection ofmacular diseases in senile cataract.Methods A cross-sectional descriptive study.From December 1 to December 30,2017,720 senile cataract patients (1380 eyes) diagnosed in Beijing Tongren Eye Center were included in this study.There were 330 males (629 eyes) and 390 females (751 eyes),with the mean age of 70.35 ± 19.05 years.There were 716 right eyes and 664 left eyes,with the visual acuity 0.05-0.8.The fundus of all the patients can be observed.All patients were examined by OCT using Cirrus HD-Model 5000 produced by German Carl Zeiss company and CDFI using MyLab90 color Doppler ultrasound system produced by ESAOTE S.P.A.Comparing the detection rate of macular lesions between the two methods by using X2 test.Using statistical methods to evaluate diagnostic tests,a crosstabulation was made to compare the consistency of frequency-domain OCT and CDFI in the diagnosis of macular lesions.Logistic regression analysis of correlation between detection of CDFI macular lesions and central foveal thickness (CFT),average thickness (AT),with or without macular anterior membrane,retinal folds,retinal cystoid edema,hard exudation,macular hole or lamellar macular hole,superficial detachment of neuroepithelium,detachment of pigment epithelium,vitreous macular traction.Results Two hundreds and thirty-nine eyes (17.3％) showed macular disease by OCT,and 161 eyes (11.7％) showed the abnormal echo in the macular region by CDFI.The detection rate of the macular disease between two methods were statistically significant (χ2=851.661,P＜ 0.001),however,the consistency was well (r=0.766,P=0.000).Logistic analysis showed that the detection rate of macular lesions was related to retinal folds,cysts in retina and CFT (r=1.396,1.041,0.12;P＜0.01).Conclusion CDFI can effectively detect macular lesions that affect the visual prognosis of senile cataract patients.

Agreement of biometry parameters measured by IOLMaster 700 and Pentacam AXL in cataract eyes / 中华实验眼科杂志

Objective:To compare the agreement of biometric parameters measured by a new swept-source optical coherence tomography IOLMaster 700 and a new Scheimpflug imaging combined with partial coherence interferometry biometer Pentacam AXL in cataractous eyes.Methods:A cross-sectional study was performed.A total of 146 eyes from 76 cataract patients were enrolled in Beijing Tongren Eye Center from 2 to 11 in January 2018, including 69 eyes in 36 males and 77 eyes in 40 females, the age ranged from 35 to 88 years, the mean age was (64.52±11.36) years.Axial length (AL), mean keratometry (Km), anterior chamber depth (ACD), central corneal thickness (CCT) and white-to-white (WTW) were measured with IOLMaster 700 and Pentacam AXL, respectively.The differences and correlations of the biometry parameters between the two devices were assessed.Bland-Altman method was used to evaluate the agreement of these parameters between the two devices and the 95% limits of agreement was calculated.This study adhered to the tenets of the Declaration of Helsinki and was approved by an Ethics Committee of Beijing Tongren Hospital (TRECKY2018-049).Results:The mean values of the AL measured by IOLMaster 700 and Pentacam AXL were (24.03±1.72)mm and (23.98±1.73)mm, Km were (44.04±1.71)D and (43.88±1.72)D, ACD were (3.24±0.47)mm and (3.28±0.47)mm, WTW were (11.82±0.51)mm and (11.49±0.49)mm, respectively.Compared with the values in Pentacam AXL, the AL, Km and WTW were larger while ACD was smaller in IOLMaster 700 with significant differences ( t=18.06, 8.94, 23.83, -15.36, all at P<0.01). The mean CCT values from the IOLMaster 700 and Pentacam AXL were (534.18±30.12)μm and (533.42±28.71)μm, respectively, with no significant difference ( t=1.04, P=0.30). The AL, Km, ACD, CCT and WTW from IOLMaster 700 were highly correlated with those from Pentacam AXL ( r=0.999, 0.992, 0.998, 0.956, 0.942; all at P<0.01). The Bland Altman analysis showed that the 95% limits of agreement of AL, Km, ACD, CCT and WTW were-0.02-0.11 mm, -0.27-0.59 D, -0.10-0.02 mm, -16.5-18.1 μm and 0.00-0.67 mm. Conclusions:IOLMaster 700 and Pentacam AXL have good agreements and narrow 95% limits of agreement in the measurements of AL, ACD, CCT, which can be clinically interchangeable.The 95% limits of agreement of WTW and Km are out of the clinically acceptable range, so the WTW and Km measured by the two devices are not interchangeable.

Ultrasonographic features of intraocular lymphoma / 中华超声影像学杂志

Objective To describe the ultrasonographic features of intraocular lymphoma . Methods It was a retrospective analysis of 19 patients ( 26 eyes ) with intraocular lymphoma at the department of ophthalmology ,Beijing Tongren Hospital from January 2015 to December 2017 . T he diagnosis was established by tissue biopsy in 4 patients with diagnostic vitrectomy and 8 with enucleation ,and other 7 cases were clinically diagnosed followed by pathological examination of central nervous system lymphoma . T he ultrasonographic features of all patients were analyzed . Results Of the 19 patients ( 26 eyes ) with intraocular lymphoma ,12 cases ( 19 eyes) of vitreoretinal lymphoma accounted for 63 .2% ,of which 7 cases were bilateral eyes ,and 7 cases ( 7 eyes ) of uveal lymphoma accounted for 36 .8% ,all of w hich were monocular . Ultrasonography of vitreoretinal lymphoma included vitreous opacity , posterior vitreous detachment ,partial retinal detachment ,irregular hypoechoic lesions under the retina ,and CDFI detected blood flow signals in the lesion . T here were two different types of ultrasound findings in uveal lymphoma . Five cases ( 5 eyes ) showed diffuse thickening of the uveal membrane with low echo , and irregular hypoechoic mass around the optic nerve and the ball wall ,in w hich CDFI detected abundant blood flow signals . Ultrasound biological microscope examination showed that the iris‐ciliary body thickened and the internal echo decreased . T his ultrasound finding accounted for 71 .4% of uveal lymphoma . T wo cases ( 2 eyes) showed a solitary ciliary‐choroid choroidal hypoechoic mass ,combined with retinal detachment and blood flow signals with CDFI ,accounting for 28 .6% of uveal lymphoma . Conclusions T he ultrasonography of intraocular lymphoma is various . T he ultrasound findings of vitreoretinal lymphoma are not specific , w hile the diffuse thickened uvea and retrobulbar hypoechoic lesions encircled optic nerve and eye wall suggest the possibility of uveal lymphoma .

Agreement of biometry parameters measured by IOLMaster 700 with IOLMaster 500 in cataract eyes with high myopia / 中华实验眼科杂志

Objective To compare the agreement of axial length (AL),anterior chamber depth (ACD) and keratometry measured by IOLMaster 500 with IOLMaster 700 in cataract eyes with high myopia.Methods A cross-sectional study was performed.One hundred and fifty-two eyes of 87 cataract patients with high myopia were included from September to October 2017 in Beijing Tongren Hospital.The best corrected visual acuity (BCVA) was 0.05-1.0,and the refraction power was-6.25--21.00 D,with an average power of (-13.625 ± 7.375) D.A L,ACD and keratometry (Kf,Ks) were measured by IOLMaster 700 and IOLMaster 500 respectively for all the eyes.The eyes were assigned to AL＞26-≤28 mm group,AL＞28-＜30 mm group and AL≥30 mm according to the results of IOLMaster 500.The measured differences between two devices were assessed using paired samples t-test,and the measured consistency of the two devices was evaluated using Bland-Altman agreement analysis.This study protocol was approved by Ethics Committee of Beijing Tongren Hospital and complied with Declaration of Helsinki.Results There were no significant differences in the AL and Kf measured by the two devices in all the three groups (all at P＞0.05).Both ACD and Ks values measured by IOLMaster 700 were lower than those by IOLMaster 500 (both at P＜0.05),which were clinically acceptable.The percentage beyond 95％ agreement limit between IOLMaster 700 and IOLMaster 500 were 4.10％,2.17％ and 3.03％ for AL differences and 4.10％,4.34％ 和 3.03％ for Kf difference in the three groups.Significant differences were found in ACD and Ks between IOLMaster 700 and IOLMaster 500 at a clinically acceptable level (both at P＜0.05),and Bland-Altamn agreement analysis showed that the percentage beyond 95％ agreement limit between IOLMaster 700 and IOLMaster 500 were 4.10％,4.34％ and 3.03％ for both ACD and Ks differences in the three groups.Conclusions There is a good agreement in AL,ACD,Kf and Ks measured by IOLMaster 700 with IOLMaster 500 and is clinically interchangeable in cataract eyes with high myopia.However,IOLMaster 700 is better because it can provide the OCT image of macula.

Diagnostic value of ultrasonic elastosonography in choroidal melanoma / 中华医学超声杂志（电子版）

Objective To explore the diagnostic value of ultrasonic elastography in choroidal melanoma. Methods A total of 96 cases (97 eyes) of choroidal melanoma were included in present study from June 2016 to June 2017 in Eye Center of Beijing Tongren Hospital, Capital Medical University. The control group consisted of 18 patients with choroidal hemangioma (18 eyes). All eyes were examined by color Doppler ultrasound and ultrasonic elastosonography. The strain ratio of the tumor and surrounding normal tissue was calculated for each case. By comparing the strain ratio between choroidal melanoma and choroidal hemangioma, the diagnostic value of ultrasound elastography in choroidal melanoma was investigated. Results The strain ratios of the two groups were 39.51±15.79 for choroidal melanoma and 13.15±10.40 for choroidal hemangioma. The independent sample t-test was performed between the two sets of data. The difference of the strain ratio between choroidal melanoma and choroidal hemangioma was statistically significant (t=6.802, P<0.001). Conclusions The stiffness of ocular malignant tumor (choroidal melanoma) is significantly higher than that in intraocular benign tumor (choroidal hemangioma). Ultrasonic elastography can be used as an important examination for the diagnosis and differential diagnosis of choroidal melanoma.

Diagnostic value of conventional ultrasound, color Doppler ultrasonography and contrast-enhanced ultrasound in sub-retinal hemorrhage / 中华医学超声杂志（电子版）

Objective To explore the value of conventional ultrasound, color Doppler ultrasound and contrast-enhanced ultrasound (CEUS) in the diagnosis of sub-retinal hemorrhage. Methods A total of 26 patients with sub-retinal hemorrhage were examined by conventional ultrasound, color Doppler ultrasound and CEUS. The results of medical history, ultrasound, color Doppler ultrasound and CEUS were recorded and analyzed.And the difference of the detection rate between the three methods was analyzed by χ2test. Results The mean fundus diameter of the sub-retinal hemorrhage was (5.31±2.21) mm, and the mean height was (1.97±0.98) mm. In twenty-two eyes (84.6%) the lesions were located in the posterior pole of the ocular wall, while in two eyes (7.7%) the lesions were located in the equator and peripheral of the ocular wall. Seven eyes (26.9%) had dome-shaped mass, ten eyes (38.5%) had flat-shaped mass, and nine eyes (34.9%) had irregular-shaped mass. The echogenecity of the lesions was homogeneous in twelve eyes (46.2%), and heterogeneous in fourteen eyes (53.8%). The lesions showed clear margin in seventeen eyes (65.4%). Blood flow signals can be detected in twenty-three eyes (88.5%). The surface of the lesions was filled by contrast-medium in all cases. The detection rate of sub-retinal hemorrhage with color Doppler and contrast-enhanced ultrasound was higher than that of conventional ultrasound, and the difference was statistically significant. Conclusion Color Doppler ultrasonography and CEUS can provide a powerful basis for the clinical diagnosis of sub-retinal hemorrhage, while CEUS has higher application value.

Value of color Doppler ultrasonography in the evaluation of retinoblastoma / 中华医学超声杂志（电子版）

Objective To evaluate the value of color Doppler ultrasonography in the diagnosis of retinoblastoma (RB). Methods One hundred and eighty-two patients (199 eyes) with RB confirmed by pathology from June 2012 to June 2016 in Beijing Tongren Hospital were included in this study. The two-dimensional gray-scale image and color Doppler imaging ultrasound features were observed. The variance analysis was used to compare the width and height of different morphologies. Comparison the detection rate of the two methods by χ2test.Results The ultrasonography of RB was characterized by substantial masses of the eyeball, which could be hemispherical, spherical, irregular, filled with vitreous cavity, or diffuse along the retina. The results of variance analysis showed statistical difference in three shapes (F= 29.134, 24.474, P<0.001),LSD-t test showed difference between hemisphere and spherical,spherical and irregular shape, hemispherical and irregular shape. The t values of basal width were 2.457,-2.333 and-6.205, respectively and all P < 0.05 respectively. The t value of height were 3.917,-6.711 and-7.244, respectively and all P < 0.05.All lesions were uneven echo. Calcification and localized low echo area within the mass was observed in 93.47% (186/199) and 52.76% (105/199) eyes respectively. 46.73% (93/199) retinal detachment and 31.16% (62/199) vitreous opacity is present. Colorful blood flow signals extended from the central retinal vessels could be seen inside the masses of 98.49% (196/199) eyes. Two-dimensional image and color Doppler imaging ultrasound were consistent with the pathological diagnosis in 96.5% (192/199) and 99.5% (198/199) RB cases, respectively.The difference was statistically significant (χ2=4.167, P=0.031). Conclusions Retinoblastoma has characteristic ultrasound manifestations. Color Doppler ultrasonography is a valuable clinical tool in the diagnosis of RB.

Ultrasound diagnosis and analysis of intraocular cysticercosis / 中华超声影像学杂志

Objective To investigate the characteristic of the B-mode ultrasonography and the color Doppler flow imaging diagnosis for intraocular cysticercosis.Methods Eleven eyes of 1 1 patients diagnosed of intraocular cysticercosis clinically and confirmed by operation and pathology were retrospectively studied. Their B-mode ultrasonography and color Doppler flow imaging were analyzed.Surgery diagosis was also reviewed.Results Among 1 1 eyes of 1 1 patients,intravitreal cysticercus presented in 7 cases (7 eyes),and 4 cases (4 eyes)diagnosed of subretinal cysticercus.Intraocular cysticercosis showed a round or oval vesicle-like echogenic mass in the vitreous body or under the retina,and the high-level echo spot in it was the scolex. Some dot and stripe echo and retinal detachment also appeared in the vitreous cavity with vitreous inflammation.The blood flow signal was detected in retinal detachment with color Doppler flow imaging. Conclusions Ultrasonography is extremely useful in the diagnosis of intraocular cysticercosis and the findings can be pathognomonic.