Quantitative analysis of contrast-enhanced ultrasound and superb microvascular imaging for the evaluation of disease activity in inflammatory bowel disease.

OBJECTIVE: To evaluate the effectiveness of conventional US (ultrasound), SMI (superb microvascular imaging), and CEUS (contrast-enhanced ultrasound) features for the assessment of the activity of inflammatory bowel disease. METHODS: Conventional US, CEUS and SMI features of 76 patients were retrospectively analyzed. Patients were categorized into two groups: active group (n = 57) and inactive group (n = 19), with endoscopic results as reference standard. Results in the active group and inactive group were compared using an independent t-test, Mann-Whitney U test, chi-square test, and receiver operating characteristic curve (ROC) analysis. Cut-off values were determined using ROC analysis, and sensitivity and specificity were calculated. US quantitative and TIC-based quantitative parameters were analyzed, and each patient was scored based on the parameters that are statistically significant and immediately available in the clinic to evaluate the diagnostic ability of conventional US, SMI, and CEUS features for active IBD patients. RESULTS: Qualitative parameters such as CEUS enhancement pattern I/II, LimbergIII/IV, and lost bowel stratification were reliable indicators of active patients. Quantitative parameters such as bowel thickness and VI of mSMI were reliable indicators of active patients. Patients scored based on these statistically significant parameters with a score ≥3, were highly suspected to be active patients. For TIC-based quantitative parameters, PE, WiAUC, WoAUC, WiWoAUC, WiR, WiPI, and WoR were statistically significant in the differentiation of active IBD from inactive IBD. CONCLUSIONS: Conventional US, SMI, and CEUS features may help in the differentiation of active IBD from inactive IBD and have potential application value in the choice of treatment options.

Fallopian Tube Leiomyoma Presenting as a Huge Abdominopelvic Cystic Mass: A Case Report and Literature Review.

INTRODUCTION: Fallopian tube leiomyoma is an uncommon, benign gynecologic tumor that originates from the smooth muscle of the fallopian tube or vascular cells supplying the fallopian tube. CASE PRESENTATION: In this study, we report a case of a patient with fallopian tube leiomyoma. What makes this instance even more unique is the association of the leiomyoma with cystic degeneration, manifesting as a large abdominopelvic cystic mass. CT scan suspected that the mass might be an ovarian cystadenoma. However, ultrasonography, a widely used diagnostic tool, effectively assisted the clinicians in confidently ruling out the possibility that the tumor was originating from the ovaries. Ultimately, the patient underwent exploratory laparoscopy and the pathologic diagnosis was fallopian tube leiomyoma with cystic degeneration. To our knowledge, no instance of a fallopian tube leiomyoma of this size with cystic degeneration has been reported. Thus, it is worth mentioning. CONCLUSION: In summary, fallopian tube leiomyomas are classified as uncommon benign gynecologic tumors, which pose challenges in clinical diagnosis. The combined use of multiple imaging modalities may be more helpful in the proper diagnosis of this disease entity.

Whether the use of intravenous contrast-enhanced ultrasound can improve the accuracy of T stage diagnosis of gastric cancer?

OBJECTIVE: To explore whether the use of intravenous contrast-enhanced ultrasound (CEUS) can improve the diagnostic accuracy of T stage of gastric cancer on the basis of oral contrast-enhanced ultrasound (OCEUS). METHODS: Eighty-one patients with gastric cancer who underwent preoperative CEUS. Criteria for T staging was AJCC Stage 8th Edition. To compare the diagnostic accuracy, sensitivity and specificity of OCEUS and CEUS for T staging of gastric cancer using pathological results as the gold standard. RESULTS: There were differences in the diagnostic accuracy of T2 (P = 0.048), T3(P = 0.002) and T4 (P = 0.000) between OCEUS and CEUS. And there was no difference in diagnostic accuracy for T1 (P = 0.118). CEUS significantly improved diagnostic sensitivity and specificity in T3 (42.86% to 61.90% for sensitivity, 86.96% to 93.75% for specificity), and T4 (64.71% to 76.47% for sensitivity, 78.33% to 95.74% for specificity). CONCLUSION: Compared with OCEUS, CEUS did improve the diagnostic accuracy of T2, T3, and T4 stages of gastric cancer.

Different power modes of microwave ablation for hepatocellular carcinoma: Evaluation of recurrence rate and factors related to recurrence.

PURPOSE: To evaluate the safety and efficacy of different power modes(constant power and variable power) percutaneous microwave ablation (MWA) for treating hepatocellular carcinoma (HCC) and to predict the risk factors of recurrence after MWA. MATERIALS AND METHODS: In this retrospective study, a total of 112 patients with solitary HCC were included from January 2015 to January 2021. All patients received MWA through a percutaneous approach that was guided by ultrasound, 45 patients received variable power MWA, and the remaining 67 were treated with constant power MWA. The complete ablation rates, local recurrence rates, complications, and short-term survival were analyzed. Possible risk factors for tumor recurrence were analyzed. RESULTS: The complete ablation rates were 95.9% for the first ablation and 100% for the second ablation for ≤3 cm lesions. The complete ablation rates were 84.2%(95.9% versus 84.2%, p = 0.039) for the first ablation and 94.7% (100% versus 94.7%, p = 0.113) for the second ablation for 3-5 cm lesions. Local and distant recurrence rates were 18.7%(21/112) and 14.3%(16/112). The 1-, 2-year survival rates were 86.3 and 66.3%, respectively. Subgroup analysis showed that 1-, 2-year survival rates were 91.1% and 78.5% in ≤3 cm group, and were 74.4% and 40.9% in 3-5 cm group, respectively. Univariate analysis revealed that a positive correlation existed between the HBV DNA replication(p = 0.007), AFP level of pre-MWA(p = 0.001) and post-MWA(p<0.001), tumor diameter(p<0.001), irregular shape(p = 0.014), proximity to the risk location(p = 0.008), poor differentiation(p = 0.003), constant power(p = 0.028), length(p<0.001) and width of ablation zone(p = 0.001), and present complication(p<0.001), and early recurrence. Multivariate analysis identified HBV DNA replication(OR = 0.266, p = 0.036), AFP level of pre-MWA (OR = 4.001, p = 0.036), tumor diameter (OR = 2.153, p = 0.042), tumor location (OR = 0.910, p = 0.046), and width of ablation zone(OR = 2.530, p = 0.044) were independent prognosis factors causing postoperative HCC recurrence. CONCLUSION: Variable power MWA of HCC appears to be a safe and effective treatment. HBV DNA, AFP level of pre-MWA, tumor diameter, tumor location, and width of ablation range appear to be independent predictors of tumor recurrence.

Anatomical characteristics affecting the surgical approach of oblique lateral lumbar interbody fusion: an MR-based observational study.

BACKGROUND: Oblique lateral lumbar interbody fusion (OLIF) is one of the most widely used lumbar interbody fusion procedures in clinical practice. The aim of this study was to minimize the incidence rate of surgical complications by measuring the anatomical parameters of structures surrounding the working channels of OLIF with 3D COSMIC sequence. METHODS: The MRI examination included conventional MRI sequence and 3D COSMIC sequence. Surgical window, psoas thickness, the transverse diameter of the endplate, and nerve distance were measured to evaluate the anatomical characteristics surrounding the OLIF working channels. RESULTS: The widths of the natural surgical window at the level of the L2-3, L3-4, and L4-5 intervertebral measured in this study were 16.25 ± 4.22, 15.46 ± 4.64 mm, and 11.71 ± 6.29 mm, respectively. The average thickness of the left psoas major muscle at the level of L2-3, L3-4, and L4-5 intervertebral space was 28.42 ± 5.08 mm, 30.76 ± 5.84 mm, and 31.16 ± 7.72 mm, respectively. The mean value of insertion angle (ß) was 45.57° ± 6.19° in L2-3 intervertebral space, 49.90° ± 6.53° in L3-4 intervertebral space, and 43.34° ± 8.88° in L4-5 intervertebral space. CONCLUSIONS: The 3D COSMIC sequences can be used for imaging anatomical assessment before OLIF surgery. In preoperative planning, the 3D COSMIC sequence can be used to measure the relevant parameters mentioned above to optimize the planned surgical approach.

Effect of enhanced patient instructions on Helicobacter pylori eradication: A systematic review and meta-analysis of randomized controlled trials.

BACKGROUND AND AIMS: To improve Helicobacter pylori (H. pylori) eradication rate, enhanced patient instructions (EPI) such as telephone-based re-education, short-message service, and Wechat have been proposed with conflicting results. The aim of this meta-analysis was to evaluate the effect of EPI on H. pylori eradication. METHODS: The PROSPERO registered number of this study is CRD42021278536. PubMed, Embase, and CENTRAL database were searched to identify relevant randomized controlled trials (RCTs) from inception to September 2021. Meta-analysis was performed to estimate the pooled relative risk (RR) with 95% confidence intervals (CI) using a random-effects model. Trial sequential analysis (TSA) was conducted to determine the robustness of the H. pylori eradication rate. RESULTS: Nine RCTs were included. Compared with patients receiving only regular instructions, patients received EPI showed significantly higher H. pylori eradication rate (n = 8 RCTs, ITT analysis: RR = 1.20, 95% CI: 1.06-1.35; PP analysis: RR = 1.12, 95% CI:1.02-1.23) and better patient compliance (n = 8 RCTs, RR = 1.23, 95% CI: 1.09-1.39), as well as higher patient satisfaction (n = 3 RCTs, RR = 1.42, 95% CI: 1.14-1.76). However, there were no significant difference between groups in the incidence of total adverse events (n = 6 RCTs, RR = 0.66, 95%CI: 0.40-1.08) and symptom relief rates (n = 2 RCTs, RR = 1.17, 95% CI: 0.89-1.54). The TSA result indicated that the effect was robust. CONCLUSIONS: Evidence from our meta-analysis shows that EPI intervention may be a promising strategy to improve H. pylori eradication rate, patient compliance, and patient satisfaction.

Mechanism and elimination of bending effect in femtosecond laser deep-hole drilling.

In this work, a comprehensive study of the bending effect, which remains one of the most critical challenges during deep-hole drilling, was conducted. The experimental statistics indicate that polarization is not the main factor in bending, but the deviation of the hole tends to be perpendicular to the polarization direction. Also, the dynamic ablated material/plasma was studied. Straight microholes were obtained by extending the interval between laser pulses to avoid dynamic ablated material existing in the millisecond time domain. Therefore, we speculated that the disturbance of the laser beam at the dynamic ablated aerosol, which have not sufficiently dispersed in the millisecond domain, is the main mechanism of bending. However, to more efficiently reduce the disturbance factor, a rough vacuum environment was applied; and the bending effect was also eliminated. The critical pressure for eliminating bending was about 2 × 10(4) Pa that is about one order of magnitude lower than the atmosphere. The fabricated high-quality microhole arrays without bending show that the proposed drilling method is convenient and efficient with high repeatability and controllability.

Etching rate enhancement by shaped femtosecond pulse train electron dynamics control for microchannels fabrication in fused silica glass.

The dependence of the etching rate on the ultrafast pulse shaping is observed when microchannels are fabricated in fused silica glass using the method of femtosecond laser irradiation followed by chemical etching. In comparison with the conventional femtosecond pulses, the temporally shaped pulse trains can greatly enhance the etching rate under the same processing conditions. The enhancement is mainly attributed to the localized transient electron dynamics control by shaping the ultrafast pulse, resulting in higher photon absorption efficiency and uniform photomodification zone. Furthermore, processing parameters, including pulse delay and pulse energy distribution ratio, have also been investigated to optimize microchannels fabrication.

High-throughput rear-surface drilling of microchannels in glass based on electron dynamics control using femtosecond pulse trains.

This study proposes a rear-surface ablation enhancement approach to fabricate high-aspect-ratio microchannels by temporally shaping femtosecond laser pulse trains. In the case study of K9 glass, enhancements of up to a 56 times higher material removal rate and a three times greater maximum drilling depth are obtained by the proposed method, as compared with conventional femtosecond laser drilling at the same processing parameters. The improvements are due to the changes of photon-electron interactions by shaping femtosecond pulse train, which can effectively adjust the photon absorption and localized transient material properties by changing electron dynamics such as free electron densities.