Are fetal gender and gestational age related to the size of cisterna magna?

OBJECTIVES: The purpose of this article was to explore whether the gestational age(GA)and gender could affect the size of the cisterna magna (CM). METHODS: This study that included pregnant women who were between 20 ∼ 39+6. The recorded included BPD, HC, anteroposterior diameter of CM and gender. The fetuses were divided into normal and isolated enlargement of the CM (IECM)group for statistical analysis. RESULTS: Seven hundred ninety six fetuses with normal CM, 412 cases were boys and 384 cases were girls. 73 fetuses with IECM, 59 cases were boys and 14 cases were girls. The anteroposterior diameter of the CM increased with GA during 20-26+6 weeks. After 27 weeks, the anteroposterior diameter of CM became stable. In the IECM group, the mean anteroposterior of male and female fetuses were 1.31 ± 0.18 cm and 1.24 ± 0.15 cm, respectively. The IECM fetus accounted for 8.4% of the total number of fetuses, male IECM accounted for 14.3% of normal male fetus, and female fetus was 3.6%, which showed that male fetus had a higher rate of IECM than female (χ2 = 21.6, p<.001). CONCLUSIONS: There is a gender difference between normal fetuses and IECM fetuses. Based on our finding, it is reasonable to establish the normal value of CM according to the gender difference.

Effect of head circumference in combination with facial profile line on ultrasonic diagnosis of microcephaly.

Objective: Recently, microcephaly has usually been misdiagnosed only by ultrasound via measurement of head circumference (HC). Therefore, the aim of this study is to find another diagnostic index to supplement the original diagnostic method of microcephaly, to improve the detection rate of fetal microcephaly and to reduce the misdiagnosis rate.Methods: We retrospectively analyzed 123 pregnant women from February 2012 to January 2017 with fetal HC less than two standard deviations (SD). The facial profile line (FPL) was determined by ultrasonography. The first method (M1) was only used HC to determine whether the fetus was microcephaly, the second one (M2) was to combine HC and FPL for the diagnosis of microcephaly. Results were classified into five orderly categories by experienced sonographers. ROC curve was drawn to evaluate the diagnostic effect.Results: Among the pregnant women, 14 cases of fetal head circumference were less than 3SD, 109 were -2SD < HC≤ -3SD. A total of 12 cases were confirmed of microcephaly by magnetic resonance imaging (MRI) or postnatal, 10 cases of HC were less than 3SD, 2 were -2SD < HC≤ -3SD. The area under the ROC curve for M1 and M2 were 0.751 and 0.983 respectively.Conclusion: The HC in combination with FPL can be used to evaluate the fetal HC and forehead development quickly, and to improve the sensitivity and specificity of diagnosing fetal microcephaly.

Comparison of traditional 2D and 3D Omniview technique in detection of fetus corpus callosum.

AIM: To explore the value of Omniview (OV) technology in assessing the fetus corpus callosum. MATERIAL AND METHODS: For the ultrasound examination of 189 fetuses (gestational week range 19-28 weeks), two-dimensional (2D) ultrasound imaging and Omniview technology were used by two physicians (A and B). The acquisition time and the quality of images were recorded. RESULTS: The acquisition time of Omniview technology was shorter comparing with the aquisition time of 2D ultrasound imaging (A2D vs. AOV: 159.44±27.09 s vs. 73.90±18.99 s, p<0.01; B2D vs. BOV: 120.22±21.89 s vs. 74.19±14.86 seconds, p<0.01). 2D ultrasound examination was performed in a longer time by the junior physician, compared with the senior physician (A2D vs. B2D: 159.44±27.09 s vs. 120.22±21.89 s, p<0.01). The intra- and inter-observer reliability of acquisition time using Omniviewtechnology was good (LoA: ‒11.8 to +12.4s, and ‒41.9 to +43.3s, respectively). The success rate of junior and senior physicians with the Omniview technique was 76.2% and 80.4%, respectively. There was good consistency between the Omniview technique and 2D ultrasound imaging in terms of image quality (Kappa = 0.782, 95% CI: 0.586-0.977). CONCLUSION: Omniview technique can not only obtain corpus callosum images more effectively but also can achieve better quality images. Therefore, it is a reliable method to image the fetal corpus callosum.

Iodine-131: An Effective Method for Treating Lymph Node Metastases of Differentiated Thyroid Cancer.

BACKGROUND The aim of this study was to assess the efficacy of radioactive iodine-131 (¹³¹I) therapy for lymph node metastasis of differentiated thyroid cancer (DTC) and to identify influential factors using univariate and multivariate analyses to determine if identified factors influence the efficacy of treatment. MATERIAL AND METHODS This study included a retrospective review of 218 patients with histologically proven DTC in the post-operation stage. After thyroid tissue remnants were eliminated with ¹³¹I therapy, patients' lymph node status was confirmed by ultrasound and by ¹³¹I whole body scan regarding lymph node metastasis, and then patients were treated with ¹³¹I as appropriate. The treatment efficacy was assessed and possible influencing factors were identified using univariate and multivariate analyses. RESULTS The total effective rate of ¹³¹I therapy was 88.07% (including a cure rate of 20.64% and an improvement rate of 67.43%). The non-effective rate was 11.93%. Of the total 406 lymph nodes of 218 patients, 319 lymph nodes (78.57%) were judged to be effectively cured, including 133 (32.75%) lymph nodes that were totally eliminated and 186 (45.82%) lymph nodes that shrank. Eighty-seven (21.43%) of the 406 lymph nodes had no obvious change. No lymph nodes were found to be in a continuously enlarging state. Distant metastasis, size of lymph node, human serum thyroglobulin (HTG) level, and condition of thyroid remnants ablation were identified as the independent factors influencing the efficacy of treatment using univariate and multivariate analyses. CONCLUSIONS The use of ¹³¹I is a promising treatment for lymph node metastasis of DCT. Distant metastasis, size of lymph nodes, HTG level, and condition of thyroid remnant ablation were independent factors influencing the treatment efficacy.

[TgAb interference with experimental Tg values detected by dilution curves].

OBJECTIVE: To identify the interference of endogenous antithyroglobulin (TgAb) with experimental thyroglobulin (Tg) values using dilution curves. METHODS: Dilution buffer, detectable TgAb serums (TgAb 20-25 IU/mL, Tg free) and undetectable TgAb serums (TgAb < 10 IU/mL, Tg free) were employed to dilute the Tg serums from patients with DTC, respectively. The Tg values were detected by immunometric assay (IMA). The experimental Tg values (Y-axis) were plotted against expected serum Tg values (X-axis). Diluted curves were used to evaluate the interference of TgAb on the experimental Tg values. A linear dilution curve is supposed to appear if no TgAb interference exists. RESULTS: The Tg dilution curves with dilution buffer were linear. Thirty six dilution curves were obtained with TgAb serums from six patients diluted by detectable TgAb serums, and 12 showed linear. Tg serums from six patients diluted by one detectable TgAb serum resulted in both linear and non-linear results. One Tg serum diluted by six TgAb serums also resulted both linear and non-linear results. Tg serums from three patients diluted by five undetectable TgAb serums resulted in 11 dilution curves, four of which were linear. CONCLUSION: Dilution curves can be used to predict TgAb interference indirectly. Detectable TgAb may not interfere with experimental Tg values. Whereas, undetectable TgAb may interfere with Tg values. TgAb could not be used to predict Tg interference.

[The correlation between endogenous TgAb and experimental Tg values in patients with differentiated thyroid carcinomas].

OBJECTIVE: To determine the interference of antithyroglobulin (TgAb) on the measurement of serum thyroglobulin (Tg) in patients with differentiated thyroid carcinomas (DTC). METHODS: The Tg positive serum and TgAb positive serum were taken from the patients with total thyroidectomy and thyroid remnant ablation by radioiodine. The Tg positive serum contained high level of Tg (>10 microg/L) and nondetectable TgAb. The TgAb positive serum contained high level of TgAb (>115 IU/mL) and nondetectable Tg. We incubated a constant amount of Tg with increasing volumes of Tg-free autoantibodies and allowed them to equilibrate at room temperature for 12 hours before measuring Tg and TgAb. The thyroglobulin and TgAb values were determined by the Roche electrode induce chemiluminescent emission system with monoclonal antibody sandwich analysis. The correlation between TgAb and serum Tg values was analysed. RESULTS: TgAb led to underestimation of serum Tg values by 15%-50% in 8 patients with DTC. TgAb was correlated with the magnitude of underestimated serum Tg values in 3 patients with DTC, but not in the other 5 patients with DTC. CONCLUSION: TgAb underestimated serum Tg values in a dose-dependent manner in some patients with DTC, but not in others.