A case of peritoneal Burkitt's lymphoma mimic of peritoneal tuberculosis.

Peritoneal lymphomatosis is a rare presentation of lymphoma that can mimic peritoneal tuberculosis. The computed tomography findings in both conditions include omental caking, thickening, and nodularity. We report the case of a 41-year-old man who presented with intermittent abdominal pain and distension. Abdominal CT initially suggested peritoneal tuberculosis due to the thickening of the peritoneum and greater omentum with multiple nodules. However, 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) images showed diffuse metabolic activity increase in the thickened peritoneum, omentum, and mesentery. An omental biopsy was performed under ultrasonography guidance, and histopathological examination revealed a high-grade Burkitt lymphoma. It is crucial to distinguish peritoneal lymphomatosis from tuberculosis, as the prognosis and management of the two conditions are vastly different.

Application of ultrasound attenuation imaging and shear wave elastography in the diagnosis of metabolic fatty liver disease.

This study aimed to investigate the application of ultrasound attenuation imaging (ATI) and shear wave elastography (SWE) in the examination of patients with metabolism-related fatty liver disease (MAFLD). A total of 210 patients were retrospectively selected and divided into MAFLD group (n=84) and no MAFLD group (n=126). ROC curve was used to analyze the diagnostic efficacy of ATI value and SWE value for MAFLD. The MAFLD groups were divided into mild group (n=39), moderate group (n=28) and severe group (n=17). Spearman correlation was used to analyze the relationship between ATI values, SWE values and the severity of MAFLD. Waist circumference, BMI, ALT, AST, TG, CHOL, ATI and SWE in MAFLD group were higher than those in non-MAFLD group (P<0.05). ROC analysis showed that the AUC of ATI value in the diagnosis of MAFLD was 0.837 and the sensitivity, specificity and cutoff values were 83.46%, 70.35% and 0.63 dB/cm/MHZ. Waist circumference and BMI were significantly lower in the mild MAFLD group than in the moderate MAFLD group (P<0.05) and ALT, AST, TG, CHOL, ATI and SWE levels gradually increased with the severity of MAFLD (P<0.05). Correlation analysis showed that ATI was positively correlated with MAFLD severity (r=0.553, P<0.001, 95% CI=0.384~0.686) and SWE was significantly positively correlated with MAFLD severity (r=0.606, P<0.001, 95% CI=0.450~0.726). Both ATI and SWE are effective in the diagnosis and evaluation of MAFLD, but ATI is more effective in the diagnosis and SWE.

Feasibility of evaluating the stenosis of intracranial segment in the vertebral artery using neck-brain integrated ultrasound: a comparison with computed tomography angiography and digital subtraction angiography.

BACKGROUND: Currently, no clear diagnostic indicator of vertebral artery hypoplasia (VAH) or intracranial stenosis exists in clinic. This study aims to study the feasibility of neck-brain integrated ultrasound for evaluating stenosis of the intracranial segment in the vertebral artery by comparing with those of computed tomography angiography (CTA) and digital subtraction angiography (DSA). METHODS: Clinical data of 138 patients who presented to our hospital with dizziness and headache as the main symptoms between April 2018 and June 2019 were retrospectively analyzed. Patients were divided into observation group and unilateral VAH group. The diagnosing accuracy of ultrasound, CTA, and DAS, the vertebral artery diameter (VAD), blood flow, end diastolic velocity (EDV), peak systolic velocity (PSV) values, resistance indexes (RIs), and difference of RI were compared between the two groups. The sensitivity, specificity and accuracy of ultrasound hemodynamic indicators in assessing stenosis of the intracranial segment of the vertebral artery were calculated. RESULTS: The accuracy rates of mild stenosis and non-stenosis with neck-brain integrated ultrasound were significantly different from those with CTA and DSA examination (P<0.05). The VAD, blood flow, EDV and PSV values of the affected side in the observation group were lower than those of the VAH side in the unilateral VAH group, while the RI and RI difference value were significantly higher than the unilateral VAH group (P<0.05). When the predicted boundary value was 2.084 mm (VAD), 56.41 mL/min (blood flow), 8.47 cm/s (EDV), 0.743 (RI), and 0.149 (difference of RI), the sensitivity and specificity were (86.43%, 49.45%), (88.67%, 47.42%), (80.47%, 68.71%), (82.71%, 84.66%), and (95.84%, 80.11%), respectively. CONCLUSIONS: Neck-brain integrated ultrasound is of great value as a noninvasive examination in the diagnosis of stenotic lesions of the internal cervical vertebral artery. VAD, EDV, blood flow, RI, and the difference in RI can be used as indicators to evaluate stenosis of the internal carotid segment of the vertebral artery and provide a reliable basis for the clinical diagnosis of posterior circulation ischemia.

miR­378 in combination with ultrasonic irradiation and SonoVue microbubbles transfection inhibits hepatoma cell growth.

Ultrasonic microbubbles in combination with microRNA (miRNAs/miRs) exhibited promising effects on cancer treatments. The aim was to investigate the role of miR­378 in hepatoma cells and the efficiency of it in combination with ultrasonic irradiation and SonoVue® microbubbles method for cell transfection. HuH­7, Hep3B and SK­Hep1 cells were transfected with an miR­378 mimic using only Lipofectamine® 3000 or combined with SonoVue microbubbles and ultrasonic irradiation at 0.5 W/cm2 for 30 sec. mRNAs and protein levels of Cyclin D1, Bcl­2, Bax, Akt, p53 and Survivin were detected by reverse transcription­quantitative PCR and western blotting, respectively. Cell survival rate, proliferation, cell cycle and apoptosis were determined by Cell Counting Kit­8, cell double cytochemical staining and flow cytometry, respectively. It was found that using a combination of ultrasonic irradiation and the SonoVue microbubbles method increased the effectiveness of miR­378 transfection into hepatocellular carcinoma (HCC) cells, and increased the inhibition of cell survival and proliferation. Moreover, miR­378 increased the rate of apoptosis and upregulated the expression of Bax and p53, and suppressed the cell cycle and downregulated the expression of Cyclin D1, Bcl­2, Akt, ß­catenin and Survivin much more effectively in the HCC cell line by applying the combined method. Thus, miR­378 was shown to be a suppressive factor to reduce proliferation and increase apoptosis in HCC cells. Additionally, the combination of ultrasonic irradiation and SonoVue microbubbles method was more efficient in the transfection of miRNA.

Association between quantitative parameters of CEUS and Sall4/Wnt/ß-catenin signaling in patients with hepatocellular carcinoma.

Objectives: In this study, we aim to investigate the correlations of quantitative parameters of contrast-enhanced ultrasonography (CEUS) and Spalt-Like Transcription Factor 4 (Sall4)/Wnt/ß-catenin signaling pathway with clinicopathological features and prognosis of patients with hepatocellular carcinoma (HCC). Methods: The CEUS was performed to detect the liver function and the prognosis of patients. The expression of Sall4, WNT3a and ß-catenin was evaluated using immunohistochemical staining. Sall4, WNT3a and ß-catenin mRNA expression was measured by SYBR green qPCR assay. Results: We found that the mRNA and protein expression of Sall4, WNT3a and ß-catenin in the HCC tissues were significantly upregulated compared with the adjacent normal tissues. Upregulation of these proteins was associated with tumor differentiation, TNM stage, tumor size, vascular invasion and liver cirrhosis of HCC patients. In addition, we found that decreased time to peak and washout time and increased peak intensity and area under the curve of CEUS in the HCC were also correlated with TNM stage, tumor size and vascular invasion. Moreover, Sall4, WNT3a and ß-catenin protein were significantly associated with the TTP, PI, AUC, and WOT. Conclusion: This study suggests that quantitative parameters of CEUS and Sall4/Wnt/ß-catenin signaling may be helpful for early diagnosis and prognosis prediction of HCC patients.