[Application value of contrast-enhanced ultrasonography for assessing the high-risk population of hepatic malignant tumor].

OBJECTIVE: To investigate the clinical value of contrast-enhanced ultrasonography (CEUS) in assessing the high-risk population of hepatic malignant tumor (HMT). METHODS: Three hundred patients with high-risk of HMT were enrolled and examined by CEUS. The clinical data of these patients were collected. A comparative analysis was performed to assess the ability of CEUS for detecting and characterizing lesions in the liver. Kappa test was used for assessing the intra-and inter-observer reliability of CEUS. RESULTS: In 87 enrolled patients with 119 malignant lesions detected by contrast-enhanced MRI, 112 lesions were detected by CEUS and 95 lesions were detected by unenhanced ultrasonography (US). The detection rate of CEUS for HMT was significant higher than that of US (94.1% vs. 79.8%; P < 0.01). More HMT lesions were detected by CEUS than by US in 17.2% patients. One hundred and seventy-seven patients with 215 lesions were confirmed by pathological diagnosis or long-time follow-up. There were 118 malignant and 97 benign lesions. The accuracy of CEUS for differential diagnosis of the liver lesions was 91.6% (197/215), significantly higher than that by US (59.1%, 127/215) (P < 0.01). CEUS improved the accuracy for 35.0% (62/177) patients. For 96 patients with 105 lesions detected for the first time, the agreement of diagnosis by CEUS was 92.4% (97/105). The reliability of CEUS was high (Kappainter = 0.866; Kappaintra = 0.934). CONCLUSIONS: CEUS improves the detection rate and diagnostic accuracy rate of the HMT high-risk population, with a high agreement for diagnosing the new lesions. CEUS may be considered as a first-line method to assess the high-risk population of HMT conveniently, accurately and reliably.

[The value of thyroglobulin measurement in fine-needle aspiration for diagnosis of suspicious lymph nodes in patients with thyroid carcinoma after thyroidectomy].

OBJECTIVE: To investigate the value of thyroglobulin measurement in ultrasound guided fine-needle aspiration(FNA-Tg)for detecting neck node metastasis in patients with papillary thyroid carcinoma(PTC)after thyroidectomy. METHODS: A total of 128 suspicious metastatic lymph nodes in 112 patients were retrospectively analyzed. Postoperative pathologic results were taken as the gold standard. The values of FNA and FNA-Tg combined FNA in the diagnosis of metastatic lymph nodes were compared with different ultrasonic features. RESULTS: The sensitivity, specificity and accuracy of single FNA for the diagnosis of neck node metastasis were 67.5%, 98.0% and 79.7% respectively, and those of FNA-Tg combined FNA were 87.0%, 100.0% and 92.2% respectively. Compared with single FNA, the sensitivity and accuracy of FNA-Tg combined FNA were increased significantly(χ(2)=8.319, P=0.004; χ(2)=8.275, P=0.004). When the ultrasonographic characteristics met any one of five indicators for neck node metastasis, the sensitivity, specificity and accuracy of single FNA for the diagnosis of neck node metastasis were 38.1%, 95.7% and 68.2% respectively, and those of FNA-Tg combined FNA were 71.0%, 100.0% and 86.4% respectively. Compared with single FNA, the sensitivity and accuracy of FNA-Tg combined FNA were increased significantly(χ(2)=4.709, P=0.030; χ(2)=4.141, P=0.042). When the ultrasonographic characteristics met any two of five indicators for neck node metastasis, the sensitivity, specificity and accuracy of single FNA for the diagnosis of neck node metastasis were 55.0%, 100.0% and 73.5% respectively, and those of FNA-Tg combined FNA were 90.0%, 100.0% and 94.1% respectively. Compared with single FNA, the sensitivity and accuracy of FNA-Tg combined FNA were increased significantly(χ(2)=6.140, P=0.013; χ(2)=5.314, P=0.021). The ultrasonographic characteristics met any three, four or five of five indicators or did not meet any of the indicators, there was no significant difference in the value of the diagnosis of metastatic lymph nodes between single FNA and FNA-Tg combined FNA(P>0.05). CONCLUSIONS: The combination of FNA with FNA-Tg could be helpful in diagnosis of lymph node metastasis. When the suspicious lymph nodes had one or two ultrasound characteristics for neck node metastasis, FNA-Tg could raise the sensitivity and accuracy of FNA, and FNA-Tg could not significantly improve in the diagnosis of FNA when presenting with no or with more than 2 ultrasonographic features.