ABSTRACT
Objective:To assess the interobserver and inter-modalities agreement with two non-invasive diagnostic modalities of hepatocellular carcinoma in high-risk patients: contrast-enhanced ultrasound liver imaging reporting and data system (CEUS LI-RADS) and magnetic resonance imaging liver imaging reporting and data system (MRI LI-RADS).Methods:From August 2017 to August 2019, the CEUS and MRI data of patients at high risk for HCC from the Second Affiliated Hospital of Zhejiang University School of Medicine were analyzed retrospectively. A total of 217 lesions in 173 patients were classified according to CEUS LI-RADS v. 2017 or MRI LI-RADS v. 2018, by 4 blinded independent observers with more than 10 years of experience of CEUS or MRI. Interobserver and inter-modalities agreement was assessed with Cohen′s kappa.Results:The interobserver agreement was moderate and comparable for CEUS/MRI LI-RADS category (κ=0.606/0.603), the inter-modalities agreement was moderate for CEUS and MRI LI-RADS category (κ=0.564), LI-RADS 3, M, 4 and 5 by two imaging methods showed that the Kappa values were 0.739, 0.551, 0.734 and 0.592, respectively.Conclusions:The total inter-modalities agreement between CEUS and MRI LI-RADS categories is moderate, while the agreements of LI-RADS 3, 4 are strong, and LI-RADS M, 5 are moderate.
ABSTRACT
Objective@#To assess value of contrast enhanced ultrasound (CEUS) in TN staging of pancreatic cancer and compared with contrast enhanced computed tomography(CECT).@*Methods@#Seventy-eight cases with pancreatic cancer confirmed by pathology were enrolled in this study. All patients were examined using CEUS and CECT and staged according to the 8th guideline of pancreas tumors of AJCC. The diagnostic accuracies of CEUS in TN staging of pancreas tumors were compared with CECT.@*Results@#The diagnostic accuracies of CEUS in T staging and N staging of pancreatic cancer were 80.8%, and 78.2%, respectively. For CECT, the diagnostic accuracies in T staging and N staging were 88.5%, and 88.5%, respectively. There was no significant difference in the diagnostic accuracies between CEUS and CECT in T staging(χ2=1.56, P=0.21). The diagnostic accuracy of CEUS in N staging was significantly lower than that of CECT(χ2=3.86, P=0.04).@*Conclusions@#The diagnostic accuracy of CEUS in T staging of pancreatic cancer is similar to that of CECT, while in its N staging is lower than that of CECT.
ABSTRACT
Objective To assess the characterization and usefulness of contrast enhanced ultrasound (CEUS) to diagnose focal lesions of pancreas in comparison to contrast enhanced computed tomography (CECT).Methods 177 cases of focal solid lesions of the pancreas confirmed by pathology were collected.The enhanced patterns and diagnostic capability of CEUS were analyzed,and these results were compared with those of CECT.Results The diagnostic accuracies of ultrasound,CEUS and CECT were 61.6％ (109/177),89.3％ (158/177),and 92.1％ (163/177),respectively.There was no significant difference between the diagnostic accuracies of CEUS and CECT (P =0.071).The sensitivity,specificity,positive predictive value (PPV),negative predictive value (NPV),and accurate rate for CEUS were 90.9％,63.6％,73.8％,86.2％,82.5％ (the areas under the curve,AUC =0.820),and 89.8％,69.3％,76.7％,85.9％,84.7％ for CECT (AUC =0.847),respectively,when the hypo-enhanced was regarded as the cut value.No significant difference was found between these results from CEUS and CECT (P =0.071).Conclusions The diagnostic ability of CEUS in focal lesions of the pancreas is similar to that of CECT.
ABSTRACT
Objective To evaluate the diagnostic performance of shear wave elastography ( SWE) with quantitative analysis and qualitative analysis of stiff rim sign between benign and malignant breast lesions . Methods Sixty-five female patients(65 lesions) underwent breast surgery or aspiration biopsy at the Second Affiliated Hospital of Zhejiang University were included . Elastic modulus of breast lesions and its rim in 1 mm ,2 mm ,3 mm were quantitive analyzed by SWE before surgery or aspiration biopsy ,Stiff rim sign was observed at the same time . Then ,the areas of receiver operating characteristic curves( AUC) of quantitative parameters of SWE and stiff rim sign were calculated to assess their clinical values in differentiating benign and malignant breast lesions ,and the correlation between them was evaluated . Afterwards , BI-RADS category was adjusted according to the optimal parameters combining the performance of SWE feature and conventional US features ,which could be used to evatulate the diagnostic effectiveness in differentiating benign and malignant breast lesions . Results The pathological results demonstrated 32 benign cases and 33 malignant cases in all patients .The maximum cut-off point of BI-RADS category was set between 4a and 4b .AUC value was 0 .935(0 .845-0 .981) ,while the sensitivity and specificity were 84 .8％ and 90 .6％ ,respectively .Maximum elasticity of 2 mm(E2Smax) area surrounding the malignant lesions were significantly higher than those in benign lesions ( P = 0 .001 ) . Among all quantitative SWE features ,E2Smax showed the highest AUC ( 0 .773) ,with sensitivity of 78 .8％ and specificity of 71 .9％ . In addition ,the stiff rim sign as qualitative parameter showed the highest AUC (0 .800) ,with sensitivity 81 .8％ and specificity 78 .1％ . The correlation coefficient between E2Smax and stiff rim sign was 0 .63 ,which was regarded as moderate correlation . the AUC of combination of stiff rim sign or E2Smax and conventional US features was 0 .937 and 0 .902 ,and the sensitivities were 81 .8％ , 93 .9％ ,the specificities were 90 .6％ and 75 .0％ . Conclusions SWE features ,especially E2Smax and hard rim sign are found moderate correlation ,and can improve a more accurate diagnosis in differentiating benign and malignant breast lesions combining with conventional US features .
ABSTRACT
Objective To evaluate the relationship between echocardiographic epicardial adipose tissue thickness(EAT) and the presence and severity of coronary artery disease(CAD). Methods One hundredand forty-seven patients (101 patients with CAD and 46 patients with normal coronary arteries by diagnostic coronary angiography) were enrolled. EAT thickness was measured using 2-D echocardiographic parasternal long-and short-axis views. EAT thickness measurements were compared with angiographic findings. Results EAT was significantly higher in CAD group comparison to control group [(7.41 ± 1.63)mm vs (4.41±1.60) mm, P ＜0.01 ]. Furthermore, EAT increased with the severity of CAD [(8.53 ± 1.00)mm vs (6.36 ±1.73)mm, P ＜0.01]. Gensini's score significantly correlated with EAT (r = 0.71, P ＜0.01 ). EAT thickness ≥5.35 mm had 87.13% sensitivity and 80.42% specificity (ROC area 0. 89, P = 0.01,95% CI [0.84 - 0.9;]) for predicting CAD. Conclusions EAT thickness, which is easily and non-invasively evaluated by transthoracic echocardiography, can be an adjunctive marker to classical risk factors for the prediction of CAD, it was significantly correlated with the severity of coronary artery disease.