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Objective:To evaluate the clinical and ultrasonographic features for early diagnosis and prediction of lateral cervical lymph node metastasis of medullary thyroid microcarcinoma.Methods:From Jan 2010 to Jan 2020 233 patients undergoing primary surgery were categorized as "medullary thyroid microcarcinoma" and "medullary thyroid macrocarcinoma". The preoperative clinical and ultrasonographic characteristics, the diagnostic positive rate of preoperative serum calcitonin and fine needle aspiration (FNA) were investigated between two groups. All patients with medullary thyroid microcarcinoma were divided on the basis of wether there was lateral cervical lymph node metastasis.Results:There were statistically significant differences in initial diagnostic method(χ 2=32.290, P=0.000), TNM staging(χ 2=50.300, P=0.000) between medullary thyroid microcarcinoma and medullary thyroid macrocarcinoma. Medullary thyroid microcarcinoma showed more malignant ultrasonic features. The diagnostic accuracy of preoperative serum calcitonin was higher than FNA for medullary thyroid micro carcinoma(χ 2=47.933, P=0.000). Multivariate regression analysis demonstrated that the abutment/perimeter ≥1/4( OR=25.475, 95%CI: 2.320-279.771), preoperative serum calcitonin >65 ng/L( OR=32.663, 95%CI:2.433-438.409) were the independent factor for lateral cervical lymph node metastases of medullary thyroid microcarcinoma. Conclusions:The combination of ultrasonography and serum calcitonin helps establish early diagnosis of medullary thyroid microcarcinoma. Medullary thyroid microcarcinoma with the abutment/perimeter ≥1/4, serum calcitonin >65 ng/L predicts lateral cervical lymph node metastases.
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Objective@#To investigate the correlation between cervical lymph node skip metastasis with ultrasonographic characteristics of papillary thyroid micro- carcinoma (PTMC).@*Methods@#We reviewed ultrasonographic features of 385 primary PTMC and cervical lymph node metastasis, confirmed by pathology in Tianjin Medical University Cancer Institute and Hospital, to evaluate the efficacy of ultrasonography in the diagnosis of cervical lymph node metastasis of PTMC patients. The relationship between ultrasonographic features of primary lesions and skip metastasis of cervical lymph nodes was analyzed by χ2 test and multiple factor Cox regression.@*Results@#Among the 385 cases of PTMC patients with cervical lymph node metastasis, 231 cases were central lymph node metastasis alone, 31 cases were lateral cervical lymph node metastasis alone, 123 cases were both central and lateral cervical lymph node metastasis. Among the 354 cases without skip metastasis of cervical lymph nodes, 48 cases were level Ⅱ, 92 cases were level Ⅲ, 83 cases were level Ⅳ, 9 cases were level Ⅴ, 354 cases were level Ⅵ. Among the 31 cases with skipping metastasis of cervical lymph nodes, 12 cases were level Ⅱ, 14 cases were level Ⅲ, 14 cases were level Ⅳ, 1 case was level Ⅴ. The sensitivity and specificity of preoperative ultrasonography in the diagnosis of central cervical lymph node metastasis were 46.3% and 66.7%, respectively, and those of lateral cervical lymph node were 91.0% and 87.8%, respectively. Univariate analysis showed that the abutment/perimeter, diameter and location of PTMC were significantly associated with skip metastasis (P<0.05), multivariate analysis showed that abutment/perimeter and location of PTMC were significantly associated with skip metastasis (P<0.05).@*Conclusions@#The sensitivity and specificity of preoperative ultrasound diagnosis for lateral cervical lymph node metastasis of PTMC is higher than that of central metastasis. PTMC with abutment/perimeter ≥1/4 and upper portion location are prone to skip metastasis.
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Kidney tumor is one of the diseases threatening human health. Ultrasound is widely applied in kidney tumor diagnosis due to its high popularization, low price and no radiation. Accurate segmentation of kidney tumor is the basis of precise treatment. Kidney tumors often grow in the middle of cortex, so that segmentation is easy disturbed by nearby organs. Besides, ultrasound images own low contrast and large speckle, leading to difficult segmentation. This paper proposed a novel kidney tumor segmentation method in ultrasound images using adaptive sub-regional evolution level set models (ASLSM). Regions of interest are firstly divided into subareas. Secondly, object function is designed by integrating inside and outside energy and gradient, in which the ratio of these two parts are adjusted adaptively. Thirdly, ASLSM adapts convolution radius and curvature according to centroid principle and similarity inside and outside zero level set. Hausdorff distance (HD) of (8.75 ± 4.21) mm, mean absolute distance (MAD) of (3.26 ± 1.69) mm, dice-coefficient (DICE) of 0.93 ± 0.03 were obtained in the experiment. Compared with traditional ultrasound segmentation method, ASLSM is more accurate in kidney tumor segmentation. ASLSM may offer convenience for doctor to locate and diagnose kidney tumor in the future.
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Humans , Algorithms , Fetal Growth Retardation , Image Processing, Computer-Assisted , Kidney Neoplasms , Osteochondrodysplasias , UltrasonographyABSTRACT
Objective@#To investigate the ultrasonographic features of synchronous and heterochronic liver metastasis in patients with stromal tumors, and to elucidate the value of ultrasonic examination in follow-up surgery.@*Methods@#A total of 1 516 patients with pathologically confirmed gastrointestinal stromal tumors (GISTs) and extra-gastrointestinal stromal tumors (EGISTs) were enrolled. The ultrasonographic features of primary lesions and liver metastases in a total of 46 cases with 95 liver metastases were analyzed.@*Results@#24 out of 46 cases had primary lesion in the small intestine, 14 in the stomach, 4 in the abdominal cavity, 1 in the colon, 2 in the esophagus, and 1 in the mesentery. The expression of CD117, Dog-1 and CD34were detected by immunohistochemical staining. The positive rate of CD117 was 100%, the Dog-1 was 95.7% and the CD34 was 69.6%. There were statistically significant differences in the maximum diameter, boundary and blood flow of primary tumors in 28 patients with synchronous liver metastasis and 18 patients with heterochronic liver metastasis (P=0.001, 0.022 and 0.036, respectively). Of the 95 liver metastases, 86 (90.5%) were located in the right lobe of the liver, 79 (83.2%) had clear boundaries, 75 (78.9%) were hypoechoic or isoechoic, 55 (57.9%) showed colored patterns, and 68 (71.6%) had no halo.11 liver metastases were cystic masses, 59 were solid masses, and 25 were mixed masses. There was a statistically significant difference in blood flow between 65 synchronous hepatic metastases and 30 heterochronic liver metastases (P=0.017).@*Conclusions@#There were differences of the primary tumor ultrasonographic features between the synchronous metastasis group and heterochronic metastasis group. The ultrasonographic features of primary tumors and liver metastases have important clinical significance for the diagnosis, follow-up and treatment of malignant mesenchymal tumors.
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Objective@#To explore clinicopathological and ultrasound characteristics of extranodal extension in metastatic papillary thyroid carcinoma patients.@*Methods@#176 patients with papillary thyroid carcinoma who were diagnosed in Tianjin Medical University Cancer Institute and Hospital between March 2011 and March 2016 were identified and recruited in the study. Among the 176 patients, 59 patients were diagnosed with regional lymph nodes metastasis accompanied with extranodal extension (extranodal extension positive group), 117 patients were regional lymph nodes metastasis without extranodal extension (extranodal extension negative group). The clinicopathological and ultrasound characteristics between extranodal extension positive group and extranodal extension negative group were also discussed in this article.@*Results@#59 patients were diagnosed with regional lymph nodes metastasis accompanied with extranodal extension (extranodal extension positive group). Single lymph node region of extranodal extension was identified in 40 patients, while 19 patients were confirmed with more than 2 regions of extranodal extension. The most frequent extranodal extension were detected in region Ⅵ lymph nodes(32 cases), following by Ⅲ(25 cases), Ⅳ(16 cases), Ⅱ(11 cases). In the aspect of ultrasound characteristics, metastatic papillary thyroid carcinoma with extranodal extension showed a higher incidence of node matting[13.6%(8/59) vs 3.4%(4/117), P=0.022], micro-calcification[66.1%(39/59) vs 46.2%(54/117), P=0.016], cystic[28.8%(17/59) vs 12.8%(15/117), P=0.013], aspect ratio(L/S)<2[88.1%(52/59) vs 75.2%(88/117), P=0.032] and larger diameter(1.95±1.01 cm vs 1.63±0.94 cm, P=0.028). Logistic multivariate analysis demonstrated that node matting (P=0.025) and cystic (P=0.026) were independent risk factors for extranodal extension.@*Conclusion@#Node matting, micro-calcification, cystic, aspect(L/T)>2 and larger diameter were associated with extranodal extension in metastatic papillary thyroid carcinoma patients, especially node matting and cystic, which might help topre-operative ultrasound diagnosis of extranodal extension.
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Objective To compare the diagnostic efficiency of superb micro-vascular imaging ( SMI) and power Doppler imaging ( PDI) in differentiating different size breast tumors . Methods Retrospective analysis were performent in a total of 170 cases of breast tumors of 144 patients screened with SMI and PDI in our hospital from August 2016 to July 2017 ,and pathological results were finally obtained . These tumors were divided into two groups according to the maximum diameter 2 .0 cm . SMI and PDI diagnostic efficiency were compared by showing blood flow distribution ,vascular morphology and Alder grade . Results There were 68 benign tumors and 102 malignant tumors .When the maximum diameter was no more than 2 .0 cm ,there were no significant difference in the blood flow distribution ,vascular morphology and Alder grade between PDI and SMI of benign tumors( all P > 0 .05) ;However ,there were significant differences in the vascular morphology and Alder grade of malignant tumors( all P < 0 .05) ,but no difference in blood flow distribution( P = 0 .174) ;The area under the curve of ROC by PDI and SMI were 0 .724 and 0 .844 ,thus , the difference was statistically significant( P = 0 .024) . When the maximum diameter was more than 2 .0 cm ,the between PDI and SMI differences in blood flow distribution ,vascular morphology and Alder grade were not statistically significant ( all P > 0 .05) in benign tumors ,but there was statistical difference in vascular morphology ( P = 0 .001) in malignant tumors ,and there was no significant difference in blood flow distribution ,Alder grade in malignant tumors between PDI and SMI ( all P > 0 .05) . The area under the curve of ROC by PDI and SMI were 0 .768 and 0 .802 ,the difference was not statistically significant ( P = 0 .447) . Conclusions SMI can show the blood flow characteristics more clearly in breast tumors . When the maximum diameter is no more than 2 .0 cm ,SMI diagnostic efficiency is better than PDI .
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Objective To compare the difference of colour Doppler flow imaging(CDFI)and superb-microvascular imaging(SMI)for detecting blood flow in cystic renal mass,and explore the consistency of conventional ultrasound combined with SMI and Contrast-enhanced ultrasonography(CEUS) in the diagnosis of renal cystic masses based on the Bosniak classification system,so as to evaluate the diagnosis value of SMI in renal cystic masses.Methods Fifty-five patients with renal cystic mass were enrolled in this study and underwent conventional ultrasound,CDFI and SMI.Patients with renal cystic mass at category Ⅱ for higher received contrast-enhanced ultrasonography additionally.The diagnostic performance of SMI and CEUS were evaluated based on final diagnosis obtained by follow-up or pathology diagnosis after surgery.Results In 55 cases,44 cases got the pathological diagnosis afer surgical resection including 38 cases of malignant masses,and 6 cases of benign masses.CDFI and SMI showed significant difference in tumor flow imaging(P <0.05).Kappa Value of SMI and CEUS was 0.866.The sensitivity,specificity, accuracy,positive predictive value and negative predictive value of SMI were 94.8%,75.0%,89.1%,90.2% and 85.7% respectively.Conclusions SMI is superior to CDFI in displaying micro-vascular of separated and solid structure in renal cystic masses.SMI has a better consistency with CEUS in Bosniak classification.SMI can improve the accuracy of non-invasive ultrasound in the diagnosis of renal cystic lesions.
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Objective To compare contrast-enhanced ultrasonography (CEUS), contrast-enhanced CT (CECT) and combined detection of two methods in the diagnosis of small renal masses, and differential diagnosis of different types of small renal masses by CEUS. Methods In 95 cases of small renal masses, there were 79 patients with small renal cell carcinoma and 16 patients with benign tumor. The diagnostic results of the three methods were compared based on the pathological results, which were used as thegold standardfor the diagnostic efficacy. The ROC curve was drawn, and the area under the curve (AUC) was compared. The characteristics of the two groups were analyzed and compared by Q-Lab software in CEUS. The angiographic parameters included arrival time (AT), time to peak (TTP) and peak intensity (PI). CEUS patterns for several pathologic types of renal tumors with larger sample sizes were compared. The characteristic manifestations of small renal masses under CEUS were analyzed. Results The accuracy, sensitivity, specificity, positive predictive value, negative predictive value and AUC of CEUS were 87.37%, 93.67%, 56.25%, 91.36%, 64.29%and 0.750, the values for CECT were 88.42%, 93.67%, 62.50%, 92.50%, 66.67%and 0.775, and the values for combined detection of two methods were 95.79%, 98.73%, 81.25%, 96.30%, 92.86%and 0.869 respectively. The sensitivities of the three methods were high, but the specificities were the same. The combined detection showed better diagnostic efficacy than that of single diagnostic method. The AT and TTP of CEUS were earlier in small renal carcinoma group than those of benign nephrotic group, and PI was higher than that of benign nephrotic group (P<0.05). There were significant differences in the contrasts ofcontrast enhancement methods between clear cell carcinoma, papillary cell carcinoma, chromophobe cell carcinoma, and angiomyolipoma (P<0.01). There was little difference in contrast enhancement between the other types of carcinoma. False envelope can be observed by CEUS.'Cystic area'of the detection rate was increased significantly by CEUS than that of conventional ultrasound. Conclusion Combined detection of CEUS and CECT can improve the diagnostic accuracy of small renal tumors. CEUS has great clinical value in the differential diagnosis of small renal masses, which is worthy of clinical promoting.
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Objective To investigate the value of TI-RADS for sonographic diagnosis of papillary thyroid carcinoma (PTC) and follicular thyroid carcinoma (FTC) and to evaluate the sonographic findings of FTC compared to PTC.Methods The clinical and sonographic data of 363 cases of pathology confirmed thyroid nodules were retrospectively analyzed.The thyroid nodules were classified by TI-RADS grading criteria,the accuracy of TI-RADS and sonographic findings between FTC and PTC was analyzed.Results In 363 thyroid nodules,114 cases were confirmed as benign lesions;249 cases were confirmed as carcinomas,including 50 FTC cases and 199 PTC cases.The sensitivity,specificity,PPV,NPV,and accuracy of PTC were 97.0％ (193/199),85.1％ (97/114),91.9％ (193/210),85.8％ (97/113),95.7％ (290/303) respectively.The sensitivity,specificity,PPV,NPV,and accuracy of FTC were 97.0％(193/199),85.1％ (97/114),91.9％ (193/210),85.8％ (97/113),95.7％ (290/303) respectively.There were significant differences of nodule size,shape,margin,echogenecity,calcification,halo and flow between FTC group and PTC group (P ＜ 0.05).Conclusion TI-RADS has higher value in the sonographic diagnosis of PTC than that of FTC.FTC are greatly different from PTC in many sonographic findings making it less valuable for the diagnosis of FTC.
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Objective To explore the diagnostic value of ultrasound guided fine needle aspiration biopsy (US-FNAB) for thyroid imaging reported and data system (TI-RADS) 4 class ≤ 10 mm thyroid nodules.Methods The preoperative ultrasound features of patients with thyroid nodule who received USFNAB examination were retrospectively analyzed,the malignant risk of each nodule was evaluated and classified according to TI-RADS.TI-RADS 4a class thyroid nodules and diameter ≤ 10 mm of 365 patients were classified as suspicious nodules and received US-FNAB examination.The nodules were classified as ＜5 mm and 5-10 mm groups.The results of cytologic diagnosis were compared with the pathological diagnosis,and the differences for nodules with different size were analyzed.Results Among 365 TI-RADS 4 class thyroid nodules diagnosed by the cytology,68 nodules were malignant;81 nodules were suspicious of malignancy;193 nodules were benign;6 nodules were unsatisfactory;and 17 nodules were undetermined.According to postoperative pathology or follow-ups,153 nodules were malignant and 212 nodules were benign.The difference between US-FNAB results and pathology was not significant (P ＞ 0.05).Cytologic positive rate and actually malignant rate of the nodules in 5-10 mm group were higher than ＜ 5 mm groups (P ＜ 0.05).The sensitivity,specificity,positive predictive value,negative predictive value,and accuracy of US-FNAB cytological diagnosis of TI-RADS 4 class thyroid nodule were 92.2％,96.2％,94.6％,94.4％and 94.5％,respectively.Conclusion US-FNAB examination is valuable for the diagnosis of TI-RADS 4a class thyroid nodules and improves the preoperative diagnosis.
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Objective To investigate the value of contrast-enhanced ultrasonography (CEUS) in the diagnosis of small renal cell carcinoma (SRCC) and renal angiomyolipoma (AML) with minimal fat.Methods The images and data of conventional ultrasound (US) and CEUS were retrospectively reviewed in 47 cases of small renal cell carcinoma and 8 cases of AML with minimal fat (d ＜ 30mm),which were confirmed by operation and pathologicall study,including 39 males and 16 females.The mean age of the patients was (54.8 ± 9.8) years old,ranged from 31 to 73 years old.The size,echo,boundary and color flow signals of renal lesions were observed by conventional US.Then the modality and phases of enhancement were observed,including the arrival time,the peak time,the washout time and the appearance of internal structures.Results On contrast-enhanced sonography,fast wash-in and wash-off were observed in most of SRCC,while slow wash-off were observed in most of RAML with minimal fat.The statistically significant differences were found between SRCC and RAML with minimal fat in the values of TFP (time a to peak) and PI (peak-intensity).The occurrence of round pseudo-capsule and contrast-enhancement characteristics in SRCC was far more often than RAML with minimal fat.Conclusions Contrast-enhanced sonography combined with time-intensity analysis provides more useful information for the diagnosis of SRCC and AML with minimal fat.
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Objective To evaluate the values of contrast-enhanced ultrasound in diagnosis of cystic renal cell carcino-ma. Methods A total of 73 patients with renal cystic lesions were included in this study. The image features of ultrasound and contrast-enhanced ultrasound examination were analysed. All of patients underwent surgical treatment and had patholog-ical results. The diagnostic values of the ultrasound and contrast-enhanced ultrasound were analyzed by evaluating the im-age features of cystic renal cell carcinoma. Results There were 64 cases of cystic renal cell carcinoma, 9 cases of benign cyst. With ultrasound and color doppler ultrasound,irregular shape, thickness wall, solid ingredients, divisions and more blood flow signals were found in cystic renal cell carcinoma. Renal cyst showed regular shape, few solid component and thin separation and inconspicuous blood flow signals. In contrast-enhanced ultrasound, cystic renal cancer contrast agent appear-ing time was (15.13±4.21)s, and reached the peak time (23.42±5.68)s, fade time was (28.42±4.27)s. The enhanced mode for fast in and fast out was found in 22 cases (34.3%), fast in and slow out in 30 cases (46.8%), slow in and fast out in 2 cases (3.2%), slow in and slow out in 4 cases (6.4%), and synchronously in and out in 6 cases (9.3%). The hyper-enhancement was found in 42 cases (65.6%), the iso-enhancement and hypo-enhancement in 22 cases (34.4%). In renal cyst, There were three cases out of contrast filling. In other 6 cases, the contrast agent appearing time was (16.67±2.73)s, the peak time was (25.83±3.06)s and fade time was (34.17±4.26)s. The enhanced mode for fast in and fast out was found in 1 case (16.7%), fast in and slow out in 1 case (16.7%) and synchronously in and out in 4 cases (66.6%). The hyper-enhancement was found in 2 cases (33.3%), the iso-enhancement and hypo-enhancement in 4 cases (66.7%). The sensitivity, specificity, positive predic-tive value, negative predictive value and accuracy of ultrasound were 85.9%, 66.7%, 94.8%, 40.0%and 83.6%. The sensitiv-ity, specificity, positive predictive value, negative predictive value and accuracy of contrast-enhanced ultrasound were 92.2%, 77.8%, 96.7%, 58.3%and 90.4%. Conclusion Contrast-enhanced ultrasound can be used in benign and malignan-cy identification of renal cystic lesion.
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<p><b>OBJECTIVE</b>To seek for the ultrasound findings of thyroid nodules related to malignancy and benign, and to assess the role of TI-RADS in the ultrosound evaluation of thyroid nodules.</p><p><b>METHODS</b>We reviewed and analyzed the ultrasound characteristics of 1838 thyroid nodules confirmed by biopsy or surgical pathology, classified the thyroid nodules by TI-RADS grading criteria, and analyzed the malignancy rate and accuracy rate of different TI-RADS grading.</p><p><b>RESULTS</b>Among the 1 838 thyroid nodules, 1 160 cases were carcinomas confirmed by surgery, while benign nodules in 212 cases. The sensitivity, specificity, PPV, NPV, and accuracy rates were 99.7% (1 156/1 160), 41.0%(278/678), 74.3% (1 156/1 556), 98.6% (278/282), and 78.2% (1 434/1 838), respectively. There were significant differences between the malignant and benign thyroid nodules in echo, margin, shape, calcification, and blood flow (P<0.001). Hypoechogenicity, marked hypoechogenicity, ill-defined margin, microcalcification, a taller-than-wide shape, and nodule internal rich flow (type III) were significantly associated with malignancy, while hyper/isoechogenicity, smooth margin, macro/no-calcifications, a wider-than-tall shape, and nodules internal poor flow (type I or type II) were significantly associated with benign nodules. There were significant differences between the malignant rates and accuracy rates obtained by different TI-RADS classifications (P<0.01).</p><p><b>CONCLUSION</b>Understanding the ultrasound characteristics of benign and malignant thyroid nodules and applying TI-RADS grading criteria to correctly classify the thyroid nodules are crucial for the clinical treatment and prognosis.</p>
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Humans , Calcinosis , Diagnosis, Differential , Sensitivity and Specificity , Thyroid Nodule , Diagnostic Imaging , Ultrasonics , UltrasonographyABSTRACT
Objective The purpose of this study was to evaluate the value of contrast-enhanced ultrasound in diagnosis of renal cell carcinoma subtyping.Methods 206 cases with renal tumors were confirmed by pathology and surgery from June 2012 to June 2014,including 113 male cases and 93 female cases.The mean age was 54 years (range 23-80 years).The subtype of renal tumor included clear cell carcinoma in 147 cases,papillary cell carcinoma in 32 cases,chromophobe cell carcinoma in 27 cases.All patients were received the CEUS before operation.The enhancement patterns,degree of enhancement,the appearance of necrosis and the time-intensity curve by contrast-enhanced ultrasound were analyzed.Results Enhancement patterns of CEUS were showed by fast in and fast out in 63.9％ (94/147)cases with clear cell carcinoma,59.4％ (19/32) cases with papillary cell carcinoma,51.9％ (14/27) cases with chromophobe cell carcinoma.Statistical significant diference was shown among those subtype groups (P ＜ 0.05).Most of the clear cell carcinomas (127/147,86.4％) showed hyperenhancing.While,the papillary renal cell carcinoma (22/32,68.8％) and chromophobe cell carcinoma (15/27,55.6％) showed hypoenhancing (P ＜ 0.05).The rate of necrosis in clear renal cell carcinoma was 62.6％ (92/147),and 59.4％ (19/32) in papillary cell carcinoma.necrosis area accounted for only 18.5％ (5/27)in chromophobe cell carcinoma (P ＜ 0.05).In the time-intensity curve analysis,the initial time,the average arrival time,the time to peak and area under the curve in renal cortex was (11.06 ± 2.75) s,(23.42 ± 2.79) s,(27.47 ± 3.02) dB,(35.01 ± 2.94)dB,respectively.Significant differences in those items were found in clear cell carcinoma,which was(8.01 ± 1.89) s,(20.05 ± 3.01) s,(30.03 ± 2.98) dB,(37.64 ± 4.01) dB respectively,compared with those in cortex (P ＜ 0.05).The arrival time,time to peak,peak intensity and area under the curve in papillary cell carcinoma were (1 1.12 ± 2.43) s,(27.29 ± 3.54) s,(20.13 ± 2.67) dB,(34.67 ±3.24) dB,respectively.The curve showed the time to peak was higher and the peak intensity were lower than those of renal cortex (P ＜0.05).The arrival time,time to peak,peak intensity and area under the curve in chromophobe cell carcinoma were (11.32 ± 2.90) s,(22.21 ± 3.62) s,(22.02 ± 2.52) dB,(28.67 ± 3.65) dB,respectively.The curve demonstrated peak intensity and area under the curve were lower than those of surrounding renal cortex (P ＜ 0.05).The increase of tumor diameter after contrast-enhanced ultrasound in clear cell carcinoma was about (0.35 ± 0.11)cm and in nonclear cell carcinoma was about (0.23 ± 0.10) cm (P ＜ 0.05).Conclusion The contrast-enhanced ultrasound played an important role in diagnosis and subtype renal cell carcinoma.
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Renal cell carcinoma is one of the most common tumors in the urinary system. Most of these tumors are malignant. The incidence of renal tumors has increased in recent years. Contrast-enhanced ultrasound examination is increasingly applied in clinics and has become a common diagnostic method for renal lesions. Contrast-enhanced ultrasound can clearly show the organization of tu-mor blood vessels and capillaries and provide dynamic observation of the blood perfusion status of normal human tissues and tumor tis-sues. This review discusses the situation and value of contrast-enhanced ultrasound in renal tumor treatment.
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<p><b>OBJECTIVE</b>To explore the ultrasound (US) findings of partially cystic thyroid nodules (PCTNs) and to analyze their relationship with differential diagnosis of benign and malignant lesions.</p><p><b>METHODS</b>265 cases of PCTNs confirmed by needle biopsy or surgical pathology were included in this study. Their ultrasound characteristics were reviewed and their significance in differential diagnosis was analyzed.</p><p><b>RESULTS</b>In the 265 PTCNs, 53 cases were malignant and 212 cases were benign lesions. According to the comparison of ultrasound and pathology results, there were 51 true-positive cases, 208 true negative cases, four false-positive cases and two false negative cases;the sensitivity was 96.2% (51/53), specificity was 98.1% (208/212), positive predictive value (PPV) was 92.7% (51/55), negative predictive values (NPV) was 99.0% (208/210), and accuracy rate was 97.7% (259/265). In terms of the PTCNs, internal structure, shape and margin were significantly associated with malignant or benign nature (P < 0.001); the aspect ratio ≥ 1, spiculated or micro-lobulated margin were significantly associated with malignancy; while the smooth margin, spongiform structure were significantly associated with benign nature. In terms of the internal solid portion of the nodules, the configuration, free margin, echogenecity, and calcification were significantly associated with malignant or benign nature (P < 0.001). The eccentric configuration with an acute angle, non-smooth free margin, hypoechogenecity, marked hypoechogenecity and micro-calcification were significantly associated with malignancy; while concentric configuration, smooth free margin, hyper/isoechogenicity, free margin of the solid component, and macro-calcifications were significantly associated with benign nature (P < 0.01). The results of logistic regression analysis showed that the echogenicity, free margin, configuration and calcification of the solid component were important predictive factors of malignant lesions (P < 0.05), that the hypoechogenecity, marked hypoechogenecity, eccentric configuration with an acute angle, non-smooth free margin and micro-calcification of the internal solid portion of the nodules were predictors for malignant PTCNs (P < 0.01).</p><p><b>CONCLUSION</b>Understanding the characteristics of US findings of partially cystic thyroid nodules is of great importance to make an accurate diagnosis of malignant nodules.</p>
Subject(s)
Biopsy, Needle , Calcinosis , Diagnosis , Diagnostic Imaging , Diagnosis, Differential , Sensitivity and Specificity , Thyroid Nodule , Diagnostic Imaging , Ultrasonics , UltrasonographyABSTRACT
Objective To explore the applied value of thyroid imaging reporting and data system (TI-RADS) strati?fication in diagnosing thyroid nodules in patients with different ages.Methods A total of 527 patients with thyroid nod?ules (aged 26-65) were divided into four groups:aged 26-35 group, aged 36-45 group, aged 46-55 group and aged 56-65 group. TI-RADS was used to evaluate patients in four groups. The results of TI-RADS were compared with the pathologic di?agnostic analysis. Results For the low aged groups (aged 26-35 group and aged 36-45 group), the positive predictive val?ue, the negative predictive value and accuracy rate were more than 90%. With regard to the patients aged 46-55, the positive and negative predictive values and accuracy rate were 81.5%, 87.5%, and 81.9%, respectively. The positive and negative predictive values, accuracy rate were 76.6%,88.8%and 77.9%for patients aged 56-65 group. The diagnostic rate of TI-RADS in patients with thyroid lesions was lower in aged 56-65 group than that of other groups. Conclusion TI-RADS method is affected by age. The diagnostic rate is lower in the high age group than that of the low age group.
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Symptomatic venous thromboembolism (VTE) has a six-to seven-fold risk of occurring in cancer patients compared with non-cancer patients. VTE is the second most common cause of death among patients with cancer, and cancer-associated VTE is be-coming increasingly prevalent. Therefore, early diagnosis and treatment of cancer-associated VTE is particularly important. This study presents a pancreatic cancer-associated deep vein thrombosis (DVT) patient who engaged in a multidisciplinary comprehensive discus-sion in the Interventional Therapy Department, Tianjin Medical University Cancer Hospital to enhance concern, interdisciplinary com-munication, and cooperation in terms of cancer-associated VTE diagnosis and treatment strategies.
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Objective To evaluate the clinical application value of pathological diagnosis by using ultrasound-guided percutaneous needle core biopsy (PNCB) for cervical lymph lesions.MethodsTwo hundred and ten patients with cervical lymph lesions underwent ultrasound-guided PNCB,and pathological diagnosis were made based on core biopsy material.The results of study were concluded by comparing the pathological diagnosis from core biopsy of the lymph nodes with those from excision biopsy. Results There were 210 patients underwent ultrasound- guided PNCB,98.6％ (207/210) cases of core biopsies yielded adequate material at first time and 92.9％ (195/210) cases of those had pathologic diagnosis.The accuracy of ultrasound-guided PNCB in differentiating benign from malignant lymphadenopathy was 99.4％ ( 194/195 ).The diagnostic accuracy of metastatic tumor and lymphoma by ultrasound-guided PNCB was 96.4％ (135/140) and 86.1％ (31/36),respectively.Only 67.7％ (21/31) patients with lymphoma could be classified by ultrasound-guided PNCB.ConclusionUltrasound-guided PNCB in patients with neck lymph lesions is a safe,convenient and quick procedure that has a high diagnosis accuracy.Ultrasound-guided PNCB can replace the open surgery for neck lymph node diagnostic method.Due to the complicated and diverse pathologic performance,lymphoma should be cut by open surgery to confirm the diagnosis and classification.