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Objective:To investigate the application value of contrast-enhanced ultrasound (CEUS) combined with thyroid imaging reporting and data system (TI-RADS) classification in the differential diagnosis of benign and malignant thyroid nodules.Methods:The clinical data of 157 thyroid nodules from 122 participants who underwent conventional ultrasound and CEUS examination from January 2016 to January 2017 in the First Hospital of Shanxi Medical University, China were collected. The image features were analyzed for conventional ultrasound and TI-RADS classification. According to CEUS results, the thyroid nodules were classified by TI-RADS. Based on pathological results, the efficacy of CEUS combined with TI-RADS classification versus conventional ultrasound combined with TI-RADS classification in the differential diagnosis of benign and malignant thyroid nodules was investigated. Results:The area under the curve of CEUS combined with TI-RADS classification (AUC = 0.900) was greater than that of conventional ultrasound combined with TI-RADS classification (AUC = 0.808). The sensitivity, specificity, accuracy, positive and negative predictive values of conventional ultrasound combined with TI-RADS classification in the differential diagnosis of benign and malignant thyroid nodules were 81.6% (80/98), 67.8% (40/59), 76.4% (120/157), 80.8% (80/99), 68.9% (40/58), respectively. They were 98.0% (96/98), 78.0% (34/59), 90.4% (142/157), 88.1% (96/109), 95.8% (46/48), respectively for CEUS combined with TI-RADS classification. The sensitivity of CEUS combined with TI-RADS classification in the differential diagnosis of benign and malignant thyroid nodules was significantly higher than that of conventional ultrasound combined with TI-RADS classification ( χ2 = 12.50, P < 0.001). Conclusion:CEUS combined with TI-RADS classification is more effective in the differential diagnosis of benign and malignant thyroid nodules than conventional ultrasound combined with TI-RADS classification.
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Objective To evaluate the diagnostic value of contrast enhanced ultrasound ( CEUS ) combined with ultrasound-guided fine-needle aspiration ( US-FNA) in differentiating malignant and benign thyroid nodules . Methods A retrospective review of preoperative CEUS and US-FNA data of 161 thyroid nodules confirmed by surgical pathology from 145 patients was performed . The CEUS enhancement patterns of whole phase hypo-enhancement ,uneven hypo-enhancement and early phase hypo-enhancement were taken as the diagnostic criteria for malignant thyroid nodules . According to the Bethesda System ,the grade≥ Ⅳ was taken as the cytologic criteria for diagnosis of malignant thyroid masses . The 161 thyroid nodules were divided into large nodules group( the longest diameter of thyroid nodules were higher than 1 .0 cm) and small nodules group ( the longest diameter of nodules were higher than 0 .5 cm but lower than 1 .0 cm) . The diagnostic value of CEUS ,US-FNA and the combination were evaluated respectively in the the two groups . Results In large nodules group ,the sensitivities of CEUS ,US-FNA and the combination were 88 .0% ,81 .3% ,94 .7% ,respectively ;their specificities were 88 .5% ,100% ,88 .5% ,respectively . There was no statistically difference in sensitivity between CEUS and US-FNA ( P ＝ 0 .301) ,the sensitivity of the combination was higher than US-FNA ( P ＝0 .004) . In small nodules group ,the sensitivities of CEUS ,US-FNA and the combination were 52 .4% ,78 .6% ,92 .9% ,respectively ;their specificities were 94 .4% ,100% , 94 .4% ,respectively . There was statistically difference in sensitivity between CEUS and US-FNA ( P ＜0 .05) ,the combination had the highest sensitivity ( P ＜ 0 .05).Conclusions For thyroid nodules whose longest diameter higher than 1 cm ,there is no statistically difference in sensitivity between CEUS and US-FNA .The combination had higher sensitivity than US-FNA .For thyroid nodules whose longest diameter higher than 0 .5 cm but lower than 1 .0 cm ,US-FNA provided higher sensitivity than CEUS ,the combination provided higher sensitivity than single CEUS or US-FNA .
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Objective To investigate the influence of size and depth of thyroid carcinoma for diagnostic accuracy of ultrasound-guided fine-needle aspiration (US-FNA).Methods A retrospective review of clinical and preoperative US-FNA data of 87 malignant thyroid nodules confirmed by surgical pathology from 87 patients was performed.According to the the Bethesda System for Reporting Thyroid Cytopathology (BSTC),the grade that higher than grade Ⅳ was the cytologic criteria for diagnosis of thyroid carcinoma.According to the cytopathological data of thyroid carcinoma confirmed by surgical pathology,the patients were divided into group A (cytopathological data was same as the surgical pathology result) and group B (cytopathological data was not same as the surgical pathology result).The longest diameter of malignant thyroid nodules and the distance from the shallow of thyroid nodules to superficial capsule of thyroid gland were analyzed.The ROC analysis was performed to find the optimal cut-off value of the longest diameter of thyroid carcinoma and the distance from the shallow of thyroid carcinoma to superficial capsule of thyroid gland.Results The consistent rate between US-FNA and surgical pathologic results was 79.31 ％ (69/87).The longest diameter of thyroid carcinoma of group A and group B was (1.63±0.58)cm and (1.01±0.42)cm respectively,which was statistically different (P＜0.01).The distance from the shallow of thyroid carcinoma to superficial capsule of thyroid gland of group A and group B was (4.15±1.83) mm and (7.86±2.08)mm respectively,which was statistically different (P＜0.01).According to the ROC analysis results,the optimal cut-off value of the longest diameter of thyroid carcinoma and the distance from the shallow of thyroid carcinoma to superficial capsule of thyroid gland was 1.05 cm and 6.1 mm respectively.Conclusion Diagnosis accuracy of US-FNA could be influenced by size and depth of thyroid carcinoma.
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Objective To investigate and analyze risk factors of re-fracture after operation of osteoporotic hip fracture.Methods Two hundred forty-seven patients receiving operation of osteoporotic hip fracture were retrospectively studied and followed up,and all patients were divided into re-fracture group (54 patients) and no-re-fracture group (193 patients).The related factors such as sex,age,body mass index (BMI),affected side,initial fracture site,operation type,perioperative blood loss,postoperative delirium,postoperative bedridden time,medical complications,Charlson comorbidity index,antiostoporosis therapy,hip function scores with Harris and functional independence measurement (FIM) scores were compared by single factor analysis and multivariate Logistic regression analysis.Results Single factor analysis and multivariate Logistic regression analysis both showed that the risk factors of re-fracture after operation of osteoporotic hip fracture included age,postoperative delirium,hypertension,diabetes mellitus,cerebrovascular disease,antiostoporosis therapy,hip function scores with Harris and FIM scores (P ＜ 0.05 or ＜ 0.01).Conclusions Risk factors of re-fracture after operation of osteoporotic hip fracture include passive factors of age,postoperative delirium and medical complications,and subjective factors of antiostoporosis therapy,hip function scores with Harris and FIM scores.Patients should receive medical treatment positively,enhance antiostoporosis therapy and rehabilitation training of hip function to prevent re-fracture.
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Objective To study the CT specialities of small lung cancer with the thin-section scan images by general CT machine.Methods Through the 3 mm-scan means in breathless condition,CT specialities of 36 cases of little lung carcinoma were analysed,which were scanned with CT before operation and proved by pathology.Results CT specialities of peripheral small lung cancer had lobular sign(91.6%);coarse spicules sign(77.8%);bubble-like lucency sign(50%);pleural retraction sign(88.9%);honeycomb sign(11.1%);cavity(2.7%);convergence sign of pulmonary vessels(66.7%),the radiative shadiness of pathological pleural side(11.1%).Conclusion The CT specialities are divided into prime and subaltern specialities in the diagnosis of peripheral small lung carinoma.The prime specialities have lobular sign,edge coarse spicules sign,bubble-like lucency sign,pleural retraction sign,convergence sign of pulmonary vessels,and the CT specialities are not agreeable with the small lung carcinoma of different tissue types.