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Objective:To compare the detection rate and time cost of different imaging methods for retinal and optic disc neovascularization in proliferative diabetic retinopathy (PDR).Methods:A cross-sectional study was conducted.Thirty-eight patients (48 eyes) with PDR were enrolled in Henan Eye Hospital from October 2019 to February 2021, including 22 males (28 eyes) and 16 females (20 eyes). The average age of the patients was (51.08±13.35) years.All patients underwent ultra-widefield imaging (UWFI), fundus fluorescein angiography (FFA), optical coherence tomography angiography (OCTA), en face optical coherence tomography (OCT), near-infrared fundus imaging (IR) combined with spectral domain OCT (SD-OCT). Wide field swept-source OCTA (WF-SS-OCTA) was performed in the patients who were unsuitable for FFA.The time required for each examination in one eye and the detection rate of neovascularization at the optic disc (NVD) and retinal neovascularization elsewhere (NVE) were recorded.This study adhered to the Declaration of Helsinki.The study protocol was approved by Henan Eye Hospital (No.HNEECKY-2021[22]). All patients were informed about the method and purpose of the study and voluntarily signed the informed consent form.Results:The mean monocular examination time costs of UWFI, IR+ SD-OCT, OCTA+ en face OCT, FFA and WF-SS-OCT was (0.51±0.13), (2.08±0.57), (5.79±0.68), (17.66±1.83) and (13.38±1.23)min, respectively.There was a significant overall difference in the mean monocular examination time among the five methods ( F=2 077.960, P<0.001). The detection rates of UWFI, IR+ SD-OCT, OCTA+ en face OCT, FFA+ WF-SS-OCT for NVE and NVD were 52.1%(25/48) and 12.5%(6/48), 81.3%(39/48) and 20.8%(10/48), 83.3%(40/48) and 27.1%(13/48), 93.8%(45/48) and 29.2%(14/48), respectively.There were significant differences in the detection rates of NVE ( χ2=26.460, P<0.001) but not in the detection rates of NVD ( χ2=4.645, P=0.200) among the various methods.Five neovascular buds were detected by OCTA in 3 eyes, but not by FFA. Conclusions:UWFI and IR+ SD-OCT are faster and non-invasive methods for the screening of NVD and NVE in PDR eyes.Compared with FFA, OCTA and en face OCT can show the shape of neovascularization more clearly.FFA provides a wide-range retinal image, but it is time-consuming and invasive.WF-SS-OCTA extends the examination range of OCTA and detects neovascularization non-invasively and faster than FFA.
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Objective:To investigate the imaging features of iris fluorescein angiography (IFA) combined with fluorescein fundus angiography (FFA) in diabetic iridopathy.Methods:A cross-sectional study was conducted.Sixty-five eyes of 44 patients with proliferative diabetic retinopathy (PDR) combined with diabetic iridopathy (DI) were enrolled in Henan Eye Hospital from May 2013 to May 2020.Patients were divided into non-proliferative diabetic iridopathy (NPDI) group and rubeosis iridis group according to the imaging results.Ophthalmic examinations including visual acuity, intraocular pressure, slit lamp miacroscopy, IFA and FFA were carried out in all patients.IFA was used to detect the iris imaging characteristics and the regression time of fluorescein in anterior chamber, and FFA was used to observe the retinal image characteristics and the incidence of optic disc neovascularization.To avoid the statistical error of recording the IFA examination time of the contralateral eye, only the relevant data of the affected eyes were analyzed.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of Henan Eye Hospital (No.HNEECKY-2020[06]). Written informed consent was obatined from all patients before any medical examination.Results:Among the patients, 30 cases (50 eyes) were with NPDI and 14 cases (15 eyes) were with rubeosis iridis.The fluorescein regression time in anterior chamber of NPDI group was (3.37±0.11) minutes, which was significantly shorter than (6.02±0.29) minutes of rubeosis iridis group ( t=8.541, P<0.001). Strong fluorescence of retinal neovascularization was observed in both groups.The incidence of optic disc neovascularization in NPDI group was 20% (6/30), which was significantly lower than 50% (7/14) in rubeosis iridis group ( P=0.04). Conclusions:Diabetic rubeosis iridis can be diagnosed by the imaging features of IFA and the fluorescein regression time in anterior chamber.PDR combined with optic disc neovascularization should be evaluated by FFA combined with IFA.
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【Objective】 To explore the relationship between climate factors and the number of street voluntary blood donors in Beijing and develop a reliable predictive model, so as to provide reference for donor recruitment. 【Methods】 The data of weather and the number of street blood donors from January 2018 to October 2019 were collected to formulate generalized additive model(GAM) and autoregressive integrated moving average model(ARIMA), and the predicative accuracy of the two models was assessed using data from November to December 2019. 【Results】 GAM indicated that the number of donors decreased when the wind force was 4 to 5 (95%CI: 0.805, 0.995), and the number on weekends and official holidays was 1.562 (95% CI: 1.510, 1.617) and 1.779 (95%CI: 1.035, 3.055) times that of the working day respectively. The number of blood donors increased with the elevation of temperature until 25℃, then declined with temperature increasing slowly. The two-day predictive accuracy of GAM and ARIMA was 92.14% and 90.55%, with overall accuracy at (84.46±11.12)% and (87.65±9.3)%, respectively. 【Conclusion】 Considering official holiday, strong wind and temperature, etc, the ARIMA model runs stable overall, while GAM is good at short-term prediction. The comprehensive use of two predictive models is helpful in guiding the recruitment of blood donors.
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Objective:To observe the incidence of diabetic iridopathy and optic disc neovascularization in the contralateral eyes of proliferative diabetic retinopathy (PDR) with proliferative diabetic iridopathy (PDI).Methods:A retrospective case-control study. From February 2014 to May 2020, 72 eyes of 36 patients with PDR and PDI who underwent iris fluorescein angiography (IFA) combined with fluorescein fundus angiography(FFA) at the Henan Eye Institute were enrolled in the study. Among them, there were 34 eyes in 17 males and 38 eyes in 19 females; the average age was 62.3±4.7 years. All patients underwent best corrected visual acuity(BCVA), intraocular pressure, IFA combined with FFA examination. The BCVA examination was performed using the international standard visual acuity chart, which was converted into logarithm of the minimum angle of resolution BCVA for statistic analysis. According to PDI staging, patients were divided into early rubeosis iridis(RI) group and neovascular glaucoma (NVG) group, with 28 and 8 cases respectively. Compared with NVG group, RI group had better BCVA and intraocular pressure, and the difference was statistically significant( t=6.433, 10.619; P=0.000, 0.011). The incidence of PDI and the incidence of binocular optic disc neovascularization in the two groups were compared, and Fisher's exact probability method was used for comparison. Results:The results of the IFA examination showed that in the RI group, the pupil border and the iris surface of the iris of the affected eyes had strong neovascular bud-like or patchy fluorescence; the pupil border and the middle of the iris of the patients in the NVG stage had strong neovascular cluster-like fluorescence. Among the contralateral eyes in the RI group, 6 eyes (21.4%, 6/28) were with PDI (stage RI), 21 eyes (75.0%, 21/28) were with non-PDI (NPDI), and 1 eye (1/ 28, 3.6%) were absence of diabetic iris disease. Among the contralateral eyes in the NVG group, there were 5 eyes with PDI (62.5%, 5/8), including 4 eyes with RI stage, 1 eye with NVG stage (12.5%, 1/8); 3 eyes with NPDI. The image of IFA in patients with NPDI early showed as punctate fluorescence in the local small blood vessels of the iris itself. The incidence of PDI in the contralateral eye of the RI group was lower than that of the NVG group, and the difference was statistically significant ( P=0.040). The results of FFA examination showed that 9 (32.1%, 9/28) and 8 (28.6%, 8/28) eyes of the affected eye and the contralateral eye in the RI group were combined with optic disc neovascularization. In NVG group, there were seperately 6 eyes (75.0%, 6/8) in the affected eyes and the contralateral eyes with optic disc neovascularization. The differences in the incidence of optic disc neovascularization between the two groups of the affected eyes and the contralateral eye were statistically significant ( P=0.046, 0.040). Conclusion:The incidence of PDI and optic disc neovascularization in the contralateral eye of PDR and PDI, RI is lower than that of NVG.
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【Objective】 To investigate the tension of donors during blood donation, so as to explore the utmost period for proper psychological intervention. 【Methods】 The donation procedure, from the completion of blood donation consultation form to the end of blood donation was divided into 17 steps, and donors were asked to recall the degree of tension at each step after the donation. 【Results】 71.65%(207/293) of the donors reported tension during donation, dominated by female donors(P<0.05)and first-time donors(P<0.05). The beginning of phlebotomyis the most intense moment.First-time donors (P<0.05), accidental donors (P<0.05) and female donors (P<0.05) were more nervous than others. Statistical differences in needle fear before and after the donation was observed(P<0.05). Multivariate analysis indicated that donation history and fear of puncture would affect the nervous level during donation. 【Conclusion】 More attention should be paid to female donors and first-time young donors to improve their self-efficacy and reduce the tension by explaining the donation procedure in detail, promoting donation appointment, and shielding the needles and blood bags.
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Objective:To compare the efficacies of MRI, X-ray mammography (XMG) and Ultrasound (US) in detecting and diagnosing breast ductal carcinoma in situ (DCIS).Methods:Two hundred and forty one consecutive patients with pathology-confirmed DCIS were retrospectively recruited from January 2011 to December 2017 in PLA General Hospital. The imaging examination modalities included MRI and/or XMG and/or US.The breast imaging reporting and data system (BI-RADS) categorizations by MRI, XMG and US were compared and their sensitivities of detecting DCIS were calculated. The causes of underestimation on MRI were interpreted with the information of XMG and US. Chi-square test was used to compare the differences.Results:The diagnostic sensitivity of XMG, US and MRI was 65.9% (29/44), 71.6% (101/141) and 91.2% (145/159), respectively, with statistical significant differences (χ2 =24.034, P<0.001). Breast density and lesion type would influence the sensitivity of XMG. And the sensitivity of US was decreased because of non-mass lesion. Of the 14 cases under-evaluated as BI-RADS category 1 to 3 on MRI, 5 were corrected by XMG and/or US to BI-RADS category 4. The cause of underestimation on MRI was the coexistence of DCIS with adenoma or other benign lesion. Conclusion:The retrospective comparison of MRI, XMG and US in this study showed that MRI had significant higher sensitivity in detecting breast DCIS, while the false negative rates of XMG and US were un-negligible.
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Peripheral nerve hyperexcitability syndromes (PNHS) encompass a spectrum of a heterogeneous condition with clinical as well as electrophysiological manifestations of peripheral nerve hyperexcitability. The PNHS consist of Isaacs syndrome, Morvan syndrome and Cramp-fasciculation syndrome, which cause widespread symptoms and signs while without evident peripheral nerve disease. Probably the most well-known condition of PNHS is Isaacs syndrome, often called acquired neuromyotonia. Clinical symptoms of PNHS are characterized by muscle twitching, cramps, stiffness, and neuropathic pain. The electrophysiological findings that are very useful in the diagnosis of PNHS are spontaneous myokymic, neuromyotonic, and cramp discharges. An overview of the history, clinical manifestations, pathophysiology, electrophysiological findings and management of PNHS is presented.
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Objective To analyze the clinical features of paracentral acute middle maculopathy(PAMM).Methods A retrospective series case observation was carried out.Clinical data of 11 eyes from 11 patients with PAMM were included in this study from January 2016 to December 2017 in Henan Eye Hospital.All of the patients received general information inquiry,regular ophthalmic examination,color fundus photography,fundus infrared imaging (IR),spectral-domain optical coherence tomography (SD-OCT),OCT angiography (OCTA),fundus fluorescence angiography(FFA),visual field examination and multifocal electroretinography.Results The ages of the patients ranged from 50 to 71 years old,with the average age of 60 years old.There were 9 males and 2 females,including hypertension in 3 patients,hypertension carotid atherosclerotic plaque in 1 patientd,diabetes with carotid stenosis in 2 patients,hypertension with diabetes in 2 patients,only carotid atherosclerotic plaque in 2 patients and chest trauma in 1 patient.The symptoms of PAMM were central or paracentral scotoma within 1 week.The best corrected visual acuity(BCVA) of the patients ranged from 0.6 to 1.0.All of the patients had central or paracentral scotoma or decrease of visual sensitivities.Mf-ERG showed that amplitude density of P1 waves was reduced in 8 eyes.With subtle-white lesion was seen in fundus of 8 eyes and no obvious symptom in 3 eyes.IR imaging demonstrated hypo-reflection in paracentral macula area in all eyes,and their FFA imaging seemed normal.SD-OCT scanning across lesion area revealed hyper-reflection in inner nuclear layer (INL).OCTA demonstrated perfusion deficit in deep capillary plexuses(DCP).After treatment,there was no improvement in BCVA for all the eyes but scotomas were lessened.Conclusions PAMM easily occurs in older males with systemic diseases.PAMM lesson is a occult paramacular middle layer of retinopathy.The combination examination of morphological and functional methods is avaiable for diagnosis.
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Amyotrophic lateral sclerosis (ALS) is an cruel,adult-onset neurodegenerative disorder affecting upper and lower motor neurons,resulting in progressive muscle weakness and finally death by respiratory failure.Its pathophysiology is unclear.In recent years,availability of next-generation sequencing techniques has led to the discovery of several new ALS genes,greatly improving our knowledge about basic mechanisms involved in ALS pathogenesis.The TANK-binding kinase 1 (TBK1) gene has recently been identified as a novel causative gene of ALS.In this review,we focus on the frequency and characteristics of the TBK1 gene variants,clinical features and pathological feature of patients with TBK 1 gene mutations and the role of TBK1 gene in the pathophysiology of ALS.
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Objective Evaluating the effects of Bushen-Gufeigao and breathing movements on the patients with chronic obstructive pulmonary disease of Lung and kidney deficiency TCM pattern. Methods The patients with chronic obstructive pulmonary disease of lung and kidney deficiency TCM pattern were recruited and randomly divided into two groups the treatment group (32 cases) and the control group (34 cases). The control group was treated with the conventional medicine, and the treatment group were added Bufei-Gushengao and breathing movements based on the treatment of control group. Both groups were treated for 1 month. The changes of the clinical symptoms, lung function and frequency of attack and duration of each attack in 10 months after treatment were observed. Results After the treatment, compared with the control group, the TCM patterns scores (5.32 ± 2.67 vs. 9.12 ± 4.11, t=4.424) of the treatment group significantly decreased, while the FVC (3.00 ± 0.49 L vs. 2.71 ± 0.47 L, t=2.408), FEV1 (2.27 ± 0.44 L vs. 1.85 ± 0.54 L, t=3.496), and the percentage of FEV1%(75.62 ± 6.84 vs. 66.86 ± 9.32, t=4.333) increased significantly. In the 10 mouths after the treatment, the treatment group showed significantly fewer patients who had attacked more than 6 times than that in the control group, and the duration of attacks showed significantly fewer minutes in the treatment group than the control group (5.56 ± 1.45 d vs. 8.06 ± 1.80 d, t=6.190). Conclusion Bushen-Gufeigao and breathing movements can effectively improve patient's lung function and symptoms.
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Objective To determine the association between weight gain induced by atypical antipsychotic and the polymorphisms of MC4R gene rs12970134.Methods 62 patients who had weight gain more than 7% of their pre -drug body weight were selected as study group,and 62 patients who had weight gain less than 7% of their pre -drug body weight were selected as control group.The polymorphism of MC4R gene rs12970134 was analyzed by using polymerase chain reaction and directly sequencing technology.Results There were no significant differences in the frequency of MC4R gene rs12970134 genotypes and alleles between the two groups(χ2 =0.648,P =0.723;χ2 =0.679,P =0.410).While after the treatment with atypical antipsychotic,the weight gain degree in patients with GG genotypes was less than patients with GA /AA genotypes[(22.18 ±0.33)kg/m2 vs.(23.53 ±0.58)kg/m2 ](t =-2.167,P =0.032).Conclusion The polymorphisms of MC4R gene rs12970134 maybe affect the weight gain degree in patients after treatment with antipsychotic.
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Purpose To explore the expressional differences of immunohistochemical indicators between the non-mass-like and mass-like breast cancers,and to identify the biological characteristics of non-mass-like breast cancer.Material and Methods Various immunohistochemical indicators (HER2,ER,PR,Ki-67) were analyzed in 19 cases non-mass-like cancer and 18 cases mass-like breast cancer retrospectively,and the expressional differences of the two groups were compared.Results 12 cases (63.2％) were diagnosed DCIS in the non-mass-like breast cancer group,but in the mass-like breast cancer group,the majority (12 cases,66.7％) were invasive cancer.HER2,ER,PR expression had no statistical difference between the two types (P＞0.05).But the Ki-67 positive rate expressed in non-mass-like breast cancer was lower significantly (P＜0.05).Conclusion The HE immunohistochemical characteristics of non-mass-like breast cancer are overlapped with that of mass-like breast cancer,but Ki-67 expression has significant difference between the two groups.There are some differences in biological characteristics of these two kinds of breast cancers.
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Background Neovascular glaucoma (NVG) is secondary to retinal ischemia and hypoxia.Iris fluorescein angiography (IFA) can be used for early detection of NVG,but it can not reflect the condition of retinal blood vessels comprehensively.IFA combined with fundus fluorescein angiography (FFA) can detect the condition of retina and iris neovascularization comprehensively,but its application on diabetic retinopathy(DR) with NVG was rare in China.Objective This study was to evaluate the clinical application of IFA combined with FFA in proliferative diabetic retinopathy (PDR) patients with NVG.Methods A retrospectively study was designed.One hundred and thirty-three eyes with PDR were enrolled in Henan Eye Hospital from February 2013 to January 2016,including 100 eyes with no iris diseases,21 eyes with rubeosis iridis,and 12 eyes with NVG.All eyes underwent ophthalmic examinations that included best-corrected visual acuity,intraocular pressure,slit lamp,IFA and FFA.The differences of IFA examination and slit lamp examination in the eyes with rubeosis iridis were compared and statistical analyzed by McNemar nonparametric test.Results In this study,100 eyes with no iris leakage were identified by IFA,32 eyes with panretinal photocoagulation (PRP) treatment history had no retinal neovascularization and 68 eyes had retinal neovascularization;21 rubeosis iridis eyes with iris leakage at pupillary border or on iris surface were observed at the early stage of IFA,and all the eyes were identified having retinal neovascularization according to FFA images;12 NVG eyes were observed having iris neovascular leakage on iris surface at the early stage of IFA,and all the eyes were identified having retinal neovascularization according to FFA images.The detection rate of IFA examination on rubeosis iridis was 100％ (21/21),which was higher than 71.43％ (15/21) of slit lamp examination,and there was a significant difference between the two detection methods (P =0.03).Conclusions IFA combined with FFA can detect PDR with rubeosis iridis early,and it is helpful to guide the treatment timely.
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PurposeTo evaluate the shear wave elastography in diagnosis of intraductal papillomas, benign or malignant breast lesions.Materials and Methods From December 2013 to December 2014, 145 female patients with 155 lesions who underwent ultrasonography and shear wave elastography in general hospital of PLA were retrospectively studied. All the lesions were confirmed by pathology via surgery or biopsy. The performance of the maximum elasticity, the mean elasticity, the minimum elasticity values and the elasticity ratio in diagnosis of benign and malignant tumors were analyzed. The portion of intraductal papillomas in misdiagnosed cases was calculated. The elasticity values of intraductal papillomas were compared with those of other breast benign and malignant lesions.ResultsAmong 155 lesions, pathology confirmed intraductal papillomas in 20 lesions, fibroadenosis in 23 lesions, fibroadenoma in 23 lesions, inflammation in 9 lesions, adenosis with fibroadenoma in 17 lesions, and breast cancer in 63 lesions. The maximum, mean, minimum elasticity values and the elasticity ratio of intraductal papillomas were (84.39±74.08) kPa, (51.33±46.36) kPa, (26.55±24.98) kPa and 2.80±2.18, respectively. The elasticity values of intraductal papillomas were between those of breast cancer and other benign lesions, and there were no statistically significant (P=0.003).ConclusionThe elasticity values of intraductal papillomas were between those of breast cancer and other benign lesions, which may be a potential reason to cause misdiagnosis using shear wave elastography to differentiate breast benign and malignant diseases.
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Background It is thought in recently that photodynamic therapy (PDT) is an effective treatment method for chronic central serous chorioretinopathy (CSC), but the dosage of verteporfin and its long-term efficacy and complications is rarely elucidated ever before.Objective This study was to observe the long-term efficacy and safety of 60％ dose verteporfin PDT for chronic CSC.Methods This is a retrospective study and a self-controlled design was used.The clinical data of 25 eyes of 21 chronic CSC patients who received 60％-dose verteporfin PDT in Henan Eye Institute from January 2009 to May 2010 were reviewed, with the male 18 (85.71％) and female 3 (14.29％) as well as monocular CSC 17 patients and binocular CSC 4 patients.The average ages of the patients were (43±5) years.Fundus fluorescein angiography (FFA) , indocyanine green angiography (ICGA), optical coherence tomography(OCT) and best corrected visual acuity (BCVA) were examined in all the patients before and after treatment.PDT with the 60％-dose verteporfin (3.6 mg/m2) was carried out on the CSC eyes.The treated eyes were examined 2 weeks, 1 month and 3 months after PDT.The BCVA,subfoveal choroid thickness,FFA and ICGA findings before and after PDT were compared.The following-up duration was 5 years or more.Results The BCVA before and 3 months after PDT were 0.5 ±0.1 and 0.9±0.2, respectively, with a statistically significant difference between them (t =19.17,P =0.00).The subfoveal choroidal thickness value 3 months after PDT was (326.56±39.47) μm,which was significantly reduced in comparison with (486.24 ±47.53) μm before PDT (t =25.17, P =0.00).FFA and ICGA showed that the leakage of fluorescein (hyperfluorescence) was disappeared in all the treated eyes.No systemic or local adverse effects and recurrence were observed during the follow-up period.Conclusions On the basis of the results of this study and available information,60％-dose verteporfin PDT seems to have a better long-term efficacy and safety than full-dose verteporfin in treating chronic CSC.
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<p><b>OBJECTIVE</b>To assess the accuracy of ultrasound-guided 16G and 18G core needle biopsy for detecting ultrasound visible breast lesions with different sonographic features.</p><p><b>METHODS</b>A total of 955 sonographically detected breast lesions examined with ultrasound-guided core needle biopsy (US-CNB) and subsequently surgically excised from July 2005 to July 2012 were retrospectively reviewed. Histological findings of US-CNB and the surgical specimens were analyzed for agreements, sensitivities, false negative rates, and underestimate rates according to different sonographic features.</p><p><b>RESULTS</b>The pathological results of the US-CNB showed malignant lesions in 84.1%, high-risk lesions in 8.4%, and benign lesions in 7.5% of the samples. The overall agreement rates were 92.4% for 16G CNB and 92.8% for 18G CNB; their complete sensitivities and false negative rates were both 98.6% and 1.4%, respectively; the high-risk underestimate rates and DCIS underestimate rates were 48.0% and 46.2% for 16G CNB vs 53.3% and 41.2% for 18G CNB, showing no significant difference between the two groups (P>0.01). For both 16G and 18G CNB, the agreements were better for mass lesions than for non-mass lesions (P<0.01). For the mass lesions with a diameter no greater than 10 mm, the agreement rates were lower than the overall data (P<0.01). Calcification in the lesions did not affect the agreement rates (P>0.01).</p><p><b>CONCLUSION</b>Ultrasound-guided 16G and 18G CNB are both accurate methods for evaluating ultrasound visible breast mass lesions with a diameter larger than 10 mm.</p>
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Adolescent , Adult , Aged , Aged, 80 and over , Female , Humans , Middle Aged , Young Adult , Biopsy, Fine-Needle , Methods , Biopsy, Needle , Methods , Breast , Pathology , Sensitivity and Specificity , Ultrasonography, MammaryABSTRACT
Purpose To study the differences of shear wave elasticity and the content of collagen fiber between benign breast lesions and malignant breast lesions, and to analyze the correlation between shear wave elasticity and the content of collagen fiber. Materials and Methods 106 patients with 116 breast lesions who were referred to PLA General Hospital for ultrasound-guided biopsy or surgery underwent shear wave elasticity examination, the biopsy specimen underwent Van Gieson (VG) dye and Image-Pro Plus 5.1 software was used to quantitatively analyze the content of collagen fiber. Results Malignant lesions exhibited signiifcantly higher max elasticity, mean elasticity, and elasticity ratio between lesions and surrounding parenchyma (140.43±70.16) kPa, (63.11±33.68) kPa, 3.49±1.95 than benign lesions (54.64±48.53) kPa, (34.52±25.23) kPa, 2.25±1.48 (t=5.329, 4.382 and 4.487, P<0.01). The content of collagen fiber of malignant lesions was signiifcantly higher than that of benign lesions (t=8.437, P<0.01). There was a positive correlation between max elasticity and the content of ifber collagen (r=0.746, P<0.05). Conclusion The elasticity of breast lesions has a close correlation with the content of collagen ifber, and collagen ifber might play an important role in the development of breast carcinoma.
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Purpose To investigate the prognosis and influencing factor of hematoma complicated from ultrasonography-guided EnCor vacuum-assisted breast biopsy system in minimally invasive surgery for breast lesions, and to provide reference for clinical treatment. Materials and Methods 280 female patients with 486 benign breast lesions underwent minimally invasive excision using a ultrasonography-guided EnCor vacuum-assisted device, occurrence and the inlfuence factors of hematoma complicated from the operation was observed. Results All the 486 lesions were completely excised with EnCor system, hematoma (≥1cm) were found in 47 cases after 24 hours and almost disappeared in 6 months. After analysis of the occurrence of hematoma, it was found that the following situations would lead to a higher incidence of hematoma, which included lumps ≥ 2.5 cm, more than two lesions removed at one time, lumps locating deep inside the areola or the edge of breasts, bigger and less dense breasts, operation in menstrual period, pressure bandaging after operation less than 12 hours and operation without using adrenaline (P<0.05 or P<0.01). Conclusion Benign lesions breast can be effectively excised using ultrasonography-guided EnCor vacuum device, and the factors listed below could affect the occurance of hematoma complicated from the surgery, including the size, location and number of the resected nodules, breast shape, surgery during menstrual period, postoperative pressure bandaging and the use of hemostatics.
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Objective To obtain the elasticity value of non-mass-like breast lesions with supersonic shear wave elastrography (SWE), in order to observe the value of quantitative elastography with SWE in differential diagnosis of non-mass-like breast lesions. Methods SWE was performed in 80 non-mass-like breast lesions. Taking pathologic results as reference, quantitative elasticity value of the lesions were performed. The diagnostic accuracy, sensitivity and speciifcity were calculated. Results In the 80 non-mass-like breast lesions, 37 lesions (46%) were malignant and 43 lesions (54%) were benign. The max and mean elasticity value of malignant lesions were (106.28±46.39) kPa and (51.02±30.06) kPa, and the max and mean elasticity value of benign lesions were (37.13±18.22) kPa and (26.44±15.62) kPa. There was statistical differences between malignant and benign lesions in max and mean elasticity values (t=15.328, 18.149, both P<0.05). Taking 61.25 kPa as the threshold of max elasticity value and 40.65 kPa as the threshold of mean elasticity value, the diagnostic accuracy, sensitivity and speciifcity were 70.53%, 66.83%, 51.22%and 68.34%, 65.81%, 50.63%, respectively. When max elasticity was combined with conventional ultrasound (US), the diagnostic accuracy, sensitivity and speciifcity were 84.17%, 92.28%and 68.39%, respectively. The diagnostic accuracy and speciifcity signiifcantly increased compared with conventional US (χ2=5.217, 9.652, both P<0.05). When mean elasticity was combined with conventional US, the diagnostic accuracy, sensitivity and speciifcity were 82.35%, 90.66%, and 63.35%, respectively. The diagnostic accuracy and speciifcity signiifcantly increased compared with conventional US (χ2=5.084, 8.686, both P<0.05). Conclusions The diagnostic accuracy and speciifcity of SWE for non-mass-like breast lesions are not high. But when SWE is combined with conventional US, the diagnostic accuracy and speciifcity increase signiifcantly, which is very helpful for the diagnostic of non-mass-like breast lesions.
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Objective To evaluate the value of supersonic shear wave elastrography(SWE) in the diagnosis of benign and malignant breast lesions.Methods SWE was performed on 134 breast lesions of 123 female patients and 74 normal breast glands to determine the values of overall elastic modulus and dispersion,and ROC curves were used to assess the diagnosis boundary value of two kinds of data respectively.Results According to the diagnostic gold standard-histopathology,the values of overall elastic modulus and dispersion were statistically significant when comparing benign lesions and malignant lesions with normal glands.ROC curve displayed that,when the Youden index reached to maximum,the diagnosis boundary value of overall elastic modulus was 41.01 kPa,the sensitivity and specificity of the value were 68.5％ and 83.8％ respectively; the diagnosis boundary value of dispersion was 12.25 kPa,the sensitivity and specificity of the value were 87.0％ and 88.7％ respectively.Conclusions The values of overall elastic modulus and dispersion for solid breast lesions can be used to reflect the elastic characteristics of lesions quantificationally,which is useful to diagnose benign and malignant breast lesions in clinical.