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Objective:To explore the vascularity index of joints synovial quantitatively evaluate activity degree of rheumatoid arthritis(RA).Methods:From January to April 2022, 102 cases of RA patients in Henan Provincial People′s Hospital were conducted ultrasound examination of 28 joints including the bilateral metacarpophalangeal joints (1-5), 1st interphalangeal and proximal interphalangeal joints (2-5), wrist joints, elbow joints, shoulder joints and knee joints. Superb microvascular imaging (SMI) was used to visualize and calculate the vascularity index (VI) in the hyperplastic synovium. Summary Vascularity index (VIsum) was calculated by adding the VI of 28 joints. Standard vascularity index (VIstand) was obtained by dividing VIsum by the number of positive joints. The mean vascular index (VImean) was obtained by dividing the VIsum by 28, which is the number of joints examined. The disease activity score in 28 joints (DAS28) was calculated, including DAS28-CRP and DAS28-ESR. Serological results related to RA were collected. The correlation between VIsum, VIstand, VImean and the above data were analyzed respectively. DAS28-ESR and DAS28-CRP stages were used as the criteria, receiver operating curve (ROC) was used, to evaluate the diagnostic efficacy, sensitivity and specificity of VI parameters in assessing RA activity.Results:VIsum, VIstand and VImean were positively correlated with DAS28-ESR, DAS28-CRP, ESR and CRP. The r values of VIsum and DAS28-ESR, DAS28-CRP, ESR and CRP were 0.703, 0.728, 0.467 and 0.529, respectively. The r values of VIstand and DAS28-ESR, DAS28-CRP, ESR and CRP were 0.665, 0.705, 0.538 and 0.605, respectively. The r values of VImean and DAS28-ESR, DAS28-CRP, ESR and CRP were 0.677, 0.690, 0.441 and 0.501, respectively (all P<0.01). Using DAS28-ESR as grouping standard, the area of ROC curve(AUC) of VIsum, VIstand, and VImean were 0.815, 0.816 and 0.814, respectively. With the cut-off value of VIstand being 12.83, the specificity and sensitivity of VIstand diagnosis were 0.882 and 0.676, respectively. Using DAS28-CRP as grouping standard, the AUC of VIsum, VIstand, and VImean were 0.812, 0.878 and 0.811, respectively. With the cut-off value of VIstand being 13.97, the specificity and sensitivity of VIstand diagnosis were 0.997 and 0.710, respectively. Conclusions:Synovitis VI can objectively evaluate the degree of synovitis activity in patients with rheumatoid arthritis. Synovial VI has high diagnostic efficacy for the activity of RA patients.
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Objective:To investigate the characteristics of multimodal ultrasound imaging in elderly hyperlipidemia patients with statin-related myopathy and to provide a reference of new method for non-invasive quantitative evaluation on statin myopathy.Methods:We collected 20 elderly hyperlipidemia patients with statin-related myopathy(the statin-related myopathy group), 20 elderly hyperlipidemia patients without statin-related myopathy after taking statins during the same period(the non-statin-related myopathy group), and 20 healthy volunteers who matched the age and sex of the above two groups during the same period(the healthy control group)in our hospital.Two-dimensional ultrasound, shear wave elastography and superb microvascular imaging were used to obtain thickness, echo, pinnation angle and shear wave velocity(SWV)values as well as vascular index(VI)values of the medial gastrocnemius during relaxation, dorsiflexion, and plantar flexion for each group, which were then analyzed.Results:There were no significant differences among the three groups in general conditions such as age, height, weight, and body mass index(all P>0.05). The mean thickness of the medial gastrocnemius in the statin-related myopathy group was about(1.04 ± 0.20)cm, which was less than(1.34 ± 0.16)cm in the non-statin-related myopathy group and(1.35 ± 0.15)cm in the healthy control group( F=22.03, P<0.001). The pinnation angle in the statin-related myopathy group was about(12.50 ± 1.10), which was less than(18.55 ± 1.28)in the non-statin-related myopathy group and(18.60 ± 1.35)in the healthy control group( F=158.03, P<0.001). Compared with the non-statin-related myopathy group and the healthy control group, SWV during resting, dorsiflexion and plantar flexion in the statin-related myopathy group decreased( F=61.71, 111.96 and 8.69, respectively, P<0.01). The average value of VI in the statin-related myopathy group was about(0.43 ± 0.12)%, which was less than that in the non-statin-related myopathy group(0.75 ± 0.20)% and in the healthy control group(0.93 ± 0.17)%( F=48.93, P<0.001). However, there was no significant difference in values from the parameters between the non-statin-related myopathy group and the healthy control group(all P>0.05). Conclusions:Multimodal ultrasound imaging of statin-related myopathy in elderly hyperlipidemia patients shows distinct characteristics and can be used to evaluate muscle damage of statin-related myopathy.
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Objective:To evaluate superb microvascular imaging used to monitor the hemodynamic changes in lower limb arteries in the treatment of diabetic foot by tibial transverse transport.Methods:From December 2019 to December 2021, 17 patients with diabetic foot were treated by tibial transverse transport at Department of Orthopedics, The Second Hospital of Shanxi Medical University. Superb microvascular imaging was used to observe the vascular index of the first dorsal metatarsal artery, the total blood flow of the anterior tibial artery and the posterior tibial artery, and the Wagner classification in the patients before surgery, one week and one month after surgery. Complications were documented.Results:After treatment, neovascularization was observed in all the 17 patients and detected on both the ipsilateral and contralateral sides of the surgery. At the last follow-up, the number of newborn collaterals was 7.0 (3.5, 9.0), significantly larger than that before surgery [1.0 (0, 1.5)] ( P<0.05). The vascular index of the first dorsal metatarsal artery at one week (9.70±10.88) and one month (9.22±5.46) after surgery was significantly higher than that before surgery (5.65±4.36) ( P<0.05). There was no significant difference in the total blood flow between the anterior tibial artery and the posterior tibial artery before surgery, one week or one month after surgery ( P>0.05). The Wagner classification at one month after surgery (grade 1 in 4, grade 2 in 11 and grade 3 in 2) was significantly better than that before surgery (grade 2 in one, grade 3 in 2 and grade 4 in 14) and one week after surgery (grade 2 in one, grade 3 in 5 and grade 1 in 11) ( P<0.05). One patient underwent amputation due to acute lower extremity arterial embolism 2 months after operation, and another patient underwent toe amputation due to blackening of the toes. Conclusion:Superb microvascular imaging is a valuable means of monitoring in tibial transverse transport because it can objectively reflect the hemodynamic changes and microcirculation in lower limb arteries and provide valuable information for prognosis of the condition in the treatment of diabetic foot by tibial transverse transport.
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Objective:To study the predictive value of superb microvascular imaging(SMI) in evaluating therapeutic efficacy of hepatic cancer treated by percutaneous radiofrequency ablation(PRFA).Methods:From Feb 2017 to Feb 2018, 55 patients (male: 31, female: 24, age range: 37-68 years, mean age: 56years) with 72 hepatic carcinoma lesions (length: 21.3-45.6 mm, average: 31.2 mm) were detected by SMI and contrast-enhanced CT(CECT)before PRFA. One month after treatment, more than two imaging examinations (CECT, CEMR, ultrasonic imaging) were used as the "gold standard" to evaluate the complete ablation rates. Consistency between the SMI grading and the arterial phase enhancement of CECT was analyzed by the Kappa-test.Results:Before PRFA, SMI showed 12 lesions (16.7%) to be in grade Ⅰ, 28 lesions (38.9%) in grade Ⅱ and 32 lesions (44.4%) in grade Ⅲ. The arterial phase of CECT showed 37 lesions (51.4%) to have no obvious enhancement and 35 lesions (48.6%) to have obvious enhancement. Consistency analysis showed that there was a high consistency between SMI and CECT(Kappa=0.861, P<0.001). The higher the SMI grading, the more obvious the enhancement on CECT. The complete ablation rates of the grade Ⅰ, grade Ⅱ and grade Ⅲ lesions were 100%(12/12), 92.9%(26/28) and 71.9%(23/32), respectively. The complete ablation rate of the lesions in grade Ⅲ was significantly lower than that in grade Ⅰ and grade Ⅱ (both P<0.05). Conclusion:SMI showed a good consistency with CECT in evaluating the blood flow signals of hepatic cancer, SMI grading could be used in predicting the therapeutic efficacy of hepatic cancer treated by PRFA.
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Carotid atherosclerotic plaque is closely related to the occurrence of ischemic stroke and coronary artery disease. Studies have shown that the vulnerability of carotid atherosclerotic plaque is one of the main causes of cardiovascular and cerebrovascular diseases, and its vulnerability is closely associated with the core of lipid necrosis, thin fibrous cap, high levels of macrophages, and intraplaque hemorrhage. With the advantages of easy operation, low cost, high safety and time -saving, ultrasound is more suitable than other imaging methods to become the routine screening method for the vulnerability of carotid atherosclerotic plaque. The article mainly introduces several emerging ultrasound technologies and their convenience and effectiveness, which are expected to detect the vulnerability of carotid atherosclerotic plaques in clinical practice.
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Objective To explore the value of superb microvascular imaging (SMI) for differentiating benign and malignant breast lesions. Methods Totally 281 patients (300 lesions) confirmed with pathology were enrolled, and the data of 2D gray-scale, CDFI and SMI were analyzed retrospectively. Adler's grading was applied to classify blood flow in breast lesions, and the ability of CDFI and SMI in detecting blood flow was compared. The vascular morphology features of breast lesions were also observed with CDFI and SMI, and then were classified and compared between benign and malignant lesions. Results The detection rate of blood flow with CDFI was 78.33% (235/300), with SMI was 90.33% (271/300), and the difference was statistically significant (χ2=116.066, P<0.001). Both CDFI and SMI showed statistically significant differences in blood flow Adler grading between benign and malignant lesions (both P<0.001). The difference of Adler grades with CDFI and SMI was significant (Z=-9.722, P<0.001). The differences in vascular morphology between benign and malignant breast lesions detected with CDFI and SMI were statistically significant (both P<0.001). The benign lesions mostly presented non-vascular, linear or curvilinear and tree-like, whereas enlarged and twisted penetrating and radial vessels were found more common in malignant lesions. Conclusion SMI can increase blood flow detection of breast lesions. SMI Adler grading of blood flow and vascular morphology are helpful to identifying benign and malignant breast lesions.
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Objective To investigate the diagnostic value of superb microvascular imaging ( SM I ) , advanced dynamic flow ( ADF ) and color Doppler flow imaging ( CDFI) in breast microcarcinoma ,and to compare the correlation coefficients between these three indicators and postoperative pathological tumor microvascular density ( M VD ) . Methods A total of 85 patients ( 87 lesions ) with BI‐RADS 4 and the maximum diameter≤1 cm were selected ,of which ,46 lesions were benign ( benign group) and 41 lesions were malignant( malignant group) . All the patients and the corresponding lesions were examined by SM I , ADF and CDFI . Blood flow grading was performed on the images using Adler grade of blood flow ,and the difference of blood flow among the 3 methods was compared . T he expression level of M VD in pathological tumor tissues was detected and analyzed for its correlation with Adler classification by three detection techniques . Results T he areas under the ROC curve( AUR) of CDFI ,ADF and SM I were 0 .694 ,0 .705 and 0 .776 respectively based on the gold standard with pathological diagnosis . T he sensitivity ,specificity , positive predictive value ,negative predictive value ,and accuracy of CDFI were 78 .0% ,54 .3% ,60 .4% , 73 .5% ,and 65 .5% , respectively ; those of ADF were 75 .6% , 60 .9% , 63 .3% , 73 .7% and 67 .8% , respectively ; and those of SM I were 78 .0% ,69 .6% ,69 .6% ,78 .0% and 73 .6% ,respectively . T he Adler grades of CDFI , ADF and SM I were positively correlated with M VD ( P ＜ 0 .05 ) , w hich the highest correlation coefficient between SM I and M VD ( r ＝0 .430 , P ＜0 .001 ) . Conclusions SM I is superior to ADF and CDFI in detecting the abundance of breast microcarcinoma , and has the highest correlation coefficient among those 3 detection techniques with tumor pathological M VD ,which indicates that SM I may be used for differential diagnosis of breast microcarcinoma and indirectly evaluate the prognosis of patients .
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Objective@#To investigate the application value of superb microvascular imaging (SMI) in the diagnosis of penile vascular ED.@*METHODS@#Seventy-two ED patients underwent SMI and color Doppler flow imaging (CDFI), all ultrasonographically diagnosed with penile vascular ED. We compared SMI and CDFI in detecting the grades of blood flow in the cavernous artery and the lengths of time needed to obtain satisfactory blood flow spectrum from the patients.@*RESULTS@#SMI mainly revealed grades Ⅲ and Ⅳ blood flow, in 43 and 20 of the 72 patients (87.5%), while CDFI chiefly manifested grades Ⅰ and Ⅱ blood flow, in 26 and 32 cases respectively (80.6%). The former showed significantly better manifestations of the penile cavernous artery than the latter. It took less time to obtain the spectrums of grades Ⅲ and Ⅳ blood flow (［1.52 ± 0.18］ and ［1.21 ± 0.11］ min) than grades Ⅰ and Ⅱ (［5.23 ± 0.44］ and ［4.46 ± 0.65］ min), and SIM took significantly less time than CDFI (［1.32 ± 0.42］ vs ［4.53 ± 0.67］ min, P < 0.05).@*CONCLUSIONS@#SMI is superior to CDFI in better manifesting the blood flow of the penile cavernous artery and shortening the examination time, and therefore deserves a wide application in the diagnosis of vascular ED.
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Objective@#To investigate the diagnostic value of superb microvascular imaging(SMI), advanced dynamic flow(ADF) and color Doppler flow imaging(CDFI) in breast microcarcinoma, and to compare the correlation coefficients between these three indicators and postoperative pathological tumor microvascular density(MVD).@*Methods@#A total of 85 patients(87 lesions) with BI-RADS 4 and the maximum diameter≤1 cm were selected, of which, 46 lesions were benign(benign group) and 41 lesions were malignant(malignant group). All the patients and the corresponding lesions were examined by SMI, ADF and CDFI. Blood flow grading was performed on the images using Adler grade of blood flow, and the difference of blood flow among the 3 methods was compared. The expression level of MVD in pathological tumor tissues was detected and analyzed for its correlation with Adler classification by three detection techniques.@*Results@#The areas under the ROC curve(AUR) of CDFI, ADF and SMI were 0.694, 0.705 and 0.776 respectively based on the gold standard with pathological diagnosis. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of CDFI were 78.0%, 54.3%, 60.4%, 73.5%, and 65.5%, respectively; those of ADF were 75.6%, 60.9%, 63.3%, 73.7% and 67.8%, respectively; and those of SMI were 78.0%, 69.6%, 69.6%, 78.0% and 73.6%, respectively. The Adler grades of CDFI, ADF and SMI were positively correlated with MVD(P<0.05), which the highest correlation coefficient between SMI and MVD (r=0.430, P<0.001).@*Conclusions@#SMI is superior to ADF and CDFI in detecting the abundance of breast microcarcinoma, and has the highest correlation coefficient among those 3 detection techniques with tumor pathological MVD, which indicates that SMI may be used for differential diagnosis of breast microcarcinoma and indirectly evaluate the prognosis of patients.
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Objective@#To compare the visualization ability for thyroid nodular vascularity among superb micro-vascular imaging (SMI), power Doppler flow imaging (PDFI), and color Doppler flow imaging(CDFI), and determine optimal vascular findings for the diagnosis of thyroid nodules.@*Methods@#A total of 58 thyroid nodules from 50 patients were enrolled, including 27 benign nodules (benign group) and 31 malignant nodules (malignant group). Vascular patterns of these nodules were detected by SMI, PDFI and CDFI, respectively.@*Results@#Thyroid cancer was characterized by type III vascular pattern. "Only central vascularity" performed best in detecting thyroid cancers. When using the criterion, SMI performed a better specificity (96.3%) and sensitivity (77.4%) than PDFI (92.5%, 41.9%) and CDFI (88.9%, 48.3%); and the specificity of SMI was significantly higher than the others (all P<0.01).@*Conclusions@#The sign of only central vascularity is of value in distinguishing malignant thyroid nodules. SMI is better on presenting thyroid nodular vascularity than CDFI and PDFI, and it could be used to differentiate thyroid nodules.
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Objective To compare the differences of superb microvascular imaging ( SMI) and color Doppler flow imaging ( CDFI) in the diagnosis of breast tumor microvessels and explore the value of microvascular morphological features in the detection of benign and malignant tumors . Methods SM I and CDFI were performed in 105 patients ( 105 breast tumors) in the breast surgery in our hospital . The morphological characteristics of the microvessels of the breast tumor were observed . Their values in the diagnosis of the benign and malignant of the tumor were compared with the pathological results . Results There were statistically differences in differentiation of microvascular morphologic types of benign and malignant breast tumors between SMI and CDFI ( P ＝ 0 .021 ,0 .042) . The type of diagnosing benign tumors was no blood vessel ,linear and treelike . The type of diagnosing malignant tumors was root hair-like and crab claw-like . The susceptibility ,specificity and accuracy of SMI and CDFI in diagnosing breast tumors were 85 .36% ,93 .75% ,90 .47% and 63 .41% ,90 .47% ,81 .90% . The area of the two ROC curves were 0 .896 and 0 .786 . The results of the Z test show that the diagnostic efficacies of the two methods were statistically significant( Z ＝2 .265 , P ＝0 .037) .Conclusions SMI is more effective than CDFI in detecting low velocity microvessels in breast tumors . Its morphological typing is of clinical significance in the diagnosis of benign and malignant tumors .
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Objective To investigate the value of vascular index(VI) in renal functionevaluation after renal transplantation by superb microvascular imaging(SMI).Methods Ultrasound and clinical data of 115 renal transplant recipients were collected:32 cases had good recovery of renal function after surgery(group A);35 cases of abnormal renal function caused by diseases or unexplained fluctuations in Scr,but the renal function was normal during the follow-up(group B);48 cases with abnormal renal function,Scr increased continuously(group C).The correlation between VI of renal cortex and Scr was analysed. Results The VI of renal cortex in group A,B and C were (33.51 ± 3.26)%,(31.64 ± 4.83)%,(25.58 ± 6.07)%, respectively.There were significant differences between VI in group A and C,and between group B and C (P<0.01),but there was no significant difference between group A and B( P > 0.05). There was significant negative correlation between VI of renal cortex and Scr in group C ( rs= -0.90, P < 0.01), there was no significant correlation between RI in the interlobular artery of kidney and Scr( rs= -0.22, P > 0.05).Conclusions When renal function is normal,VI is maintained at a high level.When renal function declines,VI decreases.VI can reflect the renal cortex blood flow,indirectly reflect the glomerular filtration function,and provide a reliable indicator for clinical evaluation of renal allograft function.
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The study included 197 thyroid nodules which were confirmed by fine-needle aspiration cytology or histopathologic examination. All nodules were graded with malignancy risk stratification of thyroids nodule accordingto the 2015 American Thyroid Association(ATA)management guidelines. Both color Doppler flow imaging (CDFI) and superb microvascular imaging(SMI) were used to classify blood flows of thyroid nodules according to Adler's grading criteria. Morphologic and distribution features of blood flow were also observed by monochrome (mSMI). The optimal threshold drawing from ROC curve and diagnostic efficacy of single and combinative modality were calculated. The results showed that mSMI was more sensitive to detect blood flow of thyroid nodules than other Doppler techniques(P<0.01). Microvascular morphologic features between benign and malignant thyroid nodules were significantly different(P<0.01). The area under ROC curves of ATA,mSMI,and ATA+mSMI were 0.745, 0.740,and 0.834,respectively,suggesting that the diagnostic performance of ATA+mSMI is superior to that of ATA or mSMI alone. There was no significant deference in the sensitivity among ATA, mSMI, and ATA+mSMI (P>0.05). But the specficity and accuracy of combinative modality ATA+mSMI was significantly higher than that of ATA or mSMI alone(P<0.05).
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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 investigate the application value of superb microvascular imaging (SMI) in benign and malignant renal lesions by comparing with power Doppler imaging (PDI). Methods:Retrospective analysis was performed on 48 cases of renal lesions in 47 pa-tients screened via PDI and SMI at Tianjin Medical University Cancer Institute and Hospital. A total of 10 and 38 cases of benign and malignant lesions were identified, respectively. We compared the diagnostic efficiency between the two methods by determining blood flow grade, distribution pattern, morphology, and ring-like blood flow. Results:Statistically significant differences in ring-like blood flow (P<0.05) but not in blood flow grade, distribution pattern, and morphology (P>0.05) were observed between benign and malignant renal tumors as detected by PDI. In SMI, statistically significant differences in blood flow grade, distribution pattern, mor-phology, and ring-like blood flow were identified between benign and malignant renal tumors (P<0.05). The sensitivity, specificity, and area under the receiver operating characteristic curve of PDI and SMI were 71.05%, 70.00%, and 0.705 and 89.47%, 90.00%, and 0.897, respectively. Significance in diagnostic efficacy between PDI and SMI was detected (P=0.025). Conclusion:Compared with PDI, SMI can more accurately describe blood flow grade, distribution pattern, morphology, and ring-like blood. Thus, SMI can improve the accuracy of differential diagnosis of benign and malignant renal tumors.
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Breast cancer is a common tumor in women.Early and timely diagnosis is crucial for treatment and prognosis.As a routine method of breast examination,ultrasonography plays an important role in diagnosis of breast diseases.Superb microvascular imaging (SMI) is a new ultrasonic blood flow imaging technique in recent years,which separates spectrum signals of low-speed flow from normal tissue motion by an adaptive algorithm.SMI can display the slow-speed flow more realistically,and has been used on breast,thyroid,liver and so on.SMI is obviously valuable in clinic.The principle and application progresses of SMI in diagnosis of breast diseases were reviewed in this article.
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Objective To discuss the application value of shear wave elastography (SWE) and superb microvascular imaging (SMI) in pathological grading of breast invasive ductal carcinoma (IDC).MethodsSixty patients with breast tumor were selected,which were totally 64 lesions.Before operation,SWE and SMI pattern were started to detect the lesions.And images in SWE and SMI pattern were saved.All lesions were proved to be IDC and pathological gradings were got according to the pathological result.The mean of Young′s modulus(AveT1) and maximum of Young′s modulus(AveT2) were recorded in SWE pattern,and degree of blood was recorded in SMI pattern followed Adler′s grading standard.Then differences of AveT1,AveT2 and degree of blood in different pathological grading of invasive ductal carcinoma were evaluated.Results ①In pathological grading 1 group,the average of AveT1 was (62.1±10.4)kPa,and the average of AveT2 was (93.0±20.1)kPa.In pathological grading 2 group,the average of AveT1 was (79.8±8.6)kPa,and the average of AveT2 was (120.6±18.7)kPa.In pathological grading 3 group,the average of AveT1 was (92.6±12.1)kPa,and the average of AveT2 was (137.3±21.5)kPa.The AveT1 and AveT2 were gradually growing with higher pathological grading of breast invasive ductal carcinoma,which were statistically significant (P<0.05).②In pathological grading 1 group,there were 7 cases in the degree of blood 0-Ⅰ and 14 in the degree of blood Ⅱ-Ⅲ.In pathological grading 2 group,there were 3 cases in the degree of blood 0-Ⅰ and 18 cases in the degree of blood Ⅱ-Ⅲ.In pathological grading 3 group,there were only 1 case in the degree of blood 0-Ⅰ and 21 cases in the degree of blood Ⅱ-Ⅲ.There were more lesions of rich blood with higher pathological grading of breast invasive ductal carcinoma,which was statistically significant (P<0.05).Conclusions There are differences of elastography and degree of blood in different pathological grading of breast invasive ductal carcinoma,SWE and SMI can prompt pathological grading and provide important clinical reference value.
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Breast cancer is a common tumor in women.Early and timely diagnosis is crucial for treatment and prognosis.As a routine method of breast examination,ultrasonography plays an important role in diagnosis of breast diseases.Superb microvascular imaging (SMI) is a new ultrasonic blood flow imaging technique in recent years,which separates spectrum signals of low-speed flow from normal tissue motion by an adaptive algorithm.SMI can display the slow-speed flow more realistically,and has been used on breast,thyroid,liver and so on.SMI is obviously valuable in clinic.The principle and application progresses of SMI in diagnosis of breast diseases were reviewed in this article.
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Objective To compare the diagnostic efficiency of superb microvascular imaging (SMI) and contrast-enhanced ultrasonographic microvascular imaging (MVI) for differentiating breast lesions.Methods One hundred and sixteen patients with 116 breast lesions were first examined by grayscale ultrasound.Then SMI and MVI were performed on all patients.Microvascular architectures of breast lesions were depicted by both methods.The lesions were evaluated based on their microvascular architectures.The diagnostic efficacy of both methods were compared.Results The diagnostic sensitivity,specificity,and accuracy of SMI and MVI were 79.24％,90.48 ％,85.35％ and 88.68％,87.30％,87.93％,respectively.The areas under the curve of SMI and MVI were 0.888 and 0.926.The diagnostic values of SMI and MVI were not statistically different (P =0.212).Conclusions SMI can detect tiny vessels and depict microvascular architecture of breast lesions as MVI do,which is beneficial for breast tumor differentiation.The diagnostic efficacy of SMI is almost the same as MVI.