Nomogram based on the O-RADS for predicting the malignancy risk of adnexal masses with complex ultrasound morphology.

OBJECTIVE: The accurate preoperative differentiation of benign and malignant adnexal masses, especially those with complex ultrasound morphology, remains a great challenge for junior sonographers. The purpose of this study was to develop and validate a nomogram based on the Ovarian-Adnexal Reporting and Data System (O-RADS) for predicting the malignancy risk of adnexal masses with complex ultrasound morphology. METHODS: A total of 243 patients with data on adnexal masses with complex ultrasound morphology from January 2019 to December 2020 were selected to establish the training cohort, while 106 patients with data from January 2021 to December 2021 served as the validation cohort. Univariate and multivariate analyses were used to determine independent risk factors for malignant tumors in the training cohort. Subsequently, a predictive nomogram model was developed and validated in the validation cohort. The calibration, discrimination, and clinical net benefit of the nomogram model were assessed separately by calibration curves, receiver operating characteristic (ROC) curves, and decision curve analysis (DCA). Finally, we compared this model to the O-RADS. RESULTS: The O-RADS category, an elevated CA125 level, acoustic shadowing and a papillary projection with color Doppler flow were the independent predictors and were incorporated into the nomogram model. The area under the ROC curve (AUC) of the nomogram model was 0.958 (95% CI, 0.932-0.984) in the training cohort. The specificity and sensitivity were 0.939 and 0.893, respectively. This nomogram also showed good discrimination in the validation cohort (AUC = 0.940, 95% CI, 0.899-0.981), with a sensitivity of 0.915 and specificity of 0.797. In addition, the nomogram model showed good calibration efficiency in both the training and validation cohorts. DCA indicated that the nomogram was clinically useful. Furthermore, the nomogram model had higher AUC and net benefit than the O-RADS. CONCLUSION: The nomogram based on the O-RADS showed a good predictive ability for the malignancy risk of adnexal masses with complex ultrasound morphology and could provide help for junior sonographers.

Changes in secondary structure of myofibrillar protein and its relationship with water dynamic changes during storage of battered and deep-fried pork slices.

Fourier transform infrared spectroscopy was used to analyze the changes of secondary structure of myofibrillar proteins in short-term storage of battered and deep-fried pork slices. These changes were combined with low-field NMR analysis results to analyze the correlation between secondary structure and dynamic changes of water content. The results showed that the number of α-helix and ß-sheet decreased by 22.90 and 16.54% respectively, and the orderly structure changed to the disorder structure. The correlation results show that NMR spin-spin relaxation time (T21) has a high negative correlation with α-helix, ß-sheet, and has a high positive correlation with irregular curl and ß-turn. The population of immobile water (P22) has a very high positive correlation with α-helix, ß-sheet, and has a relatively high negative correlation with irregular curl and ß-turn. The immobilized water plays an important role in maintaining the secondary structure.

Ultrasound diagnosis of intramural pregnancy.

Intramural pregnancy is a rare type of ectopic pregnancy, where the gestational sac is implanted inside the myometrium instead of the endometrial and fallopian tubes. Preoperative diagnosis remains very difficult. Ultrasonic findings vary according to the anatomical location or duration of pregnancy. In this study, we summarized the ultrasonic characteristics of intramural pregnancy by assessing three cases. We also propose a set of ultrasonic characteristics to facilitate differential diagnosis between intramural pregnancy and other types of ectopic pregnancy.

Role of ultrasound in diagnosing isolated torsion of fallopian tube.

AIM: To summarize the ultrasonic features of isolated fallopian tube torsion (IFTT) by retrospectively analyzing cases presenting at our hospital. METHODS: This analysis was approved by the ethical committee of our hospital. Medical records of surgically proven IFTT patients admitted to our hospital since 2002 were collected. Clinical features and preoperative diagnoses of the patients were analyzed retrospectively. Ultrasonic images were reviewed and characteristics, including location, size, shape, echo and vascularity of the fallopian tube, were summarized. RESULTS: Eleven patients with IFTT were studied. No obvious association was found between the torsion and menstruation cycle. Only four accurate diagnoses were made before the operation. Degrees of torsion ranged 360-2160°. Most of them (9/11, 81.8%) were greater than 720°. Sonograms of the 11 patients could be classified into four types: cystic masses, tube-like structures, heterogeneous masses and whirlpool signs. Cystic masses were the most commonly seen type (4/11, 36.4%), followed by tubular structures (3/11, 27.3%). Whirlpool sign was believed to be the most specific sign in diagnosing IFTT. CONCLUSION: Through review of the authors' experiences, it is possible to diagnose IFTT preoperatively by ultrasound. Sonograms of the IFTT could be divided into four types while clinical significance of this classification requires further confirmation.