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1.
Medicine (Baltimore) ; 100(16): e25517, 2021 Apr 23.
Artigo em Inglês | MEDLINE | ID: mdl-33879689

RESUMO

RATIONALE: Primary schwannoma of the thyroid gland is very rare, and its preoperative diagnosis is difficult. PATIENT CONCERNS: We report the case of a thyroid nodule in an 18-year-old woman, who presented with a mass in her left neck with stiffness and normal thyroid function. However, the patient complained of numbness in her left upper extremity, and ultrasound (US) features were suspicious of malignancy. DIAGNOSES: Multimodal US imaging was performed using B-mode, color doppler, ultrasonic elastography (UE), and contrast-enhanced ultrasound (CEUS). CEUS revealed heterogeneous enhancement and "target sign" within the tumor. The nodule was suspicious for malignancy and classified as TI-RADS 4b, while the elasticity values measured by UE indicated a benign lesion. Fine needle aspiration (FNA) was subsequently performed in the markedly contrast-enhanced area for biopsy. Cytological results revealed a benign schwannoma. INTERVENTION: The patient underwent left lobe resection. Postoperative pathology confirmed it to be a primary benign schwannoma of the thyroid. OUTCOMES: After thyroidectomy, the patient was followed-up with US. At present, all laboratory tests and thyroid imaging are normal, and the numbness of the left upper limb has disappeared. LESSONS: The combination of different US modalities is useful for the diagnosis of thyroid lesions. FNA performed under CEUS guidance improves the accuracy of biopsy sampling.


Assuntos
Técnicas de Imagem por Elasticidade/métodos , Neurilemoma/diagnóstico , Glândula Tireoide/diagnóstico por imagem , Neoplasias da Glândula Tireoide/diagnóstico , Ultrassonografia Doppler em Cores/métodos , Adolescente , Biópsia por Agulha Fina , Meios de Contraste/administração & dosagem , Feminino , Humanos , Imagem Multimodal/métodos , Neurilemoma/patologia , Neurilemoma/cirurgia , Glândula Tireoide/patologia , Glândula Tireoide/cirurgia , Neoplasias da Glândula Tireoide/patologia , Neoplasias da Glândula Tireoide/cirurgia , Tireoidectomia , Resultado do Tratamento
2.
Sichuan Da Xue Xue Bao Yi Xue Ban ; 51(6): 878-880, 2020 Nov.
Artigo em Chinês | MEDLINE | ID: mdl-33236616

RESUMO

A 41 years old female patient experienced enlarged right nipple more than 6 years ago. Physical examination showed enlarged and hardened right nipple (about 2 cm) but no tenderness. Mammographic results showed the mixed calcification pattern, which was presenting multiple sizes of circular and granular calcification of the nipple areola complex. Ultrasound revealed large calcification in the nipple areola area with posterior acoustic shadow. This patient underwent extensive excision of the nipple areola complex. The surgical margin was confirmed to be negative. Postoperative pathology confirmed an infiltrating syringomatous adenoma with ossification in some areas. Tumor cell infiltration was not found at the surgical margin. After 4 years of follow-up, no recurrence was found. The mammography and ultrasound findings of this benign tumor were significantly different from those reported in previous literatures. We should improve the understanding of the variousness of clinical imaging manifestations of this disease.


Assuntos
Adenoma , Neoplasias da Mama , Neoplasias das Glândulas Sudoríparas , Siringoma , Adenoma/diagnóstico por imagem , Adenoma/cirurgia , Adulto , Neoplasias da Mama/diagnóstico por imagem , Neoplasias da Mama/cirurgia , Feminino , Humanos , Recidiva Local de Neoplasia , Mamilos/diagnóstico por imagem
3.
Ann Transl Med ; 8(7): 495, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32395539

RESUMO

Background: Thyroid carcinoma constitutes the vast majority of all thyroid cancer, most of which is the solid nodule type. No previous studies have examined combining both conventional and elastic sonography to evaluate the diagnostic performance of partially cystic thyroid cancer (PCTC). This retrospective study was designed to evaluate differentiation of PCTC from benign partially cystic nodules with a machine learning-assisted system based on ultrasound (US) and elastography. Methods: Patients with suspicious partially cystic nodules and finally confirmed were included in the study. We performed conventional US and real-time elastography (RTE). The US features of nodules were recorded. The data set was entered into 6 machine-learning algorithms. Sensitivity, specificity, accuracy, and area under the curve (AUC) were calculated. Results: A total of 177 nodules were included in this study. Among these nodules, 81 were malignant and 96 were benign. Wreath-shaped feature, micro-calcification, and strain ratio (SR) value were the most important imaging features in differential diagnosis. The random forest classifier was the best diagnostic model. Conclusions: US features of PCTC exhibited unique characteristics. Wreath-shaped partially cystic nodules, especially with the appearance of micro-calcifications and larger SR value, are more likely to be malignant. The random forest classifier might be useful to diagnose PCTC.

4.
Sichuan Da Xue Xue Bao Yi Xue Ban ; 51(1): 30-34, 2020 Jan.
Artigo em Chinês | MEDLINE | ID: mdl-31950786

RESUMO

Objective: To explore the relationship between the imaging features of ultrasonography and thermal tomography and molecular subtypes of breast cancer. Methods: 404 female breast cancer patients with complete imaging data and pathological findings from January 2014 to June 2017 were reviewed in the West China Hospital of Sichuan University. Breast cancer pathological molecules were classified into Luminal A like type, Luminal B like type, human epidermal growth receptor-2 (HER-2) overexpression type and Basal like type according to the expression of various immune markers. The correlation of ultrasonographic BI-RADS signs, thermal tomography characteristics and immunohistochemical results of breast cancer was analyzed. Results: Breast cancer lesions with regular morphology, sharp margins, and enhanced posterior echo were more common in Basal like type; Microcalcification was more likely tend to appear in HER-2 expression breast cancer than other subtypes; The q-r curve of Luminal A like breast cancer was nearly 30°, and that was more common between 30°and 45° of HER-2 expression and Basal like breast cancer;The ratio of vertical and horizontal ≥1 of tumors and limited lymph node metastasis could not be used for distinguishing between different subtypes. Conclusion: Different molecular subtypes of breast cancer may behave routine ultrasound and thermal tomography imaging features.


Assuntos
Neoplasias da Mama , Tomografia , Ultrassonografia , Neoplasias da Mama/classificação , Neoplasias da Mama/diagnóstico por imagem , Neoplasias da Mama/genética , China , Feminino , Humanos
5.
J Ultrasound Med ; 39(6): 1203-1211, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31891216

RESUMO

OBJECTIVES: By analyzing the B-mode ultrasound and color Doppler flow imaging characteristics of breast lymphoma (BL) and breast infiltrating ductal carcinoma (BIDC), we expected to discriminate these diseases. METHODS: Thirty-two patients with BL and 30 with BIDC confirmed pathologically were selected. The BL group was divided into nodular and diffuse groups. We analyzed and compared the general and imaging characteristics of the BL subgroups and the BIDC group. RESULTS: The mean maximum diameter of BL was 54.93 ± 43.74 cm, and that of BIDC was 23.90 ± 6.79 cm (P < .05). The differences between the nodular BL and BIDC groups in a circumscribed margin (60.00% versus 20.00%), calcification (20.00% versus 53.33%), aggregation characteristics (0.00% versus 53.33%), and density (73.33% versus 10.00%) were statistically significant (P < .05). The differences between the diffuse BL and BIDC groups in calcification (6.67% versus 53.33%), aggregation characteristics (6.67% versus 53.33%) and density (40.00% versus 10.00%) were statistically significant (P < .05). The difference in a circumscribed margin (60% versus 13.33%) between the BL subgroups was statistically significant (P < .05). The blood flow signal in BL lesions was richer than that in BIDC lesions (P < .05). CONCLUSIONS: Extrasuperior-quadrant single lesions in the BL group were larger than those in the BIDC group. The edges of the lesions in the nodular BL group were circumscribed and dense. Lesions in the diffuse BL group did not have a circumscribed margin, calcification, aggregation characteristics, or density. The blood flow signal in BL lesions was richer than that in BIDC lesions.


Assuntos
Neoplasias da Mama/diagnóstico por imagem , Carcinoma Ductal de Mama/diagnóstico por imagem , Linfoma/diagnóstico por imagem , Ultrassonografia Mamária/métodos , Adulto , Idoso , Mama/diagnóstico por imagem , Diagnóstico Diferencial , Feminino , Humanos , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto Jovem
6.
Sichuan Da Xue Xue Bao Yi Xue Ban ; 49(1): 148-150, 2018 Jan.
Artigo em Chinês | MEDLINE | ID: mdl-29737108

RESUMO

OBJECTIVE: To investigate the clinical manifestations and ultrasound features of hepatic infantile hemangioendothelioma (IHE). METHODS: This study retrospectively analyzed the clinical features and ultrasound characteristics of 8 patients of IHE,whose diagnosis was confirmed by surgery or liver biopsy from January 2010 to October 2016. RESULTS: Among the eight IHE patients,the male-to-female ratio was 1:1,with the mean age ranged from 15 d to 3 yr.,of which six individuals were younger than 3 months old. Seven patients had single lesion and one case was multiple. The average size of the lesions was (8.2±1.0) cm diameter. Hypoechoic (4 cases) and echogenic lesions (3 cases) were shown by echography,the lesions border and morphology were clearly defined in 7 cases.Furthermore,internal echoes were mostly inhomogeneous (4 cases),and calcification or peripheral halo were even visible. Color Dopplar flow imaging (CDFI) showed internal visible line or more abundant blood flow signal in 6 cases,mainly to venous blood flow. CONCLUSION: The age of onset for hepatic IHE seems less than three months. The echography with single lesion with clear border,regular solid mass or calcification in the tumor,should come to the possibility of IHE.


Assuntos
Hemangioendotelioma/diagnóstico por imagem , Neoplasias Hepáticas/diagnóstico por imagem , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Estudos Retrospectivos , Ultrassonografia
7.
Sichuan Da Xue Xue Bao Yi Xue Ban ; 49(6): 955-959, 2018 Nov.
Artigo em Chinês | MEDLINE | ID: mdl-32677412

RESUMO

OBJECTIVE: To prepare vascular endothelial growth factor receptor2 (VEGFR2) targeted ultrasound contrast agent (microbubbles, MBs) by freeze-dried method and to evaluate its contrast enhanced effect and targeting capability through in vitro experiments. METHODS: Targeted MBs were prepared using the biotin-avidin linkage to conjugate rat anti-mouse VEGFR2 monoclonal antibody to the surface of biotinylated MBs. Morphology, size and distribution of MBs were assessed. The binding of streptavidin (FITC marker) and VEGFR2 monoclonal antibody (PE labeled rabbit IgG) to MBs was verified by immunofluorescence staining. In vitro targeting experiments were performed with human umbilical vein endothelial cells (HUVECs). The binding capacity of MBs to HUVECs were detected by three groups including untargeted MBs group (adding 1×107 untargeted MBs), antibody presaturation added VEGFR2 targeted MBs group (after being incubated with excess VEGFR2 antibody, 1×107 VEGFR2 targeted ultrasound MBs were added) and VEGFR2 targeted MBs group (adding 1×107 VEGFR2 targeted ultrasound MBs). Contrast enhanced effects of VEGFR2 targeted MBs were preliminarily examined using an ultrasound imaging system and a home-made extracorporeal circulating device. RESULTS: The monoclonal antibody of streptomycin and rat anti-mouse VEGFR2 can be combined with the biotinized MBs to construct the targeted ultrasound MBs of VEGFR2 by immunofluorescence staining. Under the microscope, VEGFR2 targeted MBs were round, uniform in size and uniform in distribution, with a mean diameter of (1.31±0.93) µm. Microscopy showed a small number of MBs around HUVECs in non-targeted MBs group, almost no MBs around HUVECs of antibody presaturation+VEGFR2 targeted ultrasound MBs group, and many MBs around HUVECs of VEGFR2 targeted ultrasound MBs group. The binding capacity was significantly higher than that of untargeted MBs. The self-made MBs developed well and no significant attenuation was observed as time extension in the mode of enhanced ultrasonography. CONCLUSIONS: The freeze-drying method can be used to prepare VEGFR2 targeted ultrasound contrast agent, which has good in vitro targeting ability and contrast enhanced effects for ultrasound molecular imaging.

8.
Bioorg Med Chem Lett ; 27(14): 3201-3204, 2017 07 15.
Artigo em Inglês | MEDLINE | ID: mdl-28539219

RESUMO

Herein we report the discovery of a series of new small molecule inhibitors of histone lysine demethylase 4D (KDM4D). Molecular docking was first performed to screen for new KDM4D inhibitors from various chemical databases. Two hit compounds were retrieved. Further structural optimization and structure-activity relationship (SAR) analysis were carried out to the more selective one, compound 2, which led to the discovery of several new KDM4D inhibitors. Among them, compound 10r is the most potent one with an IC50 value of 0.41±0.03µM against KDM4D. Overall, compound 10r could be taken as a good lead compound for further studies.


Assuntos
Histona Desmetilases com o Domínio Jumonji/antagonistas & inibidores , Nitrilas/química , Pirazóis/química , Pirimidinas/química , Sítios de Ligação , Avaliação Pré-Clínica de Medicamentos , Humanos , Concentração Inibidora 50 , Histona Desmetilases com o Domínio Jumonji/metabolismo , Simulação de Acoplamento Molecular , Nitrilas/síntese química , Nitrilas/metabolismo , Isoformas de Proteínas/antagonistas & inibidores , Isoformas de Proteínas/metabolismo , Estrutura Terciária de Proteína , Relação Estrutura-Atividade
10.
Sichuan Da Xue Xue Bao Yi Xue Ban ; 47(1): 93-6, 2016 Jan.
Artigo em Chinês | MEDLINE | ID: mdl-27062791

RESUMO

OBJECTIVE: To determine the clinical value of breast thermal tomography and high frequency ultrasound imaging in diagnosing breast cancer. METHODS: Breast thermal tomography and high frequency ultrasound imaging were performed in 298 patients with breast lumps. The results were compared with pathological diagnosis. RESULTS: The ultrasound imaging had a sensitivity, specificity and the area under the curve (AUC) of 99.02%, 62.78% and 0.814, respectively, compared with 83.33%, 83.16% and 0.830 of thermal tomography, for diagnosing breast cancer. The two imaging results showed statistical significance in the test of non-inferiority (P < 0.001). A combination of the two imaging results produced a sensitivity, specificity and AUC of 83.33%, 89.79% and 0.866, respectively. CONCLUSION: Thermal tomography is not inferior to ultrasonography in detecting breast cancer. The two combined can improve specificity and accuracy of the diagnosis of breast cancer.


Assuntos
Neoplasias da Mama/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Área Sob a Curva , Feminino , Humanos , Sensibilidade e Especificidade , Ultrassonografia
11.
PLoS One ; 11(2): e0148330, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-26863208

RESUMO

BACKGROUND: This study aimed to confirm whether strain ratio should be added after evaluation of lesions with 5-point elasticity scoring for differentiating benign and malignant breast lesions on ultrasonographic elastography(UE). MATERIALS AND METHODS: From June 2010 to March 2012, 1080 consecutive female patients with breast lesions were recruited into a multicenter retrospective study, which involved 8 centers across China. Each institutional ethic review board approved the study, and all the patients gave written informed consent. All the patients underwent the UE procedure and the strain ratios were calculated and the final diagnosis was made by histological findings. The sensitivity, specificity, accuracy, PPV and NPV were calculated for each of the two evaluation systems and the areas under the ROC curve were compared. RESULTS: The strain ratios of benign lesions (mean, 2.6±2.0) and malignant lesions (mean,7.9±5.8) were significantly different (p <0.01). When the cutoff point was 3.01, strain ratio method had 79.8% sensitivity, 82.8% specificity, and 81.3% accuracy, while the 5-point scoring method had 93.1% sensitivity, 73.0% specificity, and 76.8% accuracy. The areas under the ROC curve with the strain ratio method and 5-point scoring method were 0.863 and 0.865, respectively(p>0.05). The strain ratio method shows better a diagnosis performance of the lesions with elasticity score 3 and 4. CONCLUSIONS: Although the two UE methods have similar diagnostic performance, separate calculation of the strain ratios seems compulsory, especially for the large solid breast lesions and the lesions with elasticity score 3 and 4.


Assuntos
Adenocarcinoma/diagnóstico , Neoplasias da Mama/diagnóstico , Carcinoma Ductal de Mama/diagnóstico , Técnicas de Imagem por Elasticidade/métodos , Ultrassonografia Mamária/métodos , Adenocarcinoma/patologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Neoplasias da Mama/patologia , Carcinoma Ductal de Mama/patologia , Elasticidade , Técnicas de Imagem por Elasticidade/instrumentação , Feminino , Humanos , Glândulas Mamárias Humanas/patologia , Pessoa de Meia-Idade , Curva ROC , Estudos Retrospectivos , Ultrassonografia Mamária/instrumentação
12.
Sichuan Da Xue Xue Bao Yi Xue Ban ; 47(5): 800-804, 2016 Sep.
Artigo em Chinês | MEDLINE | ID: mdl-28598102

RESUMO

OBJECTIVES: To determine the value of double contrast enhanced ultrasound (DCEUS) in detecting colorectal neoplasms. METHODS: The conventional abdominal ultrasound and DCEUS (hydrocolonal ultrasound+intravenous contrast-enhanced ultrasonography) were performed in 77 patients with 79 colorectal tumors. The clinical, ultrasonic and pathological data of the patients were reviewed. RESULTS: The conventional abdominal ultrasound detected 32 colorectal tumors (32/79, with a sensitivity of 40.1%), compared with 68 tumors found in DCEUS (68/79, with a sensitivity of 86.1%). The tumors were located accurately in 21.9%(7/32) and 88.2%(60/68) cases for the conventional abdominal ultrasound and DCEUS, respectively ( P<0.05). DCEUS accurately located 94.4%(51/54)cased with colon neoplasm. Two types of enhancing modes were found with colorectal neoplasm: entirely homogeneous enhancing and heterogeneous enhancing perpendicularly from the serosal part to the mucosal part. The enhancing modes were associated with the morphology of neoplasm. Thirty-nine segmented-thickened tumors were found with perpendicularly enhancing from the serosal surface to the mucosal surface, while 29 protruding tumors were found with enhancing from their pedicles or fund. CONCLUSIONS: DCEUS has higher detection sensitivity and location accuracy than conventional ultrasound.


Assuntos
Neoplasias Colorretais/diagnóstico por imagem , Ultrassonografia , Meios de Contraste , Humanos , Sensibilidade e Especificidade
13.
Eur J Radiol ; 84(12): 2492-500, 2015 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-26349410

RESUMO

OBJECTIVES: The purpose was to evaluate whether BI-RADS (the Breast Imaging Recording and Data System) combined with UE (ultrasound elastography) could improve the differentiation and characterization of benign and malignant breast lesions by comparing with BI-RADS. METHODS: A total of 1080 patients with 1194 breast lesions were studied retrospectively at 8 different institutions from 3 geographic areas across China (North, South, and West) from June 2010 to March 2012. Each institutional ethic review board approved the study and all patients gave written informed consent. All the cases were examined by conventional US (ultrasonography) and UE prior to ultrasound-guided core biopsy. Performance of BI-RADS and BI-RADS combined with UE were compared in different size groups, age groups and area groups. RESULTS: BI-RADS combined with UE cloud improve the accuracy by 13.2% compared to BI-RADS alone for all lesions, 23.2% for <10 mm lesions, 13.3% for ≥10-20 mm lesions, 6.3% for ≥20 mm lesions, 18.4% for <50 years group, 1.7% for ≥50 years group, 13.7% for northern area group, 17.7% for southern area group and 4.4% for western area group. CONCLUSIONS: The help which UE contributed to BI-RADS was greater for breast lesions <10mm and <50 years group.


Assuntos
Neoplasias da Mama/diagnóstico por imagem , Técnicas de Imagem por Elasticidade/métodos , Sistemas de Informação em Radiologia , Ultrassonografia Mamária/métodos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , China , Diagnóstico Diferencial , Feminino , Humanos , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Estudos Retrospectivos , Adulto Jovem
14.
Asian Pac J Cancer Prev ; 16(6): 2361-8, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-25824765

RESUMO

OBJECTIVE: To evaluate the diagnostic accuracy of contrast-enhanced ultrasonography (CEUS) in differentiating between benign and malignant enlarged lymph nodes using meta-analysis. MATERIALS AND METHODS: Pubmed, Embase, SCI and Cochrane databases were searched for studies (up to September 1, 2014) reporting the diagnostic performance of CEUS in discriminating between benign and malignant lymph nodes. Inclusion criteria were: prospective study; histopathology as the reference standard; and sufficient data to construct 2?2 contingency tables. Methodological quality was assessed using Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2). Patient clinical characteristics, sensitivity and specificity were extracted. The summary receiver operating characteristic curve was used to examine the accuracy of CEUS. A meta-analysis was performed to evaluate the clinical utility in identification of benign and malignant lymph nodes. Sensitivity analysis was performed after omitting outliers identified in a bivariate boxplot and publication bias was assessed with Egger testing. RESULTS: The pooled sensitivity, specificity and AUROC were 0.92 (95%CI, 0.85-0.96), 0.91 (95%CI, 0.82-0.95) and 0.97 (95%CI, 0.95-0.98), respectively. After omitting 3 outlier studies, heterogeneity decreased. Sensitivity analysis demonstrated no disproportionate influences of individual studies. Publication bias was not significant. CONCLUSIONS: CEUS is a promising diagnostic modality in differentiating between benign and malignant lymph nodes and can potentially reduce unnecessary fine-needle aspiration biopsies of benign nodes.


Assuntos
Meios de Contraste/farmacocinética , Linfonodos/diagnóstico por imagem , Doenças Linfáticas/diagnóstico , Ultrassonografia/estatística & dados numéricos , Diagnóstico Diferencial , Humanos , Metanálise como Assunto , Curva ROC , Distribuição Tecidual
15.
Sichuan Da Xue Xue Bao Yi Xue Ban ; 45(6): 992-6, 2014 Nov.
Artigo em Chinês | MEDLINE | ID: mdl-25571731

RESUMO

OBJECTIVE: To examine the characteristics of carotid arteriosclerotic plaques in contrast-enhanced ultrasonography (CEUS) of neovascularization. METHODS: Seventy-eight patients with carotid atherosclerotic plaques were examined with real-time CEUS. The perfusion modes of neovascularization in relation to the carotid arteriosclerotic plaques were identified. Patients were categorized into four groups according to their plaque echo. Five patients with serious atherosclerotic carotid artery disease received carotid endarterectomy. The intra-plaque neovascularization recorded by CEUS were validated by post-surgery pathology examinations of the tissues. RESULTS: In routing ultrasound examinations, 23 (29. 49%) plaques were identified with low-echo, 30 (38.46%) with mixed echo, 20 (25. 64%) with equal-echo, and 5 (6. 41%) with high-echo. The CEUS imaging revealed 60 carotid atherosclerotic plaques (76. 9%) with various degrees of enhancement in intra-plaque neovascularization. The thickness of plaques was correlated with the enhanced intensity of ultrasonography, with a Pearson correlation coefficient of 0. 686 (P < 0. 05). Compared with equal and high echo plaques, the enhanced intensity of ultrasonography in low and mixed echo plaques was higher (P<0. 05). The intra-plaque neovascularization recorded by CEUS was correlated with the grade of neovascularization resulted from post-surgery examinations (Spearman coefficient= 0. 886, P 0. 05). CONCLUSION: The real-time CEUS can assess the neovascularization in carotid atherosclerotic plaques non-invasively and quantitatively.


Assuntos
Meios de Contraste , Neovascularização Patológica/diagnóstico por imagem , Placa Aterosclerótica/diagnóstico por imagem , Humanos , Ultrassonografia
16.
Sichuan Da Xue Xue Bao Yi Xue Ban ; 45(6): 1005-9, 2014 Nov.
Artigo em Chinês | MEDLINE | ID: mdl-25571734

RESUMO

OBJECTIVE: To determine the perfusion pattern of lymphadenopathy in contrast-enhanced ultrasonography (CEUS) under different reference conditions. METHODS: The CEUS perfusion patterns of 78 superficial lymph node lesions were compared with their pathology results. Time-intensity curves were used for comparison between benign and malignant lymph nodes. RESULTS: Inhomogeneous hyperenhancement was the main perfusion pattern (7/17, 41. 2%) in metastatic lymph nodes; compared with homogeneous hyperenhancement (2/4, 50. 0%) in lymphoma, homogeneous hyperenhancement and isoenhancement (6/52, 11. 5%) in reactive lymph nodes, and circle enhancement (2/4,50. 0%) in tuberculosis. Benign lymph nodes showed different mean value, peak intensity and area under the curve compared with their surrounding arteries (P<0. 05). But the differences in mean value, rise time, time to peak, peak intensity and the area under the curve between benign lymphadenopathy and their surrounding tissues were not statistically significant (P>0. 05). Malignant lymph nodes showed different mean value and peak intensity compared with their surrounding arteries and tissues (P<0. 05). The differences in time to peak between malignant lymph nodes and their surrounding tissues were also statistically significant (P< 0. 05). CONCLUSION: Different CEUS perfusion patterns are associated with different types of lymph node lesions. Time intensity curves with surrounding tissues as reference condition offer great values for the differential diagnosis of superficial lymphadenopathy.


Assuntos
Meios de Contraste , Linfonodos/patologia , Doenças Linfáticas/diagnóstico por imagem , Diagnóstico Diferencial , Humanos , Linfonodos/diagnóstico por imagem , Ultrassonografia
17.
Sichuan Da Xue Xue Bao Yi Xue Ban ; 44(4): 646-50, 2013 Jul.
Artigo em Chinês | MEDLINE | ID: mdl-24059127

RESUMO

OBJECTIVE: To investigate the monitoring of renal microcirculation perfusion alteration with contrast-enhanced ultrasound (CEU) during cardiopulmonary bypass (CPB). METHODS: Renal microcirculation perfusion before and during CPB was assessed by CEU. Time-intensity curve (TIC) were derived from three region of interest (ROI) using QLAB post-analysis software. Parameters such as TIC curve wash in slope (A), area under curve (AUC), peak intensity (DPI) as well as time to peak intensity (TTP) were then calculated. RESULTS: Contrast-enhanced ultrasound showed a significant reduction (or elongation) of perfusion parameter (A, AUC, DPI, TTP) in all three regions (superficial cortex, deep cortex and medulla) during cardiopulmonary bypass in comparison with normal cardiac cycle. CONCLUSION: Cardiopulmonary bypass (CPB) has a dramatic impact on renal microcirculation in pediatric patients which manifest as global reduction in renal perfusion as well as significant region perfusion difference. Contrast-enhanced ultrasound (CEU) could detect the renal microcirculation alteration during CPB.


Assuntos
Ponte Cardiopulmonar , Rim/irrigação sanguínea , Rim/diagnóstico por imagem , Microbolhas , Microcirculação , Criança , Pré-Escolar , Meios de Contraste , Feminino , Cardiopatias Congênitas/cirurgia , Humanos , Lactente , Rim/patologia , Masculino , Monitorização Fisiológica/métodos , Ultrassonografia
18.
Clin Breast Cancer ; 13(5): 392-400, 2013 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-23830799

RESUMO

PURPOSE: Through analysis, the elastograms characteristics of breast lesions of Chinese women, a suitable diagnostic standard of quasistatic ultrasound elastography (UE) for Chinese women was proposed. METHODS: From June 2010 to March 2012, 1036 consecutive female patients (mean age, 44 years old) with breast lesions were recruited into a multicenter retrospective study, which involved 8 centers across China. Each institutional ethic review board approved the study, and all the patients gave written informed consent. All breast lesions underwent ultrasound and UE examination. Two radiologists analyzed the elastograms and separated the elastograms into 10 types. A final diagnosis was made on the basis of histologic findings. The characteristics of the elastograms were analyzed. Receiver operating characteristic curves were plotted for evaluating the diagnostic performance. Sensitivity, specificity, and accuracy were calculated. Differences in sensitivity, specificity, and accuracy were tested by using the McNemar test. RESULTS: There were 1150 lesions (593 benign, 557 malignant). There was a highly significant correlation between the elastogram color distribution and the percentage of malignant lesions, with a value of 0.92 (2P < .0001). Through analysis the different malignant percentages in different elastogram types, UE diagnostic standard was proposed, which was correlated with the blue percentage in the elastogram. The specificity, sensitivity, and accuracy of UE were 86.4%, 80.8%, and 83.5%, respectively. The specificity and accuracy of UE were higher than with ultrasound. The area under the curve was 0.86. CONCLUSION: UE could give valuable assessment in the diagnosis of breast lesions. The proposed UE diagnostic standard was suitable for Chinese women.


Assuntos
Doenças Mamárias/diagnóstico por imagem , Neoplasias da Mama/diagnóstico por imagem , Técnicas de Imagem por Elasticidade/métodos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Grupo com Ancestrais do Continente Asiático/estatística & dados numéricos , Doenças Mamárias/epidemiologia , Neoplasias da Mama/epidemiologia , China/epidemiologia , Diagnóstico Diferencial , Feminino , Humanos , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto Jovem
19.
Artigo em Chinês | MEDLINE | ID: mdl-23141398

RESUMO

OBJECTIVE: To study the pattern of lymph node spread in papillary thyroid carcinoma (PTC) with clinically negative node (cN0). METHODS: A total of 106 patients with cN0 PTC who underwent total or subtotal thyroidectomy plus unilateral or bilateral lateral neck dissection (LND, level II-V or level I-V) at West China Hospital of Sichuan University between April 2004 and August 2010 were analyzed retrospectively. RESULTS: The lateral neck lymph node metastasis in cN0 PTC was significantly associated with sex (male, P = 0.007), tumor stage (T3/T4, P = 0.006), tumor size (> 1 cm, P = 0.014) and the number of positive central lymph nodes (≥ 2, P < 0.001), but not with age and multifocal tumor. Level III (47/116, 40.5%) was the most prevalent metastatic site, followed by level IV (41/116, 35.3%), level II (18/116, 15.5%) and level V (2/29, 6.9%). Of the cases with lymph node metastases in level III and IV, 89.8% (79/88) of primary thyroid tumors existed in the lower and middle sites of the thyroid lobes, while in the cases with lymph node metastases in level II, 77.8% (14/18) of primary thyroid tumors in the upper sites of the thyroid lobes, and 83.3% of cases with level II metastases were accompanied with level III metastases. Two cases with level V metastases were accompanied with metastases in levels II, III and IV. CONCLUSIONS: LND should be considered for cN0 PTC in male, with T3/T4 lesions and positive central lymph nodes ≥ 2, and the range of dissection should include level III and IV. Dissection of level II should be considered in cN0 PTC with primary tumor localized in the upper site of the thyroid lobe or with level III metastasis. Dissection of level V should be considered at present of metastases in level II, III, and IV. For cN0 PTC with tumor size < 1 cm, confined to the thyroid and without lymph node metastasis in the central compartment, LND is not recommended.


Assuntos
Carcinoma/patologia , Linfonodos/patologia , Neoplasias da Glândula Tireoide/patologia , Adolescente , Adulto , Idoso , Carcinoma Papilar , Criança , Feminino , Humanos , Metástase Linfática/patologia , Masculino , Pessoa de Meia-Idade , Esvaziamento Cervical , Estadiamento de Neoplasias , Estudos Retrospectivos , Câncer Papilífero da Tireoide , Adulto Jovem
20.
Artigo em Chinês | MEDLINE | ID: mdl-22932241

RESUMO

OBJECTIVE: To study the related factors of central lymph node (CLN) metastasis in papillary thyroid carcinoma (PTC),the indications and the extent of central neck dissection (CND). METHODS: A total of 153 cases treated between Jan. 2009 and Dec. 2010 was analysed retrospectively. Of the cases 28 males and 125 cases females, with a mean age of (44 ± 14) years. T1, T2, and T3 diseases accounted for 51, 10 and 81 cases, respectively; I, II, III and IV diseases for 88, 3, 26 and 36 cases, respectively. Multifocal tumors were found in 63 cases. The related clinicopathologic factors were analyzed, including sex, age, tumor size, extrathyroidal extension, and multifocal tumor. RESULTS: All the cases had total/near total thyroidectomy and CND, of them 64 cases had unilateral neck dissection and 18 cases had bilateral neck dissection. CLN metastases existed in 68.6% (105/153) cases, 37.2% (57/153) for unilateral and 31.4% (48/153) for bilateral respectively. The rates of CLN metastasis were 86.6% (71/82) in cN1 cases and 47.9% (34/71) cN0 cases, respectively,and the rates of bilateral CLN metastases were 45.1% (37/82) in cN1 cases and 15.5% (11/71) in cN0 cases. Multivariate analysis showed that extrathyroidal extension (P = 0.002, OR = 3.502) was an independent risk factor for CLN metastasis and that lateral neck lymph node metastasis (P = 0.028, OR = 3.080), surrounding tissue invasion (P = 0.014, OR = 3.113), and maximum tumor diameter greater than 1 cm (P = 0.012, OR = 3.732) were independent risk factors for bilateral CLN metastases. CONCLUSIONS: It is indicated that ipsilateral CND should be obligatory for PTC. Intraoperative frozen section examination should be routine. Bilateral CND should be conducted when ipsilateral CLN metastases accompanied by one of following issues such as more invasive tumor (surrounding tissue invasion, T3 or T4 disease), maximum tumor diameter greater than 1 cm, and lateral neck lymph node metastasis.


Assuntos
Carcinoma/patologia , Neoplasias da Glândula Tireoide/patologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma Papilar , Criança , Feminino , Humanos , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Esvaziamento Cervical , Estudos Retrospectivos , Câncer Papilífero da Tireoide , Adulto Jovem
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