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Objective:To evaluate the diagnosis and critical value reporting of ruptured tubal pregnancy by ultrasound.Methods:The clinical and ultrasound data of 70 patients with ruptured tubal pregnancy diagnosed by surgery in Peking Union Medical College Hospital from August 2017 to May 2021 were retrospectively analyzed to evaluate the diagnosis and critical value reporting of ruptured tubal pregnancy by ultrasound.Results:Among the 70 patients, 68 patients underwent gynecological ultrasonography and two patients did not. Sixty-three cases (92.6%, 63/68) were accurately diagnosed as adnexal ectopic pregnancy mass, abdominal and pelvic effusion/blood clot, and 5 adnexal ectopic pregnancy masses (7.4%, 5/68) were missed.Among the 5 missed cases, 4 cases (80%, 4/5) were heterotopic pregnancy (2 cases of IVF-ET 2 embryos, 1 case of patient taking ovulation induction drugs, 1 case of gravida with twin family history) and 1 case (20%, 1/5) of single tubal pregnancy. Critical values were reported in the all 63 cases of ruptured tubal pregnancy diagnosed by preoperative ultrasound.Conclusions:Ultrasound could accurately diagnose tubal pregnancy and assess its rupture, and timely report the critical value, effectively guarantee the medical safety. The particularity and complexity of ultrasound diagnosis in early pregnancy with assisted reproductive technique deserve more attention.
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Objective:To analyze the inter-observer consistency of Smart 3D super microvascular imaging (Smart-3D SMI) in evaluating the blood flow of breast lesions.Methods:Prospective study on Smart-3D SMI images of 225 cases of continuous breast lesions in Peking Union Medical College Hospital from January to December 2018. Two sonographers conducted qualitative evaluation of vascular architecture(VA) under Smart-3D SMI, and took the mean value of three measurements evaluations of vascular index(VI). Weighted Kappa was used to test the consistency of the vascular architecture, and Bland-Altman scatter plot was used to calculate the 95% consistency limit of the measured data for the VI value. Spearman correlation coefficient was used to analyze whether the absolute difference of VI between observers was correlated with the mean value of VI.Results:The Weighted Kappa coefficient of Smart-3D SMI for the evaluation of VA by two sonographers was 0.839 (95% CI was 0.795-0.881, P<0.001), showing strong inter-observer consistency. Bland-Altman plot analysis of VI value showed that the value of 95.11% was within the clinically acceptable range and had good consistency, and there was a correlation between the difference of VI value between observers and the value of VI mean ( r s=0.639, P<0.001). Conclusions:There is a good inter-observer consistency in evaluating the blood vascular architecture and quantitatively measuring the blood flow abundance by Smart-3D SMI.
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Objective:To discuss the value of ultrasound in the diagnosis of pelvic lipomatosis and analyze the causes of misdiagnosis.Methods:A retrospective analysis of 68 cases of pelvic lipomatosis confirmed by operation or imaging in Peking Union Medical College Hospital from January 2000 to December 2018 was made to summarize the characteristics of ultrasonic manifestations.Results:Ultrasonographic findings were as follows: 6 cases (8.8%) had increased fat-like hyperecho in pelvic cavity; 60 cases (88.2%) had abnormal bladder; 42 cases (61.7%) had pyelectasis and 24 cases (35.3%) had ureterectasis. Of the 68 cases, 6 cases (8.8%) were correctly diagnosed; 54 cases (79.4%) were missed; 8 cases (11.8%) were misdiagnosed, including 7 cases (10.3%) of bladder tumor and 1 case (1.5%) of retroperitoneal giant mass.Conclusions:Pelvic lipomatosis has characteristic sonographic features.When urinary tract obstruction and bladder wall thickening are observed, pelvic lipomatosis should be considered. Bladder shape and existence of increasing fat-like hyperecho in the pelvis should be further scanned to reduce the misdiagnosis rate of pelvic lipomatosis.
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Objective To explore the application value of ultrasound medical imaging workstation in quality control of ultrasound reports issued by resident doctors.Methods The pancreatic ultrasound reports of outpatients provided by resident doctors with 6 months and 12 months of training were derived from the ultrasound medical imaging workstation as 6-month group (G6M) and 12-month group (G12M),respectively.There were 1582 ultrasound reports in the G6M,including 420 for males and 962 for females,with 1318 for patients ＜ 65 years old and 264 for patients ≥ 65 years old.There were 2723 ultrasound reports in the G12M,including for 760 males and 1963 for females,with 2323 for patients ＜ 65 years old and 400 for patients ≥ 65 years old.Frequency of"unclear tail of the pancreas" in the report,standard image,and body markers were recorded.The chi-square test was used to compare patient gender,age,and the quality of resident reports between the two groups.Results The chi-square test showed that there was no significant difference in sex or age composition between the two groups (all P ＞ 0.05).The number of cases of"unclear tail of the pancreas" reported in the G6M and G12M was 554 (35.02％) and 734 (26.96％),respectively,and there was a statistical difference between the two groups (x2=31.029,P ＜ 0.001).In the reports with "unclear tail of the pancreas",the number of reports with "no map" was 8 (1.44％) and 14 (1.91％) in the G6M and G12M,respectively,and there was no significant difference between the two groups (P ＞ 0.05).As to "map without marker" and "map with marker",there were 337 (60.83％) vs 209 (37.73％) and 308 (41.96％) vs 412 (56.13％) in the G6M and G12M,respectively,and the chi-square test showed that there were significant differences between the two groups (x2=44.960 and 42.834,all P ＜ 0.001).Conclusion Ultrasound medical imaging workstation can be used for periodic spot check,evaluation,and feedback of resident reports,which has a positive role in promoting the quality control of ultrasound reports.
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Objective To investigate the significance of superb microvascular imaging (SMI) for the detection of neovascularization in carotid atherosclerotic plaques.Methods SMI detected 28 carotid atherosclerotic plaques in 28 patients who underwent carotid endarterectomy.The SMI grade of carotid plaque neovascularization was assigned based on the following grading system:Grade 0,no neovascularization;grade 1,some neovascularization;grade 2,neovascularization observed in the shoulder of the plaque;and grade 3,widely distributed new blood vessels.SMI was used to evaluate the degree of blood flow,maximum flow velocity,and resistance index of the new vessels in the plaque.Microvascular density was measured with CD31 staining.Results Clear correlations were observed between neovascularization density on histopathological staining of the plaque and the degree of blood flow detected with SMI (rs=0.788,P ＜ 0.001).The classification of neovascular blood flow in the plaque was positively correlated with plaque thickness (rs=0.686,P=0.002).Of the 28 cases,neovascularization was detected in 23;of these 23 cases,the direction of blood flow was from the adventitia to the intima in 17 (75％) cases,while 6 (25％) cases showed an irregular direction of blood flow.The mean neovascular flow velocity was (5.620±0.131) cm/s,and the mean neovascular resistance index was 0.660 ± 0.090.Conclusion SMI is useful for the evaluation of carotid atherosclerotic plaque neovascularization.
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Objective To explore the application of "quality control specialized management" model in ultrasound department for medical quality management and effect evaluation.Methods The "quality control specialized management" model was applied for medical quality management in ultrasound department.We explored the changes of clinical and patients' satisfaction before and after the implementation of the model by taking the measures of quality control management by special responsible person,improving patient visit process,strengthening professional training to improve doctors' ability,strengthening humanistic literacy,and improving service attitude.Before and after implementation,clinical satisfaction and patients' satisfaction were evaluated.The comparison of clinical satisfaction before and after the implementation of "quality control specialized management" and the comparison of patient satisfaction was conducted by x2 test.Results After the implementation of "quality control specialized management" model,the clinical satisfaction score was (95.5 ± 0.3) points,which was significantly higher than that before the model was applied [(90.1± 1.5) points;t=7.541,P ＜ 0.01);the patients' satisfaction score was (95.8±0.3) points,which was also significantly higher than that before the model was applied [(92.8±0.7) points;t=5.230,P ＜ 0.01).Conclusion The "quality control specialized management" model can improve clinical and patients' satisfaction effectively,representing an effective way to guarantee and improve the quality of ultrasound medical services.
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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 Explore the diagnostic value of color Doppler ultrasonography in renal vein embolism compared with contrast-enhanced CT.Analyze and summarize the sonographic features and reasons of misdiagnosis of renal vein embolism.Methods Reports of color Doppler ultrasonography and contrast-enhanced CT in 15 patients with 20 renal vein thrombosis and 25 patients with 25 renal vein tumor thrombosis were retrospectively analyzed.We summarized the sonographic features including the location of emboli,the lumen and wall of the involved veins,the information of collateral circulation and the color Doppler sonographic features.Results The diagnostic accuracy of renal vein thrombosis and tumor thrombosis were 85%and 84%for ultrasound,100%and 96%for contrast-enhanced CT,the difference was not statistically significant(all P＞0.05).The typical sonographic features include(1)Expansion of the renal vein and full of solid echogenicity;(2)No flow signals or flow filling defect in renal veins;(3)No or sparse venous flow signal in the involved kidney.Conclusions Color Doppler ultrasonography and contrast-enhanced CT have a good consistency in the diagnosis of renal vein embolism.Color Doppler ultrasonography can be used as an important imaging method to evaluate the renal vein embolism,which can combine medical history and provide a more reliable basis for the diagnosis of renal vein embolism.
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Objective To investigate the value of 18 MHz high-frequency linear array ultrasound probe in the diagnosis of thyroid anterior capsular invasion,and compare it with the conventional high-frequency ultrasound probe.Methods Seventy-three nodules in 68 patients in Peking Union Medical College Hospital from December 2015 to March 2016 underwent conventional and 18 MHz high-frequency probes examination before operation and were compared with pathological results.The accuracy,sensitivity and specificity of the 18 MHz high-frequency linear array probe and the conventional high-frequency probe were determined.The consistency between the gold standard and the diagnosis by using two different frequency probes was measured using Kappa statistics.Additionally,diagnostic accuracy of different frequency probes was further evaluated according to the area under the ROC curve.Results The diagnostic consistency test of the total sample of 73 nodules:capsular abutment as the diagnostic criterion,the diagnostic consistency of 18MHz high-frequency probe was good (Kappa=0.803,P ＜ 0.01).The specificity,positive predictive value and accuracy were superior to the conventional high-frequency probe (90.7％ vs 69.8％,87.1％vs 68.3％,90.4％ vs 79.5％).The area under the ROC curve was 0.903,higher than that of the conventional high-frequency probe (0.816),which demonstrated that the former had better diagnostic accuracy.If the disruption of the perithyroidal echogenic line as another diagnostic criterion,the diagnostic consistency of the 18 MHz and conventional high-frequency probe was general,the Kappa value were 0.677 and 0.518.The sensitivity,positive predictive value,negative predictive value and accuracy of conventional high-frequency probe were inferior to the 18 MHz high-frequency probe (53.3％ vs 70.0％,74.5％ vs 82.0％,88.9％ vs 91.3％,78.1％ vs 84.9％).Conclusions The 18 MHz high frequency probe is a feasible tool for accurate prediction of the distance between tumor and thyroid anterior capsular and anterior capsular invasion,and it is helpful for the diagnosis of the preoperative staging and the prognosis of PTC.
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Objective To summarize the clinical and sonographic features of mammary Paget's disease (MPD). Methods Totally 34 female patients with pathologically confirmed MPD were retrospectively recruited. According to diagnosis,the clinical data and sonographic findings were reviewed and analyzed. Results Among these 34 patients,7 patients had single MPD; in the remaining 27 patients,16 were accompanied by invasive ductal carcinoma (IDC),7 by ductal carcinoma in situ (DCIS),3 by both IDC and DCIS,and 1 by other pathologic types of carcinoma. Twenty-four patients presented with typical clinical features of MPD,whereas 10 patients had no typical features of MPD. Among the 24 patients with typical clinical features,ultrasound examinations showed that 11 had echoic abnormality in nipple-areolar complex,14 had lesions of breast,and 14 had microcalcifications. Among the 10 patients without typical clinical features,ultrasound examinations revealed echoic abnormality in nipple-areolar complex in 3 cases,breast lesions in 9 cases,and microcalcifications in 6 cases. Among the 14 patients with echoic abnormality in nipple-areolar complex,all of them presented as rich blood flow in nipple detected by color Doppler ultrasonography. Conclusions The main clinical feature of MPD is abnormalities in nipple-areolar complex. Sonography can recognize the echoic abnormalities of nipple and lesions of breast. Sonographer should be careful of the nipple-areolar complex when mass is found in breast.
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Objective To explore the potential value of the virtual touch tissue quantification (VTQ) in the differential diagnosis of focal pancreatic lesions. Methods Totally 51 patients with focal pancreatic lesions underwent the quantitative analysis by VTQ. Based on the pathologic or clinical diagnosis,the VTQ values including lesional shear wave velocity (LSWV),parenchymal shear wave velocity (PSWV),and difference shear wave velocity (DSWV)(DSWV=LSWV-PSWV) were compared between the lesions and background parenchyma. Results The mean LSWV and PSWV were (2.39±1.25) m/s(0.60-4.39 m/s) and (1.59±0.63) m/s (0.76-3.22 m/s) in malignant group,(1.92±1.07) m/s(0.79-4.00 m/s) and (1.43±0.41) m/s(0.80-2.23 m/s) in potentially malignant group,and (2.40±1.10) m/s (0.89-3.42 m/s) and (1.48±0.44) m/s (1.03-2.11 m/s) in benign group. There were statistically significant difference between LSWV and PSWV in bengin and malignant group (P=0.029,P=0.005),while no statistical significance in potential malignant group (P=0.087). However,LSWV,PSWV,and DSWV showed no significant difference among these three groups (P=0.401,P=0.638,P=0.625,respectively). LSWV was not significantly associated with the tumor size (r=0.253,P>0.05) but had negative correlation with the depth of region of interest (r=-0.413,P<0.05). Conclusion VTQ may be valuable in the differential diagnosis of focal pancreatic lesions,although further research is still required.
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Objective To compare the application of ultrasound and positron emission tomography/computed tomography (PET/CT) in diagnosis and lymph node staging of breast cancer. Methods Using automated breast volume scanner (ABVS) and PET/CT examination of 40 lesions in 38 patients, and for comparison with the pathological findings, the diagnostic accuracy of PET/CT and ABVS in breast cancer was comparatively analyzed. Results The sensitivity of ABVS in the diagnosis of breast cancer was 95.65%, the specificity was 70.59%, and the accuracy rate was 85.00%; the sensitivity of PET/CT in the diagnosis of breast cancer was 86.96%, the specificity was 82.35%, and the accuracy rate was 85.00%;the diagnostic sensitivity of their combined application was 86.96%, the specificity was 94.12%, and the accuracy rate was 90.00%. In 10 cases of breast cancer patients with lymph node metastasis, the sensitivity、specificity and accuracy rate of PET/CT in the diagnosis of metastatic lymph nodes were 90.0%, 92.8%, and 92.1% respectively; the sensitivity, specificity and accuracy rate of ultrasound in the diagnosis of metastatic lymph nodes were 70.0%, 96.4% and 89.5%, respectively. Conclusions The ABVS and PET/CT are both effective approaches in the diagnosis of breast cancer. Their combined application may significantly improve the specificity and accuracy of diagnosis. For patients with lymph node metastases, the sensitivity of PET/CT for lymph node metastases was high and conducive to clinical staging, which is an important implication in guiding the choice of clinical treatment and prognosis of patients.
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Objective To study the correlation between the sonographic features of papillary thyroid microcarcinoma (PTMC) and high volume lymph node metastasis. Methods Medical records of 463 PTMC patients were reviewed. Cases of all patients are completed with lymph node metastasis identified by histopathology. Sonographic features such as lesion number, lesion size, echogenicity, calcification, envelope and vascularity of papillary microcarcinoma are recorded. Univariate and multivariate analysis was performed to investigating relationship between sonographic features and high volume lymph node metastasis. Results Twenty four patients have high volume central lymph node metastasis (5.2%, 24/463), in univariate analysis,sex(11.2% in male vs 3.4% in female),age(8.3% in<45 years vs 2.4% in≥45 years),calcification(8.3% in micro vs 0.0% in coarse, 3.2% in mixed and 0.7% in non) , extracapsular invasion (9.3% with vs 3.2% without)and size(9.2% in ≥7 mm vs 2.5% in <7 mm)showed significant difference;multiple logistic regression analysis showed that male(OR=3.205,P=0.009),age<45 years(OR=2.923,P=0.031), microcalcification(OR=9.380,P=0.031)and tumor size≥7mm(OR=3.272,P=0.013)is independent risk factor for high volume lymph node metastasis in the central compartment of PTMC. 10 patients have high volume lateral lymph node metastasis(2.2%,10/463),in univariate analysis,age(4.1% in<45 years vs 0.4% in≥45 years),number of lesions(5.3% in multiple vs 0.9% in single)showed significant difference;multiple logistic regression analysis showed that age < 45 years (OR=11.939,P=0.024) and multiple lesion (OR=7.247, P=0.007) is independent risk factor for high volume lymph node metastasis in the lateral compartment of PTMC. Conclusion Sonographic features of primary papillary microcarcinoma of the thyroid has correlation with high volume lymph node metastasis.
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Background and purpose:Three-dimensional power Doppler angiography (3D-PDA) is a new technique to investigate the vessels in the organs, but the research in thyroid is limited. The purpose of this research was to investigate three-dimensional power Doppler angiography (3D-PDA) in differentiating malignant from benign thyroid nod-ules.Methods:This study prospectively evaluated 103 lesions in 94 patients who were scheduled for surgery. The patients underwent preoperative 3D-PDA scanning. Analysis of the 3D-PDA characteristics includes blood flow pattern, the num-ber of blood vessels, the shape of vessels, the spatial distribution of the vessels, the existence of rich local blood flow within nodules or in the parenchyma surrounding the nodules. This study also analyzed the difference between the benign lesions and the malignant lesions.Results:There were 50 benign lesions and 53 malignant lesions. The sensitivity and specificity of irregular vessels, the asymmetry spatial distribution, rich local blood flow within nodules or in the parenchyma surround-ing the nodules were 64.2%, 96.0%; 56.0%, 88.0%; 54.7%, 96.0%; 60.4% and 94.0%, respectively. The sensitivity, speci-ficity, positive predictive value, negative predictive value and accuracy of 3D-PDA were 83.0%, 94.0%, 93.6%, 83.9% and 90.3%, respectively.Conclusion:3D-PDA provides a useful tool to investigate vascularization of thyroid leisions.This technique is feasible for clinical application and plays an important role in diagnosis of thyroid nodules.
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<p><b>OBJECTIVE</b>To evaluate the accuracy of endorectal ultrasound (ERUS) in predicting the circumferential resection margin (CRM) and maximum tumor thickness (MTT) of in T3 rectal cancer.</p><p><b>METHODS</b>Clinicl data of 53 patients with pT3 rectal cancer admitted to the Department of General Surgery in the Peking Union Medical College Hospital from June 2011 to January 2014 were retrospectively analyzed. CRM and MTT measured by ERUS were compared with corresponding pathologic measurements to assess the accuracy of ERUS diagnosis.</p><p><b>RESULTS</b>ERUS correctly predicted CRM status in 52 patients (98.1%, 52/53), whose sensitivity was 100%, specificity was 97.8%, positive predictive value was 85.7%, and negative predictive value was 100%. ERUS correctly predicted MTT status in 51 patients (96.2%, 51/53), whose sensitivity was 100%, specificity was 95.5%, positive predictive value was 66.6%, and negative predictive value was 100%. In the Bland and Altman plot, the agreement between ERUS and pathology was good.</p><p><b>CONCLUSION</b>Endorectal ultrasonography can accurately diagnose CRM and MTT, which can satisfy the clinical need for preoperative staging of rectal cancer.</p>
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Humanos , Colectomía , Estadificación de Neoplasias , Peritoneo , Neoplasias del Recto , Estudios RetrospectivosRESUMEN
Objective To assess the value of endorectal elastography in the diagnosis of malignant rectal adenoma. Methods Sixty patients referred to the department of basic surgery of Peking Union Medical College Hospital for the evaluation of rectal adenoma from January 2011 to May 2013 were included in this prospective cohort. All patients underwent elasticity score (ES) and strain ratio(SR) examine before operation. To evaluate the reproducibility of the strain-ratio measurements, the intraclass correlation coefficient (ICC) was calculated. Compared with final operational pathological results,the diagnostic values of elasticity score and strain ratio method were assessed. Results Histopathological result showed there were 20 adenomas and 40 adenocarcinomas. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of ERUS was 68%(27/40), 40%(8/20), 58%(35/60), 69%(27/39), 38%(8/21), respectively. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of elasticity score was 85%(34/40), 70%(14/20), 80%(48/60), 85%(34/40), 70%(14/20), respectively. The SR of adenocarcinomas was significantly higher than that of adenomas(2.82±1.81 vs 1.23±0.57, t=3.333, P < 0.05). The differences among the SR of benign adenoma, benign adenoma with severe atypical hyperplasia and completely malignant lesions were statistically significant (1.26±0.84 vs 2.94±1.95, 1.42±0.55 vs 2.94±1.95, t=2.619, 2.415, P=0.013, 0.021). When 1.240 was chosen as the best cut-off value of SR, the sensitivity, specificity, accuracy, positive predictive value and negative predictive value of strain ratio was 82%(33/40), 75%(15/20), 80%(48/60), 87%(33/38), 68%(15/22), respectively. Conclusion Endorectal elasotgraphy can accurately diagnose the malignant rectal adenoma, which can provide reliable preoperative imaging evidence for clinical operation mode.
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Objective To observe the ultrasonographic features of primary squamous cell carcinoma of the breast and its clinical and histopathological characteristics. Methods The ultrasonographic features, clinical and histopathological characteristics of 7 middle-aged women (median age 61 years old) with primary squamous cell carcinoma of the breast confirmed histopathologically from January 1995 to December 2014 in Peking Union Medical College Hospital were retrospectively reviewed. Results There were 8 lesions in seven cases. Six cases were single lesion and 1 case with multiple lesions, the diameters of the lesions were 7.0-60.0 mm [mean (34.0±19.6) mm]. On grayscale ultrasound, 6 lesions with solid compoments were hypoechoic, 2 lesions with solid and cystic compoments were complex echogenic, the lesions all had irregular shape and indistinct margin, 2 lesions had calcifications. On color Doppler flow imaging, 7 lesions had rich blood flow signals (Ⅱor Ⅲ) and 1 lesion had no blood flow signal. On gross histopathological examination, 6 masses were solid, pale-white colored, medium texture and the boundary was not clear. Two masses had cystic cavity. One old patient who was 70 years old had several times chest wall recurrence after mastectomy. On ultrasonography, the lesion showed an anechoic cyst with thick wall. Two chest wall recurrence lesions were cystic with thick wall. Microscopic examination showed squamous cell carcinoma infiltrating into the fiber adipose and skeletal muscle tissue. Conclusions Primary squamous cell carcinoma of the breast is more common in large tumor size. Ultrasound can show the more cysticcomponents of the tumor and abundant vascularity, which is helpful for diagnosis.
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Objective To evaluate the diagnostic value of sonographic score in the diagnosis of salivary gland involvement in patients with Sj(o)gren's syndrome(SS). Methods One hundred and three cases (44 cases of SS group and 59 cases of control group) were involved in the study. Parotid and submandibular glands of all the cases were examined by a doctor unawaring of the clinical information. All the off-line images were scored by two doctors seperately. The best threshold and the according diagnostic efficiency were determined by statistical analysis. Results The Kappa coefficient between the two doctors was 0.80.The parotid score,submandibular score and total score of SS group were significantly higher than those of the control group (5.79 ± 2.40 vs 0.46 ± 0.97,5.93 ± 1.58 vs 1.32 ± 1.84,11.64 ± 3.27 vs 1.78 ± 2.33,respectively). According to the ROC curve for the parotid score, submandibular score and total score, the area under the curve were 0.98,0.95,0.99, respectively. The best diagnostic threshold for total score was 8 and under this threshold, the diagnostic sensitivity, specificity, positive and negative predictive values were 93%, 97%, 95%, 95%, respectively. Conclusions The sonographic score including both parotid and submandibular glands is a reliable method with high reproductivity and diagnostic accuracy in the diagnosis of SS salivary gland involvement.
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Objective To evaluate the differences among five representative and useful Doppler parameters in the diagnosis of the three common types of renal artery stenosis (RAS). Methods Five Doppler parameters including renal peak systolic velocity (RPSV), renal-aortic ratio (RAR), renal-interlobar ratio (RIR),acceleration time (AT),and resistant index (RI) were measured in 221 patients before renal arteriography. Differences between the groups of patients with various clinical causes of RAS were analyzed by Chi-Squared test. One-way ANOVA or t test were used to compare the means between different groups.The optimal cutoff value was determined with the maximum sum of sensitivity and specificity. Results Of the 442 renal arteries (main and accessory renal arteries) demonstrated at arteriography,214 were normal or stenosed less than 50 %, 204 stenoses 50% - 99 %, and 24 occlusions. RIR, RAR and RI were significantly different between the atherosclerotic and non-atherosclerotic RAS groups (P ＜0.05), while RPSV and AT were not. The optimal cutoff values of RAR,RIR and RI for detecting RAS between the atherosclerotic and non-atherosclerotic groups were much different (2.5 versus 1.9, 5. 1 versus 6.5, 0.57 versus 0.50,respectively) ,but those of RPSV and AT were similar or the same (170 cm/s versus 200 cm/s,51 ms versus 51 ms,respectively). Conclusions In the case of RAS (diameter reduction≥50%),it is advised to establish separate cutoff values of RAR, RIR and RI according to atherosclerotic and non-atherosclerotic RAS, but the same cutoff value of RPSV and AT can be applied. RIR is a good Doppler parameter in the diagnosis of RAS,especially atherosclerotic and fibromuscular dysplasia RAS.
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Objective To observe the ultrasonographic features of intravenous leiomyomatosis (IVL). Methods Ultrasonographic features, pathological results and the clinical manifestations of 7 patients with IVLs were analyzed retrospectively, and the causes of misdiagnosis were discussed as well. Results The median age of 7 IVL patients was 40 years old. Five patients underwent previously hysterectomy due to probable diagnosis of leiomyoma with the mean recurrent time of 13.8 months. Three lesions extended into the right atrium, 3 involved the inferior venous cava and 1 was confined in the pelvis venous. Ultrasonographic findings of IVL included uterine solid lesions with intravascular disease, solid occupied lesions in the pelvis with intravascular disease after hysterectomy, solid occupied lesions in the pelvis, large abdominal vessels and cardiac chambes with intravascular disease after hysterectomy. The main misdiagnosis cause was that IVL had similar ultrasonographic features with hysteromyoma, and intravascular lesions of IVL was hard to detect in the early stage. Conclusion Color Doppler ultrasonography is a valuable imaging mortality for detection and follow-up of IVL.