ObjectiveTo analyze the characteristics of ultrasound images for soft tissue lymphoma and discuss the diagnostic value of ultrasonography. MethodsBetween January 2008 and August 2014, the ultrasound images of 25 soft tissue lymphomas confirmed by histopathology and immunohistochemistry were retrospectively analyzed. ResultsOf the total 25 patients with soft tissue lymphoma (histological types of non-Hodgkin's lymphoma), there were 10 females and 15 males. Among them, 14 had diffuse large B-cell lymphoma (56%, 14/25). There was a primary lymphoma located in the lower leg, and all the rest 24 cases were secondary lymphoma. Of the 24 secondary cases, 19 presented solitary lesion located respectively in limbs (8 cases), trunk (7 cases) and head & neck (4 cases); the other 5 cases presented multiple lesions located respectively in limbs and trunk. Among all the lesions, 12 were located in muscular layer, presenting weak echo mass with irregular shape growing along the direction of muscular fibers; and 13 were located in skin and subcutaneous soft tissue, among which 4 cases showed diffused thickening of skin and subcutaneous layer with irregular hypoechoic areas on ultrasound examination, and 9 cases showed nodular or hypoechoic irregular shaped lesion, iso-hyperechoic, with heterogeneous internal echogenecity having unclear boundary. ConclusionUnderstanding the characteristics of soft tissue lymphoma on ultrasound images will help to improve diagnostic accuracy.
ObjectiveTo evaluate the performance of nuchal translucency (NT) measurement in the first trimester of pregnancy as a marker for congenital heart defects (CHD). MethodsFrom January 2010 to December 2012, middle-low risk pregnant women were prospectively evaluated at the Department of Ultrasound in West China Second Hospital of Sichuan University about Nuchal translucency and echocardiography. ResultsNT measurements was performed in 2 443 women from 2 764 pregnancy women, and a total of 2 125 case could be used in data analysis. NT measurement >2.5 mm was found in 68 fetuses, and 11 cases were diagnosed as CHD (prevalence 5.2/1 000). The sensitivity and specificity of NT measurement >2.5 mm for CHD were 45.5% and 87%, respectively. ConclusionIncreasing nuchal translucency might increase the risk of CHD in fetuses, and could be used as a method to diagnosis CHD.
Objective To evaluate the therapeutic effects of percutaneous microwave ablation (MWA) for metastatic liver cancer. Methods Ultrasound-guided percutaneous MWA technique was used to treat 27 cases of hepatic metastases with 69 nodules 〔0.9-13.2 (3.0±2.0) cm in diameter〕. Local therapeutic effect, local and distant recurrence rate and survival rate were evaluated respectively. Results The complete ablation (CA) rate which was used to evaluate the local therapeutic effects was 92.8% (64/69), with 100% (34/34), 92.3%(24/26) and 66.7% (6/9) in a diameter of nodules lt;3.0 cm, 3.0-5.0 cm and ≥5.0 cm respectively. The CA rate was lower in the group of a diameter of nodules ≥5.0 cm as compared with other two groups (Plt;0.05). The local recurrence rate was 9.4% (6/64), with 2.9% (1/34), 16.7% (4/24) and 16.7% (1/6) in a diameter of nodules lt;3.0 cm, 3.0-5.0 cm and ≥5.0 cm respectively. The intrahepatic distant recurrence rate was 44.4% (12/27). The follow-up time after MWA was 3－34 (17.0±8.7) months. During the follow-up period, 6 months, 1 and 2-year cumulative survival rate was 88.9%, 63.0% and 34.4% respectively, with a mean survival time of 17.8 months, and with a median survival time of 19.0 months.Conclusion Percutaneous MWA treatment offers satisfactory local tumoricidal efficacy to metastatic liver cancer and the patients with recurrence and new metastases can be therapy repeatedly to improve long-term survival.
Objective To study the efficiency of percutaneous acetic acid injection (PAI) or percutaneous ethanol injection (PEI) in the treatment of primary hepatic carcinoma (PHC). Methods Seventeen and 24 patients with PHC were treated, respectively by PAI or by PEI in our hospital. According to hepatic function test, soluble intereukin-2 receptor (sIL-2R), AFP, biopsy and size of tumor, the evaluation was made.Results Effective rate was 88.2% in PAI group and 87.5% in PEI group, respectively. There was no obvious influence to sIL-2R in serum in the two groups (Ｐ＞0.05). Obvious differences in impairment of hepatic functions between PAI and PEI groups were found (Ｐ＜0.01), it also showed that smaller amounts of acetic acid and less puncture frequency were required for the treatment than that of ethanol. Conclusion PAI is superior to PEI in the treatment of those patients who are complicated with cirrhosis or other vital disease.
【Abstract】ObjectiveTo introduce the minimally invasive excision and biopsy of breast neoplasm with Mammotome vacuum device guided by ultrasound. MethodsFiftytwo breast masses were detected in 30 patients through color Doppler. The ages of these patients range from 18 years to 49 years. Forty-six of those masses (88.5%) were clinically impalpable. Complete excision and biopsy of 52 breast masses were performed using Mammotome vacuum device guided by ultrasound. The patients were followed up and their postoperative condition were recorded. ResultsFiftytwo breast masses of 30 cases were excised completely, which was verified by color Doppler.The tissue excised by Mammotome were enough for pathological examination. Fortysix masses were proved to be fibroadenoma and the other 6 were proved to be adenosis. Hematoma was found in four patients after operation. The incisions were small and hidden, and the appearance of breasts remained well. Twenty patients were followed up for a shot period of time and no residual nidus or recurrence of the mass was found.ConclusionMinimally invasive excision and biopsy of breast masses with Mammotome vacuum device is an accurate and safe method. It is an ideal minimally invasive operation in treating benign breast neoplasm with few complications. It can be applied to biopsy of breast masses and complete excision of benign breast masses which are less than 2 cm in the same time.
Objective To compare canine decel luarized venous valve stent combining endothel ial progenitor cells (EPC) with native venous valve in terms of venous valve closure mechanism in normal physiological conditions. Methods Thirty-six male hybrid dogs weighing 15-18 kg were used. The left femoral vein with valve from 12 dogs was harvested to prepare decelluarized valved venous stent combined with EPC. The rest 24 dogs were randomly divided into the experimental group and the control group (n=12 per group). In the experimental group, EPC obtained from the bone marrowthrough in vitro ampl ification were cultured, the cells at passage 3 (5 × 106 cells/mL) were seeded on the stent, and the general and HE staining observations were performed before and after the seeding of the cells. In the experimental group, allogenic decelluarized valved venous stent combined with EPC was transplanted to the left femoral vein region, while in the control group, the autogenous vein venous valve was implanted in situ. Color Doppler Ultrasound exam was performed 4 weeks after transplantation to compare the direction and velocity of blood flow in the distal and proximal end of the valve, and the changes of vein diameter in the valve sinus before and after the closure of venous valve when the dogs changed from supine position to reverse trendelenburg position. Results General and HE staining observations before and after cell seeding: the decelluarized valved venous stent maintained its fiber and collagen structure, and the EPC were planted on the decelluarized stent successfully through bioreactor. During the period from the reverse trendelenburg position to the starting point for the closure of the valve, the reverse flow of blood occurred in the experimental group with the velocity of (1.4 ± 0.3) cm/s; while in the control group, there was no reverse flow of blood, but the peak flow rate was decreased from (21.3 ± 2.1) cm/s to (18.2 ± 3.3) cm/s. In the control group, the active period of valve, the starting point for the closure of the valve, and the time between the beginning of closure and the complete closure was (918 ± 46), (712 ± 48), and (154 ± 29) ms, respectively; while in the experimental group, it was (989 ± 53), (785 ± 43), and (223 ± 29) ms, respectively. There was significant difference between two groups (P lt; 0.05).After the complete closure of valve, no reverse flow of blood occurred in two groups. The vein diameter in the valve sinus of the experimental and the control group after the valve closure was increased by 116.8% ± 2.0% and 118.5% ± 2.2%, respectively, when compared with the value before valve closure (P gt; 0.05). Conclusion Canine decelluarized venous valve stent combined with EPC is remarkably different from natural venous valve in terms of the valve closure mechanism in physiological condition. The former rel ies on the reverse flow of blood and the latter is related to the decreased velocity of blood flow and the increased pressure of vein in the venous sinus segment.
ObjectiveTo evaluate the clinical effect of ultrasound guided puncture irrigation and traditional incision and drainage in the treatment of breast abscess. MethodsCNKI, Wanfang Database, CBM, PubMed, Cochrane Library, Web of Science, and EMbase were searched, at the same time complementary with other retrieval in any language to collect the randomized controlled trials (RCTs) about comparison ultrasound guided needle aspiration with incision and drainage to treat the breast abscesses published by late August, 2015. Data related to clinical outcomes were extracted by two reviewers independently. Statistical analyses were carried out using RevMan5.3 software. ResultsEight studies were included, which involving 373 participants according to the inclusion criteria. The differences were statistically significant about the cure rate [OR=2.51, 95% CI (1.47, 4.28), P=0.000 8〕, effective rate [OR=7.45, 95% CI (2.29, 24.27), P=0.000 9〕, the heeling time [SMD=-1.77, 95%CI (-2.09, -1.44), P < 0.000 01〕, the length of the scar [MD=-2.88, 95% CI (-3.43, -2.33), P < 0.000 01〕, and the complications [OR=0.18, 95% CI (0.05, 0.62), P=0.007〕. Conciusions Compared with traditional methods of incision and drainage, ultrasound guided needle aspiration and wash has the more cure rate, the more effective rate, the less heeling time and scars as well as complications.
Objective To compare the differences in the application of ultrasound scalpel and coagulation hook in thoracoscopic anterior mediastinal tumor surgery and to analyze the respective advantages and indications of the two commonly used energy instruments. Methods The clinical data of 85 patients undergoing thoracoscopic anterior mediastinal tumor surgery in West China Hospital of Sichuan University between June and November in 2017 were prospectively analyzed. There were 45 males and 40 females at age of 50.45 (18–75) years. The patients were divided into three groups including a ultrasound scalpel group (59 patients), a coagulation hook group (17 patients) and a mixed group (9 patients) according to the using time of energy devices. The clinical effect among the three groups were compared. Results No significant difference was found among the three groups in operation time, blood loss, average duration of chest tube drainage or volume of drainage (P>0.05). No significant complications occurred in all groups during operation or after operation. The proportion of subxiphoid approach in the ultrasound scalpel group was higher than that in the other two groups (49/59vs. 7/17 vs. 5/9, P<0.01). The maximum diameter of the tumor (4.58±2.19 cmvs. 4.05±1.07 cm vs. 3.00±1.45 cm, P<0.05) and the resected tissue weight (103.67±74.78 gvs. 61.17±31.97 g vs. 61.86±34.13 g, P<0.05) were also significantly greater than that in the coagulation hook group or the mixed group. Conclusion Ultrasound scalpel has good safety and reliability in the thoracoscopic anterior mediastinal tumor surgery, and is more suitable for operation in a narrow space.
Objective To explore the value of virtual touch tissue quantification(VTQ) of acoustic radiation force impulse (ARFI) in the differential diagnosis between benign and malignant thyroid nodules. Methods The ultrasound (US), elastography imaging(EI), and VTQ of ARFI were performed to determine the characteristics and features of 63 thyroid nodules. The pathological diagnosis was the gold standard. According to the receiver operating characteristic curve (ROC) of US, EI, and VTQ, the critical points and diagnostic values of US, EI, and VTQ in diag-nosis of malignant thyroid nodules were achieved. Results Of the 63 nodules, 45 were benign and 18 were malignant. The area under curves of US, EI, and shear wave velocity(SWV) were 0.837(95% CI:0.712-0.962), 0.863(95% CI:0.751-0.974), and 0.900 (95% CI:0.810-0.990) respectively, and all the 3 kinds of technique had diagnostic value(P=0.001), but there were no significant difference among the 3 kinds of technique on the area under curve(P > 0.05). According to the receiver operating characteristic(ROC) curve, the critical point of US in distinguishing benign nodules with malignant nodules was 3 conventional ultrasonography, which displayed a sensitivity of 83.3%, a specificity of 86.7%, and a accuracy of 85.7%. The critical point of EI grades in distinguishing benign nodules with malignant nodules was gradeⅣ, which displayed a sensitivity of 94.1%, a specificity of 82.6%, and a accuracy of 87.3%. The critical value of SWV in distinguishing benign nodules with malignant nodules was 3.39 m/s, which displayed a sensiti-vity of 88.9%, a specificity of 91.1%, and a accuracy of 90.5%. Conclusion US, EI, and VTQ techniques all have diagnostic values in the differential diagnosis between benign and malignant thyroid nodules, and we should make combination with all of the 3 kinds of technique when performing differential diagnosis.
The registration of preoperative magnetic resonance (MR) images and intraoperative ultrasound (US) images is very important in the planning of brain tumor surgery and during surgery. Considering that the two-modality images have different intensity range and resolution, and the US images are degraded by lots of speckle noises, a self-similarity context (SSC) descriptor based on local neighborhood information was adopted to define the similarity measure. The ultrasound images were considered as the reference, the corners were extracted as the key points using three-dimensional differential operators, and the dense displacement sampling discrete optimization algorithm was adopted for registration. The whole registration process was divided into two stages including the affine registration and the elastic registration. In the affine registration stage, the image was decomposed using multi-resolution scheme, and in the elastic registration stage, the displacement vectors of key points were regularized using the minimum convolution and mean field reasoning strategies. The registration experiment was performed on the preoperative MR images and intraoperative US images of 22 patients. The overall error after affine registration was (1.57 ± 0.30) mm, and the average computation time of each pair of images was only 1.36 s; while the overall error after elastic registration was further reduced to (1.40 ± 0.28) mm, and the average registration time was 1.53 s. The experimental results show that the proposed method has prominent registration accuracy and high computational efficiency.