Ultrasonic Diagnosis Research Articles

Value of color Doppler ultrasonography combined with coagulation test in the diagnosis of postpartum thrombosis and the prediction of thrombosis in pregnant women

Objective To evaluate the value of color Doppler ultrasonography combined with coagulation test in the diagnosis of postpartum thrombosis and the prediction of thrombosis in pregnant women. Methods Color Doppler ultrasonography and blood coagulation examination were performed at 1 weeks before and 1 weeks after delivery respectively.Two or more abnormalities in both examinations were defined as positive thrombus combined diagnosis, two ultrasound tests that showedsnowstormsign were cdefined aspositive ultrasonic diagnosis.Thrombus formation in 30d after delivery was followed up.Three-dimensional χ2 test was used to compare the sensitivity and specificity of the combined diagnosis group and the ultrasonic diagnosis group. Results 238 cases were included in the study, including 76 positive cases and 162 negative cases in combined diagnosis group, 103 positive cases and 135 negative cases in ultrasonic diagnosis group.At the end of the follow-up period, there were 28 cases (36.84%) of the deep venous thrombosis of the lower extremities occurred in the combined diagnosis positive group and 21 cases (20.39%) in ultrasound diagnosis positive group.Kaplan-Meier method was used to analyze the lower extremity deep vein thrombosis of the positive subjects in the two diagnostic methods.Log Rank showed that the difference between the two groups was statistically significant (χ2=5.952, P=0.015). The sensitivity and specificity of the combined diagnosis positive group were higher than those of ultrasound diagnosis positive group, the difference was statistically significant(90.32% vs.67.74%; 76.81% vs.60.39%) (χ2=4.00, χ2=22.69, P<0.05). Conclusion Color Doppler ultrasonography combined with blood coagulation function can be used to diagnose prethrombotic state in pregnant women, and have high sensitivity and specificity for predicting deep vein thrombosis of lower extremities in pregnant women. Key words: Lower extremity deep vein thrombosis; Prethrombotic state; Color Doppler ultrasonography; Maternal value

Evaluation of capacitance changes of capacitive micromachined ultrasonic transducers for ultrasonic diagnoses by charge‐injection

AbstractThis research reports capacitance–voltage (CV) changes of capacitive micromachined ultrasonic transducers (CMUT) for ultrasonic diagnoses. The CMUT constitutes an electrostatically vibrating film, which is fabricated by deposition processes of SiO2 and SiN films as insulator and TiN and Al films as top electrode on a Si substrate. The ultrasonic waves are transmitted by addition of AC voltage between the top electrode and the Si substrate, whereas the reflective ultrasonic wave are received with the vibrating film and converted to the electrical signals for ultrasonic diagnostic images. There is a problem that the CV changes of CMUT occur due to charge‐injection into the insulator, since a high AC and DC voltages are applied for driving the vibrating film. Thus, it is necessary to suppress the change in CV characteristics of the CMUT due to charge‐injection. It is clarified that the CV drift due to charge‐injection can be decreased by forming the top electrode so as to cover the vibrating film. Also, the CV drift is able to be suppressed by setting the driving voltage to be equal to or less than the collapse voltage.

Comparison of the clinical value of cranial ultrasonography and CT in the diagnosis of neonatal brain diseases

Objective To compare the clinical value of cranial ultrasound and head CT in the diagnosis of neonatal brain diseases. Methods One hundred and six high risk newborns were selected.All the newborns underwent cranial ultrasonography and head CT examination, and the diagnostic effects of the two methods were compared. Results Of the 106 newborns, there were 83 cases of positive ultrasonic examination and 23 cases of negative, including 14 cases of misdiagnosis and missed diagnosis that diagnosed by cranial ultrasound.There were 66 cases of positive head CT examination and 40 cases of negative, including 37 cases of misdiagnosis and missed diagnosis that diagnosed by CT.The diagnostic sensitivity of the cranial ultrasound was 87.91%, the specificity was 80.00%, the positive predictive value was 96.39%, the negative predictive value was 52.17%, and the diagnostic accuracy was 86.79%.The sensitivity of head CT was 65.93%, the specificity was 60.00%, the positive predictive value was 90.91%, the negative predictive value was 22.50%, and the diagnostic accuracy was 65.09%.The diagnostic sensitivity and accuracy of cranial ultrasound were higher than those of head CT, and the differences were statistically significant(χ2=12.381, P=0.00; χ2=13.658, P=0.00). The specificity, positive predictive value and negative predictive value between the two methods had no statistically significant differences(χ2=1.429, P=0.23; χ2=1.943, P=0.16; χ2=2.759, P=0.10). In addition, 10 cases of subarachnoid and subdural hemorrhage, 13 cases of intracerebral hemorrhage, 25 cases of ventricular dilatation, 17 cases of hypoxic-ischemic encephalopathy, and 18 cases of hydrocephalus were detected by cranial ultrasound.Compared with the actual diagnosis, the difference was not statistically significant(χ2=1.134, P=0.89). Head CT showed 18 cases of subarachnoid and subdural hemorrhage, 10 cases of intracerebral hemorrhage, 16 cases of ventricular dilatation, 8 cases of hypoxic-ischemic encephalopathy, and 14 cases of hydrocephalus.Compared with the actual diagnostic results and the results of cranial ultrasonic diagnosis, the differences were statistically significant(χ2=15.091, P=0.00; χ2=15.879, P=0.00). Conclusion The diagnostic sensitivity and accuracy of cranial ultrasound are higher than CT.The diagnosis of cranial ultrasound is consistent with the actual diagnosis.Cranial ultrasound can be widely promoted in clinical practice. Key words: Brain diseases; Ultrasonography; Tomography, X-ray computed; Neonatal screening

Calcifications in Thyroid Tumors on Ultrasonography: Calcification Types and Relationship with Histopathological Type.

PurposeThe purpose of the study is to clarify the prevalence of calcifications within thyroid tumors on ultrasonography as well as the relationship between the calcification and histopathological types.Materials and MethodsCalcifications were classified into 6 (or 8) types according to their shape, size, and region. The prevalence of calcifications and types were investigated in new outpatients and patients who underwent thyroid surgery.ResultsAmong 2,902 nodules in 2,678 new outpatients, 747 nodules (26%) had calcifications. The types showed a wide distribution. Among 941 patients with papillary carcinoma (PC), 725 patients (77%) had calcifications, and the types showed a wide distribution. 18 patients with the diffuse sclerosing variant of PC only showed punctate microcalcifications in the parenchyma (100%), 32 patients with the cyst-forming type of PC mostly fragmentary and massive types (100%), and 161 metastatic lymph nodes from PC mostly punctate microcalcifications and fragmentary types (48%). Among 337 patients with follicular carcinoma, 79 patients (23%) had calcifications, and the types were mostly fragmentary, massive, and egg-shell types. Among 41 patients with undifferentiated carcinoma, 33 patients (80%) presented with calcifications, which were mostly the massive and egg-shell types. Among 137 patients with medullary carcinoma, 99 patients (72%) had calcification, and the types showed a wide distribution. None of 173 patients with primary thyroid lymphoma had calcifications (0%).ConclusionCalcifications on ultrasonography can be one of the characteristic findings and a full understanding of the prevalence of calcifications and types will markedly contribute to the ultrasonic diagnosis of thyroid tumors.

Development of the method for decomposition of superpositions of unknown pulsed signals using the second­order adaptive spectral analysis

We considered the issue of intuitive analysis, processing, and synthesis of unknown pulse sequences in a detailed form. We studied both classical methods of analysis with all pluses and minuses and the developed prospective method created on their basis. The developed method is adaptive, it is based on the consistent use of various methods of spectral analysis, which increases reliability, sensitivity, and resolution capability of visual analysis of echo-pulse images. Thus, we solved the problem on processing pulse signals. The proposed method makes it possible to increase resolution capability in the processing of signals and images without using a priori information on the form of elementary pulses. It is resistant to the influence of measuring noise. We presented the results of numerical simulation and actual verification on the example of a seismic image. The considered method has a significant development potential, both in theoretical and application aspects (first of all, in areas of ultrasonic medical diagnosis, seismic imaging, and non-destructive testing).

Diagnosis and follow-up of patients with Kawasaki disease complicating coronary aneurysms by echocardiography: experience of 338 cases from a single center

Objective To investigate the diagnosis and prognosis of patients with coronary artery aneurysm in Kawasaki disease. Methods The data of ultrasonic diagnosis and follow-up of 338 children with Kawasaki disease complicated with coronary artery aneurysms were analyzed. Results The incidence of coronary artery aneurysm in the acute stage of Kawasaki disease was 21.2%(338/1 594). Of all the 338 cases, small aneurysms was 66.6%(225 cases), medium aneurysms was 25.1%(85 cases), and giant aneurysms was 8.3%(28 cases). There were 719 branches involved in 338 cases, 32.8% of them in left main coronary artery and 31.1% in right coronary artery; 25.3% in left anterior descending branch, and 10.8% in left circumflex branch. A total of 382 branches were followed up, including 218 branches of small coronary aneurysm group and 82.1% of them were completely recovered to the normal diameter. The medium aneurysm group was 124 brunches, the proportion of no significant change, retraction, and normal were 23.4%, 68.5% and 8.1%, respectively. There were 40 brunches in the giant anuerysm group, in which the proportion of no significant change, retraction, and normal were 70.0%, 27.5% and 2.5%, respectively. A total of 30 thrombosiswere detected by echocardiography in the acute stage, 20 thrombosis were regularly followed up, 12 thrombosis gradually subsided, and the other remained persist. Five thrombosis were detected in the sequelae stage, and all located in the giant coronary aneurysm. Seven children were clinically diagnosed with ischemic heart disease, of them, acute myocardial infarction in 1 case, 1 died of heart failure. Conclusions Kawasaki disease coronary artery disease are common in small coronary aneurysms, of which the left main artery and right coronary artery lesions are the most common, and the prognosis is better; medium and giant aneurysm need more time to recovery , and are easy to complicated with thrombosis. Key words: Echocardiography; Mucocutaneous lymph node syndrome; Coronary aneurysm

Small molecule metabolite biomarkers for hepatocellular carcinoma with bile duct tumor thrombus diagnosis

Hepatocellular carcinoma with bile duct tumor thrombus (BDTT) is a malignant disease. The most commonly used diagnosis methods for BDTT are MRCP/ERCP, ultrasonic diagnosis or CT scan. However, BDTT is often misdiagnosed as other bile duct diseases, such as extrahepatic cholangiocarcinoma (EHCC), choledochal cyst (Cyst) and common bile duct stone (Stone). Diagnostic methods, which are more accurate and less destructive, are urgently needed. In this paper, we analyzed the small molecule metabolites in the serum of BDTT, Stone, Cyst and EHCC patients and normal people using untargeted GC-MS, and identified 21 metabolites that show different levels among different samples. Using targeted UHPLC-QQQ-MS analysis, we found that several metabolites are significantly changed. ROC curve analysis revealed two metabolites, L-citrulline and D-aspartic acid, as potential biomarkers that can distinguish BDTT from other bile duct diseases.

Role of thyroid ultrasound combined with thyroglobulin in the diagnosis of postoperative recurrence of thyroid cancer.

To study the application value of thyroid ultrasound combined with thyroglobulin (Tg) in the diagnosis of postoperative recurrence of thyroid cancer, so as to provide a reference for clinical practice. Eighty patients with thyroid cancer who underwent operative treatment for more than 2 times in our hospital from January 2014 to December 2016 were selected as the objects of study. After operation, residual thyroid tissues were removed via131Iodine (131I) treatment, the serum Tg and thyroid globulin antibody (TgAb) were detected, and the cervical ultrasound was performed. At 1 week after 131I treatment, the systemic single photon emission computed tomography (SPECT) was performed. Finally, the application values of serum Tg, TgAb and ultrasound in the diagnosis of postoperative recurrence of thyroid cancer were analyzed. The sensitivity, specificity and accuracy of Tg level in detecting of recurrence and metastasis of differentiated thyroid cancer were 78.5%, 73.3% and 77.5%, respectively, and it was difficult to show whether the postoperative recurrence and metastasis of thyroid cancer occurred through the expression level of serum TgAb. Moreover, TgAb in different concentrations had an effect on the diagnosis of metastasis of differentiated thyroid cancer via Tg. When the TgAb level ≥100 IU/mL, the sensitivity, specificity and accuracy of Tg diagnosis were 51.9%, 50.0% and 51.7%, respectively. When the TgAb level <100 IU/mL, the sensitivity, specificity and accuracy of Tg diagnosis were 94.6%, 71.4% and 88.2%, respectively. Besides, the sensitivity, specificity and accuracy of ultrasonic diagnosis of lymphatic metastasis after the treatment of differentiated thyroid cancer were 78.5%, 60.0% and 75.0%, respectively. The sensitivity, specificity and accuracy of ultrasound combined with Tg in the diagnosis of thyroid cancer were 97.4%, 75.0% and 93.6%, respectively. The difference in the metastasis rate of thyroid cancer was not statistically significant between patients with papillary carcinoma and patients with follicular carcinoma after treatment (P>0.05). Thyroid ultrasound combined with Tg is of high clinical value in the diagnosis of postoperative recurrence of thyroid cancer, which can significantly improve the sensitivity, specificity and accuracy of clinical diagnosis. The TgAb level can be detected when Tg is used to monitor the postoperative recurrence and metastasis of thyroid cancer, providing a reference for the clinical prevention and treatment.

超音波診断用CMUTの電荷注入による特性変化の検討

超音波診断用CMUTの電荷注入による特性変化の検討

超声诊断头颈部迷走神经副神经节瘤1例报道

超声诊断头颈部迷走神经副神经节瘤1例报道

The Clinical Value of Prenatal 3D Ultrasonic Diagnosis on Fetus Hemivertebra Deformity- A Preliminary Study.

Objective:The present study is planned to discuss the clinical value of prenatal 3D ultra-sonic diagnosis on fetus hemivertebra deformity through the retrospective analysis of clinical data of fetus hemivertebra deformity.Methods:Selected 9 fetus hemivertebra deformity cases, which have been admitted to our hospital during the period from January, 2010 to January, 2016 as study samples, and analyzed their 2D and 3D ultrasonic examination data.Results:4 cases of the fetus hemivertebra deformity occurred at lumbar vertebra, 3 cases at thoracic vertebra, and 2 cases at thoracolumbar vertebra. There were scoliosis and opened spine bifida (OSB). In 7 cases, there was absence of ribs in fetus. The 2D ultrasonic image showed that: The echo at the center of fetus vertebral arch lesion was blurred or lost. The coronal section showed the deformity of the spine. There was obvious loss of the ossification center. From the cross section, we could see that the vertebral body of the fetus was shrinking and the edges were relatively blurred. The 3D ultrasonic image showed that: the echo at the ossification center of the fetus vertebra was relatively blurred, or even lost. The image also indicated scoliosis deformity of the spine. The vertebral body lesion could be accurately located.Conclusion:9 cases of fetus hemivertebra deformity have been detected through examination. Labor inductions have been carried out after getting the permission from the family members. The X-ray examination of the fetus after labor induction showed that the diagnosis was correct. Prenatal ultra-sonic examination holds strong potential for the diagnosis of fetus hemivertebra deformity quite early and deserves further clinical evaluation with large sample size.

Clinical Application and Value of Ultrasound in Diagnosis of Acute Abdomen—A Single Center Experience

&lt;p&gt;&lt;em&gt;This study is an analysis of the clinical value of ultrasonic diagnostic technique in the differential diagnosis of acute abdomen of the liver and gallbladder. Methods from July 2010 to October 2015, 641 cases of acute abdomen admitted to Macao &lt;/em&gt;&lt;em&gt;Conde de Sao Januario&lt;/em&gt;&lt;em&gt; Hospital were retrospectively analyzed. Among 641 cases of acute abdomen, 280 cases (43.7%) were diagnosed as acute appendicitis, 168 cases (26.3%) had acute pancreatitis, 79 cases (12.3%) had acute cholecystitis, 65 cases (10.1%) had urinary stones, 49 cases (7.6%) had liver abscesses. In 641 cases of acute abdominal disease, 584 cases were consistent with the results of ultrasonic examination and final diagnosis, which accounted for 91.1% of the total number of cases. Therefore, ultrasound diagnostic technology has a good clinical value in identifying acute abdomen, which helps to make correct pathological diagnosis, reduce misdiagnosis rate, and has no radiation and noninvasive. Therefore, it is worth further use in clinical application.&lt;/em&gt;&lt;/p&gt;

Ultrasonography in periodontal diagnosis

Ultrasonography is one of the most common diagnostic tools in medical imaging with non-invasive and non-radiation loaded characteristics. In the field of dentistry, especially for periodontology, high frequency ultrasonic device can be used for several purposes such as evaluating gingival thickness, identifying the level of alveolar bone, measuring the volume of mucosa of donor site for soft tissue graft and so on. According to recent studies, it was demonstrated that ultrasonic diagnosis had both accuracy and repeatability comparable to conventional diagnostic tools. However, improvement and development of intra-oral probe suitable for adpatation to gingiva and palatal mucosa, are considered as prerequisites for diffusion of ultrasonic diagnosis in periodontology.

Ultrasonic diagnosis and prognosis of chorionic bump in first-trimester pregnancy

Objective To study the value of ultrasonic diagnosis of chorionic bump in early pregnancy and the relationship between the sonographic features and the pregnancy outcome. Methods A retrospective analysis of the ultrasonography of 76 432 cases in early pregnancy was designed, including 137 cases with chorionic bump, their pregnancy outcomes were counted, and were compared with the control group of 8 139 cases of early pregnancy without chorionic bump. The sonographic features of chorionic bump, such as the size and number were analyzed. Results There were 55 cases of miscarriage in 137 cases, the rate happened in early pregnancy was 40.1%. The rate of miscarriage between the chorionic bump group and the control group had statistical difference(P=0.000). The chorionic bump group was divided into two subgroups according to the different number of chorionic bump, single and multiple bumps, the rates of abortion were 35.2% and 80%, respectively. There was significant difference between the two sub groups in the rate of miscarriage(P=0.001). In 82 cases of intrauterine live pregnancy, 73 cases were found the disappearance of chorionic bump in the early stage of pregnancy. Conclusions Diagnosis of chorionic bump in early pregnancy has some clinical value, and the first trimester is the critical period to determine the outcome of pregnancy. Key words: Ultrasonography, prenatal; Chorion; Pregnancy trimester, first; Pregnancy outcome; Abortion, spontaneous

Ultrasonic diagnosis of retinal detachment in eyes with silicone oil tamponade

Objective: To examine the features and values of ultrasonic diagnosis for retinal detachment in eyes with silicone oil tamponade (SOT). Methods: A prospective study. A total of 257 eyes (257 patients) were filled with silicone oil between December 1, 2015 and August 1, 2016 in the Department of Ophthalmology at a hospital in Beijing. All of the patients underwent a color Doppler ultrasound examination in the supine and sitting positions a week prior to surgery. The pre-surgery conditions were compared with the subsequent observations during the surgery to analyze the features and values of ultrasonic diagnosis for retinal detachment in eyes with SOT. Results: Ultrasound manifestations of eyes with SOT included pseudo extension of the ocular axis and an arc-shaped echo between the eye wall and silicone oil. Diagnostic accuracy was 85.6% in the supine position and 93.8% in the sitting position. Conclusion: Ultrasound diagnosis for retinal detachment in eyes with SOT manifests itself in certain patterns. Compared with the traditional ultrasound examination in the supine position, the sitting position examination can be used to further increase the diagnostic accuracy in the ultrasound diagnosis for retinal detachment in eyes with SOT, providing reliable evidence for clinical and differential diagnosis. (Chin J Ophthalmol, 2017, 53: 842-846).

Breast osteoblastoma and recurrence after resection: Demonstration by color Doppler ultrasound.

Osteoblastoma is a rare benign primary bone tumor, which occurs in any part of the skeleton. Extraskeletal osteoblastoma is rather rare. We presented an extremely rare case of extraskeletal osteoblastoma located in the breast. The tumor recurred 7 months later after resection and transformed to aggressive osteoblastoma. The histopathological features, ultrasonic manifestations and ultrasonic differential diagnoses of the primary and recurrent tumors were discussed. The recommended treatment of the tumor is surgical excision. Due to its tendency of recurrence and potential malignant transformation, adequate resection and careful follow up is essential.

Ultrasonic diagnosis for thyroid Hürthle cell tumor.

This study aims to evaluate the diagnostic value of ultrasound in thyroid Hürthle cell tumors. A retrospective analysis was carried out on 27 patients with thyroid Hürthle cell tumors, in terms of the size, shape, boundary, echo, aspect ratio, cystic degeneration, calcification, peripheral halo sign and blood supply of the tumor, through surgical pathological validation. Then, these were compared with postoperative pathological results. The maximum diameter of the thyroid Hürthle cell tumors is between 0.6 cm and 4.6 cm. It had an oval nodule with clear boundaries, an aspect ratio > 1, and peripheral low-echo halos. Furthermore, 29.6% of tumors have even low-echo nodules without cystic changes, 48.1% and 22.1% have even medium or medium-low mixed echo nodules, and 44.4% have cystic changes in varying degrees. One nodule appeared with "micro-calcification", but pathological results confirmed that it was local collagen. Color Doppler blood flow imaging revealed that 88.8% of the nodules were surrounded with blood flow, filled with rich blood inside, and only 12.2% of the nodules had a little blood inside. Thyroid Hürthle cell tumors have nodules with even or uneven echoes on the background of the normal echoes of the thyroid, with an aspect ratio of > 1, clear boundaries and peripheral acoustic halos. Cystic changes, colloid crystallization and fibrosis can be seen inside in varying degrees. Ultrasonography has no significant value for the differential diagnosis of benign and malignant Hürthle cell tumors.

EP04.03: Ultrasonic diagnosis to pathological types of fetal complete transposition of the great arteries (CTGA) and combined malformations

EP04.03: Ultrasonic diagnosis to pathological types of fetal complete transposition of the great arteries (CTGA) and combined malformations

Treatment of Incomplete Jones Fractures With Low-Intensity Pulsed Ultrasound (LIPUS).

Stress fractures of the proximal epiphysis of the fifth metatarsal bone (termed Jones fracture) frequently occur in both senior high-school-age and older contestant-level soccer players, and its incidence in Japanese soccer players is higher than that in European players. Surgery is most commonly indicated for a complete fracture, and about 3 months are required before the patient is able to return to the sport. We have performed a "Jones fracture screening" to reduce the incidence of these fractures. While surveying its frequency and promoting education on its prevalence and symptoms, we tried to discover incomplete fractures early and treat them using LIPUS without limiting their soccer practice. The subjects were 341 students (682 feet) from 3 senior high schools and university soccer clubs. Primary screening for tenderness and by diagnostic ultrasound imaging was performed as a Jones fracture screening. Fifty subjects (50 feet) were positive on the ultrasonic diagnosis, and secondary screening was recommended. Forty subjects underwent radiography (secondary screening rate: 80%), and 5 subjects (5 feet) were diagnosed with incomplete Jones fractures. Conservative treatment centering on LIPUS was performed in these 5 players who still continued to participate in all soccer practices. Bone union was achieved in 2 subjects (2 feet) after about 6 months without taking a break from soccer practice. The other 3 subjects (3 feet) are at 2 months after the diagnosis and are being followed without taking a break from soccer practice. Incomplete Jones fractures that are discovered early by an ultrasonic check-up for bone expansion with subsequent early treatment with LIPUS may heal without taking a break from practice. No preventive method has been established for Jones fractures. This check-up may serve as a useful preventative approach, and we will make an effort to suggest it as a common practice.

Solid Renal Masses in Transplanted Allograft Kidneys: A Closer Look at the Epidemiology and Management.

The objective of this review is to explore the available literature on solid renal masses (SRMs) in transplant allograft kidneys to better understand the epidemiology and management of these tumors. A literature review using PubMed was performed according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) methodology. Fifty-six relevant studies were identified from 1988 to 2015. A total of 174 SRMs in 163 patients were identified, with a mean tumor size of 2.75 cm (range 0.5-9.0 cm). Tumor histology was available for 164 (94.3%) tumors: clear cell renal cell carcinoma (RCC; 45.7%), papillary RCC (42.1%), chromophobe RCC (3%), and others (9.1%). Tumors were managed by partial nephrectomy (67.5%), radical nephrectomy (19.4%), percutaneous radiofrequency ablation (10.4%), and percutaneous cryoablation (2.4%). Of the 131 patients (80.3%) who underwent nephron-sparing interventions, 10 (7.6%) returned to dialysis and eight (6.1%) developed tumor recurrence over a mean follow-up of 2.85 years. Of the 110 patients (67.5%) who underwent partial nephrectomy, 3.6% developed a local recurrence during a mean follow-up of 3.12 years. The current management of SRMs in allograft kidneys mirrors management in the nontransplant population, with notable findings including an increased rate of papillary RCC and similar recurrence rates after partial nephrectomy in the transplant population despite complex surgical anatomy.