Ultrasonic Image Characteristics Research Articles

Ultrasonic Image Characteristics of Palatine Tonsils in Healthy Children and Analysis of Factors Influencing Image Quality.

To explore the ultrasonic image characteristics of palatine tonsils in healthy children and the factors affecting image quality. A total of 750 images of palatine tonsils were collected from 375 healthy children. According to ultrasonic image quality, the images were divided into three groups. Both systemic and local factors were analyzed among the different groups. The palatine tonsils showed quasi-circular or flat oval, low echo or light and dark band arrangement, a striped medium echo, and a clear boundary. Age, height, weight, body mass index, body surface area, distance from the skin to the posterior margin of the tonsils, thickness of the anterior soft tissue of the tonsils, and thickness of the anterior submandibular gland of the tonsils were significantly different among the different image quality groups (p < 0.05). Multivariate logistic regression analyses revealed that height, weight, thickness of the anterior soft tissue of the tonsils, and thickness of the anterior submandibular gland of the tonsils were independent factors affecting the quality of the ultrasonic images of the palatine tonsils. There are characteristic ultrasonic image manifestations of the palatine tonsils. Tonsil ultrasound image quality is affected by individual and local factors.

Value of early pregnancy ultrasound combined with ultrasound score in the evaluation of placenta accreta in scar uterus: A retrospective cohort study.

The objective of this study is to investigate the value of early pregnancy ultrasound combined with ultrasound score (USS) for the evaluation of placenta accreta (PA) in scar uteri. Thirty cases of PA in scar uteri diagnosed by ultrasound at our hospital between June 2021 and June 2022 were selected retrospectively (observation group). In addition, 30 patients had placenta attached to the anterior wall of the uterus and covered the internal orifice of the cervix; however, no PA was selected in the same period (control group). The results of surgical pathology and ultrasound examination in the first trimester of pregnancy (11-14 weeks of pregnancy, fetal top hip length 4.5-8.4 cm) were analyzed. Ultrasonic image characteristics of the 2 groups were scored using an ultrasonic scoring scale. The ultrasonic signs and ultrasonic scores of the 2 groups were analyzed. The diagnostic value of ultrasound and USS for PA in the scarred uterus alone and in combination was analyzed based on the gold standard of surgical and pathological results. The rich blood flow signal at the junction of the uterine serosa and bladder, the rate of blood flow in the cavity of the placental parenchyma, the thinning rate of the myometrium after placenta, and the abnormal rate of the low echo area after placenta in the observation group were significantly higher than those in the control group (P < .05). The USS of the observation group was significantly higher than that of the control group (P < .05). The sensitivity (93.33%) and accuracy (95.00%) of the combined examinations were significantly higher than those of ultrasound (70.00% and 83.33%, respectively) (P < .05). The sensitivity and accuracy of combined examination were slightly higher than those of USS examination (83.33% and 90.00%), but the difference was not statistically significant (P > .05). There was no significant difference between the specificity of combined examination (93.33%) and ultrasound (96.67%) and USS (96.67%) (P > .05). Early pregnancy ultrasound and USS evaluation have high application value in the diagnosis and evaluation of early scar uterine PA. The combination of the 2 methods can further improve the sensitivity and accuracy of diagnosis.

Analysis of clinical data of different endometrial pathological types in perimenopausal women with abnormal uterine bleeding.

Early detection and diagnosis are important for improving the therapeutic effect and quality of life in patients with endometrial cancer (EC). This study aimed to analyze the clinical data of different endometrial pathological types in perimenopausal women with abnormal uterine bleeding (AUB) in order to provide evidence for the prevention and early diagnosis of EC. A total of 462 perimenopausal women with AUB were enrolled in this prospective observational study. Endometrial biopsy was performed in patients with suspected endometrial lesions. According to the pathological examination results, the patients were divided into endometrial polyp group (EP) (n = 71), endometrial hyperplasia without atypia group (EH) (n = 59), atypical endometrial hyperplasia (AEH) (n = 36), and EC group (n = 27). The history risk factors and ultrasonic imaging characteristics of endometrium among the four groups were compared. Twenty-seven women were diagnosed with EC (5.84%). The prevalence rate of AEH and EC in the group of 51- to 55-year-old women was significantly higher than that in the groups of 40- to 45-year-old women and of 46- to 50-year-old women (P < 0.05). The age, body mass index, and history of diabetes gradually increased with the development of endometrial pathological types. In addition, the correlation index of endometrial blood flow increased gradually, and the proportion of uneven endometrial echo, unclear endometrial-myometrial junction (EMJ), and ovarian cyst also increased gradually. However, no statistically significant difference was found when comparing endometrial thickness (ET) and endometrial volume (EV) among endometrial pathological groups (P > 0.05). The ET, EV, endometrial vascularization index, endometrial flow index, and vascularization flow index in the ovarian cyst group were significantly higher (P < 0.05), and the proportion of uneven endometrium echo and unclear EMJ were significantly higher compared with that in the non-ovarian cyst group (P < 0.05). The most common cause of perimenopausal women with AUB was benign endometrial lesions. However, women aged 51-55 years old with endometrial high risk factors and ovarian cyst should be alert to AEH and EC. Endometrial biopsy needs to be performed to determine endometrial malignancy in necessity.

Study on the correlation between different expression levels of Ki-67 and ultrasonic image characteristics in primary breast lymphoma

ObjectiveTo investigate the correlation between different expression levels of Ki-67 and ultrasonographic features in primary breast lymphoma (PBL), in order to guide clinical prediction of malignant degree and prognosis of PBL by noninvasive ultrasonography. MethodsThe ultrasonographic characteristics of PBL proved by pathology were retrospectively summarized and analyzed, and the general clinical data, pathological types and the expression level of Ki-67 in PBL were summarized, and the correlation between the ultrasonographic characteristics and different expression levels of Ki-67 was analyzed. ResultsIn this study,The main ultrasonic manifestations of PBL were as follows: the lesions were mostly located in the left breast, large size, irregular morphology, uneven echo, no burr sign, posterior echo enhancement effect, blood flow signal, parallel growth, and no calcification. All the cases had different levels of Ki-67 expression. Among them, in the high expression group (Ki-67 ≥ 80%), 3 cases had burr sign and 13 cases had clear boundary, in the low expression group (Ki-67 < 80%), 12 cases had burr sign and 4 cases had clear boundary, and the difference between the two groups was statistically significant (P < 0.05). In the rest, there was no statistically significant difference between the two groups (P > 0.05). ConclusionKi-67 was expressed in PBL to varying degrees, and the ultrasound images of PBL in the high expression group mostly showed no “burr sign” and “clear boundary”; on the contrary, the ultrasound images of PBL in the low expression group often showed “burr sign” and “unclear boundary”. Therefore, the ultrasonic images could predict the expression level of Ki-67, the malignant degree of PBL and its prognosis.

Retracted: Application of Color Ultrasound in the Diagnosis of Gynecological Endocrine Disorders and Study of Ultrasonic Image Characteristics.

[This retracts the article DOI: 10.1155/2022/4773179.].

A Hypothesis on the Progression of Insulin-Induced Lipohypertrophy: An Integrated Result of High-Frequency Ultrasound Imaging and Blood Glucose Control of Patients.

To put forward a scientific hypothesis about the progression of insulin-injection-induced lipohypertrophy (LH) according to the high-frequency ultrasonic imaging of insulin injection sites and the blood glucose control of patients. A total of 344 patients were screened for LH by means of high-frequency ultrasound scanning. The results of their ultrasound examination were described in detail and categorized into several subtypes. Seventeen patients with different subtypes of LH were followed up to predict the progression of LH. To further verify our hypothesis, the effects of different types of LH on glycemic control of patients were observed by comparing glycated hemoglobin A1c (HbA1C) and other glycemic-related indicators. LH was found in 255 (74.1%) patients. According to the high-frequency ultrasonic imaging characteristics, LH can be categorized into three subtypes in general. Among all the LHs, the most common type observed was nodular hyperechoic LH (n = 167, 65.5%), followed by diffuse hyperechoic LH (n = 70, 27.5%), then hypoechoic LH (n = 18, 7.0%). At the follow-up after six months, all 10 patients with nodular hyperechoic LH had LH faded away. Of the five patients with diffuse hyperechoic LH, two had inapparent LH, and three had diffuse hyperechoic parts which had shrunk under ultrasound. No obvious changes were observed in the two cases of hypoechoic LH. Compared with the LH-free group, the mean HbA1C of the nodular hyperechoic LH group increased by 0.8% (9 mmol/mol) (95% CI:-1.394~-0.168, p = 0.005), that of the diffuse hyperechoic LH group increased by 2.0% (21 mmol/mol) (95% CI: -2.696~-1.20, p < 0.001), and that of the hypoechoic LH group increased by 1.5% (16 mmol/mol) (95% CI: -2.689~-0.275, p = 0.007). It was hypothesized that the earlier stage of LH is nodular hyperechoic LH. If nodular LH is not found in time and the patient continues to inject insulin at the LH site and/or reuse needles, LH will develop into a diffuse type or, even worse, a hypoechoic one. Different subtypes of LH may represent differences in severity when blood glucose control is considered as an important resolution indicator. Further studies are needed to confirm our hypothesis on the progression and reversion of insulin-induced lipohypertrophy.

Research and Analysis on Ultrasonic Imaging Characteristics of CFRP Laminates Based on Linear and Annular Array Transducers

Research and Analysis on Ultrasonic Imaging Characteristics of CFRP Laminates Based on Linear and Annular Array Transducers

Clinical analysis of 13 cases of primary squamous-cell thyroid carcinoma.

ObjectiveTo analyze the clinical features, ultrasonographic manifestations, pathological features, treatment and prognosis of primary thyroid squamous cell carcinoma (PSCTC) and summarize the experience in diagnosis and treatment of this condition.MethodsA retrospective analysis was conducted on patients who were admitted to Zhejiang Cancer Hospital from 2007 to 2021 due to thyroid nodules or thyroid malignant tumors that were ultimately confirmed by postoperative pathology as primary thyroid squamous cell carcinoma. We summarize the general situation, clinical information, laboratory examination, ultrasonic image characteristics, pathological examination, clinical treatment and prognosis of the patients.ResultsPSCTC is most often seen in older men and progresses rapidly. In laboratory tests, some patients had elevated levels of tumor markers (CA199, squamous cell carcinoma antigen level), thyroglobulin levels and tumor-related substances, but all these indicators lacked specificity. The ultrasound features of PSCTC are mainly hypoechoic, hard, substantial nodules with gross borders and a grade 1-2 blood flow signal, sometimes with signs of necrosis and calcification. In terms of treatment, PSCTC is mainly surgically resected, though some patients in this study underwent iodine-131 radiation therapy, local radiotherapy, and chemotherapy with unclear results. None of the patients survived for very long after treatment, but the prognosis of patients with highly differentiated squamous carcinoma was significantly better than that of patients with poorly differentiated squamous carcinoma. Papillary thyroid carcinoma may be one of the causes of PSCTC.ConclusionPSCTC is a malignant tumor with high malignancy and rapid clinical progression. Treatment options are mainly based on surgical resection and can be supplemented with radiotherapy and chemotherapy, but there is still a lack of a standardized treatment management system, and more cases and reports are needed to accumulate data.

Ultrasonic Characteristics Improve Prediction of Central Lymph Node Metastasis in cN0 Unifocal Papillary Thyroid Cancer.

BackgroundPrediction of central lymph node metastasis (CLNM) is vital for clinical decision-making processes in clinically N0 (cN0) unifocal papillary thyroid carcinoma (PTC), but the sensitivity of preoperative detection of CLNM is limited. The aim of the present study was to determine whether there are ultrasonic (US) characteristics associated with CLNM.MethodsIn total, 1657 PTC patients (514 men and 1143 women) were enrolled in the present study between January 2018 and May 2021. The patients met the following inclusion criteria based on preoperative detection: suspected nodule confirmed as PTC by biopsy; the nodule was unifocal and less than 4 cm in diameter; no prior neck radiation exposure; no extrathyroidal extension; and no CLNM or distant metastases on imaging. All the enrolled patients underwent total thyroidectomy with prophylactic central lymph node dissection (CLND). A postoperative pathological diagnosis was made.ResultsCLNM was found in 58.4% of male patients and 36.9% of female patients. In univariate analysis, size, adjacent anterior capsule, distance to the lower pole and color Doppler flow imaging (CDFI) were considered risk factors for the male and female groups (p < 0.05). In multivariate analyses, size, adjacent anterior capsule, distance to the lower pole and CDFI were independent risk factors for male patients. For females, the independent risk factors included size, adjacent anterior capsule, distance to the lower pole and CDFI.ConclusionIn the present cohort, US imaging characteristics, including size, adjacent anterior capsule, distance to the lower pole and CDFI, were identified to be potentially beneficial in preoperative clinical decision-making processes for cN0 unifocal PTC patients.

Risk Factors for Neck Nodal Metastasis in Papillary Thyroid Cancer With BRAF V600E Mutation.

BackgroundThe BRAF V600E mutation is the most common genetic variant in papillary thyroid cancer (PTC), but the relationship between the BRAF V600E mutation in PTC and cervical lymph node metastasis (LNM) remains controversial.ObjectiveTo estimate risk factors for neck nodal metastasis in PTC with BRAF V600E mutation.PatientsA total of 292 patients diagnosed with BRAF V600E mutation related PTC were admitted.DesignIn this retrospective study, data from 292 patients, including clinical, molecular, and ultrasonic characteristics, were analyzed. Univariate and multivariate logistic regression analyses were applied to identify risk factors for LNM in PTC with the BRAF V600E mutation.ResultsIn the univariate analysis of all PTC patients with the BRAF V600E mutation, the LNM was found to be significantly associated with age (P = 0.010), size (P = 0.000), bilaterality (P = 0.000), multifocality (P = 0.002), LNM in ultrasound (US) (P = 0.000), and capsular invasion (P = 0.010). In ultrasonic image characteristics, margin (P = 0.036), shape (P = 0.046), and microcalcification (P = 0.002) were significantly associated with LNM. In multivariate analysis, LNM in PTCs with BRAF V600E mutation was significantly associated with age ≤ 45 years (OR = 1.869, P = 0.020, 95% CI = 1.106 - 3.158), size ≥ 1cm (OR = 3.131, P = 0.001, 95% CI = 1.578 - 6.212), LNM in US (OR = 6.962, P = 0.000, 95% CI = 2.924 - 16.572), bilaterality (OR = 1.626, P = 0.007, 95% CI = 1.142 - 2.314), ill-defined margins in US (OR = 1.980, P = 0.033, 95% CI = 1.057 - 3.709), and microcalcification in US (OR = 2.786, P = 0.002, 95% CI = 1.464 - 5.303).ConclusionThis study revealed that several significant risk factors for LNM in PTCs with the BRAF V600E mutation included: age ≤ 45 years, size ≥ 1cm, LNM in US, bilaterality, ill-defined margins in US, and microcalcification in US.

The Value of Transrectal Ultrasound in the Preoperative Diagnosis of Complex Anal Fistula (CAF): Based on a Retrospective Cohort Study.

The Value of Transrectal Ultrasound in the Preoperative Diagnosis of Complex Anal Fistula (CAF): Based on a Retrospective Cohort Study.

Application of Color Ultrasound in the Diagnosis of Gynecological Endocrine Disorders and Study of Ultrasonic Image Characteristics.

In order to study gynecological endocrine disorders, color ultrasound and image examination were used for in-depth study. After examining the clinical significance, research methods, strengthening treatment measures, and adjusting physical and mental health, the research and examination of endocrine disorders under ultrasound and ultrasound images are successfully analyzed. Endocrine is like a woman's umbrella. When it is in harmony with the body, it will make women as beautiful as flowers. Once it becomes an endocrine disorder, it will cause a lot of trouble to women. According to the statistics of a magazine, the incidence of facial chloasma in young and middle-aged women is 28.2%; breast cancer in women over 30 years old has a breast mass of 38.8–49.3%, of which 1–2% may be converted to breast cancer. For the treatment of patients with gynecological endocrine disorders, we mainly use simple western medicine, but the curative effect is not ideal. The rehabilitation speed of patients is relatively slow, which has certain treatment limitations. After the ultrasound research on endocrine disorders, the ultrasound can not only determine the female endocrine function but also diagnose diseases related to endocrine disorders, which basically meets the general understanding of clinicians on the screening of endocrine disorders and physiological functions.

Utilization of Ultrasonic Image Characteristics Combined with Endoscopic Detection on the Basis of Artificial Intelligence Algorithm in Diagnosis of Early Upper Gastrointestinal Cancer.

The aim of this study was to evaluate the diagnostic value of artificial intelligence algorithm combined with ultrasound endoscopy in early esophageal cancer and precancerous lesions by comparing the examination of conventional endoscopy and artificial intelligence algorithm combined with ultrasound endoscopy, and by comparing the real-time diagnosis of endoscopy and the ultrasonic image characteristics of artificial intelligence algorithm combined with endoscopic detection and pathological results. 120 cases were selected. According to the inclusion and exclusion criteria, 80 patients who met the criteria were selected and randomly divided into two groups: endoscopic examination combined with ultrasound imaging based on intelligent algorithm processing (cascade region-convolutional neural network (Cascade RCNN) model algorithm group) and simple use of endoscopy group (control group). This study shows that the ultrasonic image of artificial intelligence algorithm is effective, and the detection performance is better than that of endoscopic detection. The results are close to the gold standard of doctor recognition, and the detection time is greatly shortened, and the recognition time is shortened by 71 frames per second. Compared with the traditional convolutional neural network (CNN) algorithm, the accuracy and recall of image analysis and segmentation using feature pyramid network are increased. The detection rates of CNN model, Cascade RCNN model, and endoscopic detection alone in early esophageal cancer and precancerous lesions are 56.3% (45/80), 88.8% (71/80), and 44.1% (35/80), respectively. The detection rate of Cascade RCNN model and CNN model was higher than that of endoscopy alone, and the difference was statistically significant (P < 0.05). The sensitivity, specificity, positive predictive value, and negative predictive value of Cascade RCNN model were higher than those of CNN model, which was close to the gold standard for physician identification. This provided a reference basis for endoscopic ultrasound identification of early upper gastrointestinal cancer or other gastrointestinal cancers.

The stability analysis of weak structural planes based on multi-frequency ultrasonic imaging characteristics during rock and soil physical model tests

The stability analysis of weak structural planes based on multi-frequency ultrasonic imaging characteristics during rock and soil physical model tests

P–405 The diagnosis and management of heterotopic intramural pregnancy after in vitro fertilization-embryo transfer: six-case series

Abstract Study question What are the ultrasonic characteristics of heterotopic intramural pregnancy (HIMP)? How to manage and what about the clinical outcomes of HIMP? Summary answer Expectant management may be a considerable choice for an non-viable intramural pregnancy (IMP). Most intrauteine pregnancies (IUPs) of HIMPs seems to have good outcomes. What is known already Heterotopic pregnancy (HP) post in vitro fertilization is very rare in infertility women, with a prevalence of 0.04%. HIMP is one of the rarest types of HP, where one gestational sac (GS) is embedded within the endometrial cavity and the other one GS is implanted in the myometriun. HIMP was firstly and only described by Jiangtao Lyu et al. in 2018. So far, little is known about its natural history and ultrasonic imaging characteristics. And there is no consensus regarding the ultrasound diagnosis and clinical management for HIMP due to few evidence-based medicine records. Study design, size, duration A retrospective observational study was conducted of 6 infertile women who obtained a HIMP through in vitro fertilization-embryo transfer (IVF-ET) between January 2009 and December 2019 at our reproductive centre. Participants/materials, setting, methods Six infertile women conceived a HIMP via IVF-ET were retrospectively retrieved between January 2009 and December 2019 at the Reproductive and Genetic Hospital of CITIC-Xiangya (Changsha City, China). The ultrasound diagnosis, clinical management and pregnancy outcome of these cases were analysed. The ultrasound findings, therapeutic methods and clinical outcomes were obtained from the hospital’s electronic medical records. This study was approved by the local ethics committee. Main results and the role of chance: Six women with HIMPs were retrospectively analysed. Among them, 5 cases were revealed by ultrasound scans; however, one case was misdiagnosed. The diagnostic accuracy was 83.3%. Five cases of HIMP were diagnosed at initial scan. The diagnostic time ranged from 22 to 38 days after ET (5 + 6 - 7 + 6 weeks). Among them, an intramural GS was observed in all 5 cases; embryonic cardiac activity (ECA) was detected in one case by the followed-up scans; there was a yolk sac only in one case; an empty GS was noted in 3 cases. An IUP was revealed in all 6 cases, and ECA was observed in 5 cases at the initial diagnosis or later. A GS with a yolk sac only was showed in one case. Among the 5 diagnostic women, one case with a live IMP was treated with laparoscopy at 8 + 1 weeks, 4 cases were managed expectantly. Of them, the IUPs of 4 cases delivered live infants and one case managed expectantly experienced miscarriage. In one case, IMP was misdiagnosed as interstitial pregnancy at day–28 scan. Exploratory laparoscopy and foetal reduction were performed at 8 + 2 weeks. Laparoscopy confirmed an IMP and the retained IUP delivered a live infant. Limitations, reasons for caution The case numbers are too few to draw any objective conclusions, because of the extreme rarity of HIMP. Thus, a further multi-centre larger prospective study will help to confidently illustrate the clinical significance, and effective and appropriate management method for women with a HIMP. Wider implications of the findings: Our study showed that HIMP may not be as rare as previously reported. Increased awareness of this condition, better comprehension of the diagnostic criteria and improved resolution of ultrasound equipment may result in more frequent and accurate detection of HIMP, which will be helpful for early management to preserve IUP. Trial registration number Not applicable.

Conventional Ultrasound Combined With Contrast-Enhanced Ultrasound in Differential Diagnosis of Gallbladder Cholesterol and Adenomatous Polyps (1-2 cm).

This study aimed to determine ultrasonic image characteristics that enable differentiation between cholesterol and adenomatous polyps and to assess the diagnostic efficacy of combining conventional ultrasound (CUS) with contrast-enhanced ultrasound (CEUS). Eighty-nine patients with gallbladder polyps of 1-2 cm in diameter were enrolled and examined by CUS and CEUS before cholecystectomy. The appearances on CUS and CEUS were recorded and analyzed. The receiver operating characteristic (ROC) curve was used to calculate the optimal size threshold for distinguishing cholesterol from adenomatous polyps. A logistic regression analysis was performed to identify diagnostic variables. ROC analysis was performed to evaluate the diagnostic efficacy of the size, the independent variables, and the combined factors. There were differences in size, number, vascularity on CUS and intralesional vascular shape, wash-out, and area under the curve on CEUS between the two groups (P< .05). ROC analysis indicated that a maximum diameter of 1.45 cm was the optimal threshold for the prediction of adenomatous polyps. The logistic regression analysis proved that the single polyp, presence of vascularity, and intralesional linear vessels were associated with adenomatous polyps (P< .05). ROC analysis showed that the area under the ROC curve, sensitivity, and specificity for the combination of the three independent variables were 0.858, 87.3%, and 67.6%. The number combined with intralesional vascular shape had the highest diagnostic sensitivity of 91.2%. The combination of CUS and CEUS demonstrated great significance in the differential diagnosis of cholesterol and adenomatous polyps.

Prenatal diagnosis of a rare variant of harlequin ichthyosis with literature review

BackgroundHarlequin ichthyosis (HI) is a rare and severe genetic skin disorder that occurs within the developing foetus. Due to the extremely poor prognosis, prenatal diagnosis becomes very important, especially for foetuses with no family history. There are few reports on prenatal diagnosis in PubMed.Case presentationWe report two cases of HI with no family history who were diagnosed by prenatal ultrasound. We searched for reports on the prenatal ultrasonic diagnosis of HI over nearly two decades and summarized the sonographic features of HI, the reasons for missed diagnoses and matters needing attention. A total of 10 articles of congenital harlequin ichthyosis diagnosed by prenatal ultrasound in PubMed were retrieved. There have been even fewer reports of late-trimester disease with no family history. Combining the two cases we reported with the literature review, we summarize the ultrasonic image characteristics of HI.ConclusionHI can be easily detected by 2D ultrasound combined with 3D, but attention should be paid to a systematic examination in the third trimester of pregnancy according to the clinical characteristics of the disease.

The Value of Combined Radial Endobronchial Ultrasound-Guided Transbronchial Lung Biopsy and Metagenomic Next-Generation Sequencing for Peripheral Pulmonary Infectious Lesions.

Background Metagenomic next-generation sequencing (mNGS) is a new technology that allows for unbiased detection of pathogens. However, there are few reports on mNGS of lung biopsy tissues for pulmonary infection diagnosis. In addition, radial endobronchial ultrasound (R-EBUS) is widely used to detect peripheral pulmonary lesions (PPLs), but it is rarely used in the diagnosis of peripheral lung infection. Objective The present study aims to evaluate the combined application of R-EBUS-guided transbronchial lung biopsy (TBLB) and mNGS for the diagnosis of peripheral pulmonary infectious lesions. Methods From July 2018 to April 2019, 121 patients from Tianjin Medical University General Hospital diagnosed with PPLs and lung infection were enrolled in this prospective randomized study . Once the lesion was located, either TBLB or R-EBUS-guided-TBLB was performed in randomly selected patients, and mNGS was applied for pathogen detection in lung biopsy tissues. The results of mNGS were compared between the TBLB group and R-EBUS-guided TBLB group. In addition, the clinical characteristics and EBUS images from 61 patients receiving bronchoscopy for peripheral lung infectious detection were analyzed and compared with the results of mNGS. Results The positivity rate of mNGS in R-EBUS-guided TBLB was (78.7%, 48/61) that was significantly higher than (60.0%, 36/60) in the TBLB group. Difference in the position of R-EBUS probe and image characteristics of peripheral lung infectious lesions affected the positivity rate of mNGS. Tissue collected by R-EBUS within the lesion produced higher positivity rate than samples collected adjacent to the lesion (P=0.030, odds ratio 17.742; 95% confidence interval, from 1.325 to 237.645). Anechoic areas and luminant areas of ultrasonic image characteristics were correlated with lower positivity rate of mNGS (respectively, P=0.019, odds ratio 17.878; 95% confidence interval, from 1.595 to 200.399; P=0.042, odds ratio 16.745; 95% confidence interval, from 1.106 to 253.479). Conclusions R-EBUS-guided TBLB is a safe and effective technique in the diagnosis of peripheral lung infectious lesions. R-EBUS significantly facilitates the accurate insertion of bronchoscope into the lesions, which improves positivity rate of mNGS analysis in pathogen detection. The R-EBUS probe position within lesion produced a higher positivity rate of mNGS analysis. Nevertheless, the presence of anechoic and luminant areas on ultrasonic image was correlated with poor mNGS positivity rate.

Comparative analysis of ultrasonographic characteristics between pancreatic neuroendocrine tumor and pancreatic ductal denocarcinoma

Objective To compare the characteristics of ultrasonic imaging between pancreatic neuroendocrine tumor (pNET) and pancreatic ductal adenocarcinoma (pDAC), and to identify the ultrasonic characteristics in different pathological grades of pNETs. Methods The ultrasonic imaging data of 67 patients with pathologically confirmed pNETs and 82 patients with pathologically confirmed pDACs from the First Affiliated Hospital of Sun Yat-sen University from January 2010 to March 2019 were retrospectively analyzed. Differences in conventional ultrasonic characteristics and CEUS manifestations between the two groups were compared. Fifty pNET lesions were confirmed with pathological grades G1, G2 and G3.Ultrasonic characteristics of the 3 pathological grades were also compared. Results ①Comparison of ultrasonic imaging characteristics between pNET and pDAC showed that: there were statistically significant differences between the two groups in lesion distribution, lesion size, echo, boundary, signal of blood flow, calcification, dilatation of main pancreatic duct, liver metastasis, vascular involvement, CEUS enhancement in the three phases and non-enhancement area of necrosis (all P<0.05). The binary logistic regression model was built including the signal of blood flow, dilation of main pancreatic duct, liver metastasis and enhancementin arterial and venous phases. The diagnostic model for pNET had 0.988 in sensitivity, 0.791 in specificity, and the area under the ROC curve at 0.951, 95%CI being (0.920, 0.983). ②Comparison of the characteristics of ultrasonic imaging between the pNETs derived from the three pathological grades: there were statistically significant differences among the three groups with the liver metastasis and the enhancement in venous phase (both P<0.05). Only 10.5% (2/19) of G1 pNETs had liver metastasis, while 47.8% (11/23) of G2 and 62.5% (5/8) of G3 pNETs had liver metastasis. In venous phase, 78.9% (15/19) of G1 pNETs showed hyper- or iso- enhancement, while 100% (8/8) of G3 lesions showed hypo-enhancement. Conclusions The combination of features from multiple ultrasonic imaging may help to differentiate pNET from pDAC. There are certain differences in ultrasonic imaging features in pNETs at different pathological grades. Key words: Ultrasonography; Contrast-enhanced ultrasound; Pancreatic neuroendocrine tumor; Pancreatic ductal denocarcinoma

Ultrasonic identification and regression analysis of 294 thyroid follicular tumors.

We analyzed the clinical features and ultrasound image features of follicular thyroid carcinoma (FTC) and follicular thyroid adenoma (FTA). This study aimed to identify ultrasonographic differences and correlations between FTC and FTA. Meanwhile, ultrasonographic manifestations of thyroid follicular tumor were also retrospectively analyzed. Using pathological results as the gold standard, the clinical and ultrasonic image characteristics of FTA and FTC were statistically analyzed, and the differences were analyzed. A total of 304 patients who were diagnosed with FTC or FTA by pathology after thyroidectomy from March 2009 to March 2018 were enrolled in this study. Their ultrasonic images were analyzed; image features were extracted and correlation analyses for these features were conducted. Differences in ultrasonic images between FTC and FTA were also compared. Independent sample t-test; Wilcoxon rank sum test; A Chi-square test: Univariate and multivariate logistic regression analyses. When performing ultrasound diagnosis, attention should be paid to identify FTC and FTA in terms of age, nodular goiter conditions, nodular boundary conditions, internal echo, calcification, blood flow signals, thyroid imaging reporting and data system (TI-RADS) grading and cystic solidity conditions. Moreover, a multivariate logistic regression showed that the boundaries were unclear, and cystic degeneration, TI-RADS, hypoecho, nodular goiter, macrocalcification and microcalcification were associated with FTC. Among them, macrocalcification is a protective factor for thyroid follicular tumors, and other indicators are risk factors. Ultrasound can provide valuable information for the identification of follicular neoplasms, but further research in this area is still necessary.