Ultrasonic Imaging Features Research Articles

Analysis of ultrasound images features and diagnostic model establishment of alveolar soft part sarcoma and intramuscular capillary-type hemangiomas

Objective: The ultrasonography features of alveolar soft part sarcoma (ASPS) and intramuscular capillary-type hemangiomas (ICTH) were analyzed, and the diagnostic model of ASPS was established. Methods: A cross-sectional study was carried out. The clinical data of 52 patients [28 males and 24 females, aged (20.7±15.1) years] with pathologically confirmed ASPS and ICTH admitted to People's Hospital of Henan Province from January 2005 to February 2023 were included in the study. According to pathological types, the patients were divided into ASPS group and ICTH group. Clinical data of patients were retrospectively collected, and meaningful indicators in the univariate analysis were included in the regression analysis for screening. After comprehensive consideration of clinical significance and statistical significance, eligible indicators were selected for inclusion in the regression analysis. Binary logistic regression analysis was used to screen the factors that distinguished the pathological types of ASPS and ICTH, and the diagnostic model was established. The area under receiver operating characteristic (ROC) curve (AUC) was used to evaluate the diagnostic effectiveness of the diagnostic model in distinguishing ASPS from ICTH. Results: There were 20 patients in ASPS group, 10 males and 10 females, aged (26.9±13.5) years, and 32 patients in ICTH group, 18 males and 14 females, aged (16.8±15.0) years. The age difference between the ASPS group and the ICTH group was statistically significant (P<0.05), and there were statistically significant differences in the ultrasound imaging features of "clear boundary" "peripheral lobe" "thin blood vessels inside the lesion are straight and out of shape" "intra-lesion liquification" "peripheral thick blood vessels" and "peripheral muscle fiber disruption" between the two groups (all P<0.001).Variables with clinical and statistical significance were selected as independent variables. Binary logistic regression analysis showed that peripheral muscle fiber interruption (OR=97.358, 95%CI:6.833-1 387.249) and internal thin blood vessels were flat and out of shape (OR=0.052, 95%CI:0.003-0.921) was the correlation factor to distinguish the pathological types of ASPS and ICTH. Two ultrasonic image features of "peripheral muscle fiber interruption" and "internal thin blood vessels are straight and out of shape" were used to establish the diagnostic model. The sensitivity of "peripheral muscle fiber interruption" diagnostic model was 81.3%, and the specificity was 95.0%. The AUC was 0.811(95%CI: 0.761-0.954). The sensitivity, specificity and AUC of the diagnosis model of "internal thin vessels with flat misshape" were 90.0%, 96.9% and 0.934(95%CI: 0.830-0.984). The sensitivity, specificity and AUC of the combined diagnosis model of "peripheral muscle fiber interruption" and "internal thin blood vessel straight out of shape" were 96.9%, 90.0% and 0.974(95%CI:0.877-0.999). Conclusion: Ultrasonography can be used to distinguish ASPS from ICTH, and the combined diagnostic model based on the two ultrasonic imaging features of "peripheral muscle fiber interruption" and "internal thin blood vessel straight out of shape" can further improve the diagnostic efficiency.

Analysis of ultrasonic imaging changes and factors related to malignant transformation in postmenopausal patients with endometrial polyps.

To examine the ultrasonic changes in postmenopausal endometrial polyps and analyze factors related to their malignant transformation. This retrospective study analyzed clinical data from 200 postmenopausal patients with endometrial polyps treated at Jinan Maternity and Child Care Hospital and Pingyin Hospital of Traditional Chinese Medicine from December 2020 to December 2023. All patients underwent pathological biopsies to diagnose the nature of the endometrial polyps. This study compared the clinical and ultrasonic imaging features of these patients and analyzed factors influencing the malignant transformation of postmenopausal endometrial polyps. Pathological findings classified 160 patients (80.00%) into the benign group and 40 patients (20.00%) into the malignant group. Significant differences were noted in endometrial thickness, polyp diameter, heterogeneity of lesion echogenicity, and vascularization between the groups (all P<0.05). The malignant group exhibited notably higher blood flow (Grade II+III constituted 70.00% compared to 29.38% in the benign group, P<0.05). The time average velocity (TAV), pulse index (PI), and resistance index (RI) were significantly lower in the malignant group (all P<0.05). The area under curve (AUC) values for TAV, PI, and RI in diagnosing malignant endometrial polyps were 0.754, 0.713, and 0.771, respectively. Increased body mass index (BMI), irregular premenopausal menstruation, and ≥2 occurrences of postmenopausal bleeding were identified as risk factors for malignant transformation (all P<0.05). These six indicators were used to create a predictive model for malignant transformation, achieving an AUC of 0.942. Malignancy in postmenopausal endometrial polyps is uncommon, yet distinct differences exist in the transvaginal color Doppler ultrasound characteristics between benign and malignant cases. Factors such as increased BMI, irregular premenopausal menstruation, and ≥2 occurrences of postmenopausal bleeding significantly contribute to the risk of malignant transformation. These findings, combined with ultrasound features, provide a robust basis for screening and monitoring these patients.

Strain ultrasonic elastography imaging features of locally advanced breast cancer: association with response to neoadjuvant chemotherapy and recurrence-free survival

BackgroundDue to the highly heterogeneity of the breast cancer, it would be desirable to obtain a non-invasive method to early predict the treatment response and survival outcome of the locally advanced breast cancer (LABC) patients undergoing neoadjuvant chemotherapy (NAC). This study aimed at investigating whether strain elastography (SE) can early predict the pathologic complete response (pCR) and recurrence-free survival (RFS) in LABC patients receiving NAC.MethodsIn this single-center retrospective study, 122 consecutive women with LABC who underwent SE examination pre-NAC and after one and two cycles of NAC enrolled in the SHPD001(NCT02199418) and SHPD002 (NCT02221999) trials between January 2014 and August 2017 were included. The SE parameters (Elasticity score, ES; Strain ratio, SR; Hardness percentage, HP, and Area ratio, AR) before and during NAC were assessed. The relative changes in SE parameters after one and two cycles of NAC were describe as ΔA1 and ΔA2, respectively. Logistic regression analysis and Cox proportional hazards model were used to identify independent variables associated with pCR and RFS.ResultsForty-nine (40.2%) of the 122 patients experienced pCR. After 2 cycles of NAC, SR2 (odds ratio [OR], 1.502; P = 0.003) and ΔSR2 (OR, 0.013; P = 0.015) were independently associated with pCR, and the area under the receiver operating characteristic curve for the combination of them to predict pCR was 0.855 (95%CI: 0.779, 0.912). Eighteen (14.8%) recurrences developed at a median follow-up of 60.7 months. A higher clinical T stage (hazard ratio [HR] = 4.165; P = 0.005.), a higher SR (HR = 1.114; P = 0.002.) and AR (HR = 1.064; P < 0.001.) values at pre-NAC SE imaging were independently associated with poorer RFS.ConclusionSE imaging features have the potential to early predict pCR and RFS in LABC patients undergoing NAC, and then may offer valuable predictive information to guide personalized treatment.

Deep learn-based computer-assisted transthoracic echocardiography: approach to the diagnosis of cardiac amyloidosis

Myocardial amyloidosis (CA) differs from other etiological pathologies of left ventricular hypertrophy in that transthoracic echocardiography is challenging to assess the texture features based on human visual observation. There are few studies on myocardial texture based on echocardiography. Therefore, this paper proposes an adaptive machine learning method based on ultrasonic image texture features to identify CA. In this retrospective study, a total of 289 participants (50 cases of myocardial amyloidosis; Hypertrophic cardiomyopathy: 70 cases; Uremic cardiomyopathy: 92 cases; Hypertensive heart disease: 77 cases). We extracted the myocardial ultrasonic imaging features of these patients and screened the features, and four models of random forest (RF), support vector machine (SVM), logistic regression (LR) and gradient decision-making lifting tree (GBDT) were established to distinguish myocardial amyloidosis from other diseases. Finally, the diagnostic efficiency of the model was evaluated and compared with the traditional ultrasonic diagnostic methods. In the overall population, the four machine learning models we established could effectively distinguish CA from nonCA diseases, AUC (RF 0.77, SVM 0.81, LR 0.81, GBDT 0.71). The LR model had the best diagnostic efficiency with recall, F1-score, sensitivity and specificity of 0.21, 0.34, 0.21 and 1.0, respectively. Slightly better than the traditional ultrasonic diagnosis model. In further subgroup analysis, the myocardial amyloidosis group was compared one-by-one with the patients with hypertrophic cardiomyopathy, uremic cardiomyopathy, and hypertensive heart disease groups, and the same method was used for feature extraction and data modeling. The diagnostic efficiency of the model was further improved. Notably, in identifying of the CA group and HHD group, AUC values reached more than 0.92, accuracy reached more than 0.87, sensitivity equal to or greater than 0.81, specificity 0.91, and F1 score higher than 0.84. This novel method based on echocardiography combined with machine learning may have the potential to be used in the diagnosis of CA.

Retracted: Ultrasonic Image Features under the Intelligent Algorithm in the Diagnosis of Severe Sepsis Complicated with Renal Injury.

[This retracts the article DOI: 10.1155/2022/2310014.].

Retracted: Evaluation of Endocrine and Metabolic Changes in Polycystic Ovary Syndrome by Ultrasonic Imaging Features under an Intelligent Algorithm.

[This retracts the article DOI: 10.1155/2022/1411943.].

Retracted: Value of Ultrasonic Image Features in Diagnosis of Perinatal Outcomes of Severe Preeclampsia on account of Deep Learning Algorithm

Retracted: Value of Ultrasonic Image Features in Diagnosis of Perinatal Outcomes of Severe Preeclampsia on account of Deep Learning Algorithm

Retracted: Artificial Intelligence Algorithm-Based Analysis of Ultrasonic Imaging Features for Diagnosis of Pregnancy Complicated with Brain Tumor.

[This retracts the article DOI: 10.1155/2021/4022312.].

Ultrasonic Image Features under the Intelligent Algorithm in the Diagnosis of Severe Sepsis Complicated with Renal Injury.

This research was aimed at analyzing the diagnosis of severe sepsis complicated with acute kidney injury (AKI) by ultrasonic image information based on the artificial intelligence pulse-coupled neural network (PCNN) algorithm and at improving the diagnostic accuracy and efficiency of clinical severe sepsis complicated with AKI. In this research, 50 patients with sepsis complicated with AKI were collected as the observation group and 50 patients with sepsis as the control group. All patients underwent ultrasound examination. The clinical data of the two groups were collected, and the scores of acute physiology and chronic health assessment (APACHE II) and sequential organ failure assessment (SOFA) were compared. The ultrasonic image information enhancement algorithm based on artificial intelligence PCNN is constructed and simulated and is compared with the maximum between-class variance (OSTU) algorithm and the maximum entropy algorithm. The results showed that the PCNN algorithm was superior to the OSTU algorithm and maximum entropy algorithm in the segmentation results of severe sepsis combined with AKI in terms of regional consistency (UM), regional contrast (CM), and shape measure (SM). The acute physiology and chronic health evaluation (APACHE II) and sequential organ failure assessment (SOFA) scores in the observation group were substantially higher than those in the control group (P < 0.05). The interlobular artery resistance index (RI) in the observation group was substantially higher than that in the control group (P < 0.05). Moreover, the mean transit time (mTT) in the observation group was significantly higher than that in the control group (4.85 ± 1.27 vs. 3.42 ± 1.04), and the perfusion index (PI) was significantly lower than that in the control group (134.46 ± 17.29 vs. 168.37 ± 19.28), with statistical significance (P < 0.05). In summary, it can substantially increase ultrasonic image information based on the artificial intelligence PCNN algorithm. The RI, mTT, and PI of the renal interlobular artery level in ultrasound images can be used as indexes for the diagnosis of severe sepsis complicated with AKI.

Ultrasonic multimodality imaging features and the classification value of nonpuerperal mastitis.

To explore the value of ultrasonic multimodality imaging for characterizing nonpuerperal mastitis (NPM) lesions and feasibility of distinguishing different subtypes. Thirty-eight NPM lesions were assessed using conventional ultrasonography (US), strain elastography (SE), and contrast-enhanced ultrasound (CEUS). The lesions were confirmed pathologically and classified as granulomatous lobular mastitis (GLM), plasma cell mastitis (PCM), or nonspecific mastitis (NSM). Furthermore, diagnostic indicators were evaluated. The diagnostic performances of the modalities were compared using the area under the receiver operating characteristic curve (AUC). The overall morphological features on US differed significantly between the GLM and PCM groups (p=0.002). Lesion size (≤10 mm) (p=0.003) and mean SE score (p=0.001) differed significantly between the PCM and NSM groups. The frequent NPM characteristic on CEUS was hyperenhancement with (or without) increased lesion size; intergroup differences were not significant. Breast Imaging Reporting and Data System > 3 was considered to indicate malignancy; accordingly, the accuracy of US alone, US with CEUS, and US with SE was 10.5%, 21.1%, and 65.8%, respectively. Moreover, the AUC for US with SE for classifying GLM and PCM was 0.616. CEUS cannot accurately classify NPM subtypes, while US and SE are valuable for classification.

Evaluation of Endocrine and Metabolic Changes in Polycystic Ovary Syndrome by Ultrasonic Imaging Features under an Intelligent Algorithm.

To explore the application of intelligent algorithm-based ultrasound in the evaluation of polycystic ovary syndrome (PCOS) and the endocrine and metabolic changes of PCOS, 44 patients diagnosed with PCOS were recruited and rolled into three groups regarding detection methods. Backpropagation algorithm-based ultrasonic detection was adopted for the patients in the experimental group. The patients in the control group were tested by conventional ultrasound. In addition, 18 healthy volunteers were selected as the normal group. The results showed that the images processed by the backpropagation algorithm were substantially better than the traditional ultrasound images (P < 0.05), and the image display was clearer. S, A, and S/A ratios measured by two different detection methods were 7.8 mm2, 3.5 mm2, and 0.449 in the experimental group, respectively, which were significantly different from 6.3 mm2, 2.6 mm2, and 0.413 in the control group (P < 0.05). The PI and RI values of the interstitial ovarian artery in the experimental group were lower than those in the control group, and the systolic peak velocity (PSV) and end diastolic velocity (EDV) values were higher than those in the control group (P < 0.05). Compared with the control group, the ovarian volume, interstitial vascularization-flow index (VFI), and flow index (FI) in the experimental group were substantially increased, and the total number of detected follicles was more (P < 0.05). The level of follicle-stimulating hormone (FSH) in PCOS patients was substantially lower than that in normal controls (P < 0.05). The LH, E2, P, and T of PCOS patients were substantially higher than those of normal controls (P < 0.05). Ultrasound on account of the backpropagation algorithm can directly display the three-dimensional structure of the ovary and follicle and accurately measure the ovarian volume and follicle number. Endocrine and metabolic indicators can provide objective information for the clinical diagnosis of PCOS and can be used as a way of clinical evaluation of PCOS.

The value of transthoracic echocardiography in the detection of extra-cardiac lesions

ObjectiveTransthoracic echocardiography (TTE) is generally recognized as the top choice for detecting myocardial and cardiac cavity lesions. Sonographers mostly focus on myocardium, cardiac cavity and cardiac hemodynamics, whereas the abnormal extra-cardiac lesions are easily remain unrecognized. The aim of this study was to investigate the ultrasonic image features in abnormal extra-cardiac lesions and the value of TTE in the detection of extra-cardiac lesions.Methods49 cases of abnormal extra-cardiac lesion detected by TTE from January 2014 to December 2019 were collected, which were confirmed by surgical pathology. The two-dimensional ultrasonic characteristics and the relationships with the cardiac and great vessels were summarized on the basis of multi-view by TTE. All patients were also examined by computed tomography (CT).ResultsIn 49 patients with abnormal extra-cardiac lesions, 37 malignant cases and 12 benign cases were included. There were 41 cases (41/49, 86.67%) of mediastinal lesions and 8 cases (8/49, 16.33%) of lung lesions. The maximum diameter ranged from 3.2 cm to 13.66 cm, and the median diameter was about 7.4 cm, among which 29 cases (29/49, 59.18%) were larger than 5 cm. 4 cases (4/49, 8.16%) of cystic anechoic lesions were pericardial cyst. 2 cases (2/49, 4.08%) of cystic-solid echogenic lesions were teratoma. The remaining 43 cases (43/49, 87.76%) presented as solid hypoechoic or heterogeneous masses. 6 cases compressed the heart and 21 cases encroached on the heart and vessels. Diagnosis coincidence rates of TTE and CT were respectively 77.55% and 93.88%, with a statistical difference (p = 0.012).ConclusionAlthough the diagnostic coincidence rate of TTE is slightly lower than that of CT, TTE has certain diagnostic value for extra-cardiac lesions.

Value of Ultrasonic Image Features in Diagnosis of Perinatal Outcomes of Severe Preeclampsia on account of Deep Learning Algorithm.

This study is aimed at discussing the value of ultrasonic image features in diagnosis of perinatal outcomes of severe preeclampsia on account of deep learning algorithm. 140 pregnant women singleton with severe preeclampsia were selected as the observation group. At the same time, 140 normal singleton pregnant women were selected as the control group. The hemodynamic indexes were detected by color Doppler ultrasound. The CNN algorithm was used to classify ultrasound images of two groups of pregnant women. The differential scanning calorimetry (DSC), mean pixel accuracy (MPA), and mean intersection of union (MIOU) values of CNN algorithm were 0.9410, 0.9228, and 0.8968, respectively. Accuracy, precision, recall, and F1-score were 93.44%, 95.13%, 95.09%, and 94.87%, respectively. The differences were statistically significant (P < 0.05). Compared with the normal control group, the umbilical artery (UA), uterine artery-systolic/diastolic (UTA-S/D), uterine artery (UTA), and digital video (DV) of pregnant women in the observation group were remarkably increased; the minimum alveolar effective concentration (MCA) of the observation group was obviously lower than the MCA of the control group, and the differences between groups were statistically valid (P < 0.05). Logistic regression analysis showed that UA-S/D, UA-resistance index (UA-RI), UTA-S/D, UTA-pulsatility index (UTA-PI), DV-peak velocity index for veins (DV-PVIV), and MCA-S/D were independent risk factors for the outcome of perinatal children with severe preeclampsia. In the perinatal management of severe epilepsy, the combination of the above blood flow indexes to select the appropriate delivery time had positive significance to improve the pregnancy outcome and reduce the perinatal mortality.

Artificial Intelligence Algorithm-Based Analysis of Ultrasonic Imaging Features for Diagnosis of Pregnancy Complicated with Brain Tumor.

This research was to explore the accuracy of ultrasonic diagnosis based on artificial intelligence algorithm in the diagnosis of pregnancy complicated with brain tumors. In this study, 18 patients with pregnancy complicated with brain tumor confirmed by pathology were selected as the research object. Ultrasound contrast based on artificial bee colony algorithm was performed and diagnosed by experienced clinicians. Ultrasonic image will be reconstructed by artificial bee colony algorithm to improve its image display ability. The pathological diagnosis will be handed over to the physiological pathology laboratory of the hospital for diagnosis. The doctor's ultrasonic diagnosis results were compared with the pathological diagnosis stage results of patients, and the results were analyzed by statistical analysis to evaluate its diagnostic value. The comparison results showed that the number and classification of benign tumors were the same, while in malignant tumors, the number diagnosis was the same, but there was one patient with diagnostic error in classification. One case of mixed glial neuron tumor was diagnosed as glial neuron tumor, and the diagnostic accuracy was 94.44% and the K value was 0.988. The diagnostic results of the two were in excellent agreement. The results show that, in the ultrasonic image diagnosis of patients with brain tumors during pregnancy based on artificial intelligence algorithm, most of them are benign and have obvious symptoms. Ultrasound has a good diagnostic accuracy and can be popularized in clinical diagnosis. The results can provide experimental data for the clinical application of ultrasonic image feature analysis based on artificial intelligence as the diagnosis of pregnancy complicated with brain tumors.

Analysis of Ultrasonic Features Based on Absence of Pulmonary Artery

According to clinical features and ultrasonic imaging features of patients with absence of pulmonary artery, it is necessary to analyze ultrasonic imaging features of absence of pulmonary artery to provide clinical basis for improving the diagnostic value and prognosis. The data and color Doppler echocardiography of 45 patients with absence of pulmonary artery are collected, who are confirmed by cardiac catheterization, CTA and operation, and the clinical features and ultrasonic imaging features are studied. The research results show that 57% of the patients have left absence of pulmonary artery and 91% of them have other cardiovascular malformations, where ASD/PFO is the most common, PDA and VSD are the second. Patients with UAPA have changes of pulmonary artery, the incidence of pulmonary artery abnormalities in multiple malformations, changes of ASD/PFO, PDA and VSD are mainly pulmonary hypertension. The ejection fraction of patients with UAPA is normal. The main manifestation of pulmonary hypertension is the increase of right cardiac volume load, and the main manifestation of pulmonary stenosis is the increase of collateral circulation. Pulmonary hypertension and its associated cardiovascular malformations may be related to the prognosis of patients. Ultrasound doctors should understand such diseases to improve the diagnosis rate and the prognosis.

A better understanding of testicular and/or epididymal tuberculosis based on clinical, ultrasonic, computed tomography, and magnetic resonance imaging features at a high-volume institute in the modern era.

There is a concerning underdiagnosis of testicular and/or epididymal tuberculosis (TB). A lack of clinician awareness has led to many patients undergoing unnecessary surgeries. The purpose of this series was to enhance understanding of testicular and/or epididymal TB based on clinical, ultrasonic, computed tomography (CT), and magnetic resonance imaging (MRI) features from the past decade. We retrospectively investigated the medical records of 69 patients diagnosed with testicular and/or epididymal TB from 2008 to 2019. All participants were diagnosed by confirmation of Mycobacterium tuberculosis in the histopathology of resected samples. Baseline characteristics, ultrasonic, CT, and MRI features were collected for analysis. A total of 69 patients with a median age of 43.5 years were included in the study. Testicular-epididymis TB, epididymal TB, and testicular TB were confirmed in 31 (44.9%), 26 (37.7%), and 12 (17.4%) patients, respectively. In sonography, testicular TB and epididymal TB imaging features are significantly different (P<0.001). Diffusely enlarged lesion heterogeneously (33/58, 56.9%) is most common in the epididymis, and miliary type (18/39, 46.2%) is most common in the testis. On enhanced CT, annular or multilocular enhancement pattern (19/21, 90.5%) was the characteristic manifestation of our patients. Laboratory findings [especially T lymphocyte spot test for tuberculosis infection (T-SPOT.TB)], accompanied by scrotal sonography and enhanced CT examinations, can help distinguish testicular and/or epididymal TB from other etiologies.

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

Analysis of ultrasonographic features of pulmonary ultrasound in children′s community acquired pneumonia

Objective To investigate the lung ultrasonography characteristics of community acquired pneumonia (CAP) in children and to compare the value of lung ultrasonography in the diagnosis of CAP in children. Methods A total of 173 patients with CAP (CAP group) were diagnosed by chest radiograph in our hospital, and 64 healthy children were treated with lung ultrasonography as the control group.The sonographic features of two groups were compared, and the positive rates of diagnosis of lung ultrasonography and chest radiograph in CAP group were also compared. Results It showed A-line disappearance(100%), B-line presence(88.4%), pleural line abnormalities(98.3%), pulmonary consolidation(46.2%), bronchial sign(42.8%), pleural effusion(9.2%), lung sliding signs(97.7%) in CAP group (P<0.001). In the control group, except the A-line disappearance, scattered in the B-line (34.4%), the others were not present.The difference of the two groups was statistically significant (P<0.001). A-line disappearance, B-line (or even fusion), pleural line abnormalities were the main signs of ultrasound in children with CAP, sensitivity and specificity were both 100%.The sensitivity of chest X radiograph was 100% and the specificity was 78.0%. Conclusion The lung ultrasonic imaging features of CAP in children include A-line disappearance, with varying numbers and lengths of B-line, pleural line abnormalities, consolidation, bronchial signs, pleural effusion and so on.LUS can diagnose CAP accurately and reliably, with high sensitivity and specificity.It is simple and noninvasive, and has the advantage of being detected at any time and avoiding the damage of X-ray.So it is worth clinical application for children with respiratory tract diseases. Key words: Lung ultrasound; Community-acquired pneumonia; Children,

Morphological Detection and Functional Assessment of Regenerated Nerve after Neural Prosthesis with a PGLA Nerve Conduit

This study aimed to observe the morphological characteristics of a PGLA [poly(glycolide-co-L-lactide)] nerve conduit and regenerated nerve bundle in the human body using high-frequency ultrasound and examine functional recovery of the regenerated nerve using functional magnetic resonance imaging (fMRI) after neural prosthesis with a PGLA nerve conduit. Thirty-nine patients underwent high-frequency ultrasound, and one patient with superficial radial nerve injury (27-mm defect) underwent fMRI at one, three, and six postoperative months. The fMRI examination results were compared with sensory detection and high-frequency ultrasound results during the same follow-up window period. The normal and regenerated nerve bundles had similar ultrasonic imaging features. At one postoperative month, fMRI displayed activeness of the normal cortex in the brain region corresponding to the contralateral superficial radial nerve, while no activeness was observed on the ipsilateral side. From three to six postoperative months, fMRI revealed gradually increasing activeness in the brain region corresponding to the ipsilateral superficial radial nerve, but the activation area on the ipsilateral side was smaller than that on the contralateral side. Combining morphological detection of the regenerated nerve using high-frequency ultrasound and functional detection of the regenerated nerve using fMRI may be a valuable method for evaluating repair of peripheral nerve injury.

Biliary complications after percutaneous ablation for patients with hepatic malignant tumors: retrospective analysis of ultrasonic imaging features and clinical outcomes

Objective To retrospectively analyze the ultrasonic imaging features and clinical outcomes of biliary complications after percutaneous ablation for hepatic malignant tumors. Methods The cli-nical data of patients with postablation biliary complications who underwent percutaneous ablation for hepatic malignant tumors in the past 7 years in our department were retrospectively analyzed. The ultrasonic imaging features and the clinical outcomes of biliary complications on follow-up of these patients were analyzed. Results Postablation biliary complications occurred in 65 patients, including 34 patients with bile duct dilatation and 31 patients with biloma. In patients with bile duct dilatation, the dilated bile ducts were located distal to the ablation lesions in all these patients. Among 30 patients with bile duct dilatation, the dilatation was progressive in 9 patients (9/30, 30.0%) and stable in 20 patients (20/30, 66.7%), while in one patient (1/30, 3.3%) it resolved on follow-up. The radiologic features of bilomas mainly manifested as four types: crescent, interspersed, circumferential and solitary nodular, and the number of patients with the four types were 13 (13/31, 41.9%), 13(13/31, 41.9%), 3(3/31, 9.7%) and 2(2/31, 6.5%), respectively. In 6 patients (6/31, 19.4%) the bilomas were subjected to interventional or surgical therapy while for the remaining 25 patients (6/31, 19.4%) they were treated conservatively. Three (3/25, 12.0%) of the latter 25 patients had spontaneously disappearance of the biloma and 2 (2/25, 8.0%) of the remaining 22 patients appeared to have progressive increase in size. In 17 (17/25, 68.0%) patients the biloma remained stable in size and in the remaining 3 patients (3/25, 12.0%) the bilomas resolved. Conclusions Postablation biliary complications of ultrasound-guided percutaneous ablation for hepatic malignant tumors mainly presented as biloma and bile duct dilatation. Dilated bile ducts were located in the distal side of the ablation zones. Crescent type and interspersed type were the most common morphological types of biloma. Although most patients with postablation biliary complications of ultrasound-guided percutaneous ablation remained stable or resolved on follow-up, interventional or surgical therapy was necessary in the minority of patients. Key words: Hepatic malignant tumors; Percutaneous ablation; Biliary complication