Results Of Ultrasound Examination Research Articles

Optimization of fine-needle aspiration biopsy of the thyroid nodes in complex diagnostic situations

Purpose of the study. To identify the most informative combinations of small non-coding RNA molecules (miRNA) associated with malignant tumors of the thyroid gland (TG) in patients with nodular formations with an uncertain conclusion based on fine needle aspiration biopsy (FNA) and the absence of gene mutations.Materials and methods. The study included 83 patients with thyroid nodules according to the results of ultrasound examination with an indefinite cytological conclusion based on FAB materials (category III–V according to the Bethesda classification) and the absence of V600E mutations in the BRAF gene, NRAS, HRAS, KRAS genes in the molecular genetic study of the aspirate. Expression activity of miRNA was determined by realtime PCR in aspirate. Using cluster analysis, homogeneous groups of miRNAs associated with malignant thyroid lesions in patients were identified.Results. In the cells of thyroid nodules obtained during FNA, malignant lesions are associated with an increase in the expression activity of miRNA‑146b,–221,–222,–885–5p and a decrease in the expression of miRNA‑455–3p and miRNA‑574–3p. Reciprocal changes in expression activity in pairs miRNA‑146b/miRNA‑574–3p, miRNA‑221/miRNA‑455–3p, miRNA‑222/miRNA‑574–3p, miRNA‑885–5p/miRNA‑574–3p are more informative when differential diagnosis of benign and malignant thyroid formations than assessing the expression of individual miRNAs.Conclusion. With an uncertain cytological conclusion based on the FAB data of thyroid nodules (categories III–V according to the Bethesda classification) and negative results of a molecular genetic study regarding gene mutations, it is recommended to direct further diagnostic search in determining the expression in the aspirate of miRNA‑146b,–221,–222,–885–5p,–455–3p,–574–3p.

- Correlation between 25-hydroxyvitamin D Level of Lactating Mothers and Bone Mineral Density of Infants and Analysis of Risk Factors

Abstract: it was to demonstrate the influencing factors of infant bone mineral density(BMD) and its correlation with serum 25-hydroxyvitamin D (25-(OH)D) in nursing mothers. 200 children aged 0 ~ 1 years were rolled into normal group (n=120) and abnormal group (n=80) regarding the results of ultrasound BMD examination. The sunshine duration of infants with different BMD and 25-(OH)D, calcium and phosphorus levels of nursing mothers were analyzed, and univariate and multivariate analyses of BMD were implemented. The results revealed that the sunshine duration and serum 25-(OH)D level of nursing mothers in abnormal group were inferior to those in normal group (P<0.05). Additionally, a notable positive correlation existedbetween sunshine duration, serum 25-(OH)D level of nursing mothers and BMD (r = 0.911 and 0.503, P<0.05). According to Logistic regression analysis, outdoor activity time 0 ~ 1 h/d, premature infants, and breastfeeding alone were independent risk factors (RFs) for abnormal BMD in infants, and vitamin D(VD) and calcium supplementation were independent protective factors (P<0.05). VD and calcium intake, adequate sunshine duration, mixed feeding, and increasing serum 25-(OH)D can reduce the occurrence of abnormal BMD in infants.

Ultrasound findings in 34 newborn foals with uroperitoneum.

Uroperitoneum is a typical disease of the newborn foal, which occurs rarely but regularly. Ultrasonography is considered the most important imaging method for diagnosing this disease. Thus far, only one older case series comprising 31 foals suffering from uroperitoneum has systematically listed results of ultrasound examinations. This paper presents the findings of an ultrasonographic examination of 34 foals with uroperitoneum in order to inform future interpretation of ultrasonographic data in suspected uroperitoneum cases. Ultrasonographic data of 34 neonatal foals up to the age of 14 days diagnosed with uroperitoneum between 2006 and 2022 were analysed. Most foals demonstrated highly increased levels of free (97%), anechogenic (91%) fluid in the abdomen. Although the urinary bladder was frequently visible (50%), bladder wall discontinuity was only occasionally detectable (18%). Transabdominal ultrasonography has proved to be a very reliable imaging method for diagnosing suspected uroperitoneum. It is recommended that it be used in every case of suspected uroperitoneum in order to exclude differential diagnoses.

Relationship between carotid atherosclerosis and lipoprotein (a) in patients with acute ischemic stroke.

This study aimed to examine the relationship between lipoprotein (a) (Lp[a]) and other blood lipid indexes and carotid artery atherosclerosis in patients with acute ischemic stroke (AIS). A total of 2,018 patients were selected from the hospital "acute stroke intervention and secondary prevention registration database" by identifying blood fat indexes (cholesterol, triglyceride, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol and Lp[a]). Based on the results of carotid artery ultrasound examinations, the patients were divided into a "no plaque" group, comprising 400 patients, a "plaque and no stenosis" group, comprising 1,122 patients and a "carotid stenosis" group, comprising 496 patients. The relationship between Lp(a) and blood lipid indexes and carotid artery atherosclerosis was then investigated using multi-factor logistics regression analysis. There were 400 patients (19.8%) with no carotid plaque, 1,122 patients (55.6%) with plaque and no carotid stenosis and 496 patients (24.6%) with carotid stenosis. As the degree of carotid artery atherosclerosis increased, the Lp(a) level gradually increased; Lp(a) and cholesterol were identified as independent risk factors for carotid atherosclerosis. Lipoprotein (a) and cholesterol are independent risk factors for patients with AIS with carotid atherosclerosis, and their levels increase with the degree of carotid artery atherosclerosis; therefore, attention should focus on levels of cholesterol and Lp(a) in acute stroke patients to control atherosclerosis effectively.

Quantitative Pancreatic Ultrasonography and Vcheck cPL Rapid Test in Dogs with Suspected Acute Pancreatitis

Abstract The aim of this study was to evaluate the importance of quantitative ultrasonography in the diagnosis of acute pancreatitis in dogs, as well as to examine the correlation between the results of ultrasound examination and the Vcheck cPL rapid test in dogs with suspected acute pancreatitis. A total of 37 dogs were included to the study – 15 healthy dogs and 22 dogs with gastrointestinal clinical signs which had at least 1 out of 3 criteria (vomiting, cranial abdominal pain and jaundice). Serum was collected to evaluate cPL level by Vcheck cPL rapid test. A score 0 implied the Vcheck cPL Rapid test result was less than 200 ng/ml. A score 1 implied Vcheck cPL Rapid test result between 200 and 400 ng/ml, and a score 2 more than 400 ng/ml. Ultrasound was performed in all dogs in order to investigate the pancreatic lesions within 48 hours and evaluate the level of pancreatitis by score from 0 to 2. The criteria for pancreatitis on ultrasonograms included enlargement or irregularity of the pancreas, hypoechoic areas of the pancreas and hyperechoic mesentery surrounding the pancreas. An ultrasound assessment of pancreatitis implied: score 0 when none of the criteria was present. Score 1 when 1–2 from 3 criteria were present, and score 2 when all of the 3 criteria were present. Correlation between Vcheck cPL Rapid test and pancreatic ultrasonography was examined. The results indicate that agreement of Vcheck cPL Rapid test and pancreatic ultrasonography had kappa values of 0.71 which are in the “moderate” agreement range. This means that both Vcheck cPL Rapid test and ultrasonography should be used in the diagnostics of acute pancreatitis in daily clinical practice. Additionally, quantitative ultrasound assessment can be helpful in distinguishing acute pancreatitis from normal pancreas.

Ultrasound-guided accesses for regenerative injection therapy of hip and knee

Interventional diagnostic and therapeutic technologies have gained considerable popularity in many surgical specialties – cardiology, vascular surgery, neurosurgery, oncology, and in orthopedics and traumatology. But unlike other specialties, ultrasound became the driving force behind the development and implementation of interventional technologies in the treatment of diseases of the musculoskeletal system. In recent years, ultrasound-guided injections have gained significant popularity, as they have given an advantage in accuracy compared to injections without such navigation. The purpose of our study was the development of ultrasound navigation accesses to the hip and knee joints for the interventional application of regenerative technologies in their pathology. The material for the study was the results of ultrasound examination of the hip and knee joints of 486 patients with diseases and injuries of the hip and knee, who were treated in the scientific and practical department of tissue and cell therapy of the State Institute of Traumatology and Orthopedics of the National Academy of Medical Sciences of Ukraine in the period from 2016 to 2023. The results. The following accesses to the knee joint under ultrasound navigation have been developed: suprapatellar longitudinal access for injections into the quadriceps tendon and patellofemoral joint, suprapatellar longitudinal access with knee bending for injections into the upper turn of the knee joint, infrapatellar longitudinal access for injections into the patellar ligament and deep infrapatellar bursa, infrapatellar transverse access for injections into Hoffa’s fat pad, lateral longitudinal access with knee bending for injections into the lateral meniscus, medial longitudinal access with bending in the knee for injections in the medial meniscus, medial transverse access for injections in the medial part of the joint space, lateral transverse access with bending in the knee joint for injections in the lateral part of the joint space, lateral longitudinal access for performing injections in the collateral fibular ligament, medial longitudinal access for performing injections in the collateral tibial ligament, infrapatellar diagonal access for performing injections in the “crow’s foot” area of the knee joint, infrapatellar medial longitudinal access for performing other injection into the medial meniscus and joint capsule, lateral longitudinal access for injections into the tendons of the biceps femoris and hamstrings. The following accesses have been developed for the hip joint: anterior longitudinal access for performing injections in the subcapsular-cervical space, anterior diagonal access for performing injections in the acetabular labrum, capsule-ligament apparatus of the hip and tendon of the rectus femoris muscle, lateral longitudinal access for performing injections in the paratrochanteric region. Conclusions. 13 ultrasonic navigation accesses have been developed for the administration of biotechnological products into the knee joint and 3 – into the hip join, which allow not only to detect damaged intra-articular and para-articular structures of the knee and hip joints, but also to deliver an orthobiologics products directly to them for maximum regenerative effect.

Correlations of IL-1 and IL-6 Gene polymorphisms with hypertrophic cardiomyopathy.

The purpose of this study was to explore the correlations of interleukin-1 (IL-1) and IL-6 gene polymorphisms with hypertrophic cardiomyopathy (HCM). A total of 200 patients with HCM were enrolled as disease group, and 200 healthy individuals were included as control group. Peripheral blood was collected from all subjects in both disease and control groups. Gene polymorphisms and serum expression levels of IL-1 and IL-6 were detected, and conjoint analysis was performed based on results of cardiac color Doppler ultrasound examination. The allele distribution of IL-1 rs1878320 showed a difference between disease and control groups (P=0.000). The frequency of the allele T was lower in disease group. The genotype distribution of IL-1 rs1878320 (P=0.001) and IL-6 rs1474347 (P=0.000) in disease group was different from that in control. The frequency of TC genotype of IL-1 rs1878320 was lower in disease group, and that of CA genotype of IL-6 rs1474347 was higher in disease group. There was a difference in the distribution of the dominant model of IL-6 rs1474347 between disease and control groups (P=0.021), and the frequency of CC + CA in the dominant model was 171 (0.855). The frequency of AC haplotype of IL-1 gene was overtly higher in disease group (P=0.000), while the frequency of AT haplotype was lower in disease group (P=0.000). The IL-1 rs1516792 polymorphism had an association with serum IL-1 level (P<0.05), the IL-1 level was notably increased in the patients with the genotype AA, and it was higher in disease group. The polymorphism of rs1878320 locus in IL-1 gene was correlated with interventricular septal (IVS) (P=0.047), and IVS was reduced in the patients with TC genotype. The polymorphism of rs1516792 locus in IL-1 gene was distinctly related to left ventricular outflow tract (LVOT) (P=0.041), and LVOT was lowered in the patients with GG genotype. The IL-6 rs2069831 polymorphism was associated with left ventricular ejection fraction (LVEF) (P=0.035), and LVEF declined in the patients with TT genotype. The IL-1 and IL-6 gene polymorphisms are correlated with the susceptibility and progression of HCM.

Ultrasound examination of the gonads of the african clary catfish in industrial aquaculture

The article is devoted to ultrasound examination of the gonads of the African clary catfish. Data on the state of the reproductive system of fish are the basis for the formation of a high-quality breeding stock. In mature fish, the state of the gonads is an informative indicator and reflects the general physiological state of the body. The object of the study was the African clarias catfish (Clarias gariepinus). A group of 10 individuals, including 5 males and 5 females, was selected for the work. The gonads were examined using the Mindray DP-50 ultrasound machine. A linear ultrasonic sensor was used to assess the gonads of the African clary catfish. The study was conducted in winter 2023. The aim of the work was an ultrasound assessment of the condition, the stage of maturity of the gonads and their variability in females and males of the African clary catfish. A study of the gonads of females, which by age and weight belong to the category of sexually mature, revealed in them the signs inherent in the gonads of the IV stage of maturity. This is typical for fish in aquaculture conditions. Ultrasound diagnostics showed that the gonads of the IV completed stage of maturity, in the upper part isoechoic, are filled with hyperechoic inclusions of high density in the form of oocytes. In the lower medial part there are hypoechoic areas with low density along the entire length of the gonads. The results of ultrasound examination of the testicles of male clary catfish showed that they are of the IV stage of maturity, enclosed in a hyperechoic shell along the entire length. Both testes have a uniform hyperechogenic fine-grained structure of high density. The lobes of both testes are not the same, clearly visualized, increased density. The results of the research allow us to conclude that ultrasound diagnostics of the sex and the study of the gonads of fish can be carried out on an ongoing basis, as it is not only painless, but also a highly informative procedure. For fish species that have lost their ability to reproduce in aquaculture conditions, determining the maturity stage of gonads using ultrasound will allow for scientifically sound hormonal stimulation and fertilization.

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.

A case report of single umbilical artery combined with fetal bladder exstrophy in singleton pregnancy and related literature review

BackgroundAccording to prenatal ultrasonographic studies, single umbilical artery may be present alone or in association with other fetal abnormalities. So far, the exact pathogenesis of bladder exstrophy is unclear. Some scholars believe that bladder exstrophy and cloacal exstrophy should be regarded as a disease spectrum to explore their pathogenesis. If bladder exstrophy and cloacal exstrophy are regarded as the same disease spectrum, then we can speculate that the single umbilical artery should have the probability of being accompanied by bladder exstrophy at the same time.Case presentationFor the first time, we report a rare case of fetal bladder exstrophy with single umbilical artery in single pregnancy. This patient underwent targeted color Doppler ultrasound at 26 weeks of pregnancy which first suspected bladder exstrophy with single umbilical artery and fetal MRI for diagnosis at 38 + 3 weeks of pregnancy which confirmed the suspicion. After the diagnosis was confirmed, the patient was scheduled for a multidisciplinary discussion. Ultimately the patient opted for induced fetal demise at 38 + 5 weeks of pregnancy and the physical appearance of the fetal demise affirmed previous ultrasound and MRI examination results.ConclusionsOur report is the first finding of single umbilical artery combined with bladder exstrophy in a singleton pregnancy. Accordingly, our case enhances the evidence that cloacal exstrophy and bladder exstrophy should be treated as the same disease spectrum. In addition, we conducted a literature review on the diagnostic progress of single umbilical artery combined with bladder exstrophy, hoping to provide useful references for the diagnosis of this disease.

Clinical and morphological features and unsolved issues in diagnosis of aggressive forms of papillary thyroid carcinoma

Differentiated thyroid cancer (DTC) is a disease with a favorable clinical course and high survival rate compared to other epithelial tumors. The majority of DTC (up to 85 %) is represented by various subtypes of papillary thyroid cancer (PTC). Aggressive forms of PTC characterized by early lymphogenous and hematogenous metastasis, low avidity to radioiodine therapy (RIT), low relapse-free survival rates and high mortality rate compared to other types of PTC occur among them. Preoperative diagnosis of PTC is based on the results of ultrasound (US) examination and fine-needle aspiration biopsy (FNA) with cytological examination of the aspirate. At the same time, the capabilities of cytological examination in determining the histological type of PTC are limited and it does not allow to predict its aggressiveness and plan adequate treatment. Molecular genetic tests of the tumor cytological and morphological material are effective in prognosis of aggressiveness of PTC due to the determination of specific mutations in the BRAF, TERT, RAS genes and the quantitative expression of oncogenic and tumor suppressive microRNAs. Some of these indicators are already used in the morphological classification of tumors of the endocrine system.&#x0D; At the same time, there are contradictory data concerning the connection of the molecular genetic portrait of PTC, the clinical manifestations of its aggressiveness (extrathyroidal invasion, early metastasis, and radioiodine resistance) and its pathomorphological structure. We tried to summarize and analyze the literature data regarding the diagnosis of aggressive variants of PTC.

Comparative analysis of the linear dimensions of the ovary, determined using sonography, in an age aspect

Aim of the study was to carry out a comparative analysis of the linear size of the right and left ovaries, determined using sonography in women in adolescence, the elderly, and old age.Material and methods. The study was based on the results of ultrasound examination of 84 women with normal pelvic dimensions who were examined at the gynecology department of the Perm Krai Clinical Hospital during the period 2021–2022 in order to exclude probable pathology of the reproductive system. Measurement of longitudinal (length), transverse (width), and anteroposterior (thickness) dimensions of the ovary was performed using transvaginal access. Women were divided into three groups: the first consisted of 28 adolescents (16 to 20 years old), the second – 29 elderly persons (56 to 74 years old), the third – 27 seniors (75 to 85 years old).Results. When comparing the indicators of ovarian size, their statistically significant decrease by old age was revealed. Right ovary length from adolescence to the old age decreased by 20.56 % (p &lt; 0.01), left – by 28.62 % (p &lt; 0.01). Right ovarian width becomes smaller by 20.87 % (p &lt; 0.01) in elderly age and by 26 % (p &lt; 0.01) in senile age, left – by 20.8 % (p &lt; 0.01) and by 28.32 % (p &lt; 0.01), respectively, the anteroposterior dimension of the right ovary – by 23.2 % (p &lt; 0.01) and by 38.8 % (p &lt; 0.01), of the left ovary – by 31.19 % (p &lt; 0.01) and by 39 % (p &lt; 0.01), respectively.Conclusions. The results obtained allow us to expand our understanding of the features of the age-related structure of the ovaries and further continue their detailed study, since new knowledge is needed to develop modern methods for the prevention of pathology of the female reproductive system and the timely provision of quality medical care.

DopUS-Net: Quality-Aware Robotic Ultrasound Imaging Based on Doppler Signal

Medical ultrasound (US) is widely used to evaluate and stage vascular diseases, in particular for the preliminary screening program, due to the advantage of being radiation-free. However, automatic segmentation of small tubular structures (e.g., the ulnar artery) from cross-sectional US images is still challenging. To address this challenge, this paper proposes the DopUS-Net and a vessel re-identification module that leverage the Doppler effect to enhance the final segmentation result. Firstly, the DopUS-Net combines the Doppler images with B-mode images to increase the segmentation accuracy and robustness of small blood vessels. It incorporates two encoders to exploit the maximum potential of the Doppler signal and recurrent neural network modules to preserve sequential information. Input to the first encoder is a two-channel duplex image representing the combination of the grey-scale Doppler and B-mode images to ensure anatomical spatial correctness. The second encoder operates on the pure Doppler images to provide a region proposal. Secondly, benefiting from the Doppler signal, this work first introduces an online artery re-identification module to qualitatively evaluate the real-time segmentation results and automatically optimize the probe pose for enhanced Doppler images. This quality-aware module enables the closed-loop control of robotic screening to further improve the confidence and robustness of image segmentation. The experimental results demonstrate that the proposed approach with the re-identification process can significantly improve the accuracy and robustness of the segmentation results (Dice score: from <inline-formula xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"> <tex-math notation="LaTeX">$0.54$</tex-math> </inline-formula> to <inline-formula xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"> <tex-math notation="LaTeX">$0.86$</tex-math> </inline-formula> ; intersection over union: from <inline-formula xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"> <tex-math notation="LaTeX">$0.47$</tex-math> </inline-formula> to <inline-formula xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"> <tex-math notation="LaTeX">$0.78$</tex-math> </inline-formula> ). <italic xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">Note to Practitioners</i> —The Doppler signal is important for the diagnosis of vascular disease, e.g., peripheral arterial disease, in clinical practices, nevertheless it is not of similar significance for state-of-the-art robotic ultrasound (US) examination systems yet. This paper explores various neural network structures to effectively extract the blood vessels from US images by incorporating the Doppler signal into the segmentation process. The final DopUS structure with two encoders extracting differentiated information from two different inputs and fusing the latent feature representations in the bottleneck layer can also inspire other tasks like multi-senor fusion. In addition, this work developed a Doppler-based tracker to assess the quality of the segmentation results in real-time. The assessment is subsequently used for a quality-aware module that enables closed-loop control of the robotic screening. Preliminary physical experiments suggest that the quality-aware robotic screening system can improve the confidence and robustness of autonomous US examination results. In the future, the Doppler signal could also be used to support clinical diagnosis. We believe the proposed quality-aware autonomous screening system is important for the development of large-scale robotic US screening programs. It will not only benefit the examination of limb arteries but also other vascular structures, e.g., carotid or aorta.

Analysis of immune cells and risk factors related to lower limb deep vein thrombosis in patients with cerebral infarction.

This study retrospectively analyzed data from 174 patients with cerebral infarction admitted to The Rehabilitation Department of Shanghai Fifth Rehabilitation Hospital and Shanghai First People's Hospital from June 2022 to June 2023. Based on the results of lower limb venous color Doppler ultrasound examinations, patients were divided into two groups: the LDVT group (35 cases) and the non-LDVT group (139 cases). We compared the clinical data and hematologic indicators (D-dimer value, fibrinogen, white blood cells, platelets, uric acid, creatinine, etc.) of the two groups to identify the risk factors of cerebral infarction complicated with LDVT. Statistical analysis revealed that the D-dimer values of the LDVT group were significantly (P<0.05) higher than those of the non-LDVT group. The uric acid value of the LDVT group was significantly lower than that of the non-LDVT group, with statistical significance (P<0.05). The Brunnstrom staging in the LDVT group was significantly different from that in the non-LDVT group (P<0.05). Meanwhile, binary logistic regression analysis showed that LDVT complicated with cerebral infarction was associated with D-dimer level [OR=1.302, 95% CI (1.077, 1.575)], uric acid level [OR=0.995, 95% CI (0.990, 1.000)], and Brunnstrom staging [OR=3.005, 95% CI (1.312, 6.880)]. D-dimer value, uric acid value, and Brunnstrom stage I to II are closely related to the occurrence of LDVT in patients with cerebral infarction. High D-dimer value, low uric acid value, and Brunnstrom stage I to II are independent risk factors for LDVT in cerebral infarction. Early assessment of D-dimer value, uric acid value, and Brunnstrom stage of cerebral infarction should be considered in clinical practice.

Evaluating the features of breast lesions identified by bimodal breast examination: a real-world study.

Several image-based diagnostic methods have been developed to examine the features of breast lesions among women, while the value of combining palpation imaging and ultrasound by a bimodal breast examination system is still unknown. A real-world study was conducted among 424 patients who visited Fujian Maternal and Child Health Hospital and Fujian Obstetrics and Gynecology Hospital, and used the Bimodal Breast Exam (BBE) systems which combines palpation imaging and ultrasound imaging. Among them, 97 patients had additional ultrasound, mammogram, or pathological examination. These patients were used to evaluate the consistency and efficacy of the BBE in interpreting the features of breast lesions as compared to results of ultrasound, mammogram, and pathological examinations. The BBE system detected 1517 lesions with palpation imaging, 1126 lesions with ultrasound examination (950 solid lesions and 176 cysts), and 391 non mass lesions. Among them, 404 patients were diagnosed as benign and 20 were diagnosed as malignant tumor. However, 12, 9 and 4 cases were diagnosed as malignant tumors by ultrasound, mammogram and pathological examination, respectively. Compared with the integrative results of ultrasound, mammogram and pathology, the sensitivity of BBE is 55.6%, and the specificity is 90.9%, with a kappa coefficient of 0.387 (0.110, 0.665), indicating moderate consistency. In clinical practice, BBE can be used to evaluate features of breast lesions with a high specificity. The diagnostic efficacy is comparable to the integrative results of ultrasound, mammography, and pathological examination.

Ultrasound assessment of the risk of venous thromboembolic complications in thrombosis of varicose transformed tributaries of the great saphenous vein.

Aim: To evaluate the ultrasound criteria for venous thromboembolic complications in patients with thrombosis of varicose veins of the tributaries of the great saphenous vein (GSV). Materials and Methods: The results of ultrasound examination of 52 patients with thrombosis of varicose veins of the tributaries of GSV were analyzed. The indicators of venous hemodynamics were compared with the control group (CG) (n=32). Results: Varicose transformation of GSV and failure of its valvular apparatus were detected in 44 (84.6%) patients, in 8 (15.4%) patients the superficial venous highway was intact. Vertical reflux was diagnosed in varicose ectasia of GSV: local reflux in 14 (31.8%), widespread reflux in 14 (31.8%), and total reflux in 16 (36.4%) patients. The diameter of GSV in tributary varicothrombophlebitis was 8.9±0.27 mm (p<0.05 vs. CG) and 11.2±0.25 mm (p<0.05 vs. CG) in the horizontal and vertical positions, respectively. The proximal and distal borders of thrombosis exceeded the clinical ones by 15.26±1.21 cm (p<0.05) and 7.94±1.32 cm (p<0.05), respectively. The spread of tributary thrombophlebitis to the superficial venous highway was detected in 14 (26.9%) patients, among whom 12 (85.7%) patients had unfixed apices of thrombotic masses. Conclusions: The results obtained convincingly demonstrate the need for early ultrasound examination of patients with tributary thrombophlebitis, which allows to identify the real limits of the thrombotic process, timely diagnose the transition of the thrombotic process to superficial and deep venous lines, effectively predict the risk of venous thromboembolic complications and choose the optimal surgical tactics.

Laporan Kasus: Pyometra Pada Anjing Ras Labrador

Pyometra is one of the important causes of infertility in female animals, including dogs. Pyometra is accumulation of pus in the uterus caused by bacteria that are normally in the uterus but in certain circumstances become pathogens due to hormonal influences. This case report aims to determine the etiology, clinical symptoms, diagnosis, prognosis and treatment of pyometra disease in dogs. The examination method that is carried out is physical examination and investigations, hematology, blood chemistry, and ultrasound. Based on a physical examination in the form of inspection of the lesions on the vulva and abdominal enlargement. Palpation of the mesogastrium and hypogastrium is the presence of abdominal tension. Hematologic results show leukocytosis, neutrophilia, and hyperchromic normocytic anemia. Blood chemistry examination results showed azotemia, increased AST, ALP and GGT. Ultrasound examination results show that an anechoic period is accumulation of uterine fluid and thickening of the uterine wall. The diagnosis of this case is pyometra. The therapy performed is ovariohisterectomy surgery. After surgery animals were given medicines including Cephalexine, Meloxicam, Ursodeoxycholic acid, and S-adenosylmethionine (SAMe). On the sixth day the animal surgery post improves again and is allowed to be taken home.

ULTRASOUND SIGN «CALCIFICATION» OF NODULAR THYROID NEOPLASMS WHEN USING THE TI-RADS SYSTEM (CASE REPORT)

The problem of improving the quality of early differential diagnosis of thyroid nodules remains relevant, since the number of patients with this pathology is steadily increasing. Obtaining reliable criteria for node malignancy is clinically significant for carrying out further therapeutic and diagnostic measures. In the case of detecting calcifications during ultrasound examination of the thyroid gland, the choice of tactics becomes more complicated, since today there is no unified understanding of the value of calcifications, and contradictions in their assessments persist. The aim is to demonstrate the complexity of differential diagnosis of nodular thyroid pathology using the clinical example. Results. The article presents a clinical case which is complex from a diagnostic point of view; it is a clinical case of nodular thyroid pathology in a patient aged 71 years. To make the diagnosis, a multiparametric ultrasound examination was performed in В-mode. Based on the results of multiparametric ultrasound examination, indications for a fine needle aspiration biopsy were determined and further management for the patient with nodular thyroid formation was determined. The results of the multiparametric ultrasound examination were ambiguous. In B-mode, the nodes were characterized by a hypoechogenic heterogeneous structure with multiple cystic cavities with intersections and microcalcifications. Taking into account these signs, the nodes were assessed as malignant (TI-RADS4). The patient underwent a fine needle aspiration biopsy, the results of which indicated goiter with signs of regressive changes (Bethesda II). The conclusion of the pathomorphological study indicated stromal calcinosis. Conclusions. Taking into account the ultrasound sign of "calicificates" made it possible to more accurately assess the nature of pathomorphological changes in the nodes in the right (TI-RADS4) and left (TI-RADS4) lobes of the thyroid gland, which was then confirmed by a pathomorphological study. Thus, multiparametric ultrasound remains the leading method in the diagnosis of nodular thyroid pathology.

MAMMOGRAPHICALLY DETERMINED ASYMMETRIES OF THE MAMMARY PARENCHYMA: CAUSES AND OPPORTUNITIES OF THEIR MAMMOGRAPHIC AND ULTRASOUND DIFFERENTIAL DIAGNOSIS

The incidence of asymmetries is 1-2% of all mammographic studies performed. However, there is no data in the literature on the prevalence of individual causes for mammographically determined asymmetries, as well as information about the opportunities of mammography and ultrasound examination (U/S) in their differential diagnosis. The aim of the study is to assess the incidence of individual causes for mammographically determined asymmetries and the opportunities of mammography and ultrasound of the mammary glands in their differential diagnosis. Material and methods. The results of mammographic and ultrasound examination of 202 patients were analyzed, in whom zones of asymmetrically distributed breast tissue were detected during mammography. Results. Technical asymmetries were detected in 14 out of 202 cases (6.93%) and could not be adequately analyzed. The true ones were asymmetries without space-occupying lesions caused by asymmetric uneven distribution of glandular (as a rule) or fibrous tissue (161 out of 202; 79.70%), as well as asymmetric edema of the breast parenchyma not associated with edematous infiltrative form of breast cancer (1 out of 202; 0.50%). These cases have always required performing breast ultrasound. The causes of true asymmetries caused by the presence of a space-occupying lesion were malignant neoplasms (breast cancer; 7 out of 202; 3.47%), benign formations (cysts, fibroadenomas, granulomas, abscesses, hematomas, chronic mastitis and other focal benign processes; 11 out of 202; 5.45%). These cases also required to perform breast ultrasound. The cause of the true asymmetries were also postoperative scars (8 out of 202; 3.96%), the differential diagnosis of which did not require ultrasound, but it and/or magnetic resonance mammography were required to assess the condition of the scar for its possible malignant transformation. Conclusions. The largest proportion of mammographically determined asymmetries in the density of mammary parenchyma (79.70%) are physiological variants of asymmetrically distributed tissues of this organ; their differential diagnosis and that of asymmetries caused by space-occupying lesions, according to mammography findings, is difficult, which requires additional ultrasound of the mammary glands. At the same time, mammography makes it possible to confidently identify technical asymmetries of the breast requiring no use of ultrasound, however, the interpretation of such sets of mammograms does not seem correct.

Possibilities of ultrasound diagnostics of paragangliomas of the neck

The purpose of the study is to evaluate the results of ultrasound examination, generalize the criteria for differential diagnosis of various types of paragangliomas in neck area and the development of a standard ultrasound protocol that provides information about the resectability of formations.Material and methods. 91 patients (100 tumors) with a clinical diagnosis of neurogenic neck tumor were examined, of which 71 (71%) were carotid paragangliomas, 18 (18%) – vagal paragangliomas, 10 (10%) – neurinomas and 1 (1%) – neurofibroma. All patients underwent ultrasound examination, including examination of the tumor structure in B-mode, assessment of the size and prevalence formations relative to the base of the skull and color Doppler mapping to assess the degree of intra-tumor blood flow and the relationship of formations with carotid arteries.The study allowed us to systematize the main ultrasound signs characteristic of various neurogenic neck tumors, among which we identified: clear, even contours; the presence of a capsule; a heterogeneous, predominantly hypoechoic structure with hyperechoic inclusions resembling “salt–pepper”. The following parameters played a crucial role in differential diagnosis: localization of formation, features of intra-tumor blood flow and the relationship of paragangliomas with carotid arteries.Results. Evaluation of the structural features of the tumor in the B-mode did not show significant differences between various paragangliomas, neurinomas and neurofibromas, all formations had clear, even contours, their capsule was clearly visualized. For carotid paragangliomas in all 71 (100%) observations, the characteristic feature was the location in the bifurcation area of the common carotid artery, with the mouths of the internal and external carotid arteries moving apart, which was 100% the diagnostic criterion of this group of formations. Vagal paragangliomas or neurinomas in all cases were located outside the bifurcation of the carotid artery, although in close proximity to the carotid arteries. The nature and degree of intra–tumor vasularization is another argument in the differential diagnosis of paragangliomas, which, unlike other neurogenic tumors, are highly vascularized tumors. The study of the nature of the intracellular blood flow showed that arterial paragangliomas predominate vessels, unlike neurinomas and neurofibromas, have significantly poorer vascularization with a predominance of venous vessels in the structure of the tumor. In 8 (44%) cases, vagal paragangliomas sprouted into the adventitia of the carotid arteries, which was characterized by a local increase in blood flow in this area in combination with turbulence during ultrasound.Conclusion. The proposed algorithm of ultrasound examination of neurogenic formations in the neck area makes it possible already at the primary stage instrumental diagnostics to identify volumetric formations, differentiate them between themselves and with other neck formations and to assume the degree of traumatism of the proposed surgical intervention.