Objective To explore the diagnostic value of contrast-enhanced ultrasonography (CEUS) in axillary and internal mammary lymph node metastasis of invasive breast cancer. Methods A total of 100 patients with invasive breast cancer treated from September 2020 to September 2022 were selected. Preoperative CEUS examination was completed, and the perfusion sequence, enhancement mode and enhancement sequence of lymph nodes were dynamically observed. The CEUS characteristics of metastatic and benign lymph nodes were compared. Using postoperative pathological results as the gold standard, the diagnostic efficacy of CEUS in evaluating lymph node status was analyzed. Results Among the 100 patients, 28 patients were diagnosed with metastatic axillary lymph nodes (ALN) by pathological biopsy. The sensitivity, specificity, accuracy, positive prediction rate and negative prediction rate of CEUS in evaluating ALN status were 71.4%, 87.5%, 83.0%, 69.0% and 88.7%, respectively. In 9 patients, CEUS showed internal mammary lymph node metastasis, and postoperative pathological examination confirmed that 5 patients had internal mammary lymph node metastasis, so the positive predictive rate of CEUS was 55.6%. Conclusion CEUS can evaluate the metastatic status of axillary and internal mammary lymph nodes.
ObjectiveTo systematically review efficacy of endoscopic ultrasonography guided biliary drainage (EUS-BD) and percutaneous transhepatic biliary drainage (PTBD) on patients with malignant obstructive jaundice.MethodsThe PubMed, EMbase, The Cochrane Library, CBM, WanFang Data, and CNKI were searched online to collect the randomized controlled trials or cohort studies of EUS-BD versus PTBD on the patients with malignant obstructive jaundice from inception to November 30, 2018. Two reviewers independently screened the literatures, extracted the data and assessed the risk of bias of included the studies, then the meta-analysis was performed by using the RevMan 5.3 software.ResultsThree randomized controlled trials and 6 cohort studies involving 496 patients were included. The results of meta-analysis showed that: compared with the PTBD, the EUS-BD had the lower occurrence of complications [OR=0.30, 95% CI (0.20, 0.47), P<0.000 01], lower rate of reintervention [OR=0.11, 95% CI (0.06, 0.22), P<0.000 01], shorter hospital stay [MD=–3.42, 95% CI (–6.72, –0.13), P=0.04], and less hospital costs [SMD=–0.83, 95% CI (–1.16, –0.49), P<0.000 01]. There were no significant differences in the technical success rate [OR=0.88, 95% CI (0.20, 3.85), P=0.86] and clinical effective rate [OR=1.73, 95% CI (0.97, 3.11), P=0.06] between the two groups.ConclusionsCurrent evidence shows that EUS-BD has some advantages of lower occurrence of complications, lower rate of reintervention, shorter hospital stay, and less hospital costs in treatment of patients with malignant obstructive jaundice as compared with PTBD. There are no significant differences between two groups in technical success rate and clinical effective rate. Due to limited quality and quantity of included studies, more high quality studies required to be verified above conclusions.
ObjectiveTo observe the morphologic characteristics of color Doppler flow imaging (CDFI) and blood stream in patients with retinopathy of prematurity, and provide the new clinical diagnostic gist.MethodsCDFI was performed on 78 patients (156 eyes) with ROP at Ⅳ and Ⅴ stage, who had the diseases history such as prematurity and low birthweight which had been diagnosed by indirect ophthalmoscope, underwent the examination of CDFI. Morphologic characteristics of the results of CDFI and features of blood flow of the pathological changes were observed. ResultsIn the patients with ROP at the Ⅳ stage, a weak zonal echo originated from one side of peripheral wall of eye ball in the vitreous body, and extended to the echo of post pole and wall of eye ball and joined the echo of optic disc. In the patients with ROP at the V stage, lumplike echo connected closely with echo of lens and the circumambience was surrounded; the focus looked like lotus when combined with retinal detachment: the swelled “corona” wrapped and tightly connected with the lens, and the thin “caulis” showed weak zonal echo which attached to the optic disc. The features of blood flow showed the signal of blood stream connected with central retinal artery at the “caulis”, which was analyzed by Doppler spectrum as the bloodflow spectrum of artery and vein in the same direction which was the same as the central retinal artery and vein.ConclusionsIn patients with ROP at the IV and V stage, the results of CDFI mainly shows zonal or lumplike echo, in which the bloodflow signal extended with central retinal artery could be seen. The morphological changes of CDFI and the features of blood flow are useful in diagnosis of ROP. (Chin J Ocul Fundus Dis, 2005,21:282-284)
OBJECTIVE: To discuss clinical application of the color Doppler ultrasonography in diagnosis and treatment of cavernous hemangioma in deep subcutaneous tissue. METHODS: From 1996, 15 cases of cavernous hemangioma were diagnosed and located with color Doppler ultrasonography and were embolized under monitoring of the ultrasonography or resected by operation before re-examination of the hemangioma via the color Doppler ultrasonography after the intervention. RESULTS: Direct embolization was achieved in 10 cases after pinpoint location of the hemangioma by the ultrasonography, and guided embolization was performed successfully in 2 cases via the monitoring of ultrasonography, and operation had to be adopted to remove the focus. No reoccurrence of the hemangioma was observed in all the cases. CONCLUSION: Cavernous hemangioma in deep subcutaneous tissue could be easily diagnosed and located with color Doppler ultrasonography, and could be removed by embolization under monitoring of the ultrasonography successfully.
ObjectiveTo explore the safety and feasibility of contrast enhanced intraoperative ultrasonographyguided percutaneous radiofrequency ablation with artificial hydrothorax to hepatocellular carcinoma in the hepatic dome. MethodsThe clinical data of nine patients with hepatocellular carcinoma in the hepatic dome underwent ultrasonographyguided percutaneous radiofrequnecy ablation with artificial hydrothorax from January 2008 to June 2009 at Department of Hepatobiliopancreatic Surgery of West China Hospital were retrospectively analyzed. The perioperative results and recurrence of tumor were also analyzed. ResultsAll of nine patients with twelve tumors received successfully radiofrequency ablation with artificial hydrothorax of (2 444±464) ml (2 000-3 000 ml). The ablation time was 12-24 min (median 12 min), with an average of (15±5) min for each tumor. No hemothorax, pneumothorax, and death occurred during operation. One patient had ascites of 2 000 ml after ablation due to hypoalbuminenia, and ascites disappeared by infusion of abumin on 4 d after operation. The total volume of pleural drainage was 250-1 420 ml, with an average of (717±372) ml for each patient, and the drainage tube was withdrawn on 3-5 d after operation. The followup time was 7-23 months (mean 15 months). Tumor recurrence was found in three patients on 5, 6, and 7 months after operation, respectively. Of them, two patients were in stable disease stage after interventional and conservative therapy, respectively, and one case recurred at six months after operation and died of hypertensive heart disease and hepatic function deterioration at sixteen months after operation. The rest patients survived and no recurrence and metastasis was observed during the follow-up period.ConclusionThe technique of percutaneous radiofrequency ablation with artificial hydrothorax increases the feasibility of the minimal invasive treatment for hepatoma, which can be applied to hepatocellular carcinoma in the hepatic dome with high safety and clinical application value.
Objective To explore the value of color Doppler ultrasonography and plasma D-dimer in diagnosis of lower limb deep venous thrombosis (DVT).Methods The clinical data of 70 cases of patients with lower limb DVT diagnosed clinically were retrospectively studied. The lower limb venous of each patient was examined by color Doppler ultrasonography and the plasma level of D-dimer were measured, furthermore the plasma levels of D-dimer in different phase and different type of thrombosis were compared. Results The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of plasma D-dimer and ultrasonography examination in lower limb DVT were 100%, 66.7%, 97.0%, 100%, and 97.1%, and 98.4%, 83.3%, 98.4%, 83.3%, and 97.1%, respectively. The plasma D-dimer in acute phase 〔(6 451±4 012.22) μg/L〕 and subacute phase 〔(2 063±1831.35) μg/L〕 of lower limb venous thrombosis were significantly higher than that in normal control group 〔(310±66.70) μg/L〕, Plt;0.01 and Plt;0.05, which was not different from that in chronic phase 〔(466±350.52) μg/L〕. Meanwhile, the plasma D-dimer in mixed limb venous thrombosis group 〔(4 464±3 753.16) μg/L〕 and central limb venous thrombosis group 〔(2 149±1 911.53) μg/L〕 were significantly higher than that in control group (Plt;0.05 and Plt;0.01), which was not different from that in peripheral limb venous thrombosis group 〔(560±315.62) μg/L〕. Conclusion Color Doppler ultrasonography is an optimal method and the plasma D-dimer is a predictive index in diagnosis of lower limb DVT.
【Abstract】 Objective To compare the accuracy of color-doppler ultrasonography, mammography and near-infrared light scanning for diagnosing breast diseases. Methods The diagnostic accuracy of the above three imaging methods were analyzed and compared with each other on the basis of the postoperative pathological results. ResultsFive hundreds and sixty-five cases (breast cancer: 274 cases, benign diseases: 291 cases) were examined. The sensitivity of color-doppler ultrasonography, mammography and near-infrared light scanning for diagnosing breast cancer were 83.7%(200/239), 84.2%(64/76) and 76.9%(100/130), respectively. The specificity were 88.6%(226/255), 93.2%(69/74) and 82.6%(114/138), and the accuracy were 86.2%(426/494), 88.7%(133/150) and 79.9%(214/268), respectively. Color-doppler ultrasonography and mammography were superior to near-infrared light in the item of accuracy (P＜0.05), especially for lesions of breast cancers that were less than 2 cm. The false negative rate of near-infrared light was higher (48.8%, 21/43）than those of the other methods in detecting breast cancer at early stage. The sensitivity for detecting intraductal papilloma and inflammation of breast using color-doppler ultrasonography were 58.8%(10/17) and 69.2%(18/26), respectively, which were higher than that of near-infrared light scanning 〔0 and 23.5%(4/17)， P＜0.05 and P＜0.01〕. The sensitivity and the accuracy of near-infrared light without physical examination reduced significantly, in which the sensitivity reduced from 76.9%(100/130) to 56.9%(74/130), P＜0.01, and the accuracy reduced from 79.9%(214/298) to 61.9%(166/268), P＜0.01. Conclusion Color-doppler ultrasonography and mammography are accurate imaging methods for diagnosing breast diseases.
Objective
To explore the minimal invasiveness and practability of combined video-assisted thoracic surgery (VATS) with two trocars and endoscopic ultrasonography (EUS) in the treatment of esophageal leiomyoma.
Methods
Between February 2007 and February 2012, we retrospectively analysed the clinical data of 166 patients who underwent various surgeries for the treatment of esophageal leiomyoma. Among them, 62 received routine thoracotomy (group A), 49 accepted conventional VATS surgery with three trocars (group B), and 55 underwent combined VATS surgery with two trocars and EUS (group C). Then, we summarized the clinical indexes of patients in all the three groups for further comparative analysis.
Results
There was no significant difference among the three groups in age, gender, and lesion location, origin level and size (P > 0.05). There were significant differences between group A and C in blood loss, surgery time, intraoperative localization, postoperative incision pain, hospitalization expenses, length of hospital stay, fasting time, pulmonary infection, and the complications during the follow-up (P < 0.05). There were significant differences between group C and B in blood loss, surgery time, intraoperative localization, fasting time and pulmonary infection (P < 0.05).
Conclusion
Combined VATS surgery with two trocars and EUS is safe, minimally invasive, thorough with few complications, which is worthy of clinical promotion.
摘要:目的:探討超聲與核素顯像在評價干燥綜合征(SS)腮腺受累情況中的價值和作用。方法:對65例SS病人分別進行超聲和核素顯像檢查。結果:超聲判為腮腺功能0級、I級、ⅡⅢ級、Ⅳ級的能力與核素顯像判為正常(χ2=0.075,Pgt;0.05)、輕度(χ2=0.12,Pgt;0.05)、中度(χ2=0.27,Pgt;0.05)、重度(χ2=0.097,Pgt;0.05)受損的能力一致,差異無統計學意義;核素發現單純攝取功能受損的超聲多表現為不均勻型、單純排泌功能受損的超聲多表現為結節型、攝取和排泌功能均受損的超聲多表現為纖維化型。結論:超聲檢查可作為SS患者腮腺受累情況評價的良好手段。Abstract: Objective: To quantitatively evaluate ultrasonography and radionuclide imaging in thediagnosis of parotid gland involvement in Sjogren syndrome (SS). Methods: Ultrasonography and radionuclide imaging were conducted on 65 cases with primary Sjogren syndrome. Results: There was no significant difference statistically between the ultrasonographic appearance of the parotid gland and radionuclide imaging (P gt;0. 05). Conclusion: As for diagnosis and evaluating the parotid gland of Sjogren syndrome, ultrasonography may be the useful choice.
Objective
To observe the axial length and anterior chamber depth in eyes with branch retinal vein occlusion (BRVO).
Methods
Randomly selected 90 eyes of forty-five patients with BRVO were enrolled in this study. There were 25 males and 20 females. The mean age was (46.22±13.45) years. All the patients were underwent examination of visual acuity, slit-lamp microscope, indiophthalmoscope, fundus color photography and fundus fluorescence angiography (FFA). Randomly selected 45 healthy individuals for control group, including 28 males and 17 females. The mean age was (48.24±15.77) years. The axial lengths and anterior chamber depths of affected and fellow eyes of BRVO patients and the eyes of controls were measured using IOL Master. The data were compared by the two sample paired t test.
Results
The mean axial length of the affected eyes in the BRVO group was (22.69±0.99) mm, and that of the fellow eyes group was (22.78±1.24) mm. The difference in axial length between the affected eyes and fellow eyes in the BRVO group was not significant (t=0.355, P＞0.05). The mean axial length of the right eyes in the control group was (23.38±1.32) mm, and that of the left eyes in the control group was (23.37±1.27) mm. The difference in axial length between the left eyes and right eyes in the control group was not significant (t=0.017, P＞0.05), while the difference in axial length between the affected eyes in the BRVO group and the right, left eyes in the control group was significant (t=?2.563, ?2.663; P＜0.05). The mean anterior chamber depth of the affected eyes in the BRVO group was (2.66±0.26) mm, and that of the fellow eyes was (2.65±0.30) mm. The difference in anterior chamber depth between the affected eyes and fellow eyes in the BRVO group was not significant (t=0.089, P＞0.05). The mean anterior chamber depth of the right eyes in the control group was (2.56±0.29) mm, and that of the left eyes was (2.59±0.30) mm. The difference in anterior chamber depth between the left eyes and right eyes in the control group was not significant (t=?0.592, P＞0.05). The difference in anterior chamber depth between the affected eyes in the BRVO group and the right, left eyes in the control group was not significant (t=1.779, 1.778, P＞0.05).
Conclusion
In the affected eyes of BRVO, the axial length is shorter and anterior chamber depth is normal.
