Objective: The automated breast ultrasound system(ABUS) is a potential method for breast cancer detection;however, its diagnostic performance remains unclear. We conducted a hospital-based multicenter diagnostic st...Objective: The automated breast ultrasound system(ABUS) is a potential method for breast cancer detection;however, its diagnostic performance remains unclear. We conducted a hospital-based multicenter diagnostic study to evaluate the clinical performance of the ABUS for breast cancer detection by comparing it to handheld ultrasound(HHUS) and mammography(MG).Methods: Eligible participants underwent HHUS and ABUS testing; women aged 40–69 years additionally underwent MG. Images were interpreted using the Breast Imaging Reporting and Data System(BI-RADS).Women in the BI-RADS categories 1–2 were considered negative. Women classified as BI-RADS 3 underwent magnetic resonance imaging to distinguish true-and false-negative results. Core aspiration or surgical biopsy was performed in women classified as BI-RADS 4–5, followed by a pathological diagnosis. Kappa values and agreement rates were calculated between ABUS, HHUS and MG.Results: A total of 1,973 women were included in the final analysis. Of these, 1,353(68.6%) and 620(31.4%)were classified as BI-RADS categories 1–3 and 4–5, respectively. In the older age group, the agreement rate and Kappa value between the ABUS and HHUS were 94.0% and 0.860(P〈0.001), respectively; they were 89.2% and0.735(P〈0.001) between the ABUS and MG, respectively. Regarding consistency between imaging and pathology results, 78.6% of women classified as BI-RADS 4–5 based on the ABUS were diagnosed with precancerous lesions or cancer; which was 7.2% higher than that of women based on HHUS. For BI-RADS 1–2, the false-negative rates of the ABUS and HHUS were almost identical and were much lower than those of MG.Conclusions: We observed a good diagnostic reliability for the ABUS. Considering its performance for breast cancer detection in women with high-density breasts and its lower operator dependence, the ABUS is a promising option for breast cancer detection in China.展开更多
Delayed liver laceration following transjugular intrahepatic portosystemic shunt (TIPS) is a serious and likely underdiagnosed complication. It is however an important complication following TIPS, which remains one of...Delayed liver laceration following transjugular intrahepatic portosystemic shunt (TIPS) is a serious and likely underdiagnosed complication. It is however an important complication following TIPS, which remains one of the most technically challenging interventional procedures performed. In addition to laceration, a number of complications regarding bleeding and perforation are well described following TIPS procedures. We feel the adoption of techniques such as ours and that of other authors described in the literature using an ultrasoundguided percutaneous transhepatic approach with a small caliber needle provides a safer and less traumatic procedure and should reduce complications of bleeding and almost completely eliminate the risk of liver laceration. Our procedure was successfully performed under conscious sedation rather than general anaesthesia further reducing the overall procedural risk to the patient.展开更多
AIM: To determine whether contrast-enhanced ultrasound(CEUS) can improve the precision of breast imaging reporting and data system(BI-RADS) categorization. METHODS: A total of 230 patients with 235 solid breast lesion...AIM: To determine whether contrast-enhanced ultrasound(CEUS) can improve the precision of breast imaging reporting and data system(BI-RADS) categorization. METHODS: A total of 230 patients with 235 solid breast lesions classified as BI-RADS 4 on conventional ultrasound were evaluated. CEUS was performed within one week before core needle biopsy or surgical resection and a revised BI-RADS classification was assigned based on 10 CEUS imaging characteristics. Receiver operating characteristic curve analysis was then conducted to evaluate the diagnostic performance of CEUS-based BI-RADS assignment with pathological examination as reference criteria. RESULTS: The CEUS-based BI-RADS evaluation classified 116/235(49.36%) lesions into category 3, 20(8.51%), 13(5.53%) and 12(5.11%) lesions into categories 4A, 4B and 4C, respectively, and 74(31.49%) into category 5. Selecting CEUS-based BI-RADS category 4A as an appropriate cut-off gave sensitivity and specificity values of 85.4% and 87.8%, respectively, for the diagnosisof malignant disease. The cancer-to-biopsy yield was 73.11% with CEUS-based BI-RADS 4A selected as the biopsy threshold compared with 40.85% otherwise, while the biopsy rate was only 42.13% compared with 100% otherwise. Overall, only 4.68% of invasive cancers were misdiagnosed.CONCLUSION: This pilot study suggests that evaluation of BI-RADS 4 breast lesions with CEUS results in reduced biopsy rates and increased cancer-to-biopsy yields.展开更多
<strong>Introduction:</strong><span style="white-space:normal;font-family:;" "=""> Cardiovascular risk is increased in systemic lupus erythematosus. Cardiovascular events are...<strong>Introduction:</strong><span style="white-space:normal;font-family:;" "=""> Cardiovascular risk is increased in systemic lupus erythematosus. Cardiovascular events are the first cause of death in lupus after five years duration. Prevention of cardiovascular events need</span><span style="white-space:normal;font-family:;" "="">s</span><span style="white-space:normal;font-family:;" "=""> a good evaluation of the risk. In this work, we tried to evaluate the performance of conventional and adjusted form</span><span style="white-space:normal;font-family:;" "="">s</span><span style="white-space:normal;font-family:;" "=""> of cardiovascular risk equations to predict high risk in lupus patients, in comparison with carotid ultrasound. <b>Method: </b>We realized a cross-sectional study during the period from 24 August 2017 to 22 November 2018. Consenting patient meeting the 1997 American college of Rheumatology criteria of systemic lupus erythematosus were recruited. The clinical characteristics and the treatment data were informed. Traditional cardiovascular risk factors were also investigated, and the assessment of cardiovascular risk was performed by Framingham and SCORE equations and their modified forms (multiplication by a factor of 1.5). Carotid ultrasound was used to detect atherosclerosis by measuring intima media thickness and search</span><span style="white-space:normal;font-family:;" "="">ing</span><span style="white-space:normal;font-family:;" "=""> for carotid plaques. In last, we compared cardiovascular risk level</span><span style="white-space:normal;font-family:;" "="">s</span><span style="white-space:normal;font-family:;" "=""> by equations to results of carotid ultrasound. Statistical analysis and data collection were performed using SPSS 23.0 software. <b>Results:</b> Forty-nine patients with a sex ratio of 0.13 and a mean age of 33.5 (±11.3) years were enrolled. More than half of patients had dyslipidemia. More than 80% of the population were at low cardiovascular risk according to the equations. However, 16% of cases had carotid atherosclerosis. Between 50% and 100% of patients having atherosclerosis were considered at low or moderate risk by equations. The best sensitivity to predict cardiovascular risk was given by modified Framingham (50%). <b>Conclusion:</b> In our study, conventional and modified risk equations had a bad performance to predict cardiovascular risk in systemic lupus erythematosus.</span>展开更多
AIM: To build and evaluate predictive models for contrast-enhanced ultrasound(CEUS) of the breast to distinguish between benign and malignant lesions. METHODS: A total of 235 breast imaging reporting and data system(B...AIM: To build and evaluate predictive models for contrast-enhanced ultrasound(CEUS) of the breast to distinguish between benign and malignant lesions. METHODS: A total of 235 breast imaging reporting and data system(BI-RADS) 4 solid breast lesions were imaged via CEUS before core needle biopsy or surgical resection. CEUS results were analyzed on 10 enhancing patterns to evaluate diagnostic performance of three benign and three malignant CEUS models, with pathological results used as the gold standard. A logistic regression model was developed basing on the CEUS results, and then evaluated with receiver operating curve(ROC). RESULTS: Except in cases of enhanced homogeneity, the rest of the 9 enhancement appearances were statistically significant(P < 0.05). These 9 enhancement patterns were selected in the final step of the logistic regression analysis, with diagnostic sensitivity and specificity of 84.4% and 82.7%, respectively, and the area under the ROC curve of 0.911. Diagnostic sensitivity, specificity, and accuracy of the malignant vs benign CEUS models were 84.38%, 87.77%, 86.38% and 86.46%, 81.29% and 83.40%, respectively. CONCLUSION: The breast CEUS models can predict risk of malignant breast lesions more accurately, decrease false-positive biopsy, and provide accurate BIRADS classification.展开更多
Background: High-intensity focused ultrasound (HIFU) has been introduced to improve skin laxity in recent years. However, very few studies have evaluated the safety and effectiveness of HIFU in Chinese populations. Me...Background: High-intensity focused ultrasound (HIFU) has been introduced to improve skin laxity in recent years. However, very few studies have evaluated the safety and effectiveness of HIFU in Chinese populations. Methods: In the study, 30 Chinese participants underwent HIFU (Bolida, Inc., Changsha, China) rejuvenation between February 1, 2022, and September 30, 2022. There were three different focal depths used depending on the area where shots were captured (4.5 mm, 4 MHz;3 mm, 7 MHz;1.5 mm, 7 MHz). After 3 months and 6 months of treatment, efficacy and safety were assessed by quantitative analysis. Results: Patients were satisfied with the clinical effects of HIFU rejuvenation after one session. In terms of effectiveness, HIFU was most successful in areas around the jawline, cheek, and perioral. In four cases, erythema was observed, in two cases, swollen gums were seen, but all of these effects were transient and mild. Conclusion: Bolida system can be safe and effective for facial tightening, additionally, they are most effective for jawline, cheek, and perioral improvements. In clinical practice, the Bolida system can be recommended as a reliable treatment option. .展开更多
自2013年美国放射学会出版第二版乳腺影像报告和数据系统(Breast Imaging Reporting and Data System,BI-RADS)后,乳腺超声的临床实践与科学研究均从中获益。本文总结了2013年版超声BI-RADS出版这10年间,乳腺超声影像技术临床应用与革...自2013年美国放射学会出版第二版乳腺影像报告和数据系统(Breast Imaging Reporting and Data System,BI-RADS)后,乳腺超声的临床实践与科学研究均从中获益。本文总结了2013年版超声BI-RADS出版这10年间,乳腺超声影像技术临床应用与革新、存在的问题与面临的挑战及未来的发展机遇,以期为临床诊治、指南推广与应用提供帮助。展开更多
文摘Objective: The automated breast ultrasound system(ABUS) is a potential method for breast cancer detection;however, its diagnostic performance remains unclear. We conducted a hospital-based multicenter diagnostic study to evaluate the clinical performance of the ABUS for breast cancer detection by comparing it to handheld ultrasound(HHUS) and mammography(MG).Methods: Eligible participants underwent HHUS and ABUS testing; women aged 40–69 years additionally underwent MG. Images were interpreted using the Breast Imaging Reporting and Data System(BI-RADS).Women in the BI-RADS categories 1–2 were considered negative. Women classified as BI-RADS 3 underwent magnetic resonance imaging to distinguish true-and false-negative results. Core aspiration or surgical biopsy was performed in women classified as BI-RADS 4–5, followed by a pathological diagnosis. Kappa values and agreement rates were calculated between ABUS, HHUS and MG.Results: A total of 1,973 women were included in the final analysis. Of these, 1,353(68.6%) and 620(31.4%)were classified as BI-RADS categories 1–3 and 4–5, respectively. In the older age group, the agreement rate and Kappa value between the ABUS and HHUS were 94.0% and 0.860(P〈0.001), respectively; they were 89.2% and0.735(P〈0.001) between the ABUS and MG, respectively. Regarding consistency between imaging and pathology results, 78.6% of women classified as BI-RADS 4–5 based on the ABUS were diagnosed with precancerous lesions or cancer; which was 7.2% higher than that of women based on HHUS. For BI-RADS 1–2, the false-negative rates of the ABUS and HHUS were almost identical and were much lower than those of MG.Conclusions: We observed a good diagnostic reliability for the ABUS. Considering its performance for breast cancer detection in women with high-density breasts and its lower operator dependence, the ABUS is a promising option for breast cancer detection in China.
文摘Delayed liver laceration following transjugular intrahepatic portosystemic shunt (TIPS) is a serious and likely underdiagnosed complication. It is however an important complication following TIPS, which remains one of the most technically challenging interventional procedures performed. In addition to laceration, a number of complications regarding bleeding and perforation are well described following TIPS procedures. We feel the adoption of techniques such as ours and that of other authors described in the literature using an ultrasoundguided percutaneous transhepatic approach with a small caliber needle provides a safer and less traumatic procedure and should reduce complications of bleeding and almost completely eliminate the risk of liver laceration. Our procedure was successfully performed under conscious sedation rather than general anaesthesia further reducing the overall procedural risk to the patient.
文摘AIM: To determine whether contrast-enhanced ultrasound(CEUS) can improve the precision of breast imaging reporting and data system(BI-RADS) categorization. METHODS: A total of 230 patients with 235 solid breast lesions classified as BI-RADS 4 on conventional ultrasound were evaluated. CEUS was performed within one week before core needle biopsy or surgical resection and a revised BI-RADS classification was assigned based on 10 CEUS imaging characteristics. Receiver operating characteristic curve analysis was then conducted to evaluate the diagnostic performance of CEUS-based BI-RADS assignment with pathological examination as reference criteria. RESULTS: The CEUS-based BI-RADS evaluation classified 116/235(49.36%) lesions into category 3, 20(8.51%), 13(5.53%) and 12(5.11%) lesions into categories 4A, 4B and 4C, respectively, and 74(31.49%) into category 5. Selecting CEUS-based BI-RADS category 4A as an appropriate cut-off gave sensitivity and specificity values of 85.4% and 87.8%, respectively, for the diagnosisof malignant disease. The cancer-to-biopsy yield was 73.11% with CEUS-based BI-RADS 4A selected as the biopsy threshold compared with 40.85% otherwise, while the biopsy rate was only 42.13% compared with 100% otherwise. Overall, only 4.68% of invasive cancers were misdiagnosed.CONCLUSION: This pilot study suggests that evaluation of BI-RADS 4 breast lesions with CEUS results in reduced biopsy rates and increased cancer-to-biopsy yields.
文摘<strong>Introduction:</strong><span style="white-space:normal;font-family:;" "=""> Cardiovascular risk is increased in systemic lupus erythematosus. Cardiovascular events are the first cause of death in lupus after five years duration. Prevention of cardiovascular events need</span><span style="white-space:normal;font-family:;" "="">s</span><span style="white-space:normal;font-family:;" "=""> a good evaluation of the risk. In this work, we tried to evaluate the performance of conventional and adjusted form</span><span style="white-space:normal;font-family:;" "="">s</span><span style="white-space:normal;font-family:;" "=""> of cardiovascular risk equations to predict high risk in lupus patients, in comparison with carotid ultrasound. <b>Method: </b>We realized a cross-sectional study during the period from 24 August 2017 to 22 November 2018. Consenting patient meeting the 1997 American college of Rheumatology criteria of systemic lupus erythematosus were recruited. The clinical characteristics and the treatment data were informed. Traditional cardiovascular risk factors were also investigated, and the assessment of cardiovascular risk was performed by Framingham and SCORE equations and their modified forms (multiplication by a factor of 1.5). Carotid ultrasound was used to detect atherosclerosis by measuring intima media thickness and search</span><span style="white-space:normal;font-family:;" "="">ing</span><span style="white-space:normal;font-family:;" "=""> for carotid plaques. In last, we compared cardiovascular risk level</span><span style="white-space:normal;font-family:;" "="">s</span><span style="white-space:normal;font-family:;" "=""> by equations to results of carotid ultrasound. Statistical analysis and data collection were performed using SPSS 23.0 software. <b>Results:</b> Forty-nine patients with a sex ratio of 0.13 and a mean age of 33.5 (±11.3) years were enrolled. More than half of patients had dyslipidemia. More than 80% of the population were at low cardiovascular risk according to the equations. However, 16% of cases had carotid atherosclerosis. Between 50% and 100% of patients having atherosclerosis were considered at low or moderate risk by equations. The best sensitivity to predict cardiovascular risk was given by modified Framingham (50%). <b>Conclusion:</b> In our study, conventional and modified risk equations had a bad performance to predict cardiovascular risk in systemic lupus erythematosus.</span>
文摘AIM: To build and evaluate predictive models for contrast-enhanced ultrasound(CEUS) of the breast to distinguish between benign and malignant lesions. METHODS: A total of 235 breast imaging reporting and data system(BI-RADS) 4 solid breast lesions were imaged via CEUS before core needle biopsy or surgical resection. CEUS results were analyzed on 10 enhancing patterns to evaluate diagnostic performance of three benign and three malignant CEUS models, with pathological results used as the gold standard. A logistic regression model was developed basing on the CEUS results, and then evaluated with receiver operating curve(ROC). RESULTS: Except in cases of enhanced homogeneity, the rest of the 9 enhancement appearances were statistically significant(P < 0.05). These 9 enhancement patterns were selected in the final step of the logistic regression analysis, with diagnostic sensitivity and specificity of 84.4% and 82.7%, respectively, and the area under the ROC curve of 0.911. Diagnostic sensitivity, specificity, and accuracy of the malignant vs benign CEUS models were 84.38%, 87.77%, 86.38% and 86.46%, 81.29% and 83.40%, respectively. CONCLUSION: The breast CEUS models can predict risk of malignant breast lesions more accurately, decrease false-positive biopsy, and provide accurate BIRADS classification.
文摘Background: High-intensity focused ultrasound (HIFU) has been introduced to improve skin laxity in recent years. However, very few studies have evaluated the safety and effectiveness of HIFU in Chinese populations. Methods: In the study, 30 Chinese participants underwent HIFU (Bolida, Inc., Changsha, China) rejuvenation between February 1, 2022, and September 30, 2022. There were three different focal depths used depending on the area where shots were captured (4.5 mm, 4 MHz;3 mm, 7 MHz;1.5 mm, 7 MHz). After 3 months and 6 months of treatment, efficacy and safety were assessed by quantitative analysis. Results: Patients were satisfied with the clinical effects of HIFU rejuvenation after one session. In terms of effectiveness, HIFU was most successful in areas around the jawline, cheek, and perioral. In four cases, erythema was observed, in two cases, swollen gums were seen, but all of these effects were transient and mild. Conclusion: Bolida system can be safe and effective for facial tightening, additionally, they are most effective for jawline, cheek, and perioral improvements. In clinical practice, the Bolida system can be recommended as a reliable treatment option. .
文摘自2013年美国放射学会出版第二版乳腺影像报告和数据系统(Breast Imaging Reporting and Data System,BI-RADS)后,乳腺超声的临床实践与科学研究均从中获益。本文总结了2013年版超声BI-RADS出版这10年间,乳腺超声影像技术临床应用与革新、存在的问题与面临的挑战及未来的发展机遇,以期为临床诊治、指南推广与应用提供帮助。