Comparative analysis of conventional ultrasound and shear wave elastography features in primary breast diffuse large B-cell lymphoma

BACKGROUND Primary breast diffuse large B-cell lymphoma(PB-DLBCL)is a rare subtype of non-Hodgkin lymphoma that accounts for<3%of extranodal lymphomas and 1%of breast tumors.Its diagnosis and management are challenging because of its rarity,heterogeneity,and aggressive behavior.Conventional ultrasound(US)is the first-line imaging modality for breast lesions;however,it has limited specificity and accuracy for PB-DLBCL.Shear wave elastography(SWE)is a novel US technique that measures tissue stiffness and may reflect the histological characteristics and biological behavior of breast lesions.AIM To compare the conventional US and SWE features of PB-DLBCL and evaluate their diagnostic performance and prognostic value.METHODS We retrospectively reviewed the clinical data and US images of 32 patients with pathologically confirmed PB-DLBCL who underwent conventional US and SWE before treatment.We analyzed conventional US features(shape,margin,orientation,echo,posterior acoustic features,calcification,and vascularity)and SWE features(mean elasticity value,standard deviation,minimum elasticity value,maximum elasticity value,and lesion-to-fat ratio)of the PB-DLBCL lesions.Using receiver operating characteristic curve analysis,we determined the optimal cutoff values and diagnostic performance of conventional US and SWE features.We also performed a survival analysis to assess the prognostic value of conventional US and SWE features.RESULTS The results showed that the PB-DLBCL lesions were mostly irregular in shape(84.4%),microlobulated or spiculated in margins(75%),parallel in orientation(65.6%),hypoechoic in echo(87.5%),and had posterior acoustic enhancement(65.6%).Calcification was rare(6.3%)and vascularity was variable(31.3%avascular,37.5%hypovascular,and 31.3%hypervascular).The mean elasticity value of PB-DLBCL lesions was significantly higher than that of benign breast lesions(113.4±46.9 kPa vs 27.8±16.4 kPa,P<0.001).The optimal cutoff value of the mean elasticity for distinguishing PB-DLBCL from benign breast lesions was 54.5 kPa,with a sensitivity of 93.8%,specificity of 92.9%,positive predictive value of 93.8%,negative predictive value of 92.9%,and accuracy of 93.3%.The mean elasticity value was also significantly correlated with Ki-67 expression level(r=0.612,P<0.001),which is a marker of tumor proliferation and aggressiveness.Survival analysis showed that patients with higher mean elasticity values(>54.5 kPa)had worse overall survival(OS)and progression-free survival(PFS)than those with lower mean elasticity values(<54.5 kPa)(P=0.038 for OS and P=0.027 for PFS).CONCLUSION Conventional US and SWE provide useful information for diagnosing and forecasting PB-DLBCL.SWE excels in distinguishing PB-DLBCL from benign breast lesions,reflects tumor proliferation and aggressiveness,and improves disease management.

Diagnostic Value and Misdiagnosis Analysis of Conventional Ultrasonography Combined with Contrast-Enhanced Ultrasonography in Thyroid Nodules

Objective:To explore the diagnostic value of conventional ultrasonography combined with contrast-enhanced ultrasonography in thyroid nodules.Methods:From June 2021 to July 2022,163 patients with thyroid nodules enrolled in our hospital were selected as research subjects.After pathological diagnosis,24 cases were malignant thyroid nodules,and 139 cases were benign thyroid nodules.The diagnosis rate of malignant and benign thyroid nodules was observed and analyzed,with 95%CI.Results:Among them,the malignant and benign detection rates of routine ultrasound were 88.63%and 75.00%,respectively,and the malignant and benign detection rates of contrast-enhanced ultrasound were 81.82%and 81.25%,respectively.The malignant and benign detection rates of conventional ultrasound combined with contrast-enhanced ultrasound were 93.18%and 87.50%,respectively,and the 95%CI was greater than 0.7.Conclusion:Conventional ultrasound combined with contrast-enhanced ultrasound can help improve the diagnostic accuracy of benign and malignant thyroid nodules and reduce the misdiagnosis rate.

Value of myocardial function in children with Kawasaki disease by two-dimensional and three-dimensional ultrasound speckle tracking

Objective:To investigate the value of two-dimensional ultrasound speckle tracking(2D-STI)and three-dimensional ultrasound speckle tracking(3D-STI)in evaluating myocardial function in children with Kawasaki disease.Methods 92 children with Kawasaki disease admitted to our hospital from February 2017 to February 2019 were retrospectively analyzed.50 children who underwent 3D-STI examination were taken as observation group and 42 children who underwent 2D-STI examination were taken as control group.The left ventricular systolic function index,storage time and analysis time of the image,the diameter of coronary artery,the strain difference of left ventricular basal segment,middle segment,apical segment and whole segment were observed.Results The levels of left ventricular end-diastolic volume(LVEDV),left ventricular end-systolic volume(LVESV),left ventricular myocardial mass(LVMI)in the observation group were higher than those in the control group(P<0.05),but there was no statistical difference in left ventricular ejection fraction(LVEF)between the two groups(P>0.05).The storage time and analysis time of the image in the observation group were significantly lower than those in the control group(P<0.05).The left coronary artery(LCA)and right coronary artery(RCA)in the observation group were higher than those in the control group(P<0.05).There was no statistical difference between left anterior descending(LAD)in the two groups(P>0.05).The longitudinal peak systolic strain(LS),circumferential peak systolic strain(CS)and radial peak systolic strain(RS)in the observation group were higher than those in the control group(P<0.05).The global longitudinal peak strain(GLS),global circumferential peak strain(GCS)and global radial peak strain(GRS)in the observation group were higher than those in the control group(P<0.05).LS and CS in the middle segment of the observation group were higher than those in the control group(P<0.05).Conclusions Compared with 2D-STI,3D-STI can objectively and accurately reflect the myocardial function of children with Kawasaki disease.

Differential diagnosis of different types of solid focal liver lesions using two-dimensional shear wave elastography

BACKGROUND The clinical management and prognosis differ between benign and malignant solid focal liver lesions(FLLs),as well as among different pathological types of malignant FLLs.Accurate diagnosis of the possible types of solid FLLs is important.Our previous study confirmed the value of shear wave elastography(SWE)using maximal elasticity(Emax)as the parameter in the differential diagnosis between benign and malignant FLLs.However,the value of SWE in the differential diagnosis among different pathological types of malignant FLLs has not been proved.AIM To explore the value of two-dimensional SWE(2D-SWE)using Emax in the differential diagnosis of FLLs,especially among different pathological types of malignant FLLs.METHODS All the patients enrolled in this study were diagnosed as benign,malignant or undetermined FLLs by conventional ultrasound.Emax of FLLs and the periphery of FLLs was measured using 2D-SWE and compared between benign and malignant FLLs or among different pathological types of malignant FLLs.RESULTS The study included 32 benign FLLs in 31 patients and 100 malignant FLLs in 96 patients,including 16 cholangiocellular carcinomas(CCCs),72 hepatocellular carcinomas(HCCs)and 12 liver metastases.Thirty-five FLLs were diagnosed as undetermined by conventional ultrasound.There were significant differences between Emax of malignant(2.21±0.57 m/s)and benign(1.59±0.37 m/s)FLLs(P=0.000),and between Emax of the periphery of malignant(1.52±0.39 m/s)and benign(1.36±0.44 m/s)FLLs(P=0.040).Emax of liver metastases(2.73±0.99 m/s)was significantly higher than that of CCCs(2.14±0.34 m/s)and HCCs(2.14±0.46 m/s)(P=0.002).The sensitivity,specificity and accuracy were 71.00%,84.38%and 74.24%respectively,using Emax>1.905 m/s(AUC 0.843)to diagnose as malignant and 23 of 35(65.74%)FLLs with undetermined diagnosis by conventional ultrasound were diagnosed correctly.CONCLUSION Malignant FLLs were stiffer than benign ones and liver metastases were stiffer than primary liver carcinomas.2D-SWE with Emax was a useful complement to conventional ultrasound for the differential diagnosis of FLLs.

Diagnostic problems in two-dimensional shear wave elastography of the liver

Two-dimensional shear wave elastography(2D-SWE)is used in the clinical setting for observation of the liver.Unfortunately,a wide spectrum of artifactual images are frequently encountered in 2D-SWE,the precise mechanisms of which remain incompletely understood.This review was designed to present many of the artifactual images seen in 2D-SWE of the liver and to analyze them by computer simulation models that support clinical observations.Our computer simulations yielded the following suggestions:(1)When performing 2D-SWE in patients with chronic hepatic disease,especially liver cirrhosis,it is recommended to measure shear wave values through the least irregular hepatic surface;(2)The most useful 2D-SWE in patients with focal lesion will detect lesions that are poorly visible on B-mode ultrasound and will differentiate true tumors from pseudo-tumors(e.g.,irregular fatty change);and(3)Measurement of shear wave values in the area posterior to a focal lesion must be avoided.

Preoperative prediction of microvascular invasion in hepatocellular carcinoma using ultrasound features including elasticity

BACKGROUND Microvascular invasion(MVI)is an important predictor of poor prognosis in patients with hepatocellular carcinoma(HCC).Accurate preoperative prediction of MVI in HCC would provide useful information to guide the choice of therapeutic strategy.Shear wave elastography(SWE)plays an important role in hepatic imaging,but its value in the preoperative prediction of MVI in HCC has not yet been proven.AIM To explore the value of conventional ultrasound features and SWE in the preoperative prediction of MVI in HCC.METHODS Patients with a postoperative pathological diagnosis of HCC and a definite diagnosis of MVI were enrolled in this study.Conventional ultrasound features and SWE features such as maximal elasticity(Emax)of HCCs and Emax of the periphery of HCCs were acquired before surgery.These features were compared between MVI-positive HCCs and MVI-negative HCCs and between mild MVI HCCs and severe MVI HCCs.RESULTS This study included 86 MVI-negative HCCs and 102 MVI-positive HCCs,including 54 with mild MVI and 48 with severe MVI.Maximal tumor diameters,surrounding liver tissue,color Doppler flow,Emax of HCCs,and Emax of the periphery of HCCs were significantly different between MVI-positive HCCs and MVI-negative HCCs.In addition,Emax of the periphery of HCCs was significantly different between mild MVI HCCs and severe MVI HCCs.Higher Emax of the periphery of HCCs and larger maximal diameters were independent risk factors for MVI,with odds ratios of 2.820 and 1.021,respectively.CONCLUSION HCC size and stiffness of the periphery of HCC are useful ultrasound criteria for predicting positive MVI.Preoperative ultrasound and SWE can provide useful information for the prediction of MVI in HCCs.

常规超声征象与剪切波弹性成像在甲状腺乳头状癌被膜侵犯预测颈部淋巴结转移风险中的价值

目的探讨常规超声征象与剪切波弹性成像弹性比(SWE-ER)在甲状腺乳头状癌(PTC)被膜侵犯预测颈部淋巴结转移(CLNM)风险中的价值。方法收集2022年6月~2024年3月在宝鸡市人民医院经术后病理证实的PTC患者87例共93个癌结节。根据术后病理分为CLNM组和未发生CLNM组,回顾性分析甲状腺癌结节与被膜关系常规超声图像特征(癌结节与被膜接触情况、被膜连续性情况、被膜侵犯范围)及SWE-ER值,以病理诊断为金标准,绘制SWE-ER、结节与被膜关系不同界值下的ROC曲线,比较不同界值下预测颈部淋巴结转移风险的价值。利用二元Logistic回归方程计算发生CLNM患者的独立危险因素。结果发生CLNM组癌结节经线高于未发生CLNM组,差异有统计学意义(P<0.05)。发生CLNM组的被膜接触情况、被膜连续性及被膜侵犯范围占癌结节周长与未发生CLNM组相比,差异均有统计学意义(P<0.001)。发生CLNM组的SWE-ER低于未发生CLNM组,差异有统计学意义(P<0.05)。以病理为金标准,绘制不同截断值下评估CLNM风险的ROC曲线,其中以被膜侵犯范围占癌结节周长1/4为截断值的ROC曲线下面积为0.756(95%CI:0.652~0.859),诊断效能最高。二元Logistic回归多因素分析显示,甲状腺被膜中断、被膜侵犯范围占癌结节周长1/4~1/2、被膜侵犯范围占癌结节周长≥1/2均为发生CLNM的独立危险因素(P<0.05)。SWE-ER和癌结节被膜是否接触不能作为PTC发生CLNM的独立危险因素(P>0.05)。结论甲状腺癌结节与被膜的关系,尤其是对甲状腺癌结节被膜侵犯范围在超声预测CLNM中有较高诊断价值;被膜中断、被膜侵犯范围占癌结节周长1/4~1/2、被膜侵犯范围占癌结节周长≥1/2均为发生CLNM的独立危险因素,而SWE-ER和癌结节是否与被膜接触不能作为PTC发生CLNM的独立危险因素。

麻醉科规范化培训超声引导下神经阻滞教学效果分析

目的讨论麻醉科规范化培训超声引导下神经阻滞教学中的效果。方法选择2019年1月—2022年12月鄂尔多斯市中心医院麻醉科接受规范化培训的40名住院医师为研究对象,以分层抽样法随机分为对照组与研究组,各20名。对照组规范化培训超声引导下神经阻滞教学采取常规教学模式,研究组规范化培训超声引导下神经阻滞教学采取常规教学模式+微课教学法。观察理论知识考核情况、技术操作考核情况、教学模式评价度。结果研究组理论基础知识[(47.58±3.22)分]、论述及病例分析[(47.68±3.50)分]、总分[(94.68±4.28)分]均高于对照组[(45.25±3.77)、(40.25±4.28)、(85.34±5.70)分],差异有统计学意义(P<0.05)。研究组技术操作考核成绩[(95.67±4.81)分]高于对照组的技术操作考核成绩[(80.65±5.33)分],差异有统计学意义(P<0.05)。研究组麻醉效果优良性为95%,高于对照组的70%,差异有统计学意义(P<0.05)。研究组记忆解剖内容[(17.25±1.25)分]、便于随时随地了解知识点[(17.92±1.22)分]、激发学习兴趣度[(18.25±1.32)分]、临床操作技术水平自评[(16.82±1.85)分]、临床麻醉效果满意度自评[(18.35±1.11)分]评分均高于对照组[(12.81±2.35)分、(10.75±2.22)分、(13.68±2.61)分、(13.28±2.58)分、(16.82±1.00)分],差异有统计学意义(P<0.05)。结论麻醉科住院医师规范化培训超声引导下神经阻滞教学中实施微课教学法,利于提高理论知识及技术操作考核结果,且该教学模式已得到麻醉科住院医师的认可及满意。

介入超声经皮穿刺活检技术在鉴别乳腺肿瘤良恶性中的应用效果

目的:分析介入超声经皮穿刺活检技术在鉴别乳腺肿瘤良恶性中的应用效果。方法:选取2021年1月—2023年12月泰州市第四人民医院收治的乳腺肿瘤患者62例为研究对象。患者均接受常规超声与介入超声经皮穿刺活检技术进行诊断。以病理学诊断结果为“金标准”,比较常规超声与介入超声经皮穿刺活检技术的灵敏度、特异度、准确率。结果:病理学诊断结果显示,良性乳腺肿瘤患者32例,占比51.61%,恶性肿瘤患者30例,占比48.39%。介入超声经皮穿刺活检术检查灵敏度及准确率高于常规超声检查,差异有统计学意义(P<0.05);两种检查方法特异度比较,差异无统计学意义(P>0.05)。结论:介入超声经皮穿刺活检术在鉴别乳腺肿瘤良恶性中的效果较好,可提高灵敏度和准确率。

MRI联合交感皮肤反应及经颅超声诊断帕金森病与多系统萎缩P型的研究

目的 探讨头部常规磁共振(MRI)联合交感神经皮肤反应(SSR)及经颅超声成像(TCS)用于诊断帕金森病(PD)与多系统萎缩P型(MSA-P型)的价值。方法 收集2019-01—2022-06郑州大学第五附属医院临床确诊且具有完整资料的22例MSA-P型患者和29例PD患者,均行头部常规MRI、SSR和TCS检查,采用ROC曲线评价头部MRI、SSR和TCS诊断MSA-P型和PD患者的临床价值。结果 壳核裂隙征具有影像特异性,MSA-P型组远高于PD组(P<0.05)。MSA-P型组上、下肢SSR平均起始潜伏期延长,平均波幅降低与PD组比较差异有统计学意义(P<0.01)。2组黑质强回声面积、黑质强回声总面积与中脑总面积比值比较差异有统计学意义(P<0.01)。ROC曲线下壳核裂隙征有高特异性(96.8%),SSR上肢潜伏期有高敏感性(88.2%),SN强回声面积诊断价值最高,曲线下面积(AUC)为0.881;头部MRI联合SSR、TCS用于预测两种疾病的敏感度为72.1%,AUC为0.913。结论 分析头部MRI检查结果,早期进行SSR、TCS检查可提高对MSA-P型与PD患者的诊断率。

多模态超声校正BI-RADS 4类乳腺肿块的价值

目的 探讨乳腺自动容积成像(ABVS)、超声弹性评分(UES)及两者联合在校正乳腺影像报告和数据系统分级(BI-RADS) 4类乳腺肿块BI-RADS分级中的应用价值。方法 收集我院经常规超声诊断为BI-RADS 4类的乳腺肿块患者109例,共113个肿块。经ABVS及UES校正BI-RADS分级后,与病理结果对比,绘制ROC曲线,比较常规超声、ABVS、UES、ABVS联合UES诊断BI-RADS 4类乳腺肿块的差异。结果 109例患者113个肿块中包含良性78个,恶性35个,ABVS联合UES校正后的敏感度、特异性、准确性、ROC曲线下面积分别为94.29%、93.59%、93.80%、0.975。结论 ABVS联合UES有助于提高BI-RADS 4类肿块的总体诊断效能。两者联合诊断可以取长补短,提高诊断率。

常规超声联合超声造影对胸膜下肺结核、细菌性肺炎的检查影像特征分析

目的分析常规超声联合超声造影对胸膜下肺结核、细菌性肺炎的检查影像特征。方法选择于本院确诊的胸膜下肺结核或细菌性肺炎患者115例,其中确诊为胸膜下肺结核的患者有78例,将其作为肺结核组;而确诊为细菌性肺炎的患者有37例,将其作为肺炎组。所有患者均行常规超声、超声造影检查,分析采用常规超声、超声造影检查的影像学表现。结果肺结核组78例患者中52例呈楔形,占比66.67%;21例呈类圆形,占比26.92%;5例为不规则形,占比6.41%。肺炎组37例患者中23例为楔形,占比62.16%;14例为类圆形,占比37.84%,将两组患者形态进行对比,无明显统计学差异(P>0.05);肺结核组中出现碎片征的患者有24例,占比30.77%,在肺炎组中有30例,占比81.08%,肺炎组患者中碎片征的占比相较于肺结核组升高(P<0.05);边缘较为规整,后方出现彗星尾征的高回声为瀑布征,肺结核组患者中瀑布征的占比为62.82%,相较于肺炎组患者中的占比16.22%上升(P<0.05);肺炎组患者中有34例患者的病灶为离心型增强模式,占比91.89%,而其余3例则为局部向整体的增强模式;肺结核组患者中有55例为离心型增强模式,占比70.51%,13例患者为向心型增强模式,占比16.67%;10例患者表现为离心型、向心型均存在的增强模式,占比12.82%,将两组患者增强模式占比进行对比,差异有统计学意义(P<0.05);肺结核组患者中共有64例出现坏死区,占比82.05%,肺炎组患者中共有11例出现坏死区,占比29.73%,经比较,肺结核组患者的坏死区占比相较于肺炎组升高(P<0.05);肺结核组患者中有33例呈现为病灶内有许多间断的筛孔样坏死,占比51.56%,而24例则呈现为形态较为规整的大片状坏死,占比37.50%,7例则呈现为病灶内几乎完全坏死,占比10.94%;肺炎组患者中有2例为形态较为规整的大片状坏死,占比18.18%,9例呈现为形态较为规整的小片状坏死,占比81.82%,经对比,两组间有统计学差异(P<0.05);两组患者超声造影下正常肺组织开始增强时间、病灶开始增强时间等指标进行对比,均无明显差异(均P>0.05)。结论肺结核病灶经常规超声检查为“瀑布征”,超声造影检查显示坏死区面积较大,且多为大片状坏死;而常规超声检查细菌性肺炎病灶为“碎片征”,坏死区面积较小,且形态较为规整,以上特点可作为鉴别两种疾病的标志。

应用经直肠超声造影微血管成像、弹性成像及常规超声靶向引导对疑似前列腺癌患者行穿刺活检的诊断效能比较

目的探讨经直肠超声造影(CEUS)微血管成像、弹性成像及常规超声靶向引导前列腺癌穿刺活检在前列腺病变诊断中的应用价值,为前列腺癌的早期诊断提供参考。方法选取2021年1月-2022年12月在西安交通大学第二附属医院泌尿外科就诊的疑似前列腺癌患者156例,根据患者采取的穿刺活检方法分为A组(n=52)、B组(n=49)和C组(n=55),其中A组给予常规超声靶向引导前列腺癌穿刺活检,B组给予弹性成像引导前列腺癌穿刺活检,C组给予CEUS微血管成像引导前列腺癌穿刺活检,比较各组前列腺穿刺阳性针比例及前列腺癌诊断价值,同时分析CEUS微血管成像、弹性成像参数诊断前列腺癌的价值。结果B组和C组前列腺穿刺阳性针比例分别24.18%和25.71%,明显高于A组的13.15%(P<0.05)。B组和C组前列腺癌诊断准确率分别为93.88%和94.55%,高于A组的75.00%(P=0.002)。B组恶性病灶弹性成像参数Emax和Emean分别为(65.56±14.43)kPa和(59.59±11.02)kPa,高于良性病灶(P<0.001);良恶性病灶CEUS微血管血流分级比较差异有统计学意义(P<0.05),其中恶性病灶血流分级3级比例达到95.65%。弹性成像参数Emean诊断前列腺癌的受试者工作特征(ROC)曲线下面积为0.810(95%CI:0.690~0.930,P<0.05);CEUS微血管成像血流分级诊断前列腺癌的ROC曲线下面积为0.965(95%CI:0.913~1.000,P<0.05)。结论相比较常规超声靶向引导前列腺癌穿刺活检,CEUS微血管成像及弹性成像引导前列腺癌穿刺活检在前列腺病变诊断中有更好的应用价值,同时CEUS微血管成像和弹性成像可为诊断前列腺病变提供半定量/定量参数依据。

常规超声及超声造影对TI-RADS 4类甲状腺皱缩结节的诊断价值

目的:探讨常规超声及超声造影对TI-RADS 4类甲状腺皱缩结节的诊断价值。方法:选取行常规超声和超声造影检查的78例病人(80个诊断为TI-RADS 4类的结节),按照病理结果分为皱缩结节组38例(38个结节)和乳头状癌组40例(42个结节),行常规超声及超声造影检查,分别对常规超声声像图特点及超声造影的增强模式进行比较。结果:2组病人常规超声声像图表现在边界、回声、纵横比、钙化类型方面差异均无统计学意义(P>0.05),在钙化位置和“晕环征”方面差异有统计学意义(P<0.01),皱缩结节组钙化位置为边缘型、有晕环征、无增强或星点状低增强发生率均高于乳头状癌组(P<0.01)。甲状腺皱缩结节主要表现为无增强或点状低增强,乳头状癌主要表现为向心性低增强。结论:通过结节的钙化位置和有无“晕环征”的超声特点及超声造影的特征性表现可以区分甲状腺皱缩结节和乳头状癌,常规超声及超声造影对鉴别甲状腺皱缩结节和甲状腺乳头状癌有重要意义。

经阴道超声RTE联合经阴道常规超声诊断宫颈癌的价值

目的:探讨经阴道超声实时弹性成像(RTE)联合经阴道常规超声在宫颈癌中的诊断价值。方法:选取本院2020年5月至2023年5月期间治疗的疑似宫颈癌患者194例作为研究对象,病理结果证实宫颈良性病变患者96例(良性病变组),宫颈癌患者98例(宫颈癌组),所有患者均行经阴道常规超声和经阴道超声RTE检查。结果:良性病变组和宫颈癌组边界比较,差异无统计学意义(P>0.05),宫颈癌组弹性硬度评分5分患者比例、肿瘤最大径、低回声患者比例、血流分级Ⅲ级患者比例明显高于良性病变组(P<0.05)。经阴道常规超声单独及联合经阴道超声RTE诊断宫颈癌与病理组织检查结果的一致性分别为中度、极高,Kappa值分别为0.527、0.814(P<0.05)。经阴道常规超声单独及联合经阴道超声RTE诊断宫颈癌的ROC曲线下面积(AUC)分别为0.765(95%CI 0.696~0.834)、0.907(95%CI 0.860~0.954)。联合诊断宫颈癌的敏感度、阴性预测值、准确度显著高于经阴道常规超声单独诊断,漏诊率显著低于经阴道常规超声单独诊断(P<0.05)。结论:经阴道常规超声联合经阴道超声RTE对于宫颈癌的鉴别诊断具有重要价值,二者联合的结果与病理诊断的一致性较高。

超声技术在乳腺癌新辅助化疗疗效评估中的应用进展

乳腺癌是全球女性发病率最高的恶性肿瘤之一,严重影响女性的身心健康。随着新辅助化疗(NAC)在乳腺癌治疗中的广泛应用,准确评估其疗效可以为乳腺癌的治疗和预后提供重要信息。因此,可量化疾病反应的超声技术对于评估接受NAC的患者至关重要。常规超声是乳腺癌诊断的主要手段,超微血管成像、三维超声成像等技术在评估乳腺癌NAC疗效方面的优势显著。因此,全面了解超声技术在乳腺癌NAC疗效评估中的作用,可以为疾病的治疗提供新思路。

常规超声联合超声造影诊断在不规则乳腺结节良恶性鉴别诊断中的应用价值

目的探讨常规超声联合超声造影在不规则乳腺结节良恶性鉴别中的应用价值。方法回顾性分析2021年12月至2022年12月于抚州市直属门诊部就诊的102例不规则乳腺结节患者的临床资料。患者均行超声造影、常规超声,以病理结果为金标准,比较良性与恶性患者常规超声联合超声造影特征,ROC曲线分析常规超声、超声造影鉴别诊断不规则乳房结节良恶性的诊断效能。结果102例不规则乳房结节患者,良性结节47例,恶性结节55例。其中良性结节包括腺病36例,浆细胞性乳腺炎5例,导管内乳头状瘤4例,纤维腺瘤2例;恶性结节包括浸润性导管癌20例,导管原位癌15例,原位癌伴微浸润13例,实性乳头状癌3例,弥漫性大B细胞淋巴瘤2例,浸润性小叶癌2例。良性患者与恶性患者微钙化、弹性、始增时间、增强强度、增强模式、增强后病变范围、周围血管征特征占比比较差异有统计学意义(P<0.05)。ROC曲线分析结果显示,常规超声联合超声造影灵敏度、特异度、准确度及AUC均高于常规超声、超声造影单一诊断。结论常规超声联合超声造影诊断评估不规则乳腺结节良恶性鉴别诊断具有较高的应用价值,可提升诊断不规则乳腺结节的准确度、灵敏度。

乳腺AI、超声联合MRI在乳腺结节BI-RADS分类中的效能

目的分析乳腺人工智能(AI)与常规超声(US)联合磁共振成像(MRI)在乳腺结节乳腺影像报告和数据系统(BI-RADS)分类中的效能。方法选取105例乳腺结节患者(140个乳腺结节),所有乳腺结节均行乳腺AI、US及MRI检查;采用BI-RADS对患者的乳腺结节进行良性和恶性的分类,以术后病理结果为标准,BI-RADS 4a及以下为良性组、BI-RADS 4b及以上为恶性组,对比3种检查方法对乳腺癌诊断的准确性、敏感性及特异性,计算受试者工作特征曲线下面积(AUC);根据US分类将55个US-BI-RADS 4a类结节作为研究对象,用AI-BI-RADS 4a作为截点值,采用AI-BI-RADS对该55个乳腺结节进行重新分类,分析调整后的AI-US-BI-RADS与US-BI-RADS、病理结果、MRI-BI-RADS诊断结果间的一致性和差异,比较AI、US和MRI对BI-RADS 4a类结节的诊断效能。结果3种方法独立应用判断乳腺结节的良恶性时,MRI的准确性和敏感性最高,AI的特异性最高;在联合诊断乳腺结节的良恶性时,US+AI+MRI联合诊断乳腺癌的准确性、敏感性及特异性最高且AUC最大;以AI-BI-RADS 4a类作为截点,对55例US-BI-RADS 4a类乳腺结节进行重新分类,AI与US、病理结果及MRI检测结果均有较高的一致性(P<0.01);AI调整后的乳腺BI-RADS分类准确性、敏感性、特异性均较调整分类前提高。结论乳腺AI、US及MRI的联合使用可提高乳腺癌的诊断效能,AI-US-BI-RADS分类可较好的预测乳腺结节的良恶性。

超声弹性成像、常规超声单独及联合应用在乳腺癌诊断中的价值对比

目的对比超声弹性成像、常规超声单独及联合应用在乳腺癌诊断中的价值。方法方便选取2022年1月—2023年6月盱眙县人民医院收治的104例疑似乳腺癌患者作为研究对象,分别通过常规超声、超声弹性成像单独及联合检查,将患者术后病理诊断结果视为金标准,对比两种单独检测方法及联合检测应用的灵敏度、特异度、准确度。结果104例疑似乳腺癌患者术后病理诊断结果显示,62例确诊乳腺癌,占比59.62%,42例确诊为乳腺良性肿瘤,占比40.38%。常规超声联合超声弹性成像诊断的灵敏度(98.39%)、准确度(97.12%)均明显高于两种单独检查方法,差异有统计学意义(χ^(2)=12.705、9.656,P均<0.05);联合诊断的特异度与两种单独检查方法对比,差异无统计学意义(P>0.05)。结论临床诊断乳腺癌疾病可采取常规超声联合超声弹性成像检查,相比两种单独检查方法具有更高的灵敏度与准确度,可为临床疾病后续治疗提供可靠影像学支持。

常规超声及UE联合DBT对乳腺肿块良恶性诊断鉴别的准确性分析

目的 分析常规超声、超声弹性成像(UE)与数字乳腺断层合成(DBT)联合应用对乳腺肿块的定性诊断价值。方法 选择2022年1月至2023年12月152例乳腺肿块女性患者,年龄22~65岁,平均年龄44.12岁;身体质量指数18~26 kg/m^(2),平均身体质量指数22.45 kg/m^(2);肿块位置:左侧100例,右侧52例;肿块直径0.5~4.7cm,平均直径2.33 cm。均行常规超声、UE和DBT检查。以手术病理诊断为金标准,对比常规超声、UE和DBT单独使用与联合应用的定性诊断价值;对比良恶性乳腺肿块患者常规超声参数、UE参数和DBT参数。结果 手术病理诊断显示,152例均为单发性结节患者,共有152个肿块,84个为恶性,68个为良性。常规超声、UE和DBT单独使用对乳腺肿块良恶性的诊断效能对比,差异无统计学意义(P> 0.05);联合诊断灵敏度更高(95.24%vs 71.43%、76.19%、73.81%),对比单一诊断差异有统计学意义(P <0.05)。恶性乳腺肿块弹性应变率、肿块直径、直径变化率、肿块面积、面积比、边缘清晰占比低于良性(2.92%±0.54%vs 6.06%±1.72%、13.56 mm±3.32 mm vs 19.78 mm±3.72 mm、0.22%±0.05%vs 0.39%±0.12%、8.68 cm2±1.72 cm2vs 16.54 cm2±3.18 cm^(2)、1.21%±0.24%vs 1.92%±0.36%、4.76%vs 73.53%),UE评分、血流信号等级、边缘模糊、遮蔽、毛刺、肿块结构扭曲、血液运行增加和血管穿入占比明显高于良性,组间差异有显著统计学意义(P <0.01)。结论常规超声、UE与DBT联合应用,可准确诊断乳腺肿块良恶性,可将影像学征象作为评估依据,有应用价值。