Diagnostic accuracy of real-time tissue elastography for breast cancer:a meta-analysis

Objective The present study aimed to determine the accuracy of real-time tissue elastography （RTE） for the diagnosis of breast cancer. Methods The search was conducted in the PubMed, Web of Science, Cochrane Library, and China Biology Medicine databases from inception through December 31, 2014, without language restrictions. The meta-analysis was conducted using STATA version 12.0 and Meta-Disc version 1.4. We calculated the summary statistics for sensitivity （Sen）, specificity （Spe）, positive and negative likelihood ratio （LR＋/LR–）, diagnostic odds ratio （DOR）, and summary receiver operating characteristic （SROC） curve. Results Ten studies that met al inclusion criteria were included in the meta-analysis. A total of 608 ma-lignant breast lesions and 1292 benign breast tumors were assessed. Al breast lesions were histological y confirmed after RTE. The pooled Sen was 0.83 （95% CI = 0.79–0.86）; the pooled Spe was 0.86 （95% CI = 0.84–0.88）. The pooled LR＋ was 9.87 （95% CI = 2.66–36.71）; the pooled LR– was 0.20 （95% CI = 0.17–0.23）. The pooled DOR of RTE for the diagnosis of breast cancer was 62.21 （95% CI = 33.88–114.24）. The area under the SROC curve was 0.9334 （standard error = 0.00125）. We found no evidence of publica-tion bias （t = –0.57, P = 0.582）. Conclusion RTE may have high diagnostic accuracy for the dif erential diagnosis of benign and malig-nant breast tumors. RTE may be a good tool for breast cancer diagnosis.

Identifying the stability of housekeeping genes to be used for the quantitative real-time PCR normalization in retinal tissue of streptozotocin-induced diabetic rats

AIM:To investigate the stability of the seven housekeeping genes:beta-actin(ActB),glyceraldehyde-3-phosphate dehydrogenase(GAPDH),18s ribosomal unit 5(18s),cyclophilin A(CycA),hypoxanthine-guanine phosphoribosyl transferase(HPRT),ribosomal protein large P0(36B4)and terminal uridylyl transferase 1(U6)in the diabetic retinal tissue of rat model.METHODS:The expression of these seven genes in rat retinal tissues was determined using real-time quantitative reverse transcription polymerase chain reaction(RT-qPCR)in two groups;normal control rats and streptozotocininduced diabetic rats.The stability analysis of gene expression was investigated using geNorm,NormFinder,BestKeeper,and comparative delta-Ct(ΔCt)algorithms.RESULTS:The 36B4 gene was stably expressed in the retinal tissues of normal control animals;however,it was less stable in diabetic retinas.The 18s gene was expressed consistently in both normal control and diabetic rats’retinal tissue.That this gene was the best reference for data normalisation in RT-qPCR studies that used the retinal tissue of streptozotocin-induced diabetic rats.Furthermore,there was no ideal gene stably expressed for use in all experimental settings.CONCLUSION:Identifying relevant genes is a need for achieving RT-qPCR validity and reliability and must be appropriately achieved based on a specific experimental setting.

Application of real-time shear wave elastography to Achilles tendon hardness evaluation in older adults

BACKGROUND Real-time shear wave elastography(SWE)is a non-invasive imaging technique used to measure tissue stiffness by generating and tracking shear waves in real time.This advanced ultrasound-based method provides quantitative information regarding tissue elasticity,offering valuable insights into the mechanical properties of biological tissues.However,the application of real-time SWE in the musculoskeletal system and sports medicine has not been extensively studied.AIM To explore the practical value of real-time SWE for assessing Achilles tendon hardness in older adults.METHODS A total of 60 participants were enrolled in the present study,and differences in the elastic moduli of the bilateral Achilles tendons were compared among the following categories:(1)Age:55-60,60-65,and 65-70-years-old;(2)Sex:Male and female;(3)Laterality:Left and right sides;(4)Tendon state:Relaxed and tense state;and(5)Tendon segment:Proximal,middle,and distal.RESULTS There were no significant differences in the elastic moduli of the bilateral Achilles tendons when comparing by age or sex(P>0.05).There were,however,significant differences when comparing by tendon side,state,or segment(P<0.05).CONCLUSION Real-time SWE plays a significant role compared to other examination methods in the evaluation of Achilles tendon hardness in older adults.

Real-time Shear Wave Elastography Assessment of Muscle Elasticity in Patients with Renal Failure

Objective:To explore the value of real-time elastic shear wave in evaluating muscle elasticity in patients with renal failure.Methods:50 patients with chronic renal failure from January 2019 to December 2022 were randomly selected as the experimental group,and 50 healthy patients aged 21-61 during the same period were selected as the control group,and the basic information of the patients,including age,gender,body mass index,etc.,were collected.Besides,the Young's modulus of the two groups of patients were observed and analyzed.Results:The Young's modulus values of left and right gastrocnemius muscles in the experimental group were significantly lower than those in the control group(P<0.05),and there was no statistical difference between the left and right sides of the experimental group and the control group(P>0.05).Conclusion:Real-time shear wave elastography provides a non-invasive,real-time and effective tool for the assessment of muscle elasticity in patients with renal failure.Through further research and optimization,real-time shear wave elastography will play a greater role in the prevention and treatment of patients with renal failure,improving the quality of life and prognosis of patients.

Assessment of Fibrosis during the Development of Fatty Liver in Rabbits using Real-time Shear-wave Elastography

Nonalcoholic and alcoholic rabbit models of fatty liver were established by feeding on high-fat diet and alcohol, respectively, and fatty liver stiffness at different pathological stages was as- sessed with real-time shear-wave elastography （SWE）, so as to investigate the fibrosis process during the development of fatty liver. The fatty liver stiffness of rabbit in nonalcoholic and alcoholic groups was higher than that in the control group, and that in alcohol group was higher than that in the nonalco- holic group （P〈0.01）. The elasticity modulus of liver in fatty liver rabbits of nonalcoholic and alcoholic groups showed a positive correlation with progression of liver fibrosis （P〈0.01）. Real-time SWE, as a noninvasive diagnostic method, can objectively reflect the liver stiffness change and progression of liver fibrosis during the development of fatty liver.

Soft Tissue Deformation Modeling in the Procedure of Needle Insertion:A Kriging‑Based Method

The simulation and planning system(SPS)requires accurate and real-time feedback regarding the deformation of soft tissues during the needle insertion procedure.Traditional mechanical-based models such as the finite element method(FEM)are widely used to compute the deformations of soft tissue.However,it is difficult for the FEM or other methods to find a balance between an acceptable image fidelity and real-time deformation feedback due to their complex material properties,geometries and interaction mechanisms.In this paper,a Kriging-based method is applied to model the soft tissue deformation to strike a balance between the accuracy and efficiency of deformation feedback.Four combinations of regression and correlation functions are compared regarding their ability to predict the maximum deformations of ten characteristic markers at a fixed insertion depth.The results suggest that a first order regression function with Gaussian correlation functions can best fit the results of the ground truth.The functional response of the Kriging-based method is utilized to model the dynamic deformations of markers at a series of needle insertion depths.The feasibility of the method is verified by investigating the adaptation to step variations.Compared with the ground truth of the finite element(FE)results,the maximum residual is less than 0.92 mm in the Y direction and 0.31 mm in the X direction.The results suggest that the Kriging metamodel provides real-time deformation feedback for a target and an obstacle to a SPS.

Alternative Approach for Studying Contractility of the Isolated Muscle Preparations in Real-Time Mode

The real-time control over the observed parameters is known to be necessary during the experiments with biological objects. The use of approaches, such as real-time operating systems, often requires significant material or human resources (operating time, the special administration and programming skills and etc.). In this paper we propose an alternative approach for the implementation of real-time mode in the experiments on muscle preparations (papillary muscles, trabeculae, walls of vessels) based on an external input-output cards with built-in analog-to-digital/digital-to-analog converters and signal processor. As a result, we developed a hardware-software complex for studying the mechanical properties of biological materials (muscles) in real-time mode. This solution has a convenient and easy-to-use user interface, and requires a minimum of computing resources and minimal cost of electricity.

经直肠实时组织弹性成像引导靶向穿刺在前列腺癌诊断中的应用研究

目的 探讨经直肠实时组织弹性成像(transrectal real-time tissue elastography,TRTE)引导靶向穿刺诊断前列腺癌的临床应用价值。方法 选取2020年1月至2022年12月于郑州市第一人民医院就诊的可疑前列腺癌患者52例为研究对象,术前均行经直肠常规超声及TRTE检查评估前列腺病变的良恶性,对TRTE发现可疑病灶的28例患者行TRTE引导靶向穿刺(2针)+系统穿刺(8针),对TRTE未发现可疑病灶的24例患者行直肠常规超声引导系统穿刺(12针),分析TRTE诊断前列腺癌的效能及对比分析靶向穿刺与系统穿刺的穿刺阳性率。结果 本研究最终病理确诊前列腺癌25例,良性病变27例;TRTE诊断前列腺癌28例,良性病变24例,诊断的阳性预测值、阴性预测值分别为75.0%(21/28)、83.3%(20/24)。TRTE发现可疑病灶的28例患者,靶向穿刺共56针,诊断前列腺癌36针,阳性率64.29%(36/56),系统穿刺共224针,诊断前列腺癌89针,阳性率39.73%(89/224);靶向穿刺的前列腺癌穿刺阳性率显著高于系统穿刺(P<0.05)。结论 TRTE可较好地诊断前列腺癌,其引导靶向穿刺诊断前列腺癌的阳性率更高,可在减少穿刺针数的基础上最大限度提高穿刺阳性率。

3种方法单独及联合诊断甲状腺微小结节的价值比较

目的 比较二维高频超声、声脉冲辐射力成像(ARFI)-声触诊组织定量(VTQ)技术及应变弹性成像3种方法单独及联合诊断甲状腺微小结节良恶性的价值。方法 回顾性分析2021年6月—2023年6月在陕西省宝鸡市人民医院就诊的99例(107个甲状腺微小实性结节)结节直径≤10.0 mm患者的临床资料,均采用二维高频超声、ARF-VTQ技术及应变弹性成像进行检查,获得超声资料评分及数据,以穿刺活检和手术病理结果为诊断“金标准”,比较3种超声检查方法单独及联合应用对甲状腺微小结节的诊断效能。结果 62例患者(共68个结节)选择FNAB,37例患者(共39个结节)选择手术。107个甲状腺微小结节中,诊断为恶性微小结节45个,良性微小结节62个。恶性微小结节与良性微小结节相比,结节内回声(等回声和高回声、极低回声和低回声)、边界、微钙化、纵横比>1及血供情况和供血动脉阻力指数(RI)比较,差异均有统计学意义(P<0.05)。二维高频超声诊断甲状腺微小结节C-TIRADS积分临界值≥2分(C-TIRADS 4b)时,诊断灵敏度为73.33%,特异度为79.03%,曲线下面积[AUC(95%CI)]为0.762(95%CI:0.670~0.839);ARFI-VTQ技术中,107个甲状腺微小结节SWV测值为0.52~7.55 m/s,平均(2.62±0.61)m/s,其中24个实性结节多次出现×.××m/s,最后测值以7.55 m/s记录。恶性微小结节SWV均值为(5.24±2.23) m/s,高于良性微小结节的(2.11±0.70) m/s,差异有统计学意义(t=10.258,P<0.05);当SWV临界值为3.19 m/s时,诊断灵敏度为77.78%,特异度为80.65%,AUC(95%CI)为0.792(95%CI:0.703~0.865);应变弹性成像检查中,当评分临界值≥3分时,诊断的灵敏度为75.56%,特异度为77.42%,AUC(95%CI)为0.765(95%CI:0.673~0.841)。三者联合应用诊断的阳性微小结节为44个,阴性微小结节63个,诊断灵敏度为93.33%,特异度为96.77%,AUC(95%CI)为0.951(95%CI:0.891~0.983)。三者联合诊断效能与二维高频超声检查、ARFI-VTQ、应变弹性成像单独检测比较,差异均有统计学意义(Z=4.861、4.393、4.842,P<0.05)。结论 二维高频超声联合ARFI-VTQ技术及应变弹性成像可提高甲状腺微小结节良恶性的诊断准确性。

实时组织弹性成像评估非酒精性脂肪性肝炎患者肝纤维化分期临床价值研究

目的探讨采用实时组织弹性成像(RTE)技术检测评估非酒精性脂肪性肝炎(NASH)患者肝纤维化分期的价值。方法2021年6月~2022年6月我院收治的159例非酒精性脂肪性肝病(NAFLD)患者【其中单纯性脂肪肝(SFL)89例、NASH 47例和肝硬化23例】和53例健康体检者,均接受彩色超声诊断仪RTE检测肝脏有关指标,NAFLD患者接受肝活检。应用受试者工作特征曲线(ROC)并计算曲线下面积(AUC)分析诊断效能。结果LC组RTE指标相对应变值为(94.3±13.5),显著低于NASH患者【(105.2±20.6),P<0.05】或SFL患者【(115.1±9.8),P<0.05】或健康人【(121.3±17.1),P<0.05】,而蓝色面积百分比、复杂度、偏度、对比度和杂乱度分别为(25.9±4.3)%、(38.5±4.2)、(0.6±0.1)、(241.0±30.5)和(0.4±0.1),均显著高于NASH患者【分别为(21.2±4.1)%、(31.9±3.7)、(0.4±0.1)、(191.3±27.9)和(0.2±0.1),P<0.05】或SFL患者【分别为(16.2±1.9)%、(25.1±3.5)、(0.3±0.1)、(153.0±19.8)和(0.1±0.1),P<0.05】或健康人【分别为(9.2±1.5)%、(19.5±2.4)、(0.2±0.0)、(113.5±20.3)和(0.1±0.0),P<0.05】;在47例NASH患者中,病理学检查发现S0/S1期肝纤维化者16例,S2期19例和S3期12例;S3和S2期患者相对应变值分别为(101.2±7.9)和(106.7±10.3),显著低于S0/S1期患者【(112.5±9.8),P<0.05】,而S3期患者蓝色面积百分比、复杂度、偏度、对比度和杂乱度分别为(23.1±3.4)%、(34.6±3.7)、(0.4±0.1)、(202.5±23.7)和(0.2±0.0),显著大于S2期患者【分别为(19.8±2.5)%、(29.3±2.9)、(0.3±0.1)、(179.1±25.9)和(0.2±0.0),P<0.05】或S0/S1期患者【分别为(16.2±3.8)%、(25.9±3.5)、(0.3±0.1)、(152.8±21.1)和(0.1±0.1),P<0.05】;ROC曲线分析显示,综合RTE指标诊断NASH患者显著性和进展期肝纤维化的AUC为0.977,其灵敏度为84.2%,特异度为66.7%,准确性为77.4%。结论采用超声RTE指标诊断NASH患者显著性和进展期肝纤维化具有一定的临床价值,值得深入研究。

基于二维超声和实时组织弹性成像的双模态影像组学诊断高尿酸血症患者并发痛风性关节炎的应用价值

目的探讨基于二维超声和实时组织弹性成像(RTE)的双模态影像组学在诊断高尿酸血症(HUA)患者并发痛风性关节炎(GA)中的应用价值。方法选取于我院就诊的HUA患者59例,其中并发GA患者41例,未并发GA患者18例,使用最小绝对收缩和选择算子(LASSO)回归5折交叉验证法分别对二维超声、RTE的影像组学特征和临床特征进行筛选,获取影像组学最优特征子集;然后使用支持向量机(SVM)分类器进行GA与非GA二分类诊断,绘制受试者工作特征(ROC)曲线分析Adaboost融合SVM分类器对HUA并发GA的诊断效能。结果基于二维超声图像筛选出14个非零系数特征,基于RTE图像筛选出18个非零系数特征,将2种类型特征串联融合筛选出16个非零系数特征。双模态分类效果的最佳精确度(ACC)、全组F1值分别为74.17%±3.72%、74.56%±5.22%,较二维超声模态的最佳ACC、全组F1值分别提高了3.88%、3.26%,较RTE模态的最佳ACC、全组F1值分别提高了6.61%、8.08%。Adaboost融合SVM分类器后模型的最佳ACC、全组F1值分别为76.24%±2.50%、75.73%±3.22%,较SVM模型分别提高了2.07%、1.17%。ROC曲线分析显示,0、1类作为正样本时的曲线下面积分别为0.718、0.910。结论基于二维超声和RTE的双模态影像组学特征可对HUA患者并发GA进行定量表征和有效预测,在GA早期诊断中具有潜在的临床应用价值;且二维超声的分类效果优于RTE,双模态分类效果优于单模态。

多参数MRI与实时组织超声弹性成像在乳腺肿瘤中的诊断价值

目的探讨多参数磁共振(Magnetic resonance imaging,MRI)与实时组织超声弹性成像(Real time tissue ultrasound elastography,RTE)在乳腺肿瘤中的诊断价值。方法选取2021年10月-2023年5月泰安市立医院收治的338例乳腺肿瘤患者为研究对象,其中乳腺恶性肿瘤169例作为恶性组,乳腺良性肿瘤169例作为良性组。所有患者均接受多参数MRI与RTE检查,统计恶性组与良性组、恶性组不同病理特征患者多参数MRI、RTE检查参数,比较多参数MRI检查、RTE检查联合多参数MRI与RTE(联合检查)对乳腺肿瘤的鉴别诊断效能以及与乳腺癌病理特征的关联性。结果恶性组平均扩散率(Mean diffusivity,MD)、扩散系数(Diffusion coefficient,D)低于良性组,平均扩散峰度值(Average diffusion kurtosis value,MK)、灌注分数(Perfusion fraction,f)、容积转运参数(Volume transfer parameters,K^(trans))、速率常数(Rate constant,K_(ep))、血管外细胞外容积分数(Extracellular volume fraction of blood vessels,V-e)、RTE评分高于良性组,差异有统计学意义(P<0.05)。联合检查对乳腺癌的诊断敏感度、准确度(97.04%、95.56%)高于多参数MRI(84.02%、89.35%)与RTE(82.25%、88.76%)单独检查,差异有统计学意义(P<0.05);联合检查特异度(94.08%)与多参数MRI检查(94.67%)、RTE检查(95.27%)比较,差异无统计学意义(P>0.05)。淋巴结转移、Ⅲ~Ⅳ期乳腺癌患者MD、D低于无淋巴结转移、Ⅰ~Ⅱ期患者,MK、f、K^(trans)、K_(ep)、V-e、RTE评分高于无淋巴结转移、Ⅰ~Ⅱ期患者,差异有统计学意义(P<0.05)。MD、D与乳腺癌淋巴结转移、疾病分期呈负相关,MK、f、K^(trans)、K_(ep)、V-e、RTE与乳腺癌淋巴结转移、疾病分期呈正相关(P<0.05)。结论多参数MRI与RTE单一检查均可诊断乳腺肿瘤良恶性,但二者联合检查可进一步提升诊断准确性,同时评估疾病病理特征,为疾病干预方案的制定提供参考依据。

实时组织弹性成像评估慢性乙型肝炎患者食管静脉曲张的研究

目的评估实时弹性组织成像(RTE)诊断慢性乙型肝炎患者出现食管静脉曲张(EVs)的性能。方法回顾性分析回顾性分析2014年1月—2015年12月东方肝胆外科医院收治的127例慢性乙型肝炎患者的临床,腹部超声,RTE和上消化道内镜(EDG)等病例资料。分析LF index与不同程度EVs之间的关系。AUROC比较不同非侵入指标诊断患者出现EVs,高危EVs的性能。结果127例患者中,EDG发现55例(43.3%)有EVs,其中轻度33例(26.0%),中度11例(8.7%),重度11例(8.7%)。食管静脉曲张组患者PLT更低,γ球蛋白、APRI、FIB-4及LF index更高(P<0.001)。LF index与EVs分级呈强正相关(P<0.001,r=0.802)。PLT、γ球蛋白、APRI、FIB-4及LF index诊断EVs的AUROC值分别为0.296、0.770、0.797、0.801和0.891。LF index最佳截断值为2.71,其相应的敏感性、特异性、阳性预测值、阴性预测值、阳性似然比、阴性似然比及诊断准确性分别为92.7%、70.8%、76.4%、90.7%、3.2、0.1及81.8%。诊断高危食管静脉曲张时,PLT、γ球蛋白、APRI、FIB-4及LF index的AUROC值分别为0.262、0.858、0.862、0.897及0.935。LF index最佳截断值为3.28,其相应的敏感性、特异性、阳性预测值、阴性预测值、阳性似然比、阴性似然比及诊断准确性分别为86.6%、90.5%、90.3%、87.1%、9.1、0.1、88.6%。结论肝脏实时组织弹性成像所测得的LF index,对诊断慢性乙型肝炎患者静脉曲张具有很高的价值。

外周血t-PAIC、PIC结合超声弹性成像技术在下肢DVT评估中的应用价值

目的:探讨外周血组织型纤溶酶原激活物/纤溶酶原激活物抑制剂-1复合物(t-PAIC)、纤溶酶-α_(2)纤溶酶抑制物复合物(PIC)结合超声弹性成像技术在下肢深静脉血栓(DVT)评估中的应用价值。方法:选取206名疑似下肢DVT患者为研究对象,将临床确诊为下肢DVT的患者纳入DVT组(n=41),非下肢DVT患者纳入非DVT组(n=165);DVT组患者再根据分期分为急性期组(n=14)、亚急性期组(n=16)和慢性期组(n=11)。比较DVT组和非DVT组、DVT组中不同分期患者外周血指标(t-PAIC及PIC水平)、超声弹性成像参数(超声弹性成像评分及应变值)、Caprini血栓风险评分水平差异;采用Pearson相关性分析其与下肢DVT分期的相关性;ROC曲线评估其对下肢DVT的诊断价值。结果:DVT组患者t-PAIC及PIC水平、超声弹性成像评分及应变值、Caprini血栓风险评分均高于非DVT组(P<0.05)。DVT组中不同分期患者外周血t-PAIC及PIC水平、超声弹性成像评分及应变值、Caprini血栓风险评分比较,差异均有统计学意义(P<0.05),且急性期<亚急性期<慢性期。相关性分析显示,t-PAIC及PIC水平、超声弹性成像评分及应变值、Caprini血栓风险评分与下肢DVT分期均呈正相关关系(r=0.654、0.812、0.514、0.711、0.681,P<0.05)。ROC曲线分析显示,外周血t-PAIC及PIC水平、超声弹性成像评分及应变值、Caprini血栓风险评分及联合检测下肢DVT的曲线下面积(AUC)分别为0.754,0.765,0.759,0.730,0.752和0.894,联合检测诊断价值更高(P<0.05)。结论:外周血t-PAIC、PIC水平联合超声弹性成像技术对下肢DVT有较好的诊断价值,且有利于疾病分期。

腹部超声中实时组织弹性成像联合剪切波速度测量在肝脏局灶性病变中的诊断价值

目的 分析腹部超声中实时组织弹性成像联合剪切波速度测量在肝脏局灶性病变中的诊断价值。方法 选择2019年3月至2021年3月郑州颐和医院收治的90例肝脏局灶性病变患者作为研究对象,所有患者均接受腹部超声中实时组织弹性成像与剪切波速度测量,以术后病理结果作为金标准,对比腹部超声中实时组织弹性成像联合剪切波速度测量诊断在肝脏局灶性病变性质中的鉴别价值。绘制受试者工作特征(ROC)曲线,分析腹部超声中实时组织弹性成像、剪切波速度测量及联合检测对肝脏局灶性病变性质中的鉴别价值。结果 以术后病理诊断结果为金标准,90例肝脏局灶性病变患者中恶性肿瘤有53个(58.89%),其中肝细胞癌35个(66.04%),肝转移癌10个(18.87%),胆管细胞癌8个(15.09%);良性肿瘤37个(41.11%),其中肝硬化结节12个(32.43%),血管瘤17个(45.94%),腺瘤4个(10.81%),炎性结节4个(10.81%)。腹部超声中实时组织弹性成像、剪切波速度测量及联合与金标准的一致性分别为0.402、0.586、0.767。三种诊断方式的特异度对比差异无统计学意义(P> 0.05);腹部超声中实时组织弹性成像、剪切波速度及联合诊断的准确度、灵敏度对比,以联合诊断最高,差异均有统计学意义(P <0.05);ROC曲线显示,腹部超声中实时组织弹性成像、剪切波速度及联合对肝脏局灶性病变的曲线下面积(AUC)分别为0.709(95%CI:0.599~0.818)、0.809(95%CI:0.716~0.901)、0.877(95%CI:0.794~0.960)。结论 腹部超声中实时组织弹性成像与剪切波速度均可有效鉴别肝脏局灶性病变性质,但通过联合检测的方式可提高诊断效能,值得应用。

Real Time Ultrasound Elastography for the Differentiation of Benign and Malignant Thyroid Nodules

The purpose of this study was to evaluate the predictive value of real-time ultrasound elastography (RUE) in differentiating benign from malignant thyroid nodules, with fine needle aspiration cytology analysis as the reference standard. A total of 78 consecutive patients with thyroid nodules who were selected for fine needle aspiration biopsies were examined in this prospective study. 78 nodules in these patients were examined by conventional ultrasound, and ultrasound elastography. The final diagnosis was obtained from cytological findings. Tissue stiffness on ultrasound elastography was scored from 1 (low stiffness over the entire nodule) to 5 (high stiffness over the entire nodule and surrounding tissue). On real-time ultrasound elastography, 47 of 62 benign nodules (76%) had a score of 1 or 2, whereas 15 of 16 malignant nodules had a score of 3 to 5, with sensitivity of 93.7%, specificity of 90%, a positive predictive value of 71%, and a negative predictive value of 98%. Real-time ultrasound elastography is a promising imaging technique that is useful in the differential diagnosis of thyroid cancer. Utilization of ultrasound elastography could reduce the rate of thyroid biopsies because of its high elasticity being highly associated with benign cytology.

DYNAMIC OPTICAL COHERENCE ELASTOGRAPHY:A REVIEW

With the development of optical coherence tomography,the application optical coherence elastography(OCE)has gained more and more attention in biomechanics for its unique features including micron-scale resolution,real-time processing,and non-invasive imaging.In this review,one group of OCE techniques,namely dynamic OCE,are introduced and discussed including external dynamic OCE mapping and imaging of ex vivo breast tumor,external dynamic OCE measurement of in vivo human skin,and internal dynamic OCE including acoustomotive OCE and magnetomotive OCE.These techniques overcame some of the major drawbacks of traditional static OCE,and broadened the OCE application fields.Driven by scientific needs to engineer new quantitative methods that utilize the high micron-scale resolution achievable with optics,results of biomechanical properties were obtained from biological tissues.The results suggest potential diagnostic and therapeutic clinical applications.Results from these studies also help our understanding of the relationship between biomechanical variations and functional tissue changes in biological systems.

Shear Wave Elastography of Invasive Ductal Carcinoma:Correlations between Shear Wave Velocity and Histological Prognostic Factors

The correlations between shear wave velocity(SWV)calculated from virtual touch tissue imaging quantification(VTIQ)technique and histological prognostic factors of invasive ductal carcinoma was investigated.A total of 76 breast tumors histologically confirmed as invasive ductal carcinomas were included in this study.SWV values were measured by VTIQ for each lesion preoperatively or prior to breast biopsy.The maximum values were recorded for statistical analysis.Medical records were reviewed to determine tumor size,histological grade,lymph node status and immunohistochemical results.Tumor subtypes were categorized as luminal A,luminal B,human epidermal growth factor receptor 2(HER2)positive and triple negative.The correlations between SWV and histological prognostic factors were analyzed.It was found that tumor size showed positive association with SWV(r=0.465,P<0.001).Larger tumors had significantly higher SWV than smaller ones(P=0.001).Histological grade 1 tumors had significantly lower SWV values than those with higher histological grade(P=0.015).The Ki67 expression,tumor subtypes and lymph node status showed no statistically significant correlations with SWV,although triple negative tumors and lymph node-positive tumors showed higher SWV values.It was concluded that tumor size was significantly associated with SWV.Higher histological grade was associated with increased SWV.There was no statistically significant correlations between SWV and other histological prognostic factors.

剪切波弹性成像技术定量评估肿块周围组织硬度对乳腺良恶性肿瘤鉴别诊断的价值

目的:探讨剪切波弹性成像技术定量评估肿块周围组织硬度在乳腺良恶性肿瘤诊断中的应用价值。方法:收集2019年7月至2022年6月,在我院经手术病理结果证实的乳腺肿瘤患者141例,共152个肿块,良性肿块66个,恶性肿块86个,进行BI-RADS分类并测量肿块及周围1 mm、2 mm、3 mm范围组织弹性模量值(E_(max)、E_(mean)、E_(sd)、E_(min)、SE_(max1)、SE_(mean1)、SE_(sd1)、SE_(min1)、SE_(max2)、SE_(mean2)、SE_(sd2)、SE_(min2)、SE_(max3)、SE_(mean3)、SE_(sd3)、SE_(min3)),比较良恶性肿块及其周围组织这16组参数之间的差异。以病理诊断为金标准,绘制受试者工作特征曲线(ROC),比较各参数的曲线下面积(AUC),获得诊断价值最大的参数。结果:乳腺良恶性肿块及其周围组织弹性模量值差异均具有统计学意义,E_(max)、E_(mean)、E_(sd)值恶性肿块高于良性,E_(min)恶性肿块低于良性;E_(max)、SE_(max1)、SE_(max2)、SE_(max3),4组参数的AUC值均大于0.90,其中SE_(max2)的AUC值最大,为0.958,诊断截断值为>128.33 kPa,诊断的敏感性77.9%,特异性85.0%,准确率85.5%。结论:乳腺良恶性肿块周围2 mm范围组织的SEmax2值诊断效能最高,诊断的敏感性、特异性、准确率均优于二维超声,有良好的临床应用价值。

缺血性脑血管病患者斑块内部不同组织成分的超声弹性图表现

目的观察缺血性脑血管病患者斑块内部不同组织成分的超声弹性图表现。方法选取郑州大学第二附属医院收治的缺血性脑血管病患者,均接受常规超声与超声实时组织弹性成像(RTE)检查,结合术后病理结果,仔细观察斑块内部不同组织成分(包括纤维组织、钙化、脂质坏死核心以及出血/血栓等)超声弹性图表现,比较不同声像图分型斑块RTE弹性评分,分析常规超声、RTE及二者联合诊断易损斑块准确性。结果超声弹性图中,纤维组织显示蓝色,钙化显示蓝白色,脂质坏死核心显示绿色,出血/血栓显示绿色与红绿色相间或者蓝绿色相间;均质型斑块RTE弹性评分明显高于脂质型、混合型、溃疡斑块(P<0.05);常规超声诊易损斑块断灵敏度82.76%,特异度66.67%,准确性80.00%,Kappa值0.41;RTE诊断灵敏度90.80%,特异度88.89%,准确性90.48%,Kappa值0.70;二者联合诊断灵敏度97.70%,特异度94.44%,准确性97.14%,Kappa值0.90;二者联合诊断准确性明显高于常规超声、RTE(P<0.05),且RTE明显高于常规超声;二者联合诊断灵敏度明显高于常规超声(P<0.05)。结论缺血性脑血管病患者斑块内部不同组织成分在超声弹性图中表现各异,相较于常规超声,RTE对易损斑块诊断准确性更高,且二者联合诊断准确性优于单一诊断。