Optimization of ultrasonic elastography by coded excitation and transmit-side multi-frequency compounding

To improve the quality of ultrasonic elastography, by taking the advantage of code excitation and frequency compounding, a transmitting-side multi-frequency with coded excitation for elastography （TFCCE） was proposed. TFCCE adopts the chirp signal excitation scheme and strikes a balance in the selection of sub-signal bandwidth, the bandwidth overlap and the number of sub-strain image based on theoretical derivation, so as to further improve the quality of elastic image. Experiments have proved that, compared with the other optimizing methods, the elastographyic signal-to-noise ratio（Re-SN） and contrast-to-noise ratio（Re-CN） are improved significantly with different echo signal-to-noise ratios （ReSN） and attenuation coefficients. When ReSN is 50 dB, compared with short pulse, Rc-SN and Re-CN obtained by TFCCE increase by 53% and 143%, respectively. Moreover, in a deeper investigation （85-95 mm）, the image has lower strain noise and clear details. When the attenuation coefficient is in the range of 0-1 dB/（cm.MHz）, Re-SN and Re-CN obtained by TFCCE can be kept in moderate ranges of 5〈Re-SN〈6.8 and 11.4〈Re-CN〈15.2, respectively. In particular, for higher tissue attenuation, the basic image quality cannot be ensured with short pulse excitation, while mediocre quality strain figure can be obtained by TFCCE. Therefore, the TFCCE technology can effectively improve the elastography quality and can be applied to ultrasonic clinical trials.

Relationship of the ultrasonic elastography parameter of thyroid carcinoma with the cancer cell growth and neovascularization in lesion tissue

Objective: To study the relationship of the ultrasonic elastography parameter of thyroid carcinoma with the cancer cell growth and neovascularization in lesion tissue. Methods:Patients with thyroid carcinoma who underwent surgical resection and were pathologically diagnosed in Dazhu People's Hospital between March 2015 and June 2017 were chosen as the case group, the patients who received ultrasonic examination and were diagnosed with benign thyroid tumor in Dazhu People's Hospital during the same period were selected as the control group, and the ultrasonic elastography parameter strain ratio as well as the oncogene expression and angiogenesis molecule contents in the thyroid carcinoma tissue and adjacent tissue was determined. Results: DMBT1, CCNG2 and Bax mRNA expression as well as ES protein level in thyroid carcinoma tissue were significantly lower than those in adjacent tissue whereas WIP1 and RET/PTC mRNA expression as well as VEGF, vWF and ANG-1 protein levels were significantly higher than those in adjacent tissue;DMBT1, CCNG2 and Bax mRNA expression as well as ES protein level in thyroid carcinoma tissue with strain ratio ≥3.14 were significantly lower than those in thyroid carcinoma tissue with strain ratio <3.14 whereas WIP1 and RET/PTC mRNA expression as well as VEGF, vWF and ANG-1 protein levels were significantly higher than those in thyroid carcinoma tissue with strain ratio <3.14. Conclusion:The testing threshold 3.14 of ultrasonic elastography parameter stain ratio of thyroid carcinoma can accurately assess the vitality of cancer cell growth and neovascularization in lesion tissue.

Value of transient ultrasonic elastography for evaluating the liver fibrosis and liver function in patients with drug-induced liver injury

Objective: To study the value of transient ultrasonic elastography for evaluating the liver fibrosis and liver function in patients with drug-induced liver injury. Methods: A total of 68 patients with drug-induced liver injury who were treated in our hospital between January 2016 and May 2017 were selected as drug-induced liver injury group, and 50 healthy volunteers who received physical examination in our hospital during the same period were selected as normal control group. The liver transient ultrasonic elastography parameter Stiffness levels as well as serum liver fibrosis index and liver function index contents of two groups of subjects were detected. Pearson test was used to evaluate the correlation of Stiffness levels with liver fibrosis and liver function damage degree in patients with drug-induced liver injury. Results:Stiffness level in drug-induced liver injury group was higher than that in normal control group;serum liver fibrosis indexes HA, LN, CⅣ, PⅢNP and CG contents were higher than those of normal control group;serum liver function indexes ALT, AST, ALP, STB and γ-GT contents were higher than those of normal control group. Conclusion: Transient ultrasonic elastography parameter Stiffness levels increase in patients with drug-induced liver injury, and the specific levels are consistent with the liver fibrosis and liver function damage degree, and can be used as the objective means to evaluate the disease severity.

Relationship of ultrasonic elastography parameters of cervical cancer with the cancer cell growth and angiogenesis in the lesion tissue

Objective: To study the relationship of ultrasonic elastography parameters of cervical cancer with the cancer cell growth and angiogenesis in the lesion tissue. Methods: A total of 110 patients who were diagnosed with cervical cancer in the hospital between December 2015 and January 2017 were collected as the observation group, 80 patients who received hysteroscopic cervical polyp resection in the hospital during the same period were collected as the control group. The levels of cervical ultrasonic elastography parameters in the two groups were detected, and fluorescence quantitative PCR was used to determine the expression of proliferation genes, apoptosis genes and angiogenesis-related genes in the lesion tissue. Pearson test was used to evaluate the correlation between cervical ultrasonic elastography parameters and the tumor malignancy indexes. Results: Elastic image press release index and strain ratio of local lesion of observation group were significantly higher than those of control group;GBP1 mRNA expression in lesion tissue of observation group was lower than that in lesion tissue of control group while Prdx4, STAT3 and Sp2 mRNA expression were higher than those in lesion tissue of control group;Survivin, FasL and Bcl-2 mRNA expression in lesion tissue of observation group were higher than those in lesion tissue of control group while Fas and Bax mRNA expression were lower than those in lesion tissue of control group;VEGF, MMP-9, COX-2 and HIF-1 mRNA in lesion tissue of observation group were significantly higher than those in lesion tissue of control group. Conclusion: Elastic image press release index and strain ratio of cervical tissue of patients with cervical cancer are higher, and the specific increase is directly correlated with the tumor malignancy.

Ultrasonic elastography in clinical quantitative assessment of fatty liver

AIM: To investigate the clinical application of ultrasonic elastography in quantitative assessment of fatty liver grading. METHODS: A total of 105 patients with fatty liver were divided into mild group (n = 46), moderate group (n = 39), and severe group (n = 20). Forty-five healthy individuals served as a normal control group. All patients who underwent routine ultrasound scan and further ultrasonic elastography were evaluated accordingly to the evaluation standards for ultrasonic elastography. The ratio of surface areas of blue region/total surface area in the desired region was measured. RESULTS: Ultrasonic elastography technique, in comparison to traditional ultrasound, had a rather high consistence in grading of fatty liver [κ value = (95.3%63.6%)/(1%-63.6%) = 0.87, P = 0.001]. The score of ultrasonic elastography increased with the severity of fatty liver with a sensitivity of 97.14% and a specificity of 91.11%. A significant difference was found in the ratio of surface areas of blue regions between different groups (P < 0.05).CONCLUSION: Ultrasonic elastography can be used in quantitative assessment of the severity of fatty liver.

Preoperative neoadjuvant chemotherapy in patients with breast cancer evaluated using strain ultrasonic elastography

BACKGROUND The incidence of breast cancer in China is increasing while its mortality rate is decreasing.The annual breast cancer incidence in China is 39.2 million,accounting for two-thirds of the urban population.In China,breast cancer is the fifth most common malignant tumor overall and the most common in women,accounting for 17%of female malignant tumors.AIM To investigate the accuracy of strain ultrasound elastography(SUE)on the evaluation of preoperative neoadjuvant chemotherapy(NAC)in breast cancer.METHODS Overall,90 patients with breast cancer treated at our hospital between January 2018 and February 2019 were selected for this study.The patients received six cycles of NAC with docetaxel,epirubicin,and cyclophosphamide.Surgical treatment was also performed,and pathological reactivity was assessed.The patients were evaluated using conventional ultrasonography and SUE before biopsy.The differences between groups were analyzed to calculate the mean and standard deviation with significance measured using a t-test,while multivariate analysis was performed using logistic regression analysis.RESULTS Of the patients analyzed,20 had a pathological complete remission(pCR)while 70 did not achieve pCR after NAC.The ratio of the elastic strain ratio(SR)and elastic score of 4–5 in patients with pCR were 5.5±1.16 and 15.00%,respectively;these were significantly lower than those in patients without pCR(85%)and significantly higher than in patients without pCR(14%).SR and elastic score 4–5 were independent factors influencing NAC efficacy(OR=0.644,1.426 and 1.366,respectively,P<0.05).SR was positively correlated with elasticity score(rs=0.411,P<0.05).The area under the receiver operator characteristic curve of SR and SR combined with elastic score in predicting patients without pCR was 0.822 and 0.891,respectively(P<0.05).CONCLUSION Strain ultrasonic elastography may be used to evaluate the effects of preoperative NAC in patients with breast cancer.

Correlation between the ultrasonic elastography parameters of cervical cancer and the malignant biological behavior of cancer cells

Objective:To investigate the correlation between the ultrasonic elastography parameters of cervical cancer and the malignant biological behavior of cancer cells.Methods: A total of 180 patients with cervical cancer who were diagnosed and treated with radical operation in this hospital were selected as research objects, and the cervical cancer tissue and adjacent tissue samples were collected during operation and stored in liquid nitrogen tanks. The ultrasonic elastography strain ratio of cervical cancer and adjacent tissues was detected before operation, and the differences in the expression of genes associated with proliferation, invasion and autophagy were compared. Pearson test was used to evaluate the correlation between the cervical cancer strain ratio and the malignant biological behavior of cancer cells. Results: The strain ratio level of cervical cancer tissue was higher than that of adjacent tissue;expressions of proliferation-related genes AEG-1, TRAF6 and FoxM1 mRNA were higher than those in adjacent tissue whereas expressions of SFRP2, MST1 and Bmi-1 mRNA were lower than those in adjacent tissue;expressions of invasion-related genes ILK, Sox2, Twist, YB-1 and Rab11 mRNA were higher than those in adjacent tissue;expressions of autophagy-related genes ARHI, Beclin1, PULK and PI3KC3 mRNA were lower than those in adjacent tissue.Conclusions: Ultrasonic strain ratio level of cervical cancer is closely related to the proliferation, invasion and autophagy activity of cancer cells, and is positively correlated with the overall malignancy of the tumor.

Correlation of the pathological features of benign and malignant thyroid nodules with ultrasonic elastography parameters

Objective:To investigate the correlation of the pathological features of benign and malignant thyroid nodules with ultrasonic elastography parameters.Methods:A total of 176 patients with thyroid tumor who underwent thyroid tumor resection in this hospital between September 2016 and February 2018 were chosen as the research subjects, the 119 patients with thyroid cancer were selected as thyroid cancer group and the 57 patients with thyroid adenoma were selected as thyroid adenoma group. The thyroid cancer-related proliferation gene and thyroid cancer-related invasion gene expression as well as ultrasonic strain ratio in tumor tissues were compared between the two groups, and Pearson test was used to evaluate the correlation between above malignant molecule expression and ultrasonic strain ratio.Results: Thyroid cancer-related proliferation genes FOXA1, YAP and TPX2 mRNA expression in lesion tissues of thyroid cancer group were higher than those of thyroid adenoma group whereas EGCG and PDCD4 mRNA expression were lower than those of thyroid adenoma group;thyroid cancer-related invasion genes BRD4, Twist1, FoxM1 and SIRT1 expression were higher than those of thyroid adenoma group whereas Wortmannin and HIC1 mRNA expression were lower than those of thyroid adenoma group;ultrasonic strain ratio was higher than that of thyroid adenoma group. The Pearson test showed that the proliferation gene and invasion gene expression in thyroid cancer tissues were directly correlated with the ultrasonic strain ratio level.Conclusion: Thyroid cancer-related proliferation gene and invasion gene expression are directly correlated with ultrasonic strain ratio level, and ultrasonic elastography can be the reliable means to judge benign and malignant thyroid nodules.

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。

BI-RADS分级联合UE在乳腺癌诊断中的价值分析

目的:探讨乳腺影像报告与数据系统(BI-RADS)分级联合超声弹性成像(UE)在乳腺癌诊断中的价值。方法:选取2019年1月—2022年1月洛阳伊洛医院检查的126例疑似乳腺癌患者作为研究对象,均采用BI-RADS分级及UE技术检查,以手术病理为金标准,判断两种检查方法联合使用的灵敏度、特异度、阳性预测值、阴性预测值、准确性。结果:126例患者中,手术病理结果显示78例患者为乳腺增生,48例为恶性肿瘤。乳腺癌组BI-RADS分级及UE评分较乳腺增生组更高,差异有统计学意义(t=7.641、10.618,P<0.05);联合检查灵敏度、特异度、阳性预测值、阴性预测值、准确性分别为95.83%、98.72%、97.87%、97.47%、97.62%,BI-RADS检查分别为79.17%、89.74%、82.61%、87.50%、85.71%,UE检查分别为77.08%、88.46%、80.43%、86.25%、84.13%,联合检查灵敏度、特异度、阳性预测值、阴性预测值、准确性较BI-RADS分级与UE检查更高,差异有统计学意义(χ^(2)=7.554、6.861、7.474、6.896、14.171,P<0.05)。结论:BI-RADS分级联合UE在乳腺癌的检查中具有较高的诊断价值,可有效提高疾病诊出率及诊断效能。

SMI联合UE鉴别甲状腺结节的价值

本研究探讨超微血管显像(SMI)联合超声弹性成像(UE)鉴别甲状腺结节良恶性的价值。甲状腺结节患者均给予彩超、SMI及UE检查,分析诊断结果。80例患者共计122枚结节,恶性结节经SMI判断结节血流分型Ⅱ~Ⅲ级比例明显高于良性结节(P<0.05);恶性结节形态规则、内部囊性病变比例明显低于良性结节(P<0.05),而边界不清、纵横比≥1、低回声和内部钙化的比例明显高于良性结节(P<0.05);恶性结节应变率比值≥3.79、弹性评分4~5分的比例明显高于良性结节(P<0.05);SMI联合UE诊断甲状腺恶性结节的灵敏性和阴性预测值明显高于彩超联合UE诊断(P<0.05)。SMI联合UE有助于提高甲状腺结节良恶性鉴别能力,值得临床使用。

不同年资医师应用TI-RADS结合UE鉴别诊断甲状腺结节价值分析

目的分析不同年资医师应用TI-RADS结合UE鉴别甲状腺良恶性结节价值。方法由两位不同年资医师分别对160例甲状腺结节进行TI-RADS分类及UE评分,以病理结果作为诊断标准,计算诊断准确率及一致性。结果不同年资医师应用TI-RADS诊断甲状腺良恶性结节一致性较好,Kappa值0.826。TI-RADS4类甲状腺结节诊断准确率相对较低,低、高年资医师分别为65.79%、74.07%。TIRADS 4类甲状腺结节结合UE,低、高年资医师诊断准确率分别提高至87.5%、90.63%。结论不同年资医师应用TI-RADS鉴别甲状腺良恶性结节有较高的一致性,TI-RADS 4类甲状腺结节结合UE,不同年资医师诊断准确率均提高。

支气管镜下UE技术在肺门纵隔淋巴结定性诊断中的应用研究

目的分析支气管镜下超声弹性成像(UE)技术在肺门纵隔淋巴结定性诊断中的应用价值。方法选取2019年6月至2021年10月梅州市人民医院经肺部增强CT检查确诊的肺门纵膈肿大患者123例,全部患者均接受支气管镜下常规超声和UE技术检查。并以经气管镜超声引导针吸活检术(EBUS-TBNA)病理结果为金标准,分析支气管镜下常规超声、UE技术定性诊断肺门纵隔淋巴结的价值。结果123例接受EBUS-TBNA检查的患者中,共穿刺139枚淋巴结,经EBUS-TBNA病理结果确诊恶性淋巴结90枚(64.75%),良性49枚(35.25%)。在EBUS-TBNA病理结果诊断为恶性的90枚淋巴结中,支气管镜下常规超声诊断为恶性69枚,良性21枚;UE技术诊断为恶性80枚,良性10枚。EBUS-TBNA病理结果诊断为良性的49枚淋巴结中,支气管镜下常规超声诊断为良性35枚,恶性14枚;UE技术诊断为良性42枚,恶性7枚。支气管镜下常规超声定性诊断肺门纵膈淋巴结与EBUS-TBNA病理结果的一致性一般(Kappa值=0.466);UE技术定性诊断肺门纵膈淋巴结与EBUS-TBNA病理结果的一致性较好(Kappa值=0.736)。支气管镜下UE评分在淋巴结良恶性组中的差异有统计学意义(P<0.05)。支气管镜下常规超声定性诊断肺门纵膈淋巴结的敏感度、准确度、特异度、阴性预测值、阳性预测值分别为76.67%、74.82%、71.43%、62.50%、83.13%;UE技术定性诊断肺门纵膈淋巴结的敏感度、准确度、特异度、阴性预测值、阳性预测值分别为88.89%、87.77%、85.71%、80.77%、91.95%;支气管镜下UE技术定性诊断肺门纵膈淋巴结的敏感度、准确度、阴性预测值均高于常规超声检查,差异有统计学意义(P<0.05)。结论支气管镜下UE技术定性诊断肺门纵隔淋巴结与EBUS-TBNA病理结果的一致性较好,有利于肺门纵隔淋巴结良恶性的鉴别诊断。

Application of Shear Wave Elastography and Contrast-Enhanced Ultrasound in Transrectal Prostate Biopsy

Objective To explore the clinical value of ultrasound shear wave elastography(SWE)and contrast-enhanced ultrasound(CEUS)in transrectal prostate biopsy.Methods A total of 54 patients(average age:67.79±12.01 years)in the experimental group underwent transrectal prostate biopsy under the guidance of SWE,while 46 patients(average age:69.22±11.54 years)in the control group underwent transrectal prostate biopsy guided by CEUS.Results There were a total of 451 needles,with an average of 8.35±1.67 needles per patient in the experimental group,and a total of 462 needles,with an average of 10.04±1.33 needles per patient in the control group.The difference in puncture times between the two groups was statistically significant(P<0.05).There was no significant difference in the positive detection rate,sensitivity or specificity between the two groups(P>0.05),but there was a significant difference in the diagnostic accuracy between the two groups(P<0.05).The E_(mean)and E_(max)of prostate cancer were significantly higher in the experimental group than in benign prostatic hyperplasia(P<0.05).The receiver operating characteristic curve(ROC)analysis showed that the area under the ROC curve(AUC)of E_(mean)was 0.752(S.E.=0.072,95%CI=0.611-0.894,P=0.007),and the best cutoff value was 47.005 kPa.Conclusion In summary,both SWE-and CEUS-guided transrectal prostate biopsy can help find the focus and guide the puncture,and improve the positive detection rate.

VTIQ、UE联合CEUS对甲状腺TI-RADS 4类结节良恶性的评估价值

目的:探讨声触诊组织量化成像(VTIQ)、超声弹性成像(UE)联合超声造影(CEUS)对甲状腺影像报告及数据系统(TI-RADS)4类结节良恶性的评估价值。方法:回顾性分析96例(118个)甲状腺TI-RADS 4类结节患者的VTIQ、UE、CEUS影像资料;以手术病理结果为金标准,通过绘制工作者特征(ROC)曲线评估VTIQ、UE、CEUS及三者联合诊断甲状腺TI-RADS 4类结节良恶性的临床价值。结果:118个甲状腺TI-RADS 4类结节,包括恶性结节62个(52.54%),良性结节56个(47.46%)。恶性组SWV值为(3.44±0.62)m/s,高于良性组的(2.37±0.54)m/s(P<0.05);两组UE、CEUS评分比较,恶性组高于良性组(P<0.05)。VTIQ(SWV≥3.04 m/s)、UE(≥4分)、CEUS(≥4分)、三者联合诊断甲状腺TI-RADS 4类结节良恶性的AUC分别为0.862、0.891、0.860、0.933,敏感度分别为75.81%、79.03%、74.19%、88.71%,特异度为85.71%、71.43%、83.93%、87.50%,三者联合诊断的敏感度、特异度高于单独诊断(P<0.05)。结论:VTIQ、UE联合CEUS诊断甲状腺TI-RADS 4类结节良恶性的效能高于三者单独诊断,具有较高的临床应用价值。

UE及SMI在鉴别甲状腺结节良恶性中的应用研究进展

超声弹性成像及超微血管成像作为超声新技术已成为近年来超声研究的热点。超声弹性成像将结节病理与结节硬度信息联系,能够对病变组织进行定性、定量及半定量的评价,为鉴别诊断甲状腺结节的良、恶性提供新途径。超声弹性成像技术在乳腺、肝脏等方面应用较为成熟,而关于甲状腺疾病良恶性定性诊断中的应用报道相对较少。超微血管成像应用于鉴别甲状腺结节良、恶性的诊断效能尚在研究中。本文就目前国内外弹性成像技术及超微血管成像在诊断甲状腺结节病变的临床研究予以综述。

UE技术+2DUS检查提高诊断乳腺癌腋窝淋巴结转移的效能

目的:探讨超声弹性成像(UE)技术+二维超声(2DUS)检查在乳腺癌腋窝淋巴结转移中的诊断效能。方法:89例乳腺癌患者,均行UE技术、2DUS检查,以组织病理学检查结果为"金标准",分析、比较淋巴结转移和未转移患者的皮髓质厚度、淋巴结纵横比、超声评分及诊断灵敏度和准确率。结果:淋巴结转移患者皮髓质厚度、淋巴结纵横比大于淋巴结未转移患者,超声评分高于淋巴结未转移患者(P<0.05);联合检查乳腺癌患者腋窝淋巴结转移的灵敏度94.3%,高于2DUS检查75.5%、UE检查77.4%,差异有统计学意义(P<0.05);联合检查准确度为89.9%,高于2DUS检查79.8%、UE检查82.0%,但差异无统计学意义(P>0.05)。结论:UE技术和2DUS检查联合应用,有助于判断乳腺癌腋窝淋巴结转移病情,提高诊断灵敏度。

CDFI、UE联合诊断乳腺结节及TNM分期效果观察

目的探讨超声弹性成像技术(UE)与彩色多普勒超声技术(CDFI)联合用于乳腺结节良恶性临床鉴别及TNM分期诊断的价值。方法选取86例乳腺结节患者作为研究对象,均给予CDFI联合UE检查。以手术病理诊断结果作为“金标准”,回顾分析该种诊断方案的应用效能。结果86例患者中62例为良性病变,24例为恶性病变。良性组、恶性组CDFI检查血流分级及UE评分比较均有明显差异,且差异均有统计学意义(P<0.05)。TNM分期不同,患者UE评分、CDFI血流分级均明显不同,且差异有统计学意义(P<0.05)。CDFI联合UE检查用于恶性乳腺结节检查的敏感度高达95.83%,显著高于UE、CDFI检查的79.17%(P<0.05),诊断特异度、准确度对比均无显著差异(P>0.05)。结论CDFI和UE检查应用于乳腺结节良性、恶性临床鉴别诊断表现出较高效能,且能够为TNM分期评估提供可靠参考数据。

超声瞬时弹性成像检测受控衰减参数评估非酒精性脂肪性肝病患者肝脂肪变程度价值研究

目的分析应用超声瞬时弹性成像检测的受控衰减参数(CAP)评估非酒精性脂肪性肝病(NAFLD)患者肝脂肪变程度的价值。方法2020年5月~2022年5月我院诊治的NAFLD患者78例,均接受肝脏超声检查和超声瞬时弹性成像检查,绘制受试者工作特征曲线(ROC)并计算曲线下面积(AUC)评估CAP诊断NAFLD患者肝脂肪变程度的效能。结果肝脏超声检查结果显示,78例NAFLD患者中包括轻度肝脂肪变41例、中度肝脂肪变23例和重度肝脂肪变14例;重度肝脂肪变患者血清ALT和AST水平分别为(77.2±14.9)U/L和(59.1±11.7)U/L,显著高于中度肝脂肪变患者【分别为(40.1±8.3)U/L和(35.9±6.2)U/L,P<0.05】或轻度肝脂肪变患者【分别为(26.7±5.5)U/L和(23.3±4.8)U/L,P<0.05】;重度肝脂肪变患者血清TG水平和CAP分别为(3.5±0.7)mmol/L和(317.7±27.6)dB/m,显著高于轻度肝脂肪变患者【分别为(1.6±0.6)mmol/L和(259.9±27.5)dB/m,P<0.05】或中度肝脂肪变患者【分别为(2.7±0.6)mmol/L和(292.1±30.7)dB/m,P<0.05】,而血清HDL-C水平为(0.8±0.4)mmol/L,显著低于轻度肝脂肪变患者【(1.3±0.3)mmol/L,P<0.05】或中度肝脂肪变患者【(1.1±0.3)mmol/L,P<0.05】;以CAP>285.4dB/m为截断点,诊断NAFLD患者中度肝脂肪变,以CAP>309.1dB/m为截断点,诊断NAFLD患者重度肝脂肪变,结果发现轻度肝脂肪变39例,中度肝脂肪变22例,重度肝脂肪变17例,其AUC、敏感度和特异度分别为0.783(95%CI:0.669~0.896)、78.3%和75.6%,和0.696(95%CI:0.515~0.876)、78.6%和69.6%(P<0.05)。结论应用CAP诊断NAFLD患者肝脂肪变程度可能比超声检查更准确,有很大的临床应用价值。

TI-RADS、UE、CEUS及FNAC在预测甲状腺乳头状癌颈部淋巴结转移中的意义

目的探讨甲状腺影像报告与数据系统(TI-RADS)、超声弹性成像(UE)、超声造影(CEUS)及细针穿刺细胞学检查(FNAC)在预测甲状腺乳头状癌(PTC)颈部淋巴结转移中的意义。方法选取我院接受手术治疗的甲状腺乳头状癌患者153例,根据术后颈部淋巴结是否转移将其分为转移组(n=83)和未转移组(n=70)。所有患者在术前均进行TI-RADS、UE、CEUS、FNAC检查。比较TI-RADS、UE、CEUS、FNAC在预测甲状腺乳头状癌颈部淋巴结转移的效能,并采用单因素和多因素Logistic回归法分析各参数对甲状腺乳头状癌颈部淋巴结转移的预测价值。结果与单独应用TI-RADS、UE、CEUS、FNAC相比,联合应用后预测颈部淋巴结转移的敏感度、特异度和准确率显著升高(P<0.05);经单因素和多因素分析发现,PSV、RI、淋巴结内囊性变、包膜被累及程度、弹性评分、内部增强均匀及FNA-Tg是甲状腺乳头状癌患者发生颈部淋巴结转移的独立危险因素(P<0.05)。根据Logistic多因素分析结果建立预测模型,发现其有较高的检验效能。结论TI-RADS、UE、CEUS、FNAC联合应用在预测甲状腺乳头状癌颈部淋巴结转移的价值较高。