Medical ultrasonography最新文献

Aims: To investigate the diagnostic value of ultrasound features with dual-phenotype hepatocellular carcinoma (DPHCC). Material and methods: A retrospective analysis was conducted on patients diagnosed with hepatocellular carcinoma (HCC) confirmed by pathology results from October 2016 to December 2023. Patients were categorized into DPHCC and non-DPHCC (NDPHCC) groups based on immunohistochemical findings. Clinical baseline characteristics and ultrasound features were compared between these groups. Multivariable logistic regression was employed to identify predictive factors. A logisticregression model and nomogram were developed to predict DPHCC.

Results: This study included 219 HCC patients (average age: 55.84±9.00, 173 males), with 61 cases of DPHCC and 158 cases of NDPHCC. The results of multivariate logistic regression indicated that halo sign (OR=1.93, p=0.049), PVP hypo-enhancement (OR=2.73, p=0.002) and nodule-in-nodule sign (OR=4.23, p=0.003) were independent predictors of DPHCC. The model's AUC value was 0.73 (95%CI: 0.65-0.80). The calibration curve displayed good predictive accuracy.

Conclusions: Ultrasound features, including CEUS, may provide additional information for the non-invasive diagnosis of DPHCC.

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Aim: This study set out to access the performance of quantitative analysis of contrast-enhanced ultrasound (CEUS) in distinguishing between benign periablational enhancement (BPE) and residual tumor (RT) following radiofrequency ablation (RFA).

Materials and methods: 165 tumors from 124 patients with hepatocellular carcinoma between 2021 and 2023 underwent RFA, contrast-enhanced computed tomography (CECT), and CEUS in less than 24 hours. Analysis was done on the quantitative parameters from RT and BPE found by CEUS.

Results: Complete ablation was obtained in 89.1% of lesions. When compared to BPE, RT had significantly greater peak intensity (PI), time to peak (TTP), area under the curve (AUC), ratio of PI and base intensity (PI/BI), and enhanced intensity (EI) values (all p<0.05). PI, TTP, AUC, PI/BI, and EI had large areas under the receiver operating (ROC) curves. A binary logistic regression analysis, respectively, demonstrated that PI and PI/BI were independent favorable prognostic variables.

Conclusions: Multiple parameters of quantitative analysis of CEUS can aid in distinguishing immediately between RT and BPE lesions. PI and PI/BI may be a more promising parameter. Immediate CEUS evaluation following RFA may allow immediate retreatment of RT during the same operation time, which reduces patients' hospital stays and financial costs.

Aim: To determine the ultrasonographic (US) features that could help to distinguish between parathyroid masses abutting the thyroid gland and thyroid masses extending into the parathyroid area.

Materials and methods: Two blinded readers retrospectively evaluated the US images of 76 histopathologically confirmed parathyroid masses abutting the thyroid gland and 34 thyroid masses extending into the parathyroid area. Maximal diameter, transverse diameter/anterior-posterior diameter (T/AP) ratio, longitudinal diameter/AP diameter (L/AP) ratio, margin, shape, echogenicity, echotexture, and echogenic interface were evaluated and compared between the two groups.

Results: Echogenic interface (p<0.001) and L/AP ratio (p<0.001) were statistically significant US features that differentiated parathyroid and thyroid masses. Other US features did not show any significant differences between the two groups. Interobserver agreement was excellent for all US features. Sensitivity/specificity of the presence of echogenic interface and L/AP ratio >2.0 were 85.5%/100% and 43.2%/82.4% in distinguishing parathyroid from thyroid masses, respectively.

Conclusion: The presence of an echogenic interface and L/AP ratio >2.0 were useful US features for differentiating parathyroid masses abutting the thyroid gland from thyroid masses extending into theparathyroid area.

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Loffler endocarditis is a rare disease associated with high mortality rates, therefore early diagnosis and prompt treatment are crucial factors in managing this condition effectively. The clinical manifestations are nonspecific which can lead to misdiagnosis easily. Here we report a case of rare idiopathic hypereosinophilic syndrome with Loffler endocarditis as the first presentation, first suspected acute coronary syndrome, diagnosed correctly by cardiac ultrasound. The purpose is to improve our understanding of the ultrasound manifestations of this disease.

Aims: Performing prophylactic central lymph node dissection for papillary thyroid microcarcinoma (PTMC) patients with clinically negative lymph node metastasis remains controversial - not all patients with PTMC are suitable for active surveillance. Therefore, we aimed to establish a nomogram based on ultrasound features for predicting CLNM in PTMC.

Material and methods: This retrospective study included 636 patients with PTMC, in which the CLNM status was pathologically confirmed. Univariate and multivariate regression analyses were conducted to screen for risk factors associated with CLNM. Then, a CLNM prediction model was established, receiver operating characteristic, calibration, and decision curve analyses were used to assess the model's performance.

Results: Five variables, including age, sex, combined CLNM status, tumor size, and capsule invasion, were included in the nomogram. The values of the area under the receiver operating characteristic curve in the training and validation datasets were 0.720 (95% confidence interval [CI], 0.649-0.791) and 0.704 (95% CI, 0.622-0.786), respectively.

Conclusions: An ultrasound-based nomogram was successfully established, of which the predictive model shows excellent predictive performance and can be used to evaluate the status of CLNM in PTMC. Thus, patients with high nomogram scores should be considered for prophylactic central neck dissection.