ObjectiveTo systematically review the clinical value of the contrast-enhanced ultrasonic in the diagnosis of breast tumors. MethodsWe electronically and comprehensively searched the databases including The Cochrane Library (Issue 2, 2013), PubMed, CNKI, WanFang Data, Chaoxing medalink, VIP, and CBM for clinical research reports of diagnosing breast cancer with Contrast-enhance ultrasonic (all from foundation to May 2013). Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data, and assessed the methodological quality of the included studies according to the QUADAS items. The Meta-DiSc software (version 1.4) was used to conduct pooling on sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio. Heterogeneity test was performed and the summary receiver operating characteristic (SROC) curve was drawn for area under the curve (AUC). ResultsA total of 19 studies involving 1 161 participants were included. The results of meta-analysis showed that, specificity, the pooled sensitivity, positive likelihood ratio, negative likelihood ratio and DOR were 0.79 (95%CI 0.75 to 0.82), 0.86 (95%CI 0.83 to 0.89), 3.92 (95%CI 2.77 to 6.56), 0.18 (95%CI 0.13 to 0.26), and 25.86 (95%CI 13.77 to 48.55), respectively. The AUC of the SROC curve was 0.917 0. ConclusionThe current evidence shows that contrast-enhanced ultrasonic has high sensitivity and specificity in the diagnosis of preoperative benign and malignant breast mass, which indicates that it could be used as a good method to diagnosing breast tumors.
ObjectiveTo explore the diagnostic value of endobronchial ultrasonography with a guide sheath (EBUS-GS) for pulmonary fungal disease.MethodsAll patients were collected from January 2015 to December 2018. They were diagnosed with pulmonary fungal disease by tissue biopsy, body fluid or blood test, and without other diseases such as pneumonia, lung cancer, lung abscess, tuberculosis, or organizing pneumonia, etc. After clinical anti-fungal treatment, clinical symptoms were relieved, chest CT lesions were absorbed, laboratory-related checks were turned negative in these patients. All patients underwent bronchoscopy, bronchoalveolar lavage fluid/brush examination, and blood galactomannan antigen test/latex agglutination test. They were divided into an EBUS-GS group and a non-EBUS-GS group according to whether EBUS-GS check was performed. Non-parametric test was used to analyze the diagnostic value of EBUS-GS in pulmonary fungal diseases.ResultsFifty-one patients were included and 20 patients in the EBUS-GS group and 31 patients in the non-EBUS-GS group. The EBUS-GS group had a higher positive rate of pulmonary fungal disease. The diagnostic rates of the EBUS-GS group and the non-EBUS-GS group were statistically different (90.0% vs. 48.4%, P<0.05).ConclusionEBUS-GS can improve the diagnosis rate of pulmonary fungal disease and provides further evidence for a clear diagnosis.
ObjectiveTo analyze the color Doppler flow imaging (CDFI) features of familial exudative vitreoretinopathy (FEVR) at different stages. MethodsA retrospective study. A total of 104 patients with 201 eyes from Department of Ophthalmology of Beijing Tongren Hospital who were hospitalized for fundus examination and diagnosed with FEVR from 2018 to 2022 were included. There were 69 male cases with 133 eyes and 35 female cases with 68 eyes. The age was ranged from 2 months to 11 years, with a mean age of 2.9 years. Fundus and CDFI examination were performed in both eyes. Fluorescein fundus angiography was performed in 72 cases (144 eyes). FEVR staging was conducted according to literature standards. The presence of avascular areas in the peripheral retina or abnormal retina neovascularization was stage 1; the presence of retinal neovascularization at the vitreoretinal interface in the avascular area was stage 2; partial retinal detachment without macula involvement was stage 3; partial retinal detachment involving the macula was stage 4; complete retinal detachment was stage 5. The CDFI ultrasound features of FEVR at different stages were analyzed. The CDFI image features of FEVR patients in different stages were observed. ResultsAmong the 104 patients, 97 (93.3%, 97/104) cases were binocular and 7 (6.7%, 7/104) cases were monocular. In 201 eyes, stages 1 to 5 of FEVR were 49 (24.4%, 49/201), 23 (11.4%, 23/201), 39 (19.4%, 39/201), 71 (35.3%, 71/201), and 19 (9.5%, 19/201) eyes, respectively. CDFI examination showed no abnormality or mild vitreous opacity in 49 eyes vitreous body at stage 1. Vitreous opacities were observed in all 23 eyes in stage 2, and the echo of the temporal ballwall was not smooth. In 39 eyes at stage 3, the anterior globular cluster echo in temporal peripheral eyes was observed in 17 eyes and partial retinal detachment was observed in 13 eyes. In 71 eyes at stage 4, 51 eyes had temporal or infratemporal retinal folds, and 20 eyes had temporal retinal detachment. All the 19 eyes in stage 5 had total retinal detachment, of which 15 eyes had closed "funnel-shaped" retinal detachment. Among the patients with retinal folds, 13 had bilateral folds, and the fellow eyes of the other 25 patients with unilateral folds all had vitreous opacity or clump echo in front of the temporal spherical wall. Blood flow signals could be detected on the retinal folds with Doppler imaging. ConclusionsThe CDFI manifestations of FEVR patients at different stages have different characteristics. The possibility of FEVR should be considered when the temporal or infratemporal retinal folds of both eyes are present, as well as the retinal folds of one eye, the contralateral vitreous body opacity, or the anterior temporal peribulbar cluster echoes are present.
Objective To compare the axial length (AL) measured with IOLMaster and contact A-Scan in eyes with macular edema (ME) and to investigate the correlation between measurement difference and foveal thickness.Methods Sixty-seven ME eyes of 42 patients (ME group) and 40 healthy eyes of 30 participants (control group) were enrolled in this study. Foveal thickness was measured with 3D optical coherence topography (OCT)-1000. The AL was prospectively measured by IOLMaster and contact A-scan.The correlation between measurement difference and foveal thickness was analyzed by Pearson correlation analysis.Results Mean foveal thickness of ME eyes was (377.85plusmn;119.84) mu;m. Mean AL by IOLMaster and contact A-scan were (22.95plusmn;0.97) mm and (22.82plusmn;1.04) mm in ME group, and (23.21plusmn;1.08) mm and (23.17plusmn;1.15) mm in the control group respectively. The difference between two groups was statistically significant (t=-3.102,P=0.003). There was no correlation between measurement difference and foveal thickness in ME group (r=-0.097;P=0.447). Conclusions There is a difference of AL measurements using contact A-scan and IOLMaster in ME eyes. However, there was no correlation between measurement difference and the foveal thickness.
【Abstract】ObjectiveTo evaluate the role of MRA, IPVG and DUS in the hemodynamics studies of portal hypertension. MethodsThirtyeight patients with portal hypertension were examined with Philips Gyroscan 1.0 Tesla MR imaging system. 3DDCE MRA and 2DPC MR were used for study of portal venous anatomy and its hemodynamics. The results were compared with those obtained from IPVG and DUS. Results3DDCE MRA could clearly display the anatomical imaging of portal venous system and its imaging quality was better than that of IPVG. The data of hemodynamics from 2DPC MR including diameter, blood velocity and blood flow were closely correlated to those from DUS. ConclusionAs a noninvasive technique, MRA can display the anatomy of portal venous system and measure its hemodynamics exactly. It should be applied as the first choice in hemodynamics evaluation for portal hypertension.
Objective To probe the significance of application of ultrasound biomicroscopy (UBM) in the diagnosis and management of the iris and ciliary tumors. Methods UBM (Mode 840, Humphrey, 50 MHz 5 mm×5 mm) was done in 34 cases (35 eyes) of iris and ciliary body tumors, and some of the affected eyes underwent B-scan or Doppler ultrasound and CT scan. Histopathological examination of the resected tumor tissues was performed in 21 eyes of the operation. Results Among this series of 35 eyes with iris and ciliary body tumors detected by UBM, the characteristics of locality and solidity of the tumors, i,e., anterior chamber in plantation cyst, cyst behind the iris, and solid tumors of iris and ciliary body, of 21 eyes undergone surgical treatment revealed the same results both in UBM and histopathological examinations. Conclusion UBM can supply precise informations in diagnosis and treatment of tumors of iris and ciliary body. (Chin J Ocul Fundus Dis, 2002, 18: 128-130)
ObjectiveTo summarize the characteristics, diagnosis, and treatment of acral glomus tumor in order to improve the level of diagnosis and treatment. MethodsThe clinical data from 70 cases of acral glomus tumor treated between June 2004 and October 2013 were analyzed retrospectively. There were 11 males and 59 females with an average age of 41 years (range, 18-67 years). The disease duration ranged from 4 months to 30 years, with a median duration of 5 years. Sixty-nine cases had solitary tumors and only 1 patient had more than 1 lesion. The tumors were located on the finger in 66 patients (67 fingers) and the toe in 4 patients (4 toes); among them, the subungual glomus tumor happened in 44 patients (44 fingers and 1 toe). All patients suffered from paroxysmal pain and pinpoint pain with positive Love's pin test, and 29 patients (28 fingers and 1 toe) had positive cold sensitivity. Fifty-two patients (48 fingers and 4 toes) were found to have glomus tumor according to the high-frequency color doppler ultrasonography. X-ray films revealed depression on the phalanx in 16 patients (14 fingers and 2 toes). ResultsNo patient suffered from delayed incision healing, and infection after surgical treatment. The follow-up time was from 1 month to 9 years and 2 months with a median follow-up time of 20 months. The clinical symptoms disappeared after surgery with no dysfunction or recurrence. ConclusionThe diagnosis of acral glomus tumor is easy because of the typical symptoms:paroxysmal pain, pinpoint pain, and cold sensitivity. High-frequency color doppler ultrasonography may play an important role in the preoperative assessment of glomus tumors with accurate localization.
Objective To explore the characteristics and diagnostic values of ultrasound examination of retinoblastoma (RB).Methods The ultrasound and CT features of 210 eyes (162 patients) with pathologically confirmed RB were analyzed retrospectively. Results The ultrasonography image of those RB eyes were all characterized by substantial masses in the posterior segment of the eyeball, shown as spherical, hemispherical and irregular in shape, and even filled the entire eyeball. Calcification within the mass was observed in 197 eyes of 149 patients (92.0%), but not observed in 13 eyes of 13 patients (8.0%).Colorful blood flow signals extended from the central retinal vessels could be seen inside the masses of all patients. Ultrasound diagnosis was consistent with the pathological diagnosis in 92.0% RB cases. CT examination revealed calcified speckles or plaques in 167 eyes from 145 patients (89.5%), consistent with the pathological diagnosis of RB.Conclusions Ultrasonography can show the tumorprime;s shape, size, internal features and the range of orbital involvement. It is a valuable clinical tool in the diagnosis of RB.
ObjectiveTo evaluate the application of dexmedetomidine for moderate sedation in patients undergoing endoscopic ultrasonography.MethodsPatients who were planned to undergo endoscopic ultrasonography in West China Hospital of Sichuan University from February to June 2019 were randomly divided into dexmedetomidine group (trial group) and propofol group (control group). The basic conditions, success rate of endoscopic ultrasound diagnosis and treatment, sedation-related adverse events, implementation of airway management, postoperative comfort evaluation and endoscopic physician satisfaction score of the two groups were compared.ResultsA total of 120 patients were eventually enrolled, 60 in each group. There was no significant difference in the basic conditions of the two groups (P>0.05). The success rate of endoscopic ultrasound diagnosis and treatment in two groups were 100%. There was no significant difference in the incidence of bucking, apnea and bradycardia between the two groups (P>0.05). The incidence of hypotension (15.0% vs. 31.7%), hypoxemia (6.7% vs.20.0%) in the trial group was lower than those in the control group, the differences were statistically significant (P<0.05). The proportion of patients in the trial group who performed airway management was lower than that in the control group (1.7% vs. 28.3%), and the difference was statistically significant (P<0.05). There was no significant difference in postoperative pain score, the first time to get out of bed and postoperative 15-item quality of recovery questionnaire score between the two groups (P>0.05). The incidence of nausea and vomiting at 6 hours after operation (48.3% vs. 3.3%) and 24 hours after operation (10.0% vs. 0.0%) and the time required for recovery of gastrointestinal function ［(201.4±178.4) vs. (148.5±75.7) min］ in the trial group were higher than those in the control group (P<0.05). The median (the lower and upper quartile) of comfort score of patients and satisfaction score of endoscopic physicians were 8 (6, 10) and 8 (7, 9) in the trial group, respectively, and were 10 (9, 10) and 9 (8, 10) in the control group, with statistically significant differences (P<0.05).ConclusionModerate sedation with dexmedetomidine could provide good sedative and analgesic effects in endoscopic ultrasonography. It has little effect on respiration and blood pressure, but the incidence of postoperative nausea and vomiting were higher than deep sedation with propofol. And patient comfort and endoscopic physician satisfaction also need to be improved.
Objective To explore the effect of endovascular treatment guided by ultrasonography combined with portosystemic shunts on the patients with Budd-Chiari Syndrome （BCS）.Methods The clinical data of 136 patients with BCS treated by balloon angioplasty and stent implantation guided by Doppler ultrasonography in our hospital from January 1995 to January 2011 were retrospectively analyzed.After balloon angioplasty,53 patients were treated by inferior vena cava （IVC） stent implantation and 31 patients with hepatic venous occlusion underwent portosystemic shunts （PSSs） at one week after endovascular treatment.The long-and short-term effects after treatment were studied.Results After endovascular procedures,the IVC pressure of patients significantly decreased （P＜0.01）,while IVC diameter, flow velocity in the lesion,and right atrial pressure of patients showed significant increase（P＜0.01）.Slight heart dysfunction appeared in 13 cases of patients.After shunting,acute pancreatitis occurred in 3 cases, and 1 patient died of upper gastrointestinal hemorrhage on the 10 d after PSSs.Doppler ultrasonography for IVC and shunt vessels showed：the swollen liver and spleen lessened on 3d after endovascular procedures.The swollen liver lessened 2-7cm （mean 5.5cm）,swollen spleen lessened 3-8cm （mean 5.8cm）, and the time of ascites disappearance was 3-60d （mean 14d）.All the patients were followed up for 1 month to 15 years with an average of 3 years.Restenosis of the distal part of stent was found in 1 patient in 2 years after operation, hepatic vein occlusion occurred in 1 case in 1 year after treatment,hepatocellular carcinoma occurred in 1 patient in 3 years after stent implantation,and 1 patient died of C type hepatitis after 1 year,and 5 out of 6 cases of patients with infertility had babies after 1 year.All patients had no stent migration or occlusion of shunts and the symptoms of portal hypertension were obviously relieved.Conclusions Endovascular treatment guided by Doppler ultrasonography is a convenient,safe,and effective method for BCS.Portosystemic shunts are commended to patients with hepatic venous occlusions.The above mentioned methods provide a feasible and effective means for IVC stenosis and short segment occlusion with hepatic vein occlusion of BCS.