Objective:This study aimed to investigate the application value of contrast-enhanced ultrasound(CEUS)before and after minimally invasive ablation procedures for benign thyroid nodule(s)(BTN).Methods:This prospective s...Objective:This study aimed to investigate the application value of contrast-enhanced ultrasound(CEUS)before and after minimally invasive ablation procedures for benign thyroid nodule(s)(BTN).Methods:This prospective study included patients with BTNs scheduled to undergo ultrasound-guided minimally invasive ablation treatment.CEUS was performed before and after ablation(at 1 day,and 1,6,and 12 months after ablation).Changes in microvascular perfusion and the volume of BTNs were noted and assessed.Results:Sixty-two patients(62 BTNs),who underwent ablation procedures between June 2016 and August 2020,were included.All lesions were confirmed by biopsy,and histopathological results were obtained before ablation treatment.On preoperative CEUS,the lesions exhibited hyperenhancement(53.23%)or iso-enhancement(46.77%)during the arterial phase,and all lesions exhibited iso-enhancement in the venous and late phases.One day after ablation,none of the BTNs exhibited obvious enhancement on CEUS.One(1.61%)lesion was retreated due to a nodule-like enhancement area detected by CEUS at the 6-month follow-up.The mean nodular volume reduction rate(VRR)at 1,6,and 12 months follow-up demonstrated no significant difference between the two ablation groups(microwave ablation versus radiofrequency ablation).Twelve months after ablation,the mean(±SD)VRR of all BTNs was 60.3±10.3%.Conclusion:CEUS helped guide treatment decisions for BTNs before ablation treatment.Moreover,it could also be used to accurately and noninvasively evaluate treatment efficacy.展开更多
Objective:To evaluate the efficacy and safety of percutaneous core needle biopsy(PCNB)using ultrasound(US)-guided and contrast-enhanced ultrasound(CEUS)-guided procedures for anterior mediastinal masses(AMMs).Methods:...Objective:To evaluate the efficacy and safety of percutaneous core needle biopsy(PCNB)using ultrasound(US)-guided and contrast-enhanced ultrasound(CEUS)-guided procedures for anterior mediastinal masses(AMMs).Methods:In total,284 consecutive patients(166 men,118 women;mean age,43.0±18.4 years)who underwent PCNB for AMMs were enrolled.Patients were divided into the US-guided group(n=133)and the CEUS-guided group(n=151).PCNB was performed using a core needle(16-gauge or 18-gauge).Internal necrosis,diagnostic yield,and diagnostic accuracy were compared between the two groups.Results:The predominant final diagnosis of the cases in this study was thymoma(29.7%),lymphoma(20.5%),thymic carcinoma(13.3%),and germ cell tumour(13.3%),respectively.There was no significant difference in patient age,sex,number of percutaneous biopsies,or display rate of internal necrosis on conventional US between the two groups.The rate of internal necrosis of the lesions was significantly higher after contrast agent injection(72.2%vs.41.7%;P<0.001).The CEUS-guided group had a higher diagnostic yield than the US-guided group(100%vs.89.5%,P<0.001).There was no significant difference between the diagnostic accuracy of the CEUSguided and US-guided groups(97.3%vs.97.4%;P=1.000).None of the patients experienced adverse reactions or complications after US-guided or CEUS-guided PCNB.Conclusions:CEUS-guided PCNB can improve the diagnostic yield by optimizing the biopsy procedure.展开更多
目的对比肝神经内分泌肿瘤(HNEN)和肝细胞癌(HCC)的超声影像学特征,探讨超声在二者鉴别诊断中的临床应用价值。方法回顾性分析2009年9月至2020年12月于复旦大学附属中山医院病理诊断为HNEN的40例患者的常规超声及超声造影声像图特征,并...目的对比肝神经内分泌肿瘤(HNEN)和肝细胞癌(HCC)的超声影像学特征,探讨超声在二者鉴别诊断中的临床应用价值。方法回顾性分析2009年9月至2020年12月于复旦大学附属中山医院病理诊断为HNEN的40例患者的常规超声及超声造影声像图特征,并随机选取同时期40例病理诊断为HCC患者的常规超声及超声造影声像图作为对照;常规超声的观察指标包括病灶的数目、边界、回声水平、动脉血流信号检出率等;超声造影的观察指标包括病灶的增强时间、增强方式、峰值表现、门脉期及延迟期表现等。分析比较2组病灶上述超声影像学特征:采用独立样本t检验或Mann-Whitney U检验比较2组间超声造影的增强开始时间、达峰时间及消退时间的差异;采用χ^(2)检验或精确概率检验比较2组间病灶数目、边界、回声水平、动脉血流信号检出率的差异。结果肿瘤数目、增强的消退时间、增强方式、峰值表现、门脉期及延迟期表现在HNEN和HCC之间差异具有统计学意义(P<0.05)。与HCC相比,HNEN更多表现为多发病灶(27/40 vs 5/40,P<0.001)。超声造影上,HNEN增强消退时间早于HCC[40.0(33.0,49.3)s vs 67.0(48.8,120.0)s],差异具有统计学意义(Z=4.592,P=0.001);HNEN以向心性增强方式增强、峰值时表现为环形强化、门脉期及延迟期表现为明显减退的比例高于HCC(8/40 vs 0/40,P=0.005;5/40 vs 0/40,P=0.048;29/40 vs 9/40,P<0.001;36/40 vs 22/40,P=0.002)。结论HNEN和HCC具有不同的超声影像学特征,超声对二者的鉴别诊断有一定帮助。展开更多
基金Supported by the National Natural Science Foundation of China(Grant No.81501471)Clinical Research Plan of SHDC(Grant No.SHDC2020CR1031B,SHDC2020CR4060)Shanghai Municipal Key Clinical Specialty(Grant No.shslczdzk03501)。
文摘Objective:This study aimed to investigate the application value of contrast-enhanced ultrasound(CEUS)before and after minimally invasive ablation procedures for benign thyroid nodule(s)(BTN).Methods:This prospective study included patients with BTNs scheduled to undergo ultrasound-guided minimally invasive ablation treatment.CEUS was performed before and after ablation(at 1 day,and 1,6,and 12 months after ablation).Changes in microvascular perfusion and the volume of BTNs were noted and assessed.Results:Sixty-two patients(62 BTNs),who underwent ablation procedures between June 2016 and August 2020,were included.All lesions were confirmed by biopsy,and histopathological results were obtained before ablation treatment.On preoperative CEUS,the lesions exhibited hyperenhancement(53.23%)or iso-enhancement(46.77%)during the arterial phase,and all lesions exhibited iso-enhancement in the venous and late phases.One day after ablation,none of the BTNs exhibited obvious enhancement on CEUS.One(1.61%)lesion was retreated due to a nodule-like enhancement area detected by CEUS at the 6-month follow-up.The mean nodular volume reduction rate(VRR)at 1,6,and 12 months follow-up demonstrated no significant difference between the two ablation groups(microwave ablation versus radiofrequency ablation).Twelve months after ablation,the mean(±SD)VRR of all BTNs was 60.3±10.3%.Conclusion:CEUS helped guide treatment decisions for BTNs before ablation treatment.Moreover,it could also be used to accurately and noninvasively evaluate treatment efficacy.
基金supported by the Natural Scienceof Shanghai“Science and Technology Innovation Action Plan”(Grant No.20ZR1452800)Clinical Research Plan of SHDC(Grant No.SHDC2020CR1031B)Shanghai Municipal Key Clinical Specialty of China(Grant No.shslczdzk03501)。
文摘Objective:To evaluate the efficacy and safety of percutaneous core needle biopsy(PCNB)using ultrasound(US)-guided and contrast-enhanced ultrasound(CEUS)-guided procedures for anterior mediastinal masses(AMMs).Methods:In total,284 consecutive patients(166 men,118 women;mean age,43.0±18.4 years)who underwent PCNB for AMMs were enrolled.Patients were divided into the US-guided group(n=133)and the CEUS-guided group(n=151).PCNB was performed using a core needle(16-gauge or 18-gauge).Internal necrosis,diagnostic yield,and diagnostic accuracy were compared between the two groups.Results:The predominant final diagnosis of the cases in this study was thymoma(29.7%),lymphoma(20.5%),thymic carcinoma(13.3%),and germ cell tumour(13.3%),respectively.There was no significant difference in patient age,sex,number of percutaneous biopsies,or display rate of internal necrosis on conventional US between the two groups.The rate of internal necrosis of the lesions was significantly higher after contrast agent injection(72.2%vs.41.7%;P<0.001).The CEUS-guided group had a higher diagnostic yield than the US-guided group(100%vs.89.5%,P<0.001).There was no significant difference between the diagnostic accuracy of the CEUSguided and US-guided groups(97.3%vs.97.4%;P=1.000).None of the patients experienced adverse reactions or complications after US-guided or CEUS-guided PCNB.Conclusions:CEUS-guided PCNB can improve the diagnostic yield by optimizing the biopsy procedure.
文摘目的对比肝神经内分泌肿瘤(HNEN)和肝细胞癌(HCC)的超声影像学特征,探讨超声在二者鉴别诊断中的临床应用价值。方法回顾性分析2009年9月至2020年12月于复旦大学附属中山医院病理诊断为HNEN的40例患者的常规超声及超声造影声像图特征,并随机选取同时期40例病理诊断为HCC患者的常规超声及超声造影声像图作为对照;常规超声的观察指标包括病灶的数目、边界、回声水平、动脉血流信号检出率等;超声造影的观察指标包括病灶的增强时间、增强方式、峰值表现、门脉期及延迟期表现等。分析比较2组病灶上述超声影像学特征:采用独立样本t检验或Mann-Whitney U检验比较2组间超声造影的增强开始时间、达峰时间及消退时间的差异;采用χ^(2)检验或精确概率检验比较2组间病灶数目、边界、回声水平、动脉血流信号检出率的差异。结果肿瘤数目、增强的消退时间、增强方式、峰值表现、门脉期及延迟期表现在HNEN和HCC之间差异具有统计学意义(P<0.05)。与HCC相比,HNEN更多表现为多发病灶(27/40 vs 5/40,P<0.001)。超声造影上,HNEN增强消退时间早于HCC[40.0(33.0,49.3)s vs 67.0(48.8,120.0)s],差异具有统计学意义(Z=4.592,P=0.001);HNEN以向心性增强方式增强、峰值时表现为环形强化、门脉期及延迟期表现为明显减退的比例高于HCC(8/40 vs 0/40,P=0.005;5/40 vs 0/40,P=0.048;29/40 vs 9/40,P<0.001;36/40 vs 22/40,P=0.002)。结论HNEN和HCC具有不同的超声影像学特征,超声对二者的鉴别诊断有一定帮助。
