Objective The aim of this study was to evaluate the additional benefit of the difference of maximum and minimum shear wave velocity(SWV) values obtained at different probe orientations(D-value) for the differential di...Objective The aim of this study was to evaluate the additional benefit of the difference of maximum and minimum shear wave velocity(SWV) values obtained at different probe orientations(D-value) for the differential diagnosis of breast tumors.Methods SWV(m/s) was measured in 123 breast tumors(92 benign,31 malignant) in 76 female patients with the probe placed on the transverse,longitudinal,and 45° planes.The areas under the receiver operating characteristic(AUROC) curves were compared with respect to the maximum SWV,minimum SWV,D-value,maximum SWV combined with the D-value,and minimum SWV combined with the D-value.Results There was a significant difference among the values of the maximum SWV,minimum SWV,and D-value for the 3 planes(P < 0.001).The AUROC curves for the maximum SWV,minimum SWV,and D-values of the 3 planes were 0.751(P = 0.379),0.486(P = 0.863),and 0.603(P = 0.204),respectively.The cutoff value for the maximum SWV for differentiating benign tumors from malignant tumors was 2.51 m/s(sensitivity 67%,specificity 50%).The cutoff value for the minimum SWV was 1.61 m/s(sensitivity 53%,specificity 50%).Adding the D-value increased the AUROC curve for the maximum SWV from 0.571 to 0.733 and the minimum SWV from 0.486 to 0.504(P = 0.964),respectively.Conclusion SWV differs in different planes of breast tumors.The D-value can provide a reference for the differential diagnosis of breast tumors.展开更多
Objective The aim of the study was to evaluate the long-term efficacy and safety of percutaneous microwave ablation(MWA) for small hepatic cancers adjacent to large vessels and to investigate the treatment strategies....Objective The aim of the study was to evaluate the long-term efficacy and safety of percutaneous microwave ablation(MWA) for small hepatic cancers adjacent to large vessels and to investigate the treatment strategies.Methods From March 2009 to July 2015,a total of 86 patients with 94 tumors underwent ultrasound(US)-guided percutaneous MWA,with pathologically proven or clinically diagnosed liver cancers measuring ≤ 3 cm in diameter and located ≤ 10 mm from a major vessel(n = 94).Regular follow-up after MWA was performed to assess treatment efficacy and perioperative complications.Results The complete ablation rate at 1 month after MWA was 93.3%(84/90).The 6-,9-,12-,24-,36-,48-,60-,72-,and 84-month local recurrence rates were 2.4%,2.4%,3.7%,6.6%,8.4%,8.4%,8.4%,8.4%,and 8.4%,respectively.There were no major complications.The perioperative special complication rate was 5.32%(5/94),including 3 cases of moderate liver function damage and 2 cases of limited sub-capsular hematoma.Conclusion Percutaneous MWA for small hepatic cancers adjacent to large vessels is feasible,effective,and safe with an acceptable rate of complications.The key point is to strictly follow operative indications and adopt proper treatment strategies.展开更多
Objective： The aim of our study was to make the qualitative and quantitative analysis to breast lesions using acoustic radiation force impulses （ARFI）, and assess the diagnostic value of ARFI for differentiation be...Objective： The aim of our study was to make the qualitative and quantitative analysis to breast lesions using acoustic radiation force impulses （ARFI）, and assess the diagnostic value of ARFI for differentiation between benign and malignant solid breast masses, meanwhile evaluate the influences of ARFI with breast imaging reporting and data system （BI-RADS） of suspicious masses. Methods： Seventy-five women with 86 breast lesions underwent conventional breast ultra- sound examination. Then B-mode BI-RADS features and assessments were recorded and standard breast US supplemented by ARFI elastographic examination were repeated. The data were recorded and analyzed as following： area ratio of breast lesion, the shear-wave velocity, the ratio of the shear-wave velocity between lesions and surrounding normal tissues, and according to the elastographic data reconsidered the BI-RADS category, all the results have been correlated with pathological results and make statistical evaluations of ARFI for differentiation between benign and malignant solid breast masses. Meantime our study has correlated the adjusted BI-RADS category of suspicious breast lesions with the pathological results and made assessment. Results： Thirty-eight patients were malignant breast carcinoma （31 invasive ductal carcinoma, 5 intraductal carcinoma in situ, 2 medullary carcinoma, 2 invasive Iobular carcinoma）, 48 patients were benign breast lesions （23 fibroadenoma, 12 benign nodular hyperplasia, 5 phyllodes tumor, 6 adenosis, 2 intraductal papilloma）. Underwent conventional breast ultrasound exam, 42 cases were BI-RADS category 3, 23 cases were BI-RADS category 4. When adding elastographic data, 46 cases were BI-RADS category 3 and 20 cases were BI-RADS category 4. Compared with pathological results showed for both the specificity of BIRADS features and the area under ROC curve has risen. Virtual touch tissue imaging （VTI） and virtual touch tissue quantification （VTQ） data showed the area ratio （AR） between elastographic lesions area and B-mode lesions area, SWV （maximal shear-wave velocity of lesions）, R-SWV （shear-wave velocity ratio between lesions and surrounding normal tissues） in benign breast lesions were lower than those in malignant lesions which has statistical significance and the cut-off point were 1.1,4.65 m/s, 5.18 respectively. Conclusion： The ARFI elastography can provide the reliable qualitative and quantitative analysis about hardness of breast lesions, supply the new BI-RADS category features to suspicious breast masses and serve as an effective diagnostic tool for differentiation between benign and malignant solid masses.展开更多
Objective The aims of this study were to analyze ultrasound features of breast ductal carcinoma in situ(DCIS) and to evaluate the value of ultrasonography(US) in early diagnosis of DCIS.Methods From July 2013 to March...Objective The aims of this study were to analyze ultrasound features of breast ductal carcinoma in situ(DCIS) and to evaluate the value of ultrasonography(US) in early diagnosis of DCIS.Methods From July 2013 to March 2015,180 patients with histologically proven DCIS were evaluated.US features recorded included the size,shape,margins,internal echogenicity,microcalcifications,posterior echogenicity,and blood supply.The data were analyzed and compared with mammographic and histologic findings.Results Among 180 cases of DCIS,168 patients had positive findings on US;the lesions were divided into 3 categories:(1) hypoechoic lesions with or without microcalcifications(n=94);(2) hypoechoic dilated ducts with or without microcalcifications(n=59);(3) microcalcifications alone without any other findings(n=15).Of the 180 lesions,microcalcifications were demonstrated by mammography in 128(71%);among these 128 lesions,90 were identified with microcalcifications on US.Only 80 cases(44%) manifested as masses or asymmetric densities on mammography.The diagnostic accuracy of US and mammography was 67%(120/180) and 69%(124/180),respectively,which can be improved to 80%(144/180) if US is combined with mammography.Conclusion US can be used as an important tool in diagnosis of DCIS.The combination of US and mammography can improve the diagnostic accuracy of breast DCIS.展开更多
Objective： The objective of this study was to compare the underestimation rate of invasive carcinoma cases with ductal carcinoma in situ （DCIS） at percutaneous ultrasound-guided core biopsies of breast lesions betw...Objective： The objective of this study was to compare the underestimation rate of invasive carcinoma cases with ductal carcinoma in situ （DCIS） at percutaneous ultrasound-guided core biopsies of breast lesions between 14-gauge automated core needle biopsy （ACNB） and 11-gauge vacuum-assisted biopsy （VAB）, and analyze the diagnostic advantages and insufficiencies in DCIS between this two methods, and to determine the relationship between the lesion type （masses or microcalcifications on radiological findings ） and DCIS underestimation rate. Methods： We collected 152 breast lesions which were diagnosed as DCIS by retrospectively reviewing data about ultrasound-guided biopsies of breast lesions （from February 2003 to July 2010）. There were 98 lesions in 95 patients by 14-gauge ACNB, and 54 lesions in 52 patients by 11-gauge VAB （The system used in this study called Mammatome, MMT）. The clinical and radiological findings were reviewed; meanwhile all the selected patients had histological results of the biopsies and follow-up surgeries which also achieved the reliable pathological results to compare with the biopsy results. The differences between two correlated histological results defined as underestimation, and the histological DCIS underestimation rates were compared between the two groups. According to the radiological characteristics, each group was classified into two subgroups （masses or micrecalcifications group）, and the differences between subgroups were also analyzed. Results： The DCIS underestimation rate was 45.9% （45/98） for 14-gauge ACNB and 16.6% （9/54） for MMT. According to the lesion type on ultrasonography, DCIS underestimation was 31.0% （26/84） in masses （43.1% using ACNB and 12.1% using MMT; P = 0.003） and 42.6% （29/68） in microcalcifications （48.9% using ACNB and 23,8% using MMT; P = 0,036）, Conclusion： The underestimation rate of invasive carcinoma in cases with DCIS at ultrasound-guided core biopsies is significantly higher for ACNB than for MMT. Furthermore, this difference does not alter among the two lesion types presented on ultrasonography. So ultrasound-guided VAB （MMT system） could be an effective and useful method for the diagnosis of DCIS lesions no matter what the lesion type is.展开更多
Breast cancer is one of the most common malignantdiseases among women worldwide. In China, themorbidity and mortality rate from breast cancer hasincreased significantly in recent years. Early diagnosis iscrucial to en...Breast cancer is one of the most common malignantdiseases among women worldwide. In China, themorbidity and mortality rate from breast cancer hasincreased significantly in recent years. Early diagnosis iscrucial to ensure the best possible prognosis. Biopsy is aninvasive technique and not recommended for screening.展开更多
基金Supported by a grant from the National Natural Sciences Foundation of China(No.81571695)
文摘Objective The aim of this study was to evaluate the additional benefit of the difference of maximum and minimum shear wave velocity(SWV) values obtained at different probe orientations(D-value) for the differential diagnosis of breast tumors.Methods SWV(m/s) was measured in 123 breast tumors(92 benign,31 malignant) in 76 female patients with the probe placed on the transverse,longitudinal,and 45° planes.The areas under the receiver operating characteristic(AUROC) curves were compared with respect to the maximum SWV,minimum SWV,D-value,maximum SWV combined with the D-value,and minimum SWV combined with the D-value.Results There was a significant difference among the values of the maximum SWV,minimum SWV,and D-value for the 3 planes(P < 0.001).The AUROC curves for the maximum SWV,minimum SWV,and D-values of the 3 planes were 0.751(P = 0.379),0.486(P = 0.863),and 0.603(P = 0.204),respectively.The cutoff value for the maximum SWV for differentiating benign tumors from malignant tumors was 2.51 m/s(sensitivity 67%,specificity 50%).The cutoff value for the minimum SWV was 1.61 m/s(sensitivity 53%,specificity 50%).Adding the D-value increased the AUROC curve for the maximum SWV from 0.571 to 0.733 and the minimum SWV from 0.486 to 0.504(P = 0.964),respectively.Conclusion SWV differs in different planes of breast tumors.The D-value can provide a reference for the differential diagnosis of breast tumors.
文摘Objective The aim of the study was to evaluate the long-term efficacy and safety of percutaneous microwave ablation(MWA) for small hepatic cancers adjacent to large vessels and to investigate the treatment strategies.Methods From March 2009 to July 2015,a total of 86 patients with 94 tumors underwent ultrasound(US)-guided percutaneous MWA,with pathologically proven or clinically diagnosed liver cancers measuring ≤ 3 cm in diameter and located ≤ 10 mm from a major vessel(n = 94).Regular follow-up after MWA was performed to assess treatment efficacy and perioperative complications.Results The complete ablation rate at 1 month after MWA was 93.3%(84/90).The 6-,9-,12-,24-,36-,48-,60-,72-,and 84-month local recurrence rates were 2.4%,2.4%,3.7%,6.6%,8.4%,8.4%,8.4%,8.4%,and 8.4%,respectively.There were no major complications.The perioperative special complication rate was 5.32%(5/94),including 3 cases of moderate liver function damage and 2 cases of limited sub-capsular hematoma.Conclusion Percutaneous MWA for small hepatic cancers adjacent to large vessels is feasible,effective,and safe with an acceptable rate of complications.The key point is to strictly follow operative indications and adopt proper treatment strategies.
文摘Objective： The aim of our study was to make the qualitative and quantitative analysis to breast lesions using acoustic radiation force impulses （ARFI）, and assess the diagnostic value of ARFI for differentiation between benign and malignant solid breast masses, meanwhile evaluate the influences of ARFI with breast imaging reporting and data system （BI-RADS） of suspicious masses. Methods： Seventy-five women with 86 breast lesions underwent conventional breast ultra- sound examination. Then B-mode BI-RADS features and assessments were recorded and standard breast US supplemented by ARFI elastographic examination were repeated. The data were recorded and analyzed as following： area ratio of breast lesion, the shear-wave velocity, the ratio of the shear-wave velocity between lesions and surrounding normal tissues, and according to the elastographic data reconsidered the BI-RADS category, all the results have been correlated with pathological results and make statistical evaluations of ARFI for differentiation between benign and malignant solid breast masses. Meantime our study has correlated the adjusted BI-RADS category of suspicious breast lesions with the pathological results and made assessment. Results： Thirty-eight patients were malignant breast carcinoma （31 invasive ductal carcinoma, 5 intraductal carcinoma in situ, 2 medullary carcinoma, 2 invasive Iobular carcinoma）, 48 patients were benign breast lesions （23 fibroadenoma, 12 benign nodular hyperplasia, 5 phyllodes tumor, 6 adenosis, 2 intraductal papilloma）. Underwent conventional breast ultrasound exam, 42 cases were BI-RADS category 3, 23 cases were BI-RADS category 4. When adding elastographic data, 46 cases were BI-RADS category 3 and 20 cases were BI-RADS category 4. Compared with pathological results showed for both the specificity of BIRADS features and the area under ROC curve has risen. Virtual touch tissue imaging （VTI） and virtual touch tissue quantification （VTQ） data showed the area ratio （AR） between elastographic lesions area and B-mode lesions area, SWV （maximal shear-wave velocity of lesions）, R-SWV （shear-wave velocity ratio between lesions and surrounding normal tissues） in benign breast lesions were lower than those in malignant lesions which has statistical significance and the cut-off point were 1.1,4.65 m/s, 5.18 respectively. Conclusion： The ARFI elastography can provide the reliable qualitative and quantitative analysis about hardness of breast lesions, supply the new BI-RADS category features to suspicious breast masses and serve as an effective diagnostic tool for differentiation between benign and malignant solid masses.
基金Supported by a grant from the National Natural Sciences Foundation of China(No.81571695)
文摘Objective The aims of this study were to analyze ultrasound features of breast ductal carcinoma in situ(DCIS) and to evaluate the value of ultrasonography(US) in early diagnosis of DCIS.Methods From July 2013 to March 2015,180 patients with histologically proven DCIS were evaluated.US features recorded included the size,shape,margins,internal echogenicity,microcalcifications,posterior echogenicity,and blood supply.The data were analyzed and compared with mammographic and histologic findings.Results Among 180 cases of DCIS,168 patients had positive findings on US;the lesions were divided into 3 categories:(1) hypoechoic lesions with or without microcalcifications(n=94);(2) hypoechoic dilated ducts with or without microcalcifications(n=59);(3) microcalcifications alone without any other findings(n=15).Of the 180 lesions,microcalcifications were demonstrated by mammography in 128(71%);among these 128 lesions,90 were identified with microcalcifications on US.Only 80 cases(44%) manifested as masses or asymmetric densities on mammography.The diagnostic accuracy of US and mammography was 67%(120/180) and 69%(124/180),respectively,which can be improved to 80%(144/180) if US is combined with mammography.Conclusion US can be used as an important tool in diagnosis of DCIS.The combination of US and mammography can improve the diagnostic accuracy of breast DCIS.
文摘Objective： The objective of this study was to compare the underestimation rate of invasive carcinoma cases with ductal carcinoma in situ （DCIS） at percutaneous ultrasound-guided core biopsies of breast lesions between 14-gauge automated core needle biopsy （ACNB） and 11-gauge vacuum-assisted biopsy （VAB）, and analyze the diagnostic advantages and insufficiencies in DCIS between this two methods, and to determine the relationship between the lesion type （masses or microcalcifications on radiological findings ） and DCIS underestimation rate. Methods： We collected 152 breast lesions which were diagnosed as DCIS by retrospectively reviewing data about ultrasound-guided biopsies of breast lesions （from February 2003 to July 2010）. There were 98 lesions in 95 patients by 14-gauge ACNB, and 54 lesions in 52 patients by 11-gauge VAB （The system used in this study called Mammatome, MMT）. The clinical and radiological findings were reviewed; meanwhile all the selected patients had histological results of the biopsies and follow-up surgeries which also achieved the reliable pathological results to compare with the biopsy results. The differences between two correlated histological results defined as underestimation, and the histological DCIS underestimation rates were compared between the two groups. According to the radiological characteristics, each group was classified into two subgroups （masses or micrecalcifications group）, and the differences between subgroups were also analyzed. Results： The DCIS underestimation rate was 45.9% （45/98） for 14-gauge ACNB and 16.6% （9/54） for MMT. According to the lesion type on ultrasonography, DCIS underestimation was 31.0% （26/84） in masses （43.1% using ACNB and 12.1% using MMT; P = 0.003） and 42.6% （29/68） in microcalcifications （48.9% using ACNB and 23,8% using MMT; P = 0,036）, Conclusion： The underestimation rate of invasive carcinoma in cases with DCIS at ultrasound-guided core biopsies is significantly higher for ACNB than for MMT. Furthermore, this difference does not alter among the two lesion types presented on ultrasonography. So ultrasound-guided VAB （MMT system） could be an effective and useful method for the diagnosis of DCIS lesions no matter what the lesion type is.
文摘Breast cancer is one of the most common malignantdiseases among women worldwide. In China, themorbidity and mortality rate from breast cancer hasincreased significantly in recent years. Early diagnosis iscrucial to ensure the best possible prognosis. Biopsy is aninvasive technique and not recommended for screening.
