Introduction: A thyroid nodule is a localized hypertrophy within the thyroid parenchyma. The aim of our study was to study the benefit of ultrasound in the Ti-rads classification of thyroid nodules. Methodology: This ...Introduction: A thyroid nodule is a localized hypertrophy within the thyroid parenchyma. The aim of our study was to study the benefit of ultrasound in the Ti-rads classification of thyroid nodules. Methodology: This was a prospective study with a descriptive aim, with prospective collection, which took place over a period of 17 months at the “Marie Curie” medical clinic. The ultrasound machine used was a Voluson E8 from 2011 and the examinations were carried out by two radiologists and two experienced sonographers. The parameters studied were sociodemographic data;clinical data and ultrasound aspects of the Ti-rads classification in the management of nodules. Results: We collected 235 patients out of 738 patients referred to the service for a cervical ultrasound, i.e. a frequency of 31.84% of cases. There was a female predominance with 95.7% of cases and a sex ratio of 0.04. The average age of our patients was 50 years. We found on cervical ultrasound: Isthmo-lobar glandular hyperplasia in 99 patients, i.e. a frequency of 42.1%. The Ti-rads 3 classification was the most represented in 69.4% of cases. The benignity criterion represented 85.6% of cases in our patients and the malignancy criterion represented 14.4% of cases. Conclusion: The precise description of a thyroid nodule provided by ultrasound (Ti-rads) is essential in the management of nodules.展开更多
Objective: To explore the correlation of TI-RADS grading with oncogene and invasion molecule expression in thyroid cancer lesions. Methods: Patients who were diagnosed with thyroid cancer in this hospital between Janu...Objective: To explore the correlation of TI-RADS grading with oncogene and invasion molecule expression in thyroid cancer lesions. Methods: Patients who were diagnosed with thyroid cancer in this hospital between January 2017 and January 2018 were divided into TI-RADS grade 4 group (n=54) and TI-RADS grade 5 group (n=56) according to TI-RADS grading. 50 patients who underwent surgery and were diagnosed with thyroid adenoma in this hospital during the same period were chosen as benign thyroid group. The differences in the expression of oncogenes and invasion molecules in lesion tissues were compared among the three groups. Results: Proto-oncogenes c-myc, c-erbB-2, RET and TRK mRNA expression in lesions of TI-RADS grade 4 group and TI-RADS grade 5 group were higher than those of benign thyroid group whereas tumor suppressor genes DPC4, p53, PTEN and HBB mRNA expression were lower than those of benign thyroid group;invasion molecules BCORL1, BRD4, STAT3, CD151, SATB1 and CXCR4 mRNA expression were higher than those of benign thyroid group whereas ST7L mRNA expression were lower than that of thyroid benign group. With the increase of TI-RADS grading, the changes in the expression of oncogenes and invasion molecules were aggravated. Conclusion: The changes in oncogene and invasion molecule expression were aggravated with the increase of TI-RADS grading of thyroid cancer, and the specific TI-RADS grading was positively correlated with tumor malignancy.展开更多
To the Editor:Living donor liver transplantation continues to be a widely ac-cepted treatment for end-stage liver diseases[1].However,biliary complications remain a significant challenge,attributable to both surgical ...To the Editor:Living donor liver transplantation continues to be a widely ac-cepted treatment for end-stage liver diseases[1].However,biliary complications remain a significant challenge,attributable to both surgical and nonsurgical factors.These complications include bile leakage,biliary stricture,and choledocholithiasis,with a reported incidence of biliary stricture in pediatric living donor liver recip-ients ranging from 10%to 35%[2].Commonly employed thera-peutic approaches for biliary complications are endoscopic retro-grade cholangiopancreatography(ERCP),percutaneous transhepatic cholangioscopic lithotomy(PTCSL),and surgery,with ERCP often being the preferred initial treatment.展开更多
Background: Non Alcoholic Fatty Liver Disease (NAFLD) is common hepatic disorder which is recognized as a great health problem causing different diseases worldwide. To determine non-alcoholic fatty liver and assess th...Background: Non Alcoholic Fatty Liver Disease (NAFLD) is common hepatic disorder which is recognized as a great health problem causing different diseases worldwide. To determine non-alcoholic fatty liver and assess the relation of fasting total lipids with different grades of fatty liver (NAFLD) subjects diagnosed through ultrasound. By identifying the risk factors of Lipid Profile and NAFLD, the health care provider can properly manage it, even awareness specific for patients and community as general being launched to diminish the morbidity and mortality by this study. Methods: This cross-sectional research carried out at Medicine Department of PMCH, Shaheed Benazirabad. This study comprises 300 subjects of NAFLD. Patients who attended the medicine department with abdominal complains after examination consultant advised ultrasound. The ultrasound performed in Radiology department, patients with findings of fatty liver selected, and history taken from all the patients with special regard to alcoholism. Fasting lipid profile done in all patients included in present study. The blood samples collected from a vein and immediately sent to the laboratory. Results: This present study enlisted total 300 patients out of them 203 (67.7%) belonged to male gender and 97 (32.3%) were females. A ratio of 2.1:1 observed in male and female subjects. There were 176 (58.7%) patients in grade I, while 82 (27.3%) patients in grade II and 42 (14%) patients in grade III. The cholesterol value was abnormal in 186 (62%), while normal in remaining 114 (38%) patients. Triglycerides were abnormal in 152 (50.7%) while in 148 (49.3%) patients were normal. HDL in 155 (51.7%) patients was abnormal while 145 (48.3%) patients had normal values. Low density lipoprotein value in 117 (39%) patient was abnormal and 183 (61%) patient normal. Very low-density lipoprotein in 117 (39%) patients was abnormal and 183 (61%) patient normal. The mean age and SD of patients in present study was 46.83 ± 8.82, with minimum 30 years and maximum age 65 years respectively (p value 0.000). The mean and SD of total cholesterol value was 154.66 ± 58.88 mg/dl (p value 1.000), TG 180.98 ± 96.46 mg/dl (p value 0.974), HDL-C 32.13 ± 5.88 mg/dl (p value 0.000), LDL-C 116.41 ± 41.002 mg/dl (p value 0.000), and VLDL-C was 43.47 ± 34.34 mg/dl (p value 0.000). Conclusions: In current study, variable changes in lipid profile observed amongst NAFLD (non-alcoholic fatty liver disease) patients who diagnosed on ultrasound. Early diagnosis and treatment of non alcoholic fatty liver with abnormal lipids can prevent from long-term complication of fatty liver.展开更多
Background: Thyroid nodules are common and fine needle aspiration (FNA) or surgery is used to assess for malignancy. Thyroid Imaging, Reporting and Data System (TI-RADS) use ultrasound for non-invasive risk stratifica...Background: Thyroid nodules are common and fine needle aspiration (FNA) or surgery is used to assess for malignancy. Thyroid Imaging, Reporting and Data System (TI-RADS) use ultrasound for non-invasive risk stratification of thyroid nodules and reduce unnecessary biopsies. This project used an online calculator and education to facilitate the application of TI-RADS in clinical practice. Methods: Retrospective review defined the baseline reporting of thyroid nodule ultrasound features. Web-based resource and presentation were used to integrate TI-RADS in reporting thyroid ultrasounds and measure the improvements in comprehensive reporting of thyroid nodules and guiding management. Results: The percentage of thyroid ultrasound reporting using TI-RADS within six months increased from 0% to 27% during the project period. Reports with TI-RADS provided twice as many recommendations compared to reports without TI-RADS. Conclusion: Online TI-RADS calculator and education have successfully facilitated the integration of TI-RADS in thyroid ultrasound reporting to provide more accurate and comprehensive reports and guide management.展开更多
目的探讨能谱CT联合超声C-TIRADS分级鉴别甲状腺结节良恶性的价值。方法选取2023年5月至2024年5月滨州医学院附属医院收治的70例甲状腺结节患者进行回顾性分析,其中良性结节26例,恶性结节44例。术前均行超声检查及能谱CT增强扫描。比较...目的探讨能谱CT联合超声C-TIRADS分级鉴别甲状腺结节良恶性的价值。方法选取2023年5月至2024年5月滨州医学院附属医院收治的70例甲状腺结节患者进行回顾性分析,其中良性结节26例,恶性结节44例。术前均行超声检查及能谱CT增强扫描。比较两组年龄、性别、结节长径、能谱CT参数等资料。通过单因素及多因素分析筛选出能谱CT的独立预测因素,引入超声C-TIRADS分级构建列线图模型。采用Bootstrap法迭代1000次,内部验证模型的稳定性。采用独立样本t检验、Mann-Whitney U检验、χ^(2)检验进行统计分析。结果良性组和恶性组能谱参数[包括动脉期及静脉期碘浓度(iodine concentration,IC)、标准化碘浓度(normal iodine concentration,NIC)、能谱曲线斜率(slope of the energy spectrum curve,λHU)]以及结节长径比较,差异均有统计学意义(均P<0.05)。多因素分析表明,动脉期IC及静脉期NIC是鉴别甲状腺结节良恶性的独立预测因素(均P<0.05)。基于上述变量构建预测模型,该模型曲线下面积(AUC)为0.940。利用超声C-TIRADS分级诊断甲状腺结节良恶性,其AUC为0.823。超声C-TIRADS分级联合能谱CT参数构建列线图,其AUC为0.982。校准曲线显示,列线图校准度表现优秀,Brier评分为0.051。决定曲线分析显示,在广泛阈值概率范围内,列线图均表现出较好的临床净收益。应用Bootstrap法进行1000次迭代,计算平均AUC来对列线图模型进行内部验证,平均AUC为0.961。结论能谱CT预测模型AUC高于超声C-TIRADS分级。联合模型可以提高能谱CT及超声C-TIRADS分级鉴别甲状腺结节良恶性的效能。展开更多
文摘Introduction: A thyroid nodule is a localized hypertrophy within the thyroid parenchyma. The aim of our study was to study the benefit of ultrasound in the Ti-rads classification of thyroid nodules. Methodology: This was a prospective study with a descriptive aim, with prospective collection, which took place over a period of 17 months at the “Marie Curie” medical clinic. The ultrasound machine used was a Voluson E8 from 2011 and the examinations were carried out by two radiologists and two experienced sonographers. The parameters studied were sociodemographic data;clinical data and ultrasound aspects of the Ti-rads classification in the management of nodules. Results: We collected 235 patients out of 738 patients referred to the service for a cervical ultrasound, i.e. a frequency of 31.84% of cases. There was a female predominance with 95.7% of cases and a sex ratio of 0.04. The average age of our patients was 50 years. We found on cervical ultrasound: Isthmo-lobar glandular hyperplasia in 99 patients, i.e. a frequency of 42.1%. The Ti-rads 3 classification was the most represented in 69.4% of cases. The benignity criterion represented 85.6% of cases in our patients and the malignancy criterion represented 14.4% of cases. Conclusion: The precise description of a thyroid nodule provided by ultrasound (Ti-rads) is essential in the management of nodules.
文摘Objective: To explore the correlation of TI-RADS grading with oncogene and invasion molecule expression in thyroid cancer lesions. Methods: Patients who were diagnosed with thyroid cancer in this hospital between January 2017 and January 2018 were divided into TI-RADS grade 4 group (n=54) and TI-RADS grade 5 group (n=56) according to TI-RADS grading. 50 patients who underwent surgery and were diagnosed with thyroid adenoma in this hospital during the same period were chosen as benign thyroid group. The differences in the expression of oncogenes and invasion molecules in lesion tissues were compared among the three groups. Results: Proto-oncogenes c-myc, c-erbB-2, RET and TRK mRNA expression in lesions of TI-RADS grade 4 group and TI-RADS grade 5 group were higher than those of benign thyroid group whereas tumor suppressor genes DPC4, p53, PTEN and HBB mRNA expression were lower than those of benign thyroid group;invasion molecules BCORL1, BRD4, STAT3, CD151, SATB1 and CXCR4 mRNA expression were higher than those of benign thyroid group whereas ST7L mRNA expression were lower than that of thyroid benign group. With the increase of TI-RADS grading, the changes in the expression of oncogenes and invasion molecules were aggravated. Conclusion: The changes in oncogene and invasion molecule expression were aggravated with the increase of TI-RADS grading of thyroid cancer, and the specific TI-RADS grading was positively correlated with tumor malignancy.
文摘To the Editor:Living donor liver transplantation continues to be a widely ac-cepted treatment for end-stage liver diseases[1].However,biliary complications remain a significant challenge,attributable to both surgical and nonsurgical factors.These complications include bile leakage,biliary stricture,and choledocholithiasis,with a reported incidence of biliary stricture in pediatric living donor liver recip-ients ranging from 10%to 35%[2].Commonly employed thera-peutic approaches for biliary complications are endoscopic retro-grade cholangiopancreatography(ERCP),percutaneous transhepatic cholangioscopic lithotomy(PTCSL),and surgery,with ERCP often being the preferred initial treatment.
文摘Background: Non Alcoholic Fatty Liver Disease (NAFLD) is common hepatic disorder which is recognized as a great health problem causing different diseases worldwide. To determine non-alcoholic fatty liver and assess the relation of fasting total lipids with different grades of fatty liver (NAFLD) subjects diagnosed through ultrasound. By identifying the risk factors of Lipid Profile and NAFLD, the health care provider can properly manage it, even awareness specific for patients and community as general being launched to diminish the morbidity and mortality by this study. Methods: This cross-sectional research carried out at Medicine Department of PMCH, Shaheed Benazirabad. This study comprises 300 subjects of NAFLD. Patients who attended the medicine department with abdominal complains after examination consultant advised ultrasound. The ultrasound performed in Radiology department, patients with findings of fatty liver selected, and history taken from all the patients with special regard to alcoholism. Fasting lipid profile done in all patients included in present study. The blood samples collected from a vein and immediately sent to the laboratory. Results: This present study enlisted total 300 patients out of them 203 (67.7%) belonged to male gender and 97 (32.3%) were females. A ratio of 2.1:1 observed in male and female subjects. There were 176 (58.7%) patients in grade I, while 82 (27.3%) patients in grade II and 42 (14%) patients in grade III. The cholesterol value was abnormal in 186 (62%), while normal in remaining 114 (38%) patients. Triglycerides were abnormal in 152 (50.7%) while in 148 (49.3%) patients were normal. HDL in 155 (51.7%) patients was abnormal while 145 (48.3%) patients had normal values. Low density lipoprotein value in 117 (39%) patient was abnormal and 183 (61%) patient normal. Very low-density lipoprotein in 117 (39%) patients was abnormal and 183 (61%) patient normal. The mean age and SD of patients in present study was 46.83 ± 8.82, with minimum 30 years and maximum age 65 years respectively (p value 0.000). The mean and SD of total cholesterol value was 154.66 ± 58.88 mg/dl (p value 1.000), TG 180.98 ± 96.46 mg/dl (p value 0.974), HDL-C 32.13 ± 5.88 mg/dl (p value 0.000), LDL-C 116.41 ± 41.002 mg/dl (p value 0.000), and VLDL-C was 43.47 ± 34.34 mg/dl (p value 0.000). Conclusions: In current study, variable changes in lipid profile observed amongst NAFLD (non-alcoholic fatty liver disease) patients who diagnosed on ultrasound. Early diagnosis and treatment of non alcoholic fatty liver with abnormal lipids can prevent from long-term complication of fatty liver.
文摘Background: Thyroid nodules are common and fine needle aspiration (FNA) or surgery is used to assess for malignancy. Thyroid Imaging, Reporting and Data System (TI-RADS) use ultrasound for non-invasive risk stratification of thyroid nodules and reduce unnecessary biopsies. This project used an online calculator and education to facilitate the application of TI-RADS in clinical practice. Methods: Retrospective review defined the baseline reporting of thyroid nodule ultrasound features. Web-based resource and presentation were used to integrate TI-RADS in reporting thyroid ultrasounds and measure the improvements in comprehensive reporting of thyroid nodules and guiding management. Results: The percentage of thyroid ultrasound reporting using TI-RADS within six months increased from 0% to 27% during the project period. Reports with TI-RADS provided twice as many recommendations compared to reports without TI-RADS. Conclusion: Online TI-RADS calculator and education have successfully facilitated the integration of TI-RADS in thyroid ultrasound reporting to provide more accurate and comprehensive reports and guide management.
文摘目的探讨能谱CT联合超声C-TIRADS分级鉴别甲状腺结节良恶性的价值。方法选取2023年5月至2024年5月滨州医学院附属医院收治的70例甲状腺结节患者进行回顾性分析,其中良性结节26例,恶性结节44例。术前均行超声检查及能谱CT增强扫描。比较两组年龄、性别、结节长径、能谱CT参数等资料。通过单因素及多因素分析筛选出能谱CT的独立预测因素,引入超声C-TIRADS分级构建列线图模型。采用Bootstrap法迭代1000次,内部验证模型的稳定性。采用独立样本t检验、Mann-Whitney U检验、χ^(2)检验进行统计分析。结果良性组和恶性组能谱参数[包括动脉期及静脉期碘浓度(iodine concentration,IC)、标准化碘浓度(normal iodine concentration,NIC)、能谱曲线斜率(slope of the energy spectrum curve,λHU)]以及结节长径比较,差异均有统计学意义(均P<0.05)。多因素分析表明,动脉期IC及静脉期NIC是鉴别甲状腺结节良恶性的独立预测因素(均P<0.05)。基于上述变量构建预测模型,该模型曲线下面积(AUC)为0.940。利用超声C-TIRADS分级诊断甲状腺结节良恶性,其AUC为0.823。超声C-TIRADS分级联合能谱CT参数构建列线图,其AUC为0.982。校准曲线显示,列线图校准度表现优秀,Brier评分为0.051。决定曲线分析显示,在广泛阈值概率范围内,列线图均表现出较好的临床净收益。应用Bootstrap法进行1000次迭代,计算平均AUC来对列线图模型进行内部验证,平均AUC为0.961。结论能谱CT预测模型AUC高于超声C-TIRADS分级。联合模型可以提高能谱CT及超声C-TIRADS分级鉴别甲状腺结节良恶性的效能。
