A simple uniformity test for ultrasound phased arrays

PurposeIt is difficult to test phased array ultrasound transducers for non functioning elements. We aimed to modify a widely performed test to improve its ease and effectiveness for these arrays.MethodsA paperclip was slowly moved along the transducer array, with the scanner operating in M-mode, imaging at a fundamental frequency with automatic gain and grey scale adjustment disabled. Non-functioning elements are identified by a dark vertical line in the image. The test was repeated several times for each transducer, looking for consistency of results. 2 transducers, with faults already shown by electronic transducer testing, were used to validate the method. 23 transducers in clinical use were tested.ResultsThe results of the modified test on the 2 faulty transducers agreed closely with electronic transducer testing results. The test indicated faults in 5 of the 23 transducers in clinical use: 3 with a single failed element and 2 with non-uniform sensitivity. 1 transducer with non-uniform sensitivity had undergone lens repair; the new lens was visibly non-uniform in thickness and further testing showed a reduction in depth of penetration and a loss of elevational focus in comparison with a new transducer.ConclusionsThe modified test is capable of detecting non-functioning elements. Further work is required to provide a better understanding of more subtle faults.     

经会阴盆底超声联合血清雌二醇对女性压力性尿失禁的诊断价值研究

摘要 目的：研究经会阴盆底超声联合血清雌二醇对女性压力性尿失禁（SUI）的诊断价值。方法：选取川北医学院附属医院2018年1月～2022年12月收治的女性SUI患者81例,记作观察组。另选取同期体检正常女性80例作为对照组。比较两组盆底超声参数以及血清雌二醇水平。采用受试者工作特征（ROC）曲线分析上述各项指标单独和联合检测的诊断效能。结果：观察组静息状态下近段尿道和人体纵轴间夹角（UIA）、最大Valsalva动作下近段尿道和膀胱后壁的夹角（PUVA）以及尿道旋转角（URA）相较于对照组较高（均P＜0.05）。观察组血清雌二醇水平相较于对照组明显更低（P＜0.05）。经ROC曲线分析发现：各项盆底超声参数联合血清雌二醇诊断女性SUI的效能优于各项指标单独诊断。结论：经会阴盆底超声可诊断女性SUI,在联合血清雌二醇时诊断女性SUI的价值更高。     

Correction method for the physical dose calculated using Clarkson integration at the center of the spread-out Bragg peak for asymmetric field in carbon-ion radiotherapy

PurposeWe previously proposed a calculation method using Clarkson integration to obtain the physical dose at the center of the spread-out Bragg peak (SOBP) for a treatment beam, the measurement point of which agrees with the isocenter [Tajiri et al. Med. Phys. 2013; 40: 071733–1–5]. However, at the measurement point which does not agree with the isocenter, the physical dose calculated by this method might have a large error. For this error, we propose a correction method.Materials and methodsTo confirm whether the error can be corrected using in-air off axis ratio (OAR), we measured the physical dose at the center of an asymmetric square field and a symmetric square field and in-air OAR. For beams of which the measurement point does not agree with the isocenter, as applied to prostate cancer patients, the physical dose calculated using Clarkson integration was corrected with in-air OAR.ResultsThe maximum difference between the physical dose measured at the center of an asymmetric square field and the product of in-air OAR and the physical dose at the center of a symmetric square field was – 0.12%. For beams as applied to prostate cancer patients, the differences between the measured physical doses and the physical doses corrected using in-air OAR were −0.17 ± 0.23%.ConclusionsThe physical dose at the measurement point which does not agree with the isocenter, can be obtained from in-air OAR at the isocenter plane and the physical dose at the center of the SOBP on the beam axis.     

彩色多普勒超声联合血清P53、midkine、S-TK1鉴别甲状腺结节良恶性的临床价值研究

摘要 目的：研究彩色多普勒超声联合血清P53、midkine及胸苷激酶1（S-TK1）鉴别甲状腺结节良恶性的临床价值。方法：将2015年1月～2020年1月我院收治的420例甲状腺结节患者纳入研究。将其按照术后病理学检查结果的不同分成恶性结节组150例与良性结节组270例。比较两组各项超声图像特征,血清P53、midkine及S-TK1水平。以受试者工作特征（ROC）曲线分析彩色多普勒超声联合血清P53、midkine、S-TK1或以上方式单独检测诊断甲状腺恶性结节的能效。结果：恶性结节组超声图像特征中形态不规则,边界不清晰,无包膜,内部钙化以及血流分级为2～3级人数占比均高于良性结节组（P＜0.05）。恶性结节组血清P53、midkine及S-TK1水平均高于良性结节组（P＜0.05）。经ROC曲线分析可得：彩色多普勒超声联合血清P53、midkine、S-TK1诊断甲状腺恶性结节的曲线下面积为0.895、灵敏度为0.92以及特异度为0.88均高于上述方式单独检测。结论：彩色多普勒超声联合血清P53、midkine及S-TK1鉴别甲状腺结节良恶性的临床价值较高。     

超声造影定量分析联合血清AFP、VEGFR-2、sTim-3对原发性肝癌TACE治疗疗效的预测价值

摘要 目的：探讨超声造影定量分析联合血清甲胎蛋白（AFP）、血管内皮生长因子受体-2（VEGFR-2）、可溶性T细胞免疫球蛋白粘蛋白分子3（sTim-3）对原发性肝癌肝动脉化疗栓塞（TACE）治疗疗效的预测价值。方法：选择2020年1月至2022年10月海军军医大学第二附属医院收治的原发性肝癌患者94例。行TACE治疗2个月,采用改良的实体瘤疗效评价标准评估患者疗效,根据不同疗效分为疗效不良组（n=32）和疗效良好组（n=62）。所有患者均行超声造影检查,比较两组超声造影定量分析参数、治疗前血清AFP、VEGFR-2、sTim-3水平,采用受试者工作特征（ROC）曲线分析超声造影定量分析参数联合血清AFP、VEGFR-2、sTim-3对原发性肝癌TACE治疗疗效的预测价值。结果：经TACE治疗,62例患者疗效良好、32例患者疗效不良,治疗有效率为65.96%。疗效良好组术前超声造影达峰时间、等增强开始时间显著长于疗效不良组（P<0.05）。疗效良好组术前血清AFP、VEGFR-2、sTim-3水平显著低于疗效不良组（P<0.05）。ROC曲线分析结果显示,超声造影定量分析联合血清AFP、VEGFR-2、sTim-3对原发性肝癌TACE治疗疗效预测的曲线下面积（AUC）为0.950,灵敏度为84.85%,特异度为82.12%,高于各指标单独检测。结论：超声造影定量分析参数、血清AFP、VEGFR-2、sTim-3水平可预测原发性肝癌患者TACE治疗的疗效,且联合诊断的预测效能更高。     

肺超声评分在预测新生儿肺不张疾病中的临床价值

摘要 目的：探讨肺超声评分在预测新生儿肺不张疾病中的临床价值。方法：2018年3月到2021年4月选择在本院新生儿重症监护病房(neonatal intensive care unit，NICU)诊治的83例新生儿肺不张疾病作为肺不张组，同期选择在本院出生的无呼吸系统疾病新生儿83例作为对照组，所有新生儿都给予肺超声，记录超声特征并进行肺超声评分，判断肺超声诊断价值与预测预测新生儿肺不张疾病的效果。结果：肺不张组的肺超声评分高于对照组(P<0.05)。在166例新生儿中，肺超声判断为肺不张82例，肺超声诊断新生儿肺不张疾病的敏感性与特异性分别为100.0%(82/82)和98.8%(83/84)。在166例新生儿中，Spearsman相关性分析显示新生儿肺不张疾病与肺超声评分存在相关性(r=0.633，P=0.000)。受试者工作特征(Receiver operating characteristics，ROC)曲线分析显示肺超声评分预测新生儿肺不张疾病肺炎曲线下面积(Area under the curve，AUC)为0.888(95%CI=1.472-3.572)。新生儿肺不张疾病在肺超声上主要表现为胸膜线增厚并模糊，粗糙不平，A线存在，肺滑动征消失，多发典型B线与多发融合B线。结论：肺超声是简便、无放射性损伤、准确的检查方法，肺超声评分能有效预测新生儿肺不张疾病中的发生，也能提高对新生儿肺不张疾病的诊断效果。     

心脏彩超检查联合血清BNP、ALB、CysC在慢性心力衰竭患者预后评估中的临床价值分析

摘要 目的：分析心脏彩超检查联合血清B型钠尿肽（BNP）、白蛋白（ALB）、胱抑素C（CysC）在慢性心力衰竭（CHF）患者预后评估中的临床价值。方法：选取2017年6月-2018年5月我院收治的123例CHF患者,心脏彩超检查左心室射血分数（LVEF）、左心房内径（LAD）和左心室内径（LVD）,实验室检测血清BNP、ALB、CysC水平。按照3年随访后患者是否死亡分为死亡组35例和存活组88例,收集临床资料,采用多因素Logistic回归分析CHF患者预后的影响因素。采用受试者工作特征（ROC）曲线分析心脏彩超检查联合血清BNP、ALB、CysC对CHF患者预后的评估价值。结果：死亡组患者的LAD、LVD及血清BNP、CysC水平高于存活组患者,而LVEF及血清ALB水平低于存活组患者（P＜0.05）。心脏彩超指标LVEF、LAD、LVD及血清BNP、ALB、CysC是CHF患者预后的影响因素（P＜0.05）。心脏彩超指标LVEF、LAD、LVD联合血清BNP、ALB、CysC检测对CHF患者预后评估的ROC曲线下面积（AUC）（0.95CI）为0.857（0.771～0.938）,灵敏度及特异度分别为0.914（32/35）、0.795（70/88）,均明显高于上述各指标单独检测。结论：心脏彩超指标LVEF、LAD、LVD和血清BNP、ALB、CysC均为CHF患者预后的影响因素,且联合检测对患者预后的评估价值较高,具有一定的临床应用价值。     

颈动脉超声定量参数联合MPV/PC比值、NLR对急性缺血性脑卒中患者预后不良的预测价值

摘要 目的：探讨颈动脉超声定量参数联合平均血小板体积（MPV）/血小板计数（PC）比值、中性粒细胞/淋巴细胞比值（NLR）对急性缺血性脑卒中（AIS）患者预后不良的预测价值。方法：选择2020年3月至2022年3月合肥市第二人民医院收治的97例AIS患者,所有患者均行颈动脉超声检查和血常规检查,获得颈动脉超声定量参数,计算MPV/PC比值、NLR。出院后90 d采用改良Rankin量表（mRS）评估患者预后,将患者分为预后不良组和预后良好组。受试者工作特征（ROC）曲线分析颈动脉超声定量参数、MPV/PC比值、NLR联合预测AIS患者预后不良的价值。结果：预后不良组动脉内膜中层厚度（IMT）、舒张末期血流速度（EDV）、MPV/PC比值、NLR大于预后良好组（P＜0.05）,收缩期峰值血流速度（PSV）小于预后良好组（P＜0.05）。IMT、PSV、EDV、MPV/PC比值、NLR预测AIS患者预后不良的曲线下面积分别为0.751、0.710、0.693、0.769、0.771,联合IMT、PSV、EDV、MPV/PC比值、NLR预测AIS患者预后不良的曲线下面积为0.883,高于单独指标预测。结论：颈动脉超声定量参数联合MPV/PC比值、NLR在AIS患者预后不良评估中具有较高的预测价值。     

一种非酒精性脂肪性肝病的超声影像人工智能辅助诊断系统开发

摘要 目的：结合人工智能方法设计针对肝脏超声影像的辅助诊断系统，辅助医生对大样本肝脏超声影像数据的标准化和高效化诊断，实现基于肝脏超声图像的非酒精性脂肪性肝病的精准诊断。方法：通过开发肝脏超声影像的识别与分类、脂肪肝分级分析和肝脏脂肪含量定量分析三个模块，建立一套非酒精性脂肪性肝病的超声影像人工智能辅助诊断系统，该系统能够自动区分输入到系统中不同采样视野的超声影像类型，并对肝脏超声图像进行数字化分析，给出待测超声图像是否呈现脂肪肝以及其肝脏脂肪含量的百分比值。结果：本研究中的超声图像识别分类模块可高通量区分出肝肾比图像和衰减率图像的两类超声影像，其分类的准确率达100%。脂肪肝分级分析模块在测试集数据的准确率达到84%，展现出可胜任辅助医生诊断的能力。基于人工肝脏脂肪含量定量方法开发的肝脏脂肪含量定量分析模块的准确率达到67.74%。结论：本研究已开发出一套基于肝脏超声影像的智能辅助诊断系统，可以辅助医生快速、简单、无创地筛选出潜在患有脂肪肝的患者，虽然现阶段实现肝脏脂肪定量分析仍有难度，但已展现出较大的临床应用潜力。     

ROC analysis of observer-response subjective rating data--application to periodontal radiograph assessment

Many physical anthropological studies require that an observer or device discriminate between states that can be easily confused. Receiver operating characteristic (ROC) analysis currently offers the best method for determining the accuracy of such choices, particularly for small sample sizes. Although ROC analysis is widely accepted in psychophysical and biomedical testing, its use in anthropological studies has not been reported. ROC analysis is used here to determine the usefulness of enhanced dental radiographs to assess vertical alveolar bone defects for quantitative studies of human variation with regard to periodontal disease. The presence or absence of vertical-bony defects (truth) for 75 human skulls was established by the consensus of two trained observers. Dental bitewing-radiographs were taken of the alveolar processes, the radiographs digitized, and the brightness and contrast of the digital images enhanced. The two observers who established truth then rated 1) plain bitewing radiographs, 2) unenhanced digital images of bitewings, and 3) enhanced digital images of bitewings for vertical bony defects. The rating scale varied from 1 (vertical defect definitely or almost definitely present) to 5 (definitely or almost definitely absent). ROC analysis was used to compared the diagnostic value of the 3 imaging modalities. All modalities had nearly identical diagnostic performance, measured as Az values (areas beneath ROC curves) that were less than 0.80, which indicates only moderate usefulness. It is concluded that enhancement does not increase success in vertical-bony-defect diagnosis from digital dental radiographs processed in this manner. Moreover, it is suggested that conventional bitewing radiographs may be unsuitable for accurate quantification of such defects.     

甲状腺髓样癌超声弹性成像定量参数与病灶组织中降钙素原的相关性研究

摘要 目的：探讨甲状腺髓样癌（MTC）超声弹性成像定量参数与病灶组织中降钙素原（PCT）的相关性。方法：回顾性选取2017年2月-2021年8月于我院行甲状腺癌手术且术后病理诊断为MTC的患者32例作为研究组,随机选择同期于我院行甲状腺良性肿瘤手术的患者40例作为对照组,所有患者均进行超声弹性成像检查。收集所有患者术后MTC和甲状腺良性肿瘤组织,采用免疫组化法检测MTC和甲状腺良性肿瘤组织中PCT的阳性表达率。采用受试者工作特征（ROC）曲线分析应变率比值对MTC和甲状腺良性肿瘤的鉴别诊断价值。采用Pearson相关分析应变率比值与病灶组织中PCT阳性表达率的相关性。结果：研究组应变率比值明显高于对照组,差异有统计学意义（P<0.05）。MTC组织中PCT阳性表达率为71.88%（23/32）高于甲状腺良性肿瘤组织中的35.00%（14/40）,差异有统计学意义（P<0.05）。经ROC曲线分析发现应变率比值鉴别诊断MTC和甲状腺良性肿瘤的最佳截断值为3.30,曲线下面积为0.761。Pearson相关分析显示应变率比值与MTC组织中PCT阳性表达率呈正相关（P<0.05）。结论：MTC超声弹性成像应变率比值与病灶组织中PCT阳性表达率呈正相关,且应变率比值对MTC具有一定的诊断价值。     

高频肺部超声结合分区域扫查早期鉴别新生儿肺透明膜病及湿肺的研究

摘要 目的：探讨高频肺部超声结合分区域扫查早期鉴别新生儿肺透明膜病（HMD）及湿肺（TTN）的临床价值。方法：选取2019年1月～2020年7月因呼吸窘迫进入我院新生儿重症监护室的163例新生儿作为研究对象,患儿均接受X线和高频肺部超声检查,采用最终临床诊断作为金标准,采用受试者工作曲线（ROC）计算超声和X线诊断HMD和TTN的灵敏度、特异性、阳性预测值、阴性预测值、曲线下面积（AUC）、95％CI。结果：超声诊断HMD的灵敏度、特异性、阳性预测值、阴性预测值、AUC均高于X线检查。Z检验显示超声与X线诊断HMD的AUC存在统计学意义（Z=3.996,P=0.001）。超声诊断TTN的灵敏度、特异性、阳性预测值、阴性预测值、AUC均高于X线。Z检验显示,超声与X线诊断TTN的AUC存在统计学差异（Z=4.188,P＜0.001）。结论：高频肺部超声结合分区域扫查早期鉴别新生儿肺透明膜病及湿肺的临床价值高于X线,值得临床推广应用。     

三维能量多普勒超声联合血清HE4、TK1、YKL-40对绝经后出血患者子宫内膜癌的预测价值

摘要 目的：研究三维能量多普勒超声联合血清人附睾蛋白4（HE4）、胸苷激酶1（TK1）、甲壳质酶蛋白40（YKL-40）对绝经后出血患者子宫内膜癌的预测价值。方法：选择我院2019年10月～2022年10月收治的150例绝经后出血患者。将其按照病理检查结果的差异分为子宫内膜癌组31例与子宫内膜良性增生组119例。对所有患者均开展三维能量多普勒超声检查,并检测血清HE4、TK1、YKL-40水平。以受试者工作特征曲线（ROC）分析三维能量多普勒超声联合血清HE4、TK1、YKL-40水平预测绝经后出血患者子宫内膜癌的效能。结果：子宫内膜癌组血流指数（FI）、血管形成指数（VI）、血管形成-血流指数（VFI）以及由该三参数构建的综合指数I相较于子宫内膜良性增生组均更高（均P＜0.05）。子宫内膜癌组血清HE4、TK1、YKL-40水平相较于子宫内膜良性增生组均更高（均P＜0.05）。经ROC曲线分析发现：三维能量多普勒超声联合血清HE4、TK1、YKL-40水平预测绝经后出血患者子宫内膜癌的曲线下面积（AUC）、灵敏度、特异度以及约登指数均高于上述四项单独预测。结论：三维能量多普勒超声联合血清HE4、TK1、YKL-40水平预测绝经后出血患者子宫内膜癌的效能较佳。     

超声造影定量参数联合血清TSH、Tg、外周血NLR在甲状腺结节良恶性诊断中的应用价值

摘要 目的：探讨超声造影定量参数联合血清促甲状腺激素（TSH）、甲状腺球蛋白（Tg）、外周血中性粒细胞与淋巴细胞比值（NLR）在甲状腺结节良恶性诊断中的应用价值。方法：选取2020年7月到2022年5月我院收治的80例甲状腺结节患者,根据病理学检查结果将其分为良性组(53例）和恶性组（27例）。所有甲状腺结节患者均行甲状腺超声造影并记录定量参数,检测血清TSH、Tg水平,计算NLR。以术后病理结果为准,采用受试者工作特征（ROC）曲线分析超声造影定量参数、血清TSH、Tg及NLR鉴别诊断甲状腺良恶性结节的价值。结果：经组织病理学确诊恶性甲状腺结节27例,良性甲状腺结节53例。恶性组超声造影定量参数平均渡越时间(mTT)、曲线下面积（AUCceus）低于良性组（P＜0.05）,血清TSH、Tg水平及NLR均高于良性组（P＜0.05）。超声造影定量参数mTT、AUCceus联合血清TSH、Tg及NLR鉴别诊断良恶性甲状腺结节的曲线下面积高于以上五项指标单独诊断。结论：恶性甲状腺结节患者超声造影定量参数mTT、AUCceus降低,且血清TSH、Tg水平及NLR增高,超声造影定量参数mTT、AUCceus联合血清TSH、Tg及NLR可提高鉴别诊断良恶性甲状腺结节的效能。     

超声多技术联合在良恶性甲状腺结节鉴别诊断中的应用价值

摘要 目的：分析超声剪切波弹性成像（SWE）、超声造影（CEUS）、声触诊组织成像及定量（VTIQ）、促甲状腺激素（TSH）多技术联合在甲状腺结节良恶性鉴别诊断中的应用价值。方法：选取宁德市医院甲状腺不确定性质结节患者120例,以病理结果为金标准将其分为良性组和恶性组,分析两组SWE、CEUS、VTIQ各影像参数及术前TSH水平差异,绘制受试者工作特征曲线（ROC）评估上述技术联合对甲状腺结节良恶性的鉴别诊断价值。结果：120例患者共检出128个结节,其中良性47个,恶性81个;恶性组SWE中弹性模量值（Emax、Emin、Emean）均大于良性组（P＜0.01）;恶性组、良性组在CEUS中强化差异有显著性（P＜0.05）;VTIQ中恶性组剪切波速度（SWV）最大值、最小值、平均值均大于良性组（P＜0.01）;恶性组患者术前TSH水平高于良性组（P＜0.01）;ROC曲线分析显示,SWE、CEUS、VTIQ、TSH联合检测诊断甲状腺结节良恶性的效能最高,其灵敏度、特异度、准确度、曲线下面积（AUC）分别为85.19%、89.36%、86.72%、0.873。结论：SWE、CEUS、VTIQ、TSH联合对区分甲状腺结节良恶性有较高价值。     

Preliminary evaluation of the sural nerve using 22-MHz ultrasound: a new approach for evaluation of diabetic cutaneous neuropathy

Background

The application of 22-MHz high-frequency ultrasound allows for visualization of the inner part of the sural nerve. The aim of this study was to evaluate the morphological changes of sural nerves in patients with type 2 diabetes mellitus using ultrasound.

Materials and Methods

The thickness/width (T/W) ratio, the cross-sectional area (CSA) of the sural nerves and the maximum thickness (MT) of the nerve fascicles were measured in 100 patients with type 2 diabetes mellitus and 50 healthy volunteers using 22-MHz ultrasound. Receiver operating characteristic (ROC) curves were plotted to determine the optimal cut-off values as well as the sensitivities and specificities. All parameters were significantly different between the subject and control groups. The ROC curves demonstrated that the MT was the most predictive of diabetic cutaneous neuropathy, with an optimal cut-off value of 0.365 mm that yielded a sensitivity of 90.3% and a specificity of 87.7%.

Conclusions

The results of this study suggest that 22-MHz ultrasound may be a valuable tool for evaluating diabetic cutaneous nerve neuropathy.     

彩色多普勒超声联合血清CEA、CA125、TK1、TFF1对乳腺癌的诊断价值研究

摘要 目的：探究彩色多普勒超声联合血清癌胚抗原（CEA）、糖类抗原125（CA125）、胸苷激酶1（TK1）、三叶因子1（TFF1）对乳腺癌的诊断价值。方法：回顾性选取2019年1月到2022年1月间我院收治的97例乳腺癌患者为观察组,同期收治的97例乳腺良性病变患者为对照组,均行彩色多普勒超声检查及血清CEA、CA125、TK1、TFF1检测,比较两组超声特征、超声参数[搏动指数（PI）、收缩期峰值流速（PSV）、阻力指数（RI）],比较两组血清CEA、CA125、TK1、TFF1水平,通过受试者工作特征（ROC）曲线分析彩色多普勒超声联合血清CEA、CA125、TK1、TFF1诊断价值及单独诊断价值。结果：与对照组比较,观察组肿块边界不清晰、内部回声不均匀、形态不规则和钙化比例明显升高（P＜0.05）。与对照组比较,观察组患者RI、PSV、PI明显升高（P＜0.05）;其中观察组血流信号分级Ⅲ级比例明显高于对照组（P＜0.05）,观察组血流信号分级0级比例明显低于对照组（P＜0.05）。与对照组比较,观察组患者血清CEA、CA125、TK1、TFF1水平明显升高（P＜0.05）。ROC曲线发现,超声诊断乳腺癌的曲线下面积（AUC）值、灵敏度、特异度依次为0.773、76.30%、78.40%。CEA诊断乳腺癌的AUC值、灵敏度、特异度依次为0.774、78.40%、74.23%。CA125诊断乳腺癌的AUC值、灵敏度、特异度依次为0.824、77.31%、80.41%。TK1诊断乳腺癌的AUC值、灵敏度、特异度依次为0.818、78.43%、81.42%。TFF1诊断乳腺癌的AUC值、灵敏度、特异度依次为0.806、78.42%、77.31%。彩色多普勒超声联合血清CEA、CA125、TK1、TFF1诊断乳腺癌的AUC值0.929,显著优于各项指标单独使用（P＜0.05）。结论：与各项指标单一应用相比,彩色多普勒超声联合血清CEA、CA125、TK1、TFF1诊断乳腺癌的价值较高,有助于乳腺癌的早期筛查。     

剪切波弹性成像对乳腺原位癌的诊断价值分析

目的:探讨剪切波弹性成像(SWE)对乳腺原位癌的诊断价值。方法:回顾性分析2015年8月-2017年8月于我院病理证实的26个乳腺原位癌病灶和45个乳腺良性病灶,术前均分别行常规超声检查和SWE检查。比较两组病灶的弹性模量值差异,两种检查方法诊断敏感度、特异度、准确度、阳性预测值、阴性预测值,并构建受试者操作特征(ROC)曲线,分析SWE对乳腺原位癌的诊断价值。结果:乳腺原位癌病灶的弹性模量最大值、平均值、最小值和与脂肪组织弹性比值分别为86.6±26.7 kpa、56.6±21.4kpa、31.3±15.7 kpa、6.7±1.8,均明显高于乳腺良性病灶(P0.05)。SWE诊断敏感度、特异度、准确度、阳性预测值、阴性预测值分别为92.31%、88.89%、90.14%、82.76%、95.23%,均显著高于常规超声成像(P0.05)。弹性模量最大值、平均值、最小值及与脂肪组织弹性比值评价乳腺原位癌的ROC曲线下面积分别为0.944、0.876、0.818、0.956。结论:乳腺原位癌病灶的弹性模量值高于良性病灶,SWE对早期发现乳腺原位癌具有重要价值。     

Evaluation of Liver Ischemia-Reperfusion Injury in Rabbits Using a Nanoscale Ultrasound Contrast Agent Targeting ICAM-1

ObjectiveTo assess the feasibility of ultrasound molecular imaging in the early diagnosis of liver ischemia-reperfusion injury (IRI) using a nanoscale contrast agent targeting anti-intracellular adhesion molecule-1 (anti-ICAM-1).MethodsThe targeted nanobubbles containing anti-ICAM-1 antibody were prepared using the avidin-biotin binding method. Human hepatic sinusoidal endothelial cells (HHSECs) were cultured at the circumstances of hypoxia/reoxygenation (H/R) and low temperature. The rabbit liver IRI model (I/R group) was established using the Pringle’s maneuver. The time-intensity curve of the liver contrast ultrasonographic images was plotted and the peak intensity, time to peak, and time of duration were calculated.ResultsThe size of the targeted nanobubbles were 148.15 ± 39.75 nm and the concentration was 3.6–7.4 × 10⁹/ml, and bound well with the H/R HHSECs. Animal contrast enhanced ultrasound images showed that the peak intensity and time of duration of the targeted nanobubbles were significantly higher than that of common nanobubbles in the I/R group, and the peak intensity and time of duration of the targeted nanobubbles in the I/R group were also significantly higher than that in the SO group.ConclusionThe targeted nanobubbles have small particle size, stable characteristic, and good targeting ability, which can assess hepatic ischemia-reperfusion injury specifically, noninvasively, and quantitatively at the molecular level.     

Development of novel DNAJB6-KIAA1522-p-mTOR three-protein prognostic prediction models for CRC

BackgroundTo evaluate the prognostic value of DNAJB6, KIAA1522, and p-mTOR expression for colorectal cancer (CRC) and to develop effective prognostic models for CRC patients.MethodsThe expression of DNAJB6, KIAA1522, and p-mTOR (Ser2448) was detected using immunohistochemistry in 329 CRC specimens. The prognostic values of the three proteins in the training cohort were assessed using Kaplan-Meier curves and univariate and multivariate Cox proportional hazards models. Prediction nomogram models integrating the three proteins and TNM stage were constructed. Subsequently, calibration curves, receiver operating characteristic (ROC) curves, the concordance index (C-index), and decision curve analysis (DCA) were used to evaluate the performance of the nomograms in the training and validation cohorts.ResultsThe three proteins DNAJB6, KIAA1522, and p-mTOR were significantly overexpressed in CRC tissues (each P < 0.01), and their expression was an independent prognostic factor for overall survival (OS) and disease-free survival (DFS) (each P < 0.05). The area under the ROC curves (AUC) and C-index values were approximately 0.7. Additionally, the calibration curves showed that the predicted values and the actual values fit well. Furthermore, DCA curves indicated that the clinical value of the nomogram models was higher than that of TNM stage. Overall, the novel prediction models have good discriminability, sensitivity, specificity and clinical utility.ConclusionThe nomograms containing DNAJB6, KIAA1522, and p-mTOR may be promising models for predicting postoperative survival in CRC.