[en] Objective: To investigate the ultrasonographic features diffuse thyroid carcinoma. Methods: The ultrasonographic features of 5 cases with diffuse thyroid carcinoma proved by pathology were retrospectively analyzed. Results: 1) In all 5 cases, diffuse hyper-echoic, coarse, heterogeneous eye-catching were visualized on ultrasonography. Scattered minimal calcifications were found in the thyroid tissue but without definite local lesions. Normal thyroid tissue was not seen on ultrasonography. 2) On color Doppler flow imaging, abundant blood supply was visualized in the thyroids in all the 5 cases. 3) All the cases had bilateral cervical lymph node metastases with minimal calcification inside. Conclusion: The ultrasonographic features of diffuse thyroid carcinoma are characteristic. Ultrasound plays an important value in the diagnosis of diffuse thyroid carcinoma. (authors)

[en] Objective: To evaluate the capacity of diffusion-weighted imaging (DWI) for characterization of tissue component in ablative foci of the liver. Methods: Conventional MRI and DWI were performed in 48 patients who had experienced ablative therapy because of the hepatic tumors. MR manifestations of ablative foci were observed and compared with the pathological changes. The signal intensities and ADC values of different tissue components in ablative foci were measured. The means of ADC values in different b factor were compared with One-Way ANOVA, and multiple comparisons among data of different tissue components were made with Bonferroni. Results: Different tissue components in ablative foci could not be correctly distinguished by conventional MRI and signal intensities of DWI. But the signal intensities were served as location of different tissue components in ablative foci for correct measurement of ADC values. In b=500 s/mm², the ADC values of different tissue components in ablative foci (unit: mm²·s^-1·10^-3) were as follow: ablative necrosis was 0.44±0.21 hepatic congestion 1.96±0.14, granulation tissue 2.28±0.24, viable tumor 1.24±0.08, and liver 1.69±0.08. As b factor increased, the ADC value became decreased. The ADC values of above-mentioned tissue components were significantly different (F=1280.49, the differences of multiple comparisons among data of different tissue components were 0.26-1.83, P<0.05). Conclusion: DWI can characterize and distinguish different tissue components of ablative foci in the liver by ADC value so that it is a valuable method for follow-up in ablative therapy of the patients with hepatic tumor. (authors)

[en] Objective: To evaluate the efficacy of diffusion-weighted imaging (DWI) for characterization of focal hepatic lesions. Methods: DWI was performed in 70 patients with focal hepatic lesions. Apparent diffusion coefficient (ADC) values of the lesions were measured and multiphase dynamic enhancement was performed to observe dynamic contrast-enhanced changes of the lesions. Results: ADC values (unit: mm²·s^-1·10^-3) in hepatocellular carcinoma, cholangiocarcinoma and metastasis were 1.33 ± 0.17, 1.23 ± 0.17, and 1.29 ± 0.13, respectively, and there were no significant differences among them (P>0.05). ADC values of haemangioma and cyst were 2.33 ± 0.22 and 4.04 ± 0.51, respectively. All ADC values of malignant tumor were lower than that of benign lesions. Average ADC value of malignant tumor was 1.29 ± 0.16, which had significant difference compared with that of benign lesion (P<0.05). In dynamic contrast enhancement MRI, 37.1% of hepatocellular carcinoma, 78.9% of cholangiocarcinoma, and 31.9% of metastasis presented contrast intensification in portal and delay phase. Conclusion: DWI is a useful tool for charactering focal hepatic lesions. (authors)

[en] Objective: To analyze the common factors of ultrasonographic misdiagnosis of thyroid nodules. Methods: From 2006 to 2009, the pre-operative ultrasonographic diagnosis on 1933 patients with pathologically confirmed thyroid nodules were reviewed. Results: Of 2011 sonograms, ultrasonic diagnosis was corxect in 1575. The 436 diagnostic errors included false negative malignancy (133), false positive malignancy (37), and misdiagnosis between benign lesions (266). Conclusion: There were three main reasons of misdiagnosis including insufficient understanding of the high morbidity of nodular goiter and the relatively low incidence of thyroid adenoma; low awareness of the ultrasonographic diversity of nodular goiter and the sonographic characteristics of the thyroid adenoma and thyroid carcinoma; coexistence of underlying thyroid disease and multifocal nodules. (authors)

[en] Objective: To observe the local therapeutic efficacy of ultrasound-guided percutaneous bipolar radiofrequency ablation for liver cancer. Methods: 24 patients with 32 liver tumor nodules who were referred to our hospital from May, 2012 to October, 2013. All patients were treated with ultrasound-guided percutaneous bipolar radiofrequency ablation with curative intention. We Observed the local therapeutic efficacy of all patients within one month after the treatment. The imageological examination (Contrast-enhanced ultrasound, contrast-enhanced Computed Tomography or contrast-enhanced magnetic Resonance Imaging) were used to decide the local therapeutic efficacy. We observed the recurrence of the tumors through the follow-up of every three months. Results: Complete ablation (CA) was achieved in 96.9% (31/32) of tumor nodules. The CA rate was remarkably higher in nodules ≤ 3 cm (100%, 27/27) than that in nodules > 3 cm (80%, 4/5) (P < 0.05). CA rate was 95.7% (22/23) for primary liver cancers and 100% (9/9) for metastatic liver cancers. There was no mortality associated with bipolar radiofrequency ablation. Patients were followed-up from 2-19 months.The local recurrence rates were 6.3% (2/32) and the distant recurrence rates were 33.3% (8/24). Conclusion: Ultrasound-guided percutaneous bipolar radiofrequency ablation for liver cancer is a safe and effective method, especially for small liver cancers. (authors)

[en] To generate and validate a prediction model based on imaging features for cancer risk of non-mass lesions (NMLs) detected on breast ultrasound (US). In this single-center study, consecutive women with 503 NMLs detected on breast US between 2012 and 2019 were retrospectively identified. The lesions were randomly assigned to the training or testing dataset with a 70/30 split. Age, symptoms, lesion size, and US features were collected. Multivariate analyses were employed to identify risk factors associated with malignancy. The predictive model was developed by using conditional inference trees (CTREE). There were 498 patients (50.9 ± 13.29 years; range, 22-88 years) with 503 NMLs with histopathologic results or > 2-year follow-up, including 224 (44.5%) benign and 279 (55.5%) malignant lesions. At multivariate analysis, age (odds ratio (OR) = 1.08, 95% confidence interval (CI), 1.06-1.11, p < 0.001), NMLs with focal mass effect (OR = 3.03, 95% CI, 1.59-5.81, p = 0.001), indistinct glandular-fat interface (GFI) (OR = 4.23, 95% CI, 2.31-7.73, p < 0.001), geographic (OR = 3.47, 95% CI, 1.20-10.8, p = 0.022) and mottled (OR = 3.67, 95% CI, 1.32-10.21, p = 0.013) patterns, and calcifications (OR = 2.15, 95% CI, 1.16-4.01, p = 0.016) were associated with malignancy. The GFI status, architectural patterns, general morphology, and calcifications were consistently identified as the strongest US predictors of malignancy using CTREE analysis. Based on these factors, individuals were stratified into six risk groups. The predictive model showed an area under the curve of 0.797 in the testing dataset. The CTREE model efficiently aids in interpreting and managing ultrasound-detected breast NMLs, overcoming BI-RADS limitations by refining cancer risk stratification. The CTREE model allows for the reclassification of BI-RADS categories into subgroups with varying malignancy probabilities, thus providing a valuable enhancement to the BI-RADS assessment for the diagnosis of ultrasound-detected NMLs, with the potential to minimize unnecessary biopsies.

[en] Objective: To analyze the influence factors for acoustic radiation force impulse (ARFI) virtual touch tissue quantification (VTQ) of nodular goiter. Methods: VTQ of ARFI elastography was used to examine 103 nodular goiter lesions. The shear wave velocity (SWV), position, diameter, shape, bound, echo, calcification, flow signal of the nodules and the SWV of the adjacent thyroid tissues at the same depth were recorded. The Fisher discriminant analysis was used to qualitatively analyze the relationship between the SWV of the nodules and the gender, age of the patients, the position, diameter, shape, bound, echo, calcification, flow signal of the nodules and the SWV of the adjacent thyroid tissues. And the multiple linear stepwise regressions was used to quantificationally analyze the relationship between the SWV of the nodules and the gender, age of the patients, the position, diameter, shape, bound, echo, calcification, flow signal of the nodules and the SWV of the adjacent thyroid tissues. Results: The mean SWV of nodular goiter were 2.11 ± 0.71 m/s (range: 0.61-4.14 m/s). The qualitative analysis classified the nodules into soft (SWV ≤ 2.1 m/s) and hard (SWV > 2.1 m/s) by its SWV value. The other attributes were treated as independent variables to work out the Fisher discriminant functions. The function for soft nodules was 0.45 × diameter + 0.488 × age + 13.478 × adjacent SWV-29.826. The function for hard nodules was 0.393 × diameter + 0.539 × age + 14.857 × adjacent SWV-34.203. The quantificational analysis treated SWV of nodules as dependent variable and other attributes as independent variables and figured out the linear regression function as: nodular SWV = -3.491 × diameter + 3.338 × adjacent SWV + 4.026. Conclusion: The diameter of nodules, the SWV of the adjacent thyroid tissues and the age of the patients had higher degree of correlation with the SWV of nodules. They were recognized as the major influence factors to the SWV value. The nodules with longer diameter probably had higher SWV. The older patients tended to have harder nodules. The higher the SWV of the adjacent thyroid tissues was, the higher the SWY of the nodules would be. The gender of the patients, the position, shape, bound, echo, calcification, flow signal of the nodules had lower degree of correlation with the SWV of nodules. (authors)

[en] Objective: To investigate the ultrasonographic features and the diagnostic value of ultrasound in patients with phyllodes tumor of the breast. Methods: 18 phyllodes tumors of the breasts in 15 patients were retrospectively analyzed by comparing the imaging findings with surgical and pathologic results. Results: Phyllodes tumors were more common in middle-aged women. All tumors were well defined and hypoechoic on ultrasound. Most of the tumors (14/18) showed abundant intra-lesional blood supply. Lobulated shape (13/18) was common and cystic changes were observed in 6 of 18 tumors. No axillary lymph node metastases occurred in this group. Conclusion: There are some characteristic sonographic features of phyllodes tumor of the breast. Pre-operative diagnostic confidence can be higher when combined with clinical findings. (authors)

[en] Objective: To investigate the value of transabdominal power-Doppler ultrasound for assessing activity of Crohn's disease. Methods: Twenty-two patients with Crohn's disease were divided into active or remission groups according to the Crohn's disease activity index. The location, thickness, layers and echoes of intestinal walls as well as the Limberg classification were recorded on power-Doppler. Results: In the active Crohn's disease group, all 19 patients had segmental intestinal wall thickening with mean thickness of 8.25 ± 2.91 mm and range of 5.1-16 mm. Mural layers were effaced in the diseased intestinal segments of 17 patients (89.5%); Limberg classifications of 18 patients were 3 or greater (94.7%). In the remission group, there was significant (P = 0.018) increase of the intestinal wall thickness for all three patients (mean thickness: 3.83 ± 0.21 mm) Anatomical structures of the intestinal walls were restored with reduced number of layers and significantly lower Limberg grading of 2 (P = 0). Conclusion: Transabdominal power-Doppler ultrasonography can be used to evaluate the activity of Crohn's disease. (authors)

[en] Objective: To compare the enhancement pattern of hilar cholangiocarcinoma on contrast-enhanced ultrasound (CEUS) with that on contrast-enhanced computed tomography (CECT). Methods: Thirty-two consecutive patients with pathologically proven hilar cholangiocarcinomas were evaluated by both low mechanical index CEUS and CECT. The enhancement feature of the tumor, portal vein infiltration, and lesion conspicuity on them was investigated. Results: In the arterial phase, the numbers of the lesions showing hyperenhancement, isoenhancement, and hypoenhancement, were 14 (43.8%), 14 (43.8%), and 4 (12.6%), on CEUS, and 12 (37.5%), 9 (28.1%), and 11 (34.4%), on CECT (P = 0.162). In portal phase, the numbers of the lesions showing hypoenhancement, isoenhancement, and hyperenhancement were 30 (93.8%), 1 (3.1%), and 1 (3.1%), on CEUS, and 23 (71.9%), 8 (25.0%), and 1 (3.1%), on CECT (P = 0.046). The detection rates for portal vein infiltration were 84.2% (16/19) for baseline ultrasound, 89.5% (17/19) for CEUS, and 78.9% (15/19) for CECT (all P > 0.05 between every two groups). CEUS significantly improved the lesion conspicuity in comparison with CECT. CEUS and CECT made correct diagnoses in 30 (93.8%) and 25 (78.1%) lesions prior to pathological examination (P = 0.125). Conclusion: The enhancement pattern of hilar cholangiocarcinoma on CEUS was similar with that on CECT in arterial phase, whereas in portal phase hilar cholangiocarcinoma shows hypoenhancement more likely on CEUS. CEUS and CECT lead to similar results in evaluating portal vein infiltration and diagnosis of this entity.