Yu-Xin Jiang

Peking Union Medical College Hospital, Peping, Beijing, China

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Publications (36)47.59 Total impact

  • [show abstract] [hide abstract]
    ABSTRACT: The goal of the study described here was to compare the accuracy of an automated breast volume scanner (ABVS) with that of hand-held ultrasound (HHUS) in assessing the pre-operative extent of pure ductal carcinoma in situ (DCIS). This prospective study consisted of 33 patients with histopathologically proven pure DCIS who received conventional HHUS and ABVS examinations. The discrepancy and correlation coefficients were calculated to assess differences in sizes determined by imaging and histopathologic examination. Mean age was 51.8 y. Mean lesion size as assessed with the ABVS did not differ significantly from that determined by histopathology. Lesion size was adequately estimated, under-estimated or over-estimated with the ABVS in 64%, 15% and 21% of patients, and with HHUS in 42%, 15% and 42%, respectively (p < 0.05). The coefficient of correlation between histopathologic and ABVS measurements was higher than that between histopathologic and HHUS measurements. The ABVS appears to assess the extent of the lesion better than HHUS and can provide more accurate information pre-operatively.
    Ultrasound in medicine & biology 09/2013; · 2.46 Impact Factor
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    ABSTRACT: Objectives- To assess the efficacy of sonography for discriminating nodular Hashimoto thyroiditis from papillary thyroid carcinoma in patients with sonographically evident diffuse Hashimoto thyroiditis. Methods- This study included 20 patients with 24 surgically confirmed Hashimoto thyroiditis nodules and 40 patients with 40 papillary thyroid carcinoma nodules; all had sonographically evident diffuse Hashimoto thyroiditis. A retrospective review of the sonograms was performed, and significant benign and malignant sonographic features were selected by univariate and multivariate analyses. The combined likelihood ratio was calculated as the product of each feature's likelihood ratio for papillary thyroid carcinoma. We compared the abilities of the original sonographic features and combined likelihood ratios in diagnosing nodular Hashimoto thyroiditis and papillary thyroid carcinoma by their sensitivity, specificity, and Youden index. Results- The diagnostic capabilities of the sonographic features varied greatly, with Youden indices ranging from 0.175 to 0.700. Compared with single features, combinations of features were unable to improve the Youden indices effectively because the sensitivity and specificity usually changed in opposite directions. For combined likelihood ratios, however, the sensitivity improved greatly without an obvious reduction in specificity, which resulted in the maximum Youden index (0.825). With a combined likelihood ratio greater than 7.00 as the diagnostic criterion for papillary thyroid carcinoma, sensitivity reached 82.5%, whereas specificity remained at 100.0%. With a combined likelihood ratio less than 1.00 for nodular Hashimoto thyroiditis, sensitivity and specificity were 90.0% and 92.5%, respectively. Conclusions- Several sonographic features of nodular Hashimoto thyroiditis and papillary thyroid carcinoma in a background of diffuse Hashimoto thyroiditis were significantly different. The combined likelihood ratio may be superior to original sonographic features for discrimination of nodular Hashimoto thyroiditis from papillary thyroid carcinoma; therefore, it is a promising risk index for thyroid nodules and warrants further investigation.
    Journal of ultrasound in medicine: official journal of the American Institute of Ultrasound in Medicine 11/2012; 31(11):1767-75. · 1.40 Impact Factor
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    ABSTRACT: The purpose of this study was to investigate the influence of atherosclerosis and age on 4 representative Doppler parameters in the diagnosis of renal artery stenosis. The 4 parameters, renal peak systolic velocity (PSV), renal-aortic ratio, renal-interlobar ratio, and acceleration time, were measured in 208 patients before angiography. The 208 patients were divided into groups according to age and atherosclerosis stratification. The Student t test, 1-way analysis of variance, and the χ(2) test were used to compare all 4 parameters and clinical characteristics. The optimal cutoff values were determined by receiver operating characteristic curves. The diagnostic concordance between atherosclerosis and age strata was evaluated by the Cohen κ coefficient. Of the 416 renal arteries shown on Doppler sonography, 204 had a diagnosis of renal artery stenosis and 19 as occlusion on angiography. The optimal cutoff values for the renal-aortic ratio and renal-interlobar ratio in the groups aged 46 years or older and younger than 46 years were much different (2.3 versus 1.4 and 5.1 versus 6.5, respectively), whereas those for the renal PSV and acceleration time were close to each other or the same (170 versus 180 cm/s and 51 versus 51 milliseconds). The κ coefficients for the renal PSV, renal-interlobar ratio, acceleration time, and renal-aortic ratio between the atherosclerosis and age strata were 0.93, 0.99, 1.00, and 0.71. Atherosclerosis and age show comparable influences on Doppler parameters in the diagnosis of renal artery stenosis. For clinical convenience, cutoff values may be separately established on the basis of a 46-year-old borderline for the renal-aortic ratio and renal-interlobar ratio, although this process is not necessary for the renal PSV and acceleration time.
    Journal of ultrasound in medicine: official journal of the American Institute of Ultrasound in Medicine 05/2012; 31(5):747-55. · 1.40 Impact Factor
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    ABSTRACT: To assess the diagnostic value of automated breast volume scanning (ABVS) or conventional handheld ultrasonography (HHUS) for the differentiation of benign and malignant breast lesions. The study prospectively evaluated 239 lesions in 213 women who were scheduled for open biopsy. The patients underwent ABVS and conventional HHUS. The sensitivity, specificity, accuracy, false positive rate, false negative rate, and positive and negative predictive values for HHUS and ABVS images were calculated using histopathological examination as the gold standard. Additionally, diagnostic accuracy was further evaluated according to the size of the masses. Among the 239 breast lesions studied, pathology revealed 85 (35.6%) malignant lesions and 154 (64.4%) benign lesions. ABVS was similar to HHUS in terms of sensitivity (95.3% vs. 90.6%), specificity (80.5% vs. 82.5%), accuracy (85.8% vs. 85.3%), positive predictive value (73.0% vs. 74.0%), and negative predictive value (93.3% vs. 94.1%). The area under the receiver operating characteristic (ROC) curve, which is used to estimate the accuracy of the methods, demonstrated only minor differences between HHUS and ABVS (0.928 and 0.948, respectively). The diagnostic accuracy of HHUS and ABVS in differentiating benign from malignant breast lesions is almost identical. However, ABVS can offer new diagnostic information. ABVS may help to distinguish between real lesions and inhomogeneous areas, find small lesions, and demonstrate the presence of intraductal lesions. This technique is feasible for clinical applications and is a promising new technique in breast imaging.
    European journal of radiology 02/2012; 81(11):3190-200. · 2.65 Impact Factor
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    ABSTRACT: The purpose of this study was to evaluate the utility of contrast-enhanced sonography as an adjunct to conventional transvaginal sonography for detecting endometrial carcinoma and defining the depth of myometrial invasion. A total of 35 patients with endometrial carcinoma diagnosed by endometrial sampling were examined with transvaginal sonography followed by contrast-enhanced sonography before treatment. The contrast enhancement phases (ie, early wash-in/out and late wash-in/out) were visually observed before comparison of tumors grouped by average diameter and histopathologic grade. We evaluated the effectiveness of contrast-enhanced sonography as an adjunct to transvaginal sonography in tumor imaging. We calculated the accuracy of contrast-enhanced sonography for diagnosing the depth of tumor invasion into the myometrium by using arcuate vascular plexus involvement as the sonographic standard for diagnosis of deep myometrial infiltration. Of the 34 tumors identified by contrast-enhanced sonography, 28 (82.4%) showed early wash-in, and 6 (17.6%) showed late wash-in. Similar numbers of cases showed early and late wash-out. The enhancement phases did not differ significantly across groups with different average tumor diameters or histologic grades (P > .05). Contrast-enhanced sonography contributed the most to tumor imaging in patients with a thin endometrium after endometrial biopsy because it enhanced the contrast between the tumor and tissue. The diagnostic accuracy of contrast-enhanced sonography for determining the myometrium infiltration depth was 85.3%. This study revealed diagnostically useful characteristics of the enhancement phase of endometrial carcinoma. The ability to enhance tumor-to-tissue contrast makes contrast-enhanced sonography a valuable adjunct to conventional sonography of endometrial carcinoma, especially for the thin endometrium found after endometrial biopsy. Contrast-enhanced sonography performed well in the diagnosis of the myometrial infiltration depth when using arcuate vascular plexus involvement as a marker of deep myometrial infiltration.
    Journal of ultrasound in medicine: official journal of the American Institute of Ultrasound in Medicine 11/2011; 30(11):1519-27. · 1.40 Impact Factor
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    ABSTRACT: To investigate the contrast-enhanced ultrasound (CEUS) characteristics of primary hepatic angiosarcoma (PHA). The sonographic findings and CEUS images of PHA in three patients were retrospectively analyzed. In our study, 3 cases of PHA (2 multiple nodules and 1 solitary mass) showed similar enhancement pattern on CEUS, characterized by remarkable central non-enhancement and peripheral irregular enhancement in the arterial and portal phase, and complete wash-out in the late phase. Furthermore, we unexpectedly found that abundant neoplastic tissues were present in the central area of non-enhancement on pathological evaluation. Based on literature review, we supposed that the unusual finding may be associated with the very low velocity of blood flow in the central region of tumors. CEUS could well depict PHA with some common features, which may provide valuable clues in diagnosis of this rare disease. And non-necrotic tumor tissue of PHA could also demonstrate non-enhancement on CEUS, which warrant further investigations.
    European journal of radiology 07/2011; 81(9):2054-9. · 2.65 Impact Factor
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    ABSTRACT: To evaluate the interobserver agreement of radiologists in the description and final assessment of breast sonograms obtained using an automated breast volume scanner (ABVS) using a unique descriptor of three-dimensional ultrasound (3D US) and the Breast Imaging Reporting and Data System (BI-RADS) US lexicon. From October to December 2010, 208 patients were subjected to an ABVS examination in the supine position, and data were automatically sent to the ABVS workstation. Two radiologists independently evaluated 234 breast masses (148 benign and 86 malignant masses) using a unique descriptor from the 3D US and the BI-RADS US lexicon. The reviewers were blinded to the patient's mammographic images, medical history, and pathologic findings. The interobserver agreement was measured using kappa statistics. Substantial agreement was obtained for lesion shape, orientation, margin, echo pattern, posterior acoustic features, calcification and final assessment (κ=0.79, 0.74, 0.76, 0.69, 0.68, 0.71 and 0.70, respectively). Fair agreement was obtained for retraction phenomenon and lesion boundary (κ=0.54 and 0.42, respectively). The interobserver agreement for breast sonograms obtained by ABVS is good, especially for lesion shape and margin; however, the interobserver agreement for the retraction phenomenon, which is a unique descriptor of coronal-plane 3D US, needs to be improved.
    European journal of radiology 07/2011; 81(9):2179-83. · 2.65 Impact Factor
  • Zhen-Hong Qi, Yu-Xin Jiang, Feng Feng, Qing Dai
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    ABSTRACT: A 33-year-old woman presented a chronic headache and sore throat on the right side of her body, continuous pulsatile tinnitus with decreasing hearing in the right ear, and recurrent bleeding from the right ear. Computer tomography and magnetic resonance imaging scan depicted a mass in the external ear canal and an enlarged right jugular bulb, which was revealed on duplex ultrasound in the upper portion of the right internal jugular vein. Surgical dissection of the tumor was performed. Pathological study revealed the mass was glomus jugulare tumor.
    Journal of neuroimaging: official journal of the American Society of Neuroimaging 06/2011; · 3.36 Impact Factor
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    ABSTRACT: This article has been withdrawn at the request of the author(s) and/or editor. The Publisher apologizes for any inconvenience this may cause. The full Elsevier Policy on Article Withdrawal can be found at http://www.elsevier.com/locate/withdrawalpolicy.
    European journal of radiology 06/2011; · 2.65 Impact Factor
  • Journal of ultrasound in medicine: official journal of the American Institute of Ultrasound in Medicine 02/2011; 30(2):277-9. · 1.40 Impact Factor
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    ABSTRACT: Medullary thyroid carcinoma (MTC) is a rare malignant tumour and usually difficult to diagnose with ultrasound. The aim of the study is to summarize the sonographic features of MTC and evaluate their diagnostic values. We analyzed the sonographic features of 35 MTCs and 50 benign nodules with respect to nodular size, echogenecity, internal content, shape, height/width, border, peripheral halo, calcifications and colour flow pattern. The ratio of long to short axis, echogenecity, internal content and calcifications were also assessed in cervical lymph nodes. The differences in sonographic features between MTCs and benign nodules were analyzed with Chi square test. The diagnostic efficiency of each sonographic feature was determined. The main sonographic features of MTC were hypoechogenicity (including marked hypoechogenicity) (n = 34, 97%), internal solid content (n = 29, 83%), taller than wide (n = 34, 97%), well defined border (n = 24, 69%), microcalcifications or macrocalcifications (n = 23, 66%). The echogenicity, internal content, shape, peripheral halo and calcifications were significantly different between these two groups, while the tall/wide, border, and perinodular and intranodular vascularisation were not significantly different. Among all the individual sonographic features, irregular shape had the highest diagnostic efficiency with a sensitivity of 51% and specificity of 92%. The combination of marked hypoechogenicity, microcalcifications, and irregular shape yielded a sensitivity of 77% and specificity of 86%. The typical sonographic features of MTC are hypoechogenicity, predominantly solid, irregularly shaped with intranodular micro- or macro-calcifications. The combination of multiple sonographic features is helpful, but not definitive, for the diagnosis of MTC.
    Chinese medical journal 11/2010; 123(21):3074-8. · 0.90 Impact Factor
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    ABSTRACT: To investigate the sonographic and computed tomography (CT) features of hepatic angiomyolipoma (HAML). Sonographic and CT findings were analyzed in 12 patients (9 females and 3 males) with pathologically proved HAML. The size, margin, location, gray scale, and color Doppler flow imaging characteristics were observed. HAML was located correctly with ultrasound in all patients. The sonographic features of 12 HAML included regular shape, clear margin, and three type of echoes including homogeneous hyperechoes (n=5), heterogeneous internal echoes (n=5), or homogeneous hypoechoes (n=2). The arterial flow signal was detected in two HAML. The CT findings included adipose density (n=3), soft tissue density (n=3), and mixed density (n=6). The sonographic and CT findings were correlated with the composition and distribution of fat, vessels, and smooth muscle tissue. Fatty tissues within HAML shows typical imaging findings. The ultrasonographic and CT have their own advantages in detecting the fatty tissue inside HAML, and therefore a combination of these two techniques may increase the diagnostic accuracy of HAML.
    Zhongguo yi xue ke xue yuan xue bao. Acta Academiae Medicinae Sinicae 10/2010; 32(5):561-4.
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    ABSTRACT: To analyze the clinical and ultrasonographic imaging features of intraductal papillary mucinous neoplasm (IPMN) of the pancreas. Twelve patients with IPMN underwent surgery between May 2005 and December 2008, including 4 (33.3%) with adenoma and 8 (66.7%) with adenocarcinoma. IPMN was classified preoperatively into 3 types based on sonographic findings of different sites: main duct, branch duct, and combined type. All clinical presentations and ultrasonographic findings of those patients were reviewed and the correlation between ultrasonographic findings and histopathological results was analyzed. There were 9 men and 3 women with a mean age of 60.1 +/- 9.6 years (range, 32-73). Of all the 12 patients with IPMN, 9 (75.0%) had experienced some symptoms of epigastric discomfort and/or pain as well as backache; 7 cases were with medical history of acute pancreatitis, 5 cases with diabetes, 4 cases with elevated CA19-9, and 2 cases with steatorrhea. All lesions of IPMN have been revealed by transabdominal ultrasonography. The mean diameters of the lesions were 1.4 +/- 0.8 cm (range, 0.5-2.0) and 6.3 +/- 6.0 cm (range, 2.0-20.0) in adenomas and adenocarcinomas, respectively. And the mean diameters of the main duct in adenomas and adenocarcinomas were 1.0 +/- 0.8 cm and 1.6 +/- 1.0 cm, respectively. Among the 4 adnomas, 3 (75.0%) cases were classified as branch type based on sonographic findings, and 2 were demonstrated as mural nodules in which no color signals was detected. Among the 8 adenocarcinomas, 5 (62.5%) cases were classified as main duct type, and 3 (37.5%) as combined type. In 7 of the 8 adenocarcinomas, mural nodules were detected within the dilated ducts or cysts of the lesions in which color flow signals were detected. Transabdominal ultrasonography can reveal the pancreatic cystic lesions of IPMN as well as dilated pancreatic ducts. Some characteristics should be noticed as suggesting the possibility of malignancy: clinical symptoms of pancreatic insufficiency, large tumor size, and mural nodules with color Doppler flow signals. Transabdominal ultrasonography could be a useful tool to help diagnose and make appropriate management of IPMN.
    Chinese Medical Sciences Journal 09/2010; 25(3):151-5.
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    ABSTRACT: To evaluate the diagnostic value of the sonographic features of Breast Imaging Reporting and Data System (BI-RADS) assessment category 4 and 5 non-palpable breast lesions. A total of 213 non-palpable breast lesions that were pre-operatively assessed to be BI-RADS category 4 and 5 lesions by ultrasound were enrolled in this study. The diagnostic value of their sonographic features were assessed by using pathologic results as the golden standards. Of these 213 lesions, 128 (60.1%) were pathologically confirmed to be benign and 85 (39.9%) to be malignant. The mean size was not significantly different between the benign and the malignant lesions (P=0.09). The sensitivity of "irregular shape" for diagnosing breast cancer was 89.9%, while the sensitivities of other sonographic features ranged from 7.6% to 42.4%. The diagnostic specificities were high for "angular margin", "microlobular", "spiculation" and "abundant flow" (89.0%-95.6%). The common sonographic findings of benign lesions included "irregular shape" (66.7%), "obscure margin" (35.1%), "shadowing" (27.2%), and "taller-than-wider" (26.3%). "Irregular shape" is the most sensitive sonographic feature in the diagnosis of malignant BI-RADS category 4 and 5 non-palpable breast lesions. Ultrasound can accurately identify the invasive margin features of breast cancers, which is especially useful for the diagnosis of BI-RADS category 5 lesions.
    Zhongguo yi xue ke xue yuan xue bao. Acta Academiae Medicinae Sinicae 08/2010; 32(4):456-60.
  • Na Li, Yu-Xin Jiang, Qing Dai
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    ABSTRACT: To summarize the sonographic features of primary non-Hodgkins lymphoma of the breast using the Breast Imaging Reporting and Data System-Ultrasound (BI-RADS-US) and explore the value of ultrasonography in the preoperative diagnosis. The clinical data of 11 patients with primary non-Hodgkins lymphoma of the breast were retrospectively reviewed. BI-RADS-US grading was performed for each lesion. Totally 13 lesions were detected in 11 patients. Single lesion at one side was detected in 9 patients (81.8%). Circumscribed (n=7, 53.8%) or microlobulated lesions (n=5, 38.5%), parallel orientation (n=10, 76.9%), and oval masses (n=8, 61.5%) were also observed on sonography. The echo pattern of the mass was hypoechoic in 10 lesions (76.9%), hyperechoic in 1 lesion, and complex echoic in 2 lesions. No mass had speculated margins or calcifications. Ipsilateral axillary lymph node involvements were noted in 6 patients. Most primary non-Hodgkins lymphomas of the breast present as single hypoechoic masses with circumscribed or microlobulated margins and parallel orientation on sonography. BI-RADS-US, combined with the analyses of multiple signs, is feasible for the pre-surgical diagnosis.
    Zhongguo yi xue ke xue yuan xue bao. Acta Academiae Medicinae Sinicae 06/2010; 32(3):289-92.
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    ABSTRACT: To evaluate the diagnostic values of four risk of malignancy indices (RMI) for malignant adnexal masses. The data of 223 women with adnexal masses admitted to the Department of Obstetrics and Gynecology of Peking Union Medical College Hospital for surgical exploration between June 2008 and December 2008 were retrospectively analyzed. The sensitivity, specificity, positive predictive value and negative predictive value of RMI1, RMI2, RMI3, and RMI4 in the diagnosis of malignant adnexal masses were calculated. When the cutoff levels of RMI1, RMI2, RMI3 were set at 200 and RMI4 at 450, the sensitivities for diagnosing malignant adnexal masses ranged 59.0%-67.2%, the specificities ranged 94.4%-96.9 %, the positive predictive values ranged 82.0%-87.8%, and the negative predictive values ranged 90.9%-92.6%. The Youdens indexes (YI) of RMI1, RMI2, RMI3, and RMI4 were 0.559,0.606,0.576, and 0.559, respectively. RMI2 was significantly different from RMI1 (P=0.000), RMI3 (P=0.008), and RMI4 (P=0.000) in terms of diagnostic efficiency. RMI1, RMI2, RMI3, and RMI4 at a cutoff level of 75.688.679.1, 177.2 respectively, according to ROC curves, yielded sensitivities of 77.8%-82.5%, specificities of 84.6%-90.1%, positive predictive values of 69.0%-75.4%, and negative predictive values of 90.9%-92.6%; the relevant YI of RMI1, RMI2, RMI3, and RMI4 were 0.635, 0.665, 0.651 and 0.705, respectively. Under this cutoff level, the difference between RMI1, RMI2, RMI3, and RMI4 in diagnosing malignancy had no statistic significant. The primary histological types arising false negative were early stage epithelial ovarian cancer and non-epithelial ovarian cancer. The primary histological types arising false positive were endometriosis masses and degenerative sex cord-stromal tumor. RMIs are useful indices for the differentiation between benign and malignant pelvic diseases. Meanwhile, their cutoff levels for Chinese populations need further study.
    Zhongguo yi xue ke xue yuan xue bao. Acta Academiae Medicinae Sinicae 06/2010; 32(3):297-302.
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    ABSTRACT: To evaluate the efficacy of ultrasound-guided fine-needle aspiration (US-FNA) in the diagnosis of thyroid nodules. US-FNA was performed for 175 thyroid nodes in 168 patients aged 4 to 75 years in Peking Union Medical College Hospital from November 2004 to December 2008. The diagnostic data obtained from US-FNA were compared with those confirmed by surgical pathology and clinical follow-up. The US-FNA results were classified as benign, malignant, suspicious, or unsatisfactory. Among these 175 thyroid nodules, surgical pathology and clinical follow-up confirmed that there were 39 malignant nodules and 136 benign nodules, while US-FNA showed that 124 aspirates (70.9%) were benign, 24 (13.7%) were malignant, 14 (8.0%) were suspicious, and 13 (7.4%) were unsatisfactory for interpretation. For US-FNA, the sensitivity was 81.1%, specificity was 93.6%, accuracy was 90.7%positive predictive value was 78.9%and negative predictive value was 94.4%. Post-puncture bleeding was observed in 3 nodules (1.7%). US-FNA is accurate and reliable in diagnosing thyroid nodules.
    Zhongguo yi xue ke xue yuan xue bao. Acta Academiae Medicinae Sinicae 02/2010; 32(1):76-80.
  • Na Su, Yu-xin Jiang, Qing Dai, Zhen-hong Qi
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    ABSTRACT: To summarize the ultrasonographic characteristics of ovarian carcinosarcoma (OCS). Totally 12 patients with OCS have been detected in our department. All patients underwent surgical resection and the OCSs were confirmed pathologically. Ultrasound examination was performed before operation. Imaging features were analyzed retrospectively for bilaterality, size, and tumor solidity (cystic or solid). Presence of ascites and other evidence of peritoneal seeding, adjacent organ invasion, and surgical staging were also evaluated. Unilateral OCSs were found in 11 patients and bilateral OCSs in one patient one side was missed by ultrasound). Nine OCSs were solid, and 3 were mixed (solid and cystic). The diameter of the largest dimension was less than 10 cm in 4 cases, 10-20 cm in 7 cases, and larger than 20 cm in one case. Other ultrasonographic findings including peritoneal seeding and direct invasion into the adjacent organs were seen in 8 patients. Surgical stages were International Federation of Gynecology and Obstetrics (FIGO) classification c and b in one patient each, c in 9 patients, and in one patient. OCSs usually present as large, hypoechoic, solid, and aggressive tumors, combined with frequent peritoneal seeding and adjacent organ invasion.
    Zhongguo yi xue ke xue yuan xue bao. Acta Academiae Medicinae Sinicae 02/2010; 32(1):113-5.
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    ABSTRACT: No conventional imaging method reliably distinguishes between benign and malignant thyroid nodules. Our objectives were to characterize the enhancement patterns of thyroid nodules on gray-scale contrast-enhanced ultrasound (US) and to evaluate whether these patterns were useful in the differential diagnosis of thyroid nodules. Ninety-five patients, scheduled for surgery for thyroid nodules detected by gray-scale sonography, were enrolled in this prospective study. In all, there were 104 nodules (47 papillary carcinomas, 3 medullary carcinomas, 1 metastatic carcinoma, 44 hyperplasia nodule, 7 follicular adenomas, 1 suture granulomas, and 1 Hashimoto's disease). After intraveneous (i.v.) injection of a 1.2 mL bolus of SonoVue, lesions were scanned with real-time gray-scale pulse inversion harmonic imaging US for at least 3 minutes at low mechanical index (MI) (0.05 to 0.08). The enhancement patterns were classified into one of four patterns by two experienced readers. After administration of SonoVue, four enhancement patterns (homogeneous, heterogeneous, ring-enhancing, and no enhancement) were observed. Four benign and 3 malignant nodules had homogeneous enhancement pattern, 4 benign and 45 malignant nodules had heterogeneous enhancement, 44 benign and 3 malignant nodules had ring enhancement, and 1 benign nodule had no enhancement. There was a significant difference between benign and malignant nodules (p < 0.001). The benign thyroid nodules showed four enhancement patterns: ring enhancement 44/53 (83.0%), homogeneous enhancement 4/53 (7.5%), heterogeneous enhancement 4/53 (7.5%), and no enhancement 1/44 (1.9%). The malignant thyroid nodules showed three enhancement patterns: heterogeneous enhancement 45/51 (88.2%), ring enhancement 3/51 (5.9%), and homogeneous enhancement 3/51 (5.9%). Ring enhancement correlated highly with a benign diagnosis (sensitivity 83.0%, specificity 94.1%, positive predictive value 93.6%, negative predictive value 84.2%, and accuracy 88.5%). Heterogeneous enhancement correlated highly with a malignant diagnosis (sensitivity 88.2%, specificity, 92.5% positive predictive value 91.8%, negative predictive value 89.1%, and accuracy 90.4%). In both mixed and solid nodules, ring enhancement was highly predictive of a benign finding, whereas heterogeneous enhancement was highly predictive of a malignant finding. Contrast-enhanced US enhancement patterns were different in benign and malignant lesions. Ring enhancement was predictive of benign lesions, whereas heterogeneous enhancement was helpful for detecting malignant lesions.
    Thyroid: official journal of the American Thyroid Association 01/2010; 20(1):51-7. · 2.60 Impact Factor
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    ABSTRACT: To investigate the feasibility and clinical efficacy of ultrasound (US)-guided diffused optical tomography (DOT) in differentiating malignant breast lesions from benign lesions. From October 2007 to August 2008, 198 women with 214 lesions scheduled for open biopsy were included in this study. Conventional US was used to locate the breast lesion, and DOT to measure the total haemoglobin concentration (THC) for each breast lesion. Sensitivity, specificity and overall accuracy were determined with surgical pathology as the gold standard. There were 96 benign lesions and 118 malignant lesions. The total haemoglobin concentration (THC) of all 214 lesions was calculated from DOT. The average THC in benign lesions was 125.5 +/- 83.4 micromol/L, and in malignant lesions 222.2 +/- 87.2 micromol/L. The THC of malignant lesions was significantly higher than that of benign lesions (p < 0.05). When a THC of 140 micromol/L was used as the cutoff value for differentiating breast cancer from benign lesions, the sensitivity, specificity, accuracy, positive predictive value and negative predictive value of DOT were 83.9%, 66.7%, 76.2%, 75.6% and 77.1%, respectively. Our study demonstrated that THC was significantly higher in malignant lesions than in benign lesions. US-guided diffused optical tomography, a noninvasive functional imaging technique, has potential utility in differentiating breast cancer from benign lesions.
    European Radiology 09/2009; 20(2):309-17. · 3.55 Impact Factor