Yu-Xin Jiang

Peking Union Medical College Hospital, Peping, Beijing, China

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Publications (40)56.17 Total impact

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    ABSTRACT: The use of ultrasound in the diagnosis of axillary lymph node metastases from breast cancer in a Chinese population was investigated. Data for 1,049 with breast cancer were retrospectively collected. All patients had undergone pre-operative axillary ultrasound and then axillary lymph node dissection. The sensitivity, specificity and accuracy of axillary ultrasound in this cohort were 69.4%, 81.8% and 77.0%, respectively. The overall false-negative rate of ultrasound images was 30.6% (123/402). False-negative ultrasound rates for pathologic N1, N2 and N3 patients were 46.2%, 21.8% and 9.3%, respectively. In patients with stage T1 disease and fewer than three metastatic lymph nodes, the false-negative ultrasound rate was 52.2% (47/90). Moreover, breast cancer patients with a false-negative axillary ultrasound were more likely to have a large tumor (p < 0.001) and high tumor grade (p = 0.009). However, there were no statistically significant differences between accuracy of axillary ultrasound and age of patients or experiences of ultrasound practitioners. In conclusion, the sensitivity, specificity and accuracy of ultrasound in the diagnosis of breast cancer metastasis to the axillary lymph nodes in Chinese patients were assessed. These data could help us to carefully use axillary ultrasound to diagnose and predict breast cancer axillary lymph node metastasis. Copyright © 2015 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.
    Ultrasound in medicine & biology 04/2015; 41(7). DOI:10.1016/j.ultrasmedbio.2015.03.024 · 2.10 Impact Factor
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    ABSTRACT: Objective To evaluate the value of contrast-enhanced ultrasound(CEUS)in diagnosing thyroid nodules coexisting with Hashimoto's thyroiditis(HT). Methods Totally 62 thyroid nodules in 48 HT patients were retrospectively analyzed. The CEUS characteristics were reviewed,and diagnostic value of enhancement pattern and peak intensity were calculated. Results Peak intensity (P=0.002) and enhancement pattern (P<0.001) differed significantly between malignant and benign thyroid nodules. The sensitivity,specificity,positive predictive value(PPV),negative predictive value(NPV),and accuracy of heterogeneous enhancement were 97.6%,85.7%,93.0%,94.7%,and 93.5%,respectively. Sensitivity,specificity,PPV,NPV and accuracy of low intensity at peak time were 85.4%,52.4%,77.8%,64.7%,and 74.2%,respectively. Conclusions Heterogeneous enhancement is effective in the diagnosis of malignant thyroid nodules coexisting with HT. CEUS can improve the diagnostic accuracy in distinguishing thyroid nodules with unknown malignancy under the conventional ultrasound.
    Zhongguo yi xue ke xue yuan xue bao. Acta Academiae Medicinae Sinicae 02/2015; 37(1):66-70. DOI:10.3881/j.issn.1000-503X.2015.01.012
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    ABSTRACT: To investigate skin elasticity using acoustic radiation force impulse (ARFI) quantification in systemic sclerosis (SSc), and compare the modified Rodnan skin score (mRSS) with measured shear wave velocity (SWV) and thickness of the skin. Fifteen patients with diffuse cutaneous SSc (dcSSc) and 15 age-matched and sex-matched healthy controls were evaluated. The SWV and thickness of skin were measured at 17 sites corresponding to those assessed in the mRSS in each participant. The SWV measurements of skin were compared between patients with dcSSc and healthy controls. The correlations between the mRSS and the skin SWV and thickness were explored using Spearman's correlation. The SWV values were higher in patients with dcSSc compared with healthy controls at right hand dorsum, right forearm, left hand dorsum, left forearm, right foot dorsum, and left foot dorsum (p < 0.05). In patients with dcSSc, the SWV values of uninvolved skin were higher than those of controls (p < 0.001), and the SWV values increased with increasing skin scores except for skin score 3 (p < 0.05). The sum of the SWV values correlated with total clinical skin score (r = 0.841, p < 0.001), and the sum of the skin thickness correlated with total clinical skin score (r = 0.740, p = 0.002). ARFI quantification is feasible and reliable for assessing the skin involvement in dcSSc. ARFI quantification could identify early skin change that may precede palpable skin involvement, and may be a valuable adjunct to skin evaluation in patients with SSc.
    The Journal of Rheumatology 01/2015; 42(3). DOI:10.3899/jrheum.140873 · 3.17 Impact Factor
  • Liang Wang · Peng Xia · Ke Lv · Jie Han · Qing Dai · Xue-Mei Li · Li-Meng Chen · Yu-Xin Jiang
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    ABSTRACT: Chronic kidney disease (CKD), a progressive and irreversible pathological syndrome, is the major cause of renal failure. Renal fibrosis is the principal process underlying the progression of CKD. Acoustic radiation force impulse (ARFI) quantification is a promising noninvasive method for assessing tissue stiffness. We evaluated whether the technique could reveal renal tissue fibrosis in CKD patients. ARFI assessments were performed in 45 patients with CKD referred for renal biopsies to measure cortical shear wave velocity (SWV). During measurement, a standardized method was employed, which aimed to minimize the potential impact of variation of transducer force, sampling error of non-cortical tissue and structural anisotropy of the kidney. Then SWV was compared to patients' CKD stage and pathological fibrosis indicators. ARFI could not predict the different stages of CKD. Spearman correlation analysis showed that SWV did not correlate with any pathological indicators of fibrosis. ARFI assesses tissue stiffness of CKD kidneys by measuring cortical SWV. However, SWV did not show significant correlations with CKD stage and fibrosis indicators despite using standardized measurement methods. We therefore suggest that it would be necessary to evaluate the effect of pathological complexity and tissue perfusion of the kidney on stiffness assessment in future studies. • Acoustic radiation force impulse (ARFI) can quantify tissue elasticity of CKD kidney. • Despite standardized measurement, ARFI-estimated elasticity did not correlate with renal fibrosis. • Effects of pathological complexity and tissue perfusion on renal stiffness warrant further study.
    European Radiology 04/2014; 24. DOI:10.1007/s00330-014-3162-5 · 4.34 Impact Factor
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    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; DOI:10.1016/j.ultrasmedbio.2013.07.010 · 2.10 Impact Factor
  • Liang Wang · Yu Xia · Yu-Xin Jiang · Qing Dai · Xiao-Yi Li
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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. · 1.53 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. · 1.53 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. DOI:10.1016/j.ejrad.2012.01.034 · 2.16 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. · 1.53 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. DOI:10.1016/j.ejrad.2011.06.026 · 2.16 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. DOI:10.1016/j.ejrad.2011.06.043 · 2.16 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; 23(2). DOI:10.1111/j.1552-6569.2011.00605.x · 1.82 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; DOI:10.1016/j.ejrad.2011.04.069 · 2.16 Impact Factor
  • Journal of ultrasound in medicine: official journal of the American Institute of Ultrasound in Medicine 02/2011; 30(2):277-9. · 1.53 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. · 1.02 Impact Factor
  • Qing Zhang · Qing-li Zhu · Yu-xin Jiang · Bo Zhang · Qing Dai · Hai-ya Lou
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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. DOI:10.3881/j.issn.1000-503X.2010.05.018
  • Ke Lü · Qing Dai · Zhong-Hui Xu · Yi-Xiu Zhang · Li Tan · Yan Yuan · Yu-Xin Jiang
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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. DOI:10.1016/S1001-9294(10)60040-5
  • Qing-li Zhu · Yu-xin Jiang · Jing Zhang · Qing Dai · Qiang Sun
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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. DOI:10.3881/j.issn.1000-503X.2010.04.021
  • Hai-Ya Lou · Hua Meng · Qing-Li Zhu · Qing Zhang · Yu-Xin Jiang
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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. DOI:10.3881/j.issn.1000-503X.2010.03.013
  • 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. DOI:10.3881/j.issn.1000-503X.2010.03.011