Contrast-enhanced ultrasound images of tuberculous diaphragmatic muscle abscess of 26 surgically confirmed patients were retrospectively analyzed.The coincidence rate of preoperative diagnosis was 77％.The contrast-enhanced ultrasound images could be divided into three types of homogeneous,uneven and non-enhancement.Contrast-enhanced ultrasonography could decipher the blood supply characteristics and the different extents of tuberculous diaphragmatic muscle abscess.Thus it has important diagnostic values in the diagnosis of tuberculous diaphragmatic muscle abscess.

The clinical data of 91 patients with axillary cystic/solid mass receiving ultrasound-guided mass puncture in Hangzhou Red Cross Hospital and Hangzhou Third Hospital from March 2010 to October 2015 were retrospectively analyzed.The biopsy cytology examination and routain bacteria culture of puncture fluid were applied in 44 cases ( control group); while X-pert examination of puncture fluid was performed in addition to biopsy cytology examination and routain bacteria culture in 47 cases ( study group) . The histopathological examination of surgical specimens were used as gold standard.The overall diagnostic accuracy rates of study and control groups were 93.6% (44/47) and 68.2% (30/44), respectively(P=0.002) .The diagnostic accuracy rates for tuberculous abscess in study and control groups were 100.0%(28/28)and 57.7%(15/26), respectively (P=0.000).However, there were no significant differences in diagnosis of other diseases, including metastatic carcinoma, abscess other than tuberculous and lymphatic hygroma between two groups.The study shows that diagnostic accuracy of multiple examination methods of puncture fluid for axillary cystic/solid mass is high and has clinical application value.

Objective To investigate the value of contrast-enhanced ultrasonography (CEUS) in the diagnosis of tuberculous mesenteric lymphadenitis by analyzing its enhancement pattern. Methods The conventional ultrasound and contrast-enhanced ultrasound images of 62 patients with tuberculous mesenteric lymphadenitis confirmed by needle core biopsy or surgery were retrospectively analyzed. The location, size, shape, internal echo and posterior enhancement of mesenteric lymph nodes were recorded. All cases were divided into two groups:the maximum diameter of the lymph node≤20 mm and the maximum diameter of the lymph node >20 mm, and the patterns of enhancement in two groups were analyzed. Results The conventional ultrasound of 62 cases with tuberculous mesenteric lymph nodes showed enlargement. And the echogenicity was hypoechoic or heterogeneity, containing punctate or clusters of calcification in 19 cases (30.6%). After CEUS, there were three forms of enhancements:rim enhancement in 29 cases (46.8%);inhomogeneous enhancement in 21cases (33.9%);non-enhancement in 12 cases (19.3%). Rim enhancement was more common in the≤20 mm group, while inhomogeneous enhancement was more common in the lymph nodes>20 mm. There was statistically significant difference of the enhancement type between the≤20 mm group and the>20 mm group (χ2=6.782, P=0.034). Conclusions Most of tuberculous mesenteric lymph nodes showed rim and inhomogeneous enhancement in CEUS, and the sizes of mesenteric lymph node tuberculosis influenced the CEUS enhancement patterns. CEUS may provide useful information for the diagnosis of the tuberculous mesenteric lymph node.

Objective To investigate the risk factors related to progressive intracranial hemorrhage (PIH) in patients with acute traumatic brain injury (TBI) and analyze their clinical significance.Methods PIH was validated by comparing the initial and repeated CT scans. Data including gender,age, injury causes, Glasgow Coma Score (GCS) on admission, time interval from injury to the first CT scan, initial CT scan manifestations, prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (Fg), thrombin time (TT), platelet (PLT) and D-dimer (D-D) in both groups were compared with Logistic regression analysis to observe the risk factors related to PIH. Results The study involved 498 patients with acute TBI, of which 139 (27.91%) patients suffered from PIH. There were 116 patients (83.45%) with PIH who received the initial CT scan within two hours post injury.There was statistical difference in aspects of age, GCS on admission, time interval from injury to the first CT scan, initial CT scan manifestations ( including fractures, subarachnoid hematoma, contusion and onset hematoma), PT, Fg and D-D values in both groups (P ＜0.01 ). Logistic regression analysis showed that CT scans (subarachnoid hemorrhage, brain contusion and primary hematoma) and plasma D-D values were predictors of PIH ( P ＜ 0.01 ). Conclusions For patients with the initial CT scan manifestations including subarachnoid hemorrhage, brain contusion, primary hematoma together with D-D value increase within two hours post injury, a continuous CT scan should be performed promptly to detect PIH early.

OBJECTIVETo study the value of contrast-enhanced ultrasound in tuberculous cervical lymph node biopsy.

METHODSSeventy-nine patients with cervical lymph node were divided into two groups. The lymph nodes of group A were used as real-time ultrasound guided biopsy; the lymph nodes of group B were contrast-enhanced ultrasound firstly to determine the target lymph node and the puncture point, then were detected with needle biopsy.

RESULTSGroup A: for the 23 lymph nodes of 23 patients, the rate of intact tissue was 52.1% and the positive rate of pathological diagnosis was 73.9%. Group B: for the 56 lymph nodes of 56 patients, the rate of intact tissue was 98.2% and the positive rate of pathological diagnosis was 100% (Chi square value was 23.37 and 12.31, P < 0.05).

CONCLUSIONThe application of contrast-enhanced ultrasound before cervical lymph node biopsy can obviously improve the rate of intact tissue and the positive rate of pathological diagnosis.

Adolescent ; Adult ; Female ; Humans ; Lymph Nodes ; pathology ; Male ; Middle Aged ; Sentinel Lymph Node Biopsy ; methods ; Tuberculosis, Lymph Node ; pathology ; Ultrasonography, Doppler ; Young Adult

Objective To compare the characteristics of high-frequency ultrasonography with CT in chest wall tuberculosis, and to explore the diagnostic value of high-frequency ultrasound in chest wall tuberculosis abscess. Methods Retrospective analysis was performed on 35 patients with chest wall tuberculous abscess from November 2014 to may 2017, who were admitted to Hangzhou Red Cross hospital. All case were confirmed by surgery and pathology, and all patients were performed ultrasound and chest CT scan. The Chi square test was uesed to compare the results of high-frequency ultrasound and CT examination in 35 patients with tuberculous abscess of chest wall. Results High-frequency ultrasonography and CT were both 100% sensitive to the 35 cases of chest wall tuberculous abscess. High-frequency ultrasonography showed rib lesions in 17 cases, while CT showed rib lesions in 15 cases. Ultrasonography showed dead bone in 5 cases, while CT showed dead bone in 3 cases, the difference was not statistically significant. The ultrasonography showed the cortical roughness of ribs in 3 cases, while the CT showed that in 1 case, the difference was not statistically significant. The ultrasonography showed the thickened rib in 2 cases, while the CT showed that in 10 cases, the CT detection rate was higher than the ultrasound examinations with significant difference. Ultrasonography showed rib fractures in 12 cases, while CT showed that in 11 cases, the difference was not statistically significant. In the cases of rib lesion＜0.1 cm, ultrasound identified 2 cases, while CT identified only 1 case, but the difference was not statistically significant. Conclusion Compared with CT, high-frequency ultrasonography can show tuberculous abscess and rib lesions, which can be used as an important imaging diagnostic method for chest wall tuberculosis.

Objective To investigate dynamic changes of serum Tau proteins and their correlation with cognitive dysfunction in patients with acute traumatic brain injury (TBI).Methods A total of 95 patients with acute TBI were retrospectively studied by case-control study.There were 61 males and 34 females,with age of 16-65 years [(40.7 ± 13.6)years].The Glasgow coma scale (GCS) was 3-8 points in 9 patients,9-12 points in 11,and 13-15 points in 75.A total of 30 healthy physical examinees were recruited as control group.The levels of Tau proteins were measured at days 1,3,5,7 and 14 after TBI.The cognitive dysfunction was evaluated by the Montreal Cognitive Assessment (MoCA) score at 6 months after injury.The correlation between Tau protein levels at different time points and MoCA was determined.Results The serum Tau proteins of TBI group was significantly higher than that of control group at all time points (P ＜ 0.05).In TBI group,39 (41％) out of 95 patients developed cognitive dysfunction assessed by MoCA scale.The main manifestations of cognitive dysfunction were the defects in visual spatial and acting function,delayed memory,language,abstract,attention and calculation,with statistical significance compared with control group (allP ＜ 0.05).The serum Tau proteins of patients with cognitive dysfunction were significantly higher than those without cognitive dysfunction at all time points after TBI (P ＜ 0.05).Tau proteins at days 1,3,5 after TBI was significantly correlated with cognitive dysfunction at 6 months after TBI (P ＜ 0.05).Conclusions The levels of serum Tau proteins show a significant increase after TBI,the early changes of which are statistically related to cognitive dysfunction.The early changes of serum Tau protein after TBI can be used as a reliable biomarker for early prediction of cognitive function prognosis.