Around 50% of the population harbour thyroid nodules on ultrasonography, up to 7% of which may be malignant irrespective of size. While fine-needle aspiration biopsy is reliable, subjecting every thyroid nodule to this procedure is not cost-effective. Hence, ultrasonography is used primarily to characterise thyroid nodules, whereas nodules that have suspicious features are subject to a fine-needle aspiration biopsy. The presence of microcalcifications, macrocalcifications, irregular margins, 'taller-than-wide' shape, marked hypoechogenicity and intrinsic vascularity are features that render a thyroid nodule suspicious for malignancy. Spongiform appearance and the presence of colloid plugs or purely cystic nodules are considered features of benignity. In this article, these aforementioned sonographic features of malignancy and benignity are pictorially illustrated and a basic approach to dealing with solitary and multiple thyroid nodules is highlighted.
Humans ; Predictive Value of Tests ; Thyroid Neoplasms ; diagnosis ; diagnostic imaging ; Thyroid Nodule ; diagnosis ; diagnostic imaging ; Ultrasonography

During a discussion on temporal bone imaging, a group of resident trainees in otolaryngology were asked to corroborate the finding of a fracture in set of images that were supposed to be representative of a fracture involving the otic capsule.1(Figure 1) Their comments included the following statements: “The image still does not clearly identify the fracture. It would have been better if the images were set to the optimal bone window configuration...” “The windowing must be of concern as well. The exposure setting for the non-magnified view is different from the magnified ones. One must observe consistent windowing in order to assess the fractures more accurately.” “...the images which demonstrate a closer look on the otic capsule areas are not rendered in the temporal bone window which makes it difficult to assess.” “...aside from lack of standard windowing...”
Tomography, X-Ray Computed ; Temporal Bone Diagnostic ; Imaging Diagnostic Tests ; Routine ; Tomography, X-Ray Computed ;

OBJECTIVETo introduce Meta-analysis in evaluating diagnostic tests.

METHODAdjusted SROC method was used in assessing 7 diagnostic tests on fatty liver.

RESULTSThe pooled sensitivity and specificity of type B ultrasonography were 0.89 [95% confidence interval (CI): 0.87-0.92] and 0.94 (95% CI: 0.92-0.96) respectively while the Q value was 0.90 by adjusted SROC method. The results indicated that the diagnostic value of type B ultrasonography were high, thus could be regarded as an effective method for fatty liver diagnosis.

CONCLUSIONMeta-analysis on evaluating diagnostic tests could be used to assess the diagnostic test to increase the power of conclusion, and to improves its reliability.

Diagnostic Tests, Routine ; standards ; Evaluation Studies as Topic ; Fatty Liver ; diagnosis ; diagnostic imaging ; Humans ; Liver ; diagnostic imaging ; Predictive Value of Tests ; Sensitivity and Specificity ; Ultrasonography

OBJECTIVEThe purpose of this study was to compare the difference of craniofacial morphology between oral and nasal breathing children, and discover the relationship between respiratory mode and craniofacial morphology.

METHODSUsing the system for the simultaneous measurement of oral and nasal respiration, 34 oral breathing children and 34 nasal breathing children aged from 11 to 14 years were selected.

RESULTSCompared with the nasal-breathing children, the oral-breathing children showed apparently vertical growth pattern. The mandibuler plane Angle of oral breathing children is 39.3, which is significant greater than that of nasal breathing children (P < 0.01). The jans, the oral-breathing children had shorter mandibular body, larger gonion angle, retrusive chin and face (P < 0.05). On the other hand, in the sagittal direction, the oral breathing children may display all kinds of skeletal facial types. There is no significant difference between the two groups.

CONCLUSIONSOral breathing is one of the factors related to the vertical over-development.

Adolescent ; Child ; Craniofacial Abnormalities ; diagnostic imaging ; Facial Bones ; diagnostic imaging ; Female ; Humans ; Male ; Mandible ; diagnostic imaging ; Mouth Breathing ; diagnostic imaging ; physiopathology ; Nose ; Radiography ; Respiration ; Respiratory Function Tests ; Skull ; diagnostic imaging ; Statistics as Topic

Objective:To study the application value of narrow-band imaging in the diagnosis of laryngopharyngeal reflux. Methods:A total of 275 patients admitted to the inpatient department or laryngoscopy room of the Otolaryngology Head and Neck Surgery Department of the First Affiliated Hospital of Harbin Medical University from September 2022 to April 2023 due to throat discomfort were selected as the research subjects. All of them completed RSI, RFS scoring scales and electronic laryngoscopy（including ordinary white light and NBI）. According to the expert consensus of LPRD in 2022, RSI and RFS scoring scale were used as diagnostic criteria to divide them into LPR group and non-LPR group. Chi-square test was used to analyze the differences of positive rates of characteristic manifestations under NBI among different groups. The consistency of NBI and scale diagnostic methods was analyzed by Kappa, and RSI and RFS scoring were used as diagnostic criteria, The diagnostic efficiency of NBI method was analyzed. Results:There were 190 people in the LPR group, 157 of whom showed characteristic performance under the NBI mode, with a positive rate of 82.6%（157/190）; there were 85 people in the non-LPR group, with a positive rate of 18.8%（16/85）. There was a statistically significant difference in the positive rate between the two groups（χ²=102.47, P<0.05）. The consistency rate between RSI, RFS and NBI was 82.2%（226/275）. Kappa consistency analysis was used, and Kappa=0.605（P<0.05）, indicating good consistency between the two diagnostic methods. Using RSI and RFS as diagnostic criteria for LPR, the sensitivity of NBI diagnostic method was 82.6%（157/190）, specificity 81.2%（69/85）, positive predictive value 90.8%（157/173） and negative predictive value 67.6%（69/102）. Conclusion:Narrow-band imaging, as a new endoscopic imaging technique, can show small changes in mucosal surface micro vessels and play an important role in the diagnosis of laryngopharyngeal reflux.
Humans ; Laryngopharyngeal Reflux/diagnostic imaging* ; Narrow Band Imaging ; Laryngoscopy/methods* ; Pharynx ; Predictive Value of Tests

OBJECTIVETo systematically assess imaging diagnostic tests for fatty liver and provide a decision-making basis for clinical diagnosis and screening.

METHODSElectronic searches were conducted on the Chinese Biomedical Database, PubMed, and EMBASE, combining with manually searching of Chinese literature. All searches were completed until November 2002. All studies which evaluated imaging diagnostic test of human fatty liver were included. Data of diagnostic accuracy in the included studies were extracted, and methodological quality of the studies was assessed independently by two reviewers according to the established quality standard. Quantitative analysis or qualitative description were performed based on available data.

RESULTSOf 13 studies that met the eligibility criteria, 10 studies evaluated the diagnostic accuracy of B-mode ultrasound, 3 studies evaluated contrast-enhanced (helical) CT. To assess 7 diagnostic test studies for fatty liver that used liver biopsy as reference test: the pooled sensitivity of B-mode ultrasound was 0.89 (95% confidence interval 0.87-0.92), specificity was 0.94 (95% confidence interval 0.92-0.96) and the Q value was 0.90 by adjusted SROC method. To assess 2 diagnostic test studies for fatty liver that used CT as reference test: the pooled sensitivity, specificity, and Q value were 0.92 (95% confidence interval 0.89-0.96), 0.88 (95% confidence interval 0.84-0.92), and 0.90 respectively by adjusted SROC method.

CONCLUSIONSB-mode ultrasound method can be regarded as an effective method for fatty liver diagnosis and screening. The methodologic quality of diagnostic test needs to be improved.

Fatty Liver ; diagnosis ; diagnostic imaging ; Female ; Humans ; Liver ; diagnostic imaging ; Male ; Predictive Value of Tests ; Sensitivity and Specificity ; Tomography, Spiral Computed ; Ultrasonography

OBJECTIVE: To explore the high resolution CT image of temporal bone in infants with hearing loss, and its value in evaluating the cause of hearing loss. METHOD: In 2005, 0.12 million newborns have been included in the hearing screening system in Shanghai, and 1077 infants have failed to pass the hearing screening. One hundred and eight four infants were diagnosed as congenital hearing loss from mild to profound. A temporal bone HRCT scanning was performed to these infants. RESULT: Among the 184 patients with congenital hearing loss, HRCT showed that 26 cases (14.1%) were associated with external ear malformation, and 21 cases (11.4%) were associated with middle ear malformation, 31 cases (16.8%) associated with inner ear malformation. The patients with inner ear malformation included 12 cases with Mondini malformation, 1 case with common cavity malformation, 6 cases with large vestibule malformation, 5 cases with internal auditory canal abnormalities, and 10 cases with vestibule, semicircular canals abnormalities. In addition, there were 20 cases (10.8%) with fluid in middle ear. CONCLUSION HRCT image play an important role in the differential diagnosis and treatment of infants with congenital hearing loss.
Hearing Loss ; diagnostic imaging ; Hearing Tests ; Humans ; Infant, Newborn ; Neonatal Screening ; Temporal Bone ; diagnostic imaging ; Tomography, X-Ray Computed

OBJECTIVETo evaluate the efficacy of (99m)Tc-dimercaptosuccinic acid (DMSA) scanning in predicting vesicoureteral reflux (VUR) among young children with febrile urinary tract infection (UTI) and to investigate the priority in applying either micturating cystourethrography (MCU) or DMSA.

METHODSThe medical records of children (age < or = 2 years), presenting with febrile UTI between January 2000 and December 2009, were retrospectively reviewed. All cases underwent DMSA renal scan within 1 week after diagnosis and MCU within 1 week after infection. According to the results of MCU, children were divided into groups of non-VUR, low-grade and high-grade VUR.

RESULTSA total of 370 children (233 boys, 137 girls) were included, of whom 263 (71.1%) had abnormal DMSA results and 126 (34.1%) were identified as VUR on MCU. Among children with VUR, the number of high-grade was 103 (81.7%). The rate of abnormal results on DMSA of high-grade VUR group was significantly higher than the rates of the other two groups (P < 0.01). The sensitivity of DMSA for detecting high grade VUR was 99.0%. The negative predictive value was 99.1% and negative likelihood ratio was 0.03, respectively.

CONCLUSIONHigh-grade VUR remains an important risk factor of renal damage for young children with febrile UTI. The possibility to detect high-grade VUR on MCU is rather low when the result of DMSA is negative. It is recommended that DMSA be used before MCU to investigate the febrile UTI children at acute phase, because it would predict the majority of children with high-grade VUR while detecting renal lesions.

Child, Preschool ; Female ; Fever ; diagnostic imaging ; Humans ; Infant ; Infant, Newborn ; Kidney ; diagnostic imaging ; Male ; Predictive Value of Tests ; Radionuclide Imaging ; Retrospective Studies ; Risk Factors ; Sensitivity and Specificity ; Technetium Tc 99m Dimercaptosuccinic Acid ; Urinary Tract Infections ; diagnostic imaging ; Vesico-Ureteral Reflux ; diagnostic imaging

To evaluate the white-matter integrity and its correlation with cognitive function in patients with mild cognitive impairment (MCI) complicated with lacunar infarctions (LI) by diffusion tensor imaging (DTI) of magnetic resonance (MR).
 Methods: Twenty-six patients with MCI were selected including 14 patients with combined LI and 12 patients without combined LI, and 16 healthy volunteers were recruited as normal control. All subjects completed cognitive function assessment and DTI sequence of MR. Factional anisotropy (FA) and mean diffusivity (MD) values among the MCI with LI group (MCI-LI), the MCI without LI group (MCI-non LI), and the normal control group (NC) were compared, and the correlation between DTI parameters and cognition was determined by multiple linear stepwise regression.
 Results: Compared with the MCI-non LI group, the FA values were significantly decreased (P<0.05) and MD values were significantly increased (P<0.05) in the white matter fiber bundles (such as the left hippocampus of the cingulate tract, the frontal fascicle of the corpus callosum, the right inferior frontal occipital fascicle, and the right superior longitudinal fascicle) in the MCI-LI group. In the MCI-LI group, the FA value of right cingulate gyrus was significantly correlated with Activity of Daily Living Scale (ADL) score (B=-50.2, 95% CI -77.7 to -22.7, P=0.003); the FA value of left anterior thalamic radiation (B=443.8, 95% CI 222.9 to 664.8, P=0.001) and MD value of left inferior longitudinal tract (B=-318.5, 95% CI -534.7 to -102.3, P=0.009) were significantly correlated with Wechsler digit symbol substitution (WDSS) score; the FA value of left superior temporal lobe longitudinal tract was significantly correlated with Backward Digit Span (BDSP) score (B=12.5, 95% CI 1.5 to 23.4, P=0.030).
 Conclusion: The integrity of white matter is significantly destroyed in MCI patients with LI than that in MCI patients without LI, and there is a correlation between cognitive function and DTI parameters in some white matter tracts in MCI patients with LI.
Anisotropy ; Brain ; Cognitive Dysfunction ; diagnostic imaging ; Diffusion Magnetic Resonance Imaging ; Diffusion Tensor Imaging ; Humans ; Neuropsychological Tests ; Stroke, Lacunar ; White Matter

OBJECTIVE: To evaluate the diagnostic performance of a non-invasive, non-radiating, economical and convenient infrared thermal imaging in the detection of oral squamous cell carcinoma (OSCC) cervical lymph node metastasis, and evaluate its applicability via parallel test and series test. METHODS: This study was a prospective clinical study which passed the ethical review by the Biomedical Ethics Committee, Hospital of Stomatology, Peking University, and had been submitted for clinical trial registration. Totally 74 OSCC patients who were to undergo a neck dissection were included in this study. The inclusion criteria were patients who: (1) were pathologically diagnosed as malignant tumors and planned to undergo surgical treatment including neck dissection; (2) agreed to participate in this study. The exclusion criteria were those who: (1) had undergone surgeries at head and neck previously; (2) with a history of systemic tumor adjuvant therapies such as radiotherapy or chemotherapy etc; (3) were unwilling or unable to cooperate. Basal information as well as clinical examination results were collected, such as physical examination and contradictive enhanced CT. Besides, infrared thermal imaging was done ahead of surgery. Analysis of the diagnostic power of infrared thermal imaging followed the principles of diagnostic test. The positive signs of infrared thermal imaging were: (1) asymmetric thermographic pattern including vascular pattern in ROI; (2) thickening image of unilateral facial artery/vein, submental artery/vein or external carotid artery; (3) surface temperature of ROI raised over 1 °C compared with the opposite side; (4) changes of neck profile with abnormal temperature pattern. The gold standard of this diagnostic test was pathology diagnosis of cervical lymph nodes. RESULTS: The sensitivity of infrared thermal imaging was 75.0%, while the specificity was 69.0%, accuracy was 71.6%, positive predictive value was 64.9% and negative predictive value was 78.4%. The sensitivity of parallel test which stood for the combination of infrared thermal imaging and conventional clinical examinations was 87.9% while the specificity of series test was 97.6%. CONCLUSION Infrared thermal imaging is a promising non-invasive, non-radiating and economical tool in the detection of cervical lymph node metastasis from OSCC when combined with conventional pre-operative examination.
Carcinoma, Squamous Cell/diagnostic imaging* ; Diagnostic Tests, Routine ; Head and Neck Neoplasms ; Humans ; Infrared Rays ; Lymph Nodes ; Mouth Neoplasms/diagnostic imaging* ; Prospective Studies ; Sensitivity and Specificity