Objective:To investigate the value of histogram analysis of ultrasound gray scale in differential diagnosis of triple negative breast invasive ductal carcinoma (TN-IDC) and non-triple-negative breast invasive ductal carcinoma (NTN-IDC).Methods:Totally 195 patients with invasive ductal carcinoma confirmed by pathology in Hubei Cancer Hospital from September 2017 to July 2020 were retrospectively analyzed.According to immunohistochemical results after surgery, 195 patients were divided into TN-IDC group ( n=44) and NTN-IDC group ( n=151). All cases were retrospectively analyzed to observe the ultrasonoscopy histogram features of tumors and obtain the histogram parameters, including mean, variance, skewness, kurtosis and percentile gray-scale values. The histogram parameters of TN-IDC were compared with those of NTN-IDC. The ROC curves were constructed to observe the efficiency of differential diagnosis. Results:The values of variance, 90th and 99th percentiles in TN-IDC group were much lower than those in NTN-IDC group (all P<0.05). The values of mean, skewness, kurtosis and other percentile (1st, 10th, and 50th) values between the two groups were not significantly different(all P>0.05). The optimal cutoff value for the accurate identification of TN-IDC and NTN-IDC groups was 552.85 for variance[sensitivity 75.0%, specificity 79.5%, positive predictive value(PPV) 51.6%, negative predictive value(NPV) 91.6%, accuracy 78.5%, and area under curve 0.829, respectively]. The optimal cutoff value for the accurate identification of TN-IDC and NTN-IDC groups was 74 for 90th percentile (sensitivity 68.2%, specificity 57.6%, PPV 31.9%, NPV 86.1%, accuracy 60.0%, and area under curve 0.648, respectively). The optimal cutoff value for the accurate identification of the two groups was 107 for 99th percentile (sensitivity 75.0%, specificity 77.5%, PPV 49.3%, NPV 91.4%, accuracy 76.9%, and area under curve 0.772, respectively). Conclusions:Histogram analysis of ultrasound gray scale can provide certain value for the differential diagnosis of TN-IDC and NTN-IDC, the variance and 99th percentile values could perform better.

Objective To investigate the detection rate of contrast-enhanced ultrasound (CEUS) for iso-echo liver cancers, and to evaluate the application of CEUS in treating iso-echo liver cancers with radiofrequency ablation (RFA). Methods A total of 27 patients with liver cancers (31 lesions in total) were enrolled in this study. Of the 27 patients, hepatocellular carcinoma (HCC) was seen in 11 (11 lesions) and hepatic metastasis in 16 (20 lesions). In all patients the diagnosis was detected by contrast-enhanced CT or contrast-enhanced MRI and was clinically confirmed. Under real-time CEUS guidance, RFA was carried out for all the 31 lesions. The ablated extent was evaluated by CEUS, and CEUS findings were used to guide the further treatment. Results All 31 lesions were detected by CEUS and were treated with RFA. No serious complications occurred after RFA. Both CEUS and CECT performed one month after RFA showed that complete tumor necrosis was seen in all the 31 lesions. After RFA the serum AFP levels in all 11 HCC patients fell to normal range, and the serum CEA, CA-199 as well as CA-153 levels in patients with hepatic metastasis decreased significantly(P<0.01). Conclusion CEUS can markedly increase the detection rate of iso-echo liver cancers. Besides, CEUS plays an important role in guiding the performance of RFA for iso - echo liver lesions.