Objective To investigate the types of ultrasonographic appearance of post-hepatectomy in operative position. Methods The data about operative manner,operative position, type of plugger in residul cavitity of 176 cases who underwent hepatic operation,were collected. Their ultrasonographic findings of post-operative liver in operative position in different phrases after operation were analyzed retrospectively. Results The main appearance was: ① Absence of partial hepatic lobe or hepatic segment; ② anechoic area with thin wall or mixed mass in operative position; ③ conformation of irregular high-echo conglomeration in operative position, irregular wall thickeness and inhomogenous internal echoes appeared in anechoic area and mixed mass in operative position, color Doppler twinking artifact appeared around some plugger and residual cavity which made by curettage and aspiration technique with time passing by. Conclusions Ultrasonographic appearance of post-hepatectomy in operative position varies with different operative manner, operative position, resected area, and Absence or existence of plugger in residual cavity, different type of plugger in residual cavity.

Objective To build the method of computerized case classification,for the purpose of perfecting the diseases typing and classification,and supporting the management based on the quality and expenses of the disease.Methods 875 cases were defined into two types.Eight parameters were selected for non-surgery cases,namely the disease diagnosis,severity at admission,and age.For surgery cases,five parameters were defined,namely the disease diagnosis,operative quantity,and severity at admission.Then Fisher function was called into play to obtain the function descriminant equation,realizing computerized classification.Results The rate of matching was 86.2％ between computerized classification and manual classification.The high accuracy of function descriminant equation proves the satisfactory outcomes of the classification.Collusion The computerized classification is satisfactory in its outcomes,and therefore it can better quality of care and cost management of diseases in clinical practice.

Objective To evaluate the association of the size of thyroid nodules and accuracy of fineneedle aspiration cytology in diagnose of thyroid nodules.Methods 691 thyroid nodules in 630 patients pathologically confirmed were retrospectively analyzed in our hospital.All imaging data of preoperative ultrasound-guided FNAC were collected in our review.Yields of FNAC were divided into six levels according to the classification criteria of the Bethesda system(level Ⅰ,insufficient material or nondiagnosed;level Ⅱ,benign ; level Ⅲ,atypical hyperplasia; level Ⅳ,follicular neoplasm ; level Ⅴ,suspicious for malignancy; level Ⅵ,malignant),＞level Ⅳ was the malignant cytologic criteria for diagnosis of thyroid nodules.According to the maximal diameter of thyroid nodules,the nodules were divided into group A(L≤0.5 cm),group B(0.5 cm＜L＜1.0 cm) and group C(L≥1.0 cm).Postoperative pathologic results were taken as the gold standard.Results Of 691 nodules,there were 176(25.47％),298(43.13％) and 217(31.40％) in group A,group B and group C respectively.Among the three groups,accuracy of ultrasound-guided FNAC in group B (90.94 ％) was higher than in group A(80.11％) and group C(83.41 ％),with statistically significant(P ＜0.05).There was not statistically different between group A and group C(P ＞0.05).The specificity,positive predictive value and negative predictive value were not statistically different among three groups(P ＞0.05).Conclusions The size of thyroid nodules was partly associated with accuracy of ultrasound-guided FNAC.

Objective To assess the therapeutic efficacy of colonic tumor with targeted microbubbles encapsulated VEGFR2 monoantibody (mAb) combined with ultrasonic abrupted destroy.Methods Seventeen Balb/C nude mice with subcutaneous colonic carcinoma xenografts were divided into three groups:group A (5 mice) underwent contrast-enhanced ultrasonography (CEUS) examination and sham ultrasonic abrupted destroy;group B (6 mice) underwent lipid-microbubbles administration combined with ultrasonic irradiation;group C (6 mice) underwent VEGFR2 monoantibody-loaded microbubbles injection combined with ultrasonic irradiation.Red fluorescent protein(RFP) was labeled to all the nude mice model.Both CEUS and flurography were performed before and one week after abrupted destroy.The size,fluroscent area and fluroscent intensity(FI) and vessel density (VD) of each tumor were measured and compared.Results The parameters of length,fluroseent area,FI and VD of each tumor before abrupted destroy were no significant difference among three groups ( P ＞0.05).Parameters of post-sham ultrasonic abrupted destroy in group A were higher than those before sham ultrasonic abrupted destroy ( P ＜0.05).FI and VD in group B were significantly lower than those after abrupted destroy( P ＜0.05).There were no difference of length,fluroscent area of tumor in group B between pre- and post- ultrasonic abrupted destroy (P ＞0.05).Length,fluroscent area,FI and VD of each tumor in groups C were decreased significantly compared with post ultrasonic abrupted destroy ( P ＜0.01 ).There were significant difference of length,fluroscent area,FI and VD of each tumor among groups after ultrasonic abrupted destroy( P ＜0.05).Conclusions VEGFR2 mAb-loaded lipid microbubble combined with ultrasonic abrupted destroy can improve the therapeutic efficacy of colonic tumor.

Objective To evaluate the application of transrectal ultrasound elastography (TRE) in the detection of prostate cancer(PCa).Methods One hundred and eighteen patients with suspected PCa were enrolled in this study.Each patient underwent transrectal ultrasound (TRUS), TRE and sonography guided prostatic biopsy on the same day.The accuracy rate of PCa detection using TRE were compared with the pathology results.Results Patients with PCa were detected in 62 of the 118 patients,including 48 cases by TRE and 38 cases by TRUS.The sensitivity for TRE (73.6％) was significantly higher than that of TRUS (52.8％) in periurethral zone(P ＜0.05).The sensitivity and specificity for strain ratio(SR) in predicting PCa were 85.7％ and 67.7％ respectively(cut off value：3.6,area under the curve 0.8, P ＜0.01,95％CI [0.68 - 0.92]).Conclusions TRE can detect PCa in the periurethral zone with good accuracy and has potential to increase ultrasound-based PCa detection rate.

Objective To evaluate the diagnostic and prognostic value of BRAF V600E mutation screening of ultrasound-guided fine-needle aspiration (FNA)specimens in patients with thyroid nodule. Methods The BRAF V600E mutation status were assessed in FNA specimens of 104 patients with thyroid nodules before operations.The BRAF mutation status,clinical,and pathology records of the patients were reviewed and the associations between these characteristics and papillary thyroid cancer (PTC ) were analyzed.Results Seventy-one PTC and 14 benign thyroid nodules were included in this study.BRAF V600E mutations were found in 57/71 (80%)PTC.All benign thyroid nodules had no BRAF V600E mutation.The sensitivity,specificity,positive predictive value and negative predictive value of BRAF V600E mutations in differentiation between PTC and benign thyroid nodules were 80%,100%,100% and 50%(P < 0.001 ).In 44 patients with PTC who underwent surgery,the central compartment lymph node metastases and extrathyroidal invasion were not significantly different between BRAF-positive and BRAF-negative PTC (P = 0.283 and 0.307 ).Conclusions BRAF V600E mutation may be a potential tool to facilitate ultrasound in diagnosis of PTC.In patients with PTC,the presence of the BRAFV600E mutation was not significantly associated with prognostic factors.

Objective:To summarize the clinical characteristics of pancreatic solid pseudopapillary neoplasm (pSPN).Methods:From March 2007 to August 2022, at the First Affiliated Hospital of Zhejiang University School of Medicine, the clinical data and follow-up results of 253 patients with pSPN and underwent surgical treatment were retrospectively analyzed. The diagnostic accuracy of preoperative ultrasound, magnetic resonance imaging (MRI), computed tomography (CT) and puncture biopsy of aspiration were compared and analyzed. Kaplan-Meier method was performed to calculate disease-free survival rate. The gender differences in the clinical and pathological features of pSPN were compared. According to whether recurrence and metastasis occurred after the primary operation, the patients with pSPN were divided into recurrence and metastasis group ( n=3) and disease-free survival group ( n=250). Univariate analysis was used to analyze whether gender, age, married status, with clinical symptoms, history of alcohol drinking or smoking, puncture biopsy of aspiration before operation, location and maximum diameter of tumor, surgical method (open surgery, minimally invasive surgery), type of surgery (parenchymal preservation surgery, conventional surgery), and pathological features (cellular atypia, invasion of adjacent organs, lymphovascular invasion, peripancreatic fat invasion, perineural invasion, capsular invasion and pancreatic parenchyma invasion) were predictive factors of recurrence and metastasis of pSPN. Two independent sample t test, chi-square test and Fisher′s exact test were used for statistical analysis. Results:Among 253 patients with pSPN, 49 (19.4%) were males and 204 (80.6%) were females. The diagnostic accuracy of MRI and CT were both higher than that of ultrasound (73.4%(124/169), 64.0%(146/228) vs. 33.3%(78/234)), and the diagnostic accuracy of MRI was higher than that of CT, and the differences were statistically significant ( χ2=62.93, 43.58 and 3.89, P<0.001, <0.001 and =0.049). The diagnostic accuracy of puncture biopsy of aspiration combined with immunochemistry was higher than that without combined immunochemistry (100.0%(23/23) vs. 8/13), and the difference was statistically significant (Fisher′s exact test, P=0.003). Eight cases missed during follow-up, and all the other 245 patients survived with the 5- year and 10-year disease-free survival rates of 99.2% and 97.2%, respectively. Male pSPN patients were older than female patients at diagnosis ((40.0±13.2) years old vs. (32.6±11.9) years old) and the maximum diameter of tumor was smaller than that of female patients ((3.88±2.05) cm vs. (4.87±3.05) cm), and the differences were statistically significant ( t=3.83 and -2.15, P<0.001 and =0.032). The results of univariate analysis showed that lymphovascular invasion was significantly correlated with pSPN recurrence and metastasis (Fisher′s exact test, P=0.012), and the other factors were not correlated with pSPN recurrence and metastasis (all P>0.05). Conclusions:CT, MRI and puncture biopsy of aspiration are comparatively reliable diagnostic method for pSPN before operation. There are significant differences in pSPN tumor growth and age of onset between genders. The postoperative recurrent rate of pSPN is low and the prognosis is good. Even if recurrence and metastasis occur, the patients can still survive for a long time after surgical treatment.

Objective: To assess value of contrast enhanced ultrasound (CEUS) in TN staging of pancreatic cancer and compared with contrast enhanced computed tomography(CECT). Methods: Seventy-eight cases with pancreatic cancer confirmed by pathology were enrolled in this study. All patients were examined using CEUS and CECT and staged according to the 8th guideline of pancreas tumors of AJCC. The diagnostic accuracies of CEUS in TN staging of pancreas tumors were compared with CECT. Results: The diagnostic accuracies of CEUS in T staging and N staging of pancreatic cancer were 80.8%, and 78.2%, respectively. For CECT, the diagnostic accuracies in T staging and N staging were 88.5%, and 88.5%, respectively. There was no significant difference in the diagnostic accuracies between CEUS and CECT in T staging(χ²=1.56, P=0.21). The diagnostic accuracy of CEUS in N staging was significantly lower than that of CECT(χ²=3.86, P=0.04). Conclusions The diagnostic accuracy of CEUS in T staging of pancreatic cancer is similar to that of CECT, while in its N staging is lower than that of CECT.