Objective To explore the efficacy of transvaginal color Doppler sonography(TV-CDS)in the diagnosis and differential diagnosis of cornual pregnancy.Methods The characteristics of gray-scale and color Doppler ultrasonography of 30 patients with cornual pregnancy confirmed by surgery and pathology,were studied retrospectively.The position,size,figure,echogenicity and vascular pattern of the pregnancy tissue were evaluated,and the resistance index was calculated.Results The 30 patients were classified into two groups:group A with typical gestational sac and group B with abnormal mass in the area of corner.The overall diagnostic accuracy for these patients was 43.3%(13/3)and classified as 90%(9/10)accuracy for group A and 20%(4/20)for group B.Among the 17 patients who were misdiagnosed or diagnosed unclearly by TV-CDS,one patient in group A was misdiagnosed as a normal pregnancy,11 patients in group B were misdiagnosed as gestational trophoblastic disease and the rest 5 patients in group B were diagnosed unclearly.Conclusions TV-CDS is useful for differential diagnosis of cornual pregnancy.The cornual pregnancy with abnormal mass is usually misdiagnosed,and therefore clinical features and laboratory data should be fully evaluated for its diagnosis.

Objective: To observe the efficacy of azithromycin in treating the bacterial infectious diseases.　Methods: Intravenous administration of azithromycin was carried out in 40 cases.　Results: The clinical cure rate and eradication rate were 85.0% and 84.8%, respectively. Drug sensitivity tests showed that more isolates were sensitive to azithromycin (87.9%) than to erythromycin (42.4%). The MIC of azithromycin was lower than that of erythromycin. In addition, the adverse effects occurred with low frequency and were usually mild.　Conclusion: Azithromycin is effective and safe in treating bacterial infectious diseases.

Objective To investigate the value of 18 MHz high-frequency linear array ultrasound probe in the diagnosis of thyroid anterior capsular invasion,and compare it with the conventional high-frequency ultrasound probe.Methods Seventy-three nodules in 68 patients in Peking Union Medical College Hospital from December 2015 to March 2016 underwent conventional and 18 MHz high-frequency probes examination before operation and were compared with pathological results.The accuracy,sensitivity and specificity of the 18 MHz high-frequency linear array probe and the conventional high-frequency probe were determined.The consistency between the gold standard and the diagnosis by using two different frequency probes was measured using Kappa statistics.Additionally,diagnostic accuracy of different frequency probes was further evaluated according to the area under the ROC curve.Results The diagnostic consistency test of the total sample of 73 nodules:capsular abutment as the diagnostic criterion,the diagnostic consistency of 18MHz high-frequency probe was good (Kappa=0.803,P ＜ 0.01).The specificity,positive predictive value and accuracy were superior to the conventional high-frequency probe (90.7％ vs 69.8％,87.1％vs 68.3％,90.4％ vs 79.5％).The area under the ROC curve was 0.903,higher than that of the conventional high-frequency probe (0.816),which demonstrated that the former had better diagnostic accuracy.If the disruption of the perithyroidal echogenic line as another diagnostic criterion,the diagnostic consistency of the 18 MHz and conventional high-frequency probe was general,the Kappa value were 0.677 and 0.518.The sensitivity,positive predictive value,negative predictive value and accuracy of conventional high-frequency probe were inferior to the 18 MHz high-frequency probe (53.3％ vs 70.0％,74.5％ vs 82.0％,88.9％ vs 91.3％,78.1％ vs 84.9％).Conclusions The 18 MHz high frequency probe is a feasible tool for accurate prediction of the distance between tumor and thyroid anterior capsular and anterior capsular invasion,and it is helpful for the diagnosis of the preoperative staging and the prognosis of PTC.

Objective To assess the value of endorectal elastography in the diagnosis of malignant rectal adenoma. Methods Sixty patients referred to the department of basic surgery of Peking Union Medical College Hospital for the evaluation of rectal adenoma from January 2011 to May 2013 were included in this prospective cohort. All patients underwent elasticity score (ES) and strain ratio(SR) examine before operation. To evaluate the reproducibility of the strain-ratio measurements, the intraclass correlation coefficient (ICC) was calculated. Compared with final operational pathological results,the diagnostic values of elasticity score and strain ratio method were assessed. Results Histopathological result showed there were 20 adenomas and 40 adenocarcinomas. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of ERUS was 68%(27/40), 40%(8/20), 58%(35/60), 69%(27/39), 38%(8/21), respectively. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of elasticity score was 85%(34/40), 70%(14/20), 80%(48/60), 85%(34/40), 70%(14/20), respectively. The SR of adenocarcinomas was significantly higher than that of adenomas(2.82±1.81 vs 1.23±0.57, t=3.333, P < 0.05). The differences among the SR of benign adenoma, benign adenoma with severe atypical hyperplasia and completely malignant lesions were statistically significant (1.26±0.84 vs 2.94±1.95, 1.42±0.55 vs 2.94±1.95, t=2.619, 2.415, P=0.013, 0.021). When 1.240 was chosen as the best cut-off value of SR, the sensitivity, specificity, accuracy, positive predictive value and negative predictive value of strain ratio was 82%(33/40), 75%(15/20), 80%(48/60), 87%(33/38), 68%(15/22), respectively. Conclusion Endorectal elasotgraphy can accurately diagnose the malignant rectal adenoma, which can provide reliable preoperative imaging evidence for clinical operation mode.

Objective To observe the ultrasonographic features of intravenous leiomyomatosis (IVL). Methods Ultrasonographic features, pathological results and the clinical manifestations of 7 patients with IVLs were analyzed retrospectively, and the causes of misdiagnosis were discussed as well. Results The median age of 7 IVL patients was 40 years old. Five patients underwent previously hysterectomy due to probable diagnosis of leiomyoma with the mean recurrent time of 13.8 months. Three lesions extended into the right atrium, 3 involved the inferior venous cava and 1 was confined in the pelvis venous. Ultrasonographic findings of IVL included uterine solid lesions with intravascular disease, solid occupied lesions in the pelvis with intravascular disease after hysterectomy, solid occupied lesions in the pelvis, large abdominal vessels and cardiac chambes with intravascular disease after hysterectomy. The main misdiagnosis cause was that IVL had similar ultrasonographic features with hysteromyoma, and intravascular lesions of IVL was hard to detect in the early stage. Conclusion Color Doppler ultrasonography is a valuable imaging mortality for detection and follow-up of IVL.

Objective To investigate the role of gray-scale sonography in the diagnosis of thyroid microcarcinoma(TMC).Methods The sonographic characteristics of 58 TMC and 61 benign thyroid nodules(≤1 cm)were retrospectively reviewed and compared with each other.The size,echogenicity,internal solid/cystic component,configuration,anteroposterior to transverse dimension ratio(A/T),margin,halo sign and calcification type of the nodules were studied.Statistical analysis was performed using the chi-square test.The sensitivity,specificity,positive predictive value,negative predictive value and accuracy of individual sonographic characteristics were calculated respectively.Results In ultrasonography,TMC manifested as marked hypoechoic in 48.3%,solid lesion in 98.3%,irregular-shape in 74.1%,irregular halo sign in 37.0%,with internal microcalcifications in 62.1%.There were significantly statistical differences between the benign and malignant nodules in those findings (P＜0.001).However,there was no obviously statistical difference in the obscure margin.The sensitivity,specificity and accuracy were 86.2%,77.0% and 81.5% respectively when using marked internal hypoechoic echo,A/T≥1 and microcalcification as a new combined criterior.Conclusions The gray-scale sonographic findings between the small benign and malignant thyroid nodules(≤1 cm)are different.Combining these sonographic signs can significantly improve diagnostic value of TMC.

Background and purpose:Three-dimensional power Doppler angiography (3D-PDA) is a new technique to investigate the vessels in the organs, but the research in thyroid is limited. The purpose of this research was to investigate three-dimensional power Doppler angiography (3D-PDA) in differentiating malignant from benign thyroid nod-ules.Methods:This study prospectively evaluated 103 lesions in 94 patients who were scheduled for surgery. The patients underwent preoperative 3D-PDA scanning. Analysis of the 3D-PDA characteristics includes blood flow pattern, the num-ber of blood vessels, the shape of vessels, the spatial distribution of the vessels, the existence of rich local blood flow within nodules or in the parenchyma surrounding the nodules. This study also analyzed the difference between the benign lesions and the malignant lesions.Results:There were 50 benign lesions and 53 malignant lesions. The sensitivity and specificity of irregular vessels, the asymmetry spatial distribution, rich local blood flow within nodules or in the parenchyma surround-ing the nodules were 64.2%, 96.0%; 56.0%, 88.0%; 54.7%, 96.0%; 60.4% and 94.0%, respectively. The sensitivity, speci-ficity, positive predictive value, negative predictive value and accuracy of 3D-PDA were 83.0%, 94.0%, 93.6%, 83.9% and 90.3%, respectively.Conclusion:3D-PDA provides a useful tool to investigate vascularization of thyroid leisions.This technique is feasible for clinical application and plays an important role in diagnosis of thyroid nodules.

Objective To evaluate and screen out the specific characters of thyroid nodules on grayscale and color Doppler ultrasonography. Methods One hundred and four thyroid nodules in 95 patients were studied with gray-scale and color Doppler ultrasound before surgery.According to the probability of malignancy,the main independent characters were screened out by Logistic regression analysis and then got the formula which could calculate the probability of malignancy.Results Fifty three nodules,included 44 hyperplasia,7 adenomas,1 switch granuloma and 1 Hashimoto's disease,were benign.Fifty one nodules,included 47 papillary carcinomas,3 medullary carcinomas,1 metastatic carcinomas,were malignant pathologically.The significant characters to differentiate malignant from benign were the shape,margin,border,halo,echostucture,echogenecity,echo uniformity,calcicum,bolood vessel shape and partial abnormal rich blood of thyroid nodules.After two variables logistic regression analysis,a fomula were worked out.Probability of malignancy=1/1+e-z,which z=-7.44+1.30×halo+1.05×calcicum+1.5×vessel shape.If a thyroid nodule with no halo,microcalcicum and irregular vessel shape,the probability of malignancy was 0.99,while with complete halo,no calcicum and regular vessele shape,the probability of malignancy of the nodule was 0.02.Conclusions The halo,calcium and blood vessel shape of thyroid nodules were three independent characters of thyroid nodules to predict malignant thyroid nodules on gray scale and color Doppler ultrasound.

Objective To evaluate the diagnostic value of sonographic score in the diagnosis of salivary gland involvement in patients with Sj(o)gren's syndrome(SS). Methods One hundred and three cases (44 cases of SS group and 59 cases of control group) were involved in the study. Parotid and submandibular glands of all the cases were examined by a doctor unawaring of the clinical information. All the off-line images were scored by two doctors seperately. The best threshold and the according diagnostic efficiency were determined by statistical analysis. Results The Kappa coefficient between the two doctors was 0.80.The parotid score,submandibular score and total score of SS group were significantly higher than those of the control group (5.79 ± 2.40 vs 0.46 ± 0.97,5.93 ± 1.58 vs 1.32 ± 1.84,11.64 ± 3.27 vs 1.78 ± 2.33,respectively). According to the ROC curve for the parotid score, submandibular score and total score, the area under the curve were 0.98,0.95,0.99, respectively. The best diagnostic threshold for total score was 8 and under this threshold, the diagnostic sensitivity, specificity, positive and negative predictive values were 93%, 97%, 95%, 95%, respectively. Conclusions The sonographic score including both parotid and submandibular glands is a reliable method with high reproductivity and diagnostic accuracy in the diagnosis of SS salivary gland involvement.