Objective To investigate the value of early?phase enhancement ratio combined with peripheral vascular diameter in the differential diagnosis of benign and malignant breast lesions using 3.0 T dynamic contrast?enhanced magnetic resonance imaging (DCE?MRI). Methods Sixty seven cases of patients (35 with malignant lesions and 32 with benign lesions in the breasts) were retrospectively analyzed. Their diagnoses were confirmed by surgery and pathology and all the patients underwent breast MRI plain scan and DCE?MRI in the two weeks before surgery. Lesion ROIs were drawn and time?signal intensity curves in the DCE?MRI were generated. Early?phase enhancement rate, time to peak, early?phase enhancement ratio, numbers of tumor vessel within 3 cm of the lesion and diameter of the largest vessel were recorded. Mann?Whitney U test was used to compare the difference of DCE?MRI between benign and malignant lesions, and the ROC curve was used to evaluate the efficiency of early?phase enhancement rate, early?phase enhancement ratio and vascular diameter in differentiating benign and malignant lesions. Results With breast malignant lesions, the medians of time to peak, early?phase enhancement rate, early?phase enhancement ratio, numbers of tumor vessel and vascular diameter were 2.2 s, 176.0%, 100.0%, 4 and 2.96 mm respectively, while with benign lesions of these parameters were 4.7 s, 113.3%, 81.9%, 0 and 0.00 mm respectively, and the differences were statistically significant (all P<0.05).When early?phase enhancement rate was used for differential diagnosis of breast benign and malignant lesions, the area under the ROC curve was 0.702 and the sensitivity and specificity were 82.86%and 56.25%with a threshold of 120.0%. When early?phase enhancement ratio was used, the area under the ROC curve was 0.854 and the sensitivity and specificity were 94.29% and 68.75% with a threshold of 86.0%. When peripheral vascular diameter was used, the area under the ROC curve was 0.896 and the sensitivity and specificity were 74.29%and 84.38% with a threshold of 2.78 mm. When early?phase enhancement ratio was combined with peripheral vascular diameter, the area was 0.925 and the sensitivity and specificity were 97.14% and 62.50%. Conclusion In the differential diagnosis of benign and malignant breast lesions under DCE?MRI, early?phase enhancement ratio combining with peripheral vascular diameter has improved sensitivity.

Objective To analyze the current situation of the quality of critical value management in ultrasound department,and to explore the application and effect of PDCA cycle method in critical value management.Methods The quality status of emergency data during the period from January 2015 to January 2019 after the PDCA cycle was adopted was analyzed.The PDCA cycle method was applied to improve the overall quality.The reporting rate,awareness rate,qualified rate of writing,and timely rate of clinical treatment were compared before and after the PDCA cycle was adopted to evaluate the effect of PDCA cycle method.Results From January 2015 to January 2019,the reporting rate was 96.4％,98.0％,94.5％,and 96.7％,the awareness rate of critical value was 63.2％,78.6％,84.8％,and 92.2％,the qualified rate of writing was 70.4％,77.2％,85.3％,and 94.0％,and the timely rate of clinical treatment was 50.9％,71.7％,81.1％,and 85.5％,respectively.The awareness rate,the qualified rate of writing,and the timely rate of clinical treatment were significantly improved (x2=12.464,38.184,52.926,all P ＜ 0.05).Conclusion PDCA cycle method can improve the quality of emergency management in ultrasound department.

Objective: To investigate the correlation between the maximum elastic modulus(Emax) of breast cancer obtained by shear-wave elastography (SWE) and immunohistochemical profiles. Methods: One hundred and sixty patients with 171 pathologically proven breast lesions were included in this study. All of them underwent conventional ultrasound and SWE examination before surgery. The Emax and maximum diameter were obtained. Histologic grade, immunohistochemical profiles ER, PR, HER-2, Ki-67 and molecular subtypes were recorded according to pathological results after surgery. The correlation between Emax and tumor size, histological grade, ER, PR, HER-2, Ki-67 and molecular subtypes were analyzed. Results: ①There was a positive correlation between the tumor size with Emax(r=0.510, P<0.05); ②The Emax of tumors with HER-2 positive expression were higher than that with HER-2 negative expression(P<0.05), the Emax of tumors with Ki67 high expression were higher than that with Ki67 low expression (P<0.05); ③There were significant differences in Emax between different molecular subtypes(P<0.05), the Emax of HER-2 positive tumor was the highest, followed by those of Luminal B tumor, triple-negative and Luminal A tumor; ④Multiple linear regression indicated that tumor size was the strongest pathologic determinate of Emax value(P<0.05), its standardized partial regression coefficient was 0.500, and HER-2 also had significant influence on Emax value of tumor(P<0.05), the standardized partial regression coefficient was 0.237. Conclusions Some prognosis immunohistochemical feature of breast cancer showed association with the Emax. Breast cancers with higher Emax at shear-wave elastography had poor prognostic features. To some extend, the value of Emax can reflect the biological characteristics of breast cancer, SWE may provide a certain imaging basis for the prognosis of breast cancer and the choice of treatment plan.

Objective To explore the value of endocervical curettage (ECC) in the detection of high-grade cervical squamous intraepithelial lesion (HSIL). Methods We retrospectively analyzed the clinical features and colposcopical characteristics of 678 female patients with complete clinical data. Results Among 678 cases, 391 cases were confirmed by cervical biopsy only and 7 cases by ECC only (57.67% vs. 1.03%, P < 0.001). ECC checked out 287 HSIL patients (42.33%, including cervical biopsy positive and negative cases) and cervical biopsy checked out 671 HSIL cases (98.97%, including ECC positive and negative cases). There were 68 positive ECC cases in the conversion area of Type 1+Type 2 and 247 positive ECC cases in the conversion area of Type 3(33.33% vs. 52.11%, P < 0.001). The positive rates of ECC in patients≥45 years old and < 45 years old were 145 and 170, respectively (55.13% vs. 40.96%, P < 0.001). Conclusion The cervical biopsy plays a dominant role in the detection of HSIL, and ECC can only be used as a supplement to it. Female patients older than 45 years or with Type 3 transformation zone examined by colposcopy should be concerned with cervical lesions.