1.The preoperative evaluation value of three-dimensional ultrasound imaging for ovarian masses
Lijuan SUN ; Qingqing WU ; Tiejuan ZHANG ; Lina ZHANG ; Jijing HAN ; Wei DUAN ; Weimin KONG ; Xiuhui DUAN
Chinese Journal of Medical Ultrasound (Electronic Edition) 2017;14(2):105-110
Objectives To explore the clinical value of preoperative three-dimensional ultrasound imaging for ovarian tumors for reflecting the anatomy postoperatively.Methods Forty-seven patients with ovarian cystic-solid or solid masses from Beijing Obstetrics and Gynecology Hospital,Capital Medical University were evaluated by two-dimensional (2D) and three-dimensional (3D) ultrasound examination within one week before surgery from January 2008 to December 2009.Every ovarian mass was examined by three-dimensional ultrasound and tomographic ultrasound imaging (TUI) and the results was compared with the specimen postoperatively.Results Forty-seven ovarian masses were confirmed by pathology,including 23 benign masses and 24 malignant masses (six borderline tumors).Compared with the postoperative specimens,the accuracy of preoperative 3D ultrasound imaging of ovarian tumors for the anatomical structures was 89.4% (42/47).The misdiagnosis causes in 5 cases included failure to detect tiny papillae on the Sturface and small cysts in the mass,failure to display the compressed structures accurately,wrongly believe the teeth on the tumor wall as papillae and wrongly believe two adjacent ovarian tumors as one unilateral mass.Conclusions Compared with postoperative specimens,the anatomy of ovarian tumors could be reflected accurately by 3D ultrasound imaging preoperatively.It could be helpful for differential diagnosis between benign and malignant ovarian tumors and the decision of surgical plan.
2.The correlation between three-dimensional histogram vascular indexes of ovarian tumors and microvessel density
Lijuan SUN ; Qingqing WU ; Tiejuan ZHANG ; Ling YAO ; Yuqing MA ; Li WANG ; Xiuhui DUAN
Chinese Journal of Medical Ultrasound (Electronic Edition) 2017;14(2):122-126
Objective To evaluate the correlation between three-dimensional histogram vascular indexes of ovarian tumors and microvessel density (MVD).Methods Fifty-seven patients with ovarian cystic-solid or solid masses from Beijing Obstetrics and Gynecology Hospital,Capital Medical University were evaluated by three-dimensional (3D) power ultrasound within one week before surgery from January 2008 to December 2009.We captured 3D power imaging in the interested and solid areas of tumors,and used three-dimensional histogram from virtual organ computer-aid analysis (VOCAL) to calculate vascularization index (Ⅵ),flow index (FI) and vascularization-flow index (VFI).After operation the specimens underwent immunohistochemistry staining and MVD and vascular endothelial growth factor (VEGF) were calculated.Two independent-samples t tests were used to compare MVD between ovarian benign and malignant tumors.Rank sum test was used to compare VEGF.Spearman was used to analyze the relationship between 3D PD vascular indices and MVD.Results Sixty-two ovarian masses in 57 patients were confirmed by pathology (5 cases were bilateral tumors),including 22 benign and forty malignant messes (including eight borderline tumors).Fifty-four tumors underwent immunohistochemistry staining.MVD and VEGF were calculated.Both of MVD and VEGF in ovarian malignant tumors were obviously higher than those in benign ones (t=-5.255,Z=-3.868,both P < 0.01).Both of Ⅵ and VFI were positive correlative to MVD (r=0.295,0.280,both P < 0.05).Conclusions There was a positive correlation between vascular indexes and microvessel density.The vascular indexes could reflect the density of angiogenesis in ovarian tumors before surgery,and they could provide valuable information for early-stage diagnosis of ovarian cancer.
3.Serum vitamin D levels in tuberculosis patients with different blood glucose status
Xin ZHAO ; Yanli YUAN ; Yunlong BAI ; Tiejuan ZHANG ; Guangxu YANG ; Meng WANG ; Zhixian XIE
Chinese Journal of General Practitioners 2018;17(6):447-451
Objective To investigate serum vitamin D levels in tuberculosis (TB) patients with different blood glucose status.Methods Two hundred and forty seven TB patients were recruited from tuberculosis clinics in Jilin province and 80 normal subjects who underwent health check up in Beijing Hospital served as controls.Blood samples were collected,fasting blood glucose (FBG) and serum vitamin D [25 (OH)D] levels were measured.Results FBG results showed that there were 95 patients with normal FBG,69 with pre-diabetes (pre-DM) and 83 with diabetes mellitus (DM).Vitamin D measurement showed that 25(OH) D level in TB patients with normal FBG,pre-DM and DM was 16.1 (10.7,26.2) μg/L,12.9 (9.6,20.1) μg/L and 12.4 (10.4,16.9) μg/L,respectively,(x2 =19.608,P < 0.001) and were much lower than that in the normal controls (20.5 μg/L) (x2 =21.701,P < 0.001).Proportion of TB patients with 25 (OH)D sever deficiency(< 10.0 μg/L)in patients with normal FBG,pre-DM and DM was 20.0% (19/95),31.9% (22/69),and 24.1% (20/83) respectively (x2 =6.376,P < 0.05);proportion of 25 (OH) D deficiency (10.0-19.9 ng/ml) in three groups was 41.1% (39/95),40.6% (28/69),and 57.8 % (48/83),respectively (x2 =15.141,P < 0.05);sufficient 25 (OH) D (≥ 30.0 μg/L) was 14.7% (14/95),7.2% (5/69),and 1.2% (1/83),respectively (x2 =19.118;P <0.05).While the proportion of TB patient with 25 (OH) D insufficiency (20.0-29.9 ng/ml) was 24.2% (23/95),20.3% (14/69),and 16.9% (14/48) respectively (x2 =0.933,P =0.627).In TB patients with normal FBG,risk factors for 25 (OH) D deficiency were smoking (OR =5.619,95% CI:1.293-24.424,P =0.021),cold season (OR =14.402,95%CI:4.070-50.965,P < 0.001) and smear negative TB (OR =6.194,95 % CI:1.873-20.481,P =0.003).Living in rural area (OR =3.429,95% CI:1.040-11.299,P =0.043) was the risk factor for 25 (OH) D deficiency in TB patients with pre-DM and age ≥ 60 years (OR =2.474,95%CI:1.086-5.623,P =0.031) was risk factor for 25 (OH) D deficiency in those with DM.Conclusions Vitamin D level is lower in TB patients than that in normal controls.The diabetic TB patients have the lowest 25 (OH) D level and have highest proportion of vitamin D deficiency and sever deficiency,particularly for elderly patients.
4.Prenatal ultrasound diagnosis of amniotic band syndrome in the first trimester
Na LIANG ; Tiejuan ZHANG ; Jijing HAN ; Xuesong MA ; Li WANG
Chinese Journal of Ultrasonography 2024;33(8):683-687
Objective:To summarize the prenatal ultrasound characteristics of fetal malformations with amniotic band syndrome (ABS) in early pregnancy, in order to improve the ultrasound detection rate of this disease.Methods:Pregnant women who underwent systematic ultrasound screening of early pregnancy fetal malformations in Beijing Obstetrics and Gynecology Hospital from January 2017 to October 2023 were retrospectively collected. Twenty-three cases of early pregnancy ABS were collected and confirmed by ultrasound diagnosis and induced abortion results. Clinical data, images, and examination results of these cases were studied and the ultrasound characteristics of early pregnancy ABS were summarized.Results:In all 23 cases, adhesions between the intrauterine amniotic band and the affected parts of the fetus were found during ultrasonography, and the malformations in each case were different and closely related to the damage to different body surface parts of the fetus. Multiple fetal malformations accounted for 78% (18/23) and single cases accounted for only 22% (5/23). Among the 23 cases, 19 (83%) involved fetal limbs, 11 (48%) brains, 11 (48%) thoracic and abdominal walls, 10 (43%) spine, 5 (22%) faces, and 5 (22%) umbilical cords.23 (100%) patients were confirmed to have ABS after induction of labor, which was consistent with the ultrasound diagnosis, but 11 (48%) of them did not accurately describe fetal limb or facial abnormalities.Conclusions:The fetal malformation of ABS in the first trimester is closely related to the amniotic band, which has the characteristics of multiple properties, uniqueness, randomness and asymmetry. The most affected parts are the fetal limbs, brain, and body wall, and severe malformations are common.Prenatal ultrasound can provide suggestive diagnosis.