1.Ultrasound evaluation of neoadjuvant chemotherapeutic response in breast cancer and its correlation with histopathology
Yaling CHEN ; Wei ZENG ; Cai CHANG
Chinese Journal of Ultrasonography 2010;19(12):1059-1063
Objective To study ultrasound features of breast cancer before and after neoadjuvant chemotherapy,and its correlation with histopathology. Methods One hundred and nine patients with breast cancer underwent paclitaxel plus carboplatin neoadjuvant chemotherapy, the change of the primary lesions and axillary lymph nodes were studied by ultrasound,and compared with histopathology. Results Seventeen patients achieved complete remission under ultrasound, the rest measurable lesions became significantly shortened in maximum diameter [ ( 22.46 ± 11.50) mm vs (34. 71 ± 13.67) mm, P < 0. 001 ], and showed decrease both in longitudinal-transverse ratio (0. 80 ± 0. 23 vs 0. 86 ± 0. 22, P >0. 05) and grades of blood flow (0. 51 ± 0.80 vs 1.23± 1.05, P <0. 001 ). 44. 83% (44/92) of metastatic axillary lymph nodes disapeared after treatment. Comparing with histopathology, the sensitivity and specificity of ultrasound assessing complete remission were 57. 89 % ( 11 / 19) and 93.33 % (84/90), respectively. The moderate concord between ultrasound with histopathology might be attributed to the pathologic change of breast tissue and stroma after treatment, nevertheless grades of blood flow might be more meaningful. Conclusions Ultrasound assessment of neoadjuvant chemotherapeutic response might be of reference value,and studying corresponding ultrasonic manifestation of different kinds of pathological changes would help with better evaluation.
2.Ultrasonographic characteristics of breast lymphoma and comparison with mammography and MRI
Yaling CHEN ; Wei ZENG ; Cai CHANG
Chinese Journal of Ultrasonography 2011;20(8):684-687
Objective To retrospectively study the value of ultrasonography in diagnosing breast lymphoma and compare with mammography and MRI. Methods Imaging characteristics of 26 patients who were pathologically comfirmed as breast lymphoma were reviewed, including ultrasonography,mammography and MRI, and compare the diagnostic accuracy among the three. Results Twenty-four patients underwent ultrasonography and 32 lesions were found, with longest diameters averaged 30 mm.Tumors were mostly hypoechoic or very hypoechoic (81.3%), some were lobular (25.0%) or oval (21.9 % ) in shape, the margins were most frequently circumcribed (62. 5 % ), and a few tumors showed an echogenic boundary (18.8 % ). Color Doppler imaging showed hypervascularity in most tumors (59.4 % ).Ninteen patients undewent mammography, 15 solitary lesions were identified in 12 patients, asymmetric density in five,punctate calcification in one,and no abnormality in one. Eleven lesions were identified in MRI of 10 patients, 10 lesions showed hypointensity on T1-weighted images and hyperintensity on T2-weighted images, and heterogeneous enhancement after contrast. The diagnostic accuracy of ultrasonography,mammography and MRI was 83%, 52% and 100%, respectively. Conclusions The sonograms of breast lymphoma have some distinct features, the combination of ultrasonography and MRI might benefit the diagnosis of breast lymphoma.
3.Value of ultrasonography,mammography and magnetic resonance imaging in diagnosis of granulomatous lobular mastitis
Fen WANG ; Yi GAO ; Min CHEN ; Yaling CHEN ; Cai CHANG
Chinese Journal of Ultrasonography 2016;(1):53-57
Objective To evaluate the ultrasonographic ( US ) findings of granulomatous lobular mastitis( GLM ) ,and to compare the diagnostic accuracy among US ,mammographic ,and magnetic resonance imaging ( MRI) . Methods Imaging characteristics of 56 patients who were pathologically comfirmed as GLM were reviewed .All the lesions were assessed by BI‐RADS ( Breast Imaging Reporting and Data System) . Results Fifty‐eight lesions were found in 56 patients . Thirty ( 51 .7% ) were irregular ,20 (34 .5% ) were lobular and 8(13 .8% ) were round or oval in shape . Forty two lesions (72 .4% ) were hypoechoic ,14 (24 .1% ) were mixed echoic textur ,including 6 lesions (10 .3% ) with tubular connections and 8 lesions ( 13 .8% ) with irregular markly hypoechoic internal echoes . Two ( 3% ) were isoechoic .No calcification were found . Color Doppler signals were detected in 33 cases(56 .9% ) ,and the resistance index ( RI) ranged from 0 .61 to 0 .79 . Forty patients underwent mammography ,there were no distinct lesions in 6 cases(15% ) ,suspicious calcification in two(5% ) , asymmetric density in twenty(50% ) ,and solitary masses in twelve(30% ) . MRI was performed in 36 patients ,and revealed no abnormality in two patients(5 .6% ) , twenty nine lesions ( 80 .6% ) showed hypointensity on T1‐weighted images and hyperimensity on T2‐weighted images ,five lesions ( 13 .9% ) showed isointensity on T1‐weighted images and hyperimensity on T2‐weighted images ,and all the lesions showed heterogeneous enhancement after contrast .The diagnostic accuracy of ultrasonography , mammography and MRl was 63 .8% , 45% and 61 .1% , respectively . Conclusions There were no specific imaging characteristics of GLM ,the combination of ultrasonography , mammography and MRI might benefit the diagnosis of GLM .
4.The application of BI-RADS in the diagnosis of breast cystic-solid lesions
Fen WANG ; Yi GAO ; Yaling CHEN ; Min CHEN ; Cai CHANG
Chinese Journal of Ultrasonography 2016;25(6):520-524
Objective To analyze the ultrasonographic characteristics of breast cystic-solid lesions and to investigate the diagnostic value of BI-RADS breast imaging reporting and data system in this kind of disease Methods Imaging characteristics of 105 breast cystic-solid lesions of 93 patients were analyzed All the lesions were assessed by BI-RADS Histopathologic examination was used as the reference standard Results Among 105 lesions 57 54 3% were benign and 48 45 7% were malignant Differences in orientation shape margin calcification and vascularity were statistically significant between the benign and malignant lesions P < 0 05 whereas the echo pattern and the posterior acoustic feature did not show significant differences P >0 05).There were 5 1 predominantly solid mass,which appeared as solid mass with little dispersed or centralized cystic regions or solid mass with surrounding cystic regions,including 33 benign lesions and 1 8 malignant lesions.The area under the curves of ROC was 0.956 in this type.There were 25 lesions predominantly cystic,which had regular or irregular thick walls or septa,or had nodules protruding to the cystic component,including 1 1 benign lesions and 14 malignant lesions.The area under the curves of ROC was 0.753.There were 29 mixed solid-cystic mass,in which the solid component equaled to the cystic,including 13 benign lesions and 16 malignant lesions.The area under the curves of ROC was 0.887.The area under curves of ROC was 0.873 for the all breast cystic-solid lesions.The rates of malignant cystic-solid lesions in the three types had no significant difference(P >0.05).Conclusions Ultrasound is a useful tool for diagnosing breast cystic-solid lesions.The proportion of the cystic component is not helpful to differentiate malignancy from benignancy.
5.The value of shear wave elastography for differential diagnosis of benign and malignant thyroid nodules
Fen WANG ; Yi GAO ; Yaling CHEN ; Min CHEN ; Cai CHANG
Chinese Journal of Ultrasonography 2015;(12):1047-1050
Objective To investigate the value of shear wave elastography (SWE)for differential diagnosis of benign and malignant thyroid nodules.Methods A total of 1 56 patients referred for surgery of thyroid nodules underwent standard ultrasound as well as elastography.The following characteristics of all the nodules were assessed:location,size,shape,margin,echogenicity,calcification and blood flow.The SWE elasticity indices of maximum (Emax),mean (Emean),minimum (Emin),and standard deviation (Esd) were automatically calculated by the US system.Thresholds were calculated by receiver operating characteristic (ROC ) curve analysis.The diagnostic performance of conventional US and SWE were compared.Histopathologic examination was used as the reference standard.Results Among a total of 1 56 nodules,1 1 8 were malignant and 38 were benign.SWE elasticity indices were significantly higher in malignant than in benign nodules (P ≤0.001 ).Sensitivity and specificity for predicting malignancy were 83.9%,92.1 % respectively using Emean with a threshold of 32.1 kPa,the specificity was significantly higher than using conventional ultrasound (P <0.05 ).Area under the ROC curve (Az)of Emean was highest (0.880,95% CI:0.81 7,0.943),however the differences were not significant(P >0.05).Conclusions SWE provides higher specificity for predicting malignancy without losing sensitivity.
6.Discussion on medical equipment support in actual combat training
Junpeng TIAN ; Fanzong HONG ; Yihe GUO ; Yaling CAI ; Qun MO
Chinese Medical Equipment Journal 2017;38(4):134-135,153
Objective To explore medical equipment support in actual combat training to improve mobile medical unit in medical service support.Methods Combined with the characteristics of actual combat training,the problems and difficulty of medical equipment support were discussed in actual combat training.Results Some measures were put forward for medical equipment support such as cherishing of medical serviceman on equipment,equipment quality control and maintenance beforeutilization,effective protection and fixation,minimization of influence of instable power supply and plan preparation for loading and transport.Conclusion The study on medical equipment support in actual combat training contributes to enhancing medical support ability of mobile medical unit.
7.Anisotropy of shear wave elastography in breast lesions and its correlation with histopathology
Yaling CHEN ; Yi GAO ; Fen WANG ; Na LI ; Aiyu MIAO ; Wenxiang ZHI ; Cai CHANG
Chinese Journal of Ultrasonography 2017;26(3):254-258
Objective To retrospectively study the anisotropy of shear wave elastography (SWE)quantitative parameters of breast lesions,and the correlation with histopathology.Methods A total of 281 consecutive women with 281 breast lesions (179 malignant,102 benign) were included,who underwent conventional ultrasound (US) and 2D SWE before surgical excision.Three acquisitions each for transverse and longitudinal planes were obtained,and maximum elasticity (Emax),mean elasticity (Emean),standard deviation (Esd) of the whole lesion and ratio between the elasticity in the mass and the fatty tissue (Eratio)were recorded.Anisotropic difference (AD) and anisotropy factors (AF) were calculated,and correlation with histopathology was analyzed.Results The average Emax,Emean and Esd of transverse planes were significantly higher than those of longitudinal planes.AF showed positive correlation with quantitative elasticity (Emax,Emean,Esd and Eratio) (P =0.000),and was significantly higher in malignant lesions than that in benign besions (P =0.000).AUC of AF was significantly higher than that of AD (P <0.001).AF was significantly higher in invasive ductal carcinoma than that in ductal carcinoma in situ.Higher AF was associated with higher histopathological grades of invasive ductal carcinoma (P =0.000),and correlated with ER/PR(+).Conclusions Anisotropy of SWE is an indicator of malignancy of breast lesions,and is of predictive value for prognosis in breast cancer.
8.A New Phenolic Acid from Rhizomes of Abacopteris penangiana
Zhongxiang ZHAO ; Jinlan RUAN ; Jing JIN ; Yaling CAI ; Chenchen ZHU ; Yang YU
Chinese Herbal Medicines 2010;02(3):165-167
Objective To study the chemical constituents of Abacopteris penangiana.Methods The compounds were separated and purified by various chromatographic techniques and their structures were elucidated on the basis of physiochemical properties and spectroscopic methods.Results Seven compounds were purified and their structures were identified as:(7'Z)-3-O-(3,4-dihydroxy phenylethenyl)-caffeic acid(1),caffeiein B(2),matteucinol(3),protocatechuic acid(4),p-methoxybenzoic acid(5),β-sitosterol(6),and daucosterol(7).Conclusion Compound 1 is a new phenolic acid compound named abacopteric acid,and the other compounds are isolated from the plant for the first time.
9.The correlation study between greyscale ultrasonography of invasive breast cancer and axillary lymph node involvement
Zhaoting SHI ; Jian LE ; Yaling CHEN ; Jiawei LI ; Wenxiang ZHI ; Cai CHANG
Chinese Journal of Ultrasonography 2017;26(5):424-429
Objective To investigate the relationship of greyscale ultrasonographic signs and clinical pathological characteristics with axillary lymph node metastasis in invasive breast cancer.Methods Three hundred and thirty-five patients with pathologically confirmed breast cancer were retrospectively analyzed,which categorized into 2 groups,including lymph node metastasis group and lymph node non-metastasis group.The clinical and pathological characteristics included age,primary tumor size,histological grade,and molecular subtypes.The ultrasonographic features were examined including orientation,shape,margin,echo pattern,posterior acoustic feature,and calcification.Chi-Square test and Logistic regression analysis were performed to analyze the relationship of clinical pathological characteristics and greyscale ultrasonographic signs with axillary lymph node metastasis.Results Age (<45 years),primary tumor size (≥2 cm),histological grade(Ⅲ grade),molecular subtype (Luminal B),and number of margin angulation (> 10) contributed to axillary lymph node metastasis in 335 cases,according to univariate analysis (P <0.05).Multivariate Logistic regression analysis showed age (OR =0.573,P =0.019),the primary tumor size (OR=2.359,P =0.001),histological grade (OR=0.529,P =0.008),and number of marginangulation (OR =1.889,P =0.031) were risk factors of axillary lymph node metastasis in breast cancer.Conclusions Univariate and multivariate analyses show the correlation between ultrasonographic features and axillary lymph node involvement.Combining with clinical pathological data,it can provide a predictor of axillary lymph node metastasis.
10.Quantitative features and diagnostic value of 3-dimensional shear wave elastography in breast lesions
Yaling CHEN ; Yi GAO ; Fen WANG ; Na LI ; Aiyu MIAO ; Wenxiang ZHI ; Cai CHANG
Chinese Journal of Ultrasonography 2017;26(7):613-617
Objective To retrospectively study the quantitative features and diagnostic value of 3-dimensional shear wave elastography (3D-SWE) in breast lesions.Methods A total of 198 consecutive women with 198 breast lesions (125 malignant,73 benign) were included,who underwent conventional ultrasound (US) and 3D-SWE before surgical excision.Quantitative parameters of transverse planes,sagittal planes and coronal planes were calculated,including maximum elasticity (Emax-w),mean elasticity (Emean-w),standard deviation (Esd) of the whole lesion and ratio between the stiffest elasticity (Emean-s)in the lesion and the fatty tissue (Eratio).Area under ROC curve(AUC) for combination of quantitative parameters and US were calculated.Results The AUC,sensitivity and specificity for US were 0.919,88.0% and 78.1 %,respectively.In the total 198 lesions,Emax-w,Emean-w,Esd,Eratio and Emean s were significantly lower in coronal planes than those in transverse and sagittal planes (all P <0.001).AUC for combination of each quantitative parameter and US were significantly higher than those of US (all P <0.05),except Emean-w of transverse plane,while there was no significant difference among the three orthogonal plane (P>0.05).Sensitivity significantly increased by combining US with Emean-s,Eratio (transverse,sagittal and coronal planes),Emean-w (coronal and sagittal planes) or Esd (coronal and transverse planes) (all P<0.05).Combination of US and Emean w of coronal plane yielded significantly higher sensitivity than those of transverse and sagittal planes.Conclusions Combination of quantitative features of 3D-SWE and US can significantly increase diagnostic accuracy and sensitivity in breast lesions.Emean-w of coronal plane yields the highest sensitivity.