Objective To assess the value of intraoperative ultrasonography during the uterus septum resection under a hysteroscope.MethodsThe uterus septum resection was performed under the guidance of transabdominal ultrasonography by using a hysteroscope in 30 patients.The operative procedure and the position of the hysteroscope were monitored,and the depth of the dissection and thickness of the myometrium in the fundus uteri were measured with transabdominal ultrasound during the operation.ResultsThe thickness between the incisal surface and serosal layer in the fundus uteri was within the normal limits in 28 cases.In 2 cases,the tissue was over-ectomized.The position of the urethral catheter balloon was correct in all of the 30 cases.Three months after the procedure,reexamination by transvaginal ultrasonography showed that the uterine cavity was normal in the patients.ConclusionsIntraoperative ultrasonography is quick,safe and precise for monitoring uterus septum resection.It is valuable for establishing surgical strategy and reducing operative complications.

Objective To evaluate the usefulness of contrast enhanced ultrasound in the diagnosis of breast lesions. Methods Contrast enhanced ultrasound was performed after administration of SonoVue in 104 patients scheduled for surgical tumor removal. The enhancement morphology was classified as non, peripheral,homogeneous,regional,or heterogeneous enhancement based on distribution of enhancing areas. All breast lesions enhancement morphology were analyzed, and the diagnostic value of contrast enhanced ultrasound was calculated. Results The prevalence of non enhancement was significantly higher in benign lesions than in malignant ones(P = 0.013),and the prevalence of peripheral enhancement was significantly higher in malignant lesions than in benign ones (P = 6.02 × 10-7). Conclusions Contrast enhanced ultrasound is useful in diagnosis of breast lesions.

Objective To study the CT features of pulmonary non-tuberculous mycobacteria (NTM) disease in patients with acquired immunodeficiency syndrome (AIDS) and explore the different CT appearances between AIDS-NTM and AIDS-TB.Methods CT findings of pulmonary NTM disease in 27 AIDS patients (NTM group) were retrospectively analyzed and compared with that of tuberculosis in 30 AIDS patients (TB group).The results were statistically analyzed using Fisher's exact test.Results CT findings of NTM appeared significantly more than that of TB as follows:high-density nodules (n =18 vs 1,P ＜ 0.01),ground-glass opacities (n =10 vs 0,P ＜ 0.01),fibrotic band (n =17 vs 3,P ＜ 0.01),bronchiectasis (9 vs 2,P =0.012).CT findings of NTM appeared significantly less than that of TB as follows:miliary nodules (0 vs 6,P =0.016),air space consolidations (n =2 vs 11,P ＜ 0.01),pleural effusion (n =1 vs 9,P ＜ 0.01).Conclusion Nodule and fibrotic band companied with bronchiectasis were the main CT manifestations of pulmonary NTM disease in AIDS patients,while air space consolidation companied with pleural effusion and miliary nodules were the predominate CT findings of pulmonary tuberculosis in AIDS patients.

Objective MicroRNAs (miRNAs) play important roles in the chemoradiotherapy efficacy of rectal cancer (RC).This study aimed to screen the chemoradiotherapy-associated microRNAs and their target genes of RC through bioinformatics approaches in order to promote the fundamental study of RC chemoradiotherapy.Methods The chemoradiotherapy-associated microRNAs were manually searched through the published papers via PubMed and its target genes were identified by comprehensively analyzing these public data of microRNA-mRNA and gene expression profiles.Both gene ontology (GO) and pathway analysis of the target genes were performed by DAVID and IPA programs,respectively.Results A total of 38 microRNAs were collected from PubMed,and 3 545 putative target genes were inferred from the integrated microRNA-mRNA associations,among them,131 were differentially expressed (DE) (P ＜ 0.05) in the selected gene expression profile (GSE35452).The GO and pathway enrichment analyses indicated that the DE genes were closely involved in the responses of chemoradiotherapy of RC.Conclusions These microRNAs and their regulated DE genes may contribute to the molecular mechanism of the differential efficacy of RC chemoradiotherapy,which may provide a theoretical reference for predicting the response of RC to chemoradiotherapy.

Objective To analyze the laboratory results and chest CT appearances of novel recombinant avian-origin influenza A (H7N9) in discharged patients for understanding the imaging changes.Methods The clinical and imaging data of 4 patients with novel recombinant avian-origin influenza A (H7N9) were collected.The imaging changes and laboratory results were analyzed.Results All patients underwent chest CT examination 2 to 5 times from admission to discharge.The lesions primarily presented as ground-glass opacity (GGO) and mainly located in the inferior lobe of the left lung in 3 cases,in the inferior lobe of the right lung in 1 case,alternating between absorption and progress.GGO was absorbed obviously in about 3 days after treatment and consolidation was progressed after treatment.Consolidation absorption was observed with continue treatment in 1 case.The pulmonary lesions were absorbed obviously in 1 case 7 days after discharge.Synchronous reduction of the absolute values of CD3,CD8,CD4,CD45 were observed in 3 cases and the ratio of CD4/CD8 was normal.Conclusions (1) The areas of pulmonary involvement are large and variable in H7N9.The lesion area and imaging patterns are important for disease prognosis.(2) H7N9 virus infection may causes immunosuppression,decrease of CRP value can predict the improvement of the disease.

Objective To observe the clinical, mammographic and sonographic features of pure invasive lobular breast carcinoma (ILC), and to explore the value of combined imaging assessment of ILC. Methods Sonographic appearances of 55 patients of ILC were retrospectively reviewed in correlation with mammographic, pathologic and clinical findings, and the causes of false negative were analyzed. Results The main features found in clinical examination were mass (96.15%) and thickening in the size of breast (3.85%). The main mammographic features were spiculated or ill-defined mass (65.38%) and architectural distortion (23.08%). The most common sonographic patterns were mass (98.00%) and distortion (2.00%). The accuracy for detecting ILC of clinical examination, mammography and ultrasonography was 94.55%, 83.87% and 98.04%, respectively, while combining the three modalities, the detection rate increased to 100%. Conclusion Sonography has higher accuracy than mammography in detecting ILC. Combining clinical examination, mammography and ultrasonography can increase the pre-operative diagnostic accuracy of ILC.

Objective To measure total hemoglobin concentration (THC) of breast lesion using US-guided diffused optical tomography(DOT) and to investigate the THC optimal threshold value in different size breast lesions.Methods DOT was performed on 500 breast lesions and surgical pathology was as the gold standard.The optimal diagnostic threshold and the efficacy were figured out.Results There were 265 benign and 235 malignant lesions.In malignant lesions,THC of ≥2 cm lesion group was higher than that of ＜2 cm lesion group(P =0.000).In benign lesions,there was no statistical difference between ≥2 cm group and ＜2 cm group (P =0.13).As for ＜2 cm breast lesions,when a THC threshold value of 146.9 μmol/L and 102.2 μmol/L were used,the sensitivity,specificity,positive predictive value,negative predictive value and accuracy were 74.2％,70.0％,71.7％,62.9％,79.9％ and 86.7％,44.4％,61.6％,51.6％,83％,respectively.As for ≥2 cm breast lesions,when a THC threshold value of 210.4 μmol/L were used,the sensitivity,specificity,positive predictive value,negative predictive value and accuracy were 74.0％,86.7％,79.1％,89.2％,69.2％.Conclusions THC of breast cancer increased with the increasing size of lesions.The different diagnostic threshold value should be used according to different size lesions so as to enhance sensitivity,specificity and accuracy.

Objective To evaluate the contrast enhanced perfusion pattern of PTC micro-vascular imaging (MVI) quantitatively.Investigate the correlation between PTC MVI features and CD34 micro-vascular density (MVD).Methods Thirty-nine pathological and clinical confirmed sporadic PTCs were evaluated with real-time gray-scale contrast-ernhanced micro-vascular imaging under a low mechanical index.The micro-bubble agent was SoneVue.Of the 39 PTCs,33 were classical PTCs,6 were PTC with follicular variant (FVPTC).The △ ROI,which is the subtraction of peak echo intensity between the lesion region of interest (ROI) and normal thyroid parenchyma ROI,was used to evaluate the perfusion characteristics of PTC MVI quantitatively.The paraffined specimens were selected for immunohistochemical (IHC) staining for CD3,and the correlation between △ ROI and the CD34 were evaluated.Results △ ROI was strongly correlated with the CD34 expression (P=0.000),significant differences were detected in the distribution pattern of △ ROI value among different CD34 expression levels,no overlapping of the mean △ ROI values and the 95％ confidence intervals was found among the 3 CD34 expression levels.The PTC MVI perfusion was classified into 3 patterns,low perfusion,focal perfiusion and high perfusion,on the basis of combining△ ROI values with the peak ehco pattem in time-intensity curve.Conclusions The △ ROI is strongly correlated with the CD34 expression in papillary thyroid cancer.It can be used for the quantitative evaluation ofPTC MVI pattem and intensity as an objective indicator.

ObjectiveTo investigate the correlation of ultrasonographic features of mesenteric fibromatosis and its pathological findings.MethodsTen mesenteric fibromatosis confirmed histopatho1ogica1ly in Peking Union Medical College Hospital were retrospectively reviewed.Results There were 7 females and 3 males. Their ages ranged 32~74 years (mean age 50.5±13.1 years). Of the 10 cases, 5 occurred in mesentery of the small bowels, 4 in the mesocolons, and 1 in junction portion of duodenum and jejunum. On ultrasound image, the diameters of the masses were 4.3~22.0 cm (mean 8.8±5.2 cm). 6 were regular and 4 were irregular. 9 of 10 cases were well-defined and 1 was poor defined. 6 has capsule echoic. All the 10 cases were hypoechoic. 9 presented as solid mass and 1 was solid-cystic leision. On gross pathology,they were solid, firm, grey and yellowish. Histopathology, there were boundles of fibroblasts in collagenous stroma with scarce degeneration. The cystic changes noted on sonograms corresponded histopathologically to areas of myxoid and cystic degeneration.ConclusionsMesenteric fibromatosis is a rare disease with characteristic ultrasonographic features, which were well correlated with their pathology findings. They mostly presents as well-circumscribed masses with hypoecho, regular shape and little vascularity. Ultrasound was important in the diagnosis of this disease.

Objective To evaluate the inter-observer variability of static breast sonogram final assessment among observers with different breast imaging experience, using the first edition of the Breast Imaging Reporting and Data System(BI-RADS) for ultrasound. Methods Thirty patients with 30 breast lesions were included who underwent beast lesions resection operation. A pathological diagnosis was available for all 30 lesions:16 (53%) malignant and 14 (47%) benign. Twelve radiologists independently reviewed two sonograms of each lesion, and assigned a final BI-RADS assessment category. Inter-observer variability was measured using kappa statistic. Positive predictive value(PPV) and negative predictive value (NPV) for final assessment were also calculated. Results As for the experienced observers,kappa values of categories 3,4 and 5 were 0.72,0.28 and 0.60,NPV of category 3 was 93% ,PPV of category 5 was 97% ,all of which decreased as the breast imaging experience reduced. PPVs of categories 4a,4b and 4c were 56 % ,88% and 69%, respectively. Conclusions Using BI-RADS final assessment, radiologists with sufficient breast imaging experience can provide accurate and consistent assessment for breast ultrasonography,but the agreement of diagnosis decreased as the breast imaging experience reduced. The clinical feasibility of 4a,4b and 4c subcategories is uncertain.