1.Lymphatic and Venous Contrast-Enhanced Ultrasound Imaging for Differential Diagnosis of Cervical Lymph Node Metastasis in Thyroid Cancer.
Li XU ; Wen-Bo WAN ; Tian GAO ; Tao-Hua GOU ; Yan ZHANG
Acta Academiae Medicinae Sinicae 2025;47(1):16-22
Objective To investigate the value of the novel lymphatic contrast-enhanced ultrasound(LCEUS)and conventional venous contrast-enhanced ultrasound(VCEUS)in the differential diagnosis of benign and malignant cervical lymph nodes in patients with thyroid cancer. Methods Patients with suspected thyroid cancer underwent conventional ultrasound,VCEUS,and LCEUS examinations of cervical lymph nodes before biopsy.The diagnostic abilities of conventional ultrasound,VCEUS,and LCEUS were compared with pathological results as the golden standard. Results Forty-four patients with 52 lymph nodes were included in the final data.Thirty-eight metastatic lymph nodes were confirmed by pathological results,and 14 were benign.The diagnostic sensitivity,specificity,and accuracy were 97.37%,71.43%,and 90.38% for LCEUS,92.11%,35.71%,and 76.92% for VCEUS,and 94.74%,21.43%,and 75.00% for conventional ultrasound,respectively.The area under the curve of LCEUS analyzed by the receiver operating characteristic curve was greater than that of VCEUS(P=0.020)and conventional ultrasound(P<0.001). Conclusion LCEUS could significantly improve the differential diagnosis of cervical lymph node metastasis in the patients with thyroid cancer,providing a basis for precise clinical treatment.
Humans
;
Thyroid Neoplasms/diagnostic imaging*
;
Lymphatic Metastasis/diagnostic imaging*
;
Diagnosis, Differential
;
Female
;
Male
;
Middle Aged
;
Ultrasonography
;
Adult
;
Lymph Nodes/pathology*
;
Contrast Media
;
Neck
;
Aged
;
Young Adult
;
Adolescent
;
Sensitivity and Specificity
2.Cellular and Histopathological Characteristics of Ultrasonically Underdiagnosed 3/4a Thyroid Nodules.
Wu WEI-QI ; Xu CUN-BAO ; Li YOU-JIA ; Su CHUN-YANG ; Feng-Shun ZHANG ; Yi-Feng CHEN
Acta Academiae Medicinae Sinicae 2025;47(1):23-28
Objective To analyze the cellular and histopathological characteristics of underdiagnosed thyroid nodules of Chinese thyroid imaging reporting and data system(C-TIRADS) categories 3 and 4a,thus improving the understanding of these lesions. Methods The data of ultrasound and fine needle aspiration cytology were collected from 683 nodules diagnosed based on pathological evidence in 549 patients undergoing thyroid surgery.The cellular and histopathological characteristics of C-TIRADS 3 and 4a nodules were analyzed. Results Two hundred and sixty-eight nodules were classified as C-TIRADS category 3,including 236 benign nodules,12 low-risk ones,and 20 (7.46%) malignant ones.Two hundred and twenty-one nodules were classified as C-TIRADS category 4a,including 133 benign nodules,7 low-risk ones,and 81 (36.65%) malignant ones.The malignancy rates differed between C-TIRADS 3 and 4a nodules (χ2=58.93,P<0.001),and both were higher than the recommended malignancy rate in the guidelines for malignancy risk stratification of thyroid nodules (C-TIRADS) (both P<0.001).According to the pathological evidence,the underdiagnosed C-TIRADS 3/4a nodules were mainly papillary thyroid carcinoma,especially in patients with Hashimoto thyroiditis.There was not a consistent one-to-one match between each ultrasound result and each cytological classification of low-risk thyroid nodules.Conclusions When the malignant features in preoprative ultrasound imaging are atypical or absent,papillary thyroid carcinoma (especially with Hashimoto thyroiditis),follicular carcinoma,and medullary carcinoma are likely to be underdiagnosed as C-TIRADS 3 or 4a nodules.Therefore,efforts should be made to fully understand the cellular and pathological characteristics of these lesions.
Humans
;
Thyroid Nodule/diagnostic imaging*
;
Female
;
Male
;
Middle Aged
;
Adult
;
Ultrasonography
;
Biopsy, Fine-Needle
;
Aged
;
Young Adult
;
Thyroid Neoplasms/diagnostic imaging*
;
Adolescent
3.Research Progressin Application of Ultrasound in the Diagnosis and Treatment of Greater Trochanteric Pain Syndrome.
Fan WU ; Yi MAO ; Chun-Bao LI ; Long-Tao YAN ; Ming-Bo ZHANG
Acta Academiae Medicinae Sinicae 2025;47(2):289-294
Greater trochanteric pain syndrome(GTPS)is a disease caused by structural lesions of the muscles,fascia,ligaments,and bursae near the greater trochanter of the femur.GTPS causes lateral hip joint pain,severely affecting patients' quality of life.Ultrasound has many advantages,such as real-time diagnosis,portable operation,non-radiation,and high resolution,demonstrating a high application value in the diagnosis and interventional therapy of GTPS.This article reviews the current status of ultrasound in the diagnosis and interventional therapy of GTPS and prospects its application.
Humans
;
Ultrasonography
;
Femur/diagnostic imaging*
;
Hip Joint/diagnostic imaging*
;
Arthralgia/therapy*
4.Ultrasound Characteristics of Secondary Squamous Cell Carcinoma of the Thyroid.
Dong LIU ; Yan-Jia GOU ; Quan WEN ; Su-Ting ZONG
Acta Academiae Medicinae Sinicae 2025;47(3):390-395
Objective To analyze the ultrasonographic features of secondary squamous cell carcinoma of the thyroid(SSCC-T)and evaluate the diagnostic value of ultrasound.Methods A retrospective analysis was conducted on clinical and ultrasonographic data from 12 patients with pathologically confirmed SSCC-T treated at Beijing Friendship Hospital,Capital Medical University between January 2016 and January 2025.Evaluated parameters included lesion size,echogenicity,edge,vascularity,calcification,and cervical lymph node metastasis.Descriptive statistical analysis was performed to analyze the ultrasonographic features of SSCC-T,and Fisher's exact test was conducted to analyze the correlation between different ultrasound classifications and thyroid dysfunction.Results The 12 patients showed the following ultrasound classifications:nodular type(50.0%,6/12),diffuse type(33.3%,4/12),and mixed type(16.7%,2/12).All diffuse-type patients exhibited a characteristic cord-like hypoechoic pattern.Cervical lymph node metastasis was observed in all the patients,with 75.0%(9/12)showing lymph nodes >2 cm in maximum diameter.Thyroid dysfunction occurred in 66.7%(8/12)of patients,including 2 patients with dynamic shifts from hyperthyroidism to hypothyroidism.Diffuse and mixed types were associated with hypothyroidism(P=0.038).Conclusions SSCC-T demonstrates specific ultrasonographic features,particularly the cord-like hypoechoic pattern in the diffuse type.For patients with squamous cell carcinoma,regular ultrasound examinations of the thyroid and cervical lymph nodes combined with changes in thyroid function are conducive to the timely detection of thyroid metastasis of squamous cell carcinoma.
Humans
;
Retrospective Studies
;
Ultrasonography
;
Carcinoma, Squamous Cell/diagnostic imaging*
;
Thyroid Neoplasms/diagnostic imaging*
;
Lymphatic Metastasis
;
Male
;
Female
;
Middle Aged
;
Thyroid Gland/diagnostic imaging*
;
Adult
5.Chinese Expert Consensus on the Clinical Application of Ultrasound Screening for Gastric Cancer(2025 Edition).
Acta Academiae Medicinae Sinicae 2025;47(5):679-701
The five-year survival rate of gastric cancer in China is close to that in European and American countries but far lower than that in the Republic of Korea and Japan,which have established national gastric cancer screening systems.It is of great significance to build a high-quality gastric cancer screening system adaptive to China's national conditions.Due to the large number of people at risk of gastric cancer and uneven distribution of medical resources,it is still difficult for China to carry out a nationwide gastroscopy screening plan for gastric cancer.Gastric ultrasound,with painlessness,no radiation,and easy acceptance and popularization,could be used as one of the alternative methods for initial screening of gastric cancer.Based on two gastric ultrasound-related consensuses published in 2020,this consensus elaborates on the necessity,feasibility,and existing problems of conducting preliminary gastric cancer ultrasound screening in China by analyzing the gastric cancer screening strategies and the difficulties faced by nationwide gastric cancer screening.Furthermore,this consensus introduces the indications and contraindications of gastric ultrasound examination,requirements for the operator and the contrast agent,ultrasound standard section,essentials of scanning operations,and stomach ultrasound report and data system (Su-RADS) and proposes the relevant consensus opinions accordingly.After multiple rounds of discussions and voting by experts from multiple societies,a total of 17 consensus opinions have been formed on gastric ultrasound as a preliminary screening technique for gastric cancer,with the aim of standardizing the popularization of gastric ultrasound.In addition,the consensus calls for conducting nationwide multicenter prospective studies to improve the level of evidence and provide data support for the construction of a preliminary gastric cancer ultrasound screening system that is in line with China's national conditions.
Humans
;
China
;
Early Detection of Cancer/methods*
;
Mass Screening
;
Stomach/diagnostic imaging*
;
Stomach Neoplasms/diagnostic imaging*
;
Ultrasonography
6.Clinical and Intestinal Ultrasound Findings in Mitochondrial Neurogastrointestinal Encephalomyopathy:Report of One Case.
Xiao-Yan ZHANG ; Qing-Li ZHU ; Ge-Chong RUAN ; Wen-Bo LI
Acta Academiae Medicinae Sinicae 2025;47(5):758-761
Mitochondrial neurogastrointestinal encephalomyopathy(MNGIE),a rare mitochondrial disorder caused by TYMP gene mutations,is characterized by severe gastrointestinal dysmotility,peripheral neuropathy,and leukodystrophy.This article summarizes the clinical data and intestinal ultrasound findings of a MNGIE case,aiming to provide insights for clinical diagnosis and treatment.
Humans
;
Mitochondrial Encephalomyopathies/diagnostic imaging*
;
Ultrasonography
;
Intestines/diagnostic imaging*
;
Male
;
Female
;
Intestinal Pseudo-Obstruction/diagnostic imaging*
;
Ophthalmoplegia/congenital*
;
Muscular Dystrophy, Oculopharyngeal
7.Clinical and Ultrasound Manifestations of Immune Checkpoint Inhibitor-Associated Enterocolitis:Report of One Case.
Xiao-Yan ZHANG ; Jing QIN ; Xiao-Qing LI ; Guan-Nan ZHANG ; Wen-Bo LI
Acta Academiae Medicinae Sinicae 2025;47(5):771-775
Immune checkpoint inhibitor-associated enterocolitis is an immune-related adverse reaction during tumor treatment with immune checkpoint inhibitors.In this article,we present the clinical data and ultrasound manifestations of a patient with immune checkpoint inhibitor-associated enterocolitis,aiming to share diagnostic and therapeutic insights.
Humans
;
Immune Checkpoint Inhibitors/adverse effects*
;
Enterocolitis/chemically induced*
;
Ultrasonography
;
Male
8.Value of Ultrasonographic Features Combined With Immunohistochemistry in Predicting Axillary Lymph Node Metastasis in Middle-Aged Women With Breast Cancer.
Qian-Kun CHANG ; Wen-Ying WU ; Chun-Qiang BAI ; Zhi-Chao DING ; Wei-Fang WANG ; Ming-Han LIU
Acta Academiae Medicinae Sinicae 2025;47(4):550-556
Objective To investigate the value of ultrasonographic features combined with immunohistochemistry in predicting axillary lymph node metastasis in middle-aged women with breast cancer.Methods A retrospective analysis was conducted on 827 middle-aged female breast cancer patients who underwent surgical treatment at the Affiliated Hospital of Chengde Medical University from June 2017 to June 2023.Ultrasonographic and immunohistochemical information was collected,and the patients were randomly allocated into a training set(579 patients)and a validation set(248 patients).Univariate and multivariate Logistic regression analyses were performed to identify ultrasonographic and immunohistochemical risk factors associated with axillary lymph node metastasis in these patients,and a nomogram model was developed.Receiver operating characteristic curves and calibration curves were established to evaluate the performance of the nomogram model,and clinical decision curves were built to assess the clinical value of the model.Results The maximum diameter,morphology,boundary,calcification,and expression of human epidermal growth facor receptor 2 and Ki-67 in breast cancer lesions were identified as risk factors for predicting axillary lymph node metastasis in middle-aged women.The areas under the curve of the nomogram model on the training and validation sets were 0.747(0.707-0.787)and 0.714(0.647-0.780),respectively.Calibration curves and clinical decision curves indicated good consistency and performance of the model.Conclusion The nomogram model constructed based on ultrasonographic features and immunohistochemistry of the primary breast cancer lesion demonstrates high value in predicting axillary lymph node metastasis in middle-aged women with breast cancer.
Humans
;
Female
;
Breast Neoplasms/diagnostic imaging*
;
Middle Aged
;
Lymphatic Metastasis/diagnostic imaging*
;
Axilla
;
Retrospective Studies
;
Nomograms
;
Ultrasonography
;
Immunohistochemistry
;
Lymph Nodes/diagnostic imaging*
;
Risk Factors
;
Ki-67 Antigen
9.Bibliometric Analysis of Intelligent Ultrasound Imaging in the Diagnosis of Thyroid Nodules.
Yang LI ; Jian-Lin WANG ; Jiao-Jiao MA ; Zhe SUN ; Bo ZHANG
Acta Academiae Medicinae Sinicae 2025;47(4):590-600
Objective To explore the research progress and hotspots of intelligent ultrasound imaging in the diagnosis of thyroid nodules and clarify the research directions via the bibliometric method.Methods The relevant research articles on intelligent ultrasound imaging in the diagnosis of thyroid nodules were retrieved from the Web of Science Core Collection,covering the period from January 2004 to August 2024.Python was used to analyze the number of annual publications.VOSviewer was used to create the co-occurrence network of authors and the keyword density map.CiteSpace was used to demonstrate the dual-map overlays of the journals,as well as the bursts and clustering of co-citations and keywords.Results A total of 1 179 articles were included.The annual number of publications increased steadily.The involved journals demonstrated high quality,and the publications showed a trend of cross-research.Chinese researchers were the core research force in this field.Haugen et al.'s study on the guidelines for thyroid nodules had the most citations.The clustering of co-citations and keywords indicated studies in multiple fields.Thyroid nodules,cancer,and deep learning were the representative keywords in this field.Conclusions The continuous enrichment of research topics promotes the rapid development of intelligent ultrasound imaging for thyroid nodules.Intelligent diagnosis methods based on deep learning can provide diagnostic suggestions,while there are still challenges such as interpretation.One of the research directions is the deep combination of intelligent diagnosis algorithms and medical knowledge.
Thyroid Nodule/diagnostic imaging*
;
Humans
;
Ultrasonography
;
Bibliometrics
10.Research Progress in Clinical Applications of Gastric Contrast-Enhanced Ultrasound.
Qiao-Yun ZHAO ; Chun-Quan ZHANG ; Liang-Yun GUO
Acta Academiae Medicinae Sinicae 2025;47(5):702-709
Gastric contrast-enhanced ultrasound is a non-invasive imaging method that uses oral gastrointestinal ultrasound contrast agents to fill the stomach cavity and display the structure and lesions of the stomach wall.In recent years,the development of contrast agents and the technological innovations of ultrasound equipment have boosted the unique advantages of this examination technique in the diagnosis of gastrointestinal diseases.Gastric contrast-enhanced ultrasound is becoming an important complementary examination means to gastroscopy and X-ray barium meal examination.In this paper,we summarize the clinical applications of gastric contrast-enhanced ultrasound at home and abroad in recent years and systematically analyze its clinical application value and limitations in six aspects:screening and staging of gastric cancer,differentiation and diagnosis of gastric tumors,diagnosis and follow-up of gastritis and gastric ulcers,assessment of gastric contents and gastric volume,evaluation of gastric emptying and gastric motility,and other special applications.
Humans
;
Contrast Media
;
Ultrasonography/methods*
;
Stomach/diagnostic imaging*
;
Stomach Neoplasms/diagnostic imaging*

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