1.Value of ex vivo sound touch elastography in the assessment of donor kidney fibrosis after brain death
Daopeng YANG ; Gang HUANG ; Fushun PAN
Chinese Journal of Ultrasonography 2024;33(12):1056-1061
Objective:To investigate the value of ex vivo sound touch elastography (STE) in evaluating donor kidney fibrosis after brain death. Methods:From March 2022 to August 2023, 94 kidneys donated after brain death in the Organ Transplant Center of the First Affiliated Hospital of Sun Yat-sen University were prospectively included. Baseline gray-scale ultrasound (kidney size, parenchymal thickness, and cortical echo quantification) and ex vivo STE were performed prior to transplantation. The STE indexes included superficial cortex (STE SC), deep cortex (STE DC) and medulla (STE ME). Zero-time biopsy was performed for all the donor kidneys. The donor kidneys were divided into 3 groups based on pathological Remuzzi score as gold standard, including Remuzzi 0-3 group ( n=50), Remuzzi 4-6 group ( n=32) and Remuzzi 7-12 group ( n=12). Analysis of variance or Pearson χ 2 test was used to evaluate the differences between groups for baseline demographic features, gray-scale ultrasound and STE. The intra-group correlation coefficient was used to evaluate the intra-observer repeatability of STE parameters. The correlation between variables was assessed by Spearman rank correlation coefficient, and the value of STE in evaluating renal fibrosis was evaluated by ROC curve. Results:There were significant differences in hypertension and diabetes prevalence among the 3 groups (all P<0.05). There were no significant differences in donor kidney size (kidney length diameter, thickness diameter and parenchymal thickness) among the 3 groups (all P>0.05), whereas the difference of cortical echo was statistically significant among the 3 groups ( P<0.05). There were statistically significant differences in the elasticity values of different regions (STE SC, STE DC and STE ME) among the 3 groups (all P<0.001). Further comparison between the two groups showed that the differences of STE parameters were statistically significant (all P<0.01) apart from the difference of STE ME between the Remuzzi 0-3 group and the Remuzzi 4-6 group. The intraclass correlation coefficients in STE SC, STE DC and STE ME groups were 0.825, 0.908 and 0.908, respectively, the intraobserver repeatability was excellent. Donor age, incidence of diabetes and hypertension, cortical echo, STE SC, STE DC and STE ME were all positively correlated with Remuzzi score ( rs=0.314, 0.273, 0.412, 0.391, 0.654, 0.591 and 0.356, respectively; all P<0.05). For the group diagnosed with Remuzzi 0-3 group, the areas under ROC curve of cortical echo, STE SC, STE DC and STE ME were 0.673 (cut-off value 36.3), 0.840 (cut-off value 15.7 kPa), 0.798 (cut-off value 27.2 kPa) and 0.675 (cut-off value 42.8 kPa), respectively. The diagnostic efficiencies of STE SC and STE DC were higher than that of cortical echo (all P<0.001). For the Remuzzi 7-12 group, the areas under ROC curves of cortical echo, STE SC, STE DC and STE ME were 0.753 (cut-off value 46.5 kPa), 0.905 (cut-off value 20.4 kPa), 0.914 (cut-off value 33.4 kPa) and 0.907 (cut-off value 45.6 kPa), respectively. The diagnostic efficiencies of STE SC, STE DC and STE ME were better than that of cortical echo (all P<0.001). Conclusions:STE can effectively evaluate the degree of fibrosis of donor kidney, and it is feasible to provide imaging evidence for the evaluation of donor kidney after brain death.
2.Value of ex vivo sound touch elastography in the assessment of donor kidney fibrosis after brain death
Daopeng YANG ; Gang HUANG ; Fushun PAN
Chinese Journal of Ultrasonography 2024;33(12):1056-1061
Objective:To investigate the value of ex vivo sound touch elastography (STE) in evaluating donor kidney fibrosis after brain death. Methods:From March 2022 to August 2023, 94 kidneys donated after brain death in the Organ Transplant Center of the First Affiliated Hospital of Sun Yat-sen University were prospectively included. Baseline gray-scale ultrasound (kidney size, parenchymal thickness, and cortical echo quantification) and ex vivo STE were performed prior to transplantation. The STE indexes included superficial cortex (STE SC), deep cortex (STE DC) and medulla (STE ME). Zero-time biopsy was performed for all the donor kidneys. The donor kidneys were divided into 3 groups based on pathological Remuzzi score as gold standard, including Remuzzi 0-3 group ( n=50), Remuzzi 4-6 group ( n=32) and Remuzzi 7-12 group ( n=12). Analysis of variance or Pearson χ 2 test was used to evaluate the differences between groups for baseline demographic features, gray-scale ultrasound and STE. The intra-group correlation coefficient was used to evaluate the intra-observer repeatability of STE parameters. The correlation between variables was assessed by Spearman rank correlation coefficient, and the value of STE in evaluating renal fibrosis was evaluated by ROC curve. Results:There were significant differences in hypertension and diabetes prevalence among the 3 groups (all P<0.05). There were no significant differences in donor kidney size (kidney length diameter, thickness diameter and parenchymal thickness) among the 3 groups (all P>0.05), whereas the difference of cortical echo was statistically significant among the 3 groups ( P<0.05). There were statistically significant differences in the elasticity values of different regions (STE SC, STE DC and STE ME) among the 3 groups (all P<0.001). Further comparison between the two groups showed that the differences of STE parameters were statistically significant (all P<0.01) apart from the difference of STE ME between the Remuzzi 0-3 group and the Remuzzi 4-6 group. The intraclass correlation coefficients in STE SC, STE DC and STE ME groups were 0.825, 0.908 and 0.908, respectively, the intraobserver repeatability was excellent. Donor age, incidence of diabetes and hypertension, cortical echo, STE SC, STE DC and STE ME were all positively correlated with Remuzzi score ( rs=0.314, 0.273, 0.412, 0.391, 0.654, 0.591 and 0.356, respectively; all P<0.05). For the group diagnosed with Remuzzi 0-3 group, the areas under ROC curve of cortical echo, STE SC, STE DC and STE ME were 0.673 (cut-off value 36.3), 0.840 (cut-off value 15.7 kPa), 0.798 (cut-off value 27.2 kPa) and 0.675 (cut-off value 42.8 kPa), respectively. The diagnostic efficiencies of STE SC and STE DC were higher than that of cortical echo (all P<0.001). For the Remuzzi 7-12 group, the areas under ROC curves of cortical echo, STE SC, STE DC and STE ME were 0.753 (cut-off value 46.5 kPa), 0.905 (cut-off value 20.4 kPa), 0.914 (cut-off value 33.4 kPa) and 0.907 (cut-off value 45.6 kPa), respectively. The diagnostic efficiencies of STE SC, STE DC and STE ME were better than that of cortical echo (all P<0.001). Conclusions:STE can effectively evaluate the degree of fibrosis of donor kidney, and it is feasible to provide imaging evidence for the evaluation of donor kidney after brain death.
3.Ultrasonographic diagnosis of pseudothrombophlebitis
Fushun PAN ; Yanling ZHENG ; Zhu WANG ; Jinyu LIANG ; Xueling HUANG ; Xiaoxi LI ; Xiaoyan XIE
Chinese Journal of Ultrasonography 2013;(3):243-246
Objective To investigate the ultrasound characteristics of pseudothrombophlebitis.Methods The ultrasound characteristics of thirty-two popliteal cyst cases with pseudothrombophlebitis which were confirmed by MRI or puncture were retrospectively analyzed.The former group was matched with a case control group of sixty-four patients with asymptomatic popliteal cysts,the ultrasound images were comparative analysis between the two groups.Results Compared to the control group,both the length and width of the case group were larger [(12.4 ± 4.7) ×(2.5±0.4)cm vs (5.3±2.9) × (1.2±0.4)cm,P < 0.001],and there were 18(43.8%) cases with the cysts extension into the calf.The case group were more prone to show cyst with poor ultrasound penetration or solid-cystic echo (78.1% vs 9.4%,P =0.000),which were diagnosed as popliteal cyst with hematoma or infection.Six cases of case group showed irregular anechoic area surrounding the inferior border of the cysts,which were diagnosed as ruptured popliteal cyst,no similar imaging detected in the control group(P =0.001).Both the two group showed septation in the cyst,but it did not differ significantly(P >0.05).Conclusions Ultrasonography is helpful to the diagnosis of pseudothrombophlebitis,the ultrasound characteristics include large cyst extension into the calf,cyst with poor ultrasound penetration or solid-cystic echo and irregular anechoic area surrounding the inferior border of the cysts.
4.Clinical analysis of 60 thyroglossal tract cyst cases.
Chun LIN ; Ze-geng GUO ; Le-zhong TENG ; Zu-hui PAN ; Bo CHEN ; Hong-ping LI ; Guo-bin LI
West China Journal of Stomatology 2007;25(3):263-265
OBJECTIVETo study the characteristics of thyroglossal tract cyst epidemiology and summarize how to improve the operation therapeutic effect.
METHODSThe clinic appearance, the pathological characteristics and the therapeutic effect of the 60 thyroglossal tract cyst cases were analyzed.
RESULTSThyroglossal tract cyst mostly occurred in children and teenagers. The incidence of female patients was more than that of male patients. Most of thyroglossal tract cyst located in the middle line of the neck and were explored tubular-objects and fibroropes. The histopathological feature was variform.
CONCLUSIONThe clinical appearance and pathology characteristic of thyroglossal tract cyst are variform. Thyroglossal tract cyst may be recurred easily if it is not operated well.
Adolescent ; Child ; Female ; Humans ; Male ; Thyroglossal Cyst

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