Objective:To investigate the ultrasound image and pathological features of invasive fibromatosis, and to provide a basis for the diagnosis of invasive fibromatosis.Methods:The clinicopathological data of 22 patients pathologically diagnosed with invasive fibromatosis from January 2016 to March 2019 in Shanxi Provincial Cancer Hospital were retrospectively analyzed. The clinical, ultrasound and pathological data were also summarized.Results:Ultrasound images of invasive fibromatosis showed irregular morphology, unclear boundaries, uneven echo, spot-like or strip-shaped blood flow signals. The coincidence rate of ultrasound diagnosis was 59.1% (13/22), 3 cases were misdiagnosed as fibrous, fat and other sarcomas, 4 cases were misdiagnosed as nerve-derived tumors, 1 case was misdiagnosed as nodular fasciitis, and 1 case was misdiagnosed as gastrointestinal stromal tumor. The pathological characteristics of invasive fibromatosis were more typical, and the positive expression rate of vimentin and β-catenin in immunohistochemistry was 100.0% (22/22); the coincidence rate of preoperative pathological diagnosis of puncture was 78.6% (11/14), 1 case was misdiagnosed as nerve fiber tumor, 1 case was misdiagnosed as low-grade fibromyxoid sarcoma, and 1 case was misdiagnosed as nodular fasciitis.Conclusion:Invasive fibromatosis has a certain specificity in ultrasound and pathological diagnosis, which can be diagnosed and differentially diagnosed according to the ultrasound image and pathological characteristics.

Objective:To investigate the relationship between BRAF V600E gene mutation and ultrasonography manifestations as well as the lesion invasiveness in thyroid cancer.Methods:A total of 153 patients pathologically diagnosed as thyroid cancer after surgery who underwent thyroidectomy in Shanxi Provincial Cancer Hospital from January 2018 to October 2019 were selected, including 146 cases of papillary thyroid carcinoma. Ultrasonography was performed before operation. Paraffin embedded tissue after operation was used to detect BRAF V600E gene mutation. According to the results of BRAF V600E gene detection, patients were divided into mutation group and non-mutation group. The ultrasonic characteristics of the two groups were compared. The relationship of BRAF V600E gene mutation with ultrasonic characteristics, clinicopathological characteristics as well as cervical lymph node metastasis was analyzed by using logistic regression.Results:There were 130 cases (85.0%) of BRAF V600E gene mutation and 23 cases of BRAF V600E gene non-mutation in 153 patients with thyroid cancer. Among 146 cases with papillary thyroid carcinoma, there were 128 cases (87.7%) of BRAF V600E gene mutation. The percentage of patients with the unclear boundary between thyroid lesions and capsule in BRAF V600E gene mutation group was higher than that of patients in non-mutation group, and the difference was statistically significant [46.9% (60/128) vs. 11.1% (2/18), χ 2 = 8.261, P = 0.004]. There were no significant differences in age, gender, nodule long diameter, aspect ratio, nodal location, internal calcification, internal echo, echo uniformity, cystic solid, nodal shape, boundary clarity, blood flow signal, the number of tumor site, lymph node metastasis and nodular goiter between BRAF gene mutation group and non-mutation group (all P > 0.05). The results of logistic regression analysis showed that only the boundary clarity between thyroid lesions and capsule was an independent influencing factor of BRAF V600E gene mutation ( OR = 14.400, 95% CI 1.847-112.246, P = 0.011), tumor lesion size was an independent influencing factor of cervical lymph node metastasis in papillary thyroid carcinoma ( OR = 2.714, 95% CI 1.335-5.517, P = 0.006). Conclusions:In papillary thyroid carcinoma, BRAF V600E gene mutation is related with lesion and the unclear boundary between the tumor and capsule, but not related with lymph node metastasis. The size of the tumor lesion is associated with lymph node metastasis.

Objective: To investigate the location, size, ultrasonic characteristics and clinical significances of normal parathyroid glands. Methods: A total of 350 healthy subjects with no relevant diseases in Shanxi Provincial Cancer Hospital from January 2017 to December 2017 were selected. The age ranged from 9 to 83 years old. They were divided into seven groups according to age, with 50 in each group. The position, size, shape, echo, boundary, and blood flow signal characteristics of the normal parathyroid glands in these healthy subjects examined by ultrasound were retrospectively analyzed, and the differences among the different groups were compared. Results: The detection rate of normal parathyroid glands in 350 subjects was 95.4% (1 335/1 400). The normal parathyroid glands were oval, fusiform or irregular shape hyperechoic or isoechoic nodules, with homogeneous echoes and clear borders. There was no obvious blood flow signal in most glands. The proportion of fusiform shape in upper parathyroid glands (24.4%, 161/659) was higher than that in lower parathyroid glands (18.4%, 125/676), the difference was statistically significant (χ ² = 6.99, P < 0.05). The superior parathyroid gland was mainly located in the superior thyroid region, while the inferior parathyroid gland was mainly located in the inferior thyroid region, especially within the range of 2 cm from the inferior thyroid pole. In the age ≤ 20 years old group, the proportion of patients with upper parathyroid gland in the upper thyroid region (80.4%, 74/92) was higher than that in the other age groups, and the proportion of patients with lower parathyroid gland in the subthyroid region (30.6%, 30/98) was higher than that in the other age groups, the difference was statistically significant (χ ² = 3.35, P < 0.05). There was no significant difference in the size of parathyroid gland among different age groups (P > 0.05). Conclusions The detection rate of normal parathyroid glands is high, and they mainly located in the upper and lower thyroid regions within 2 cm from the lower margin of the thyroid. Ultrasound images are mainly characterized by the clear elliptical shape and the uniform high echo. The ultrasonic characteristics of normal parathyroid glands are conducive to preoperative localization of parathyroid glands and provides a reliable basis for finding and retaining parathyroid glands in thyroid surgery.

Objective To investigate ultrasonographic features of different pathological types of mucinous breast carcinomas (MBC), and to improve the diagnosis rate of MBC. Methods The ultrasonographic features of 42 MBC cases between January 2014 and December 2015 in Shanxi Provincial Cancer Hospital were retrospectively analyzed according to pathological types. Results There were 24 cases of simple type and 18 cases of mixed type in 42 MBC cases (46 lesions in total). The coincidence rate of preoperative ultrasound diagnosis for cancerous lesions was 93.5 % (43/46), including 24 cases of 27 simple type lesions with oval form or lobulated (20/27, 74.1 %), clear boundary (21/27, 77.8 %), uniform internal echo (17/27, 63.0 %), posterior echo enhancement (11/27, 40.7 %), and 18 cases of 19 mixed type lesions with irregular shape (14/19, 73.7 %), unclear border (16/19, 84.2 %), uneven internal echo (13/19, 68.4 %), posterior echo attenuation (13/19, 68.4 %). The differences between the two types of ultrasound images were statistically significant (both P＜0.05). Of 42 cases, 76 axillary lymph nodes were transferred in 13 cases. Preoperative ultrasonography showed that 32 axillary lymph nodes enlargement were abnormal in 12 cases, and the detection rate was 42.1 % (32/76). The positive rates of estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER-2) were 87.5 % (21/24), 79.2 % (19/24), 8.3 % (2/24) in simple type and 83.3 % (15/18), 88.9 % (16/18), 5.6 % (1/18) in mixed type respectively. There was no significant difference in the positive rates of 3 kinds of molecular markers among two types (all P＞0.05). Conclusions Due to the different tissue components in different types of MBC, ultrasonic features show several differences. Simple type is similar to benign masses, while mixed type shows the characteristics of invasive carcinomas.

Objective: To evaluate the usage of ultrasound guided wire-localization, nano-carbon staining and the combination of the above two methods in detecting sentinel lymph node (SLN) in breast cancer. Methods: A total of 159 cases of breast cancer from May 2015 to December 2017 in Shanxi Provincial Cancer Hospital were selected, and they were treated with ultrasound guided wire-localization, nano-carbon staining and combination of the two methods separately to detect SLN before the operation. After the operation, SLN and axillary lymph node in each group were marked and made pathological diagnosis. Results: There were 69 cases with pathological diagnosis of SLN metastasis and 90 cases without abnormal representation. With the patient as the unit, the sensitivity of ultrasound guided wire-localization was 100.0% (69/69), the sensitivity of nano-carbon staining was 98.6% (68/69), and the sensitivity of combination of the two methods was 97.1% (67/69). The specificity of ultrasound guided wire-localization was 3.3% (3/90), the specificity of nano-carbon staining was 2.2% (2/90), and the specificity of combination of the two methods was 5.6% (5/90). With the count of SLN as the unit, the combination of the two methods had the highest diagnostic efficiency in detecting SLN, and the difference was statistical significant (χ² = 34.31, P < 0.001). Conclusions Ultrasound guided wire-localization and nano-carbon staining are safe and accessible methods for detecting SLN. It provides a precise treatment for early breast cancer, and it can protect medical staff from radiation, which is expected to be the best method for detection of SLN in breast cancer.

Objective To analyze the ultrasonic imaging characteristics of primary breast lymphoma and their significance for diagnosis.Methods Data of ultrasonograph from 21 cases of primary breast lymphoma were reviewed, and all cases had been certificated by pathology.Results All of 21 cases with primary breast lymphoma were solid mass.The contours of 16 cases were regular, and the boundaries of 9 cases were clear.20 cases were hypoechoic masses, besides 3 cases with lower echo like liquefactive degeneration.The internal echoes of 19 cases were disorderly, part of them with hyperechoic trabs.The rear echoes of 17 cases were neither enhanced nor fading.The surrounding tissues of 19 cases were not changed.13 cases had more than 3 blood vessels on color Doppler imaging.Conclusion There are some ultrasound characteristics in primary breast lymphoma, which would be helpful in the diagnosis of primary breast lymphoma.

Objective To explore the factors affecting diagnosis accuracy on T stage of oral ultrasonic contrast agent examination on ulcerative gastric neoplasms.Methods Data from 82 patients were analyzed who were pathologically diagnosed as ulcerative gastric neoplasms ultrasounds data of oral ultrasonic contrast agent before surgery were compared to postoperative pathology,analysis had been done on influence of the lesion site,size of the T staging on ulcerative gastric neoplasms.Results The diagnosis accuracy rate of T stage on lesser curvature of stomach and gastric antrum were 91.3 ％ (21/23) and 85.7 ％ (24/28),compared with the pathological results were in good concordancy (Kappa =0.763,0.68,P ＜ 0.05).The accuracy rate of T stage on cardiac lesions was 68.0 ％ (17/25),compared with the pathological results consistency in general (Kappa =0.446,P ＜ 0.05).Further research on the effects of T stage accuracy would be necessary.The accuracy rate ofT staging on tumor size ≤ 5.0 cm group and ＞ 5.0 cm were 92.3 ％ (36/39) and 72.1％ (31/43),the difference was significant in two groups (x2 =5.591,P ＜ 0.05).Conclusion Oral ultrasonic contrast agent application is more accurate on lesser curvature of stomach,gastric antrum and lesions size ≤ 5.0 cm.

Objective To explore the value of oral ultrasonic contrast agent on preoperative T staging of gastric cancer.Methods 62 patients diagnosed with gastric neoplasms by operation and pathology were analyzed retrospectively.Patients were treated by oral ultrasonic contrast agent and conventional ultrasonography before surgery,two methods were compared with postoperative pathology.Results Oral ultrasonic contrast agent and conventional ultrasound detection rates of gastric neoplasms were 100.0 ％(62/62)and 64.5 ％ (40/62),The difference was significant between the two examination methods(x2 =24.369,P ＜ 0.05).The oral ultrasonic contrast agent and conventional ultrasound with T1,T4 staging accuracy rates were 85.7 ％(6/7),0,92.3 ％(36/39),59.0 ％(23/39),there were significant differences(both P ＜ 0.05).T2,T3 staging accuracy rate were 75.0 ％(3/4),0,83.3 ％(5/6),33.3 ％(2/6),the differences were not significant(P =0.143,P =0.242).Conclusion Oral ultrasonic contrast agent in preoperative T staging diagnosis has higher accuracy rate in gastric neoplasms,it could guide clinical rational therapy.It is worth promoting non-invasive,convenient means of stomach diseases census.

Objective To discuss the contrast-enhanced ultrasonography diagnostic value of the liver low-density focus on contrast-enhanced CT. Methods The contrast-enhanced ultrasonography results of 47 cases of the liver low-density focus on contrast-enhanced CT. were retrospectively analyzed. Results The pathological diagnosis in 47 focuses was metastatic carcinoma 20 cases, inflammatory pseudotumour 9 cases,hepatic hemangioma 6 cases, primary liver carcinoma 4 cases, cyst 2 cases, abscess 2 cases, tuberculosis 2 cases, FNH (focal liver nodular hyperplasia) 1 case, local adipose tissue infiltration of liver 1 case. 45 cases of contrast-enhanced ultrasonography diagnosis was consistent with pathological or clinical diagnosis. Cysts and inflammatory pseudotumour had not ultrasound contrast enhancement in the entire phase, but the crossed blood vessels was observed in inflammatory pseudotumour. The local adipose infiltration of liver had synchronous ultrasound contrast enhancement accompanied with liver tissue enhancement. 80% (12/15) of liver metastases of lack of blood supply showed fast contrast enhancement around the tumour edge and homogeneous and light contrast enhancement in the tumour center. 80 % (4/5) of liver metastases of rich of blood supply showed heavy and rapid contrast enhancement in the whole tumour. The enhancement degree in bscess and tuberculosis in the ultrasound contrast enhancement was correlated with necrosis degree, which showed fast and uneven contrast enhancement, hepatic hemangioma showed gradually contrast enhancement from its edge to center, whose enhancement time lasted for longer time than that of metastatic tumour with a statistically difference. FNH showed a typical contrast enhancement pattern, fast enhancement and fast weakening from center to edge. Hepatic cell carcinoma showed fast enhancement and fast weakening in the whole tumour. Conclusion Contrast-enhanced ultrasonography have diagnostic value of CT liver focus of low-density, which is helpful for the differential diagnosis of such focus.

Objective To compare the value of intrarectal filling with water and filling in rubber sheath with water in endoluminal uhrasonography for preoperative staging of rectal tumors. Methods 215 cases of rectal tumors were divided into two groups. 120 cases using the method of filling in rubber sheath with water and 95 cases using intrarectal filling with water were diagnosed with uhrasonography. The results were compared with corresponding pathologic results for the judgment of their accuracy. Results The accuracy for the diagnosis of infiltration depth was 60.0 % in the first group and was 73.7 % in the second. The difference was statistically significant (P <0.05). The accuracy for diagnosis of metastases of perirectal lymph nodes was 82.5 % in the first group and was 80.0 % in the second. The difference has no statistical significance (P >0.50). Conclusion Intrarectai filling with water is better than filling in rubber sheath with water in the diagnosis of infiltration depth of rectal tumors, while there is no difference in the diagnosis of metastasis of perirectal lymph nodes.