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Archives
Vol. 5, No. 2 Published: 30 June 2021
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Original Researchs

  • Hepatic Reactive Lymphoid Hyperplasia and Primary Hepatic Lymphoma: Ultrasound Features and Differentiation Diagnosis
  • Xiaohui Qiao, MD, Kun Chen, MD, Gang Chen, MD, PhD, Liyun Xue, MD, Guangwen Cheng, MD, Hong Ding, MD, PhD
  • 2021, 5 (2): 63-72. DOI:10.37015/AUDT.2021.200069
  • Abstract ( 417 ) HTML ( 37 ) PDF ( 320 ) 　　

  • Objective: To investigate the ultrasound features of hepatic reactive lymphoid hyperplasia (HRLH) and primary hepatic lymphoma (PHL), and determine the value of ultrasound on the diagnosis and differentiation of them.
    Methods: The ultrasound findings of 11 HRLH lesions and 14 PHL lesions from April 2011 to September 2020 were retrospectively analyzed. The conventional ultrasound and contrast-enhanced ultrasound (CEUS) manifestations of them were compared.
    Results: HRLH showed significant female preference than PHL (100% and 64.3%) (P = 0.046). There were no significant differences of other demographics between HRLH and PHL patients. On conventional ultrasound, the diameter of HRLH (16.5 ± 3.8 mm) was significantly smaller than that of PHL (48.3 ± 36.2 mm) (P = 0.008), and a regular shape was seen more frequently in HRLH (90.9%) than that in PHL (50%) (P = 0.038). There were no significant differences of other indexes between HRLH and PHL. On CEUS, both HRLH and PHL presented arterial enhancement and washout in early portal phase. But rim enhancement at the beginning of washout was seen more frequently in HRLH (90.0%) than that in PHL (33.3%) (P = 0.036), and HRLH usually displayed hyperenhancement (100%) in arterial phase while PHL could be hypoenhancement (16.7%), isoenhancement (33.3%) and hyperenhancement (50%) (P = 0.036).
    Conclusion: Ultrasound can supply valuable imaging evidences for the diagnosis of HRLH and PHL. The ultrasound features including size, shape, degree of arterial phase enhancement and rim enhancement at the beginning of washout can be used for the differentiation of HRLH and PHL.

  • The Morphology and Hemodynamic Characteristics of Patients with Internal Jugular Vein Stenosis
  • Lingyun Jia, MD, Yang Hua, MD, Xunming Ji, MD, Kaiyuan Zhang, MD, Shengnan Li, MD, Yu Tang, MD, Yingqi Xing, MD
  • 2021, 5 (2): 73-79. DOI:10.37015/AUDT.2021.210001
  • Abstract ( 344 ) HTML ( 9 ) PDF ( 403 ) 　　

  • Objective: This study was to investigate the characteristic morphology and hemodynamics in patients with internal jugular vein (IJV) stenosis by color duplex ultrasonography (CDU).
    Methods: From 2017 October to 2019 October, 111 patients with unilateral IJV regional stenosis at the J3 segment (IJV out of the jugular foramen to the anatomic level of the carotid artery bifurcation) and 126 healthy individuals (control group) were enrolled. Using CDU, the diameter, maximum velocity (Vmax), maximum pressure gradient (PGmax), and mean flow volume (FVm) of bilateral IJVs were measured. With MR venous angiography (MRV) and/or CT venous angiography (CTV) as reference, the optimal cut-off values of Vmax and PGmax were determined by ROC analysis.
    Results: Among the 111 patients, 39 (35.1%) were associated with intracranial hypertension (ICH). The diameter at the IJV stenosis was significantly smaller than that of the segment distal to the stenosis (2.04 ± 0.36mm vs. 4.49 ± 0.68mm, t = 19.367, P < 0.001). The Vmax and PGmax at the IJV stenosis segment were obviously higher than those at the segment distal to the stenosis (Vmax: 106.8 ± 29.0 cm/s vs. 32.4 ± 13.1 cm/s, t = 29.259; PGmax: 5.10 ± 2.69 mmHg vs. 0.50 ± 0.53 mmHg, all P < 0.001). With MRV/CTV as reference, the ROC curves of Vmax and PGmax at the stenosis site showed high diagnostic efficacy. The optimal cut-off value of Vmax was 75cm/s, with a sensitivity of 87.4% and a specificity of 95.2%. The optimal cut-off value of PGmax was 2.2 mmHg, with a sensitivity of 92.8% and a specificity of 96.0%.
    Conclusion: CDU may be a useful method to evaluate IJV regional stenosis.

  • The Effects of Liver Function Damage after Thermal Ablation on the Prognosis of HCC Patients and Its Prediction
  • Yan Zhou, Jianmin Ding, Fengmei Wang, Zhengyi Qin, Yandong Wang, Hongyu Zhou, Xiang Jing
  • 2021, 5 (2): 80-86. DOI:10.37015/AUDT.2021.210017
  • Abstract ( 303 ) HTML ( 8 ) PDF ( 415 ) 　　

  • Objective: To investigate the influence of liver function damage in patients with hepatocellular carcinoma (HCC) after microwave ablation (MWA) on the prognosis and to establish an algorithm to predict liver function damage.
    Methods: This is a retrospective study. A total of 745 patients were enrolled and classified into the modeling group and the validation group. The risk factors of liver function damage were analyzed by using logistic regression model. The β coefficients derived from a logistic analysis were used to calculate the risk score. Diagnostic accuracy based on risk score was assessed by the area under the curve (AUC).
    Results: 69 patients in the modeling group suffered from liver function damage. The 1-,3-,5- and 7-year progression free survival were 69.4%, 37.2%, 22.6% and 12.4% for patients without liver function damage and 69.5%, 33.0%, 14.4% and 0% for patients with liver function damage, respectively (P = 0.537). The 1-, 3-, 5- and 7-year overall survival were 94.3%, 75.9%, 61.5% and 54.5% for patients without liver function damage and 81.3%, 57.1%, 42.7% and 42.7% for those with liver function damage (P = 0.004), respectively. The AUC of the risk score for predicting liver function damage was 0.798 for the modeling group and 0.832 for the validation group. The sensitivity and specificity of the risk score to identify liver function damage was 65.2%, 84.4% in the modeling group and 60.6%, 88.3% in the validation group, respectively.
    Conclusion: Liver function damage after MWA is unfavorable the long-term prognosis. The prediction algorithm based on five risk factors is robust and can be used to predict possible liver function damage.

  • Improving Diagnostic Coincidence Rate of Graves’ Disease by Ultrasound Examination with Clinical Symptoms
  • Bingyan Liu, MD, Jie Hu, MD, Wei Liao, MD, Donglin Wang, MD, Xiangxiang Jing, MD
  • 2021, 5 (2): 87-94. DOI:10.37015/AUDT.2021.190014
  • Abstract ( 336 ) HTML ( 8 ) PDF ( 408 ) 　　

  • Objective: Combining ultrasound parameters with patient’s clinical symptoms to explore the feasibility of improving the diagnostic coincidence rate of hyperthyroidism.
    Methods: A total of 179 untreated patients with diffuse echogenic changes of the thyroid on ultrasound and abnormal laboratory examinations were enrolled this study. There were 119 cases of hyperthyroidism, 29 cases of subclinical hyperthyroidism, 26 cases of subclinical hypothyroidism, and 5 cases of Hashimoto’s thyroiditis with clinically confirmed diagnosis. The thyroid volume, blood supply grade, peak velocity of the superior thyroid artery (STA) by ultrasound, heart rate (HR), and clinical symptoms was used to determine the optimal indicators for the diagnosis of hyperthyroidism, and to compare these indicators (study group) with the previous ultrasound criteria reported in the literature (control group).
    Results: According to logistic regression analysis, from all the factors studied, hyperthyroidism symptoms had the most significant correlation with the diagnosis of hyperthyroidism (P = 0.001), followed by STA peak velocity (P = 0.005), HR (P = 0.009), echogenicity(P = 0.015)and blood flow Grade III (P = 0.041) in order of importance, the other factors include thyroid volume, blood flow Grade I and II were not correlated with the diagnosis of hyperthyroidism (P > 0.05). The diagnostic coincidence rate of hyperthyroidism by increased STA peak velocity was 85.7% (102/119), while the hyperthyroidism symptoms significantly increased the diagnostic coincidence rate to 95.8% (114/119). Comparing the study group to the control group, the area under the receiver operating curve (ROC) was 0.993 vs 0.899 (Z = 3.868, P = 0.001). The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value were 89.92% vs. 68.91%, 96.67% vs. 96.67%, 92.18% vs. 78.21%, 98.17% vs. 97.62%, and 82.80% vs. 61.05%, respectively.
    Conclusions: The optimal indicators for the diagnosis of hyperthyroidism is the presence of hyperthyroidism symptoms in untreated patients with diffuse echogenic changes of the thyroid, followed by increased STA peak velocity. This suggests that ultrasound doctors should carefully considerate clinical information and instead of just limited to ultrasound itself. By combining ultrasound parameters with the clinical manifestations of patients, the diagnostic coincidence rate can be truly improved.

Case Reports

  • Sonographic Features of Urothelial Carcinoma: A Case Study
  • Chelsea Robb. BS, RDMS, RVT, Traci Fox, EdD, RT(R), RDMS, RVT
  • 2021, 5 (2): 95-97. DOI:10.37015/AUDT.2021.200038
  • Abstract ( 320 ) HTML ( 11 ) PDF ( 318 ) 　　

  • The most common type of bladder cancer is urothelial carcinoma which arises from the inside lining (e.g., urothelium) of the bladder. As the disease progresses, the tumor may invade into the deep layer of the bladder wall, spread to adjacent areas of the bladder, or to other organs of the body. Common clinical symptoms of bladder cancer may present as painless hematuria. High-resolution ultrasound imaging has been used for diagnosis and differential diagnosis of bladder abnormalities. We report a case study using gray-scale and Doppler imaging to evaluate urothelial carcinoma of urinary bladder.

  • Thyroglossal Duct Cyst Papillary Carcinoma: A Case Report and Review of the Literature
  • Rong Hu, MM, Hui Liang, MD, Bei Wang, MD
  • 2021, 5 (2): 102-105. DOI:10.37015/AUDT.2021.200050
  • Abstract ( 427 ) HTML ( 17 ) PDF ( 483 ) 　　

  • Thyroglossal duct cyst is the most common congenital cyst, locating in the midline neck below the hyoid bone. Carcinoma occurring in a thyroglossal duct cyst is rare. Diagnosis generally depends on postoperative pathological diagnosis, because preoperative diagnosis is difficult, but imaging and fine-needle aspiration biopsy (FNAB) can help with the diagnosis. In addition, there is no consensus on the optimal management of thyroglossal duct cyst carcinoma. This paper describes a case of carcinoma in the thyroglossal duct cyst in a 60-year-old man and contains a review of the literature about the presentation, imaging manifestations and treatment.

  • Incomplete Shone’s Complex with BAV and VSD in Adult Diagnosed by Echocardiography
  • Yichen Qu, MD, Ya Yang, MD, Jinjie Xie, MD, Rongjuan Li, MD, Han Zhang, MD, Li Song, MD, Yueli Wang, MD, Jing Li, MD
  • 2021, 5 (2): 106-108. DOI:10.37015/AUDT.2021.200017
  • Abstract ( 311 ) HTML ( 4 ) PDF ( 231 ) 　　

  • Abstract: The Shone’s complex, defined as a constellation of parachute mitral valve (PMV), supravalvular ring of the left atrium, subaortic stenosis, and aorta coarctation, is a rare entity, which more commonly occurs in its incomplete form. We report the case of a 28-year-old female patient who presented for chest congestion and palpitation with history of congenital mitral valve malformation. Echocardiography revealed the coexistence of PMV, aortic coarctation with bicuspid aortic valve (BAV), and ventricular septum defect (VSD). The patient then received surgical intervention. The diagnosis of Shone’s complex with BAV and VSD made by echocardiography were confirmed later at surgery.

  • New Vessels or MCA Stem: A Case of Asymptomatic Chronic Middle Cerebral Artery Occlusion on TCCS
  • Yanting Wang, MD, Zhenzhen Hu, MD, Yu He, MD, PhD
  • 2021, 5 (2): 109-111. DOI:10.37015/AUDT.2021.200028
  • Abstract ( 234 ) HTML ( 8 ) PDF ( 210 ) 　　

  • We present a case of an asymptomatic chronic middle cerebral artery (MCA) occlusion that was incidentally detected on transcranial color-coded sonography (TCCS) and confirmed by magnetic resonance angiography (MRA). Besides the presence of accelerated blood flow velocity in the ipsilateral anterior cerebral artery (ACA) and posterior cerebral artery (PCA), which is known as signs of pial collaterals, TCCS specifically visualized some deep anastomoses and new vessels running along the occluded MCA stem course. Therefore, TCCS showed transcortical collaterals indirectly and deep anastomoses and neovascularization directly, providing at least as much information as MRA in explaining patient’s lack of symptoms and predicting his outcome. However, during TCCS procedures, we should be aware of the possibility of mistaking neovascularization as a patent MCA stem, tortuous MCA, or indistinct MCA influenced by poor temporal bone window.

Consensus and Guidelines

  • Expert Consensus on Some Issues of Cerebral and Carotid Vascular Ultrasonography
  • The Professional Committee of Vascular Ultrasound of Stroke Prevention and Treatment Expert, Committee of the National Health Commission , The Professional Committee of Superficial Organ and Peripheral Vascular Ultrasound of the Chinese Medical Ultrasound Engineering , The Professional Committee of Craniocerebral and Cervical Vascular Ultrasound of the Chinese Medical Ultrasound Engineering
  • 2021, 5 (2): 153-162. DOI:10.37015/AUDT.2021.200057
  • Abstract ( 257 ) HTML ( 11 ) PDF ( 193 ) 　　

  • The consensus was established based on some questions of cerebral and carotid ultrasound examination in practice through the collection, elucidation and explanation by three professional committees in the field of vascular ultrasonography, including the Professional Committee of Vascular Ultrasound of Stroke Prevention and Treatment Expert, Committee of the National Health Commission; the Professional Committee of Superficial Organ and Peripheral Vascular Ultrasound of the Chinese Medical Ultrasound Engineering; the Professional Committee of Craniocerebral and Cervical Vascular Ultrasound of the Chinese Medical Ultrasound Engineering, in order to promote the professional field and the level of technology standardization. It has important value in clinic leading and professional guidance.

Open Access, Peer-reviewed

ISSN 2576-2516 (Online)

ISSN 2576-2508 (Print)

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