Cover, Foreword and Content
2021, 5 (4): 0-0.
Abstract ( 70 ) PDF ( 7600KB ) ( 50 ) 　　

Original Research

Comparison of Diagnostic Efficacy of US, CT, and MRI for Pancreatic Intraductal Papillary Mucinous Neoplasms

Yue Yu, MM, Ling Zhang, MM, Bangwei Zeng, MM, Zhikui Chen, PhD

2021, 5 (4): 291-297. DOI:10.37015/AUDT.2021.210008

Abstract ( 322 ) HTML ( 20 ) PDF ( 653KB ) ( 559 ) 　　

Objective: Imaging modalities for pancreatic intraductal papillary mucinous neoplasm (IPMN) often provide a large amount of information, and an adequate comparison of their diagnostic efficacies cannot be made by simply referring to the diagnostic accuracy rates. The aim of the study was to apply a novel scoring system to evaluate the pancreatic IPMN diagnostic efficacy of transabdominal ultrasound (TAUS), computed tomography (CT), and magnetic resonance imaging (MRI).

Methods: The clinical and diagnostic imaging data of 42 patients with pancreatic IPMN diagnosed at Fujian Medical University Union Hospital between January 2014 and November 2020 were retrospectively analyzed. We applied our scoring system for the quantitative, location, and qualitative diagnosis of each imaging modality, and the diagnostic efficacy was determined.

Results: The mean rank scores of quantitative diagnosis for MRI, CT, and TAUS were 53, 48.96, and 48.54, respectively (P = 0.267). The mean rank scores of location diagnosis for these three methods were 51.72, 49.58, and 48.97, respectively (P = 0.752). The mean rank scores of qualitative diagnosis for MRI, CT, and TAUS were 59.69, 41.08, and 51.18, respectively; the difference was statistically significant (P = 0.015).

Conclusions: The novel scoring system could comprehensively and accurately evaluate the diagnostic efficacy of TAUS, CT, and MRI for pancreatic IPMN. MRI had the highest quantitative, localization, qualitative, and comprehensive diagnostic efficacy.

Quantitative Evaluation of Cirrhosis by Geometrical Characteristics of Hepatic Capsule Based on High-frequency Ultrasound Imaging: an Experimental Study

Jialin Song, MS, Xiang Liu, MD, Jianquan Zhang, MD, Jiaqi Zhao, MD, Lulu Zhao, MS

2021, 5 (4): 298-303. DOI:10.37015/AUDT.2021.200073

Abstract ( 208 ) HTML ( 18 ) PDF ( 2779KB ) ( 385 ) 　　

Objective: To explore the feasibility of quantitative evaluation of cirrhosis by geometrical characteristics of hepatic capsule based on high-frequency ultrasound imaging.

Methods: Rabbits with models of cirrhosis were established and then were divided into four groups: control, 6-week, 12-week and 18-week groups. Two-dimensional high-frequency ultrasound images of hepatic capsule of all rabbits were collected to obtain hepatic capsual contours and key points refltected shapes of these contours (shape control points) which were approximated by the principle of vertical gradient maximization under the manual supervision. Subsequently, the number of continuous segments of the contour line, the mean value and variance of angles between adjacent seed points were extracted to evaluate the continuity and smoothness of the contour line of the hepatic capsule.

Results: With aggravating cirrhosis, the number of segments required to make the sum of lengths of continuous segments reach up to 80% of the total width of the imaging section was gradually increased. The differences between the control group and 18-week group (P = 0.025) as well as between 6-week group and 18-week group (P = 0.004) were statistically significant. Similarly, the mean value and variance of the angles were also gradually increased, and the differences between the control group and the 6-week (P = 0.015, P = 0.036), 12-week (P < 0.001, P = 0.002) and 18-week groups (P = 0.023, P < 0.001) were statistically significant. In addition, the difference in variance of angles between the 6-week group and 18-week group (P = 0.030) was statistically significant.

Conclusion: Sonographic analysis of geometrical characteristics of the hepatic capsule could be used to partially indicate the presence of early-stage cirrhosis, which could provide a quantitative method for non-invasive assessment of cirrhosis.

Evaluation of Features of Adrenal Adenomas and Nonadenomas Using Dynamic Contrast-Enhanced CT Biomarkers

Xifu Wang, MD, Xizhong Dong, BS, Tingting Huang, MS, Jie Meng, BS, Yuanxun Kuang, MS, Jiwen Kang, BS, Renju Bai, MD, Zhaojun Li, MD

2021, 5 (4): 304-312. DOI:10.37015/AUDT.2021.210020

Abstract ( 276 ) HTML ( 12 ) PDF ( 1836KB ) ( 402 ) 　　

Objective: To investigate the correlation between the DCE-CT imaging biomarkers and histological biomarkers of tumor angiogenesis in adrenal adenomas and non-adenomas for the enhancement mechanism of DCE-CT.

Methods: Forty-two patients with 45 adrenal masses including 27 adenomas and 18 non-adenomas diagnosed pathologically were enrolled in this study. The features of DCE-CT (imaging biomarkers) and tumor angiogenesis (histological biomarkers) in adrenal masses were evaluated, and their correlations were explored.

Results: The enhanced features of DCE-CT in adrenal masses were classified: rapid washout group and slow washout group. Type A and C of time density (TD) curves, relative washout rate (Washr) ≥34%, and absolute washout rate (Washa) ≥43% belonged to the rapid group. In contrast, type B, D and E, Washr <34%, and Washa <43% belonged to the slow group. There was significant difference between the biomarkers of DCE-CT in adrenal masses. The rapid group was mainly found in adenomas, whereas the slow was mainly present in nonadenomas. The tumor angiogenesis, histological biomarkers, including microvessel density (MVD), vascular endothelial growth factor (VEGF), and microvascular ultrastructures demonstrated significant difference between the rapid and the slow washout group revealed by DCE-CT. The MVD and VEGF expression in rapid group were remarkably higher than those in slow group. Meanwhile, the tumor angiogenesis was also significantly different between adenomas and nonadenomas. The MVD and VEGF expression were also significantly higher in adenomas than those in nonadenomas. Furthermore, different microvascular ultrastructures were identified between adenomas and nonadenomas, which were in accordance with those between the rapid and the slow group. Microvascular ultrastructures in adrenal adenomas and/or the rapid group showed regular lumens and nonstenosis; more pinocytotic vesicles and fenestrations of endothelium; widening of the intercellular space; uniform thinning and better integrity of basal membrane; regular and uniform thinning, along with less stroma of extra vessel space. In comparison, opposite microvascular ultrastructures, in adrenal nonadenomas and/or the slow group.

Conclusion: The close correlation of DCE-CT imaging biomarkers and histological biomarkers of tumor angiogenesis was found between adrenal adenomas and nonadenomas. Tumor angiogenesis in adrenal adenomas and nonadenomas were shown the different enhancement characteristics at DCE-CT.

Case Reports

Prenatal Ultrasound Diagnosis of Klippel-trenaunay Syndrome Associated with the Thickened Thigh and Dilated Inferior Vena Cava: A Case Report and Literature Review

Shiyun Peng, MM, Pan Yang, MM, Jinzhou Wan, MM, Siyu Yue, MB, Ling Wang, MB, Xiyue Zhang, MB, Fan Yang, MD

2021, 5 (4): 313-316. DOI:10.37015/AUDT.2021.210012

Abstract ( 442 ) HTML ( 13 ) PDF ( 830KB ) ( 350 ) 　　

Klippel-Trenaunay syndrome (KTS) is a rare congenital disorder. In this case study, we reported prenatal ultrasound study on a 33-year-old pregnant woman at the gestation of 26 weeks and 3 days, whose fetus was suspected of KTS associated with enlarged right thigh and dilated inferior vena cava. Additionally, we comprehensively reviewed literatures of prenatal KTS published on Medline to further understanding of the prenatal ultrasonographic manifestations of KTS.

Application Value of Two-Dimensional Ultrasound Combined with Contrast-Enhanced Ultrasound for the Diagnosis of Multiple Bile Duct Hamartomas: A Case Report

Tong Zhang, MD, Xiaolin Yin, Shuang Zheng, MD, Mingwei Sui, MD, Dezhi Zhang, MD

2021, 5 (4): 317-320. DOI:10.37015/AUDT.2021.200064

Abstract ( 257 ) HTML ( 10 ) PDF ( 491KB ) ( 367 ) 　　

Bile duct hamartomas (BDHs), also known as von Meyenburg complexes, are small neoplasms of the liver, of which the pathology is a benign bile duct malformation. We report a case of multiple BDHs of a 55-year-old male diagnosed using two-dimensional (2-D) ultrasound combined with contrast-enhanced ultrasound (CEUS) and further clinically diagnosed using magnetic resonance imaging (MRI) and magnetic resonance cholangiopancreatography (MRCP). The 2-D ultrasound showed diffusely distributed hyperechoic nodules and cystic masses in the liver, accompanied by small strong echoes with a comet tail sign. The CEUS showed that the hyperechoic nodules observed no abnormal enhancement in the arterial phase and equal enhancement with the surrounding liver tissue in the portal vein and delayed phase. We conclude that the appearance of BDHs on ultrasound has distinct characteristics and can be used as the preferred method for diagnosis. The CEUS can differentially diagnose the disease and improve diagnostic accuracy. Therefore, 2-D ultrasound, combined with CEUS, is a helpful method for diagnosing BDHs.

Absence of the Horizontal Portion of the Left Portal Vein Diagnosed by Ultrasound and Computed Tomography

Yanling Cheng, MM, Xi Liu, MD, PhD, Wenxiao Zhu, BM, Chuang Gao, BM, Hao Sun, BM, Hongtao Li, BM

2021, 5 (4): 321-324. DOI:10.37015/AUDT.2021.210002

Abstract ( 209 ) HTML ( 8 ) PDF ( 737KB ) ( 354 ) 　　

The absence of the horizontal portion of the left portal vein is rare, and it is often not diagnosed by ultrasound. This article reports a case where ultrasound identified a structural anomaly between the gallbladder and the round ligament of the liver, and then computed tomography confirmed the absence of the horizontal portion of the left portal vein. We proposed the possible etiologies from an embryonic development perspective, and described the questions to be further investigated after a literature review.