Application of neck ultrasound in the diagnosis of sarcoidosis

Objective To explore the significance of neck ultrasound (NUS) combined with contrast-enhanced ultrasound (CEUS) in the diagnosis of sarcoidosis. Methods 88 patients with evidence of intrathoracic lymphadenopathy and suspected sarcoidosis with enlarged cervical lymph nodes underwent NUS, CEUS, fine-needle aspiration and core needle biopsy when technically feasible were retrospectively analyzed in this study. Seven characteristics such as enhanced mode (EM), resolution time, color Doppler flow imaging (CDFI), fading time, peaking state-uniformity, strengthen the area and symmetry were considered to perform the logistic regression model. Results Of 88 patients included in this study, sarcoidosis was accounted in 20 cases, tuberculosis in 23 cases, malignancy in 22 cases and inflammatory lymph node in 23 cases. There were statistically significant differences in symmetry, lymphatic hilum, homogeneity, CDFI pattern and elasticity score between the sarcoidosis and non-sarcoidosis groups via NUS. Similarly, we also acknowledged a statistically significant differences in EM, homogeneity, presence or absence of necrosis between the sarcoidosis and non-sarcoidosis groups via CEUS to further group the non-sarcoidosis into tuberculosis, malignancy or inflammatory disorder. The percentage correction of prediction was 90% (18/20). Conclusion NUS combined with CEUS has characteristic features in sarcoidosis with cervical lymph node involvement, which is helpful for its diagnosis and differential diagnosis. The binary classification model of NUS combined with CEUS features can help differentiate sarcoidosis from non-sarcoidosis groups.

Diagnosis of Breast Sparganosis by Ultrasonography Combine with Molecular Biological Methods

Background: Sparganosis is a parasitic zoonosis caused by the plerocercoid larvae of the genus Spirometra. The sites affected by the plerocercoid infection include subcutaneous tissues, brain, eyes, the abdominal viscera, and urogenital organs. In clinical practice, due to the limited laboratory approaches for the specific detection of sparganum, breast Sparganosis was often initially suspected to be breast tumor. Case presentation: In the present report, a 65-year-old woman was admitted to the Sun Yat-sen University Cancer Center, Guangzhou, China, because of a mass in her left breast. Breast ultrasonography showed multiple bands with low echo and uneven echo, and color doppler flow imaging showed no blood flow signal in the lesion. Therefore, the possibility of tumor was excluded and a preliminary diagnosis of Sparganosis was made. Subsequently, a lumpectomy was carried out and revealed a 30 cm worm. Then histopathological examination diagnosed this case was sparganosis and the worm was Sparganum proliferum. To further verify our diagnosis, the cytochrome oxidase subunit 1 (COX1) gene was amplified by PCR, sequence analysis of PCR products made us sure that it was the Sparganum proliferum. Conclusion: We present Sparganosis could be preliminarily distinguished from breast tumor by ultrasonography, and then confirm Sparganosis by molecular biological methods, which provided a more efficient method for the detection of Sparganosis.

Contrast-Enhanced Ultrasound in the Bladder: Critical Features to Differentiate Occupied Lesions

Objective. To study the clinical diagnostic value of contrast-enhanced ultrasound (CEUS) in bladder occupied lesions. Methods. 38 cases of conventional-ultrasound-found bladder occupied lesions did color Doppler flow imaging (CDFI) and CEUS checks. By comparing the difference between two types of blood flow imaging technologies in displaying the flow of bladder occupied lesions and observing the perfusion modes of contrast agents to enter lesions, the perfusion characteristics of CEUS were analyzed. Finally, they were contrasted with the surgical pathology results. Results. Of all the 38 cases, there were 51 bladder occupied lesions, including 43 bladder malignant tumors, 2 bladder inverted papillomas, and 6 glandular cystitis lesions. The blood flow display rate of bladder occupied lesions was 100% using CEUS. Apparently, it was higher than that of CDFI (62.7%), and the result of these showed a statistically significant difference ( P < 0.05 ). Using CEUS, 46 malignant lesions and 5 glandular cystitis lesions were indicated, and the diagnostic accuracy rate was 86.3%. Conclusion. CEUS can improve the blood flow display rate of bladder occupied lesions, and it can also observe the real-time blood flow of these lesions. It can help judge their nature and has a higher clinical value in differentiating the benign from the malignant.

Revealing the Angiopathy of Lacrimal Gland Lesion in Type 2 Diabetes

For a better understanding of diabetic angiopathy (DA), the potential biomarkers in lacrimal DA and its potential mechanism, we evaluated the morphological and hemodynamic alterations of lacrimal glands (LGs) in patients with type 2 diabetes and healthy counterparts by color Doppler flow imaging (CDFI). We further established a type 2 diabetic mice model and performed hematoxylin-eosin (HE) staining, immunofluorescence staining of CD31, RNA-sequencing analysis, and connectivity map (CMap) analysis. We found atrophy and ischemia in patients with type 2 diabetes and mice models. Furthermore, we identified 846 differentially expressed genes (DEGs) between type 2 diabetes mellitus (T2DM) and vehicle mice by RNA-seq. The gene ontology (GO) analysis indicated significant enrichment of immune system process, regulation of blood circulation, apoptotic, regulation of secretion, regulation of blood vessel diameter, and so on. The molecular complex detection (MCODE) showed 17 genes were involved in the most significant module, and 6/17 genes were involved in vascular disorders. CytoHubba revealed the top 10 hub genes of DEGs, and four hub genes (App, F5, Fgg, and Gas6) related to vascular regulation were identified repeatedly by MCODE and cytoHubba. GeneMANIA analysis demonstrated functions of the four hub genes above and their associated molecules were primarily related to the regulation of circulation and coagulation. CMap analysis found several small molecular compounds to reverse the altered DEGs, including disulfiram, bumetanide, genistein, and so on. Our outputs could empower the novel potential targets to treat lacrimal angiopathy, diabetes dry eye, and other diabetes-related diseases.

Application of Neck Ultrasound in the Diagnosis of Sarcoidosis

Objective: To explore the significance of neck ultrasound (NUS) combined with contrast-enhanced ultrasound (CEUS) in the diagnosis of sarcoidosis.Methods: 88 patients with evidence of intrathoracic lymphadenopathy and suspected sarcoidosis with enlarged cervical lymph nodes underwent NUS, CEUS, fine-needle aspiration (FNA) and core needle biopsy (CNB) when technically feasible were retrospectively analyzed in this study. Seven characteristics such as enhanced mode (EM), resolution time (RT), Color Doppler Flow Imaging (CDFI) , fading time (FT), peaking state-uniformity (PTSU), strengthen the area (STA) and symmetry were considered to perform the logistic regression model.Results: Of 88 patients included in this study, sarcoidosis was accounted in 20 cases, tuberculosis in 23 cases, malignancy in 22 cases and inflammatory lymph node in 23 cases. There were statistically significant differences in symmetry, lymphatic hilum, homogeneity, CDFI pattern and elasticity score between the sarcoidosis and non-sarcoidosis groups via NUS. Similarly, we also acknowledged a statistically significant differences in enhanced mode, homogeneity, presence or absence of necrosis between the sarcoidosis and non-sarcoidosis groups via CEUS to further group the non-sarcoidosis into tuberculosis, malignancy or inflammatory disorder. The percentage correction of prediction was 90% (18/20).Conclusion：NUS combined with CEUS has characteristic features in sarcoidosis with cervical lymph node involvement, which is helpful for its diagnosis and differential diagnosis. The binary classification model of NUS combined with CEUS features can help differentiate sarcoidosis from non-sarcoidosis groups.

Application of Superb Microvascular Imaging in the Diagnosis of Vascular Erectile Dysfunction

To compare the difference between superb microvascular imaging (SMI) and color doppler flow imaging (CDFI) on vascular grading and blood flow display rate of the penile cavernous artery of vascular erectile dysfunction (ED), and to evaluate the length of time to obtain blood flow spectrum. 68 patients with ED were preformed for the examination of SMI and CDFI. The difference between the two techniques on vascular grading and blood flow display rate were compared. Hemodynamic parameters, namely peak systolic velocity (PSV), end diastolic velocity (EDV), and resistant index (RI) and the length of time obtained blood flow spectrum were compared. SMI was more sensitive to assess vascular grading and blood flow display rate than CDFI (P < 0.05). Hemodynamic parameters (PSV, EDV, and RI) measured by SMI and CDFI were well correlated (r = 0.981, P < 0.001; r = 0.879, P < 0.001; r = 0.937, P < 0.001). The duration of time necessary obtained the spectrums of grade 3 and grade 4 blood flow was shorter than that of grade 1 and grade 2, and SMI was comparatively shorter than CDFI (P < 0.05). In conclusion, SMI detected the blood flow of the penile cavernous artery better and maked the examination time shorter than CDFI, which can be considered as a more effective technique to diagnose vascular ED.

Research on The Frame of Reference with The Downward Displacement of The Posterior Leaflet and Anterior Leaflet of Tricuspid Valve in Children by Ultrasound

To investigate the frame of reference with the downward displacement of the posterior leaflet and anterior leaflet of tricuspid valve in children by ultrasound.The downward degree of anterior and posterior tricuspid valve was evaluated with tricuspid annulus and coronary sinus as reference structures under ultrasound, and the position of tricuspid regurgitation orifice was shown by color ultrasound. Color Doppler flow imaging showed that the position of tricuspid regurgitation orifice moved down obviously in all 42 children. One case showed 2.2cm from the root of the anterior valve to the tricuspid annulus in the two-chamber and four-chamber view of the apical right heart. Color Doppler can show that the position and direction of tricuspid regurgitation orifice are obviously deviated to the anterolateral side. The obvious deviation of the tricuspid regurgitation orifice to the anterolateral direction may be an ultrasonic sign for diagnosing the downward displacement of the anterior tricuspid valve in children.

Evaluation of Choroidal Melanoma Vascularization by Color Doppler Flow Imaging: An Option for Follow-Up Tumor Control Assessment after CyberKnife®?

Background and Objectives: Thus far, tumor control for choroidal melanoma after teletherapeutic radiation is clinically difficult. In contrast to brachytherapy, the tumor height does not necessarily have to shrink as a result of teletherapy. Therefore, the objective of this study was to evaluate tumor vascularization determined by color Doppler flow imaging (CDFI) as a possible approach for monitoring the therapy response after teletherapy of choroidal melanoma. Materials and Methods: A single-center retrospective pilot study of 24 patients was conducted, all of whom had been diagnosed with choroidal neoplasm, treated and followed up. Besides tumor vascularization, the following parameters were collected: age, gender, tumor entity, location, radiation dose, knowledge of relapse, tumor height, radiation-related complications, occurrence of metastases, visual acuity in logMAR. Results: The level of choroidal melanoma vascularization markedly decreased in all included subjects after treatment with the CyberKnife® technology. Initially, the level of vascularization was 2.1 (SD: 0.76 for n = 10); post-therapeutically, it averaged 0.14 (SD: 0.4). Regarding the tumor apex, CDFI sonography also demonstrated a significant tumor regression (mean value pre-therapeutically: 8.35 mm—SD: 3.92 for n = 10; mean value post-therapeutically: 4.86 mm—SD: 3.21). The level of choroidal melanoma vascularization declined in the patient collective treated with ruthenium-106 brachytherapy. The pre-therapeutic level of vascularization of 2 (SD: 0 for n = 2) decreased significantly to a level of 0 (mean: 0—SD: 0). The tumor height determined by CDFI did not allow any valid statement regarding local tumor control. In contrast to these findings, the patient population of the control group without any radiation therapy did not show any alterations in vascularization. Conclusions: Our data suggest that the determination of the tumor vascularization level using CDFI might be a useful and supplementary course parameter in the follow-up care of choroidal melanoma to monitor the success of treatment. This especially applies to robot-assisted radiotherapy using CyberKnife®. Further studies are necessary to validate the first results of this assessment.

Evaluation of Multimode Color Doppler Flow Imaging in the Diagnosis of Solid Renal Tumor

Background. Renal cell carcinoma is one of the most common malignant tumors in urinary system, seriously affecting people’s health and life. This study aimed to evaluate the clinical value of multi-mode color Doppler flow imaging for diagnosis of solid renal tumor. Methods. Sixty-six renal solid tumors from 63 patients were examined by color Doppler flow imaging (CDFI), power Doppler flow imaging (PDFI), superb microvascular imaging (SMI), and contrast-enhanced ultrasound (CEUS) before surgery. The diagnostic efficacy of the four methods was compared by determining blood flow grade and ring-like blood flow with Adler’s method. Chi-square test and Fisher’s test were performed to compare the results of sensitivity and specificity among four methods. Results. Statistically significant differences in blood flow grade and ring-like blood flow were observed between benign and malignant renal tumors as detected by SMI and CEUS ( P < 0.05), whereas no difference was found as detected by CDFI and PDFI ( P > 0.05). The results indicated that the sensitivity and specificity of SMI (82.46%, 88.89%) and CEUS (84.21%, 88.89%) were higher than those of CDFI (42.11%, 66.67%) and PDFI (47.37%, 77.78%). Compared with the abilities of CDFI and PDFI, SMI and CEUS can better display the micro-blood flow in the tumors and evaluate the blood flow grading, which indicated that SMI and CEUS may have high values in the differential diagnosis of benign and malignant solid renal tumors. Conclusion. SMI and CEUS can improve the sensitivity and specificity of the diagnosis of benign and malignant renal tumors and have a high application value.