Objective To compare differences of characteristics of ultrasonic elasticity imaging for benign and malignant small thyroid nodules with or without Hashimoto thyroiditis (HT). Methods The thyroid nodules with ≤1 cm size and the category 4A, 4B, 4C, and 5 of Thyroid Imaging Reporting and Data System (TI-RADS) were included into this study, and a further examination of real-time elastography was performed. The final diagnosis was relied on the pathological diagnosis. The elasticity score and strain ratio (SR) were recorded and compared between these two groups, respectively. Results Of the 424 nodules, 103 nodules were accompanied with HT (thyroid nodule with HT group), 321 nodules were not accompanied with HT (thyroid nodule without HT group). In the thyroid nodule with HT group, the area under the receiver operator characteristic (ROC) curve (AUCs) of the elasticity score and the SR was 0.685 and 0.676, respectively; the optimal cut offs of the elasticity score and the SR was 3 points and 2.45 respectively, their corresponding sensitivity, specificity, and accuracy was 75.7%, 57.6%, 68.0% and 75.7%, 60.6%, 67.6%, respectively. In the thyroid nodule without HT group, the AUCs of the elasticity score and the SR was 0.692 and 0.692, respectively; the optimal cut offs of the elasticity score and the SR was 4 points and 2.84, respectively; their corresponding sensitivity, specificity, and accuracy was 57.5%, 74.2%, 69.2% and 76.1%, 59.7%, 67.7%, respectively. Conclusions Elastography is helpful in differential diagnosis of benign and malignant small thyroid nodules. While, standards of elasticity score and SR value in differential diagnosis are different between benign and malignant small thyroid nodules with HT and without HT, elasticity score and SR ratio decrease in benign and malignant small thyroid nodules with HT.
ObjectiveTo reveal and demonstrate the hotspots and further research directions in screening technology for early lung cancer, and provide references for the future studies. MethodsResearches related to lung cancer screening from 2011 to 2021 in the Web of Science database were included. Biblioshiny, a bibliometrics program based on R language, was used to perform content analysis and visualization of the included literature information. ResultsResearches related to lung cancer screening were increasing year by year. Six major cooperation groups were formed between countries. The current research hotspots in the field of early lung cancer screening technology mainly focused on the multi-directional fusion of radiographic imaging, liquid biopsy and artificial intelligence. ConclusionLow-dose spiral CT screening is still the most important and mainstream method for the screening of early lung cancer at present. The combination and integration of artificial intelligence with various screening methods and the innovation of novel testing and diagnostic equipment are the current research hotspots and the future research trend in this field.
Objective To develop an innovative recognition algorithm that aids physicians in the identification of pulmonary nodules. MethodsPatients with pulmonary nodules who underwent thoracoscopic surgery at the Department of Thoracic Surgery, Affiliated Drum Tower Hospital of Nanjing University Medical School in December 2023, were enrolled in the study. Chest surface exploration data were collected at a rate of 60 frames per second and a resolution of 1 920×1 080. Frame images were saved at regular intervals for subsequent block processing. An algorithm database for lung nodule recognition was developed using the collected data. ResultsA total of 16 patients were enrolled, including 9 males and 7 females, with an average age of (54.9±14.9) years. In the optimized multi-topology convolutional network model, the test results demonstrated an accuracy rate of 94.39% for recognition tasks. Furthermore, the integration of micro-variation amplification technology into the convolutional network model enhanced the accuracy of lung nodule identification to 96.90%. A comprehensive evaluation of the performance of these two models yielded an overall recognition accuracy of 95.59%. Based on these findings, we conclude that the proposed network model is well-suited for the task of lung nodule recognition, with the convolutional network incorporating micro-variation amplification technology exhibiting superior accuracy. Conclusion Compared to traditional methods, our proposed technique significantly enhances the accuracy of lung nodule identification and localization, aiding surgeons in locating lung nodules during thoracoscopic surgery.
摘要:目的:探讨关节镜微创手术对膝关节色素沉着绒毛结节性滑膜炎的诊断和治疗价值。方法:本组12例,男7例,女5例,年龄18～46岁,平均33岁;病史2～60个月,平均16个月;其中左膝8例,右膝4例;初次就诊11例,外院开放手术后复发1例。所有病例术前均行MRI检查,并行关节镜检,滑膜切除,记录该病在关节镜下的表现形式(局灶型或弥漫型),样本全部送病理检查。术后加压包扎、局部冰敷并按计划功能锻炼,术后3～4周行患膝放射治疗。结果:本组12例,其中局灶性病例8例,弥漫性4例,术后病理检查确诊;所有病例获得了3~21个月,平均13个月随访,未见复发;术前Lysholm评分(62.3±2.4)分;国际膝关节评分委员会(IKDC)膝关节功能主观评分(56.4±31)分;术后3月复查Lysholm评分(82.5±3.2)分;IKDC主观评分(85.3±2.5)分。除1例开放手术后复发病例术后3月膝关节屈曲受限(80°)外,其余患者功能良好。结论:关节镜手术创伤小,显露充分,病灶切除彻底,术后功能恢复理想,辅以放射治疗可有效降低复发率,对膝关节色素沉着绒毛结节性滑膜炎具有较高的诊治价值。Abstract: Objective: To evaluate the role of arthroscopy in the diagnosis and treatment in knee joint pigmented villonodular synovitis. Methods: 12 cases of knee joint pigmented villonodular synovitis with the age of 18 to 46 years old were treated with arthroscopical synovectomy with a combined application of postoperative exercise and radiotherapy. The history of disease was 2 to 60 months, with the mean of 16 months. The clinical data were reviewed when followedup and evaluated by Lysholm score and and IKDC score. Results: 12 patients diagnosed by pathologic examination,including 8 localized and 4 diffused, were followed up for 3 to 21 months(13 months on average)with no relapses at the time of followup. Lysholm score was (62.3±2.4)points preoperatively, but (82.5±3.2) points 3 months later.The International Knee Documentation Committee (IKDC) score was (56.4±3.1) and (85.3±2.5) respectively before surgery and 3 months later. All patient remained good functions of knee joints except one who relapsed after open operation. Conclusion:In case of pigmented villonodular synovitis of the knee joint, arthroscopical synovectomy combined with postoperative radiotherapy and physical exercise is an effective treatment with less invasion and better function than open operation.
ObjectiveTo study the clinical manifestation, radiographic characteristics, and treatments of reactive lymphoid hyperplasia(RLH) of liver. MethodsThe clinical data and treatment process of 1 patient with RLH of liver in our hospital was analyzed retrospectively, and the other 49 cases reported in English literature were reviewed. ResultsThere were 33 pieces of case reports found in PubMed database. For all 50 patients, there were 45 female(90%) and 5 male(10%) patients, and the mean age was(57.6±14.0) years(15-85 years). Only 8 patients(16%) were discovered with multiple mass, the rest of them were solitary mass(84%). Of the 50 patients, 6 patients(12%) were discovered because of bellyache, 2 patients(4%) were discovered during operation, 2 patients(4%) were discovered by pathological examination after liver transplantation, 1 patient(2%) was discovered during autopsy, 39 patients were discovered during examination or reexamination. The tumors were located in the right lobe for 25 patients(50%), in the left lobe for 15 patients(30%), in the both lobes for 4 patients(8%), and in the caudal lobe for 1 patient(2%), while 5 cases(10%) were not given in the articles. Eleven patients(22%) had the history of malignancy, 15 patients(30%) were concomitant with autoimmune disease, and 5 patients(10%) were concomitant with virus hepatitis infection. Thirty-six patients(72%) were diagnosed as malignancy preoperatively, and 43 patients(86%) underwent surgical resection. ConclusionsRLH of liver is an extremely rare and benign condition which presents a female predilection and often concomitants with autoimmune disease and history of malignancy. Considering the risk of malignant transformation, surgical resection is recommended and further researches are necessary for better understanding of this disease.
ObjectiveTo explore the clinical issues associated with video-assisted pulmonary segmentectomy and to provide reference for better implementation of thoracoscopic pulmonary segmentectomy and reduction of perioperative complications through analyzing the clinical results of thoracoscopic segmentectomy.MethodsThe clinical data of 90 patients who planned to undergo thoracoscopic segmentectomy in our department from October 2017 to December 2019 were retrospectively analyzed, including 35 males with an average age of 60.34±9.40 years and 55 females with an average age of 56.09±12.11 years. The data including lung nodule number, benign or malignant, preoperative location by Hookwire, preoperative planning and actual implementation, operation time, intraoperative blood loss, postoperative drainage volume and time of drainage tube removal, postoperative hospital stay and complications were collected and analyzed.ResultsAmong the 90 patients, 38 were preoperatively positioned by Hook-wire, 52 were directly operated on; 87 were completed under thoracoscopic surgery among whom 3 underwent passive lobectomy after segmentectomy under thoracoscopic surgery, and 3 were converted to thoracotomy among whom 1 underwent lobectomy. Operation time was 198.58±56.42 min, intraoperative blood loss was 129.78±67.51 mL, lymph node samples were 6.43±1.41, drainage time was 2.98±1.25 d, the amount of postoperation drainage was 480.00±262.00 mL, hospital stay was 7.60±2.38 d. In all patients, 73 had single nodules and 17 had multiple nodules. Totally 113 pulmonary nodules were resected, 14 (12.39%) were benign nodules and 99 (87.61%) were malignant nodules. There was no perioperative death or serious complications.ConclusionFor those pulmonary parenchymal nodules which meet the indications, it is feasible to perform thoracoscopic anatomic pulmonary segmentectomy according to preoperative thin-slice CT and three-dimensional computed tomography-bronchography and angiography (3D-CTBA) reconstruction results. Preoperative Hookwire localization can ensure effective edge resection and reduce unplanned lobotomy for intersegmental nodules and non-palpable peripheral pure ground-glass nodules.
Lung cancer is a malignant tumor with the highest mortality worldwide, and its early diagnosis and evaluation have a crucial impact on the comprehensive treatment of patients. Early preoperative diagnosis of lung cancer depends on a variety of imaging and tumor marker indicators, but it cannot be accurately assessed due to its high false positive rate. Liquid biopsy biomarkers can detect circulating tumor cells and DNA in peripheral blood by non-invasive methods and are gradually becoming a powerful diagnostic tool in the field of precision medicine for tumors. This article reviews the research progress of liquid biopsy biomarkers and their combination with clinical imaging features in the early diagnosis of lung cancer.