PURPOSE:To develop and internally validate a super-resolution ultrasound microvascular imaging (SR-UMI) model for noninvasive preoperative prediction of sentinel lymph node (SLN) involvement in breast cancer and to assess incremental value over clinical variables. MATERIALS AND METHODS:In this prospective single-center study (January-June 2025), 162 consecutive patients with pathologically confirmed breast cancer underwent contrast-enhanced SR-UMI of the primary tumor prior to axillary surgery and SLNB. SonoVue (2.4 mL) was administered as an antecubital venous bolus. Examinations were performed on an Ultimus 9E ultrasound system using a 5-15 MHz linear transducer at low MI (0.08). Three predictor sets were evaluated: clinical-only (9 variables), SR-UMI-only (98 features), and combined (107 predictors). Elastic net-regularized logistic regression (EN-LR) was prespecified as the primary model and evaluated using nested stratified cross-validation (outer 5-fold, inner 3-fold) with pooled out-of-fold (OOF) predictions, assessing discrimination, calibration, and decision-curve analysis (DCA). RESULTS:SLN involvement was present in 55/162 patients (34.0%). EN-LR achieved AUC 0.662, PR-AUC 0.471, and Brier 0.232 for clinical-only predictors; SR-UMI-only improved performance (AUC 0.800; PR-AUC 0.572; Brier 0.185). The combined model performed similarly (AUC 0.802; PR-AUC 0.574; Brier 0.185). At the Youden operating point (threshold 0.514), the combined model yielded sensitivity 0.782, specificity 0.766, PPV 0.632, and NPV 0.872. Bootstrap OOF comparisons showed significant AUC improvements for SR-UMI-only versus clinical-only and combined vs. clinical-only, whereas combined vs. SR-UMI-only was not significant. Calibration showed a negative intercept and slope > 1 (combined: -0.637, 1.270). DCA demonstrated higher net benefit for EN-LR than treat-all/treat-none across threshold probabilities 0.05-0.60. CONCLUSION:SR-UMI microvascular features enabled good internal-validation performance and significantly improved discrimination over clinical/biopsy variables. The combined model offered no meaningful gain over SR-UMI only. External validation with recalibration is warranted.

Anterior disc displacement with reduction (ADDwR) most frequently occurs in temporomandibular joint disorder (TMD) and poses a major clinical challenge. Both botulinum toxin (BTX) and hypertonic dextrose (HD) injections have been reported for the treatment of ADDwR. However, the clinical confirmation of precise injection into the lateral pterygoid muscle and bilaminar zone is difficult. This study evaluated ultrasound-guided injection of BTX and HD for the treatment of ADDwR. Thirty patients with ADDwR received real-time ultrasound-guided injection of 30 units of BTX and 0.2 ml of 50

Objective: To evaluate the efficacy of microwave ablation (MWA) for benign thyroid nodules (BTNs) based on composition and compare complications and procedure conditions with surgery for BTNs. Materials and methods: 181 patients (MWA: 92; Surgery: 89) with BTNs were enrolled and followed up at the 1st, 3rd, 6th, 12th month. Efficacy contains volume reduction rate (VRR) and technique efficacy (VRR >50 %) during follow-up periods. Cosmetic scores, Hamilton Anxiety Rating Scale (HAMA), visual analog scale (VAS) scores, thyroid functions, complications and other procedure conditions were also compared between the two groups. Results: The VRRs at the 12th month after ablation of nodules with solid portion <10 %, 10 % <= solid portion <50 %, 50 % <= solid portion <95 % and solid portion >= 95 % were 97.51 %, 90.35 %, 65.12 % and 61.52 %, respectively. Cosmetic scores and HAMA scores in the surgery group were higher than those in the MWA group. VAS scores of surgery group were significantly higher than that of MWA on the day after treatment. Only thyroid-stimulating hormone (TSH) levels of surgery were significantly higher than baseline at the 1st, 3rd, 6th month. The incidence of complications in the two groups were similar. Conclusion: For cystic mainly nodules (solid portion <10 %, 10 % <= solid potion <50 %), MWA could be an alternative treatment option. For solid mainly nodules (50 % <= solid portion <95 %, solid portion >= 95 %), MWA could be another selection for patients who are intolerant to surgery, have high cosmetic requirements, and are in an anxious state. (c) 2025 Asian Surgical Association and Taiwan Society of Coloproctology. Publishing services by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/ by-nc-nd/4.0/).

Thyroid nodules are a common clinical condition, while thermal ablation (TA) has emerged as a minimally invasive alternative to surgery. Single-session ablation often fails to achieve complete symptomatic resolution in large, hypervascular nodules. Post-ablation carbonization further limits volumetric resorption, necessitating optimized therapeutic strategies. This pilot study aimed to evaluate the feasibility, safety, and preliminary efficacy of combined vacuum-assisted excision and thermal ablation (VAE-TA) for symptomatic benign thyroid nodules refractory to initial ablation. From December 2023 to January 2025, five patients underwent VAE-TA at a single center. Inclusion criteria included persistent symptoms ≥12 months post-initial ablation and confirmed benignity via fine-needle aspiration. The procedure involved ultrasound-guided vacuum-assisted excision of post-ablation fibrotic tissue followed by microwave ablation. Primary outcomes included feasibility and safety, while secondary outcomes focused on volume reduction rate (VRR) and symptom improvement. Patients were followed up at 1 and 6 months. These preliminary findings suggest that VAE-TA may be a feasible, minimally invasive salvage approach for selected symptomatic benign thyroid nodules with incomplete response to initial ablation, although larger, controlled studies with longer follow-up are required.

Ultrasound-guided Vacuum-Assisted Breast Biopsy has been widely utilized as a key modality for breast nodule resection. Nevertheless, its application remains relatively contraindicated in patients who have undergone breast prosthesis placement. This study aimed to evaluate the feasibility and safety of ultrasound‑guided vacuum‑assisted breast biopsy (US‑VABB) for the resection of breast nodules ≤ 1.5 cm with BI-RADS 3-4a in patients with retroglandular breast implants. A single-center retrospective observational study was conducted on patients with breast nodules who underwent US-VABB in the Department of Ultrasound, Beijing Friendship Hospital, Capital Medical University from January 2020 to October 2024. A total of 18 patients (18 nodules) who had previously undergone breast implant placement with implants located behind the glandular tissue were included. The complete nodule resection rate, implant-related complications, postoperative pathological results, and short-term follow-up data were analyzed. Primary outcomes included complete resection rate and implant-related complications, while secondary outcomes included pathological findings and short-term follow-up results. The maximum diameter of the nodules in the 18 patients ranged from 0.5 to 1.5 cm (mean: 1.1 ± 0.4 cm), and all nodules were completely resected in a single operation, with no evidence of residual lesions on imaging. No serious complications such as breast implant rupture or leakage occurred during or after the operation. The implant rupture rate was 0% (0/18), and minor complications occurred in 16.7% of patients. Postoperative pathology revealed fibroadenoma (n=11), breast adenosis (n=3), intraductal papilloma (n=2), atypical ductal hyperplasia (n=1), and ductal carcinoma in situ (DCIS, n=1). The patient with DCIS underwent additional resection, with no residual tumor detected. These findings demonstrate that US-VABB is a safe and feasible minimally invasive approach for patients with retroglandular breast implants presenting with breast nodules ≤1.5 cm and BI-RADS 3-4a, with high resection success and low complication rates.

Background:Accurate and noninvasive quantification of hepatic steatosis is essential for managing metabolic dysfunction-associated steatotic liver disease (MASLD). This study evaluated the diagnostic accuracy, spatial stability, and clinical correlates of ultrasound-derived fat fraction (UDFF) in MASLD patients. Methods:In this prospective study of an Asian population, we enrolled 109 patients with MASLD and 20 healthy controls. UDFF was measured across hepatic segments V-VIII, with the mean value (UDFF mean) calculated. Magnetic resonance imaging-proton density fat fraction (MRI-PDFF) served as the reference standard. Diagnostic performance, agreement, and determinants were assessed using receiver operating characteristic (ROC) curves, Bland-Altman analysis, and multivariable regression. Results:UDFF mean increased stepwise with MRI-PDFF-defined steatosis grades (P<0.0001). The areas under the curve (AUCs) for detecting ≥S1, ≥S2, and S3 steatosis were 1.00, 0.99, and 0.99, respectively. Optimal cut-off values were 5.09%, 11.18%, and 18.46%. UDFF demonstrated excellent reproducibility with an intraclass correlation coefficient (ICC) of 0.98 and showed no significant systematic bias on Bland-Altman analysis. Alanine aminotransferase (ALT), gamma-glutamyl transferase (GGT), age, and sex were independently associated with UDFF (all P<0.05). Conclusions:UDFF provides a stable and accurate ultrasound-based assessment of hepatic fat burden in MASLD, with excellent agreement with MRI-PDFF and high spatial reproducibility, supporting its clinical utility for noninvasive risk stratification and longitudinal monitoring.

BACKGROUND:Graft fibrosis is a critical pathological endpoint of chronic injury after liver transplantation (LT). While serum-based scores are validated in native liver diseases, their efficacy in LT recipients remains controversial. This study compared the diagnostic performance of shear wave elastography (SWE) with common serological indices (APRI, FIB-4, GPR) for detecting significant graft fibrosis (≥S2) in adult and pediatric recipients. METHODS:We retrospectively analyzed 111 LT recipients (63 adults, 48 children) who underwent liver biopsy and concurrent SWE/biochemical testing. Fibrosis was staged by the Scheuer classification. Diagnostic accuracy was evaluated using Spearman correlation and receiver operating characteristic (ROC) curves, stratified by recipient and graft age. RESULTS:SWE demonstrated the strongest correlation with histological fibrosis stage (ρ = 0.76, p < 0.001), significantly outperforming all serological indices. For the detection of significant fibrosis, SWE achieved an AUC of 0.927 (95% CI: 0.879-0.975), superior to GPR (0.759), APRI (0.691), and FIB-4 (0.594). Notably, FIB-4 showed no significant correlation with fibrosis (ρ = -0.02, p = 0.818). SWE maintained high diagnostic accuracy across adult and pediatric recipients, with optimal cut-off values of 10.14 kPa and 10.92 kPa. Moreover, SWE exhibited stable performance across different graft ages, whereas serological indices showed marked variability in the early post-transplant period. CONCLUSION:SWE provides a superior and more stable assessment of graft fibrosis compared to conventional serological models in both adult and pediatric LT recipients. Given its high NPV, SWE serves as a robust first-line tool for long-term non-invasive graft surveillance.

Background:Ductal carcinoma in situ (DCIS) cases diagnosed by ultrasound-guided core needle biopsy (US-CNB) carry a risk of postoperative upstaging to invasive breast carcinoma, complicating clinical management. This study aimed to investigate clinicopathological and ultrasound (US) predictors for postoperative upstaging and to develop a nomogram for individualized risk prediction. Methods:A total of 240 patients with 246 DCIS lesions diagnosed by US-CNB were enrolled in this retrospective study from May 2013 to January 2025. Clinicopathological and US features were compared using the Student's t-test for continuous variables and the Chi-squared or Fisher's exact test for categorical variables. Multivariate logistic regression identified predictors of upstaging to DCIS with invasive components (DCIS-IC). A nomogram was developed and internally validated. Discrimination was assessed using the area under the receiver operating characteristic curve (AUC-ROC) with 1,000 bootstrap replicates. Calibration was evaluated through calibration curves and the Hosmer-Lemeshow (H-L) test, and clinical utility was examined using decision curve analysis (DCA). Results:Among all the lesions, 161 (65.4%) were diagnosed as pure DCIS, while 85 (34.6%) were upstaged to DCIS-IC, including 37 (15.0% of total) with microinvasive carcinoma. Age [per 1-year increase, odds ratio (OR) =1.04; 95% confidence interval (CI): 1.01-1.06; P=0.01], Ki-67 >20% (OR =2.56; 95% CI: 1.35-4.86; P=0.004), and suspicious axillary lymph node (ALN) on US (OR =3.00; 95% CI: 1.07-8.45; P=0.04) were independent predictors of postoperative upstaging to DCIS-IC. The nomogram showed moderate discrimination with an apparent area under the curve (AUC) of 0.72 (95% CI: 0.65-0.78), which was internally validated as 0.70 (95% CI: 0.66-0.72) using 1,000 bootstrap replicates. It demonstrated good calibration (H-L test, P=0.86). The DCA showed that the nomogram provided net benefit across a threshold probability range of 20% to 88% compared to default strategies. Although larger tumor size (>1 cm; P=0.02) and non-circumscribed mass margins (P=0.03) were associated with upstaging in univariate analysis, they were not retained as independent predictors in the multivariate model. Conclusions:The nomogram incorporating age, Ki-67, and suspicious ALN on US effectively predicts DCIS upstaging risk in cases diagnosed by US-CNB and may assist in clinical decision-making. US characteristics (size >1 cm, non-circumscribed mass margins) may provide supplementary information but require further validation.

OBJECTIVE:To investigate the diagnostic value of quantitative analysis using ultra-resolution microscopy (URM) in differentiating benign from malignant breast lesions. MATERIAL AND METHODS:This prospective study enrolled 60 patients with 60 breast lesions who underwent contrast-enhanced ultrasound (CEUS) using SonoVue (Bracco Imaging, Italy) between June 2024 and August 2024. Quantitative parameters of microvascular density and velocity maps were generated for the lesion interior, rim region, and combined interior and rim area using URM software on CEUS images. The parameters were analyzed for differences between benign and malignant breast lesions, and their diagnostic efficacy was evaluated. RESULTS:Multivariate analysis indicated that breast malignancy was associated with microvascular ratio and complexity level. The area under the curve (AUC) for the combined diagnostic method that included microvascular parameters at the lesion margin (Rim group) and BI-RADS classification + Rim was higher than other diagnostic approaches (AUC = 0.92), although there was no significant difference when compared with the combined approach of evaluating parameters within the lesion and at the margin alongside BI-RADS (Mass + Rim + BI-RADS group, P = .293). The BI-RADS group showed high sensitivity (100%) and negative predictive value (100%); the Mass group (parameters within the lesion) demonstrated higher sensitivity (87.0%), and the Rim group (parameters at the lesion margin) exhibited the highest specificity (91.9%). CONCLUSION:URM shows potential in distinguishing between benign and malignant breast lesions, offering a precise assessment of lesion hemodynamics and providing valuable information for clinical diagnosis and treatment.

Objective To retrospectively analyze the efficacy and safety of laser ablation (LA) and microwave ablation (MWA) in the treatment of papillary thyroid microcarcinoma (PTMC). Methods This was a retrospective study of 103 patients (109 nodules) who underwent thermal ablation for PTMC between October 2019 and March 2023; 61 underwent LA and 48 underwent MWA. The mean patients' age was 43.50 ± 12.42 years. After ablation, changes in tumor size at different time points, local recurrence, new lesions, lymph node metastasis, and complications were evaluated and recorded. The feasibility, success rate, and safety of LA and MWA were analyzed. Results Complete absence of enhancement on contrast-enhanced ultrasonography was observed in all target tumors after ablation. At the last follow-up, the mean volume of the PTMC nodules decreased from 0.09 ± 0.09 to 0.03 ± 0.03 ml (LA group) and from 0.11 ± 0.10 to 0.06 ± 0.08 ml (MWA group) (both, P < 0.05). There was no significant difference in volume change between the groups (P (groups): 0.520; P (groups over time): 0.423), indicating similar efficacy between the groups. There was also no significant difference in the volume reduction rate between the groups during follow-up, except for at 3 months (P = 0.023). The complication rates did not differ between the LA group (8.2 %) and MWA group (6.3 %) (P > 0.05). Conclusion During the short-term follow-up, ultrasound-guided LA and MWA were effective and safe for PTMC, and there were no significant differences in treatment outcomes between the methods.

ObjectivesDifferentiation of benign and malignant changes in lymph nodes is extremely important. We aimed to identify the ultrasound and clinical diagnostic criteria permitting this differentiation.MethodsClinical and ultrasound data were collected at Beijing Friendship Hospital from May 2019 to November 2020. Univariate and multivariate analysis were performed using statistical methods, and a mathematical model was established to evaluate benign and malignant lymph nodes.ResultsA total of 1343 LNs (person) with US‐guided core needle or fine needle biopsy (CNB or FNB) were evaluated in the analysis. Variables with a high predictive power were sex (odds ratio, OR: 3.360, p<0.001), short diameter (OR: 4.660, p<0.001), short/long diameter (S/L) ratio (OR: 1.515, P=0.007), border (OR: 1.626, p=0.002), cortex echogenicity (OR: 2.089, P<0.001), fusion (OR: 2.313, p=0.002), vascularity (peripheral vascularity, OR: 3.424, p<0.001; mixed vascularity, OR: 4.127, p<0.001), and medical history (fever/local pain, OR: 0.316, p<0.001; tumor history in the drainage area, OR: 4.595, p<0.001; both, OR: 5.554, p<0.001). The cut-off score on receiver operating characteristic (ROC) curve analysis using these eight variables was 2.5. The largest area under the ROC curve (Az) value was 82.3% (95% confidence interval (CI), 0.805–0.851), and the sensitivity (79.4%), specificity (72.3%), and accuracy (74.8%) were higher than those for nearly all the single indices.ConclusionThe model of combination of ultrasound and clinical symptoms can preliminarily evaluate the benign and malignant of lymph nodes.

目的:评估新型智能三维脑血流成像系统诊断颅内动脉病变与常规经颅多普勒(TCD)诊断结果的一致性,验证三维成像系统检查方法作为筛查颅内血管狭窄的有效手段.方法:在通过伦理学审查及中国临床试验中心注册后,选取医院神经内科脑血流图室就诊的57例脑血管病患者,使用三维脑血流成像系统共采集患者双侧114支大脑中动脉(MCA)的三维图像及血流频谱,评估三维成像系统采集成功率,根据测得血流频谱判断其狭窄情况,并与TCD诊断的狭窄结果进行对比,采用一致性检验评估三维成像系统与TCD诊断结果的一致性.结果:三维成像系统采集的114支MCA中采集成功93支,采集成功率为81.6％;三维成像系统诊断MCA无狭窄73支,TCD诊断MCA无狭窄71支;三维成像系统诊断MCA轻-中度狭窄12支,TCD诊断MCA轻-中度狭窄14支;三维成像系统诊断MCA重度狭窄-闭塞8支,TCD诊断MCA重度狭窄-闭塞8支;三维成像系统与TCD诊断MCA狭窄具有较好的一致性(Kappa=0.942,P<0.05).结论:智能三维脑血流成像系统与TCD诊断一致性均在中等以上,在一定程度上可以作为MCA狭窄有效的筛查方法.

目的:探讨改良隔离法在高风险甲状腺结节消融时对周围组织保护的应用价值.方法:选取医院收治的656例行微波消融的甲状腺良性病变结节患者,消融时向甲状腺病灶所在腺体及周围结构建立隔离带,按隔离方法的不同将其分为传统隔离组(310例)和改良隔离组(346例),比较两种隔离方法在术中的应用效果.结果:传统隔离组和改良隔离组术中隔离液的注入量分别为(33.17±9.31)ml和(47.77±14.14)ml,差异有统计学意义(t=-4.722,P<0.05);传统隔离组和改良隔离组消融时间分别为(108.52±73.72)s和(106.07±78.44)s,差异无统计学意义(t=0.291,P>0.05);传统隔离组与改良隔离组并发症发生情况中,喉返神经永久损伤分别为2例及0例,短暂性声音嘶哑(3月内恢复)分别为15例及2例,差异有统计学意义(x2=16.254,P<0.05);传统隔离组与改良隔离组术区疼痛感分别为158例和132例,差异有统计学意义(x2=10.482,P<0.05);传统隔离组与改良隔离组视觉疼痛评分分别为(3.78±0.70)分和(3.29±0.75)分,差异有统计学意义(t=-2.100,P<0.05);传统隔离组与改良隔离组颈部肿胀感分别为42例和108例,差异有统计学意义(x2=64.149,P<0.05);传统隔离组与改良隔离组二次消融率分别为4.84％和0.58％,差异有统计学意义(x2=10.131,P<0.05).结论:改良隔离法在高风险甲状腺结节消融术中有效的减少了并发症的发生,保证了手术的成功实施.

Abstract Background To compare the short-term clinical outcomes of ultrasound-guided microwave ablation (MWA) and parathyroidectomy (PTX) for severe secondary hyperparathyroidism(SHPT). Methods In a prospective multi-center study, we compared the outcomes of MWA and PTX for severe SHPT. The outcome measures were case rate of successful treatment, improvement of clinical symptoms, incidence of complications, and differences in treatment parameters and costs between the two groups. Results A total of 167 eligible patients were included in the study, of which 79 underwent MWA and 88 underwent PTX. There was no significant difference in rate of successful treatment between the MWA and PTX groups (χ2=2.299, p = 0.125). However, the MWA group showed significantly lower range of intact parathyroid hormone (iPTH) decrease than the PTX group (t=−2.352, p = 0.023). Postoperative clinical symptoms improved in both groups, with no significant difference between the two groups (p > 0.05). Postoperative hypocalcemia was significantly more common in the PTX group (p < 0.05). The operative time, incision and postoperative pain of the MWA group were significantly better than those of the PTX group (p < 0.05), while postoperative recurrent laryngeal nerve injury and hematoma showed no significant difference between the two groups (p > 0.05). The cost of MWA was significantly less than PTX (p = 0.000). Conclusions Both MWA and PTX are effective and safe for severe secondary hyperparathyroidism. PTX is more thorough and traumatic, while MWA is minimally invasive and postoperative iPTH is more consistent with the Kidney Disease: Improving Global Outcomes (KDIGO) recommendation.

目的:分析探讨浅表转移性淋巴结及淋巴瘤的声像图特点,以提高超声诊断准确率.方法:选取医院收治的136例(138枚)浅表转移性淋巴结及淋巴瘤(除甲状腺癌外)患者,依据病理结果将其分为淋巴瘤组(39例,40枚)和转移组(97例,98枚),所有患者均在放化疗前经超声诊断并采集声像图,分析其临床和声像图特点,包括是否合并临床症状和(或)体征、淋巴结大小、形状、边缘、淋巴结门回声、皮质回声、内部回声、有无钙化及血流模式.结果:淋巴瘤组出现临床症状和(或)体征、可触及肿块及发热的比例高于转移组,差异有统计学意义(x2=18.816,x2=8.166,x2=4.957;P<0.05);淋巴瘤组较转移组的淋巴结长径更大,差异有统计学意义(t=1.678,P<0.05).两组形态不规则、淋巴结门样血流、周边血流、网格样改变及部分极低回声或条索样改变以及回声不均匀比较,差异均有统计学意义(x2=15.971,x2=8.530,x2=10.344,x2=43.488,x2=32.137;P<0.05).在纳入的可疑超声征象中,网格样改变、部分极低回声或条索样改变较好的提示为淋巴瘤;而回声不均匀、形态不规则提示为转移性淋巴结.结论:淋巴瘤的声像图特点与转移性淋巴结存在差异,常规超声对鉴别浅表转移性淋巴结及淋巴瘤有一定临床意义.

Abstract Purpose To explore the clinical outcomes and safety of ultrasound-guided microwave ablation (MWA) for treating thyroid benign solid nodules during a three-year follow-up. Methods A total of 53 patients with thyroid benign solid nodules with the largest diameter exceeding 2 cm were treated with US-guided MWA between January 2015 and December 2017. Nodule volume, the cosmetic score, and the symptom scores were evaluated before ablation and 1, 2, and 3 years after the operation. The characteristics of MWA and complications were also evaluated. Results The thyroid nodule volume at each time point after ablation was significantly smaller than that before ablation (p < .05). The Symptom and Cosmetics score were significantly improved (p < .05). Hoarseness was the major complication, with an incidence of 1.89%. The original nodules volume was 7.28 ± 11.42 mL; the isolating fluid was 34.36 ± 13.35 mL; the ablation time was 188.77 ± 89.13s. Conclusions MMA is an effective and safe approach for reducing nodule volume and symptoms in patients with benign thyroid solid nodules.

PURPOSE:The aim of this article was to determine the efficacy and safety of the combined use of ethanol and microwave (MWA) to thyroid cysts and explore the differences of various cysts. MATERIALS AND METHODS:A total of 136 patients and 142 thyroid cystic nodules and predominantly cystic nodules received combination therapy of ethanol and MWA between January 2016 and December 2019 in BeiJing Friendship Hospital. They were divided into different groups according to the size, and the characteristics of fluid aspirated. We compared the Initial size, treatment procedure, postoperative complications, and follow-up results to analyze the characteristics of different groups. RESULTS:The combination treatments reduced the size of cysts by more than 93% with less complications at the end of follow-up. The treatment duration was longest in the colloid cysts (difference from the clear-fluid group, p < 0.01), the absolute volume of the clear-fluid group at the end of follow-up was the smallest (difference from the other two groups: P < 0.01).There were the similar mean volume reduction rate (VRR) between the large cysts and the small cysts (p > 0.05). CONCLUSION:The combination treatments were applicable to all types of cysts. Understanding the characteristics of different cystic nodules and adopting different methods are helpful for us to carry out the minimally invasive treatment of cysts better.

目的 探讨液体隔离法在超声引导乳腺表浅良性结节真空辅助旋切术中的应用价值.方法 选取86例乳腺表浅良性结节(与皮肤间距＜0.5 cm)患者,采用液体隔离法增加结节与皮肤间的距离,超声实时引导下真空辅助全自动乳腺微创旋切系统切除结节,分析所有患者治疗效果及安全性.结果 86例患者89个病灶均一次性成功切除,成功率100％;术后3个月超声复查无残留及复发;术后6个月超声检查原病灶区复发1例,复发率1.16％;术后无1例皮肤出现损伤;术后24～48 h扫查术区,71例(82.56％)出现小血肿,其中59例术后1个月消失,余12例术后3个月消失;术后1周12例(13.95％)皮肤出现凹陷,8例(9.30％)皮肤出现瘀斑,均于1个月内恢复正常.结论 超声引导下真空辅助旋切术切除乳腺表浅良性结节时应用液体隔离法安全、有效.

Background The optimal treatment method for papillary thyroid microcarcinoma (PTMC) is lacking consensus. Here we aimed to compare the efficacy and safety of surgery and microwave ablation (MWA) for PTMC. Methods The clinical data of 644 patients with PTMC treated between July 2013 and June 2020 were retrospectively analyzed. A total of 320 and 324 patients underwent MWA and surgery, respectively. We observed lesion changes in the MWA group and compared the recurrence, metastasis, complications, and other health economic indicators between the 2 groups. Results The mean follow-up time was 890.7 +/- 532.9 (187.9-2679.0) days in the MWA group and 910.9 +/- 568.4 (193.8-2821.5) days in the surgery group. In the MWA group, lesion volume increased significantly after ablation and then gradually decreased. The final lesion volume reduction rate was 90.73% +/- 7.94%, and 193 lesions (60.3%) disappeared completely. There were no significant intergroup differences in recurrence or metastasis. The incidence of main complications (temporary hypothyroidism, hypoparathyroidism, and temporary hoarseness) was significantly lower in the MWA group than in the surgery group (p < 0.001). The treatment time, intraoperative blood loss, and hospital stay were significantly lower in the MWA group than in the surgery group (p < 0.001). Conclusions MWA is effective for treating PTMC, with a low incidence of complications and less trauma. The rates of post-treatment recurrence and metastasis are similar to those of surgery, indicating that MWA is a suitable alternative to surgery.

目的:探讨超声引导下乳腺良性结节微创旋切术后血肿形成影响因素及其预后.方法:选取有完整随访记录的68例(79枚结节)乳腺结节患者,对其均行超声引导下乳腺良性结节真空辅助微创旋切手术治疗,于术后24 h、1周、1个月、3个月以及6个月时超声复查血肿形成及吸收情况,分析血肿形成的影响因素.结果:68例患者术后24 h有44例形成血肿,术后一周血肿吸收4例(占9.1％),术后1个月血肿吸收19例(占43.2％),术后3个月血肿吸收40例(占90.9％),术后6个月血肿吸收43例(占97.7％).多因素Logistics回归分析结果显示,非纤维腺瘤良性乳腺病变、周边组织结构以脂肪组织为主、结节深度≤0.65 cm或≥1.5 cm和血流信号Adler血流分级2级或3级为血肿形成的独立危险因素(OR=6.5,OR=6.8,OR=14.1,OR=4.7;P<0.05).结论:超声引导下乳腺良性结节微创旋切术后血肿形成后无需特殊干预,可于6个月基本消失.非纤维腺瘤的良性乳腺病变、结节周边以脂肪组织为主、结节过深或过浅以及结节血流较丰富(血流信号Adler血流分级≥2级)是血肿形成的危险因素,此类结节应警惕血肿的形成.