IntroductionSpindle cell and sclerosing rhabdomyosarcoma (Sc/SRMS) are rare histologic subtypes of rhabdomyosarcoma, increasingly recognized for their distinct molecular profiles and aggressive clinical behavior. Retroperitoneal involvement is exceptionally uncommon and poorly characterized. To characterize the clinical, pathological, and molecular features of retroperitoneal Sc/SRMS through a combined institutional case series and individual patient data (IPD) meta-analysis.MethodsWe retrospectively analyzed 12 adult patients with retroperitoneal Sc/SRMS treated at Peking University International Hospital between 2014 and 2023. Clinical data, imaging, histopathology, immunohistochemistry, and MYOD1 mutation status were evaluated. In parallel, we conducted a systematic review and IPD meta-analysis of 136 publications, yielding 403 unique Sc/SRMS cases. Data were extracted on demographics, tumor characteristics, treatment, molecular alterations, and outcomes.ResultsAll institutional cases presented with large, high-grade retroperitoneal tumors, frequently invading adjacent organs. MYOD1 mutations were detected in 33.3% of patients, and MyoD1 immunopositivity exceeded myogenin (92% vs. 42%, P<0.05). All patients experienced local recurrence; 83.3% died of disease. Kaplan-Meier analysis revealed a 2-year survival rate of 40%. The IPD meta-analysis identified six additional retroperitoneal cases, none of which reported molecular data. Across the full dataset, MYOD1 and PIK3CA mutations were observed in 95.5% and 100% of tested cases, respectively. Fusion genes such as FUS::TFCP2 and EWSR1::TFCP2 were also prevalent. Overall, 34.7% of patients died of disease and 41.7% developed local recurrence.DiscussionRetroperitoneal Sc/SRMS exhibits a highly aggressive clinical course, marked by extensive local invasion, high recurrence rates, and poor survival. Our institutional series represents the largest molecularly characterized cohort of retroperitoneal cases to date. Integration with IPD meta-analysis supports the importance of MYOD1 mutation and highlights the frequency of PIK3CA co-mutations. However, these frequency estimates are derived from a subset of tested cases and should be interpreted within the context of variable molecular data reporting across studies. These findings highlight the potential value molecularly guided treatment strategies in this rare and lethal disease subtype.

Background:Adult primary retroperitoneal lymphangioma (RPL) is an exceptionally rare benign vascular malformation. This study aims to elucidate the clinical presentation, imaging characteristics, management strategies, and long-term outcomes of this condition. Methods:We conducted a retrospective analysis of our prospectively maintained retroperitoneal tumor database at Peking University International Hospital (2014-2024). Inclusion criteria comprised adults (≥18 years) undergoing initial surgical resection with pathological RPL confirmation. Patients with other malignancies or recurrent disease were excluded. Comprehensive follow-up was performed to assess outcomes. Results:Among 28 enrolled patients (13 males, 15 females; median age 31 years), clinical presentation included incidental discovery (42.9%), abdominal discomfort (42.9%), lumbago (10.7%), and lower limb pain (3.6%). Preoperative imaging assessment was performed using Ultrasonography (US) (82.1%), computed tomography (CT, 100.0%), and magnetic resonance imaging (MRI, 14.3%). Characteristic CT findings typically included thin-walled multiloculated cystic masses with septal enhancement. All patients achieved R0/R1 resection, with 18 open and 10 laparoscopic procedures (2 conversions). Major complications occurred in 10.7% of cases (lymphatic leakage: 2; pancreatic fistula: 1), all resolving with appropriate management. Histopathological and immunohistochemical analysis confirmed lymphatic differentiation (D2-40: 100%; CD31: 89.3%; CD34: 84.6%). During median follow-up of 76 months, no recurrences or disease-specific mortality were observed. Conclusions:RPL represents a rare benign tumor frequently presenting with nonspecific symptoms. Complete surgical resection demonstrates excellent safety and long-term efficacy, with individualized approach selection based on tumor characteristics. Our findings from this substantial Chinese adult cohort provide valuable insights for managing this uncommon condition.

Crisscross heart (CCH) is an extremely rare congenital cardiac malformation, and literature on long-term outcomes after total cavopulmonary connection (TCPC) in CCH patients remains limited. We report a unique case demonstrating sustained anastomotic patency and objective postoperative evolution 26 years after TCPC in a patient with CCH. A 39-year-old female with crisscross heart and double-outlet right ventricle underwent TCPC at age 13 in 2000. Serial Doppler echocardiography (2013–2026) consistently demonstrated patent superior vena cava–right pulmonary artery anastomosis and inferior vena cava conduit without obstructive flow velocities (SVC-RPA: 30.6–43.9 cm/s; IVC conduit: 39.0–23.2 cm/s). The clinical course was complicated by progressive atrial arrhythmias: first-degree atrioventricular block with atrial premature beats (2017), atrial fibrillation with incomplete right bundle branch block (2020), and atypical atrial flutter (2026). NT-proBNP increased from 124 pg/mL (2024) to 592.3 pg/mL (2026), with persistently elevated hemoglobin (164–171 g/L). Management included beta-blockers for rate control and clinical surveillance without anticoagulation. At 26 years post-TCPC, the patient maintained NYHA functional class II, with patent Fontan pathways and preserved left ventricular function (EF 60%, 2026), and no protein-losing enteropathy, plastic bronchitis, or thromboembolic events. This case demonstrates that durable anastomotic patency and preserved functional status are achievable, while highlighting the inevitability of progressive atrial arrhythmias necessitating lifelong surveillance.

OBJECTIVES:To assess critical care ultrasound (CCUS) utilization, training coverage, and barriers to implementation among ICU clinicians across economically diverse regions in China.DESIGN:An online cross-sectional survey with chi-square tests, Mann-Whitney U tests, multivariate logistic regression, and principal component analysis (PCA)-based clustering.SETTING:ICU clinicians from all 31 provincial-level regions in mainland China, classified into high- and low-gross domestic product (GDP) groups by per capita GDP relative to the national average.SUBJECTS:Six hundred fifty-five ICU clinicians who completed the survey.INTERVENTIONS:The survey included demographics, CCUS training experience, equipment availability, clinical usage frequency, and perceived implementation barriers.MEASUREMENTS AND MAIN RESULTS:A total of 61.4% of respondents reported receiving CCUS training, with similar coverage between high- and low-GDP regions (61.9% vs. 60.8%; p = 0.769). Clinicians from high-GDP areas reported significantly higher self-assessed ultrasound proficiency (p = 0.008). Dedicated ultrasound equipment was unavailable in approximately one-third of ICUs, slightly more common in low-GDP regions (37.7% vs. 31.4%; p = 0.094). Major barriers included insufficient expert support (36.9%), lack of ultrasound consultants (31.3%), and difficulties in image interpretation (31.1%). Logistic regression analysis showed structured training significantly reduced the odds of encountering equipment-related barriers (odds ratio, 0.57; 95% CI, 0.34-0.97; p = 0.036). PCA-based clustering identified three clinician profiles: frequent users (high training and usage, predominantly from high-GDP areas), moderate users, and infrequent users (limited training and primarily from low-GDP regions).CONCLUSIONS:Structured CCUS training significantly enhances utilization and clinician expertise, irrespective of regional economic conditions. Policies promoting standardized training, equitable equipment distribution, and sustainable expert support are essential for broader CCUS integration in critical care settings across China.

ObjectiveTo measure wall shear stress (WSS), oscillatory shear index (OSI) and relative residence time (RRT) at multiple locations along the femoropopliteal artery in adults without peripheral artery disease (PAD), and to investigate whether low WSS, high OSI and/or high RRT are present in regions with a high prevalence of atherosclerotic lesions.Materials and methodsA total of 116 presumed healthy adult volunteers were recruited. Ankle-brachial index and lower-limb arterial duplex ultrasound assessments were performed to exclude participants with PAD. Maximum WSS, mean WSS, and OSI were measured at the near and far walls of ten arterial sites along the femoropopliteal artery using ultrasound vector flow imaging (VFI). RRT was calculated from OSI and mean WSS values obtained via VFI.ResultsA total of 113 participants (46 males and 67 females; 222 lower limbs), with a mean age of 37.6 years, were included in the analysis. Compared to the overall mean values across all 20 measurement sites, significantly higher OSI and higher RRT were recorded at the posterior wall of the common femoral artery (P < 0.01), while significantly lower WSS, higher OSI, and higher RRT were observed at the posterior wall of the femoral artery bifurcation (P < 0.01). The distal superficial femoral artery (SFA) at the adductor canal demonstrated significantly lower WSS and higher OSI at both near and far walls (P < 0.01). When comparing hemodynamic indices between sexes, males exhibited significantly lower WSS at several near-wall sites, significantly higher OSI at multiple near- and far-wall sites, and significantly higher RRT at the near wall of the proximal SFA and the far wall of the profunda femoris artery (P < 0.05).ConclusionsVariations in WSS, OSI, and RRT are evident along the femoropopliteal artery in adults without PAD. Notably, the distal SFA at the adductor canal demonstrated significantly lower and more oscillatory WSS, consistent with the region's reported high prevalence of atherosclerotic plaque and occlusion. Whether these hemodynamic patterns contribute to lesion development later in life remains uncertain and warrants further investigation.

Objectives: Retroperitoneal nerve sheath tumors are uncommon, representing a small fraction of all primary retroperitoneal neoplasms. Accurate differentiation between benign and malignant forms is essential for optimal clinical management. This study assessed the clinical profiles and sonographic traits of retroperitoneal nerve sheath tumors with the goal of enhancing diagnostic precision and developing therapeutic strategies. Methods: A retrospective analysis of patients diagnosed with benign retroperitoneal nerve sheath tumors who completed surgical treatment and underwent ultrasound imaging was carried out. Tumors were classified based on sonographic features and blood flow characteristics as per Adler's grading system. Statistical analysis was performed using SPSS 25.0. ROC curve analysis was carried out to determine the optimal diagnostic cutoff values. Results: A total of 49 patients were included in the study. There were no significant variances in age, gender, or tumor localization among the groups. However, pronounced disparities were observed in tumor number, size, shape, definition of borders, internal echo pattern, structural composition, presence of calcification, and blood flow signals between the classic and malignant groups. Notably, malignant tumors tended to manifest as larger masses with indistinct margins and irregular shapes. The maximum tumor diameter emerged as a discriminating factor for malignancy, with a diagnostic cutoff of 9.9 cm, yielding an AUC of 0.754 from the ROC curve analysis. Conclusion: This study outlines the distinctive clinical and sonographic features of retroperitoneal nerve sheath tumors, with a particular focus on malignant subtypes. Ultrasonography emerges as a valuable diagnostic tool, contributing to the differentiation of tumor categories and potentially to the development of targeted treatment strategies. The identification of specific sonographic markers may facilitate the early detection and detailed characterization of these tumors, which could contribute to improved patient outcomes.

ObjectiveThis study aims to develop and internally validate a multivariable logistic regression model and a simplified scoring system, based on standardized ultrasonographic features, for the preoperative differentiation of retroperitoneal ganglioneuroma (GN) from schwannoma (SW), and to evaluate their discrimination, calibration, and clinical utility.MethodsWe retrospectively included patients with retroperitoneal GN or SW confirmed by surgical pathology. Standardized ultrasonographic features were extracted, and candidate predictors were selected using least absolute shrinkage and selection operator (LASSO) regression, while retaining potential confounders (age, sex, lesion long diameter). A multivariable model was constructed, and a six-variable simplified score was derived. Discrimination [area under the curve (AUC)], calibration (intercept, slope, Brier score), and decision curve analysis (DCA) were evaluated using stratified fivefold cross-validation and bootstrap resampling (B = 2,000). Two task-oriented thresholds were predefined: R1 [rule-out, sensitivity (Se) ≥ 0.95] and S1 [standard diagnosis, specificity (Sp) ≥ 0.50].ResultsA total of 74 patients were included (GN, 25, 33.8%; SW, 49, 66.2%). After optimism correction, the multivariable model achieved an AUC of 0.930, and the simplified score achieved an AUC of 0.917. Independent predictors included pelvic extraperitoneal location (loc_pelvic = 1), absence of cystic/necrotic change, and lower SD/LD ratio. For R1, the model threshold of 0.149 yielded Se = 0.960, Sp = 0.837, and negative predictive value (NPV) = 0.976; the score threshold of 0.206 yielded Se = 1.000, Sp = 0.592, and NPV = 1.000. For S1, the model threshold of 0.426 yielded Se = 0.920 and Sp = 0.939, and the score threshold of 0.594 yielded Se = 0.760 and Sp = 0.918.ConclusionBoth the multivariable model and the simplified score demonstrated excellent performance in differentiating GN from SW, suggesting potential value as rapid, interpretable tools for bedside use and in resource-limited settings. Their clinical utility should be confirmed through external validation and recalibration in multicenter, prospective cohorts and further enhanced through integration with multimodal imaging such as CT, MRI, and contrast-enhanced ultrasound (CEUS).

This study aimed to compare clinical and pathological features of retroperitoneal classical schwannomas and cellular schwannomas. A total of 64 cases of retroperitoneal classical schwannoma and 48 cases of cellular schwannoma were studied. Histopathological analysis was performed using hematoxylin and eosin staining and immunohistochemistry. Retroperitoneal cellular schwannomas exhibited 100% (48/48) and 75% (36/48) positive expression for glial fibrillary acidic protein (GFAP) and cytokeratins (CK), respectively. Classical schwannomas showed rates of 6.25% (4/64) and 15.63% (10/64), respectively (P < .05). In classic schwannomas, 85.9% (55/64) showed a reticular pattern of positive anti-CD34 staining around tumor margins and subcapsular areas vs 52.1% (25/48) in cellular schwannomas (P < .05). Cellular schwannomas exhibited more mitotic figures than classical schwannoma (P < .05). The recurrence rate of cellular schwannomas was 10.42% (5/48), while that of classical schwannomas was 1.56% (1/64) (P < .05). Retroperitoneal cellular schwannomas commonly express GFAP and CK compared to classical schwannomas, suggesting that cellular schwannoma may originate from unmyelinated Schwann cells, while classical schwannoma may originate from myelinated Schwann cells. Anti-CD34 staining patterns may be used to distinguish between the 2 types. Retroperitoneal cellular schwannomas also show higher mitotic activity and are more prone to recurrence.

Abdominal vascular compression syndrome (AVCS) is caused by the compression of abdominal blood vessels by adjacent structures or the compression of abdominal organs by neighboring blood vessels. Such compressions can result in a variety of clinical symptoms. They are not commonly seen in ultrasound practices, and their presence may have been underrecognized and underdiagnosed. This article reviews the clinical features, ultrasound characteristics, and diagnostic criteria of four types of AVCS, namely, celiac artery compression syndrome, renal vein compression syndrome, iliac vein compression syndrome, and superior mesenteric artery syndrome to increase awareness of these conditions among ultrasound practitioners. The ultrasound criteria for AVCS are primarily based on studies with small sample sizes, and therefore, it is important to exercise caution if these criteria are used.

Background This study evaluates the diagnostic accuracy of ultrasound-guided fine needle aspiration (US-FNA) and core needle biopsy (US-CNB) for detecting axillary lymph nodes in women with breast cancer. Methods Eligible studies and pertinent literature resources were identified in Cochrane, PubMed, Embase, CNKI, VIP, and Wanfang databases using subject-specific keywords. Study outcomes were tested for heterogeneity, and meta-analyses were performed to estimate sensitivity, specificity, and diagnostic odds ratios (DORs). The summary receiver operating characteristic (SROC) curve analysis was also performed. Results A total of 22 studies involving 3,548 patients were included to evaluate the diagnostic accuracy of US-FNA and 11 studies involving 758 patients were included to evaluate the diagnostic accuracy of US-CNB in identifying axillary lymph nodes in women with breast cancer. The accuracy of US-FNA in identifying suspicious axillary lymph nodes was as follows: overall sensitivity, 79% (95% CI: 73%–84%); global specificity, 96% (95% CI: 92%–98%); overall positive likelihood ratio, 18.55 (95% CI: 10.53–32.69); overall negative likelihood ratio, 0.22 (95% CI: 0.17–0.28); DOR, 71.68 (95% CI: 37.19–138.12); and the area under the SROC curve, 0.94 (95% CI: 0.92–0.96). The accuracy of US-CNB in identifying suspicious axillary lymph nodes was as follows: overall sensitivity, 85% (95% CI: 81%–89%); global specificity, 93% (95% CI: 87%–96%); overall positive likelihood ratio, 11.88 (95% CI: 6.56–21.50); overall negative likelihood ratio, 0.16 (95% CI: 0.12–0.21); overall DOR, 66.83 (95% CI: 33.28–134.21), and the area under SROC curve 0.96 (95% CI: 0.94–0.97). Conclusions The results indicate that both US-FNA and US-CNB have high accuracy for suspicious axillary lymph nodes.

Background This study sought to investigate the accuracy of estimating left atrial pressure (LAP) using the continuous wave Doppler spectrum of mitral regurgitation. Methods Dog models of left atrial hypertension with mitral regurgitation were established with disposable biopsy forceps and the injection of melamine formaldehyde resin microsphere suspension. A total of 40 models of left atrial hypertension with different hemodynamic statuses were established by injecting either esmolol or dobutamine in which the spectrums of mitral regurgitation were clear and the regurgitation velocity exceeded 3.5 m/s. The continuous wave Doppler spectrums of mitral regurgitation were recorded and analyzed to estimate left atrial pressure (LAPECHO). The mean left atrial pressure (LAPC-MEAN), the isovolumic diastolic left atrial pressure (LAPC-IVRT), the maximum left atrial pressure (LAPC-MAX), and the minimum left atrial pressure (LAPC-MIN) were also measured using the catheter method in the same cardiac cycle. Results The LAPECHO (mean ± standard deviation; 11.77±4.36 mmHg) was correlated with the LAPC-MEAN (11.51±4.77 mmHg; r=0.887, P=0.000), but the difference was not statistically significant (P=0.459). The LAPECHO was correlated with the LAPC-IVRT (12.16±4.72 mmHg; r=0.883, P=0.000), but the difference was not statistically significant (P=0.271). There was a correlation between the LAPC- MEAN and the LAPC-IVRT (r=0.987, P=0.000), and the difference was statistically significant (P=0.000). Conclusions This study suggests that the ultrasound evaluation of LAP correlates well with LAP measured using the gold standard catheter method, and is a simple, convenient, non-invasive method to quantitatively estimate LAP. This method is promising, but further large-scale animal experiments and clinical studies need to be conducted.

[This corrects the article DOI: 10.3389/fcvm.2022.829825.].

INTRODUCTION:This study aims to evaluate changes in the arterial spectral Doppler waveform in a canine artery stenosis model.METHODS:Canine femoral artery stenosis models were established in 12 beagle dogs. Doppler waveforms were recorded in the femoral artery preoperatively and postoperatively in the femoral artery and at the ankle after formation of a 50%, 70%, and 90% stenosis or occlusion. Major descriptors for arterial Doppler waveform were used to analyse waveforms.RESULTS:The proportion of multiphasic waveforms proximal to a moderate stenosis decreased compared to normal baseline, although the difference was not statistically significant, whereas the decreases at the stenosis, distal to the stenosis, and at the ankle were significant (p < 0.05). The decreases in arteries with a more severe stenosis or occlusion were significant at all locations (p < 0.05). The proportion of high resistive waveforms decreased significantly at the ankle in the arteries with a moderate stenosis (50%) (p = 0.002), but the decreases proximal to, at, and distal to the stenosis were not significant. The decreases were significant at all locations in the arteries with a more severe stenosis (p < 0.05). The decrease was significant at the ankle in the arteries with an occlusion (p < 0.001) but not significant pre, at, and post an occlusion.CONCLUSIONS:Phasicity and resistance of Doppler waveforms alter in canine femoral arteries with a stenosis. Phasicity change seems more sensitive in response to an arterial stenosis than resistance change. Additional information on arterial resistance could be obtained using end-diastolic ratios, resistive indices, and potentially end-systolic notch velocity measurements.

Objective To investigate the value of Vector Flow Imaging (V Flow) in the assessment of post-stenotic turbulence in the canine arterial stenosis model. Materials and Methods Canine femoral artery stenosis models were established using ameroid constrictors in 12 beagle dogs. 50% and then 70% femoral artery stenoses were confirmed by selective femoral artery angiography. V Flow was used to measure femoral artery flow turbulence index (Tur) preoperatively as a baseline. After establishing of a 50% and then 70% stenoses, the Tur indices were recorded in the femoral artery at 1, 3, 5, 7, 9, 11, 13, 15, 17, and 19 mm distal to the stenosis. Results Baseline Tur indices of normal canine femoral arteries were <1% in 11 of 12 cases (91.7%). Distal to a 50% stenosis, the Tur index (>1%) was recorded in 83.3–100% cases between 1 and 9 mm, 41.7–58.3% between 11 and 17 mm, and 16.7% at 19 mm. For a 70% stenosis, the Tur index (>1%) occurred in 81.8–100% cases between 1 and 17 mm distal to the stenosis, and 63.6% at 19 mm. The Tur index peaked around 7 mm or 2.3 times of the initial vessel diameter (3 mm) downstream for a 50% stenosis and 11 mm or 3.7 times of vessel diameter downstream for a 70% stenosis. Conclusion V Flow with Tur index measurement adds quantitative information of post-stenotic turbulence when assessing an arterial stenosis with ultrasound. Tur index of 1% seems a useful threshold for assessment of flow turbulence in this small sample study. Further studies with larger sample size are needed to evaluate the value of V Flow in clinical applications.

目的 应用超声向量血流成像(V Flow)技术测量不同程度犬股动脉狭窄后血流离散度(血流Tur值),分析下肢动脉狭窄后血流紊乱分布规律.方法 选择12条比格犬为研究对象,使用血管缩窄环制备股动脉狭窄模型.应用超声V Flow分别测量犬股动脉术前(0狭窄),以及术后50％和70％狭窄后不同部位的Tur值.结果 12条犬股动脉术前0狭窄、术后50％和70％狭窄后不同部位Tur值分别进行3组间比较,差异均具有统计学意义(P＜0.05);50％狭窄后0～1cm、70％狭窄后0～2 cm范围内各部位Tur值较术前0狭窄时均增高,组间两两比较差异均具有统计学意义(P＜0.05).结论 超声V Flow技术可观察犬股动脉不同程度(50％及70％)狭窄后血流离散程度,对评估血流紊乱有一定的应用价值.

目的 通过对比观察不同角度的楔形导声垫在颈动脉超声检查中获得的参数,探讨楔形导声垫在血管超声检查中的应用价值.方法 对50例颈动脉超声检查结果阴性的成人患者右侧颈总动脉进行超声检查,在无导声垫及使用18°、25°、32°楔形导声垫四种条件下测量颈总动脉收缩期峰值流速(Peak systolic velocity,PSV,cm/s)及多普勒角度.结果 无导声垫及使用18°、25°、32°楔形导声垫,测得的颈总动脉PSV分别为(90.10±8.21)cm/s、(84.42±7.91)cm/s、(78.30±7.88)cm/s、(72.25±7.62)cm/s,差异均有统计学意义,P值均<0.01,变异系数(Coefficient of Variation,CV)分别为0.091、0.094、0.100、0.101;多普勒角度校正分别为(59.78±0.51)°、(54.92±1.51)°、(50.78±2.48)°、(46.22±2.82)°,差异均有统计学意义,P值均<0.01,CV分别为0.008、0.027、0.049、0.061.结论 增加楔形导声垫角度可明显降低颈动脉血流速PSV及多普勒角度,潜在提高了超声评估颈动脉血流速度的准确性,对PSV的变异系数影响不明显.

Purpose: To investigate the value of anteroposterior-to-transverse ratio (ATR) and the effect on features of nodules in ultrasound (US) diagnosis of thyroid nodules in different locations.Methods: The nodules were divided into three groups according to the different nodule location: isthmus group; upper and lower poles of bilobed thyroid group; and the middle of the bilobed thyroid group. The diameters of the nodules were recorded, and ATR of the nodule was calculated on the transverse and longitu-dinal sections. The transverse and the longitudinal sections of ATR of thyroid nodules in different groups were compared.Result: The transverse section of ATR was significantly different among the three groups (p = 0.001). In addi-tion, there are significant differences in many US features among three groups, including nodule composition, thyroid parenchyma, morphology, echogenicity, shape, calcifications, vascularity, nodule ACR TI-RADS and his-topathologic (all p < 0.05). In the group of upper and lower poles of bilobed thyroid, significant difference was found between the transverse and the longitudinal section of ATR (p = 0.019). The cut-off values of transverse section and longitudinal section of ATR were 0.967 and 0.750, respectively.Conclusion: The transverse section of ATR at different location of thyroid may be a predictor for malignancy with clinical diagnostic significance.

Hepatic venous gas (HVG) is a very rare ultrasonic finding, and it is defined as abnormal accumulation of gas in the hepatic venous system. Various diseases can cause HVG, and femoral venous catheter is the most common cause. We, herein, present the case of a 79-year-old female patient with HVG that was caused by spontaneous rupture of a Klebsiella pneumoniae liver abscess. This was first found by bedside ultrasonography. On the basis of the blood culture results, imipenem–cilastatin and cefoperazone sulbactam were administered and the effect was acceptable. After 41 days of antibacterial and symptomatic treatment in the hospital, the patient had recovered well and was discharged. All of the previous reports on HVG have been summarized by thoroughly reviewing the previous published work. Overall, this is the first patient with HVG in association with spontaneous rupture of a K. pneumoniae liver abscess, and it might provide insights for future studies regarding the treatment of this disease. Keywords Hepatic venous gas , liver abscess rupture , , , bedside ultrasound , spontaneous , treatment , femoral venous catheter

目的 分析甲状腺嗜酸细胞肿瘤的超声图像特征,提高对良、恶性甲状腺嗜酸细胞肿瘤的诊断和鉴别诊断水平.方法 回顾性分析13例甲状腺嗜酸细胞肿瘤患者的超声图像及临床病理特征.结果 13例甲状腺嗜酸细胞肿瘤(HCN)患者共计14个结节,其中嗜酸细胞腺瘤(HCA)10例,嗜酸细胞癌(HCC)3例.HCN结节大多具有良性病变的超声特征.HCC与甲状腺乳头状癌(PTC)比较,结节的大小、形态、边界、纵横比、周边晕征、有无钙化、血流等差异均具有统计学意义(P＜0.05);而成分、回声、被膜连续性差异无统计学意义(P＞0.05).结论 甲状腺Hürthle细胞肿瘤具有特定的超声特征,FNA可诊断嗜酸细胞肿瘤,但不能判断有无血管和包膜侵犯;手术后组织学病理是明确良、恶性病变的金标准.