目的 探讨伴髓样特征的乳癌超声造影特征.方法 选取2017年1月—2020年7月青岛市市立医院普外科收治、行乳房超声造影检查并经手术病理证实的伴髓样特征的乳癌病人36例及乳房纤维腺瘤病人50例,回顾性分析其超声造影特征.结果 36例伴髓样特征的乳癌病人中35例常规超声表现与乳房纤维腺瘤相似.伴髓样特征的乳癌病人超声造影均表现为快进慢退离心性不均匀性高增强,边缘伴毛刺,范围较常规超声扩大(平均4 mm),周边可见汇聚征,其中5例伴有充盈缺损;而38例乳房纤维腺瘤病人超声造影表现为等进快退均匀性向心性等增强,边缘清晰,范围较常规超声无明显扩大,周边未见汇聚征,未见充盈缺损.超声造影定量分析显示,伴髓样特征的乳癌病灶的造影剂灌注初始时间(IT)和最大峰值到达时间(PT)值较同水平正常乳房组织低,造影峰值强度(PI)值较同水平正常乳房组织高,差异有统计学意义(t=2.65～3.76,P<0.05);乳房纤维腺瘤病灶的IT和PT值较同水平正常乳房组织低,PI值较同水平正常乳房组织高,但差异无统计学意义(P>0.05).结论 伴髓样特征的乳癌与乳房纤维腺瘤在常规超声图像上有相似性,但两者的超声造影表现不尽相同,因而对于此种类型的病变术前进行超声造影检查,可提供更多的诊断信息.

患者男,58岁,因发现左侧睾丸增大1周且伴睾丸疼痛加重2d入院.体格检查:左侧阴囊较对侧明显增大,阴囊内扪及一直径约5 cm实性肿物,质韧,无触痛,睾丸扪诊欠清.实验室检查:血常规、血沉、肿瘤标记物均未见异常.二维超声检查:左侧睾丸较对侧体积增大,其内见一大小约4.8 cm×3.4 cm不均质低回声区,边界不清晰;CDFI示其内可探及树枝状丰富血流信号;频谱多普勒呈高速低阻血流,收缩期峰值流速52.85 cm/s,阻力指数0.41(图1,2).超声提示:左侧睾丸病变,考虑炎性,肿瘤性病变不除外,建议行超声造影进一步检查.超声造影检查:病灶于12 s见造影剂开始灌注,16 s病灶整体呈均匀高增强,36 s造影剂消退呈不均匀低增强,呈"快进快出"模式(图3,4).超声造影提示:左侧睾丸恶性病变可能性大,考虑淋巴瘤.排除禁忌后于椎管麻醉下行左侧睾丸根治性切除术.

Objective To investigate the diagnostic features of ultrasonography and pathology of solitary fibrous tumors (SFT). Methods Contrast-enhanced ultrasonography and pathology data of 6 patients with solitary fibrous tumor (SFT) confirmed by surgery and pathology in Qingdao Municipal Hospital from January 2015 to December 2019 were retrospectively analyzed, and the diagnostic characteristics were summarized. Results Three cases were male, and three cases were female in six patients. The ages range from 32 to 65. One case was located in the abdominal wall, 1 case was located in the foot dorsum, 1 case was located in the eye socket, 2 cases were located in the chest wall and 1 case was located in mammary gland. The two-dimensional ultrasonographic manifestations of 6 cases of SFT were hypoechoic, moderate or mixed echogenic masses with clear or unclear boundaries and smooth edges. 4 cases were oval, 2 cases were round, 2 cases had non-uniform echo with liquefaction, 4 cases had relatively uniform echo, 4 cases had abundant branching blood flow signals, and the vascular resistance was small. Contrast-enhanced ultrasonography showed high enhancement of uniformity or unevenness in the arterial phase, 2 cases showed increased lesion enhancement range compared with conventional ultrasound, 4 cases showed no significant increase in lesion enhancement range compared with conventional ultrasound, and there was no significant clearance in the delayed phase, showing slightly higher enhancement. All tumors of the 6 cases were surgically removed, 4 cases had complete capsule, 2 cases had unclear boundary with surrounding tissue, 4 cases had abundant vascular supply, 2 cases had necrotic liquefaction zone, 4 cases had ductile, 2 cases had medium texture. Postoperative routine HE staining: source of mesenchymal tissue tumors and tumor cells showed spindle type, around blood vessel growth, a spiral or funicular, cell clusters alternating with sparse area distribution of tumor cell distribution. Unequal thickness and red color of collagen fibers and abundant dendritic parenchyma vessels were found in the interstitium. Four cases of nuclear had mild atypia and few mitotic, while 2 cases of nuclear had moderate atypia and visible mitotic. Immunohistochemical results: CD34 positive (4/6), Bcl-2 positive (5/6), Vimentin positive (5/6), CD99 positive (6/6), SMA positive (4/6). S100 negative (6/6), consistented with the the diagnosis of SFT. Conclusion Contrast-enhanced ultrasonography and pathology of SFT have certain characteristics, which are helpful for their diagnosis. Key words: Solitary fibrous tumors; Ultrasonography; Contrast media; Pathology; Diagnosis

患者女,61岁,因体检发现肝内占位来我院就诊.12年前曾因子宫平滑肌肉瘤行子宫及双侧附件切除;1年前因平滑肌肉瘤小肠转移行部分肠切除术,术后行周期性化疗.实验室检查:甲胎蛋白(-),乙肝表面抗原(-).常规超声检查:肝左叶内见2个团状低回声,大小分别为5.0 cm×4.0 cm、2.3 cm×1.6 cm,边界尚清,形态尚规则,回声欠均;CDFI未探及明显血流信号.

Although most patients with papillary thyroid cancer (PTC) are curable, there are still a few patients showing poor outcomes and increased risk of secondary cancers after therapies. In this study, we aimed to investigate the correlation between miR-4500 and PTC and to explore its molecular functions. A total of 50 patients were included, and sonography and histological examinations were used for diagnosis. Quantitative real-time polymerase chain reaction (qRT-PCR) was applied for detection of mRNA levels while Western blotting was used for measuring protein expression. Cell proliferation was tested using CCK-8 and colony formation assays. Caspase-3 activity and nucleosomal fragmentation assays were employed to test cell apoptosis. Cell invasive ability was measured using transwell assay. MiR-4500 target was identified using luciferase assay and RNA pull-down assay. MiR-4500 expression was significantly decreased in five PTC cell lines compared with Nthy-ori 3-1 cells and in PTC tissues compared with adjacent normal thyroid tissues, respectively. Decreased expression of miR-4500 showed lower survival rate, higher cancer stage, and lymphatic metastasis. Therefore, our results implied that miR-4500 could serve as a potential biomarker for PTC prognosis. Overexpression of miR-4500 repressed colony formation, proliferation, and invasiveness of PTC cells whereas increased cell apoptosis. We identified that PLXNC1 was a direct target of miR-4500. PLXNC1 knockdown showed similar effects on cell viability, colony formation, and cell apoptosis as overexpression of miR-4500 in PTC cells. In conclusion, miR-4500 inhibits the malignant transformation of PTC cells by directly targeting and repressing PLXNC1.

单发性骨软骨瘤是最常见的良性骨肿瘤之一, 其超声表现报道很少,本组回顾性分析36例骨软骨瘤患者的超声及临床资料,探讨超声在单发性骨软骨瘤检查中的应用价值.

ObjectiveTo explore the relationship between serum markers and liver fat content predicted by hepatorenal ratio in type 2 diabetic mellitus (T2DM) patients.Methods A total of 120 T2DM patients were recruited from January 2011 to September 2012 in the Affi liated Hospital of Qingdao University. The sagittal liver-right kidney diagrams of the patients were obtained by two-dimensional ultrasonic examination, and the hepatorenal ratio were analyzed by NIHimage. Then, the related serum markers were tested 24 hours later. The relationship between hepatorenal ratio and serum markers was analyzed by Spearman rank correlation on the patients of T2DM. Then, the affective factors on the hepatorenal ratio were analysed by multivariate linear regression analysis, with hepatorenal ratio as dependent variable, and the concentration of triglyceride (TG,X1) , total cholesterol (TC,X2), high density lipoprotein cholesterol (HDL-C,X3), low density lipoprotein cholesterol (LDL-C,X4), alanine aminotransferase (ALT,X5), aspartateaminotransferase (AST,X6), glutamyltransferase (γ-GT,X7) , and alkaline phosphatase (ALP,X8) as independent variables. The receiver operating characteristic curve (ROC) was drawn to diagnose the point of the hepatorenal ratio when the TG began to increase (>1.92 mmol/L).Results There was positive correlation between hepatorenal ratio and TG, AST, ALT,γ-GT (r=0.420,P=0.000;r=0.383,P=0.000;r=0.309,P=0.001;r=0.253,P=0.005), while no correlation between hepatorenal ratio and glycosylated hemoglobin, TC, HDL-C, LDL-C, ALP or blood uric acid (BUA) (r=0.0.067,P=0.368;r=0.145,P=0.115;r=?-0.148,P=0.106;r=0.002,P=0.986;r=0.160,P=0.081;r=0.064,P=0.489) were found; the linear regression analysis showed that TG level (X1) was the only markers which had correlation with hepatorenal ratio in the T2MD patients with the regression equation ofY=1.245+0.062X. The ROC curve analysis showed that the optimal cutoff value for hepatorenal ratio to in diagnosinge increased TG (>1.92 mmol/L) was 1.236 in T2DM patients, and the area under the curve was 0.677. The sensitivity and specifi city were 86.7% and 45.3% respectively. Conclusions Hepatorenal ratio can be a reliable indicator to predict liver fat content, which has correlation with TG, ALT, AST andγ-GT. The increased TG level can refl ect the increasing fat content in the liver, and TG begin to increase when the hepatorenal ratio reach 1.236.

目的：探讨非局限性肿块型乳腺癌超声声像图表现。方法选取43例经手术或穿刺病理诊断为乳腺癌、超声未见明确局限性肿块的女性患者,分析所有患者乳腺病变的二维超声、彩色多普勒血流信息以及术后或穿刺病理诊断结果。结果43例乳腺癌中39例(90.7%)表现为片状结构紊乱区,3例(7.0%)表现为密集强光点聚集区；1例(2.3%)超声检查无明显阳性发现。病灶中沙粒样或针尖样微钙化33例(76.7%),腋窝淋巴结转移11例(25.6%)。结论非局限性肿块型乳腺癌以片状结构紊乱区为主要表现且常伴微钙化,少数表现为密集强光点聚集区；密集强光点聚集区以早期浸润性癌多见；腋窝异常淋巴结的出现有助于诊断。

Objective To observe the characteristics of contrast-enhanced ultrasound on patients with hepatocellular carcinoma(HCC) underwent transcatheter arterial chemoembolization(TACE)and to explore the value of time-intensity parameters of contrast-enhanced ultrasound(CEUS) for residual and recurrent viable tumor blood supply for the patients with HCC after TACE. Methods The therapeutic effects on quantitative analysis of contrast-enhanced ultrasound on 42 HCC patients with 47 tumor lesions underwent CEUS examination after TACE were evaluated. The residual and recurrent viable tumor blood supply parameters after TACE were analyzed by means of time-intensity curve of CEUS. Results The CEUS examination showed that the residual and recurrent viable tumors have enhancement in 39 lesions and have not identify enhancement in any of the remaining 8 lesions for the HCC patients after TACE .Compared with DSA , the sensitivity rate, specifity and accuracy rate of CEUS in the diagnosis for the patients with HCC after TACE was 97.4%,87.5%,95.7%respectively.Time-intensity curve of CEUS showed that the arrival time and enhanced intensity were statistically different in the HCC patients after TACE with 38 residual and recurrent viable tumors.(P<0.05). Conclusions The CEUS examination could be a useful and effective technique for evaluation of the therapeutic effects on the patients with HCC. The quantitative analysis of time-intensity on CEUS is helpful for the evaluation and analysis of residual tumor blood supply .

Objective:To evaluate the clinical application of color doppler ultrasound and CT in the diagnosis of cryptorchidism and its malignant transformation,to provide effective,economic and non-invasive way for qualitative diagnosis.Method:Forty-five patients with 51 cryptorchidism were examined by ultrasound and CT in recent years. Their imageological examinations were compared with surgical and pathological results respectively. Result:In 51 cryptorchidism ,45 cryptorchidism were detected by ultrasound,with the detection rate of 88.2%. Among those cases,4 of 5 malignant transformations were detected by ultrasound(detection rate 80.0%). In contrast,43 out of 51 cryptorchidism were detected by CT examination(detection rate 84.3%),of which 5 malignant cases were detected by CT with the accuracy rate of 100%. Among total 14 celiac cryptorchidism cases,11 cases(78.5%)were detected by ultrason examinations,while 13 cases(92.8%)were detected by CT scan. There was no significant difference between ultrasound and CT examination as for the detection rate in the diagnosis of cryptorchidism and its progression(P>0.05). Conclusion:Compared with CT,the color doppler ultrasound examination are high accuracy,easier to check,low-cost and non-invasive,therefore it is the preferred method in the diagnosis of cryptorchidism. However,in order to improve the diagnosis rate,ultrasound examination should be recommended to cooperate with CT for celiac cryptorchidism patients or patients with cryptorchidism malignant transformation.