ultrasonography

超声检查
  • 文章类型: Journal Article
    乳腺癌转移对全球女性健康影响显著。本研究旨在利用临床血液标志物和超声数据构建预测模型来预测乳腺癌患者的远处转移。确保临床适用性,成本效益,相对非侵入性,以及这些模型的可访问性。对来自两个中心的416名患者的数据进行了分析,专注于临床血液标志物(肿瘤标志物,肝肾功能指标,血脂标志物,心血管生物标志物)和超声检查的最大病变直径。使用Spearman相关和LASSO回归进行特征还原。使用LightGBM建立了两个模型:临床模型(使用临床血液标志物)和组合模型(结合临床血液标志物和超声特征),在培训中验证,内部测试,和外部验证(test1)队列。对这两个模型都进行了特征重要性分析,然后对这些特征进行单因素和多元回归分析。训练中临床模型的AUC值,内部测试,和外部验证(测试1)队列分别为0.950,0.795和0.883.组合模型在训练中的AUC值分别为0.955、0.835和0.918,内部测试,和外部验证(test1)队列,分别。临床效用曲线分析表明,在所有队列中,组合模型在识别具有远处转移的乳腺癌方面具有优越的净收益。这表明组合模型具有优越的判别能力和较强的泛化性能。肌酸激酶同工酶(CK-MB),CEA,CA153,白蛋白,肌酸激酶,超声的最大病变直径在模型预测中起着重要作用。CA153,CK-MB,脂蛋白(a),超声最大病灶直径与乳腺癌远处转移呈正相关,间接胆红素与镁离子呈负相关。这项研究成功地利用临床血液标志物和超声数据来开发AI模型来预测乳腺癌的远处转移。组合模型,结合临床血液标志物和超声特征,表现出更高的准确性,提示其在预测和识别乳腺癌远处转移方面的潜在临床应用。这些发现凸显了在临床肿瘤学中开发具有成本效益且易于使用的预测工具的潜在前景。
    Breast cancer metastasis significantly impacts women\'s health globally. This study aimed to construct predictive models using clinical blood markers and ultrasound data to predict distant metastasis in breast cancer patients, ensuring clinical applicability, cost-effectiveness, relative non-invasiveness, and accessibility of these models. Analysis was conducted on data from 416 patients across two centers, focusing on clinical blood markers (tumor markers, liver and kidney function indicators, blood lipid markers, cardiovascular biomarkers) and maximum lesion diameter from ultrasound. Feature reduction was performed using Spearman correlation and LASSO regression. Two models were built using LightGBM: a clinical model (using clinical blood markers) and a combined model (incorporating clinical blood markers and ultrasound features), validated in training, internal test, and external validation (test1) cohorts. Feature importance analysis was conducted for both models, followed by univariate and multivariate regression analyses of these features. The AUC values of the clinical model in the training, internal test, and external validation (test1) cohorts were 0.950, 0.795, and 0.883, respectively. The combined model showed AUC values of 0.955, 0.835, and 0.918 in the training, internal test, and external validation (test1) cohorts, respectively. Clinical utility curve analysis indicated the combined model\'s superior net benefit in identifying breast cancer with distant metastasis across all cohorts. This suggests the combined model\'s superior discriminatory ability and strong generalization performance. Creatine kinase isoenzyme (CK-MB), CEA, CA153, albumin, creatine kinase, and maximum lesion diameter from ultrasound played significant roles in model prediction. CA153, CK-MB, lipoprotein (a), and maximum lesion diameter from ultrasound positively correlated with breast cancer distant metastasis, while indirect bilirubin and magnesium ions showed negative correlations. This study successfully utilized clinical blood markers and ultrasound data to develop AI models for predicting distant metastasis in breast cancer. The combined model, incorporating clinical blood markers and ultrasound features, exhibited higher accuracy, suggesting its potential clinical utility in predicting and identifying breast cancer distant metastasis. These findings highlight the potential prospects of developing cost-effective and accessible predictive tools in clinical oncology.
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  • 文章类型: Journal Article
    目的:甲状腺乳头状癌(PTC)与桥本甲状腺炎(HT)的相关性存在争议。这项研究的目的是评估HT的存在对PTC的侵袭性施加任何影响,并建立了预测PTC侵袭可能性的列线图。
    方法:对2017年1月至2020年12月373例伴有/不伴有HT的PTC患者进行回顾性分析。收集患者的临床病理和超声特征进行单变量和多变量分析。根据PTC侵袭性的危险因素建立了列线图。
    结果:男性(p=0.001),肿瘤大小>1.0cm(p=0.046)和淋巴结转移(p=0.018)与PTC和HT共存呈负相关,而与多焦频率显著正相关(p=0.010)。单变量和多变量分析表明,年龄≥55岁(p=0.000),男性(p=0.027),HT(p=0.017),肿瘤大小>1.0cm(p=0.015),多焦点(p=0.041),到囊膜的距离≤0cm(p=0.050)和血流量(I级:p=0.044)是预测PTC侵袭性的独立危险因素.进一步开发和验证了根据这些预测因子的列线图。受试者工作特征曲线(培训和验证队列的AUC=0.734和0.809,分别)和决策曲线分析表明,列线图模型在临床上有用。校准曲线表明,列线图表现出优异的一致性。
    结论:在这项研究中,共存的HT可能在预防PTC的增殖中起保护作用。通过术前识别超声和临床特征并结合预测的列线图模型,可以减少PTC中的可分配的积极治疗。
    OBJECTIVE: The association between Papillary Thyroid Carcinoma (PTC) and coexistent Hashimoto\'s Thyroiditis (HT) was controversial. The purpose of this study was to evaluate the presence of HT exerts any influence on the aggressiveness of PTC, and to establish a nomogram for predicting the possibility of aggressiveness in PTC.
    METHODS: 373 consecutive PTC patients with/without coexistent HT from January 2017 to December 2020 were retrospective reviewed. Patients\' clinicopathologic and sonographic characteristics were collected for univariate and multivariate analyses. A nomogram was established based on the risk factors for aggressiveness in PTC.
    RESULTS: Male (p = 0.001), tumor size >1.0 cm (p = 0.046) and lymph node metastasis (p = 0.018) were negatively associated with PTC coexisted with HT, while it was significantly positively associated with the frequence of multifocality (p = 0.010). Univariate and multivariate analyses suggested that age ≥55 years (p = 0.000), male (p = 0.027), HT (p = 0.017), tumor size >1.0 cm (p = 0.015), multifocality (p = 0.041), distance to capsular ≤0 cm (p = 0.050) and blood flow (Grade I: p = 0.044) were independent risk factors for predicting the aggressiveness in PTC. A nomogram according to these predictors was further developed and validated. The receiver operating characteristic curve (AUC = 0.734 and 0.809 for training and validation cohorts, respectively) and decision curve analyses indicated that the nomogram model was clinically useful. The calibration curve revealed that the nomogram exhibited an excellent consistency.
    CONCLUSIONS: In this study, the coexistent HT might play a protective role in preventing the proliferation of PTC. Dispensable aggressive treatment may be reduced in PTC by pre-operative identification of sonographic and clinical characteristics and incorporating with the predicted nomogram model.
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  • 文章类型: Journal Article
    背景:研究仰卧位患者胸腔积液(PE)体积超声定量的三个模型公式的准确性。
    方法:进行了一项前瞻性研究,包括100例肺静脉穿刺引流患者。三个模型公式(单段模型,两段模型和多段模型)用于计算PE体积。进行了从三个模型得出的计算体积与实际PE体积之间的相关性和一致性分析。
    结果:通过三个模型计算的PE体积均显示出与仰卧位实际PE体积的显着线性相关性(均p<0.001)。多截面模型预测PE体积的可靠性明显高于单截面模型,略高于二截面模型。与实际排水量相比,单截面模型的类内相关系数(ICC),两段模型和多段模型分别为0.72、0.97和0.99。对于全PE体积范围(ICC0.98),通过使用两段模型和多段模型计算的PE体积之间存在显著一致性。
    结论:基于超声定量PE体积的便利性和准确性,在常规临床中,两段模型被推荐用于胸腔积液的评估,但可以根据临床需要选择不同的模型配方。
    BACKGROUND: To investigate the accuracy of three model formulae for ultrasound quantification of pleural effusion (PE) volume in patients in supine position.
    METHODS: A prospective study including 100 patients with thoracentesis and drainage of PE was conducted. Three model formulae (single section model, two section model and multi-section model) were used to calculate the PE volume. The correlation and consistency analyses between calculated volumes derived from three models and actual PE volume were performed.
    RESULTS: PE volumes calculated by three models all showed significant linear correlations with actual PE volume in supine position (all p < 0.001). The reliability of multi-section model in predicting PE volume was significantly higher than that of single section model and slightly higher than that of two section model. When compared with actual drainage volume, the intra-class correlation coefficients (ICCs) of single section model, two section model and multi-section model were 0.72, 0.97 and 0.99, respectively. Significant consistency between calculated PE volumes by using two section model and multi-section model existed for full PE volume range (ICC 0.98).
    CONCLUSIONS: Based on the convenience and accuracy of ultrasound quantification of PE volume, two section model is recommended for pleural effusion assessment in routine clinic, though different model formulae can be selected according to clinical needs.
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  • 文章类型: Journal Article
    本研究旨在探讨超声引导下经皮射频消融术(RFA)治疗抗原诱导关节炎(AIA)模型兔膝关节滑膜增生的疗效和安全性。
    将40只日本大耳白兔分为AIA组和对照组。在成功诱导AIA模型后,膝关节被随机分为RFA和非RFA组.RFA组行超声引导下RFA治疗膝关节滑膜增生。对各种检测指标进行动态观察,以评估RFA程序的安全性和有效性。
    RFA组成功进行滑膜消融,无术中或围手术期死亡。术后膝关节周长在术后第三周下降之前达到峰值。术后皮肤溃疡的发生率和直径与非RFA组比较差异无统计学意义(p>0.05)。解剖检查显示RFA组消融区域周围肌间筋膜完整。消融滑膜组织最初表现为白色肿块,随后液化成乳白色粘性流体。观察到大体关节软骨,随着病理组织学上滑膜的液化坏死和周围软组织中炎性细胞的浸润。
    实验结果表明,超声引导下膝关节RFA治疗AIA模型动物滑膜增生既有效又安全。
    UNASSIGNED: This study aimed to investigate the efficacy and safety of ultrasound-guided percutaneous radiofrequency ablation (RFA) for the treatment of synovial hyperplasia in the knee joints of antigen-induced arthritis (AIA) model rabbits.
    UNASSIGNED: Forty Japanese large-eared white rabbits were divided into AIA and control groups. After successful induction of the AIA model, the knee joints were randomly assigned to RFA and non-RFA groups. The RFA group underwent ultrasound-guided RFA to treat synovial hyperplasia in the knee joint. Dynamic observation of various detection indices was conducted to evaluate the safety and effectiveness of the RFA procedure.
    UNASSIGNED: Successful synovial ablation was achieved in the RFA group, with no intraoperative or perioperative mortality. Postoperative the circumference of the knee joint reached a peak before decreasing in the third week after surgery. The incidence and diameter of postoperative skin ulcers were not significantly different compared to the non-RFA group (p > .05). Anatomical examination revealed an intact intermuscular fascia around the ablated area in the RFA group. The ablated synovial tissue initially presented as a white mass, which subsequently liquefied into a milky white viscous fluid. Gross articular cartilage was observed, along with liquefied necrosis of the synovium on pathological histology and infiltration of inflammatory cells in the surrounding soft tissue.
    UNASSIGNED: The experimental results demonstrated that ultrasound-guided RFA of the knee in the treatment of synovial hyperplasia in AIA model animals was both effective and safe.
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  • 文章类型: Journal Article
    背景:在过去几年中,异种肾脏移植取得了重大进展,这个领域正在加速向临床转化。因此,用适当的工具监测异种移植物非常重要.超声检查已广泛用于肾脏同种异体移植,并作为一种经济且无创的监测同种异体移植的方法。然而,为人类同种异体肾脏建立的超声检查标准是否也可以应用于异种移植仍存在疑问.
    方法:在目前的研究中,我们建立了猪恒河猴异种肾脏移植模型。异种移植物接受了使用灰度的强化监测,彩色多普勒超声以及二维剪切波弹性成像。肾脏的生长,血液灌注,每天测量两次皮质硬度。将这些参数与包括尿量在内的临床数据进行比较,化学,和病理结果。
    结果:移植后观察持续16天。在POD9上观察到尿量下降和血清肌酐升高,并在同一天观察到活检证实的抗体介导的排斥反应。异种移植物经历了大量的生长,观察结束时,长轴长度增加了32%,体积增加了三倍。异种移植动脉的阻力指数因排斥反应而升高,连同受损的皮质灌注,而收缩期峰值速度(PSV)未受损。皮质刚度也随着排斥而增加。
    结论:总之,异种肾的超声检查结果与同种异体肾的超声检查结果相似,但具有一些独特的特征。需要建立一个修改的标准,以进一步应用超声在肾脏异种移植中。
    BACKGROUND: Significant progress has been made in kidney xenotransplantation in the past few years, and this field is accelerating towards clinical translation. Therefore, surveillance of the xenograft with appropriate tools is of great importance. Ultrasonography has been widely used in kidney allotransplantation and served as an economical and non-invasive method to monitor the allograft. However, questions remain whether the ultrasonographic criteria established for human kidney allograft could also be applied in xenotransplantation.
    METHODS: In the current study, we established a porcine-rhesus life sustaining kidney xenotransplantation model. The xenograft underwent intensive surveillance using gray-scale, colorful Doppler ultrasound as well as 2D shear wave elastography. The kidney growth, blood perfusion, and cortical stiffness were measured twice a day. These parameters were compared with the clinical data including urine output, chemistry, and pathological findings.
    RESULTS: The observation continued for 16 days after transplantation. Decline of urine output and elevated serum creatinine were observed on POD9 and biopsy proven antibody-mediated rejection was seen on the same day. The xenograft underwent substantial growth, with the long axis length increased by 32% and the volume increased by threefold at the end of observation. The resistive index of the xenograft arteries elevated in response to rejection, together with impaired cortical perfusion, while the peak systolic velocity (PSV) was not compromised. The cortical stiffness also increased along with rejection.
    CONCLUSIONS: In summary, the ultrasound findings of kidney xenograft shared similarities with those in allograft but possessed some unique features. A modified criteria needs to be established for further application of ultrasound in kidney xenotransplantation.
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  • 文章类型: Journal Article
    本研究旨在构建基于高频超声和磁共振成像结果的早期肝硬化慢性乙型肝炎(CHB)患者的非侵入性诊断列线图,这些慢性乙型肝炎(CHB)无法通过常规非侵入性检查方法检测,但只能通过有创肝脏穿刺进行病理检查来诊断。72例CHB患者参加了这项前瞻性研究,根据病理结果分为肝硬化S4期和非肝硬化S0-S3期。进行二元logistic回归分析以确定独立预测因子,并构建了CHB相关的早期肝硬化的诊断列线图。通过Bootstrap自提取对其进行了验证和校准。二元Logistic回归分析显示,年龄(OR1.14,95%CI(1.04-1.27)),右肝静脉直径(OR0.43,95%CI0.23-0.82),是否存在结节(OR31.98,95%CI3.84-266.08),和肝实质回声分级(OR12.82,95%CI2.12-77.51)被确定为独立的预测指标。基于上述4个因素的列线图显示出良好的性能,敏感性和特异性分别为90.70%和89.66%,分别。预测模型的曲线下面积(AUC)为0.96,预测模型显示出比APRI评分(AUC0.57)更好的预测性能,FIB-4评分(AUC0.64),INPR评分(AUC0.63),和LSM评分(AUC0.67)。预测模型的校正曲线与理想曲线吻合良好,决策曲线分析表明,该模型的净收益是显著的。在这项研究中的列线图可以检测大多数CHB患者的肝硬化没有肝活检,提供一个直接的,快,和临床医生准确实用的诊断工具。
    This study aimed to construct a non-invasive diagnostic nomogram based on high-frequency ultrasound and magnetic resonance imaging results for early liver cirrhosis patients with chronic hepatitis B (CHB) which cannot be detected by conventional non-invasive examination methods but can only be diagnosed through invasive liver puncture for pathological examination. 72 patients with CHB were enrolled in this prospective study, and divided into S4 stage of liver cirrhosis and S0-S3 stage of non-liver cirrhosis according to pathological findings. Binary logistic regression analysis was performed to identify independent predictors, and a diagnostic nomogram was constructed for CHB-related early cirrhosis. It was validated and calibrated by bootstrap self-extraction. Binary logistic regression analysis showed that age (OR 1.14, 95% CI (1.04-1.27)), right hepatic vein diameter (OR 0.43, 95% CI 0.23-0.82), presence or absence of nodules (OR 31.98, 95% CI 3.84-266.08), and hepatic parenchymal echogenicity grading (OR 12.82, 95% CI 2.12-77.51) were identified as independent predictive indicators. The nomogram based on the 4 factors above showed good performance, with a sensitivity and specificity of 90.70% and 89.66%, respectively. The area under the curve (AUC) of the prediction model was 0.96, and the predictive model showed better predictive performance than APRI score (AUC 0.57), FIB-4 score (AUC 0.64), INPR score (AUC 0.63), and LSM score (AUC 0.67). The calibration curve of the prediction model fit well with the ideal curve, and the decision curve analysis showed that the net benefit of the model was significant. The nomogram in this study can detect liver cirrhosis in most CHB patients without liver biopsy, providing a direct, fast, and accurate practical diagnostic tool for clinical doctors.
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  • 文章类型: Journal Article
    本研究旨在使用临床变量和超声影像组学特征来构建机器学习模型,以预测胰腺肿瘤的良性或恶性性质。
    2020年1月至2023年6月在广西医科大学第一附属医院住院的242例胰腺肿瘤患者纳入本回顾性研究。将患者随机分为训练队列(n=169)和测试队列(n=73)。我们收集了28例患者的临床特征。同时,从患者肿瘤的超声图像中提取了306个影像组学特征。最初,使用逻辑回归算法构建临床模型.随后,使用SVM建立影像组学模型,随机森林,XGBoost,和KNN算法。最后,我们将临床特征与应用影像组学模型计算的新特征RADprob相结合,构建融合模型,并基于融合模型开发了列线图。
    融合模型的性能超过了临床和影像组学模型。在训练组中,融合模型在5倍交叉验证中的AUC为0.978(95%CI:0.96~0.99),在试验队列中的AUC为0.925(95%CI:0.86~0.98).校准曲线和决策曲线分析表明,由融合模型构建的列线图具有较高的准确性和临床实用性。
    包含临床和超声影像组学特征的融合模型在预测胰腺肿瘤的良性或恶性性质方面表现出出色的性能。
    UNASSIGNED: This study aimed to construct a machine learning model using clinical variables and ultrasound radiomics features for the prediction of the benign or malignant nature of pancreatic tumors.
    UNASSIGNED: 242 pancreatic tumor patients who were hospitalized at the First Affiliated Hospital of Guangxi Medical University between January 2020 and June 2023 were included in this retrospective study. The patients were randomly divided into a training cohort (n=169) and a test cohort (n=73). We collected 28 clinical features from the patients. Concurrently, 306 radiomics features were extracted from the ultrasound images of the patients\' tumors. Initially, a clinical model was constructed using the logistic regression algorithm. Subsequently, radiomics models were built using SVM, random forest, XGBoost, and KNN algorithms. Finally, we combined clinical features with a new feature RAD prob calculated by applying radiomics model to construct a fusion model, and developed a nomogram based on the fusion model.
    UNASSIGNED: The performance of the fusion model surpassed that of both the clinical and radiomics models. In the training cohort, the fusion model achieved an AUC of 0.978 (95% CI: 0.96-0.99) during 5-fold cross-validation and an AUC of 0.925 (95% CI: 0.86-0.98) in the test cohort. Calibration curve and decision curve analyses demonstrated that the nomogram constructed from the fusion model has high accuracy and clinical utility.
    UNASSIGNED: The fusion model containing clinical and ultrasound radiomics features showed excellent performance in predicting the benign or malignant nature of pancreatic tumors.
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  • 文章类型: Journal Article
    背景:本研究的目的是评估多参数超声成像组学模型在预测乳腺癌术后复发风险和分子分型方面的功效。
    方法:回顾性分析534例经术前超声和病理确诊为乳腺癌的女性患者。2018年1月至2023年6月在新疆医科大学附属肿瘤医院就诊。单因素分析和多因素logistic回归模型用于确定与临床特征相关的独立危险因素。PyRadiomics软件包用于在选定的超声图像中描绘感兴趣的区域并提取放射学特征。随后,通过最小绝对收缩和选择算子(LASSO)回归和支持向量机(SVM)方法建立影像学评分。使用受试者工作特征(ROC)曲线评估模型的预测性能,并计算曲线下面积(AUC)。通过校准曲线和判定曲线评价诊断效能和临床实用性。
    结果:在训练集中,术后复发风险预测模型的AUC值为0.9489,他们是0.8491。关于分子分型预测模型,HER-2过表达表型的训练集和验证集中的AUC值分别为0.93和0.92,TNBC表型为0.94和0.74,腔A表型为1.00和0.97,腔B表型为1.00和0.89,分别。在全面分析校准和判定曲线的基础上,结果表明,该模型具有较强的预测性能和临床实用性。
    结论:使用多参数超声成像组学在预测乳腺癌术后复发风险和分子分型方面具有重要价值。这种非侵入性方法为该病的诊断和治疗提供了至关重要的指导。
    BACKGROUND: The aim of this study is to assess the efficacy of a multiparametric ultrasound imaging omics model in predicting the risk of postoperative recurrence and molecular typing of breast cancer.
    METHODS: A retrospective analysis was conducted on 534 female patients diagnosed with breast cancer through preoperative ultrasonography and pathology, from January 2018 to June 2023 at the Affiliated Cancer Hospital of Xinjiang Medical University. Univariate analysis and multifactorial logistic regression modeling were used to identify independent risk factors associated with clinical characteristics. The PyRadiomics package was used to delineate the region of interest in selected ultrasound images and extract radiomic features. Subsequently, radiomic scores were established through Least Absolute Shrinkage and Selection Operator (LASSO) regression and Support Vector Machine (SVM) methods. The predictive performance of the model was assessed using the receiver operating characteristic (ROC) curve, and the area under the curve (AUC) was calculated. Evaluation of diagnostic efficacy and clinical practicability was conducted through calibration curves and decision curves.
    RESULTS: In the training set, the AUC values for the postoperative recurrence risk prediction model were 0.9489, and for the validation set, they were 0.8491. Regarding the molecular typing prediction model, the AUC values in the training set and validation set were 0.93 and 0.92 for the HER-2 overexpression phenotype, 0.94 and 0.74 for the TNBC phenotype, 1.00 and 0.97 for the luminal A phenotype, and 1.00 and 0.89 for the luminal B phenotype, respectively. Based on a comprehensive analysis of calibration and decision curves, it was established that the model exhibits strong predictive performance and clinical practicability.
    CONCLUSIONS: The use of multiparametric ultrasound imaging omics proves to be of significant value in predicting both the risk of postoperative recurrence and molecular typing in breast cancer. This non-invasive approach offers crucial guidance for the diagnosis and treatment of the condition.
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  • 文章类型: Journal Article
    利用超声检查结果和临床特征,我们构建并验证了一个新的列线图,用于区分附睾结核和非结核性附睾炎,两者都有相似的症状。我们回顾性分析了2013年1月1日至2023年3月31日期间住院的附睾结核和非结核性附睾炎患者的资料。符合条件的患者被随机分配到推导和验证队列(比率,7:3)。我们绘制了一个列线图,通过多元逻辑回归构建诊断模型,并对模型进行可视化。我们使用了一致性指数,校准图,和决策曲线分析来评估歧视,校准,和列线图的临床实用性,分别。在这项研究中,136名参与者患有附睾结核,79名非结核性附睾炎。五个变量-C反应蛋白水平,阴囊皮肤温度升高,结节性病变,慢性感染,和阴囊皮肤溃疡-显着,并用于构建列线图。推导和验证队列的一致性指数分别为0.95和0.96(95%置信区间,分别为0.91-0.98和0.92-1.00)。此列线图的决策曲线分析表明,它有助于区分附睾结核和非结核性附睾炎。此列线图可以帮助临床医生区分附睾结核和非结核性附睾炎。从而提高诊断的准确性。
    Using ultrasound findings and clinical characteristics, we constructed and validated a new nomogram for distinguishing epididymal tuberculosis from nontuberculous epididymitis, both of which share similar symptoms. We retrospectively examined data of patients with epididymal tuberculosis and nontuberculous epididymitis hospitalized between January 1, 2013, and March 31, 2023. Eligible patients were randomly assigned to derivation and validation cohorts (ratio, 7:3). We drew a nomogram to construct a diagnostic model through multivariate logistic regression and visualize the model. We used concordance index, calibration plots, and decision curve analysis to assess the discrimination, calibration, and clinical usefulness of the nomogram, respectively. In this study, 136 participants had epididymal tuberculosis and 79 had nontuberculous epididymitis. Five variables-C-reactive protein level, elevated scrotal skin temperature, nodular lesion, chronic infection, and scrotal skin ulceration-were significant and used to construct the nomogram. Concordance indices of the derivation and validation cohorts were 0.95 and 0.96, respectively (95% confidence intervals, 0.91-0.98 and 0.92-1.00, respectively). Decision curve analysis of this nomogram revealed that it helped differentiate epididymal tuberculosis from nontuberculous epididymitis. This nomogram may help clinicians distinguish between epididymal tuberculosis and nontuberculous epididymitis, thereby increasing diagnosis accuracy.
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  • 文章类型: Journal Article
    目的:本研究旨在探讨小儿睾丸表皮样囊肿的临床特征和外科治疗,从而有助于与这种疾病的诊断和治疗干预有关的现有知识体系。
    方法:对23例睾丸表皮样囊肿患儿的临床资料进行回顾性分析。他们在2013年4月至2024年2月期间被我们的机构录取。同时,我们对相关文献进行了全面回顾和分析,以扩大研究结果。
    结果:观察到表皮样囊肿发病的平均年龄为6.0岁。所有病例都是单数和单方面的。B超诊断为表皮样囊肿6例,11作为畸胎瘤,6为不确定,诊断灵敏度为26.1%。所有患者都接受了保留睾丸的肿块切除术,9例患者接受了术中快速冰冻切片分析,发现8例睾丸表皮样囊肿和1例畸胎瘤,诊断灵敏度为88.89%。术后组织病理学检查确诊为睾丸表皮样囊肿。
    结论:小儿睾丸表皮样囊肿并不常见,主要表现为无痛的阴囊肿块,可以模仿睾丸恶性肿瘤的临床特征。成像方式和组织病理学评估在小儿睾丸表皮样囊肿的诊断过程中至关重要。对于B超没有定论的病例,应考虑快速术中病理检查。
    OBJECTIVE: This study aims to examine the clinical characteristics and surgical management of pediatric testicular epidermoid cysts, thereby contributing to the existing body of knowledge pertinent to the diagnosis and therapeutic intervention s for this condition.
    METHODS: A retrospective analysis was conducted on the clinical records of 23 pediatric patients diagnosed with testicular epidermoid cysts, who were admitted to our institution between April 2013 and February 2024. Concurrently, a comprehensive review and analysis of pertinent literature were undertaken to augment the findings.
    RESULTS: The mean age at which the onset of epidermoid cysts was observed was 6.0 years. All cases were singular and unilateral. B-ultrasound diagnosis categorized 6 cases as epidermoid cysts, 11 as teratomas, and 6 as indeterminate, yielding a diagnostic sensitivity of 26.1%. All patients underwent testicle-sparing mass resection, and nine patients underwent rapid intraoperative frozen section analysis, revealing eight cases of testicular epidermoid cysts and one teratoma, with a diagnostic sensitivity of 88.89%. Postoperative histopathological examination confirmed the diagnosis of testicular epidermoid cyst.
    CONCLUSIONS: Pediatric testicular epidermoid cysts are an uncommon occurrence, primarily presenting as a painless scrotal mass, which can mimic the clinical features of malignant testicular tumors. Imaging modalities and histopathological assessment are pivotal in the diagnostic process for pediatric testicular epidermoid cysts. For cases where B-ultrasound is inconclusive, rapid intraoperative pathological examination should be considered.
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