Aim To classify the FIGO's PALM‐COEIN etiology for abnormal uterine bleeding (AUB) patients according to the ultrasound and histopathology and to evaluate the etiology prevalence distribution for AUB patients. Methods A total of 1065 women with AUB in the Second Hospital of Shandong University between January 2019 and March 2021. The intrauterine histopathological and ultrasound results were reviewed retrospectively.PALM‐COEIN etiology classification was performed according to histopathology and ultrasound. The classification system was stratified into nine basic categories: Polyp (AUB‐P), adenomyosis (AUB‐A), leiomyoma (AUB‐L), malignancy and hyperplasia (AUB‐M), coagulopathy (AUB‐C), ovulatory disorders (AUB‐O), endometrium (AUB‐E), Iatrogenic(AUB‐I), and not classified (AUB‐N). The number of cases and composition ratio were also calculated. Results According to the FIGO's classification system, the PALM group (656,61.60%), which were defined as structural entities that can be measured visually with ultrasound and/or histopathology. 176 (16.53%) patients were classified as AUB‐P,102 (9.58%) patients were classified as AUB‐A, 487(45.73%) patients were classified as AUB‐L, 31 (2.91%) patients were classified as AUB‐M. The COEIN group (409,38.40%), which were defined as nonstructural entities that cannot be measured by ultrasound and/or histopathology. Nobody were classified as AUB‐C in our group, and 383 (35.96%) patients were classified as AUB‐O, 4 (0.38%) patients were classified as AUB‐E,14 (1.31%) patients were classified as AUB‐I,8 (0.75%) patients were classified as AUB‐N. Conclusion In our study, AUB‐L was the most common cause, followed by AUB‐O, AUB‐P, AUB‐A, AUB‐M, AUB‐I, AUB‐N, and AUB‐E.PALM‐COEIN etiology classification system played an important role in the epidemic and management standardization of AUB patients, provided an effective communication between physicians and researchers also. Ultrasonography was the preferred examination for AUB patients, especially with structural abnormalities.

Objective: To explore the ultrasonic(US)features of calcified epithelioma Malherbe (CEM) and epidermoid cyst(EC) in differential diagnosis and improve the accuracy of US diagnosis of CEM.Materials and Methods: We retrospectively analyzed 309 subjects, who underwent US examination before operation and pathological diagnosis for CEM or EC post-operation. The subjects were categorized into the training and validation sets according to different inspection times. The US and clinical features of CEM were evaluated through univariate analysis. A multivariate logistic regression model was used to establish the diagnostic model. Results: Statistically significant variables in univariate analysis(P<0.05)were included in the multivariate logistic regression model. The results demonstrated that the diagnostic model for CEM was statistically significant (P<0.001). The risk factors included posterior echo attenuation and hypoechoic halos (OR=9.277, 10.254) and the protective factors included age, thickness diameter, and posterior echo enhancement (OR=0.936, 0.302, 0.156). The diagnostic models tested in the training set (AUC=0.974, 95% CI=0.955-0.994) and the validation set(AUC=0.967, 95% CI=0.926-1.000) demonstrated good discriminant ability.Conclusions: The diagnostic accuracy for CEM is higher compared to EC when the nodule is characterized by posterior echo attenuation, hypoechoic halos, smaller thickness, and younger age. US diagnostic model can guide the diagnosis of CEM.

Objectives Intussusception is one of the most common abdominal emergencies in early children. Intussusception recurs in 8–20% of children after successful nonoperative reduction. The aim of this study was to explore the ultrasound findings to predict risk of recurrence in pediatric intussusception after air enema reduction. Methods A total of 336 intussusception children were followed up for 1 year after received successful air enema reduction. They were divided into the recurrent group and the non‐recurrent group. The differences of clinical characteristics, ultrasonic features, and laboratory tests were analyzed by univariate analyses and the Cox proportional hazard model. Results Sixty‐five children with recurrent intussusception were identified. There were statistically significances in the diameter of the mass, in the presence or absence of enlarged lymph nodes out of the sleeve, and in the sleeve between recurrent and non‐recurrent groups (P < .05). Other ultrasonic features, clinical characteristics, and blood parameters had no differences (P > .05). Multivariate Cox proportional hazard model showed that the diameter of the mass and abdominal lymph nodes may be the risk factors of intussusception recurrence (HR = 1.395, 95% CI: 1.045~1.863 and HR = 2.078, 95% CI: 1.118~3.865, P < .05). The cut‐off value of mass diameter was 2.55 cm, above which recurrence is more likely. Conclusions Intussusception recurrence was prone with greater mass diameter (>2.55 cm) and enlarged abdominal lymph nodes. Although these ultrasound findings for recurrence do not necessarily reduce the rate of recurrence, it can predict the recurrent possibility, and help the emergency physicians to be more vigilant in these children and better counsel parents upon discharge.

Aims: Ultrasound (US) findings of epidermoid cyst (EC) are complex and diverse. Cases of misdiagnoses are high when EC is accompanied by inflammation. The aim of this study was to analyze the features of US diagnosis of EC with inflammation and explore the characteristic images which can improve the accuracy of ultrasound diagnosis.Material and methods: A total of 241 cases were included and retrospectively analyzed. Complete clinical data of all cases were available. Lesions were examined by US before operation and the diagnosis was confirmed by histopathological examination. Based on pathological results ECs with/without acute and chronic inflammation and/or granuloma, all cases were divided into two groups: inflammation and non-inflammation group. The difference of clinical data and US features between groups was analyzed by univariate and multivariate logistic regression.Results: Analysis of skin color, length/thickness, shape, boundary, CDFI and US diagnosis accuracy showed statistical differences between the two groups (p<0.05). Multivariate logistic regression model showed that indistinct boundaries and color Doppler signal were more frequent than those in ECs without inflammation (OR=4.72, 5.89, p<0.05).Conclusion: Indistinct boundaries and color Doppler signal are important features for US diagnosis of EC with inflammation, which can help in improving the accuracy of diagnosis

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