Objective: To develop a nomogram for predicting axillary lymph node (ALN) metastases using the breast imaging reporting and data system (BI-RADS) ultrasound lexicon. Methods: A total of 703 patients from July 2015 to January 2018 were included in this study as a primary cohort for model construction. Moreover, 109 patients including 51 pathologically confirmed N1 patients (TNM staging) and 58 non-metastatic patients were recruited as an external validation cohort from March 2018 to August 2019. Ultrasound images and clinical information of these patients were retrospectively reviewed. The ultrasonic features based on the BI-RADS lexicon were extracted by two radiologists. The features extracted from the primary cohort were used to develop a nomogram using multivariate analysis. Internal and external validations were performed to evaluate the predictive efficacy of the nomogram. Results: The nomogram was based on two features (size, lesion boundary) and showed an area under the curve of 0.75 (95% confidence interval [CI], 0.70-0.79) in the primary cohort and 0.91 (95% CI, 0.84-0.97) in the external validation cohort; it achieved an 88% sensitivity in N1 patients. Conclusion: The nomogram based on BI-RADS ultrasonic features can predict breast cancer ALN status with relatively high accuracy. It has potential clinical value in improving the sensitivity and accuracy of the preoperative diagnosis of ALN metastases, especially for N1 patients.
Background: A meta-analysis was performed to evaluate the relationship between chronic obstructive pulmonary disease (COPD) and occupational dust exposure, and to provide a scientific basis for the prevention and treatment of COPD caused by occupational factors. Methods: PubMed and Embase databases were used to search for original epidemiological literature related to theme. Both random and fixed effects models were used to calculate pooled odds ratios and their corresponding 95% confidence intervals. Review Manager was used to perform data analysis. Results: Nine studies were included in the meta-analysis in accordance with the inclusion criteria. There was a significantly obvious correlation between occupational dust exposure and COPD of the population-based studies assessed in this article. The risk of developing COPD for workers exposed to dust was 1.51 times higher than for controls ( I 2 = 40%, 95% confidence interval: 1.27-1.79). The presence of publication bias was not found. Conclusion: The study provided evidence supporting the association between occupational dust exposure and the risk of developing COPD.
Background: To observe and assess the diagnostic value of the venous phase enhancement patterns of contrast-enhanced ultrasounds (CEUS) in patients with solid pancreatic lesions that show iso-to hyperenhancement in the arterial phase of the CEUS. Methods: Patients who underwent CEUS for pancreatic lesions in the Peking Union Medical CollegeHospital between April 2017 and August 2019 were identified from the dynamic CEUS imaging database in the hospital. A total of 57 patients with pathologically or clinically diagnosed pancreatic lesions were retrospectively included in this study, and the CEUS images from these patients were evaluated. The enhancement patterns in each phase were analyzed, and each lesion was classified as malignant or benign using a five-point scale of confidence based on morphology, boundary, vascular invasion, blood flow, and enhancement patterns in ultrasound (US) and CEUS images.Results: Rapid washout in the venous phase of CEUS images was detected in 30 malignant lesions and 4 benign lesions with malignant potential. The specificity for determining malignancy was 77.8%. Continuous isoenhancement with normal pancreatic tissues in the venous phase achieved a high specificity of 95.0% for determining benign lesions. Early hyperenhancement in the arterial phase followed by slow washout in the venous phase showed high specificity of 98.1% for determining metastasis. The diagnostic confidence improved after reviewing CEUS scans (area under the receiver operating characteristic curve was 0.737 for baseline US and 0.910 for CEUS; P=0.056).Conclusions: Enhancement patterns in the venous phase of CEUS images were beneficial in the differential diagnosis of solid pancreatic lesions with iso-to hyperenhancement in the arterial phase on CEUS.
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