To address the issue of strong reliance on experience in identifying abnormal features during prenatal ultrasound diagnosis of fetal omphalocele， an intelligent auxiliary quality control and diagnosis model was developed to enhance the screening efficiency of primary physicians.
Methods
The data of pregnant women who underwent prenatal ultrasound examinations at Shenzhen Maternal and Child Health Hospital from January 2016 to December 2024 were retrospectively collected.A total of 324 cases of fetal omphalocele （1620 images） and 1000 cases of normal fetuses （2555 images）were included.After being labeled by ultrasound experts， the data were divided into training set， validation set， and test set at a ratio of 7：2：1 based on the case level.A dual-task model based on YOLO V8 was constructed： assessment of the quality of the cross-sectional images of the umbilical cord abdominal wall insertion （standard/non-standard） and detection of abnormal abdominal wall structures （abdominal wall defect， protruding mass）.The efficacy of the model in detecting target structures was evaluated by precision，recall rate， and average accuracy.The consistency and agreement between the model's section classification and the true category were analyzed by accuracy and weighted Kappa coefficient.
Results
The average accuracy of the model for detecting key structures reached 0.932.The detection of abdominal wall contour（0.987）， umbilical cord insertion （0.977）， and protruding mass （0.938） was excellent， while the detection accuracy of abdominal wall defect was slightly inferior （0.826）.The classification accuracy of the model for standard sections， non-standard sections， and omphalocele was 96.8% （151/156）， 100% （55/55）， and 96.1%（148/154）， respectively， and was highly consistent with the true category （weighted Kappa = 0.955， P＜0.001）.
Conclusion
The artificial intelligence model based on YOLO V8 can achieve standardized quality control and abnormal feature identification in prenatal ultrasound diagnosis of omphalocele， and is particularly suitable for assisting primary physicians in rapid prenatal ultrasound screening.
To compare the sonographic and clinicopathological characteristics of ovarian granulosa cell tumors （GCTs） and ovarian thecoma-fibroma group （OTFG） of tumors.
Methods
A retrospective analysis was conducted on 136 patients （42 GCTs and 94 OTFG tumors） with pathologically confirmed diagnoses between January 2015 and September 2024 from Guangdong Women and Children Hospital.Clinical manifestations， sonographic features， and laboratory indicators were compared.Receiver operating characteristic curve was plotted to analyze the sensitivity， specificity， and area under the curve （AUC） of anti-Müllerian hormone（AMH） in diagnosing GCT.Cochran Armitage trend test was used to analyze the correlation between tumor diameter， pelvic and peritoneal fluid accumulation， and carbohydrate antigen 125 （CA125）.
Results
The GCT group comprised 36 adult-type GCTs （85.71%， 36/42） and 6 juvenile-type GCTs （14.29%， 6/42）.The OTFG group included 59 fibrothecomas （62.77%， 59/94）， 32 fibromas （34.04%， 32/94）， and 3 thecomas （3.19%， 3/94）.OTFG tumors predominantly presented as solid hypoechoic masses （90.43%， 85/94） with posterior acoustic attenuation（86.17%， 81/94） and low vascularity （grades 1-2： 94.68%， 89/94）.In contrast， GCTs mainly manifested as cysticsolid （57.14%， 24/42） or heterogeneous solid masses （35.71%， 15/42） without posterior attenuation， with abundant vascularity （grades 3-4： 88.09%， 37/42）.In the OTFG group， tumor diameter showed a significant positive correlation with ascites and elevated CA125 levels （P＜0.001）； all three cases with Meigs syndrome had tumors ＞10 cm and elevated CA125.In the GCT group， tumor diameter was only associated with elevated CA125 （P＜0.05）.The incidences of clinical symptoms （83.33% vs 57.45%）， hormonal abnormalities （50.00% vs 12.20%）， and elevated AMH levels（80.00% vs 0） were significantly higher in the GCT group compared to the OTFG group （P=0.003， ＜0.001， and ＜0.001，respectively）.AMH demonstrated a sensitivity of 0.80， specificity of 1.00， and an AUC of 0.90 for diagnosing GCT（P＜0.001）.
Conclusion
OTFG tumors and GCTs exhibit distinct sonographic， clinical， and laboratory characteristics.Ultrasonography combined with AMH testing provides a reliable preoperative diagnostic framework for ovarian sex cord-stromal tumors.
To assess the clinical value of ultrasound features combined with the risk of ovarian malignancy algorithm （ROMA） index in predicting type I and type II epithelial ovarian cancer（EOC）.
Methods
A total of 195 patients with EOC confirmed by surgical pathology at Tongji University Affiliated Obstetrics and Gynecology Hospital （Shanghai First Maternity and Infant Hospital） from January 2021 to January 2024 were retrospectively included， and all patients underwent transvaginal ultrasound examination before treatment.Among them， 64 patients had type I EOC and 131 had type II.The differences in ultrasound features between the two groups were compared， and multivariate Logistic regression analysis was used to screen the independent predictors of type II EOC.The efficacy of ROMA index， ultrasound features， and their combination in predicting EOC subtypes was assessed by receiver operating characteristic（ROC） curve analysis.
Results
Type II EOC was mostly solid lesions （67/131， 51.14%）， while type I EOC was mostly single-chamber cystic-solid lesions （29/64， 45.3%）.Type I EOC was mostly unilateral lesions（58/64， 90.6%）， while type II EOC was mostly bilateral lesions （85/131， 64.9%）， and often accompanied by ascites （69/131， 52.67%）.The cystic part of type II EOC usually had anechoic echoes （43/64， 67.19%）， and papillary protrusions were more common （80/131， 61.07%）， while the cystic part of type I EOC usually had non-anechoic echoes （38/54， 70.4%）， and papillary protrusions were relatively rare （28/64， 43.7%）.All the above differences between the two groups were statistically significant （P＜0.05）.When the critical value of ROMA index was set at 58.48%， it had the highest predictive efficacy for type I and type II EOC， with an area under the ROC curve （AUC） of 0.805， and its sensitivity， specificity， positive predictive value， and negative predictive value were 74.8%， 75.0%， 57.8%， and 82.4%， respectively.The AUC of ultrasound feature prediction was 0.919， with a sensitivity， specificity， positive predictive value， and negative predictive value of 82.4%， 89.1%， 73.4%， and 91.6%， respectively.The combination of ultrasound features and ROMA index showed the highest diagnostic performance， with an AUC of 0.963， and a sensitivity， specificity， positive predictive value， and negative predictive value of 90.8%， 90.6%， 84.4%， and 92.4%， respectively.
Conclusion
ROMA index and ultrasound features have appreciated predictive value for type I and type II EOC， and the combination of ultrasound features and ROMA index has the best efficacy.
To investigate the quality of life， depression status， and the influencing factors of non-remission of depression in patients with T1N0M0 papillary thyroid carcinoma （PTC） before and after microwave ablation （MWA）.
Methods
A prospective longitudinal study design was adopted.A total of 302 T1N0M0 PTC patients who underwent MWA in the Department of Interventional Ultrasound of Chinese PLA General Hospital from November 2023 to October 2024 were prospectively selected.The Patient Health Questionnaire （PHQ-9）， European Organization for Research and Treatment of Cancer Quality of Life Questionnaire （EORTC QLQ-C30）， and Thyroid Cancer-specific Quality of Life Questionnaire （THYCA-QoL）were used to evaluate quality of life （QOL） and depressive status of the patients before and one month after surgery.The scores before and after treatment were compared， and multivariate Logistic regression was used to analyze the independent influencing factors related to unrelieved depression in PTC patients after ablation.
Results
After excluding 93 patients who did not complete the postoperative questionnaire， 209 patients with PTC were included in this study.Compared with the scores before MWA， depression scores were significantly decreased one month after MWA （3.74±2.69 vs 2.64±2.15， P＜0.001）.The incidence of depression （PHQ-9 score ≥5 points） decreased from 30.6% （64/209） before MWA to 17.2% （36/209） after MWA， with a statistically significant difference （P=0.001）.Compared with those before MWA treatment， the total QOL score of EORTC QLQ-C30 had no significant change （P=0.947）， but the scores of emotional and cognitive function were improved （P=0.048 and 0.035， respectively）， and that of role function was decreased （P=0.002）.THYCA-QoL total score decreased significantly after treatment （17.60±3.41 vs 16.80±2.80， P=0.009）， and neuromuscular， attention， sympathetic nerve， psychological， sensory， and feeling cold scores were significantly improved （P=0.013， 0.010， 0.031， 0.001， 0.031， and 0.010， respectively）.Multivariate logistic regression analysis showed that female gender （odds ratio ［OR］=5.598， 95% confidence interval ［CI］： 1.127-27.813， P=0.035） and nodules adjacent to the danger triangle of the face （OR=10.230， 95%CI： 2.542-41.168， P=0.001） were independent risk factors for unrelieved depression in PTC patients after MWA.
Conclusion
MWA can improve depression，thyroid cancer-specific symptoms， and quality of life related to emotional and cognitive function in early PTC patients.However， female patients or patients with nodules adjacent to the death triangle have poor relief in depression after MWA， and they should receive additional psychological support to better relieve depression and improve the QOL.
To evaluate the clinical value of a postoperative recurrence risk prediction model for luminal B breast cancer based on preoperative automated breast ultrasound （ABUS） images combined with clinicopathological features.
Methods
A retrospective analysis was conducted on 293 female patients with luminal B breast cancer who were diagnosed and underwent surgical treatment at Xijing Hospital from January 2016 to December 2019.All patients underwent preoperative ABUS examination.Patients were categorized into a recurrence group and a non-recurrence group based on their recurrence status.Differences in clinicopathological characteristics and ABUS imaging features between the two groups were compared.Factors identified to have statistical significance in the univariate analysis were included in a multivariate Cox regression model to identify independent risk factors for postoperative recurrence in luminal B breast cancer patients.Based on the identified independent risk factors， three predictive models were constructed： a clinicopathological model， an ABUS model，and a combination model.Receiver operating characteristic （ROC） curves were generated to assess the predictive performance of each model.The area under the ROC curve （AUC） values of the three models were compared using the DeLong test.The model with the best performance was used to develop a nomogram， and its internal validation was performed using the Bootstrap method.Calibration curves and decision curve analysis （DCA） were used to evaluate the efficacy of the optimal model.Kaplan-Meier survival curves stratified by different recurrence risk factors were constructed， and the differences were tested using the Log-rank test.
Results
Among the 293 postoperative luminal B breast cancer patients， 36 experienced recurrence during a median follow-up of 68 months，resulting in a postoperative recurrence rate of 12.3% （36/293）.Significant differences were observed between the recurrence and non-recurrence groups in N stage， histological grade， Ki-67 expression， maximum tumor diameter，calcification， and the presence of a coronal skip sign （P＜0.05）.Multivariate Cox regression analysis identified N3 stage（hazard ratio ［HR］=3.762， 95% confidence interval ［CI］： 1.147-12.337， P=0.029）， histological grade III（HR=3.558， 95%CI： 1.631-7.759， P=0.001）， calcification（HR=4.066， 95%CI： 1.888-8.757， P＜0.001）， and the coronal skip sign（HR=2.178， 95%CI： 1.064-4.460， P=0.033） as independent risk factors for recurrence-free survival in luminal B patients.Three predictive models were developed， with concordance indices （C-index） of 0.687 for the clinicopathological model， 0.734 for the ABUS model， and 0.791 for the combination model.ROC curve analysis demonstrated that the AUC values for the clinicopathological model， ABUS model， and combination model were 0.688， 0.707， and 0.779 in predicting 3-year recurrence risk， and 0.724， 0.745， and 0.819 in predicting 5-year recurrence risk， respectively.The DeLong test indicated that the AUC of the combination model at years was significantly higher than those of the clinicopathological model and the ABUS model （P＜0.05）.Internal validation revealed satisfactory stability for the combination model （C-index=0.788）.The calibration curve of the combination model closely matched the ideal curve.DCA showed that the combination model had higher clinical net benefit within a wide threshold probability range of 3.0% to 81.0%.Survival analysis demonstrated statistically significant differences in cumulative survival rates among patients with varying N stages， histological grades， Ki-67 expression levels， maximum tumor diameters， the presence or absence of calcification， and the presence or absence of a coronal skip sign （P＜0.05）.
Conclusion
The predictive model established by combining ABUS imaging features with clinicopathological characteristics demonstrates favorable performance， providing an efficient， accurate， and cost-effective approach for predicting postoperative recurrence risk in luminal B breast cancer patients.This model can assist clinicians in assessing recurrence risk and developing individualized followup strategies.
s To investigate the clinical utility of contrast-enhanced voiding urosonography （ceVUS） in detecting intrarenal reflux （IRR） and analyze its spatial correlation with renal parenchymal damage identified by dimercaptosuccinic acid （DMSA） scintigraphy.
Methods
A cohort of 205 non-duplex kidney patients， 410 pyeloureteral units （PUUs） were selected at the Children's Hospital Affiliated to Zhejiang University School of Medicine from January 2021 to December 2024， 302 vesicoureteric reflux（VUR）-positive diagnosed by ceVUS was analyzed.IRR was defined as contrast agent infiltration into renal collecting tubules.Kidneys were divided into upper， middle， and lower thirds along the long axis for IRR localization.IRR detection rates across VUR grades and age groups were compared.Kendall’s correlation analysis was performed to evaluate spatial concordance between IRR and DMSA abnormalities in 98 patients（196 PUUs）.
Results
The overall IRR detection rate was 20.86% （63/302 PUUs）， exclusively observed in grade III-V VUR.Grade-specific detection rates were： III （27.08%， 26/96）， IV （43.55%， 27/62）， and V （52.63%，10/19）.IRR incidence was significantly higher in infants＜1 year （27.28% ［35/126］ vs 15.91% ［28/176］， P＜0.05）.IRR distribution was： upper （42.06%， 53/126）＞lower （33.33%， 42/126）＞middle （24.60%， 31/126）.DMSA abnormalities occurred in 51.53% （101/196）， showing a strong association with IRR （80.00% ［44/55］ vs 40.42%［57/141］， P＜0.05）.DMSA abnormalities were distributed as： upper （47.78%， 75/157）＞lower （36.94%， 58/157）＞middle （15.29%， 24/157）.IRR and DMSA abnormalities demonstrated a moderate spatial correlation （Kendall’s τ=0.543， P＜0.05）.
Conclusion
CeVUS effectively identifies IRR in grade III-V VUR， particularly in younger children.The spatial concordance between IRR and DMSA abnormalities supports incorporating IRR into VUR grading systems to optimize clinical decision-making.
To investigate the correlation between left atrial/ventricular diameter ratio（LAD/LVD） and the degree of left ventricular outflow tract （LVOT） obstruction in patients with obstructive hypertrophic cardiomyopathy （HOCM）.
Methods
A total of 364 HOCM patients in Xijing Hospital were continuously enrolled.The demographic parameters and 24-hour brachial artery blood pressure parameters of the patients were collected.The following parameters were obtained using transthoracic echocardiography：maximum septal thickness （MIVS） at the base of the septum， length of anterior mitral leaflet （AML） and posterior mitral leaflet （PML）， coaptation point of the leaflets and the septum （CS）， left ventricular enddiastolic volume index （LVEDVi）， left ventricular end-systolic volume index （LVESVi）， left ventricular enddiastolic left atrial diameter （LAD） and left ventricular end-diastolic diameter（LVD）， and left atrial/ ventricular diameter ratio （LAD/LVD）.SAM and E/e' were recorded as well.LVOT resting gradient （LVOTPG-r） was measured by continuous Doppler and LVOT provoking gradient （LVOTPG-p） was measured by exercise stress echocardiography.The correlation between LAD/LVD and LVOTPG-r and LVOTPG-p was analyzed.
Results
Pearson correlation analysis showed that natural logarithm LVOTPG-r ［ln（LVOTPG-r）］ was linearly correlated with age （r =0.240， P＜0.001）， MIVS （r =-0.224， P＜0.001）， AML （r =0.135， P =0.010），LAD/LVD ratio （r =0.195， P ＜0.001）， LVESVi （r =0.113， P =0.031）， and E/e' （r =0.195， P ＜0.001）.Spearman's correlation analysis showed that ln（LVOTPG-r） was linearly correlated with gender （r =0.191，P＜0.001） and SAM classification （r =0.343， P＜0.001）.Multivariate linear regression analysis showed that after adjusting for age， gender， MIVS， AML， SAM classification， LVESVi， and E/e'， the LAD/LVD ratio was independently correlated with ln（LVOTPG-r） （P =0.008）.Pearson correlation analysis showed that natural logarithm LVOTPG-p ［ln（LVOTPG-p）］ was linearly correlated with age （r =0.128， P＜0.001）， mean diastolic blood pressure （DBP） （r =-0.127， P =0.015）， heart rate （HR） （r =1.04， P =0.048）， MIVS （r =-0.210，P＜0.001）， AML （r =0.116， P =0.027）， PML （r =0.184， P＜0.001）， LAD/LVD ratio （r =0.195， P＜0.001），and E/e' （r =0.201， P＜0.001）.Spearman's correlation analysis showed that ln（LVOTPG-p） was linearly correlated with gender （r =0.125， P =0.017） and SAM classif ication （r =0.296， P＜0.001）.Multivariate linear regression analysis showed that after adjusting for age， gender， mean DBP， HR， MIVS， AML， PML， and E/e'，the LAD/LVD ratio was independently correlated with ln（LVOTPG-p） （P =0.017）.
Conclusion
There is an independent correlation between the LAD/LVD and the degree of LVOT obstruction in patients with HOCM，whether at rest or under exercise state.This suggests that clinicians need to fully consider the contribution of LAD/LVD ratio to LVOT obstruction in patients with HOCM， in order to develop reasonable treatment plans and prognostic evaluation strategies.
To evaluate the left ventricular systolic function in children with mycoplasma pneumoniae pneumonia （MPP） using echocardiographic automated cardiac motion quantification （aCMQ）technology， and to explore its correlation with the load of mycoplasma pneumoniae DNA in bronchoalveolar lavage fluid （BALF MP-DNA）.
Methods
A retrospective study was conducted on 56 children with MPP admitted to the Children's Medical Center of Tianxin Pavilion， Hunan Provincial People's Hospital， from October 2023 to June 2024.Additionally， 51 children undergoing routine health check-ups or normal physical examinations were selected as controls.The 56 MPP children were further divided into two subgroups based on the presence or absence of abnormal serum high-sensitivity cardiac troponin I （hs-CTnI）： MPP-A group consisted of 37 children with abnormal hs-CTnI levels， and MPP-B group included 19 children with normal hs-CTnI levels.Routine echocardiographic parameters were measured in all the three groups， and left ventricular myocardial strain indices were assessed using aCMQ technology.Differences in these indices among the three groups were compared.The diagnostic efficacy of left ventricular strain indices was evaluated using receiver operating characteristic （ROC）curves， and the correlation between these indices and BALF MP-DNA load was analyzed.
Results
There were no significant differences in routine echocardiographic parameters among the three groups （all P＞0.05）.The left ventricular longitudinal strain indices ［global longitudinal strain （LVGLS）， apical four-chamber longitudinal strain（AP4LS）， apical three-chamber longitudinal strain （AP3LS）， and apical two-chamber longitudinal strain （AP2LS）］in the MPP-A group were significantly lower than those of the MPP-B group and the control group （all P＜0.05）.However， no significant differences were observed in these indices between the MPP-B group and the control group （all P＞0.05）.Similarly， no significant differences were found in left ventricular circumferential strain indices ［global circumferential strain （LVGCS）， basal short-axis circumferential strain （SAXBCS）， mid short-axis circumferential strain （SAXMCS）， and apical short-axis circumferential strain （SAXACS）］ among the three groups（all P＞0.05）.LVGLS， AP4LS， AP3LS， and AP2LS all demonstrated the ability to predict early left ventricular systolic dysfunction in MPP children， with area under the curve （AUC） values of 0.929， 0.784， 0.840， and 0.852，respectively.Among them， LVGLS exhibited the highest predictive value （P＜0.05）.The MP-DNA load in MPP children was linearly and negatively correlated with the absolute values of LVGLS， AP2LS， AP3LS， and AP4LS（r =-0.453， -0.443， -0.429， and -0.347， respectively， all P＜0.05）.
Conclusion
The left ventricular longitudinal strain indices obtained using aCMQ technology can accurately and objectively evaluate left ventricular systolic function in MPP children.Among these indices， LVGLS holds higher clinical value for assessing myocardial injury in MPP children.The correlation between left ventricular longitudinal strain index and BALF MP-DNA load provides a new perspective for explaining the mechanism of MPP's impact on the cardiovascular system.
To explore the value of contrast-enhanced ultrasound （CEUS） in evaluating the clinical stage of patients with giant cell arteritis （GCA） of superficial temporal arteries.
Methods
From January 2020 to March 2024， 87 patients clinically diagnosed with GCA at Ningbo No.2 Hospital were enrolled.According to the criteria established by the National Institutes of Health （NIH）， patients were categorized into active and inactive groups.All patients underwent blood inflammatory index testing， routine temporal artery ultrasound， and CEUS examinations.The differences in blood inflammatory indices， routine temporal artery ultrasound parameters， and CEUS parameters between patients in the active and inactive groups were comparatively analyzed， as well as the various parameters among patients with different CEUS grades.The changes in various parameters before and after treatment in patients in the active phase were analyzed， along with the correlations between the intima-media thickness （IMT） of the vessel wall， CEUS grade， C-reactive protein （CRP）， erythrocyte sedimentation rate （ESR）， and monocytes in patients in the active phase.
Results
Among the 87 patients， 72 were in the active phase of GCA and 15 were in the inactive phase.The differences in CRP， ESR， IMT， and CEUS grade between the two groups were statistically significant （t=8.976， 9.029， and 3.324， and χ2=12.135， respectively， all P＜0.05）.The differences in CRP， ESR，monocytes， and IMT among different CEUS grades were statistically significant （F=32.978， 81.550， 6.432，and 21.664， respectively， all P＜0.05）.Using CEUS grade ≥ 2 as the criterion for evaluating the active phase of GCA， the diagnostic sensitivity and specificity were 75% and 100%， respectively.In patients with active GCA， CEUS grade was moderately positively correlated with CRP （r=0.72， P＜0.001） and significantly positively correlated with ESR （r=0.846， P＜0.001）.In patients with active temporal artery GCA， the higher the CEUS grade before treatment， the more significant the decrease in CRP and ESR after treatment（F=36.653 and 98.279， respectively， P＜0.001）， while IMT had no significant difference （H=20.465， P＞0.05）.
Conclusion
CEUS can accurately assess the clinical stages and the degree of inflammation of GCA，providing imaging evidence to guide timely adjustment of clinical treatment plans and improve the prognosis of patients with temporal artery GCA.
