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| 1 | Current guidelines for the management of non-alcoholic fatty liver disease:A systematic review with comparative analysis显示文摘The current epidemic of non-alcoholic fatty liver disease(NAFLD) is reshaping the field of hepatology all around the world.The widespread diffusion of metabolic risk factors such as obesity,type2-diabetes mellitus,and dyslipidemia has led to a worldwide diffusion of NAFLD.In parallel to the increased availability of effective anti-viral agents,NAFLD is rapidly becoming the most common cause of chronic liver disease in Western Countries,and a similar trend is expected in Eastern Countries in the next years.This epidemic and its consequences have prompted experts from all over the word in identifying effective strategies for the diagnosis,management,and treatment of NAFLD.Different scientific societies from Europe,America,and Asia-Pacific regions have proposed guidelines based on the most recent evidence about NAFLD.These guidelines are consistent with the key elements in the management of NAFLD,but still,show significant difference about some critical points.We reviewed the current literature in English language to identify the most recent scientific guidelines about NAFLD with the aim to find and critically analyse the main differences.We distinguished guidelines from 5 different scientific societies whose reputation is worldwide recognised and who are representative of the clinical practice in different geographical regions.Differences were noted in: the definition of NAFLD,the opportunity of NAFLD screening in high-risk patients,the noninvasive test proposed for the diagnosis of NAFLD and the identification of NAFLD patients with advanced fibrosis,in the follow-up protocols and,finally,in the treatment strategy(especially in the proposed pharmacological management).These difference have been discussed in the light of the possible evolution of the scenario ofNAFLD in the next years. | Simona Leoni Francesco Tovoli Lucia Napoli Ilaria Serio Silvia Ferri Luigi Bolondi | 2018 | World Journal of Gastroenterology2018，24，30： | 42 |
| 2 | Limitations of liver biopsy and non-invasive diagnostic tests for the diagnosis of nonalcoholic fatty liver disease/nonalcoholic steatohepatitis显示文摘It is estimated that 30%of the adult population in Japan is affected by nonalcoholic fatty liver disease(NAFLD).Fatty changes of the liver are generally diagnosed using imaging methods such as abdominal ultrasonography(US)and computed tomography(CT),but the sensitivity of these imaging techniques is low in cases of mild steatosis.Alanine aminotransferase levels may be normal in some of these patients,warranting the necessity to establish a set of parameters useful for detecting NAFLD,and the more severe form of the disease,nonalcoholic steatohepatitis(NASH).Although liver biopsy is currently the gold standard for diagnosing progressive NASH,it has many drawbacks,such as sampling error,cost,and risk of complications.Furthermore,it is not realistic to perform liver biopsies on all NAFLD patients.Diagnosis of NASH using various biomarkers,scoring systems and imaging methods,such as elastography,has recently been attempted.The NAFIC score,calculated from the levels of ferritin,fasting insulin,and typeⅣcollagen 7S,is useful for the diagnosis of NASH,while the NAFLD fibrosis score and the FIB-4 index are useful for excluding NASH in cases of advanced fibrosis.This article reviews the limitations and merits of liver biopsy and noninvasive diagnostic tests in the diagnosis of NAFLD/NASH. | Yoshio Sumida Atsushi Nakajima Yoshito Itoh | 2014 | World Journal of Gastroenterology2014，20，2： | 45 |
| 3 | 胸部肿瘤经皮穿刺活检中国专家共识显示文摘活检应用于胸部疾病的诊断已有百余年历史。根据取材方法不同,胸部肿瘤活检可分为经支气管镜活检、经皮穿刺活检、经胸腔镜活检和开胸性活检。胸部肿瘤经皮穿刺活检(percutaneous transthoracic needle biopsy,PTNB)是在影像设备引导下完成的活检操作,随着影像技术设备的不断更新,经皮穿刺活检的临床应用范围不断拓展,从最早的病理诊断扩大到组织亚型分类、基因诊断,临床需求日益增多。 | 中国抗癌协会肿瘤介入学专业委员会 中国抗癌协会肿瘤介入学专业委员会青年委员会 | 2018 | 中华医学杂志2018，98，23： | 38 |
| 4 | Diabetic nephropathy:Is it time yet for routine kidney biopsy?显示文摘Diabetic nephropathy(DN)is one of the most important long-term complications of diabetes.Patients with diabetes and chronic kidney disease have an increased risk of all-cause mortality,cardiovascular mortality,and kidney failure.The clinical diagnosis of DN depends on the detection of microalbuminuria.This usually occurs after the first five years from the onset of diabetes,and predictors of DN development and progression are being studied but are not yet implemented into clinical practice.Diagnostic tests are useful tools to recognize onset,progression and response to therapeutic interventions.Microalbuminuria is an indicator of DN,and it is considered the only noninvasive marker of early onset.However,up to now there is no diagnostic tool that can predict which patients will develop DN before any damage is present.Pathological renal injury is hard to predict only with clinical and laboratory findings.An accurate estimate of damage in DN can only be achieved by the histological analysis of tissue samples.At the present time,renal biopsy is indicated on patients with diabetes under the suspicion of the presence of nephropathies other than DN.Results from renal biopsies in patients with diabetes had made possible the classification of renal biopsies in three major groups associated with different prognostic features:diabetic nephropathy,non-diabetic renal disease(NDRD),and a superimposed non-diabetic condition on underlying diabetic nephropathy.In patients with type 2 diabetes with a higher degree of suspicion for NDRD,it is granted the need of a renal biopsy.It is important to identify and differentiate these pathologies at an early stage in order to prevent progression and potential complications.Therefore,a more extensive use of biopsy is advisable. | Maria L Gonzalez Suarez David B Thomas Laura Barisoni Alessia Fornoni | 2013 | World Journal of Diabetes2013，4，6： | 29 |
| 5 | CT引导下经皮肺穿刺对周围型肺部肿块的临床应用价值显示文摘 | 李为春 朱银喜 | 2006 | 临床肺科杂志2006，11，3： | 30 |
| 6 | Clinical practice guidelines for sentinel lymph node biopsy in patients with early-stage breast cancer: Chinese Society of Breast Surgery (CSBrS) practice guidelines 2021显示文摘Axillary lymph node assessment is one of the important indicators in the clinical pathological staging of breast cancer.Studies have shown that sentinel lymph node biopsy(SLNB)has the advantages of fewer complications and less trauma than conventional axillary lymph node dissection(ALND)/[1] Common mapping methods for SLNB include blue dye,radioisotopes,a combination of blue dye and radioisotopes,and fluorescence imaging. | Jing-Ming Ye Bao-Liang Guo Qian Liu Fei Ma Hong-Jin Liu Qian Wu Ling Xin Yuan-Jia Cheng Hong Zhang Shuang Zhang Xue-Ning Duan Jian-Guo Zhang Yin-Hua Liu | 2021 | Chinese Medical Journal2021，，8： | 26 |
| 7 | 液基细胞学技术在甲状腺结节细针穿刺病理诊断中的应用显示文摘甲状腺结节为临床常见疾病,随着高分辨率超声的普及应用,甲状腺结节的检出率可达20%~76%,其中恶性结节占5%~6.5%。鉴别结节的良恶性一直是临床上的难点,超声引导下细针穿刺活检(ultrasonic guidance fine-needle aspiration biopsy,UG-FNAB)是一种简便、安全、微创的细胞学检查方法,被国内外公认为是诊断甲状腺结节性质的首选方法”。 | 信芳杰 林东亮 赵诚 张晓娟 刘晖 | 2017 | 临床与实验病理学杂志2017，33，1： | 24 |
| 8 | Narrow-band imaging with magnifying endoscopy is accurate for detecting gastric intestinal metaplasia显示文摘AIM:To investigate the predictive value of narrowband imaging with magnifying endoscopy (NBI-ME) for identifying gastric intestinal metaplasia (GIM) in unselected patients. METHODS:We prospectively evaluated consecutive patients undergoing upper endoscopy for various indications, such as epigastric discomfort/pain, anaemia, gastro-oesophageal reflux disease, suspicion of peptic ulcer disease, or chronic liver diseases. Patients underwent NBI-ME, which was performed by three blinded, experienced endoscopists. In addition, five biopsies (2 antrum, 1 angulus, and 2 corpus) were taken and examined by two pathologists unaware of the endoscopic findings to determine the presence or absence of GIM. The correlation between light blue crest (LBC) appearance and histology was measured. Moreover, we quantified the degree of LBC appearance as less than 20% (+), 20%-80% (++) and more than 80% (+++) of an image field, and the semiquantitative evaluation of LBC appearance was correlated with IM percentage from the histological findings. RESULTS:We enrolled 100 (58 F/42 M) patients who were mainly referred for gastro-esophageal reflux disease/dyspepsia (46%), cancer screening/anaemia (34%), chronic liver disease (9%), and suspected celiac disease (6%); the remaining patients were referred for other indications. The prevalence of Helicobacter pylori (H. pylori ) infection detected from the biopsies was 31%, while 67% of the patients used proton pump inhibitors. LBCs were found in the antrum of 33 patients (33%); 20 of the cases were classified as LBC+, 9 as LBC++, and 4 as LBC+++. LBCs were found in the gastric body of 6 patients (6%), with 5 of them also having LBCs in the antrum. The correlation between the appearance of LBCs and histological GIM was good, with a sensitivity of 80% (95%CI:67-92), a specificity of 96% (95%CI:93-99), a positive predictive value of 84% (95%CI:73-96), a negative predictive value of 95% (95%CI:92-98), and an accuracy of 93% (95%CI:90-97). The NBI-ME examination overlooked GIM in 8 cases, but the GIM was less than 5% in 7 of the cases. Moreover, in the 6 false positive cases, the histological examination showed the presence of reactive gastropathy (4 cases) or H. pylori active chronic gastritis (2 cases). The semiquantitative correlation between the rate of LBC appearance and the percentage of GIM was 79% (P < 0.01). CONCLUSION:NBI-ME achieved good sensitivity and specificity in recognising GIM in an unselected population. In routine clinical practice, this technique can reliably target gastric biopsies. | Edoardo Savarino Marina Corbo Pietro Dulbecco Lorenzo Gemignani Elisa Giambruno Luca Mastracci Federica Grillo Vincenzo Savarino | 2013 | World Journal of Gastroenterology2013，19，17： | 23 |
| 9 | 经支气管冷冻肺活检二例显示文摘弥漫性肺疾病(diffuse lung disease,DLD)是呼吸科临床上比较难诊断的一类疾病,明确诊断一般需要通过组织病理学.目前获取组织标本的方法主要有经支气管钳夹活检(transbronchial forceps biopsy,TBFB)、经皮肺穿刺活检和外科肺活检(surgical lung biopsy,SLB).TBFB因其获取组织标本小,质量较差,难于满足病理需要,诊断效能低;经皮肺穿刺活检同样存在标本小常难满足病理需要的问题,且有发生气胸和血气胸的风险.SLB因创伤大,费用高,受心肺功能限制多,临床应用少.为了解决诊断DLD满意获取肺组织标本的问题,我们开展了2例DLD的经支气管冷冻肺活检(transbronchial cryobiopsy,TBCB),取得良好效果,报道如下. | 李一诗 郭述良 曹友德 | 2016 | 中华结核和呼吸杂志2016，39，11： | 21 |
| 10 | Contrast-enhanced ultrasound of histologically proven hepatic epithelioid hemangioendothelioma显示文摘AIM: To analyze contrast-enhanced ultrasound(CEUS) features of histologically proven hepatic epithelioid hemangioendothelioma(HEHE) in comparison to other multilocular benign focal liver lesions(FLL).METHODS: Twenty-five patients with histologically proven HEHE and 45 patients with histologically proven multilocular benign FLL were retrospectively reviewed. Four radiologists assessed the CEUS enhancement pattern in consensus.RESULTS: HEHE manifested as a single(n = 3) or multinodular(n = 22) FLL. On CEUS, HEHE showed rim-like(18/25, 72%) or heterogeneous hyperenhancement(7/25, 28%) in the arterial phase and hypoenhancement(25/25, 100%) in the portal venous and late phases(PVLP), a sign of malignancy. Eighteen patients showed central unenhanced areas(18/25, 72%); in seven patients(7/25, 28%), more lesions were detected in the PVLP. In contrast, all patients with hemangioma and focal nodular hyperplasia showed hyperenhancement as the most distinctive feature(P < 0.01).CONCLUSION: CEUS allows for characterization of unequivocal FLL. By analyzing the hypoenhancement in the PVLP, CEUS can determine the malignant nature of HEHE. | Yi Dong Wen-Ping Wang Vito Cantisani Mirko D'Onofrio Andre Ignee Lorenzo Mulazzani Adrian Saftoiu Zeno Sparchez Ioan Sporea Christoph F Dietrich | 2016 | World Journal of Gastroenterology2016，22，19： | 21 |
| 11 | 细针吸取细胞学的进展显示文摘 | 王念黎 | 2006 | 中华病理学杂志2006，35，5： | 21 |
| 12 | Noninvasive models for assessment of liver fibrosis in patients with chronic hepatitis B virus infection显示文摘There are approximately 240 million patients with chronic hepatitis B virus(HBV) infection worldwide. Up to 40% of HBV-infected patients can progress to liver cirrhosis, hepatocellular carcinoma or chronic end-stage liver disease during their lifetime. This, in turn, is responsible for around 650000 deaths annually worldwide. Repeated hepatitis flares may increase the progression of liver fibrosis, making the accurate diagnosis of the stage of liver fibrosis critical in order to make antiviral therapeutic decisions for HBV-infected patients. Liver biopsy remains the 'gold standard' for diagnosing liver fibrosis. However, this technique has recently been challenged by the development of several novel noninvasive tests to evaluate liver fibrosis, including serum markers, combined models and imaging techniques. In addition, the cost and accessibility of imaging techniques have been suggested as additional limitations for invasive assessment of liver fibrosis in developing countries. Therefore, a noninvasive assessment model has been suggested to evaluate liver fibrosis, specifically in HBVinfected patients, owing to its high applicability, interlaboratory reproducibility, wide availability for repeated assays and reasonable cost. The current review aims to present the status of knowledge in this new and exciting field, and to highlight the key points in HBVinfected patients for clinicians. | Da-Wu Zeng Jing Dong Yu-Rui Liu Jia-Ji Jiang Yue-Yong Zhu | 2016 | World Journal of Gastroenterology2016，22，29： | 21 |
| 13 | Effect of alcohol consumption on liver stiffness measured by transient elastography显示文摘AIM:To determine the evolution of transient elastography(TE) in patients with alcoholic liver disease according to alcohol cessation or continuation.METHODS:We retrospectively selected in our local database all patients who had two TE between June 2005 and November 2010 with chronic alcohol excessive consumption and excluded those with associated cause of liver disease.TE was performed at least one week apart by senior operator.TE examinations with less than ten successful measures or with an interquartile range above 30% were excluded.We retrospectively reviewed file of all patients to include only patient followed up by trained addictologist and for which definite information on alcohol consumption was available.Concomitant biological parameters [aspartate amino transferase(AST),alanine amino transferase and gamma-glutamyl transpeptidase(GGT)] within 4 wk of initial and final TE were recorded.Putative fibrosis score according to initial and final TE were determined with available cut-off for alcoholic liver disease and hepatitis C.Initial and final putative fibrosis score were compared according to alcohol consumption during follow-up.RESULTS:During the study period 572 patients had TE examination for alcoholic liver disease and 79 of them had at least two examinations.Thirty-seven patients met our criteria with a median follow-up of 32.5 wk.At the end of the study,13(35%) were abstinent,and 24(65%) relapsers.Eight patients had liver biopsy during follow-up.TE decreased significantly during follow-up in 85% of abstinent patients [median(range):-4.9(-6.1,-1.9)],leading to a modification of the putative fibrosis stage in 28%-71% of patient according to different cut-off value.In relapsers TE increased in 45% and decreased in 54% of patient.There was no statistical difference between initial and final TE in relapsers.In the overall population,using 22.6 kPa as cut-off for cirrhosis,4 patients had cirrhosis at initial TE and 3 patients had cirrhosis at final TE.Using 19.5 kPa as cut-off for cirrhosis,7 patients had cirrhosis at initial TE and 5 patients had cirrhosis at final TE.Using 12.5 kPa as cut-off for cirrhosis,16 patients had cirrhosis at initial TE and 15 patients had cirrhosis at final TE.Evolution of biological data was in accordance with the relapse or abstinent status:abstinence ratio(duration of abstinence/duration follow-up) was correlated with AST ratio(r =-0.465,P = 0.007) and GGT ratio(r =-0.662,P<0.0001).GGT was correlated with initial(r = 0.488,P = 0.002) and final TE(r = 0.49,P<0.005).Final TE was correlated with AST(r = 0.362,P<0.05).Correlation between TE ratio and AST ratio(r = 0.44,P = 0.01) revealed that TE varied proportionally to AST for all patients irrespective of their alcohol status.The same relationship was observed between TE ratio and GGT ratio(r = 0.65,P<0.0001).Evolution of TE was significantly correlated with the ratio of time of abstinence to observation time(r =-0.387,P = 0.016) and the evolution of liver enzymes.CONCLUSION:TE significantly decreased with abstinence.Results of TE in alcoholic liver disease cannot be interpreted without taking into account alcohol consumption and liver enzymes. | Edouard Bardou-Jacquet Ludivine Legros Draman Soro Marianne Latournerie Anne Guillygomarc'h Caroline Le Lan Pierre Brissot Dominique Guyader Romain Moirand | 2013 | World Journal of Gastroenterology2013，19，4： | 20 |
| 14 | Systemic air embolism after transthoracic lung biopsy: A case report and review of literature显示文摘Computed tomography (CT)-guided lung biopsy is a common diagnostic procedure that is associated with various complications, including pneumothorax, hemoptysis and parenchymal hemorrhage. Systemic air embolism is a very rare (0.07%) but potentially lifethreatening complication. We report a fatal case of air embolism to the cerebral and coronary arteries confirmed by head and chest CT, followed by a review of the literature. | Wessam Bou-Assaly Perry Pernicano Ellen Hoeffner | 2010 | World Journal of Radiology2010，2，5： | 20 |
| 15 | Review of 336 patients with hepatocellular carcinoma at Songklanagarind Hospital显示文摘AIM To determine the clinical presentations,survival and prognostic factors of hepatocellularcarcinoma(HCC)in Southern Thailand.METHODS Retrospective analysis wasperformed on the 336 hepatocellular carcinomapatients treated at Songklanagarind hospitalbetween 1 January 1991 and 31 January 1999.RESULTS Of these 336 patients,276 weremales and 60 were females.The mean age was54.4 years.The common symptoms and signswere abdominal pain and hepatomegaly.Themost common presentation of tumor was adominant mass with daughter nodules.Portalvein involvement was found in 50% of total.Extrahepatic metastasis was found in 13%,andthe lung was the most common site.There were55.4% with evidence of cirrhosis and half ofthem were in Childs class B.HBsAg waspositive in 72.6%.Regarding Okuda’s tumorstaging,15%,61% and 24% were stage Ⅰ,Ⅱand Ⅲ,respectively.Overall median survivalwas 2.1 months(11.5,2.6 and 0.7 months forstage Ⅰ,Ⅱ and Ⅲ respectively).Treatments ofHCC improved patient survival(5.5 months vs1.6 months for untreated patients ).Mostcommon causes of death were hepatic failure.Using multivariate analysis,the prognostic factors identified were tumor staging,alpha-fetoprotein level above 10000μg·L-1extrahepatic metastasis,portal vein thrombosisand treatment.CONCLUSION HCC in Thailand is a fataldisease with poor outcome due to latepresentation and high prevalence of livercirrhosis.Early detection and propermanagement may improve outcome. | Pasiri Sithinamsuwan Teerha Piratvisuth Wiwatana Tanomkiat Nualta Apakupakul Surat Tongyoo | 2000 | World Journal of Gastroenterology2000，6，3： | 19 |
| 16 | Chronic hepatitis C and liver fibrosis显示文摘Chronic infection with hepatitis C virus(HCV) is a leading cause of liver-related morbidity and mortality worldwide and predisposes to liver fibrosis and endstage liver complications. Liver fibrosis is the excessive accumulation of extracellular matrix proteins, including collagen, and is considered as a wound healing response to chronic liver injury. Its staging is critical for the management and prognosis of chronic hepatitis C(CHC) patients, whose number is expected to rise over the next decades, posing a major health care challenge. This review provides a brief update on HCV epidemiology, summarizes basic mechanistic concepts of HCV-dependent liver fibrogenesis, and discusses meth-ods for assessment of liver fibrosis that are routinely used in clinical practice. Liver biopsy was until recently considered as the gold standard to diagnose and stage liver fibrosis. However, its invasiveness and drawbacks led to the development of non-invasive methods, which include serum biomarkers, transient elastography and combination algorithms. Clinical studies with CHC patients demonstrated that non-invasive methods are in most cases accurate for diagnosis and for monitoring liver disease complications. Moreover, they have a high prognostic value and are cost-effective. Non-invasive methods for assessment of liver fibrosis are gradually being incorporated into new guidelines and are becoming standard of care, which significantly reduces the need for liver biopsy. | Giada Sebastiani Konstantinos Gkouvatsos Kostas Pantopoulos | 2014 | World Journal of Gastroenterology2014，20，32： | 19 |
| 17 | Transient elastography: Kill two birds with one stone?显示文摘Assessment of liver fibrosis and steatosis is crucial in chronic liver diseases in order to determine the prognosis, the need of treatment, as well as monitor disease progression and response to treatment. Liver biopsy is limited by its invasiveness and patient acceptability. Transient elastography (TE, Fibroscan ) is a non-invasive tool with satisfactory accuracy and reproducibility to estimate liver fibrosis and steatosis. TE has been well validated in major liver diseases including chronic hepatitis B and C, non-alcoholic fatty liver disease, alcoholic liver disease, primary biliary cirrhosis, and primary sclerosing cholangitis. As alanine aminotransferase (ALT) is one of the major confounding factors of liver stiffness in chronic hepatitis B, an ALT-based algorithm has been developed and higher liver stiffness measurements (LSM) cutoff values for different stages of liver fibrosis should be used in patients with elevated ALT levels up to 5 times of the upper limit of normal. Otherwise falsely-high LSM results up to cirrhotic range may occur during ALT flare. TE is also useful in predicting patient prognosis such as development of hepatocellular carcinoma (HCC), portal hypertension, post-operative complications in HCC patients, and also survival. Unfortunately, failed acquisition of TE is common in obese patients. Furthermore,obese patients may have higher LSM results even in the same stage of liver fibrosis. The new XL probe, a larger probe with lower ultrasound frequency and deeper penetration, increases the success rate of TE in obese patients. The median LSM value with XL probe was found to be lower than that by the conventional M probe, hence cutoff values approximately 1.2 to 1.3 kPa lower than those of M probe should be adopted. Recent studies revealed a novel ultrasonic controlled attenuation parameter (CAP) of the machine is a useful parameter to detect even low-grade steatosis noninvasively. CAP may also be used to quantify liver steatosis by applying different cutoff values. As both LSM and CAP results are instantly available at same measurement, this makes TE a very convenient tool to assess any patients who are suspected or confirmed to suffer from chronic liver diseases. | Grace Lai-Hung Wong | 2013 | World Journal of Hepatology2013，5，5： | 18 |
| 18 | Performance of liver stiffness measurements by transient elastography in chronic hepatitis显示文摘AIM:To compare results of liver stiffness measurements by transient elastography(TE) obtained in our patients population with that used in a recently published meta-analysis.METHODS:This was a single center cross-sectional study.Consecutive patients with chronic viral hepatitis scheduled for liver biopsy at the outpatient ward of our Infectious Diseases Department were enrolled.TE was carried out by using FibroScan(Echosens,Paris,France).Liver biopsy was performed on the same day as TE,as day case procedure.Fibrosis was staged according to the Metavir scoring system.The diagnostic performance of TE was assessed by using receiver operating characteristic(ROC) curves and the area under the ROC curve analysis.RESULTS:Two hundred and fifty-two patients met the inclusion criteria.Six(2%) patients were excluded due to unreliable TE measurements.Thus,246(171 men and 75 women) patients were analyzed.One hundred and ninety-five(79.3%) patients had chronic hepatitis C,41(16.7%) had chronic hepatitis B,and 10(4.0%) were coinfected with human immunodeficiency virus.ROC curve analysis identified optimal cut-off value of TE as high as 6.9 kPa forF ≥ 2;7.9 kPa forF ≥ 3;9.6 kPa for F = 4 in all patients(n = 246),and as high as 6.9 kPa for F ≥ 2;7.3 kPa for F ≥ 3;9.3 kPa for F = 4 in patients with hepatitis C(n = 195).Cut-off values of TE obtained by maximizing only the specificity were as high as 6.9 kPa for F ≥ 2;9.6 kPa for F ≥ 3;12.2 kPa for F = 4 in all patients(n = 246),and as high as 7.0 kPa forF ≥ 2;9.3 kPa forF ≥ 3;12.3 kPa forF = 4 in patients with hepatitis C(n = 195).CONCLUSION:The cut-off values of TE obtained in this single center study are comparable to that obtained in a recently published meta-analysis that included up to 40 studies. | Giovanna Ferraioli Carmine Tinelli Barbara Dal Bello Mabel Zicchetti Raffaella Lissandrin Gaetano Filice Carlo Filice Elisabetta Above Giorgio Barbarini Enrico Brunetti Willy Calderon Marta Di Gregorio Roberto Gulminetti Paolo Lanzarini Serena Ludovisi Laura Maiocchi Antonello Malfitano Giuseppe Michelone Lorenzo Minoli Mario Mondelli Stefano Novati Savino FA Patruno Alessandro Perretti Gianluigi Poma Paolo Sacchi Domenico Zanaboni Marco Zaramella | 2013 | World Journal of Gastroenterology2013，19，1： | 18 |
| 19 | 空芯针穿刺活检在乳腺疾病诊治中应用价值研究进展显示文摘空芯针穿刺活检 ( core needle biopsy, CNB)是乳腺疾病诊断的一种重要手段。CNB自20世纪90年代应用于临床后,因其操作简便、诊断准确性高、创伤小、费用低等特点而受到关注与广泛应用。随着影像引导技术的进步、乳腺癌临床研究的进展以及真空辅助等穿刺设备的改进,CNB正发挥越来越重要的作用。它不仅对乳腺癌的确诊有重要意义,而且为乳腺癌综合治疗方案的选择提供了重要的依据。本文就CNB在乳腺疾病诊治中的应用价值作一综述。 | 孙龙 陈小松 沈坤炜 | 2013 | 中华外科杂志2013，51，6： | 18 |
| 20 | Contrast-enhanced ultrasound improved performance of breast imaging reporting and data system evaluation of critical breast lesions显示文摘AIM: To determine whether contrast-enhanced ultrasound(CEUS) can improve the precision of breast imaging reporting and data system(BI-RADS) categorization. METHODS: A total of 230 patients with 235 solid breast lesions classified as BI-RADS 4 on conventional ultrasound were evaluated. CEUS was performed within one week before core needle biopsy or surgical resection and a revised BI-RADS classification was assigned based on 10 CEUS imaging characteristics. Receiver operating characteristic curve analysis was then conducted to evaluate the diagnostic performance of CEUS-based BI-RADS assignment with pathological examination as reference criteria. RESULTS: The CEUS-based BI-RADS evaluation classified 116/235(49.36%) lesions into category 3, 20(8.51%), 13(5.53%) and 12(5.11%) lesions into categories 4A, 4B and 4C, respectively, and 74(31.49%) into category 5. Selecting CEUS-based BI-RADS category 4A as an appropriate cut-off gave sensitivity and specificity values of 85.4% and 87.8%, respectively, for the diagnosisof malignant disease. The cancer-to-biopsy yield was 73.11% with CEUS-based BI-RADS 4A selected as the biopsy threshold compared with 40.85% otherwise, while the biopsy rate was only 42.13% compared with 100% otherwise. Overall, only 4.68% of invasive cancers were misdiagnosed.CONCLUSION: This pilot study suggests that evaluation of BI-RADS 4 breast lesions with CEUS results in reduced biopsy rates and increased cancer-to-biopsy yields. | Jun Luo Ji-Dong Chen Qing Chen Lin-Xian Yue Guo Zhou Cheng Lan Yi Li Chi-Hua Wu Jing-Qiao Lu | 2016 | World Journal of Radiology2016，8，6： | 17 |
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