Objectives The current study sought to explore the effects of ultrasound (US)‐guided radiofrequency ablation (RFA) on papillary thyroid microcarcinoma (PTMC) and influencing factors. Methods PTMC patients were assigned to observation (US‐guided RFA) and control (surgical operation) groups. A series of operation‐related indexes (operation time, intraoperative bleeding, wound closure time, hospital stay, and expenses), visual analogue scale score, lesion size, and thyroid function‐related indexes (thyroid‐stimulating hormone [TSH], free triiodothyronine*** [FT3], free thyroxine [FT4]), inflammatory factors, and thyroglobulin antibody (TgAb) were assessed and compared. After a 6‐month follow‐up period, the complications and recurrence were recorded, in addition to analyses of postoperative recurrence cumulative incidence and evaluation of recurrence risk factors. Results Operation‐related indexes of the observation group were relatively decreased compared with the control group. In addition, the lesion volume in the observation group was lower compared to that in the control group at the 6th month after operation, whereas the volume reduction rate was higher. There were no significant differences in regard to thyroid function‐related indexes in the observation group before/after operation. After operation, serum TSH levels and inflammatory factors, and TgAb levels were all diminished, while the FT3 and FT4 levels were both elevated in the observation group relative to the control group, and postoperative recurrence cumulative incidence was lower in the observation group. TSH and TgAb were established as the independent risk factors for recurrence after RFA in PTMC patients. Conclusions Our findings highlighted that US‐guided RFA exhibits better efficacy, safety, and postoperative recovery and lower recurrence risk for PTMC.

Background There are two types of testicular torsion: complete and incomplete. The degree and duration of symptoms of this condition are critical for treatment decision-making, as the consequences for untimely diagnosis and management can be serious. The preoperative assessment of the degree of acute testicular torsion using ultrasonography is particularly important for determining the appropriate intervention. The purpose of this study was to compare the effectiveness of high-frequency versus contrast-enhanced ultrasonography in determining the degree of acute testicular torsion. Methods Fifteen patients with clinically diagnosed acute testicular torsion underwent both high-frequency and contrast-enhanced ultrasonography. We compared the characteristics of the ultrasonographic images of the testicular parenchyma in both the afflicted and contralateral (healthy) testes to determine the reliability of contrast-enhanced ultrasonography in assessing the degree of acute testicular torsion. Results The high-frequency ultrasound and contrast-enhanced ultrasound diagnosis of 4 complete testicular torsion and 11 incomplete testicular torsion were correct before operation. However, 5 patients with incomplete testicular torsion were misdiagnosed as complete testicular torsion because no blood flow was detected by high frequency ultrasound. Finally, low speed blood flow was detected by contrast-enhanced ultrasound and the diagnosis was corrected. The accuracy of diagnosing incomplete testicular torsion was 100% using contrast-enhanced ultrasonography and 66.7% using high-frequency ultrasonography; the difference between the two methods was statistically significant (χ2 = 2.50, P ≤ 0.05). Conclusion Contrast-enhanced ultrasonography can diagnose testicular torsion with high accuracy and can detect low-velocity blood flow and show microcirculatory blood perfusion in the testicular parenchyma. This can avoid misdiagnosing incomplete testicular torsion as complete, thus averting unnecessary orchiectomy.

Background The incidence of epithelium angiomyolipoma is extremely low, and the accurate diagnosis of pre-treatment imaging is clinically significant for treatment choice and patient prognosis. This study analyzed the computed tomography (CT) imaging features of patients with epithelium angiomyolipoma (EAML) and explored the causes of misdiagnosis to improve the accuracy of imaging diagnosis. Methods This study was a retrospective analysis of the clinical manifestations, imaging data, and characteristics of 13 patients (14 lesions) with EAML in our hospital from March 2011 to March 2021; further, we performed a review of the domestic and international literature on its CT imaging characteristics. Results The clinical presentations included abdominal pain, abdominal discomfort, or physical examination findings. All patients had a single lesion, except for one patient with one lesion in each kidney and one patient with additional renal vascular smooth muscle lipomas. Half of the lesions occurred in the left/right kidney, eight occurred in the middle of the kidney (57.1%), five (42.9%) occurred in the lower pole, 10 (71.4%) occurred mainly in the renal cortex, 10 (71.4%) showed exophytic growth, four (28.5%) were intraparenchymal, nine (64.3%) showed equal or slightly high density, eight (57.1%) had measurable fat components, 13 (92.9%) lacked calcification, 11 (84.6%) were round or oval, and 10 (71.4%) showed wedge-shaped signs on three-dimensional reconstruction. Seven lesions showed an early washout pattern (50.0%), seven (50.0%) showed a prolonged enhancement pattern, 10 (71.4%) showed inhomogeneous enhancement, and eight (57.1%) showed tumor neovascularization on enhancement scans. No lesions were correctly diagnosed preoperatively as epithelioid vascular smooth muscle lipoma. Four were mentioned in the differential diagnosis as requiring differentiation from fat-depleted vascular smooth muscle lipoma. Conclusions The diagnostic accuracy of EAML imaging is low, the clinical manifestations are non-specific, and the imaging manifestations are difficult to distinguish from renal cancer or vascular smooth muscle lipoma. Lesions showed equal or slightly high density on CT scans, starting from the renal cortex, with exophytic growth, “wedge sign,” and prolonged enhancement patterns. This disease should be considered in cases with early washout patterns with more uniform enhancement or intratumoral neoplasia in the lesion.

Background We aimed to analyze the computed tomography (CT) and magnetic resonance imaging (MRI) findings of gouty arthritis primarily involving the large joints of the upper limbs, signal or density characteristics of the tophi, growth patterns, involvement of the adjacent joints, and differentiation from other lesions occurring in this area and to discuss the causes of misdiagnosis. Methods CT and MRI data were collected from 14 patients with gouty arthritis, primarily involving the shoulder and elbow joints, and their imaging features were analyzed. Results All the patiens were ranged from 28-85 years old, and the tophi deposition can be observed on either CT or MRI.The tophi deposition apperas as slightly higher density nodules or masses on CT images,or nodules or masses on MRI with isosignal/hypointensity on T1WI and hyperintensity on T2WI. Five patients showed narrowing of the affected joint space, four had different degrees of bone erosion under the articular surface, eight developed joint effusion, and all showed surrounding soft tissue swelling. The tophi grew around the joint, with anterolateral and posterolateral tophi predominantly in the shoulder joint and dorsal tophi predominantly in the elbow joint on the MRI, with compression and edema of the surrounding soft tissues. Conclusions Gouty arthritis occurs in the large joints of the upper limbs and is characterized by fluid accumulation in the joint capsule and the formation of tophi. These tophi are usually large, with subcutaneous bone resorption and erosion, with or without cartilage destruction. However, extensive edema appeared in the soft tissue around the tophi, but the edema only produced pressure without any obvious signs of soft tissue infiltration, which may be distinguished from the joint tumor. In addition, the gout incidence rate is increased in young patients. Therefore, when the patient has a large joint mass, it is important to confirm whether there is a history of gout.