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The number of people suffering from scrub typhus, which is not of concern, is increasing year by year, especially in Yunnan Province, China. From June 1, 2021 to August 15, 2022, a total of 505 mammalian samples were collected from farm, forest, and residential habitats with high incidence of scrub typhus in Yunnan, China, for nPCR (nested PCR) and qPCR (quantitative real-time PCR) detection of Orientia tsutsugamushi. A total of 4 orders of murine-like animals, Rodentia (87.52%, n = 442), Insectivora (10.29%, n = 52), Lagomorpha (1.79%, n = 9) and Scandentia (0.40%, n = 2) were trapped. Comparing the qPCR infection rates in the three habitats, it was no significant difference that the infection rate of residential habitat (44.44%) and that of the farm habitat (45.05%, P>0.05), which is much larger than that of the forest habitat (3.08%) (P<0.001). Three genotypes (Karp-like, Kato-like and TA763-like) of O. tsutsugamushi were found from Yunnan, China in this study. [ABSTRACT FROM AUTHOR]

Simple Summary: Bartonella is an intracellular parasitic zoonotic pathogen that can infect animals and cause a variety of human diseases. The prevalence and the copy number of Bartonella spp. in different tissues in small mammals were studied using conventional PCR and real-time quantitative PCR in Yunnan Province, China. Results showed a 31.5% detection rate, varying across species. Genetic analysis identified thirty, ten, and five strains based on ssrA, rpoB, and gltA genes, with nucleotide identities ranging from 92.1% to 100.0%. Seven species of Bartonella were identified, including B. grahamii, B. rochalimae, B. sendai, B. koshimizu, B. phoceensis, B. taylorii, and a new species in Episoriculus leucops (GS136). Analysis of the different tissues naturally infected by Bartonella spp. revealed varied copy numbers across different tissues, with the highest load in spleen tissue. These findings underscore Bartonella's species diversity and host range in Yunnan Province, highlighting the presence of extensive tissue tropism in Bartonella spp. naturally infecting small mammalian tissues. Bartonella is an intracellular parasitic zoonotic pathogen that can infect animals and cause a variety of human diseases. This study investigates Bartonella prevalence in small mammals in Yunnan Province, China, focusing on tissue tropism. A total of 333 small mammals were sampled from thirteen species, three orders, four families, and four genera in Heqing and Gongshan Counties. Conventional PCR and real-time quantitative PCR (qPCR) were utilized for detection and quantification, followed by bioinformatic analysis of obtained DNA sequences. Results show a 31.5% detection rate, varying across species. Notably, Apodemus chevrieri, Eothenomys eleusis, Niviventer fulvescens, Rattus tanezumi, Episoriculus leucops, Anourosorex squamipes, and Ochotona Thibetana exhibited infection rates of 44.4%, 27.7%, 100.0%, 6.3%, 60.0%, 23.5%, and 22.2%, respectively. Genetic analysis identified thirty, ten, and five strains based on ssrA, rpoB, and gltA genes, with nucleotide identities ranging from 92.1% to 100.0%. Bartonella strains were assigned to B. grahamii, B. rochalimae, B. sendai, B. koshimizu, B. phoceensis, B. taylorii, and a new species identified in Episoriculus leucops (GS136). Analysis of the different tissues naturally infected by Bartonella species revealed varied copy numbers across different tissues, with the highest load in spleen tissue. These findings underscore Bartonella's diverse species and host range in Yunnan Province, highlighting the presence of extensive tissue tropism in Bartonella species naturally infecting small mammalian tissues. [ABSTRACT FROM AUTHOR]

The genetic diversity of coronaviruses (CoVs) is high, and their infection in animals has not yet been fully revealed. By RT-PCR detection of the partial RNA-dependent RNA polymerase (RdRp) gene of CoVs, we screened a total of 502 small mammals in the Dali and Nujiang prefectures of Western Yunnan Province, China. The number of overall CoV positives was 20, including β-CoV (n = 13) and α-CoV (n = 7), with a 3.98% prevalence in rectal tissue samples. The identity of the partial RdRp genes obtained for 13 strains of β-CoV was 83.42–99.23% at the nucleotide level, and it is worth noting that the two strains from Kachin red-backed voles showed high identity to BOV-36/IND/2015 from Indian bovines and DcCoV-HKU23 from dromedary camels (Camelus dromedarius) in Morocco; the nucleotide identity was between 97.86 and 98.33%. Similarly, the identity of the seven strains of α-CoV among the partial RdRp sequences was 94.00–99.18% at nucleotide levels. The viral load in different tissues was measured by quantitative RT-PCR (qRT-PCR). The average CoV viral load in small mammalian rectal tissue was 1.35 × 106 copies/g; differently, the mean CoV viral load in liver, heart, lung, spleen, and kidney tissue was from 0.97 × 103 to 3.95 × 103 copies/g, which revealed that CoV has extensive tropism in rectal tissue in small mammals (p < 0.0001). These results revealed the genetic diversity, epidemiology, and infective tropism of α-CoV and β-CoV in small mammals from Dali and Nujiang, which deepens the comprehension of the retention and infection of coronavirus in natural hosts. [ABSTRACT FROM AUTHOR]

A correction notice was issued for a study on the detection of Alpha- and Betacoronaviruses in small mammals in Western Yunnan Province, China. The correction involved updating the species name "Short-tailed shrew" to "Chinese mole shrew" in Table 2 of the publication. The scientific conclusions of the study were deemed unaffected by this correction, which was approved by the Academic Editor. [Extracted from the article]

Abstract: Objective: The aim of this study was to evaluate the blood flow characteristics of intracranial vertebral–basilar artery (V-BA) in healthy Chinese adults with transcranial color Doppler flow imaging (TCDFI) and provide reference values of healthy people of different ages and genders. Methods: Three hundred healthy Chinese adults were divided into three groups based on their ages: Group I: 20–39 years, Group II: 40–59 years, Group III: ≥60 years. Each group was subdivided into two subgroups according to their gender. Peak systolic velocity (Ps), end-diastolic velocity (Vd), time average maximum velocity (TAMAX), pulsatility index (PI), and resistance index (RI) were measured from intracranial V-BA scanning. Results: Ps, Vd, and TAMAX decreased with age, while PI and RI increased in all groups. Flow velocity in women was slightly higher than that of men, and there was significant differences in group III between men and women (P<.05). However, no difference was found in the flow parameters between left and right vertebral arteries. Conclusions: This study offered reference values of intracranial V-BA flow parameters in healthy Chinese adults and indicated that these parameters varied with age and gender. [Copyright &y& Elsevier]

This paper presents a comparative study of the diagnostic results of the ultrasologists with/without using a novel enhancement algorithm for breast ultrasonic images based on fuzzy entropy principle and textural information. Totally, 350 ultrasound images of 115 cases were analyzed including 59 benign and 56 malignant lesions. The original breast images were fuzzified, the edge and textural information were extracted, and the images were enhanced. The original and enhanced images were assessed and evaluated by ultrasologists using double blind method before and after enhancement. The diagnostic sensitivity and specificity were calculated by the areas (Az) under the receiver operating characteristic (ROC) curves. And the two diagnostic results before and after enhancement were compared by Chi-square test in a 2×2 table. The results demonstrated that the discrimination rate of breast masses had been highly improved after employing the novel enhancement algorithm. The result indicates the sensitivity could be raised from 74.3% to 89.3% with the false-positive rate 14.3%, and the area (Az) under the ROC curve of diagnosis also increased from 0.84 to 0.93. The novel enhancement algorithm can increase the classification accuracy and decrease the rate of missing and misdiagnosis, and it is useful for breast cancer control. [ABSTRACT FROM AUTHOR]

Abstract: Objective: The aims of this prospective study were to investigate the manifestations of the hemodynamics and morphology of a normal intracranial vertebral artery (VA) and diffusely severe or localized critical vertebral artery stenosis (VAS) on transcranial color Doppler flow imaging (TCDFI) and to discuss the criteria of TCDFI in detecting severe VAS. Methods: There were 30 patients suspected of having an intracranial VAS in a patient group and 30 healthy volunteers in a control group. All the patients underwent both TCDFI and digital subtraction angiography (DSA). The intracranial VA was imaged through the suboccipital window by TCDFI. The size and tortuousness of the vessels were observed. The hemodynamics of those vessels were measured by means of peak systolic velocity (PSV) and pulsatility index (PI). Results: In the control group, the VA junction with basilar artery appeared as Y shaped and filled with well-distributed blue coded on color imaging, which showed flow below the baseline with fast early systolic acceleration, and normal PSV ranged from 0.42 to 0.80 m/s on pulse wave Doppler. In the patients with diffusely severe VAS (>70% lumen reduction, the length of plaque >1 cm or multiple plaques) or localized critical VAS (>90% lumen reduction) diagnosed by TCDFI and confirmed with DSA, a narrowed and tortuous VA was demonstrated with minimal flow on color Doppler imaging and decreased 50% of normal PSV and PSV <0.30 m/s accompanied by slow early systolic acceleration on Doppler spectrum. There was a significant difference (P<.05 or P<.01) in the hemodynamic parameters (PSV and PI) between patients with severe VAS and healthy subjects. Conclusion: TCDFI is a useful noninvasive tool in assessing the hemodynamics of intracranial arteries. The sensitivity was 90.9% and the specificity was 75.0% by using PSV <0.30 m/s and 50% reduction of normal PSV as low cutoff criteria in the diagnosis of diffusely severe or localized critical VAS with TCDFI. [Copyright &y& Elsevier]

Objective: The accurate preoperative differentiation of benign and malignant adnexal masses, especially those with complex ultrasound morphology, remains a great challenge for junior sonographers. The purpose of this study was to develop and validate a nomogram based on the Ovarian-Adnexal Reporting and Data System (O-RADS) for predicting the malignancy risk of adnexal masses with complex ultrasound morphology. Methods: A total of 243 patients with data on adnexal masses with complex ultrasound morphology from January 2019 to December 2020 were selected to establish the training cohort, while 106 patients with data from January 2021 to December 2021 served as the validation cohort. Univariate and multivariate analyses were used to determine independent risk factors for malignant tumors in the training cohort. Subsequently, a predictive nomogram model was developed and validated in the validation cohort. The calibration, discrimination, and clinical net benefit of the nomogram model were assessed separately by calibration curves, receiver operating characteristic (ROC) curves, and decision curve analysis (DCA). Finally, we compared this model to the O-RADS. Results: The O-RADS category, an elevated CA125 level, acoustic shadowing and a papillary projection with color Doppler flow were the independent predictors and were incorporated into the nomogram model. The area under the ROC curve (AUC) of the nomogram model was 0.958 (95% CI, 0.932–0.984) in the training cohort. The specificity and sensitivity were 0.939 and 0.893, respectively. This nomogram also showed good discrimination in the validation cohort (AUC = 0.940, 95% CI, 0.899–0.981), with a sensitivity of 0.915 and specificity of 0.797. In addition, the nomogram model showed good calibration efficiency in both the training and validation cohorts. DCA indicated that the nomogram was clinically useful. Furthermore, the nomogram model had higher AUC and net benefit than the O-RADS. Conclusion: The nomogram based on the O-RADS showed a good predictive ability for the malignancy risk of adnexal masses with complex ultrasound morphology and could provide help for junior sonographers. [ABSTRACT FROM AUTHOR]

Introduction and hypothesis: We hypothesized that differences in post-partum levator hiatus (LH) measurements, as well as the area of urethra and bladder (AUB), viewed under ultrasound, correlate with diastasis rectus abdominis (DRA) occurrence. The primary objective of this study is to determine ultrasound parameters available for diagnosing DRA in post-partum women. We compared LH and AUB measurements under ultrasound in primiparous women, with and without DRA, at 24–26 weeks postpartum. Methods: One hundred ninety-four women underwent routine examination, including a self-made clinical symptoms questionnaire, DRA evaluation, and LH and AUB measurements. Independent samples t- and chi-squared tests were used to compare the differences between women with and without DRA. Results: DRA incidence was significantly higher among those who underwent cesarean section (CS) than for vaginal delivery (VD) (P = 0.038). DRA patients could potentially have urinary urgency, frequency, pain, dysuria, and perineal tears. Additionally, statistically significant differences were found between VD patients, with or without DRA, in the resting LH transverse diameter (TrD) (P = 0.032) and the area of the levator hiatus (ALH) (P = 0.048) as well as AUB at Valsalva (P = 0.049). No differences, however, were found between the DRA and no DRA groups for all those measurements among women who had cesarean deliveries. Conclusions: DRA was more likely in post-CS women. Furthermore, the results showed a plausible association between DRA occurrence and LH expansion, especially in women with VD under rest and Valsalva. This could be useful for developing therapeutic plans based on these parameters for post-partum rehabilitation of women with DRA to avoid long-term complications. [ABSTRACT FROM AUTHOR]

Global myocardial work (MW) analysis by pressure-strain loops (PSL) allows the non-invasive assessment of left ventricular (LV) function. We aimed to investigate the relationship between LV global MW and the degree of coronary artery stenosis in suspected coronary artery disease (CAD) patients with normal LV ejection fraction and regional wall motion. A total of 164 suspected CAD patients were divided into four groups according to coronary artery angiography. The results showed that global work efficiency (GWE) as the most significant predictor in all MW parameters had the optimal cut-off value of 94.5% for detecting moderate stenosis, and the sensitivity and specificity was 89.7% and 85.8%, respectively. A cut-off value of 94.0% for GWE was the most significant predictor of severe stenosis, and the sensitivity and specificity was 81.4% and 76.1%, respectively. In conclusion, LV global MW is a sensitive tool in detecting the degree of coronary artery stenosis and a potential valuable method to provide early diagnosis for CAD patients. [ABSTRACT FROM AUTHOR]

Objectives: To explore the efficacy of microwave ablation (MWA) in the treatment of benign thyroid nodules, and analyze related influencing factors. Methods: The clinical and ultrasound data of 115 patients with 115 benign thyroid nodules treated with MWA were retrospectively analyzed. The volume of nodules at 1, 3, 6, and 12 months after the procedure was obtained, and the volume reduction rate (VRR) at each time point was calculated. With VRR > 90% as the criterion for nodule cure, binary logistic regression was employed to screen the factors that affect the efficacy. Results: ‹ At 1, 3, 6, and 12 months after the procedure, the volume of nodules continued to decrease, the VRR gradually increased, and the differences at each time point were statistically significant (p < 0.05). A total of 29 (25.21%) nodules disappeared completely at 12 months after the procedure; › Multivariate stepwise logistic regression showed that there was a statistically significant difference for the internal component of nodules, enhancement mode, and immediate volume after the procedure in determining the ablation efficacy (p < 0.05); fi The ROC curve was plotted for predicting the efficacy of MWA, with the results showing that the AUC, sensitivity, specificity, and accuracy were 0.82, 67.50, 88.00, 79.10%, respectively; fl 11 cases (9.56%) had side effects, 10 cases (8.70%) had minor complications, and three cases (2.61%) had major complications. Conclusion: MWA is safe and effective in the treatment of benign thyroid nodules. The internal component of nodules, enhancement mode, and immediate volume after the procedure are independent factors that affect the efficacy of ablation. [ABSTRACT FROM AUTHOR]

In the investment casting process, different parts of the casting always have various macroscopic structures. Different distribution of internal stress appears in these different parts in the casting, which let each part have different shrinkage distribution. As the design of die cavity can be based on computer-aided design model and fractional shrinkage in the casting process, it can be of benefit for the die cavity design if the fractional shrinkage can be predicted based on structural parameters of the computer-aided design model. Compared to the traditional die-repair method, it is favorable to achieve fast die-repairing and reduce trial-manufacture cost. As an initial study, a wheel shape casting is designed and it is divided into three parts. Fractional shrinkage of these parts is analyzed to research shrinkage rule. The research methods are casting simulation and experiment. The same process parameters are used in the two methods. The simulated and measured results of fractional shrinkage distribution in the corresponding parts show the same trend. It can be concluded that the simulated result can also reflect the fractional shrinkage distribution effectively. Besides, structural parameters that can influence fractional shrinkage are chosen. Then, the mapping model between these structural parameters and fractional shrinkage is built by regression method. Furthermore, the predicted values of the mapping model are compared with measured values. The result shows that the mapping model has a good performance in predicting fractional shrinkage of different parts in wheel shape casting. [ABSTRACT FROM AUTHOR]

The turbine blade is one of the most important parts in turbine machinery. Casting deformation is an important index to evaluate the quality of the turbine blade. In order to control the deformation of the turbine blade during investment casting, a novel compensation method based on reverse deformation was proposed in this study. Firstly, the process of deformation compensation was discussed. To overcome the disadvantage of the iteration compensation process, a one-step compensation model was developed based on Taylor expansion. Moreover, a smooth deformation function for the compensation model was regressed based on casting simulation results. Finally, two blades were optimized according to the proposed methodology. The deformations before and after compensation were compared. The results indicated that the casting deformation was reduced significantly. Hence, a more accurate blade can be achieved. [ABSTRACT FROM AUTHOR]

Proper evaluation of myocardial microvascular perfusion and assessment of infarct size is critical for clinicians. We have developed a novel computer-aided diagnosis (CAD) approach for myocardial contrast echocardiography (MCE) to measure myocardial perfusion and infarct size. Rabbits underwent 15 min of coronary occlusion followed by reperfusion (group I, n = 15) or 60 min of coronary occlusion followed by reperfusion (group II, n = 15). Myocardial contrast echocardiography was performed before and 7 d after ischemia/reperfusion, and images were analyzed with the CAD system on the basis of eliminating particle swarm optimization clustering analysis. The myocardium was quickly and accurately detected using contrast-enhanced images, myocardial perfusion was quantitatively calibrated and a color-coded map calibrated by contrast intensity and automatically produced by the CAD system was used to outline the infarction region. Calibrated contrast intensity was significantly lower in infarct regions than in non-infarct regions, allowing differentiation of abnormal and normal myocardial perfusion. Receiver operating characteristic curve analysis documented that −54-pixel contrast intensity was an optimal cutoff point for the identification of infarcted myocardium with a sensitivity of 95.45% and specificity of 87.50%. Infarct sizes obtained using myocardial perfusion defect analysis of original contrast images and the contrast intensity-based color-coded map in computerized images were compared with infarct sizes measured using triphenyltetrazolium chloride staining. Use of the proposed CAD approach provided observers with more information. The infarct sizes obtained with myocardial perfusion defect analysis, the contrast intensity-based color-coded map and triphenyltetrazolium chloride staining were 23.72 ± 8.41%, 21.77 ± 7.8% and 18.21 ± 4.40% (% left ventricle) respectively ( p > 0.05), indicating that computerized myocardial contrast echocardiography can accurately measure infarct size. On the basis of the results, we believe the CAD method can quickly and automatically measure myocardial perfusion and infarct size and will, it is hoped, be very helpful in clinical therapeutics. [ABSTRACT FROM AUTHOR]

Aims To observe the geometric changes in aortic-mitral valve coupling ( AMC) on three-dimensional transesophageal echocardiography and the factors leading to decreased mitral regurgitation (MR) after coronary artery bypass grafting ( CABG). Methods and Results This study included 23 patients undergoing CABG for coronary artery disease. Fifteen patients with moderate to severe MR were separately analyzed to determine whether the severity of MR influences the geometric change in AMC. Echocardiographic examinations were performed pre- and post- CABG, and the studied parameters were obtained using Siemens Auto Valve Analysis software. The effective mitral regurgitant orifice area, left ventricular ejection fraction ( LVEF), end-diastolic volume ( EDV), and end-systolic volume ( ESV) were measured pre- and post- CABG using Philips QLAB software. Ischemic MR, EDV, and ESV significantly decreased (all P < 0.05) and LVEF significantly improved (P < 0.05) after CABG. There were no significant differences between the pre- and post- CABG mitral valve (MV) parameters, aortic valve parameters, aortic-mitral annular angle, or centroid distance (all P > 0.05). Patients with moderate to severe MR exhibited the same results. Conclusion The results of this study show that CABG does not cause an acute change in the geometry of AMC. Improved left ventricular function might increase the closing force of the MV, leading to decreased MR after CABG alone. MR significantly improved after CABG alone without MV treatment in the present study. This result may help to guide surgeons in choosing the optimal surgical methods for individual patients. [ABSTRACT FROM AUTHOR]

Aim To summarize the ultrasonic features of isolated fallopian tube torsion ( IFTT) by retrospectively analyzing cases presenting at our hospital. Methods This analysis was approved by the ethical committee of our hospital. Medical records of surgically proven IFTT patients admitted to our hospital since 2002 were collected. Clinical features and preoperative diagnoses of the patients were analyzed retrospectively. Ultrasonic images were reviewed and characteristics, including location, size, shape, echo and vascularity of the fallopian tube, were summarized. Results Eleven patients with IFTT were studied. No obvious association was found between the torsion and menstruation cycle. Only four accurate diagnoses were made before the operation. Degrees of torsion ranged 360-2160°. Most of them (9/11, 81.8%) were greater than 720°. Sonograms of the 11 patients could be classified into four types: cystic masses, tube-like structures, heterogeneous masses and whirlpool signs. Cystic masses were the most commonly seen type (4/11, 36.4%), followed by tubular structures (3/11, 27.3%). Whirlpool sign was believed to be the most specific sign in diagnosing IFTT. Conclusion Through review of the authors' experiences, it is possible to diagnose IFTT preoperatively by ultrasound. Sonograms of the IFTT could be divided into four types while clinical significance of this classification requires further confirmation. [ABSTRACT FROM AUTHOR]

Abstract: Objective: To assess the clinical value of strain ratio in differentiating thyroid solid nodules and explore its distribution characters based on pathological results. Materials and methods: The study was approved by the ethic committee and the informed consents were signed. Ninety nine solid thyroid nodules (67 benign and 32 malignant) from 71 female (mean age 46.3±9.8 years) and 28 male (mean age 54.9±11.7 years) patients were evaluated. Five radiologists evaluated the nodules based on a four-degree elastography score system. Strain ratio was calculated on-line. Diagnostic performances of the two evaluations were compared using Receiver Operating Characteristic (ROC) curves. Values of different pathological nodules were compared by one-way ANOVA. Results: Areas under the ROC curve (AUC) of the five readers were 0.82, 0.81, 0.79, 0.73 and 0.83, respectively. The AUC of strain ratio evaluation was higher (0.88 vs. 0.79, p <0.001) than that of the ES score evaluation. Best cut-off points of the two evaluations were 3.5 (82% sensitivity, 72% specificity) and 4.225 (81% sensitivity, 83% specificity), respectively. Both the ES score and strain ratio were higher for malignant nodules than that for benign ones (p <0.001). Conclusions: Strain ratio was a useful index in differential diagnosis of thyroid solid nodules. It can provide quantitative information on thyroid nodule characterization and improve diagnostic confidence. The best cut-off point for benign and malignant nodules was 4.2. [Copyright &y& Elsevier]

We investigated the effect of using a novel segmentation algorithm on radiologists' sensitivity and specificity for discriminating malignant masses from benign masses using ultrasound. Five-hundred ten conventional ultrasound images were processed by a novel segmentation algorithm. Five radiologists were invited to analyze the original and computerized images independently. Performances of radiologists with or without computer aid were evaluated by receiver operating characteristic (ROC) curve analysis. The masses became more obvious after being processed by the segmentation algorithm. Without using the algorithm, the areas under the ROC curve (Az) of the five radiologists ranged from 0.70∼0.84. Using the algorithm, the Az increased significantly (range, 0.79∼0.88; p < 0.001). The proposed segmentation algorithm could improve the radiologists' diagnosis performance by reducing the image speckles and extracting the mass margin characteristics. [ABSTRACT FROM AUTHOR]

Abstract: Objective: To evaluate the clinical value of transvaginal elastography (TVES) in diagnosing cervical malignancies by detecting changes of tissue stiffness. Methods: One hundred and ten consecutive patients with cervical lesions were enrolled. Pathological results were used as the gold standards. TVES was employed to detect the stiffness changes of the cervix. Strain ratio was calculated and compared between the benign and malignant lesions. Depth of invasion into stromas of 56 cases of cervical cancers measured by TVES were recorded and compared with the pathological results. Interclass correlation coefficient (ICC) was used to analyze the reproducibility. Results: Strain ratio of malignant lesions were much higher than that of the benign lesions (8.19±5.66 vs. 2.81±2.24, P <0.01). Area under the curve (AUC) was 0.905 with a 95% CI (0.835–0.976). The best cut-off point of strain ratio value was 4.53. Specificity and sensitivity for the best cut-off point were 0.788 and 0.897, respectively. Mean depth of the 56 malignant lesions was 17.8±7.4mm measured by TVES (range 5.4–43.1mm) and 11.5±8.8mm measured by pathological samples (range 3.7–38.4mm). ICC of the 2 methods were 0.87 (95% CI 0.863–0.947) and 0.931 (95% CI 0.902–0.952) for the 2 observers. Conclusions: TVES was a useful technique in confirming the diagnoses of cervical cancer and in estimating the infiltrating region. When the strain ratio of a cervical lesion was higher than 4.53, it is confidential to be diagnosed as malignant. [Copyright &y& Elsevier]