Matrix protein of vesicular stomatitis virus targets the mitochondria, reprograms glucose metabolism，and sensitizes to 2-deoxyglucose in glioblastoma.

A potential therapeutic approach for cancer treatment is target oxidative phosphorylation and glycolysis simultaneously. The matrix protein of vesicular stomatitis virus (VSV MP) can target the surface of mitochondria, causing morphological changes that may be associated with mitochondrial dysfunction and oxidative phosphorylation inhibition. Previous research has shown that mitochondrial abnormalities can direct glucose metabolism towards glycolysis. Thus, after treatment with VSV MP, glycolysis inhibition is necessary to completely block glucose metabolism and eradicate cancer. Here, to inhibit glycolysis, the 2-deoxy-D-glucose (2-DG), a synthetic glucose analog, was used to combine with VSV MP to treat cancer. This study aims to determine how VSV MP effects the glucose bioenergetic metabolism of cancer cells and to evaluate the synergistic effect of 2-DG when combined with VSV. Our results indicated that in U87 and C6 glioblastoma cell lines, VSV MP caused mitochondrial membrane potential loss, cytochrome c release, and glucose bioenergetics metabolism reprogramming. When combined with 2-DG, VSV MP synergistically aggravated cell viability, apoptosis and G2/M phase arrest. Meanwhile, the combination therapy exacerbated ATP depletion, activated AMPK, and inhibited mTOR signaling pathways. In addition, 2-DG treatment alone induced autophagy in glioblastoma cells, however, VSV MP inhibited the autophagy induced by 2-DG in combined treatment, and finally contributed to the enhanced cytotoxic effect of the combination strategy in U87 and C6 cancer cells. In the orthotopic U87 glioblastoma model and subcutaneous C6 glioblastoma model, the combined treatment led to significant tumor regression and prolonged survival. A potent therapeutic approach for treating glioblastoma may be found in the combination of VSV MP and glycolytic inhibitors.

Case report: Prostatic malakoplakia: a rare disease that has a profile mimicking prostate cancer.

Prostatic malakoplakia (PMP) is a rare inflammatory disease, and misdiagnosis on imaging is a major reason for unnecessary punctures; however, information on imaging is even rarer. Five patients with PMP between May 2022 and February 2023 were enrolled in this study to summarize the imaging manifestations. All patients underwent ultrasound (US)-guided prostate biopsy and were confirmed by pathology, and the presence of prostate cancer was also excluded by pathology. The five patients, with a median age of 71 years (range = 58-74 years), had a median total prostate-specific antigen (T-PSA) of 10.40 ng/mL (range = 1.74-63.42 ng/mL). In two patients, chest computed tomography showed pulmonary infections. All patients underwent magnetic resonance imaging (MRI). Of these patients, four had a Prostate Imaging-Reporting and Data System (PIRADS) score of 5, while one had a score of 4. The lesions were mostly distributed in the peripheral zone of the prostate and appeared as a high signal on T1-weighted imaging (T1WI) and a low signal on T2-weighted imaging (T2WI). In the US examination, four patients had abnormal prostate morphology, with an unsmooth envelope and non-uniform parenchymal echogenicity. Four patients had increased prostate volume. US showed a hypoechoic nodule with non-uniform internal echogenicity, and an abundant internal blood flow signal was detected by color Doppler US. PSA, MRI, and US were not specific for PMP in our study, but we found that a history of co-infection may be helpful in an accurate diagnosis and to avoid unnecessary biopsy.

Effects of miR-214 on adenosine A2A receptor and carboxymethyl chitosan nanoparticles on the function of keloid fibroblasts and their mechanisms.

This work prepared and investigated the impact of carboxymethyl chitosan nanoparticles (MC-NPs) on the proliferative capability of keloid fibroblasts (KFBs) while analyzing the mechanistic roles of miR-214 and adenosine A2A receptor (A2AR) in fibroblasts within hypertrophic scars. MC-NPs were synthesized through ion cross-linking, were characterized using transmission electron microscopy (TEM) and laser particle size scattering. The influence of MC-NPs on the proliferation capacity of KFBs was assessed using the MTT method. Changes in the expression levels of miR-214 and A2AR in KFBs, normal skin fibroblasts (NFBs), hypertrophic scar tissue, and normal skin tissue were analyzed. KFBs were categorized into anti-miR-214, anti-miR-NC, miR-214 mimics, miR-NC, si-A2AR, si-con, anti-miR-214+ si-con, and anti-miR-214+ si-A2AR groups. Bioinformatics target prediction was conducted to explore the interaction between miR-214 and A2AR. Real-time quantitative PCR and immunoblotting (WB) were employed to detect the expression levels of miR-214, A2AR, apoptotic protein Bax, and TGF-ß in different cells. Cell counting kit-8 (CCK8) and flow cytometry were employed to assess cell proliferation activity and apoptosis. The results indicated that MC-NPs exhibited spherical particles with an average diameter of 236.47 ± 4.98 nm. The cell OD value in the MC-NPs group was lower than that in KFBs (P < 0.05). The mRNA levels of miR-214 in KFBs and hypertrophic scar tissue were lower than those in NFBs and normal tissue (P < 0.001), while the mRNA and protein levels of A2AR were significantly elevated (P < 0.05). Compared to the control group and anti-miR-NC, the anti-miR-214 group showed significantly increased cell OD values and Bcl-2 protein expression (P < 0.001), decreased levels of apoptotic gene Bax protein, TGF-ß gene mRNA, and protein expression (P < 0.001). Continuous complementary binding sites were identified between miR-214 and A2AR. Compared to the control group, the si-A2AR group exhibited a significant decrease in A2AR gene mRNA and protein expression levels (P < 0.001), reduced cell viability (P < 0.001), increased apoptosis rate (P < 0.001), and a significant elevation in TGF-ß protein expression (P < 0.001). miR-214 targetedly regulated the expression of A2AR, inducing changes in TGF-ß content, promoting the proliferation of keloid fibroblasts, and inhibiting cell apoptosis.

Comprehensive phytohormone metabolomic and transcriptomic analysis of tobacco (Nicotiana tabacum) infected by tomato spotted wilt virus (TSWV).

Tomato spotted wilt virus (TSWV) is ranked among the top 10 most destructive viruses globally. It results in abnormal leaf growth, stunting, and even death, significantly affecting crop yield and quality. Phytohormones play a crucial role in regulating plant-virus interactions. However, there is still limited research on the effect of TSWV on phytohormone levels, particularly growth hormones and genes involved in the phytohormone pathway. In our study, we combined phytohormone metabolomics and transcriptomics to examine the impact of TSWV infection on phytohormone content and gene expression profile. Metabolomic results showed that 41 metabolites, including major phytohormones and their precursors and derivatives were significantly altered after 14 days of TSWV inoculation tobacco plants cvK326, with 31 being significantly increased and 10 significantly reduced. Specifically, the levels of abscisic acid (ABA) and jasmonoyl-isoleucine (JA-Ile) were significantly reduced. The levels of indole-3-acetic acid (IAA) have remained unchanged. However, the levels of cytokinin isopentenyladenine (iP) and salicylic acid (SA) significantly increased. The transcriptome analysis revealed 2,746 genes with significant changes in expression. Out of these, 1,072 genes were significantly downregulated, while 1,674 genes were significantly upregulated. Among them, genes involved in ABA synthesis and signaling pathways, such as 9-cis-epoxycarotenoid dioxygenase (NCED), protein phosphatase 2C (PP2C), serine/threonine-protein kinase (SnRK2), and abscisic acid responsive element binding factor (ABF), exhibited significant downregulation. Additionally, expression of the lipoxygenase gene LOX, Jasmonate ZIM domain-containing protein gene JAZ, and transcription factor gene MYC were significantly down-regulated. In the cytokinin pathway, while there were no significant changes in the expression of the cytokinin synthesis genes, a significant downregulation of transcriptionally active factor type-B response regulators (type-B RRs) was observed. In terms of SA synthesis and signaling pathways, the isochorismate synthase gene ICS1 and the pathogenesis-related gene PR1 were significantly upregulated. These results can strengthen the theoretical foundation for understanding the interaction between TSWV and tobacco and provide new insights for the future prevention and control of TSWV.

Case Report: The ultrasound features of acquired cystic disease-associated renal cell carcinoma: a case series.

Background: Acquired cystic disease-associated renal cell carcinoma (ACD-RCC) is a new subtype listed by the 2016 World Health Organization (WHO) classification, which occurred in end-stage renal disease (ESRD) patients. This study will present the imaging characteristics of the four cases diagnosed with ACD-RCC. Ultrasound is expected to help detect abnormalities early in the follow-up of patients on regular dialysis, allowing patients to receive early treatment. Case presentation: We searched the pathology database of our hospital for all inpatients diagnosed with ACD-RCC between January 2016 and May 2022. Pathology, ultrasound, and radiology readings are performed by experienced physicians with the title of attending physician or higher. Four cases were included in this study, all of whom were male, aged from 17 to 59. Two cases suffered from ACD-RCC in both kidneys, and kidney nephrectomies were performed. One case underwent renal transplantation, whose creatinine was back to normal, and the rest were on hemodialysis. On the pathological images, heteromorphic cells and oxalate crystals can be seen. Both ultrasound and enhanced CT showed an enhancement of the solid component of the occupancy. We followed up with outpatient and telephone visits. Conclusion: In clinical work, ACD-RCC should be considered when the mass appears in the background of multiple cysts in the kidney in patients with ESRD. A timely diagnosis will help with treatment and prognosis.

Full-length RNA sequencing reveals the mechanisms by which an TSWV-HCRV complex suppresses plant basal resistance.

Viruses deploy numerous strategies to infect plants, typically by forming complexes with another virus, leading to more efficient infection. However, the detailed plant responses to viral infection and the underlying mechanisms of co-infection remain unclear. Previously, we found that tomato spotted wilt orthotospovirus (TSWV) and Hippeastrum chlorotic ringspot orthotospovirus (HCRV) could infect plants in the field by forming a complex. In this study, we found that TSWV infected tobacco (Nicotiana benthamiana) plants in cooperation with HCRV, leading to a more efficient infection rate of both viruses. We then used the in-depth full-length transcriptome to analyze the responses of N. benthamiana to complex infection by TSWV-HCRV (TH). We found that infection with individual TSWV and HCRV triggered plant defense responses, including the jasmonic acid signaling pathway, autophagy, and secondary metabolism. However, TH co-infection could not trigger and even suppress some genes that are involved in these basal resistance responses, suggesting that co-infection is advantageous for the virus and not for the plants. Typically, the TH complex inhibits NbPR1 expression to suppress tobacco resistance. Moreover, the TH complex could alter the expression of microRNAs (miRNAs), especially novel-m0782-3p and miR1992-3p, which directly interact with NbSAM and NbWRKY6 and suppress their expression in tobacco, leading to downregulation of NbPR1 and loss of resistance in tobacco to TSWV and HCRV viruses. Overall, our results elucidated the co-infection mechanisms of TH in tobacco by deploying the miRNA of plants to suppress plant basal resistance and contributed to developing a novel strategy to control crop disease caused by this virus complex.

Can contrast-enhanced ultrasound differentiate the type of hepatic echinococcosis: cystic echinococcosis or alveolar echinococcosis?

BACKGROUND: Hepatic echinococcosis (HE) is a zoonotic disease caused by Echinococcus, and Echinococcus granulosus and E. multilocularis are the most common, causing cystic echinococcosis (CE) and alveolar echinococcosis (AE), respectively. Contrast-enhanced ultrasound (CEUS) is an imaging technique which has been recommended for identifying focal lesions in the liver. However, the effect of CEUS on the differentiation of hepatic echinococcosis type remains unclear. METHODS: Twenty-five patients with 46 HE lesions confirmed by histopathology in our hospital from December 2019 to May 2022 were reviewed by conventional ultrasound (US) and CEUS examinations, respectively. After US was completed, the CEUS study was performed. A bolus injection of 1.0-1.2 ml of a sulfur hexafluoride-filled microbubble contrast agent (SonoVue®) was administered. The images and clips of the lesions by US and CEUS were reviewed retrospectively. The lesions detected using US were evaluated including the location, size, morphology, margin, internal echogenicity and the internal Doppler signal. The lesions detected using CEUS were evaluated including the enhancement degree, enhancement pattern and enhancing boundary in different phases. The diagnoses of lesions by US or CEUS were respectively recorded. By taking the histopathology as the gold standard, the paired Chi-square test was performed with statistical software (IBM SPSS; IBM Corp., Armonk, NY, USA), and the results of differentiation of HE type by US and CEUS were statistically analyzed. RESULTS: A total of 46 lesions were involved in 25 patients, including 10 males (40.0%) and 15 females (60.0%) aged 15-55 (42.9 ± 10.3) years. By histopathology, 24 lesions of nine patients were diagnosed as CE and 22 lesions of 16 patients were diagnosed as AE. Among the 46 HE lesions, compared with histopathological examination, the accuracy rate was 65.2% and 91.3% in US and CEUS findings, respectively. Among the 24 CE lesions, 13 lesions were correctly differentiated by US, and 23 by CEUS. The difference between US and CEUS was statistically significant (Chi-square test, [Formula: see text] = 8.10, df = 23, P < 0.005). Among the total 46 HE lesions, 30 lesions were correctly differentiated by US, and 42 by CEUS. The difference between US and CEUS was statistically significant (Chi-square test, [Formula: see text] = 10.08, df = 45, P < 0.005). CONCLUSIONS: CEUS is a more effective technique than US for differentiating the type of HE between CE and AE. It could be a reliable tool in the differentiation of HE.

Chelating decorporation agents for internal contamination by actinides: Designs, mechanisms, and advances.

During the wide utilization of the actinides in medicine, energy, military, and other fields, internal contaminations can profoundly endanger human health and public security. Chelating decorporation agents are the most effective therapies to reduce internal contamination that includes radiological and chemical toxicities. This review introduces the structures of chelating decorporation agents including inorganic salts, polyaminocarboxylic acids, peptides, polyphosphonates, siderophores, calixarenes, polyethylenimines, and fullerenes, and highlights ongoing advances in their designs and mechanisms. However, there are still numerous challenges that block their applications including coordination properties, pharmacokinetic properties, oral bioavailability, limited timing of administration, and toxicity. Therefore, additional efforts are needed to push novel decorporation agents with high efficiency and low toxicity for the treatment of internal contamination by actinides.

Misdiagnosis of a Patient with Hepatic Alveolar Echinococcosis with Hepatapostema: A Case Report.

Alveolar echinococcosis (AE) is an important zoonotic tropical disease in China that affects people living in western endemic areas. The disease is prone to occur in the liver with a characteristic similar to slow-growing malignant tumors. We report a 31-year-old male patient with serious complication after hepatorrhaphy, who had presented with clinical manifestations of hepatapostema with infection. Ultrasound (US) and computer tomography (CT) are two important medical imaging modalities to diagnose hepatic AE. Based on the medical history, clinical findings, laboratorial and imaging results, the patient was misdiagnosed with hepatapostema. A series of subsequent treatments were ineffective. Finally, partial hepatectomy was performed, and postoperative pathological results confirmed hepatic AE. The patient has now recovered.

Case report: Ultrasonographic findings of retroperitoneum and abdominal wall metastases of renal cell carcinoma with FH gene deletion.

Renal cell carcinoma with FH gene deletion is a rare subtype of renal cell carcinoma. There had been few reports about ultrasonographic imaging of metastasis of renal cell carcinoma with FH gene deletion. This case reported one of the features of metastasis of renal cell carcinoma with FH gene deletion of a male patient 7 months after undergoing radical nephrectomy. He was diagnosed with a renal malignant tumor before the operation and confirmed to be primary FH gene-deficient renal cell carcinoma after undergoing radical nephrectomy in another hospital. Reexamination 7 months after the operation indicated that multiple metastases all over the body were found; therefore, he came to our hospital for further diagnosis and therapy. The tumors have metastasized in the lungs, bones, and lymph nodes adjacent to the left reproductive vessels and external iliac vessels, retroperitoneum, and abdominal wall so far as confirmed by PET/CT or MRI. Ultrasonographic findings of masses in the retroperitoneum and abdominal wall are fully discussed, which have been confirmed by biopsy and diagnosed as renal cell carcinoma with FH gene deletion by pathology.

Supercritical CO2 extraction of fermented soybean lipids against erastin-induced ferroptosis in rat pheochromocytoma cells.

The optimum supercritical carbon dioxide (SC-CO2) extraction of fermented soybean lipids (FSE-C) was as follows: 35 °C, 30 MPa, and 2.40 ± 0.19% moisture content using response surface methodology. The fatty acid composition of FSE-C contained more palmitic acid and α-linolenic acid and less linoleic acid than unfermented soybean lipids (SE-C). FSE-C had higher contents of minor active components (phytosterols, squalene, total flavonoid, and total polyphenol) than SE-C. The protective effects of FSE-C on erastin-induced ferroptosis were investigated to reveal the potential mechanisms of action characterized by increasing cell viability and glutathione concentrations, attenuating levels of intracellular Fe2+ ion, lipid peroxidation, and ROS, as well as modifying mRNA expression (GPx4, SLC7A11, ACSL4, and LPCAT3) and lipid metabolism. These findings suggest that FSE-C is a class of active ingredients against erastin-induced ferroptosis and warrants further exploration and utilization as a functional food.

Analysis of clinical effect of the four-step pouch approach in ocular plastic surgery.

PURPOSE: To investigate the clinical effect of the four-step pouch plastic surgery in ocular plastic surgery. METHODS: Patients with ocular plastic surgery admitted to our hospital from January 2018 to October 2019 were selected as the study subjects. The patients were divided into the observation group (n=41) and the control group (n=43) according to the different surgical modalities received. The traditional skin approach of lower eyelid, and the four-step pouch plastic surgery were used as the control group and observation group, respectively. The operation time, postoperative recovery time of the eye skin, clinical effect, postoperative complications, and satisfaction rate were compared between the two groups. RESULTS: The operation time was compared between the two groups, indicating no significant difference (P > 0.05). The postoperative recovery time of the eye skin was significantly shorter in the observation group than the control group (P < 0.05). The total clinical effective rate (95.12%) was significantly higher in the observation group than that in the control group (79.07%) (P < 0.05). The total incidence of complications (7.32%) was significantly lower in the observation group than that in the control group (25.58%) (P < 0.05). The overall satisfaction rate was significantly higher in the observation group than the control group (P < 0.05). CONCLUSION: The clinical effect of four-step pouch plastic surgery in ocular plastic surgery is significant.

Sonographic Features of Pure Mucinous Brelast Carcinoma With Micropapillary Pattern.

OBJECTIVE: Previous studies have mostly discussed the clinical manifestations and prognosis of mucinous breast carcinoma with a micropapillary pattern. The purposes of this study were to investigate the sonographic features of pure mucinous breast carcinoma with micropapillary pattern (MUMPC) and to identify the role of ultrasound in the differential diagnosis between MUMPC and conventional pure mucinous breast carcinoma (cPMBC). MATERIALS AND METHODS: We obtained written informed consent from all patients, and the Ethics Committee of West China Hospital approved this retrospective study. The study was conducted between May and August 2020. We enrolled 133 patients with 133 breast lesions confirmed as mucinous breast carcinoma (MBC) histopathologically between January 2014 and January 2020.We retrospectively assessed sonographic features (margin, shape, internal echogenicity, calcification, posterior acoustic feature, invasive growth, blood flow grade, and rate of missed diagnosis) and clinical characteristics (age, tumor size, tumor texture, initial symptom, and lymph node metastasis). Bivariable analyses were performed using SPSS version 19.0. RESULTS: The 133 lesions included 11 MUMPCs, 65 cPMBCs, and 57 mixed MBCs (MMBCs). There were significant differences in margin, shape, calcification, posterior acoustic feature, invasive growth, rate of missed diagnosis, average tumor size, and lymph node metastasis among the three groups (p < 0.05). The subsequent pairwise comparisons showed that there were significant differences in lymph node metastasis, margin, and invasive growth between MUMPC and cPMBC (p < 0.05). In patients aged >45 years, there was a significant difference in tumor size among the three groups (p = 0.045), and paired comparison showed that the average tumor size in the cPMBC group was larger than that in the MMBC group (p = 0.014). CONCLUSION: MUMPC showed a non-circumscribed margin and invasive growth more frequently than cPMBC did. Lymphatic metastasis was more likely to occur in MUMPC than cPMBC. Ultrasound is helpful to distinguish MUMPC from cPMBC.

A narrative review of artificial intelligence-assisted histopathologic diagnosis and decision-making for non-small cell lung cancer: achievements and limitations.

OBJECTIVE: To summarize the current evidence regarding the applications, workflow, and limitations of artificial intelligence (AI) in the management of patients pathologically-diagnosed with lung cancer. BACKGROUND: Lung cancer is one of the most common cancers and the leading cause of cancer-related deaths worldwide. AI technologies have been applied to daily medical workflow and have achieved an excellent performance in predicting histopathologic subtypes, analyzing gene mutation profiles, and assisting in clinical decision-making for lung cancer treatment. More advanced deep learning for classifying pathologic images with minimal human interactions has been developed in addition to the conventional machine learning scheme. METHODS: Studies were identified by searching databases, including PubMed, EMBASE, Web of Science, and Cochrane Library, up to February 2021 without language restrictions. CONCLUSIONS: A number of studies have evaluated AI pipelines and confirmed that AI is robust and efficacious in lung cancer diagnosis and decision-making, demonstrating that AI models are a useful tool for assisting oncologists in health management. Although several limitations that pose an obstacle for the widespread use of AI schemes persist, the unceasing refinement of AI techniques is poised to overcome such problems. Thus, AI technology is a promising tool for use in diagnosing and managing lung cancer.

The role of contrast-enhanced ultrasound in the diagnosis of hepatic alveolar echinococcosis.

To evaluate the value of contrast-enhanced ultrasound (CEUS) compared with ultrasound (US) in the diagnosis of hepatic alveolar echinococcosis (AE).Thirty-one patients with 43 hepatic AE lesions between January 2010 and September 2017 were included in the study. All lesions which were histopathologically proven to be hepatic AE were retrospectively reviewed. Features of the lesions by CEUS were retrospectively studied.All lesions were detected by US and CEUS in the 31 patients (17 males and 14 females) with a mean age of 38.5 ±â€Š10.6 years (range: 16-58 years). The size of the lesions ranged from 1.5 × 0.7 cm to 15 × 18 cm. By US, 3 lesions (7%, 3/43) were hypoechoic nodules, 21 (48.8%, 21/43) were hyperechoic, and 19 lesions (44.2%, 19/43) were of mixed echogenicity type (solid-cystic). 27 lesions (62.8%, 27/43) had calcifications. Only 1 lesion was detected blood-flow signals. With CEUS, 23 lesions (53.5%, 23/43) displayed no enhancement in the arterial phase, portal phase and delayed phase on CEUS. 11 lesions (25.6%, 11/43) displayed a slight ring-like hyper-enhancement in the arterial phase and displayed hypo-enhancement in the portal and delayed phase. 6 lesions (14%, 6/43) displayed hyper-enhancement in the arterial phase and hypo-enhancement in the portal and delayed phase. 2 lesions (4.7%, 2/43) showed iso-enhancement in the arterial, portal, and delayed phase. 1 lesion (2.3%, 1/43) showed slight hypo-enhancement in the arterial, portal, and delayed phase.CEUS is a more valid technique for diagnosing AE than US. It could be a reliable tool in the diagnosis of hepatic AE.

Transient Segmental Enhancement of Pyogenic Liver Abscess: A Comparison Between Contrast-Enhanced Ultrasound and Computed Tomography.

OBJECTIVE: This study aimed to investigate the correlation between the transient segmental enhancement (TSE) of liver abscesses on contrast-enhanced ultrasound (CEUS) imaging and contrast-enhanced computed tomography (CT) scans. METHODS: In total, 42 abscesses in 38 patients were evaluated with real-time CEUS and contrast-enhanced CT imaging. The CT imaging and CEUS examinations were performed within one to 2 days of each other in all cases. The initial reports of the observations of TSE on CEUS scans were correlated later with the findings of TSE on contrast-enhanced CT images. Contrast-enhanced CT was used as the reference standard to evaluate the presence of TSE. Relationships between the 2 groups were analyzed using the χ test. P < 0.05 was considered to be statistically significant. RESULTS: In 16 patients, 16 typical TSE signs were shown by CEUS. Meanwhile, enhanced CT imaging showed 18 typical signs of TSE in 17 patients. We identified 38 patients with hepatic abscesses proven by needle aspiration (10 patients) or image-guided biopsy (28 patients). Ten patients had hepatobiliary cholelithiasis, 5 had diabetes mellitus type 2, and 2 had gastric cancer, whereas no evidence of underlying hepatobiliary or gastrointestinal diseases was found in the other 21 patients. Considering that enhanced CT is the reference standard for the diagnosis of hepatic abscesses, the sensitivity of CEUS in showing TSE was 89%, and the specificity was 100%. The χ test indicated that CEUS and enhanced CT were significantly correlated for detection of hepatic perfusion disorders (P < 0.05). CONCLUSIONS: The appearance of TSE in liver abscess was reliably detected by CEUS, which correlated well with the enhanced CT images (P < 0.05).

Can the Contrast-Enhanced Ultrasound Washout Rate Be Used to Predict Microvascular Invasion in Hepatocellular Carcinoma?

The objective of this study was to investigate use of the washout rate of hepatocellular carcinoma on contrast-enhanced ultrasound (CEUS) for pre-operative determination of the presence of microvascular invasion. The study included 271 patients who underwent liver resection for hepatocellular carcinoma between April 2008 and December 2012, and were examined with contrast-enhanced ultrasound before surgery. Patients were followed up at 3-mo intervals for 3 y. Four washout patterns were classified according to the start time of washout: rapid, portal, delayed and slow. Rapid washout, presence of two or more tumors and tumor size ≥5 cm were identified as independent pre-operative predictors of microvascular invasion on multivariate analysis. Recurrence rates for patients with none, one, two or three predictors were 22.6%, 34.7%, 57.6% and 75.0%, respectively. In combination with tumor number and tumor size, contrast-enhanced ultrasound washout rate may have a role in identifying hepatocellular carcinoma patients with microvascular invasion.

Ultrasonographic findings of small lesion of hepatic alveolar echinococcosis.

OBJECTIVE: To investigate the features of small lesions of hepatic alveolar echinococcsis paragonimiasis (AE) on conventional ultrasound (US) and contrast-enhanced ultrasound (CEUS) imaging. METHODS: This retrospective study was approved by the Institutional Review Board, and the requirement for informed consent was waived. US and CEUS features of seventeen lesions histopathologically proven hepatic AE were retrospectively reviewed. Nine patients with seventeen hepatic AE lesions who were admitted to our hospital between January 2008 and June 2015 were enrolled. All hepatic AE lesions were small (≤3cm). The US and CEUS examinations were performed with a Philips IU22 scanner with a 1-5-MHz convex transducer. After US was completed, the CEUS study was performed. Pulse-inversion harmonic imaging was used for CEUS. A bolus injection of 2.4mL of a sulfur-hexafluoride-filled microbubble contrast agent (SonoVue) was administered. The features of the lesions by US and CEUS were retrospectively reviewed. RESULTS: In total, all lesions were detected by US and CEUS. The mean size of the lesions was 1.8±0.7cm (range: 1.0-3.0cm). Five patients (55.6%, 5/9) had a lesion in the right hepatic lobe; two (22.2%, 2/9) had two lesions in the left hepatic lobe; and two patients (22.2%, 2/9) had four lesions in the right lobe. Seven lesions (41.2%, 7/17) were hypoechoic nodules and ten (58.8%, 10/17) were hyperechoic nodules. Nine lesions (52.3%, 9/17) were of mixed echogenicity type. Ten lesions (58.8%, 10/17) had a regular shape. Nine lesions (52.3%, 9/27) had a sharp margin and six (35.3%, 6/17) had indistinct margins. Four lesions (57.1%, 4/7) with hypoechoic nodule had small dotted calcifications, none was found in hyperechoic nodule. Seven nodules (41.2%, 7/17) showed short striated blood-flow signals surrounding the margin, on color Doppler flow imaging. By CEUS, All the lesions were hypoechoic with mixed content (). 12 lesions (70.1%, 12/17) were rim enhanced with irregular piece-like nonenhanced internal areas and showed nonhomogeneous hypo-enhancement during the arterial phase, with mixed echogenicity. The main pathological findings included: (1) (1) coagulative or liquefactive necrosis within the lesion with sporadic distribution of wizened alveolar hydatid cysts; and (2) hyperplasia of granulomatous and fibrous tissue around the lesion. CONCLUSION: Hyperechogenicity, mixed echogenicity type, dotted calcification with hypoechogenicity, sharp margin, rim enhancement and piece-like nonenhanced areas could be seen as the main ultrasonographic features of small lesion of hepatic alveolar echinococcosis.