Correlation analysis of contrast-enhanced ultrasound Liver Imaging Reporting and Data System classification with hepatocellular carcinoma differentiation and Ki-67 index / 中华超声影像学杂志

Objective:To investigate the correlation of hepatocellular carcinoma (HCC) classified by contrast-enhanced ultrasound (CEUS) Liver Imaging Data and Report System (LI-RADS) with differentiation degree and Ki-67 index.Methods:A multicenter, retrospective study was conducted.The clinical and CEUS imaging data of 208 patients with 208 HCC lesions from December 2017 to December 2020 in China CEUS database were included and analyzed. According to the CEUS LI-RADS version 2017 proposed by the American College of Radiology, the HCC was classified. The diagnosis and pathological information of all lesions were confirmed by pathology. The differentiation degree of HCC and the distribution of Ki-67 index in different LI-RADS categories were evaluated, and their correlation was analyzed.Results:The degree of differentiation and Ki-67 index among HCC of different CEUS LI-RADS were statistically significant ( P<0.001, P=0.009). LI-RADS M HCC was more likely to be poorly differentiated and showed a higher Ki-67 index. The category of LI-RADS was positively correlated with the degree of tumor differentiation (tau-b=-0.250, P<0.001) and the Ki-67 index (tau-b=0.178, P=0.002), that is, the higher the category of LI-RADS, the lower differentiation degree and the higher the Ki-67. Conclusions:The CEUS LI-RADS classification of HCC is correlating with the degree of differentiation and Ki-67 index.

The value of preoperative ultrasound in predicting microvascular invasion of hepatocellular carcinoma / 中华超声影像学杂志

Objective To analyze the ultrasound imaging features and clinical characteristics in patients with hepatocellular carcinoma ( HCC ) , and assess the value of ultrasound in preoperatively predicting microvascular invasion ( M VI) of HCC . Methods One hundred and seventy‐one patients with HCC were retrospectively collected from January 2016 to July 2018 . T he ultrasound imaging features and clinical data that may be associated with M VI were analyzed by univariate and multivariate analyses ,and the diagnostic efficacy of independent risk factors was further evaluated . ROC curves were plotted to compare the diagnostic efficacy of combined diagnostic mode 1 ,mode 2 ,peritumoral enhancement ,and tumor margin . Results Univariate analysis showed that the serum AFP level ,tumor size ,peritumoral hypoechoic halo , peritumoral enhancement , and tumor margin were significantly correlated with M VI ( P ＜ 0 .05 ) . M ultivariate logistic regression analysis further indicated that peritumoral enhancement and non‐smooth tumor margin were the independent risk factors for predicting M VI . T he sensitivity ,specificity ,positive predictive value and negative predictive value of peritumoral enhancement and non‐smooth tumor margin were 51 .4% vs 83 .8% ,81 .4% vs 48 .5% ,67 .9% vs 55 .4% ,and 68 .7% vs 79 .7% ,respectively . T he AUC of mode 1 ,mode 2 ,peritumoral enhancement and tumor margin were 0 .741 ,0 .716 ,0 .664 ,and 0 .661 , respectively . Conclusions Preoperative ultrasound is valuable in predicting M VI of HCC . Peritumoral enhancement and non‐smooth tumor margins are independent risk factors for predicting M VI of HCC . T umor size ,hypoechoic halo around the tumor ,and serum AFP levels must be taken into account w hen predicting MVI of HCC by using preoperative ultrasound .

Anti-cicatricial and anti-restenosis effect of verapamil on anterior urethral stricture: A randomized controlled clinical trial / 中南大学学报(医学版)

To evaluate the anti-cicatricial and anti-restenosis effect of verapamil on anterior urethral stricture.
 Methods: A total of 32 patients received anterior urethral stricture were enrolled in this study. They were divided into 4 blocks according to the duration of previous urethral operations and dilations. Every block was further randomly divided into an experimental group and a control group. Experimental groups received 2 mL injection of verapamil around the anastomosis site of urethra before and after the surgery (2, 4, 6, 8, and 10 weeks after the surgery), while the control groups only received the anastomosis surgery. After surgery, maximal urinary flow rate (Qmax) was examined for all patients once the catheter was removed. In addition, they were also conducted palpation of urethral scar range. The sum of long transverse diameters of urethral scar was measured, and the narrowest urethral inner diameter was examined. The Qmax was rechecked and the urethral scar range was assessed by penis color Doppler elastography after 12 weeks of surgery. The above 4 indexes were used to evaluate the inhibitory effect of verapamil on urethral scar.
 Results: The length of palpated urethral scar in the Block 1 to 4 of the experimental groups was (22.75±1.03), (21.25±0.25), (20.75±1.03), and (20.0±0.58) mm, respectively; and those in the control groups (26.00±0.82), (24.5±1.04), (25.75±1.65), and (28.25±1.75) mm, respectively. The Qmax rates in the Block 1 to 4 of the experimental groups were (11.85±0.77), (11.33±0.81), (10.23±0.26), and (10.35±0.17) mL/s, respectively; and those in the control groups were (10.85±0.39), (10.50±0.76), (10.53±1.00), (12.60±0.39) mL/s, respectively. The Qmax rates in the Block 1 to 4 of the experimental groups were (11.73±0.87), (10.65±0.25), (10.23±0.19), and (10.35±0.29) mL/s, respectively; and those in the control groups were (8.05±0.28), (7.73±0.68), (7.53±0.92), and (9.60±0.32) mL/s, respectively. The narrowest diameters of urethral in the Block 1 to 4 of the experimental groups were (9.00±0.58), (7.50±2.89), (7.00±0.10), and (7.00±0.41) mm, respectively; and those in the control groups were (5.50±0.29), (5.00±0.41), (4.75±0.48), and (6.75±0.48) mm, respectively. The ultrasound strain ratio in the Block 1 to 4 of the experimental groups were 6.10±0.22, 6.10±0.17, 5.10±0.16, and 6.90±0.19, respectively; and those in the control groups were 8.00±0.25, 10.60±0.29, 11.30±0.16, and 8.90±0.33, respectively. Compared with the control groups, the experimental groups displayed smaller urethral scar range, less severe scarring, improved Qmax rates and wider inner diameters (all P<0.05).
 Conclusion: Urethral regional injection of verapamil intraoperatively or postoperatively can prevent overgrowth of urethral scar tissues after the transperineal anastomosis surgery, and reduce the tendency of postoperative restenosis of anterior urethral stricture.

Value of dynamic three-dimensional contrast-enhanced ultrasonography in evaluating therapeutic response of hepatoma treated with radiofrequency ablation / 中华医学超声杂志（电子版）

Objective To investigate the value of dynamic three-dimensional contrast-enhanced ultrasound (3D-CEUS) in evaluating therapeutic response of hepatoma treated with radiofrequency ablation (RFA).Methods Totally 48 cases of patients with hepatic carcinoma (48 lesions) admitted in Xiangya Hospital of Central South University from September 2012 to January 2014 were selected.All patients underwent radiofrequency ablation,of which 30 patients were diagnosed by pathology after surgery,18 patients by clinical diagnosis.All patients underwent two-dimensional contrast-enhanced ultrasound (2D-CEUS) and 3D-CEUS 1 month and 3 months after RFA treatment to evaluate the therapeutic response,and the results of contrast-enhanced ultrasound and enhanced computed tomography (CT) [or magnetic resonance imaging (MRI)] were compared.The final diagnostic results of pathologic biopsy or more than two imaging examinations [ultrasonography,CT,MRI,positron emission tomography (PET)],tumor markers,and more than 3 months follow-up of patients were used as the gold standard.The sensitivity,specificity and accuracy of dynamic 3D-CEUS,2D-CEUS,enhanced CT (or MRI) in the diagnosis of tumor inactivation were calculated respectively.Results After radiofrequency ablation,dynamic 3D-CEUS could provide more valuable information in 75.0％ (36/48) lesions,which contribute to assess the efficacy of radiofrequency ablation.While compared with 2D-CEUS,3D-CEUS did not change the diagnosis or clinical management in 12 (25.0％) lesions.40 of 48 lesions were found no-enhancement in entire CEUS procedure suggesting that the tumor completely inactivated,while 8 lesions showed local enhancement on the edge of lesion suggesting that part of the tumors were active.39 of 48 lesions showed no-enhancement and other 9 with irregular enhancement on enhanced CT (or MRI).The sensitivity,specificity and accuracy of CEUS and enhanced CT (or MRI) in detection of residual tumor after radiofrequency ablation were 80.0％,100％,95.8％ and 80.0％,97.4％,93.8％,respectively.Conclusions There was no statistical significance among 3D-CEUS,2D-CEUS and enhanced CT or MRI in evaluating therapeutic response of hepatoma treated with radiofrequency ablation.But 3D-CEUS can provide more valuable information,3D-CEUS has potential usefulness in the evaluation of percutaneous radiofrequency ablation of hepatic tumors.

Ultrasonic characteristics of intraductal papillary mucinous neoplasm of the bile duct / 中华超声影像学杂志

Objective To explore the ultrasound characteristics of intraductal papillary mucinous neoplasm of the bile duct( IPM N-B) and evaluate its diagnostic value . Methods Seventeen cases of IPM N-B were diagnosed by ultrasonic examination and confirmed by surgery and pathology . The ultrasound findings and distribution of color Doppler flow signals were observed and analyzed in comparison with the surgical and pathological results . Results Ultrasound revealed the characteristics of IPMN-B:① Bile duct mural nodules that looked like papillary or polypoid were observed; ② Asymmetry bile duct dilatation ,namely obvious dilatation in the lesion intrahepatic bile duct ,but only mild dilatation in the normal intrahepatic bile duct ;③Typical lesions showed mucus in bile duct along bile duct wall without acoustic shadow or move . High frequency ultrasound revealed that mucus in bile duct could float that looked like gelatin when operator vibrated probe in those superficial lesions . This is reliable characteristics of IPMN-B by ultrasound . Conclusions Ultrasound is of high value in the diagnosis of IPMN-B .

Comparasion of contrast-enhanced ultrasound in diagnosis of cholangiocarcinoma and different differentiated hepatocellular carcinoma / 中国医学影像技术

Objective To compare the characteristics of intrahepatic cholangiocarcinoma (ICC) and different differentiated hepatocellular carcinoma (HCC) by CEUS and evaluate the diagnostic value of CEUS.Methods The cases who underwent CEUS and were pathologically demonstrated as ICC (n=34) and HCC (n=136) were observed.The characteristics of ICC and different differentiated HCC in conventional ultrasound and CEUS were analyzed,and the diagnostic efficiency of wash out time were calculated.Results ICC had higher percentage (24/34,70.59％) of washout emerging in early portal phase than those of HCC.And ICC had lower percentage (0;4/34,11.76％) of washout emerging in middle and late portal phase than poorly and moderate differentiated HCC.Poorly differentiated HCCs had higher percentage (16/41,39.02％) of washout emerging in middle portal phase than well differentiated HCC.The sensitivity,specificity,positive predictive value,negative predictive value,accuracy,positive likelihood ratio and negative likelihood ratio of washout time in diagnosis of ICC were 82.35 ％ (28/34),91.18％ (124/136),70.00％ (28/40),95.38％ (124/130),89.41％ (152/170),9.4,0.2,respectively.The rise time of ICC and well,moderate and poorly differentiated HCC were (13.03 ± 3.49) s,(13.80 ± 3.04)s,(14.89±4.12)s,(16.00±3.38)s,respectively,and the difference was significant (F=4.369,P＜0.05).The rise time of ICC was significantly higher than that of well differentiated HCC (P＜0.05).Conclusion The CEUS performances are different significantly among ICCs and different differentiated HCCs,which has value for the differential diagnosis.

Quantitative analysis of liver function with contrast enhanced ultrasonography of liver cirrhosis / 中国医学影像技术

Objective To observe the corelation between quantitative index and the grade of the liver function with contrast-enhanced ultrasonography (CEUS) in hepatic cirrhosis. Methods Seventy-five patients of cirrhosis after HBV were divided into 3 groups (each n=25) on the basis of the liver function by Child-pugh method, while 20 healthy subjects were enrolled in the control group. The inner diameter and Doppler spectrum of right hepatic vein (RHVD, RHVF) were measured. After intravenous bolus injection 1.2 ml SonoVue, RHA and RHV were observed continually on real time, hepatic artery transit time (HATT) and hepatic vein transit time (HVTT) were recorded, then HTTs were calculated. Results In hepatic cirrhosis groups, RHVD decreased remarkably, RHVF was abnormal, HVTT and HTT were obviously shorter, and HTTs were shortened significantly.Conclusion CEUS may play an important role in qualitative evaluation of liver function, and HTT is more valuable than HVTT.

Preliminary study on three-dimensional ultrasonographic features of ocular diseases / 中华超声影像学杂志

Objective To explore three-dimensional ultrasonographic features of common ocular diseases. Methods To acquire the data, the free-hand scanning without positioning system was employed in 3 to 5 seconds. Following or after acquisitions, the data were processed and 3D image was reconstructed. Then three-dimensional ultrasonographic features of ocular diseases were characterized. Results 3D images were rendered successfully on 46 eyes of 48 ones. The reconstruction of 3D ultrasonography provided clear stereo images in which shape, dimension, structure, location of retinal detachment, choroidal detachment, vitreous fibrous membrane, lens dislocation, intraocular foreign body and intraocular trauma could be clearly demonstrated. Conclusions 3D ultrasonography needs much shorter scanning time with good space visualization. In the diagnosis of ocular diseases 3D ultrasonic reconstruction can provide more useful information than traditional 2D ultrasonography.

Radiofrequency ablation therapy for liver cancer / 中国普通外科杂志

Objective To sum up the effect and experience in radiofrequency ablation(RFA) for liver cancer(LC). Methods The clinical data of 102 patients with LC treated by percutaneous and intraoperative RFA were analysed retrospectively. Results RFA was used to treat 195 tumors (median diameter 5.6 cm,ranging from 1.5 to 9.5 cm) in 102 patients.Of them, primary liver cancer was found in 80 patients( 78.4%),and metastatic liver tumor was in 22 patients(21.6%). Percutaneous RFA(PRFA) and intraoperative RFA(IRFA) was performed in 77 patients(75.5%) and 25 patients(24.5%) respectively. There was no severe complications after RFA in this series. All of the 102 cases had been followed up for 3～24months,AFP positive returned to negative in 70.3%(52/74)of the patients.The rate of concreted necrosis of liver cancer showed by CT was 88.2%(90/102). The 1 year survival rate was 93.8%.Conclusions RFA is a safe and effective treatment for patients with LC. Patients with small and readily accessible tumor are the indications of PRFA;while the patients with large,multiple,perivascular or otherwise inaccessible liver tumor are also the indications for IRFA.The adoption of the TACE and other methods to occlude the vascular inflow can improve the efficacy of RFA.

Application of Ultrasound Guided Percutaneous Automatic Biopsy of Mediastinal Tumors / 中国医师杂志

Objective To assess the value of ultrasound guided percutanuous automatic biopsy of mediastinal tumors.Method Forty-six consecutive biopsies were performed on forty-six patients suffered from mediastinal tumor included 14 thymomas,12 lymphomas,9 metastasis carcinomas,5 mediastinal lung carcinomas,3 teratomas,2 neuroblastomas,1 granulosa cell tumor.Under US guidance,a 18-guage core needle with automatic biopsy device was used.Specimen was fixed with 10% formaldehyde solution.Results The procedure of puncture was successful in all patients.The positive rate histologically was 89%(41/46).No complication (such as hemorrhage,pneumothorax and dyspnoea) was happened.Conclusion We consider that the ultrasound-guided percutaneous needle biopsy is a safe and reliable method for the histological diagnosis of mediastinal tumors.

The Role of Ultrasonic Diagnosis in Osteoarthritis / 中国医师杂志

Objective To evaluate the role of two-dimensional ultrasound, conventional color and power Doppler ultrasound in the diagnosis of knee osteoarthritis. Methods Eighty-three patients with knee osteoarthritis (118 knee joints) and 61 healthy subjects as a control received clinical, laboratory and ultrasound examinations. Results A higly significant difference in the thickness of knee articular cartilage between the patients and controls was found by ultrasound examination(P

The application of ultrasonography in breast cancer′s screening of chinese women with dense breast / 中国普通外科杂志

Objective To explore the contribution of ultrasonic examination and localization in early breast cancer screening of chinese women with dense breast.Methods From February,2002 to April,2006,the breasts of 5 000 women were examined using ultrasonic examination,and in about 4 000 women a mass was detected,which included 142 cases of breast cancer proved by pathology with diameter ≤2cm occurred in patients with dense breast.In these parients,ultrasonic visualization and molybdenum target mammographic were performed.Results In these with breast cancer and dense breast,there were 47 cases(33.10%) with microcalcification detected by ultrasonography,the sensitivity rate was 74.60% and the accuracy rate was 88.73%.Only 38(26.76%) cases were detected by mammography,the sensitivity rate was(60.32)% and the accuracy was 82.39%.About 44.37% breast cancer with dense brast display as the(microcalcification).There were 110 cases(77.46%) of the small breast cancer detected by ultrasonography,the sensitivity was 88.71% and the accuracy rate was 90.14%.There were 100 cases(70.42%)(detected) by mammography,the sensitivity rate was 80.65% and the accuracy rate was 83.10%.Also,in 12 patients an unpalpation breast lesion was correctly excised by the use of ultrasonic localization.(Conclusions)(1)For the small breast cancer in dense breast the sensitivity and the accuracy of ultrasonography(surpassed) those of mammography.(2)The ultrasonic examination is an effective way for early breast cancer screening in young women with dense breast and flat breast.Ultrasonography can improve the rate of dignosis in early breast cancer,and also improve the breast-conserving surgical rate.Ultrasonography is worth of widespread use spreading.

Comparative Study of Efficacy on Percutaneous Renal Biopsy Guided by Ultrasound with Two Approaches / 中国医师杂志

Objective To investigate the efficacy of percutaneous automatic renal biopsy guided by ultrasound with two approaches. Methods One hundred and fifty patients who were suspected with diffuse renal disease were divided into two groups randomly: group A (n=74) and group B (n=76). In both groups A and B, an 18G cut needle with automatic biopsy gun was inserted the inferior pole of right kidney from proximal and distal end of transducer, respectively. After accomplishment, the times of puncture, length of sample, number of glomeruli and complications were recorded were recorded. And the number of glomeruli per centimeter was calculated. Results The differentiation of diffuse renal disease was assured by the specimens obtained by biopsy in all the patients. The puncture times in group A was less than those in group B (P0.05), and the number of glomeruli per centimeter in group A was more than that in group B (P

Hemodynamic changes of liver carcinoma after radiofrequency ablation evaluated by color doppler ultrasonography / 中国普通外科杂志

Objective To evaluate the results of liver carcinoma treated by radiofrequency ablation(RFA) with color Doppler ultrasonography(CDU). Methods Hemodynamic changes of the interior and periphery of 212 nodules of liver carcinoma in 152 patients were investigated by CDU one week before and one month after RFA. Results Blood flow signals were found in 187 cancerous nodules before RFA, and were chiefly from mixed arterio-venous blood supply. After RFA, the blood flow signals of these 187 cancerous nodules completely disappeared in 133, were reduced in 40 and did not change in 14. Peripherar blood flow did not change in 51.2% of the tumors. Conclusions CDU is useful in evaluating the therapeutic effect of RFA in patients with liver carcinoma and may provide information for further treatment.

Prognostic risk factors and therapeutic effect of radiofrequency ablation for primary hepatic carcinoma:a report of 195 cases / 中国普通外科杂志

Objective To investigate the effect and the prognostic factors of radiofrequency ablation(RFA) for primary liver cancer(PLC).Methods RFA was performed in 195 patients with PLC,and the efficency was evaluated with univariate analysis.Cox′s regression analysis model was used to analyze the factors affecting the prognosis.Results In the whole group of patients,the 1,2,3 and 5-year overall survival rate was 80.5%,67.4%,49.1% and 32.7% respectively,and in the patients with small PLC(the size≤3 cm),the 1,2,3 and 5-year overall survival rate was 91.7%,81.2%,60.5% and 40.4% respectively.The Cox regression models indicated that the independent factors in determining the prognosis were: Liver function of Child-Pugh stage,tumor size and occlusion of hepatic inflow during RFA.Conclusions RFA is an effective mini-invasive treatment for patients with PLC,and especially for the patients with small PLC.The efficency of RFA for small PLC has the same outcome as that of surgical resection of the tumor.Liver function of Child-Pugh stage,tumor size and occlusion of hepatic inflow during RFA are the independent prognostic factors.