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Objective:To evaluate the ability of vascular endothelial growth factor receptor 2(VEGFR2)/integrin α vβ 3 dual-targeted microubble (MBD) to target angiogenesis of renal cell carcinoma (RCC) in vivo. Methods:Non-targeted microbubble (MBN) USphere LA was employed as a template to prepare single- and dual-targeted microbubbles which could bind VEGFR2 and/or integrin α vβ 3 (MBV and MBI) by the biotin-avidin bridging method. A total of 40 RCC nude mice models were established by subcutaneously injecting 786-O cells.Twenty of the models were all injected with MBN, MBV, MBI and MBD in a random order, and the other 20 models were registered for antibody blocking assays. The results of ultrasound images were used for quantitative analyses, and the following quantitative parameters were obtained: intensity increment (a 1), peak halving speed (a 2), curve rising slope (a 3), perfusion time (t 0), time to peak (TTP), peak intensity (PI), mean transit time (MTT) and area under the curve (AUC) for the first three minutes, peak intensity at 10 s before (P 1) and after (P 2) ultrasound destruction, and the differences of tissue enhancement (dTE) between P 1 and P 2 (dTE=P 1-P 2). All the quantitative parameters of four contrast agents and the antibody blocking assays were compared.Besides, the immunohistochemical assays were performed to evaluate the expression of CD31, VEGFR2 and integrin α vβ 3 in tumor tissues. Results:The differences of parameters of a 1, a 3, t 0, TTP, PI and P 2 among four different microbubbles had no statistical significances (all P>0.05), and all parameters between the two single-targeted contrast agents were not statistically different (all P>0.05). The parameters of AUC, MTT, P 1 and dTE all showed a trend that dual-targeted bubbles > single-targeted bubbles > non-targeted bubbles (all P<0.05). On the contrary, the trend of dual-targeted bubbles < single-targeted bubbles < non-targeted bubbles (all P<0.05) was observed for a 2. In the antibody blocking experiment, a 2 was faster after the antibody injection ( P<0.001), while AUC, MTT, P 1 and dTE were all lower than those before the antibody injection ( P<0.001), and the other parameters were not statistically different before and after the antibody injection (all P>0.05). Immunohistochemical analyses confirmed the high expression of CD31, VEGFR2 and integrin β 3 in tumor tissues. Conclusions:The VEGFR2 and integrin α vβ 3 dual-targeted microbubble has a good potential to target the angiogenesis of human RCC in vivo.
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Objective:To explore the capability of vascular endothelial growth factor receptor 2 (VEGFR2)/integrinα vβ 3 dual-targeted microbubbles in assessing the expression level of pro-angiogenic factors during renal cell carcinoma (RCC) growth. Methods:VEGFR2/integrinα vβ 3 dual-targeted microbubbles were prepared by using biotin-avidin linkage method. Twenty subcutaneous RCC xenografts in nude mice were established by subcutaneously injecting 786-O cells and then divided into 2 groups randomly. The targeted contrast-enhanced ultrasound (t-CEUS) examination was performed for all 10 mice in the first group when xenograft tumors were metered from 5 to 10 mm and >10 to 20 mm respectively. And the quantitative parameters of RCC on t-CEUS were longitudinally evaluated during tumor growth. The second group were divided into two subgroups according to xenograft tumors′ diameter, which was 5 to 10 mm and >10 to 20 mm respectively, and underwent t-CEUS examination. Quantitative analysis was performed for all t-CEUS images to obtain the targeted quantitative parameters, which including peak intensity (PI), area under the time-intensity curve (AUC), the differential tissue enhancement (dTE, presenting the difference in PI before (P 1) and after (P 2) the process of Flash). All xenograft tumors in the second group were harvested for immunohistochemical staining to observe the expression of VEGFR2, integrinα vβ 3 and CD31, and their differences in RCC with different tumor sizes. And the correlations between quantitative parameters and VEGFR2, integrinα vβ 3 and CD31 were analyzed. Results:The longitudinal comparison showed that there were statistically significant differences between AUC and dTE of RCC with different tumor sizes (all P<0.001). The larger the tumor size, the smaller the parameters were. According to the horizontal comparison, the expression levels of VEGFR2 and integrinα vβ 3 in larger RCCs were higher than those of RCCs with smaller size (both P<0.05), but there was no significant difference in CD31 expression between the two subgroups ( P=0.754). Both the targeted quantitative parameters (AUC anddTE ) and pro-angiogenic factors (VEGFR2 and integrinα vβ 3) were negatively correlated with tumor size ( rs=-0.83, -0.81, -0.70, -0.88; all P<0.05). Further more, there were good positive correlations between AUC and VEGFR2, integrinαvβ ( rs=0.76, 0.72; all P<0.05). There were good positive correlations between dTE and VEGFR2, integrinα vβ 3 ( rs=0.81, 0.70; all P<0.05). Additionally, the parameter PI was positively correlated with the expression of CD31 ( rs=0.70, P=0.025). Conclusions:The t-CEUS, mediated by VEGFR/integrinα vβ 3 dual-targeted microbubbles, allows noninvasive assessment of the expression levels of VEGFR2 and integrinα vβ 3 in RCCs, which decrease gradually with the increase of tumor size.
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Objective:To investigate the clinical feasibility of three-dimensional contrast-enhanced ultrasound (3D-CEUS) in the quantitative assessment of blood perfusion of hepatocellular carcinoma (HCC).Methods:Between January 2020 and August 2021, 36 HCC patients (39 lesions in total) confirmed by pathology and clinical diagnosis without any treatment from Zhongshan Hospital, Fudan University were enrolled and underwent both 2D-CEUS and 3D-CEUS examinations. Each examination last for 150 s and all images were recorded, and then the data were analyzed. A region of interest was manually drawn along the margin of the whole tumor and then the time-intensity curve (TIC) generated. The following perfusion parameters were extracted: peak intensity (PI), peak time (TTP), ascending slope (AS), mean transit time (MTT) and area under the curve (AUC). After calculating the quality of fit (QOF) of the curve, the intraobserver agreement of the 3D-CEUS quantitative parameters obtained by the same doctor between two times were assessed, and the consistency of the 3D-CEUS and 2D-CEUS quantitative parameters was evaluated when QOF>75%. The differences of the quantitative parameters between different groups (divided by depth of 8 cm and necrosis rate of 50%, respectively) in 3D-CEUS were compared.Results:There were 38 lesions (97.4%, 38/39) with QOF>75% in 3D-CEUS. The intraobserver agreement was excellent, the intraclass correlation efficient(ICC) values was 0.85-0.99. The consistency of the time quantitative parameters (TTP and MTT) were high (the ICC values of 0.87 and 0.91), and the correlation of intensity quantitative parameters were substantial, the rs values were 0.71, 0.72 and 0.71. The differences in 3D-CEUS quantitative parameters of the two groups of lesions with different depths were statistically significant (all P<0.05); but there were no significant differences in quantitative parameters between the two groups with different necrosis rate (all P>0.05). Conclusions:Quantitative 3D-CEUS is an useful and creditable tool in evaluating the blood perfusion of HCC, especially when the depth of lesion was less than 8 cm.
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Objective:To explore the value of contrast-enhanced ultrasound(CEUS) in distinguishing of renal oncocytoma(RO) and chromophobe renal cell carcinoma(chRCC).Methods:The ultrasonic image features of 49 ROs and 72 chRCCs between October 2007 and January 2020 were retrospectively analyzed, all lesions underwent ultrasonic examination (including 19 ROs and 70 chRCCs with CEUS imaging) and were pathologically approved in our institution. The statistically significant parameters from univariate analyses were then entered for further multivariable Logistic regression. The value of each ultrasonic imaging feature in differentiating RO and chRCC was evaluated.Results:According to the univariate analyses, all imaging features on conventional ultrasound were not statistically different between RO and chRCC (all P>0.05), while the characteristics of tumor wash-in/out pattern, enhancement degree and homogeneity at peak time and pseudocapsule around tumor were significantly different (all P<0.05). After multivariable analyses, tumor wash-in and wash-out pattern were excluded for tumor differentiation ( P>0.05), and the parameters of enhancement degree or homogeneity at peak time and pseudocapsule around tumor were still significantly different between tumor types (all P<0.05, odd ratio was 8.683, 6.667 and 18.774 respectively). The overall sensitivity, specificity and accuracy of these three parameters in diagnosing RO was 68.4%, 91.4% and 86.5%, respectively. Conclusions:CEUS can provide some useful information for the differentiation of RO and chRCC.
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Objective:To investigate the value of contrast-enhanced ultrasonography (CEUS) in detecting minute renal cell carcinoma (MRCC) smaller than 15 mm (by ultrasonic measurement) and the strategy to improve its detection rate.Methods:Fifty-three pathologically confirmed MRCCs by surgery from November 2007 to October 2019 at Zhongshan Hospital of Fudan University were enrolled in this retrospectively study. All of them underwent both conventional ultrasound and CEUS examinations. The clinical and imaging data were collected and analyzed. Common features, such as tumor size, location, echogenicity, morphology, border, and blood flow signals were observed on conventional ultrasound. On CEUS, the presence of enhancement, wash in and wash out pattern, perfusion uniformity within the lesions were observed.Results:Post-operative pathology confirmed 48 clear cell carcinomas, 4 papillary carcinomas, and 1 chromophobe cell carcinoma. On conventional ultrasound, 12/53 lesions showed no protrusion out of the kidney, and 41/53 cases slightly protruded out of the kidney. There was considerable difficulty in the detection of ten lesions, which was achieved with the guidance of CT/MRI, due to their dorsal location of the kidney. On conventional ultrasound, solid, hyper-echoic, color flow signal with varying degrees were the main features of MRCC.The boundary could be well- or ill-defined, and cystic changes existed in part of cases. On CEUS, most MRCCs showed simultaneous enhancement in cortical phase, iso- to hyper-enhancement at peak, and rapid washout in parenchymal phase. The comparisons of imaging features demonstrated that the characteristics were significantly different between conventional ultrasound and CEUS with regard to boundaries, blood supply, and perfusion uniformity (χ 2=12.425, 20.247, 7.185; all P<0.01). Conclusions:CEUS can significantly improve the detection rate of MRCC, which is superior to conventional ultrasound.
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Objective@#To investigate the value of contrast-enhanced ultrasound(CEUS) in differential diagnosis of complex renal cysts and clear renal cell carcinoma with cystic change(CRCCC).@*Methods@#The ultrasonographic datas of 82 lesions in 82 patients with complicated renal cysts or CRCCC confirmed by pathology were analyzed. The characteristics of conventional ultrasound and CEUS were observed and evaluated. The lesions were graded according to Bosniak classification criteria.@*Results@#Pathological examination showed that 36 cases were complicated renal cysts and 46 cases were CRCCC. Routine ultrasound showed there were 9 cases (25.0%) with cystic masses and 27 cases (75.0%) with solid and cystic masses in complex renal cysts, of which 14 cases (38.9%) could detect color flow signals. In CRCCC, 2 cases (4.3%) were with cystic masses and 44 cases (95.7%) were with solid and cystic masses, of which 33 cases (75.0%) could detect color flow signals. CEUS showed that only 18 cases (50.0%) of the complex renal cysts showed enhancement of cystic wall or septum, with equal or low enhancement at the peak, 9 cases (50.0%) accompanied by decrease of renal cortex, 35 cases (97.2%) had thin and regular cystic wall, no enhancement of cystic wall in all lesions, and 33 cases (91.7%) had septal thickness less than 1 mm. Forty-five cases (97.8%) of CRCCC showed enhancement of cystic wall or septum, 40 cases (88.9%) showed equal or high enhancement at peak, 30 cases (66.7%) were faster than the decrease of renal cortex, 37 cases (80.4%) showed uneven thickness of cystic wall, 24 cases (52.2%) showed enhancement of cystic wall nodules, and 28 cases (60.9%) showed uneven thickness of septum. After CEUS, 33 cases (91.7%) of complex renal cysts were classified as grade Ⅰ and Ⅱ, while 42 cases (91.3%) of CRCCC were classified as grade Ⅲ and Ⅳ.@*Conclusions@#The CEUS manifestations of complex renal cysts are different from those of CRCCC. The application of Bosniak criteria in CEUS is helpful for the differential diagnosis of complex renal cysts and CRCCC.
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Objective To investigate the value of contrast-enhanced ultrasound(CEUS)in differential diagnosis of complex renal cysts and clear renal cell carcinoma with cystic change(CRCCC).Methods The ultrasonographic datas of 82 lesions in 82 patients with complicated renal cysts or CRCCC confirmed by pathology were analyzed.The characteristics of conventional ultrasound and CEUS were observed and evaluated.The lesions were graded according to Bosniak classification criteria.Results Pathological examination showed that 36 cases were complicated renal cysts and 46 cases were CRCCC. Routine ultrasound showed there were 9 cases (25.0％) with cystic masses and 27 cases (75.0％) with solid and cystic masses in complex renal cysts,of which 14 cases (38.9％) could detect color flow signals.In CRCCC,2 cases(4.3％)were with cystic masses and 44 cases(95.7％)were with solid and cystic masses, of which 33 cases(75.0％)could detect color flow signals.CEUS showed that only 18 cases(50.0％)of the complex renal cysts showed enhancement of cystic wall or septum,with equal or low enhancement at the peak,9 cases(50.0％) accompanied by decrease of renal cortex,35 cases (97.2％) had thin and regular cystic wall,no enhancement of cystic wall in all lesions,and 33 cases(91.7％)had septal thickness less than 1 mm.Forty-five cases (97.8％) of CRCCC showed enhancement of cystic wall or septum,40 cases(88.9％)showed equal or high enhancement at peak,30 cases(66.7％)were faster than the decrease of renal cortex,37 cases (80.4％) showed uneven thickness of cystic wall,24 cases (52.2％) showed enhancement of cystic wall nodules,and 28 cases (60.9％) showed uneven thickness of septum.After CEUS,33 cases(91.7％)of complex renal cysts were classified as grade Ⅰ and Ⅱ,while 42 cases(91.3％) of CRCCC were classified as grade Ⅲ and Ⅳ.Conclusions The CEUS manifestations of complex renal cysts are different from those of CRCCC.The application of Bosniak criteria in CEUS is helpful for the differential diagnosis of complex renal cysts and CRCCC.
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Objective To prepare the vascular endothelial grow th factor receptor 2 ( VEGFR2 )/Integrinαv β3 dual‐targeted contrast ultrasound agent ,and further evaluating the physical properties ,imaging characteristics and targeted ability in v itro . Methods VEGFR2 targeted microbubble ( MBV ) ,Integrinαv β3 targeted microbubble ( MBI) and VEGFR2/Integrinαv β3 dual targeted microbubble ( MBD) were prepared by attaching VEGFR2 antibody ,Integrinαv β3 antibody and both of VEGFR2/Integrinαv β3 antibody with no targeted USphere LA respectively , using biotin‐avidin linkage method . USphere LA with no antibody attached were used as non‐targeted microbubble( MBN ) . M icrobubble′s physical properties were observed , and its stability was detected by caculating bubble′s concentration at different time points . MBD′s ultrasound imaging characteristics were evaluated by comparing its grey level of ultrasound imaging with SonoVue at the time of preparation and 3 days after preparation . To detect the targeted ability of microbubble ,different types of microbubble were added into Hepa 1‐6 and C3H10 cells ,respectively . T he above procedure was repeated using the pre‐antibody blocking test in Hepa 1‐6 cell . Results MBD had a mean size of 1 256 nm .T he concentration of microbubble in the first duration of three days was declining slowly ,and its speed was accelerated after five days of preparation . T he grey level of new prepared MBD was similar to that of SonoVue in the same concentration ( P ＝0 .113) ,while the level was higher than that of SonoVue within 3 days after preparation( P ＜0 .001) . T he number of microbubble binding to Hepea1‐6 led a tendency of MBD＞ single targeted microbubble ＞ MBN ( all P ＜0 .05 ) . T he number of C3H10 and pre‐blocked Hepa1‐6 cell attached to each group of microbubble had no statistical difference ( all P ＞0 .05) . In addition ,following the pre‐blocked precedure ,the number of Hepa 1‐6 cell attached to each group of microbubble had no statistical difference either ( all P ＞ 0 .05 ) . Conclusions VEGFR2/Integrinαv β3 dual‐targeted contrast ultrasound agent is a stable microbubble and it has excellent ultrasound imaging and targeting ability in v itro .
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Objective To compare the ultrasound differences between gouty arthritis with chronic kidney disease( GCKD) and simple gouty arthritis( GA) ,and evaluate the correlation between the number of tophi and the degree of renal impairment . Methods Twenty-two patients with GCKD and 22 patients only with GA were examined by high frequency and color Doppler ultrasound . The differences between the tophus , intra-tendinous aggregate , double contour sign , hyperechoic spots in synovium , synovium hyperplasia ,effusion and erosion of the knee ,ankle and first metatarsophalangeal joint ( M TP 1 ) were examined . The correlation between the degree of renal impairment and the number of tophi was analyzed . Results The prevalence of tophi in GCKD group were significant serious compared with simple GA group ( Z = - 3 .915 ,P < 0 .001) . The articulations involved tophi in GCKD group were more than those in simple GA group( χ2 = 20 .283 , P < 0 .001) . And the tophi in GCKD group were more likely to involve multiple articulations while simple GA group frequently manifested none or single articulation involved( χ2 = 13 .165 , P = 0 .001 ) . The tophus in GCKD group was more frequently involved tendon than that in simple GA group ( χ2 = 6 .783 , P = 0 .009) ,but the number of aggregates in tendon showed no significant difference between the two groups ( Z = - 1 .499 , P = 0 .134) . The double contour sign was more frequent in GCKD group than that in simple GA group( χ2 = 7 .511 , P = 0 .006) ,there was no difference of hyperechoic spots in synovium ,synovium hyperplasia ,effusion and erosion between the two groups . The number of tophi was correlated with estimated glomerular filtration rate ( eGFR) ,serum creatinine( SCr) and blood urea nitrogen ( BUN) ( rs = - 0 .595 ,0 .511 ,0 .583 ;all P < 0 .001) ,respectively .Conclusions GCKD is more likely to manifest multiple tophi ,multiple tophus-involved articulations ,intra-tendinous tophi and double contour sign .The number of tophi is correlated with the degree of renal impairment .
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Objective To compare the efficiencies of handheld ultrasound ,automated breast volume scanner ( ABVS) and breast specific gamma imaging (BSGI) in the diagnosis of breast cancer . Methods A retrospective review was performed in 200 women ( 210 breast lesions) underwent handheld ultrasound , ABVS and BSGI before surgery . The results were verified with histological examination . Results There was no obvious difference among the three methods in the sensitivity for the diagnosis of breast cancer( P >0 .05) . There was no difference of specificity between handheld ultrasound and ABVS ,BSGI( P = 0 .393 , 0 .139) . Compared with BSGI ,ABVS was an imaging modality with highest specificity for the diagnosis of breast cancer( P = 0 .021) ,and there was no difference between handheld ultrasound and ABVS ,BSGI ( P =0 .07 ,0 .29) . The areas under the ROC curve of handheld ultrasound ,ABVS and BSGI were 0 .855 ,0 .894 and 0 .818 ,respectively . The difference was obvious between ABVS and BSGI ( P = 0 .02) . Conclusions The diagnostic efficacy of ABVS in diagnosis of breast malignant lesions is similar to that of handheld ultrasound . BSGI has certain clinical value in the diagnosis of breast cancer ,and it is an effective supplement for breast cancer ultrasound examination .
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Objective To evaluate the effectiveness of automated breast volume scanner(ABVS) and magnetic resonance imaging(MRI) in the detection and diagnosis of breast cancer and to assess the value of these modalities as well as the joint use of the two.Methods In this study,a total of 50 breast lesions in 37 patients proved by surgery and pathology were included.Before operation,all patients were underwent both ABVS and dynamic contrast-enhanced (DCE-MRI) examinations,and classified into groups according to BI-RADS classification.Then the effectiveness of the two examinations were contrasted,the image features on the two techniques were analyzed,and their differential diagnosis in benign and malignant breast lesions were compared.Results The sensitivity,specificity,accuracy,positive predictive value (PPV) and negative predictive value(NPV) of ABVS and MRI for the diagnosis of breast cancer were 91.67％ and 95.83％,88.46％ and 80.77％,90.00％ and 88.00％,88.00％ and 82.14％,92.00％ and 95.45％,respectively,and there was no statistical difference between ABVS and MRI(P ＞0.05);The sensitivity and specificity of the combination of the two were 99.65％ and 97.78％,respectively.The difference of the ABVS coronal features and MRI dynamic enhancement curve types between malignant breast lesions and the benign were statistically significant (P ＜ 0.05).Conclusions Both ABVS and MRI are effective to diagnose breast cancer well,while the combination of the two can improve the diagnosis more accurately.
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Objective To explore the image performance of mucinous breast carcinoma( MBC) on automated breast volume scanner ( ABVS ) and its pathologic features ,for the purpose of improving the recognition of this disease on ABVS ,as well as diagnostic ability . Methods Retrospectively analyzed the sonogram and pathological data of 17 patients with 18 MBC lesions that included 9 PMBC ( pure mucinous breast carcinoma) and 9 MMBC( mixed mucinous breast carcinoma) ,all patients were examined by ABVS before operation and confirmed by pathology . Results Luminal A was the main molecular subtype of MBC ,as well as rarely lymph node metastases;The image of the MBC on ABVS mainly showed a round like or irregular mass ,isoechoic or slightly lower with posterior acoustic enhancement ,and clearly edge with microlobulated or angular ;While on the coronal plane ,it might presented unsmoothed contour ,retraction phenomenon and expansive growth pattern like a spherical nodular;The image characteristics of the PMBC and MMBC lesions on ABVS had no statistical difference( P > 0 .05) ,but the PMBC often performed isoechoic mass with clearly marge ,in contrast , the MMBC usually performed hypoechoic mass with indistinct and angular edge ,and the malignant image features on the coronal plane . Conclusions The three vertical sections of ABVS are beneficial to observe the morphological features of MBC completely ,which can help to identify it from the benign lesions ,reduce misdiagnosis ,and provide some guidance for MBC surgical treatment in the early stage .
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<p><b>OBJECTIVE</b>The purpose of this study was to compare MRI findings of solitary hypovascular hepatic nodules, benign and malignant, to identify their MRI characteristics.</p><p><b>METHODS</b>We retrospectively assessed solitary hypovascular hepatic nodules ≤ 3 cm in 135 patients, among them there were 55 malignant nodules [29 peripheral nodules of cholangiocarcinoma, PCC, and 26 hepatic metastases, HM] and 80 benign nodules [48 inflammatory myofibroblastic tumors, IMT, and 32 hepatic hemangioma, HG], proved by surgery, biopsy or follow-up imaging. Unenhanced and dynamic enhanced MRI findings of the 135 patients were analyzed retrospectively. Statistical analysis included Chi-square test or Fisher's exact test, and receiver operating characteristic (ROC) curve.</p><p><b>RESULTS</b>There was significant difference (P < 0.05) between the malignant group and benign group in terms of location, margin, T2WI signal intensity, heterogeneity or homogeneity of the nodule, and type and degree of peritumoral and intratumoral enhancement. Area under the curve at the first film reading by three radiologists was 0.678 ± 0.047, 0.920 ± 0.022 at the second time, and there was a significant difference (Z = 5.22, P < 0.05) between them.</p><p><b>CONCLUSIONS</b>Our data indicated that solitary hypovascular hepatic nodules show unenhanced and dynamic enhanced MRI features. Therefore, MR imaging combined with clinical and biochemical data does provide reliable information for a proper diagnosis of such hepatic lesions and differentiation of malignant from benign nodules.</p>
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Humans , Cholangiocarcinoma , Pathology , Diagnosis, Differential , Hemangioma , Pathology , Liver , Pathology , Liver Neoplasms , Pathology , Magnetic Resonance Imaging , ROC Curve , Retrospective StudiesABSTRACT
Objective To explore the value of convergence symptom in predicting the treatment sensitivity and the prognosis of patients with breast infiltrating ductal carcinoma (IDC).Methods A retrospective review was performed in 46 women with 47 IDC lesions.Correlation between clinicopathological characteristics and convergence symptom was analyzed.Clinicopathological characteristics included tumor size,tumor grade,axillary lymph node state and the expression of ER,PR and H ER2.Results There was no obvious difference within different IDC groups by tumor size or axillary lymph node state in the presentation of convergence symptom (P ＞ 0.05).The convergence symptom was more common in grade Ⅱ IDC lesions than in grade Ⅲ IDC lesions and the difference was statistically significant (P =0.008).No difference was found between the presentation of convergence symptom and the expression of ER (P =0.055).Significant correlations were found between the presentation of convergence symptom and the expression of PR and HER2 (P ＜0.05).Conclusions Convergence symptom is helpful in predicting the treatment sensitivity and the prognosis of patients with breast infiltrating ductal carcinoma.
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Objective To investigate the value of contrast-enhanced ultrasound (CEUS) in diagnosis of renal epithelioid angiomyolipoma (eAML).Methods The CEUS features of 18 patients with 18 histopathologically proved renal eAMLs were retrospective analyzed using both of qualitative and quantitative approachs.Tumor conventional ultrasound and CEUS features were observed.The Sonoliver software was applied to perform quantitative analysis,which provided five parameters,including the maximum intensity (IMAX),rise time (RT),time to peak (TTP),mean transit time (mTT) and area under the curve (AUC).Results All of 18 lesions were pathological proved as eAML,among them,heterocyst was observed in 7 lesions,1 lesion had dissemination inter-kidney and vessel invasion,necrosis or cystic degeneration was found in 3 eAMLs.On conventional ultrasound,eAML showed hypoecho,isoecho and hyperecho were 14(77.8％),3(16.7％) and 1 (5.6％) respectively.Blood flow could be detected in 16 (88.9％) lesions.On CEUS,the characters of slow-in,synchronous-in,slow centripetal enhancement and entire enhancement were observed in 10 (55.6％),8 (44.4％),8 (44.4％) and 12 (55.6％) lesions,respectively.Most of eAMLs showed homogeneous enhancement (15/18,83.3％) and hyper-or iso-enhancement (16/18,88.8 ％) at peak time.The characters of fast-out,synchronous-out and slow out were observed in 8 (44.4％),2 (11.2％) and 8 (44.4％) cases,respectively.Pseudocapsule was detected in 5 (27.8％) lesions.The parameters of RT,TP and AUC for eAMLs were higher than that for renal cortex (P ＜ 0.05),while the parameters of IMAX and mTT had no significant statistical difference between eAMLs and renal cortex(P ＞0.05).Conclusions Qualitative and quantitative analysis of CEUS reflect the blood perfusion of eAMLs in different aspect,which offer some useful informations for the diagnosis of eAMLs.
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Objective: To observe the impact of electroacupuncture on the pain threshold and the content of excitatory amino acids in the spinal cord of the rats with neuropathic pain to discuss the mechanism of electroacupuncture in treating neuropathic pain. Methods: The rats were randomly divided into a control group (n=10), a sham surgery group (n=10) and a surgery group (n=30) to take spared nerve injury (SNI) surgery of sciatic nerve. The successful SNI model rats in the surgery group were randomly divided into a model group (n=10), an electroacupuncture group (n=10) and a sham electroacupuncture group (n=10). The mechanical pain threshold (MPT) and heat pain threshold (HPT) were measured on the preoperative day, postoperative day 7, postoperative day 9 and the day after the sixth acupuncture treatment. The electroacupuncture was carried out at Huantiao (GB 30) and Weizhong (BL 40) starting from the postoperative day 10 to reflect the impact on the mechanical pain threshold and heat pain threshold. The pre-column deriverization and HPLC fluorescence detection as well as microdialysis method were adopted to test the content of EAAs in spinal cord of rats. Results: The SNI surgery decreased the mechanical pain threshold of rats significantly. The glutamate (Glu) and aspartic acid (Asp) in the microdialysis solution of rats in the model group were higher than in the control group and sham surgery group at the same time point (P<0.05). The contents of Glu and Asp in the microdialysis solution of rats in the electroacupuncture group and sham electroacupuncture group decreased significantly (P<0.05), comparing with model group at the same time point (except the Glu of the sham electroacupuncture group at the second time point). The electroacupuncture reduced the mechanical allodynia markedly. Conclusion: The mechanism of electroacupuncture treating neuropathic pain may relate with the decrease of excitatory amino acids in spinal cord.