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Objective:To investigate the application value of double contrast-enhanced ultrasonography (DCEUS) combined with serum pepsinogen (PG) in the diagnosis of early gastric cancer(EGC).Methods:Eighty-two patients suspected of EGC from July 2020 to July 2022 in the People′s Hospital of Guangxi Zhuang Autonomous Region, and preoperative DCEUS examination and PG test were performed, and the patients were divided into benign lesion group(13 cases), early gastric cancer group(57 cases) and progressive gastric cancer group(12 cases) using postoperative pathology as the gold standard. Parameters for comparison included time to peak (TTP), peak intensity (PI), enhanced intensity (EI), serum pepsinogen Ⅰ (PGⅠ), serum pepsinogenⅡ (PGⅡ) and their ratio (PGⅠ/PGⅡ). The sensitivity, specificity, and accuracy of DCEUS and PG alone and in combination for the diagnosis of EGC were analyzed by plotting the ROC curve, and its diagnostic value was compared.Results:In the comparison of DCEUS parameters, PI and EI values were higher in the malignant group than in the benign lesion group and TTP was the opposite, with statistically significant differences (all P<0.05). In the comparison of PG detection, PGⅠ and PGⅠ/PGⅡ were lower in the malignant group than in the benign lesions, and lower in the progressive gastric cancer than in the EGC, while PGⅡ was the opposite, with statistically significant differences (all P<0.05). As shown by the ROC curve results, the sensitivity of DCEUS and PG alone and in combination for the diagnosis of EGC was 80.7%, 73.7% and 87.7%, respectively; the specificity was 76.0%, 72.0% and 80.0%, respectively; and the accuracy was 79.3%, 73.2% and 85.4%, respectively. The area under curve (AUC) of the two modalities alone and combined were 0.784 (95% CI=0.669-0.898), 0.728 (95% CI=0.606-0.850) and 0.839 (95% CI=0.734-0.943), respectively, and the combined diagnosis had a higher diagnostic value than the single diagnostic modality. Conclusions:The combined diagnostic modality of DCEUS and PG can further improve the diagnostic efficacy of EGC and reduce its underdiagnosis rate, which has good application value.
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Objective:To assess the combination of conventional ultrasound with contrast-enhanced ultrasound(CEUS)in the diagnosis of urothelial carcinoma(UC)of the renal pelvis in elderly patients.Methods:Sixty-seven elderly patients with a histopathologic diagnosis of UC of the renal pelvis and surgically treated at our hospital between April 2015 and March 2023 were retrospectively analyzed.Characteristics of regular preoperative 2D ultrasound, color Doppler flow imaging(CDFI)and CEUS were examined.Results:Of 67 patients, 49(73.13%)were found to have localized lesions in the renal pelvis and renal calyces.Lesions in 53 patients(79.10%)could be clearly identified by conventional ultrasound, with 46(86.79%)being isoechoic or hypoechoic, and 7(13.21%)being hyperechoic.Analysis of tumor blood flow by CDFI found 22 cases(41.51%)with avascular lesions, 21(39.62%)with hypovascular lesions and 10(18.87%)with hypervascular lesions.The average value of the resistance index(RI)was 0.64.Enhancement was seen in 62 lesions(92.54%)by CEUS after injection of SonoVue.Compared with the cortex of the ipsilateral kidney, a slow enhancement pattern was observed in 46(74.19%), 14(22.58%)showed simultaneous enhancement, and 2(3.23%)showed fast enhancement.At peak enhancement, 43 lesions(69.35%)had hypo-enhancement, 10(16.13%)had iso-enhancement, and 9(14.52%)had hyper-enhancement, compared with the cortex.Concerning the homogeneity of enhancement, 16(25.81%)displayed heterogeneous enhancement, with tumor necrosis or hemorrhage, and 46(74.19%)had homogeneous enhancement.When the contrast agent washout rate was assessed, a fast washout pattern was observed in 53(85.48%), synchronous washout in 6(9.68%), and slow washout in 3(4.84%).Conclusions:UC of the renal pelvis mostly shows isoechoic and hypoechoic lesions on conventional ultrasound, avascular or hypo-vascular lesions on CDFI, and slow-in, fast-out and hypo-enhancement on CEUS, compared with the cortex.Conventional ultrasound combined with CEUS can help improve the diagnostic accuracy of UC of the renal pelvis.
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In recent years, although the quantity of organ donation after citizen's death has been constantly increased, a large number of patients with end-stage renal diseases are waiting for kidney transplantation every year. The imbalance between donor and recipient is still one of the main problems affecting kidney transplantation in clinical practice. Therefore, it is of clinical significance to accurately evaluate the quality of donor kidney and fully utilize the expanded criteria donor kidney. Contrast-enhanced ultrasound has been gradually applied in the detection of multiple solid organs due to its safety, portability, real-time detection, quantification and other characteristics, and it also has promising application prospect in the evaluation of donor kidney quality. In this article, the advantages and limitations of current evaluation methods for donor kidney and current status and advantages of contrast-enhanced ultrasound in donor kidney evaluation were reviewed, and the application prospect of contrast-enhanced ultrasound in the evaluation of donor kidney quality was discussed, aiming to increase the methods and enhance the accuracy for donor kidney evaluation, and provide reference for rational use of expanded criteria donor kidney.
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Objective To investigate the value of ultrasound and contrast-enhanced ultrasound (CEUS) in the differential diagnosis of mass-type autoimmune pancreatitis (AIP) and pancreatic ductal adenocarcinoma (PDAC). Methods A retrospective analysis was performed for the clinical data, ultrasound findings, and CEUS findings of 11 patients with mass-type AIP who were diagnosed in Tangshan Workers' Hospital from January 2015 to December 2020, and their characteristic manifestations were analyzed and compared with the data of 23 patients with PDCA. The chi-square test was used for comparison of categorical data between two groups. Results For the 11 patients with mass-type AIP, CEUS had a diagnostic accuracy of 63.64%, and all of these patients had hypoechoic single lesions; the patients with clear boundaries, regular morphology, pancreatic duct dilatation or cutoff, and blood flow signal accounted for 54.55%, 63.64%, 18.18%, and 36.36%, respectively, while in the PDCA group, such patients accounted for 30.43%, 34.78%, 78.26%, and 21.74%, respectively, and there was a significant difference in the presence or absence of pancreatic duct dilatation or cutoff between the two groups( χ 2 =11.089, P 0.05). For the 11 patients with mass-type AIP, CEUS showed that 7 patients (63.64%) had hyperenhancement and 4 (36.36%) had iso-enhancement in the arterial phase, and 5 patients (45.45%) had hyperenhancement in the arterial phase and 6 (54.55%) had iso-enhancement in the venous phase; for the 23 patients with PDCA, 22 (95.65%) had hypoenhancement of lesions in both arterial and venous phases, and there were significant differences in the enhancement pattern in arterial and venous phases between the two groups ( χ 2 =30.345 and 30.084, both P < 0.05). Conclusion The enhancement pattern of CEUS and the presence or absence of pancreatic duct dilatation or cutoff have a relatively high value in the differential diagnosis of mass-type AIP and PDCA.
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Pancreatic metastasis of small cell lung cancer is very rare in clinic. The purpose of this article is to improve the knowledge of clinical and radiologists about this disease by reporting one case.
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Objective:To explore the microcirculation formation mechanism of contrast-enhanced ultrasonography imaging performance in rabbits with limb muscle crush injury.Methods:Seventy-two New Zealand white rabbits were randomly divided into two groups. A limb muscle crush injury model was created by airing a balloon cuff device with a force of 40 kPa. Contrast-enhanced ultrasonography parameters were detected in the first group.In vivo microcirculation parameters were detected in the second group. Fine blood vessel diameter and blood flow velocity were calculated before extrusion and 0.5 h, 2 h, 6 h, 24 h, and 3 days after decompression.Results:Totally six animals died before the end of the experiment (3 rabbits in ultrasonic imaging and microcirculation detection groups, respectively). Compared with the uninjured muscle, the reperfusion of the injured muscle showed early and high enhancement in contrast-enhanced ultrasonography images. The peak intensity and area under the curve were significantly higher than those of the control subgroup at each time point after decompression(all P<0.05), and reached the peak at 24 h after decompression. The time-intensity curve showed a trend of rapid elevation and gradual drop. In the microcirculation group, compared with the control group, fine artery and vein diameters in the experimental group were wider and the blood flow velocity was slower, especially in the fine veins(all P<0.05). At each time point after decompression, there was a statistical difference between the control subgroup and the control subgroup, and the change reached the peak at 24 h after decompression. The blood flow state showed that the arterioles were dominated by linear flow and linear grain flow at each time point after decompression, and linear grain flow, grain flow and grain pendulum flow were observed in the fine veins. Blood flow stagnation and adhesion of white blood cells and white microthrombus were also observed in the fine veins. Correlation analysis showed that the peak intensity and area under the curve were positively correlated with the inner diameter of arterioles and veins( r=0.84, 0.94; r=0.85, 0.94; all P<0.05), and negatively correlated with the flow velocity of arterioles and veins( r=-0.94, -0.96; r=-0.93, -0.96; all P<0.05). Conclusions:In vivo microcirculation detection can reflect changes in muscle microvascular diameter and blood flow velocity, which have a correlation with quantitative ultrasound imaging parameters.
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INTRODUCTION@#Image-guided thermal ablation, preferably with ultrasonography (US), is increasingly used for treatment of small liver tumours. Perfluorobutane-contrast-enhanced US (pCEUS) is a promising tool that may allow for targeting of tumours that are otherwise imperceptible on greyscale US. Although pCEUS has been reported to be effective, the literature has been limited outside of Japan and South Korea. We aimed to provide data that supports the use of pCEUS in the thermal ablation of sonographically occult liver tumours.@*METHODS@#We conducted a retrospective single-centre study of 35 consecutive patients who underwent pCEUS-guided ablation of 48 liver tumours with a median size of 1.2 cm. Periprocedural, one-month post-treatment and relevant follow-up imaging studies were reviewed. Electronic records were also obtained, with long-term follow-up data of 12-28 months being available for 32 patients.@*RESULTS@#36 (75%) tumours that were imperceptible on greyscale US became visible with pCEUS. Overall, complete tumour ablation at one month was 89%. 1 (3%) patient developed a major complication following treatment, while 6 (17%) had minor post-treatment complaints. The local tumour progression rate was 17%, with a median time of 14 months.@*CONCLUSION@#pCEUS has a role in US-guided thermal ablation of liver tumours, offering a high technical success rate that is comparable to reported data. Additional benefits may include improved procedural time and freedom from ionising radiation.
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Objective:To apply contrast-enhanced ultrasound in renal function evaluation for patients with spinal cord injury complicated with hydronephrosis. Methods:From October, 2015 to November, 2018, 23 patients with spinal cord injury complicated with hydronephrosis and renal disfunction (spinal cord injury group) and 19 cases of normal kidneys (control group) accepted contrast-enhanced ultrasonography and the image was analyzed with software. The region of interest (ROI) in the renal cortex, and the time intensity curve was drawn. Logistic regression was performed with time to initial peak (TTP), peak intensity (DPI), slope of ascending time (A), area under the curve (AUC) as the independent variable and renography as the dependent variable. The data was analyzed with ROC. Results:There was no significant difference in serum creatinine and ureophil between two groups (P > 0.05). TTP was longer (t = 5.068, P < 0.001), and A and AUC were lower (t > 3.784, P < 0.01) in the spinal cord injury group than in the control group. AUC was the factor related to renography (P < 0.01). The smaller the AUC was, the greater the likelihood of kidney damage was. The sum of sensitivity and specificity was 1.759 and the corresponding AUC was 982.518 dBS. Conclusion:Contrast-enhanced ultrasound can evaluate renal function of patients with spinal cord injury complicated with hydronephrosis. The decrease in AUC of the time-intensity curve indicates that the renal function is impaired.
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Objective To study the relationships between microscopic marginal extensions and tumor types ,and ultrasonic characteristics of malignant liver tumors . Methods Two‐dimensional ultrasonography , contrast‐enhanced ultrasonography and ultrasound‐guided biopsy of hepatic tumors and surrounding hepatic tissues were performed in 78 patients with malignant liver tumor . Pathological microscopic extensions were observed after hematoxylin‐eosin staining of biopsy specimens . Results T he microscopic marginal extension rates of hepatocellular carcinoma ( HCC) ,intrahepatic cholangiocarcinoma ( ICC) and metastatic liver cancer ( M LC) were 62 .5% ( 30/48 ) ,87 .5% ( 7/8 ) ,and 91 .0% ( 20/22 ) ,respectively . For tumors with well‐defined and poorly‐defined two‐dimensional ultrasound boundary ,microscopic marginal extension rates were 50% ( 14/28) ,and 86% ( 43/50) . T umor type and two‐dimensional ultrasound boundary were independent predictors for microscopic extension rate ( P ＜ 0 .05 ) . T he median microscopic extension distances of HCC ,ICC and M LC were 1 .0 ( 0 ,3 .0 ) mm ,4 .0 ( 2 .3 ,4 .0 ) mm ,and 2 .0 ( 1 .8 ,4 .0 ) mm ,respectively . T he distance of microscopic extension increased with tumor size . T umor type and tumor size were independent predictors for the distance of microscopic extension ( P ＜0 .05) . Conclusions ICC ,MLC ,and tumors with larger diameter or poorly‐defined two‐dimensional ultrasound boundary have a larger distance of microscopic extension .
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Objective To provide a reference for differential diagnosis of orbit tumors in extraconal compartment by analyzing the parameters of contrast‐enhanced ultrasonography ( CEUS) . Methods A total of 76 patients with orbit tumors in extraconal compartment w ho underwent CEUS examination were retrospectively analyzed . T hese patients were divided into two groups depending on histological diagnosis including 27 cases with malignant tumor and 49 cases with benign tumor . CEUS images were analyzed using Sonoliver software . T he time‐intensity curve ( T IC ) and dynamic vascular pattern curve ( DVPC ) were acquired and the characteristics of the arterial flow infusion of these were analyzed . T he related parameters such as time of arrival time( AT ) ,rise time ( RT ) ,time to peak( T T P) ,mean transit time( mT T ) ,slope of rise( K1 ) ,the absolute value for slope of down ( K 2 ) were also obtained . T he differences of DVPC ,TIC and quantitative parameters between the two groups were compared . Receiver operating curve analysis was used to acquire the cut‐off values of these parameters for differential diagnosis . Results ① T ICs of the benign tumors were mainly fast rise and slow drop and DVPCs were mainly positive biphasic ,w hile T ICs of the malignant tumors were mainly fast rise and fast drop and DVPCs were mainly biphasic . ② T he differences of quantitative parameters IM AX ,K 1 ,K2 ,mT T and RT of T ICs were statistically significant between the two groups ( P ＜0 .05) ,w hile those of A T and T T P were not ( P ＞ 0 .05 ) . ③ IM AX＝ 456 .2% ,K1 ＝109 .6 ,K2 ＝35 .2 ,RT＝7 .9 s ,mT T＝28 .1 s were the best cut‐off values for differential diagnosis . Among these parameters ,mT T with 28 .1 s had the highest diagnostic value ( sensitivity :81% ,specificity :77% ) . Conclusions The quantitative CEUS parameters can provide effective reference for differential diagnosis of orbit tumors in extraconal compartment .
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Objective@#To study the relationships between microscopic marginal extensions and tumor types, and ultrasonic characteristics of malignant liver tumors.@*Methods@#Two-dimensional ultrasonography, contrast-enhanced ultrasonography and ultrasound-guided biopsy of hepatic tumors and surrounding hepatic tissues were performed in 78 patients with malignant liver tumor. Pathological microscopic extensions were observed after hematoxylin-eosin staining of biopsy specimens.@*Results@#The microscopic marginal extension rates of hepatocellular carcinoma (HCC), intrahepatic cholangiocarcinoma (ICC) and metastatic liver cancer (MLC) were 62.5%(30/48), 87.5%(7/8), and 91.0% (20/22), respectively. For tumors with well-defined and poorly-defined two-dimensional ultrasound boundary, microscopic marginal extension rates were 50%(14/28), and 86%(43/50). Tumor type and two-dimensional ultrasound boundary were independent predictors for microscopic extension rate (P<0.05). The median microscopic extension distances of HCC, ICC and MLC were 1.0(0, 3.0)mm, 4.0(2.3, 4.0)mm, and 2.0(1.8, 4.0)mm, respectively. The distance of microscopic extension increased with tumor size. Tumor type and tumor size were independent predictors for the distance of microscopic extension (P<0.05).@*Conclusions@#ICC, MLC, and tumors with larger diameter or poorly-defined two-dimensional ultrasound boundary have a larger distance of microscopic extension.
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Objective@#To provide a reference for differential diagnosis of orbit tumors in extraconal compartment by analyzing the parameters of contrast-enhanced ultrasonography (CEUS).@*Methods@#A total of 76 patients with orbit tumors in extraconal compartment who underwent CEUS examination were retrospectively analyzed. These patients were divided into two groups depending on histological diagnosis including 27 cases with malignant tumor and 49 cases with benign tumor. CEUS images were analyzed using Sonoliver software. The time-intensity curve (TIC) and dynamic vascular pattern curve (DVPC) were acquired and the characteristics of the arterial flow infusion of these were analyzed. The related parameters such as time of arrival time(AT), rise time (RT), time to peak(TTP), mean transit time(mTT), slope of rise(K1), the absolute value for slope of down (K2) were also obtained. The differences of DVPC, TIC and quantitative parameters between the two groups were compared. Receiver operating curve analysis was used to acquire the cut-off values of these parameters for differential diagnosis.@*Results@#①TICs of the benign tumors were mainly fast rise and slow drop and DVPCs were mainly positive biphasic, while TICs of the malignant tumors were mainly fast rise and fast drop and DVPCs were mainly biphasic. ②The differences of quantitative parameters IMAX, K1, K2, mTT and RT of TICs were statistically significant between the two groups (P<0.05), while those of AT and TTP were not (P>0.05). ③IMAX=456.2%, K1=109.6, K2=35.2, RT=7.9 s, mTT=28.1 s were the best cut-off values for differential diagnosis. Among these parameters, mTT with 28.1 s had the highest diagnostic value(sensitivity: 81%, specificity: 77%).@*Conclusions@#The quantitative CEUS parameters can provide effective reference for differential diagnosis of orbit tumors in extraconal compartment.
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Objective@#To explore the value of superb micro-vascular imaging(SMI) combined with conventional ultrasound in differential diagnosis of polypoid lesions of gallbladder.@*Methods@#The ultrasonographic and pathological datas of 67 patients with polypoid lesions of gallbladder (of ≥1 cm) in diameter were analyzed retrospectively. According to the pathological results, the patients were divided into tumorous polyp group and non-tumorous polyp group.Conventional ultrasound, SMI and contrast-enhanced ultrasound (CEUS) were performed in all patients before operation, and the basal width, continuity of cystic wall and internal blood flow morphology of polyps were evaluated. The ROC curve was used to calculate the area under the curve and the optimum boundary value of tumorous polyps, the sensitivity and specificity of SMI combined with conventional ultrasound in the diagnosis of neoplastic polyps were calculated according to the optimal threshold. Kappa consistency test was used to analyze the consistency between microblood flow ability and CEUS shown by SMI technique.@*Results@#Of the 67 patients, 22 cases were neoplastic polyps, and 45 cases were non-neoplastic polyps.The polyps were scored quantitatively by SMI combined with conventional ultrasound (0-9 points) and the ROC curve was plotted with, area under curve 0.893(95% CI 0.792-0.994). The sensitivity, specificity and accuracy of diagnosing neoplastic polyps with score (≥4.5) were 77.3%, 93.3% and 88.1%, respectively. Compared with the score of CEUS for microblood flow display (0-4 points), the Kappa values of CDFI, SMI was 0.186, 0.688. SMI and CEUS have good consistency.@*Conclusions@#SMI combined with conventional ultrasound is helpful in differential diagnosis of polypoid lesions of gallbladder, with a high diagnostic value. SMI and CEUS have good consistency in the display of micro-blood flow. It can provide a new diagnostic basis for differential diagnosis of polypoid lesions of gallbladder.
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Objective To compare the diagnostic efficacies of contrast-enhanced ultrasonography (CEUS) and gadoxetic acid-enhanced magnetic resonance imaging (EOB-MRI) in the diagnosis of liver nodules ≤2.0 cm in patients with cirrhosis,and to explore the clinical values of combining the arterial phase of CEUS and hepatobiliary phase of EOB-MRI in the diagnosis of early hepatocellular carcinoma (HCC).Methods One hundred and thirteen nodules with diameters lower than 2.0 cm in 98 patients from February to December 2016 in Tianjin Third Central Hospital were included in this retrospective study.The enhancement patterns of nodules in CEUS and EOB-MRI were analyzed.The reference standard was pathological diagnosis or substantial lesion growth at a follow-up of at least 6 months.The efficiencies of CEUS and EOB-MRI in the diagnosis of liver lesions with a diameter lower than 2.0 cm were compared.A new diagnostic strategy,which combines the arterial phase of CEUS and hepatobiliary phase of EOB-MRI was presented to diagnose the early HCC in this study.Results The area under the ROC curve of CEUS and EOB-MRI were 0.858 and 0.814 (P ＞ 0.05),the sensitivity were 79.1％,81.4％,specificity were 92.6 ％,81.5 ％ and diagnostic accuracy were 82.3 ％ and 81.4 ％,respectively.By combination of CEUS and EOB-MRI,the area under the ROC curve was 0.831,without difference from CEUS,EOB-MRI (0.831 vs 0.858,0.814;all P ＞0.05);its sensitivity was 66.3 ％,specificity was 100％ and diagnostic accuracy was 74.3％.The area under the ROC curve of the new diagnostic strategy,combining the arterial phase of CEUS and hepatobiliary phase of EOB-MRI was 0.934,which was larger than that of CEUS,EOB-MRI and the combination of CEUS and EOB-MRI(0.934 vs 0.858,0.814,0.831;all P ＜0.05).The sensitivity,specificity and diagnostic accuracy of new strategy were 94.2％,92.6％ and 93.8％,respectively.Conclusions The new diagnostic strategy based on the arterial phase of CEUS and hepatobiliary phase of EOB-MRI improves the sensitivity and accuracy in detecting small lesions,which can be used as a complementary diagnostic enhancement pattern for lesions with an atypical enhancement pattern in CEUS or EOB-MRI.
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Objective To explore the value of superb micro-vascular imaging(SMI)combined with conventional ultrasound in differential diagnosis of polypoid lesions of gallbladder.Methods The ultrasonographic and pathological datas of 67 patients with polypoid lesions of gallbladder (of ≥1 cm) in diameter were analyzed retrospectively.According to the pathological results,the patients were divided into tumorous polyp group and non-tumorous polyp group.Conventional ultrasound,SMI and contrast-enhanced ultrasound (CEUS) were performed in all patients before operation,and the basal width,continuity of cystic wall and internal blood flow morphology of polyps were evaluated.The ROC curve was used to calculate the area under the curve and the optimum boundary value of tumorous polyps,the sensitivity and specificity of SMI combined with conventional ultrasound in the diagnosis of neoplastic polyps were calculated according to the optimal threshold.Kappa consistency test was used to analyze the consistency between microblood flow ability and CEUS shown by SMI technique.Results Of the 67 patients,22 cases were neoplastic polyps,and 45 cases were non-neoplastic polyps.The polyps were scored quantitatively by SMI combined with conventional ultrasound(0-9 points) and the ROC curve was plotted with,area under curve 0.893 (95％ CI 0.792-0.994).The sensitivity,specificity and accuracy of diagnosing neoplastic polyps with score(≥4.5) were 77.3％,93.3％ and 88.1％,respectively.Compared with the score of CEUS for microblood flow display(0-4 points),the Kappa values of CDFI,SMI was 0.186,0.688.SMI and CEUS have good consistency.Conclusions SMI combined with conventional ultrasound is helpful in differential diagnosis of polypoid lesions of gallbladder,with a high diagnostic value. SMI and CEUS have good consistency in the display of micro-blood flow.It can provide a new diagnostic basis for differential diagnosis of polypoid lesions of gallbladder.
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Objective To investigate the diagnostic value of ultrasonography.in elderly patients with gastric tumors.Methods A total of 42 elderly patients with gastric tumors confirmed by surgery pathology underwent oral contrast-enhanced ultrasonography and electronic gastroscopy.The diagnostic effect of oral contrast-enhanced ultrasonography and electronic gastroscopy were compared based on the gold standard of surgical pathology.Results Of the 42 elderly patients with gastric tumors,40 patients were diagnosed by oral contrast-enhanced ultrasonography and the surgical pathology(40/42,95.2％),with Kappa value of 0.812.And 38 cases were diagnosed by electronic gastroscopy and the surgical pathology(38/42,90.5 ％),with Kappa value of 0.718 (P ＜ 0.05).Based on gold standard of surgical pathology results,the accuracies of T1,T2,T3 and T4 stage by oral contrast-enhanced ultrasonography were 95.0％ (38/40),95.0％ (38/40),100.0％ (40/40) and 100.0％(40/40),respectively.The sensitivity and specificity of T3 and T4 stage for oral contrastenhanced ultrasonography reached to 100.0 ％.The diagnostic accuracies of N0,N1-N3,M0 and M1 by oral contrast-enhanced ultrasonography were 95.0 ％ (38/40),95.0 ％ (38/40),100.0 ％ (40/40) and 100.0％(40/40).Conclusions Oral contrast-enhanced ultrasonography is a simple,painless and non-invasive method for the diagnosis of gastric tumors in the elderly.And its qualitative coincidence rate of the tumors diagnosis is similar to that of gastroscopy.So it can be used as the first choice for the examination of gastric tumors in the elderly.Oral contrast-enhanced ultrasonography has a high diagnostic accuracy on TNM staging of gastric tumor.When combined with electronic gastroscopy,it may provide a more reliable basis for the choice of evaluation of treatment and prognosis in elderly patients with gastric tumor.
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Objective To investigate the biologic viability and boundary range of hepatic alveolar echinococcosis (HAE) by the contrast-enhanced ultrasonography (CEUS) and acoustic radiation force impulse elastography (ARFI). Methods Totally 27 HAE patients confirmed by pathology underwent CEUS and ARFI examinations. Results Gray scale sonography of HAE showed unclear boundary, inhomogeneous, and middle hyperechoic nodules, and the maximum area was (6.08 ± 4.47) cm2 in 27 lesions. CEUS of HAE showed non-enhancement in three phases and black hole sign. Circumferential enhancement on the pe riphery of the lesion was synchronized with the liver parenchyma and showed “fast in and slow out”. The maximum area was (8.87 ± 4.83) cm2. The area of ECUS was larger than gray scale sonography in HAE (t = 2.20, P = 0.03). The mean shear wave velocities (SWVs) of the interior, the boundary range, and the surrounding liver tissues of HAE were statistically different by ARFI (F = 84.538, P < 0.001), and the interior had the highest values. Conclusions CEUS and ARFI examinations can detect the biologic viability and boundary range of migrating zone around HAE, which is valuable for guiding treatment, judging curative effect, and predicting prognosis.
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Objective@#To investigate the diagnostic value of ultrasonography.in elderly patients with gastric tumors.@*Methods@#A total of 42 elderly patients with gastric tumors confirmed by surgery pathology underwent oral contrast-enhanced ultrasonography and electronic gastroscopy.The diagnostic effect of oral contrast-enhanced ultrasonography and electronic gastroscopy were compared based on the gold standard of surgical pathology.@*Results@#Of the 42 elderly patients with gastric tumors, 40 patients were diagnosed by oral contrast-enhanced ultrasonography and the surgical pathology(40/42, 95.2%), with Kappa value of 0.812.And 38 cases were diagnosed by electronic gastroscopy and the surgical pathology(38/42, 90.5%), with Kappa value of 0.718(P<0.05). Based on gold standard of surgical pathology results, the accuracies of T1, T2, T3 and T4 stage by oral contrast-enhanced ultrasonography were 95.0%(38/40), 95.0%(38/40), 100.0%(40/40)and 100.0%(40/40), respectively.The sensitivity and specificity of T3 and T4 stage for oral contrast-enhanced ultrasonography reached to 100.0%.The diagnostic accuracies of N0, N1-N3, M0 and M1 by oral contrast-enhanced ultrasonography were 95.0%(38/40), 95.0%(38/40), 100.0%(40/40)and 100.0%(40/40).@*Conclusions@#Oral contrast-enhanced ultrasonography is a simple, painless and non-invasive method for the diagnosis of gastric tumors in the elderly.And its qualitative coincidence rate of the tumors diagnosis is similar to that of gastroscopy.So it can be used as the first choice for the examination of gastric tumors in the elderly.Oral contrast-enhanced ultrasonography has a high diagnostic accuracy on TNM staging of gastric tumor.When combined with electronic gastroscopy, it may provide a more reliable basis for the choice of evaluation of treatment and prognosis in elderly patients with gastric tumor.
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Objective@#To compare the diagnostic efficacies of contrast-enhanced ultrasonography (CEUS) and gadoxetic acid-enhanced magnetic resonance imaging (EOB-MRI) in the diagnosis of liver nodules ≤2.0 cm in patients with cirrhosis, and to explore the clinical values of combining the arterial phase of CEUS and hepatobiliary phase of EOB-MRI in the diagnosis of early hepatocellular carcinoma (HCC).@*Methods@#One hundred and thirteen nodules with diameters lower than 2.0 cm in 98 patients from February to December 2016 in Tianjin Third Central Hospital were included in this retrospective study. The enhancement patterns of nodules in CEUS and EOB-MRI were analyzed. The reference standard was pathological diagnosis or substantial lesion growth at a follow-up of at least 6 months. The efficiencies of CEUS and EOB-MRI in the diagnosis of liver lesions with a diameter lower than 2.0 cm were compared. A new diagnostic strategy, which combines the arterial phase of CEUS and hepatobiliary phase of EOB-MRI was presented to diagnose the early HCC in this study.@*Results@#The area under the ROC curve of CEUS and EOB-MRI were 0.858 and 0.814(P>0.05), the sensitivity were 79.1%, 81.4%, specificity were 92.6%, 81.5% and diagnostic accuracy were 82.3% and 81.4%, respectively. By combination of CEUS and EOB-MRI, the area under the ROC curve was 0.831, without difference from CEUS, EOB-MRI (0.831 vs 0.858, 0.814; all P>0.05); its sensitivity was 66.3%, specificity was 100% and diagnostic accuracy was 74.3%. The area under the ROC curve of the new diagnostic strategy, combining the arterial phase of CEUS and hepatobiliary phase of EOB-MRI was 0.934, which was larger than that of CEUS, EOB-MRI and the combination of CEUS and EOB-MRI(0.934 vs 0.858, 0.814, 0.831; all P<0.05). The sensitivity, specificity and diagnostic accuracy of new strategy were 94.2%, 92.6% and 93.8%, respectively.@*Conclusions@#The new diagnostic strategy based on the arterial phase of CEUS and hepatobiliary phase of EOB-MRI improves the sensitivity and accuracy in detecting small lesions, which can be used as a complementary diagnostic enhancement pattern for lesions with an atypical enhancement pattern in CEUS or EOB-MRI.
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Objective To explore the value of virtual touch tissue imaging quantification(VTIQ) and contrast-enhanced ultrasonography(CEUS) in the differential diagnosis of benign and malignant breast lesions with non-mass type. Methods A retrospective analysis of 85 cases by conventional ultrasound examination for the type of breast lesions in patients of image data,with pathologic results as the gold standard,analysis of US,VTIQ,CEUS and VTIQ joint CEUS for the breast type value in the differential diagnosis of benign and malignant lesions. Results There were 46 benign cases and 39 malignant cases in 85 cases of breast non-mass lesions. The internal shear wave velocity (SWV) and SWV ratio of breast non-mass benign lesions were significantly lower than that of malignant lesions(3. 43 ± 0. 59 m/s vs 4. 76 ± 0. 95 m/s,1. 73 ± 0. 43 vs 2. 67 ± 0. 77). The sensitivity,specificity and accuracy of VTIQ in the diagnosis of breast non-mass-like lesions were 76. 9％,80. 4％ and 78. 8％ respectively. Type of breast malignant lesions CEUS was high-enhanced enhancement compared with glandular tissue around the contrast agent into early enhancement and immediately wash-out and more for the nonuniformity,around the lesions or internal contrast enhancement of blood vessels,the sensitivity of CEUS in the diagnosis of mammary gland non tumor lesions, specific degrees and accuracy were 79. 5％,80. 4％ and 80. 0％ respectively. VTIQ type combined with CEUS in the diagnosis of breast mass lesions sensitivity and accuracy of the specific degree were 89. 7％,93. 5％ and 91. 8％ respectively,the joint diagnosis efficiency was significantly higher than single use of CEUS or VTIQ (P< 0. 05),CEUS and VTIQ diagnostic value were significantly higher than the US (P < 0. 05). Conclusion CEUS,VTIQ type in breast tumors in the differential diagnosis of benign and malignant lesions has good diagnostic value,VTIQ joint CEUS complementary advantages,more comprehensive diagnostic information available pathological changes,the type of breast disease diagnosis accuracy is improved.