Value of contrast-enhanced ultrasound liver imaging reporting and data system version 2017 and MRI liver imaging reporting and data system version 2018 in predicting the malignant risk of focal liver lesion / 中华超声影像学杂志

Objective:To compare the predictive value of contrast-enhanced ultrasound(CEUS) Liver Imaging Reporting and Date System(LI-RADS) version 2017 with magnetic resonance imaging(MRI) LI-RADS version 2018 applied alone or in combination for focal liver lesions in high-risk patients.Methods:From January 2018 to October 2021, the clinical and imaging datas of 212 patients with 300 nodules underwent CEUS and contrast-enhanced MRI(CEMRI) within 4 weeks in Ruijin Hospital and its Wuxi branch were retrospectively analyzed. Each nodule was categorized according to the CEUS LI-RADS v2017 and CT/MRI LI-RADS v2018. Inter-modalities agreement was assessed with Cohen′s Kappa. The diagnostic performances of the two classification criteria applied alone and in combination for the predictive value of malignant risk of focal liver lesions were compared using histopathology or follow-up as gold standard.Results:The inter-modalities agreement of CEUS LI-RADS v2017 and MRI LI-RADS v2018 was moderate (Kappa=0.441). The specificity of CEUS LR-5, MRI LR-5 and CEUS LR-5+ MRI LR-5 in the diagnosis of HCC was 93.66%, 95.07% and 88.73% ( P>0.05), respectively, positive predictive values of them were 93.13%, 93.81% and 89.81%( P>0.05), respectively. The sensitivity of CEUS LR-M, MRI LR-M and CEUS LR-M+ MRI LR-M in the diagnosis of non-HCC malignancy was 85.71%, 82.86% and 100%, respectively. CEUS LR-M+ MRI LR-M had higher sensitivity than MRI LR-M( P=0.033), whereas no difference was found between CEUS LR-M+ MRI LR-M and CEUS LR-M( P=0.063). Conclusions:The inter-modalities agreement of the LI-RADS category between CEUS and MRI is moderate. The specificity and positive predictive values of HCC in LR-5 of the CEUS and MRI LI-RADS are comparable. In addition, the sensitivity of non-HCC malignancy in LR-M of the CEUS and MRI LI-RADS are comparable. The combined application of CEUS and MRI LR-M can improve the diagnostic sensitivity of non-HCC malignancy.

Ultrasonographic features of different pathological types of thyroid lymphoma and its clinical features / 中华超声影像学杂志

Objective:To investigate the ultrasonographic features of thyroid lymphoma and its different pathological types.Methods:The clinical manifestations and sonographic findings were analyzed retrospectively in 30 patients with pathological confirmed thyroid lymphoma from January 2014 to November 2019 in Ruijin Hospital Affiliated to the Shanghai Jiao Tong University of Medicine. Ultrasonographic features of different pathological types of thyroid lymphoma were compared.Results:There were 30 patients included in the study. All the lesions were pathologically diagnosed as diffuse large B-cell lymphoma(17/30, 56.7%), mucosa-associated lymphoma(8/30, 26.7%), follicular lymphoma(3/30, 10.0%), gray zone lymphoma(1/30, 3.3%), and lymphoblastic lymphoma(1/30, 3.3%). Clinical features included short-term neck enlargement (60.0%), with compression symptoms (46.7%), Ⅲ/Ⅳ cervical region lymphadenopathy (63.3%), thyroid dysfunction (10.0%), combined with Hashimoto′s thyroiditis (63.3%). Statistical differences were found in the longitudinal diameter of the lesion ( P=0.036), ultrasonographic features ( P=0.036), and the margin of the lesion ( P=0.005) between diffuse large B-cell lymphoma and mucosa-associated lymphoid tissue lymphoma.Ultrasonographic features ( P=0.005) and lesion edges ( P=0.020) differed significantly between different aggressiveness. Conclusions:Patients with Hashimoto′s who have noticed a short-term enlargement of extremely low echogenic mass in the thyroid gland and lymphadenopathy in the neck Ⅲ/Ⅳ region should be suspected of having thyroid lymphoma. Very low echo lesions with irregular edges and flaky hyperechoes are characteristic features of diffuse large B cell lymphoma, and very low echo lesions with rims and grid echoes are characteristics of mucosa-associated lymphoma.

The value of preoperative clinical and sonographic characteristics of clinically node‐negative papillary thyroid carcinomain predicting central lymph node metastasis / 中华超声影像学杂志

To investigate the association of preoperative clinical and sonographic characteristics of clinically node‐negative ( cN0) papillary thyroid carcinoma ( PTC) with central lymph node metastasis ( CLNM ) . Methods A total of 514 patients with PTC confirmed by pathology in our hospital were included in the retrospective analysis . Clinical and sonographic characteristics were assessed including age ,gender ,tumor size ,and the distance between the tumor and the capsule . These cases were all diagnosed as cN0 according to clinical and sonography examinations . And the cases were divided into CLNM ( + ) group and CLNM ( －) group based on the pathological results . T hen statistical analysis was used to evaluate the correlation between CLNM and risk factors of cN 0 PTCs . Results ① Of the 514 cN0 PTC cases ,211 cases ( 41 .1% ) were CLNM ( + ) and 303 cases ( 58 .9% ) were CLNM ( －) . ② With the presence of capsule invasion in the ultrasound examination ,the probability of CLNM ( + ) group was higher than that of CLNM ( －) group ( 62 .1% vs 37 .9% ) . ③ In the 364 cases without capsule invasion ,the probability of CLNM ( + ) was significantly increased when the distance between the tumor and the capsule was ＜ 1 .5 mm ( 88 .8% vs 11 .2% ) . ④ M ultivariate analysis showed that risk factors independently associated with CLNM included age ＜45 years old ,tumor maximum diameter ≥10 mm ,and the distance between the tumor and the capsule ＜ 1 .5 mm ,among w hich the distance between the tumor and the capsule ＜1 .5 mm had the highest OR value . Conclusions In cN0 PTC patients ,CLNM is associated with age ,size and the distance between the tumor and the capsule .

Effect of naked-eye assessment on the diagnosis of ultrasound-guided fine needle aspiration in thyroid nodules / 中华超声影像学杂志

Objective@#To evaluate the feasibility and efficacy of naked-eye assessment (NA) of ultrasound-guided fine needle aspiration cytology(US-FNAC) smears, which was performed by a trained non-cytological physician.@*Methods@#A total of 290 smears of FNAC in 143 thyroid nodules were used to evaluate the value of NA by an assistant with more than two years experience of intervention with ultrasound guidance. NA results such as the background of smear (bloody/non-bloody), thickness (thick/thin), as well as the contents (granulated/non-granulated) were recorded. The correlation between NA and cytological results was analyzed. Number of cells under microscopy, the non-diagnostic rate, and the significance between benignity and malignancy with different features of specimens were compared.@*Results@#There was no significant difference between the NA background and cytological findings(P=0.707, 0.200, 0.705, respectively). There was significance in number of cells, non-dianostic rate between thick and thinner specimens (P=0.000, 0.001, respectively). However, there was no significance in benignity and malignancy between thick and thinner specimens (P=0.385). There was significance in cytology results between the granulated and non-granulated smears(all P=0.000). The difference was found in 51.1% of the smears with granulates were malignancy in cytology. While 77.8% of the non-granulated smears were ultimately diagnosed as benignity.@*Conclusions@#The NA could be performed by a trained non-cytological physician and contribute to preliminary predictions of cytology effect.

Research on the learning curve of contrast-enhanced ultrasonography in sentinel lymph node of breast cancer / 中华超声影像学杂志

Objective To investigate the learning curve of contrast-enhanced ultrasonography ( CEUS) in sentinel lymph node( SLN ) of breast cancer and provide a theoretical basis for leaners to learn SLN CEUS . Methods The multi-center study of SLN CEUS in breast cancer" was planned by Sichuan Cancer Hospital . According to the uniform inclusion and exclusion criteria , 511 patients with complete clinical data and follow-up results from 9 hospitals in Multi-center were included in this study . According to the inspection time ,the patients were divided into 3 groups named as group A ( 170 patients) ,group B ( 170 patients) and group C ( 171 patients ) ,respectively . The basic clinical data ,ultrasound imaging data , intraoperative and postoperative pathological findings of all patients were recorded . With the accumulation of cases examined ,analysis was performed to find the learning curve of the SLN CEUS examination time , SLN CEUS detection rate ,SLN CEUS surface marking accuracy rate and SLN CEUS diagnosis rate ,the learning curve was analyzed . Results ① There was no statistical significant difference in patients ages , tumors sizes ,tumors locations ,SLNs numbers and LCs numbers among the three groups( all P > 0 .05) . ②As the number of cases examined increases ,the examination time was reduced gradually ,but SLN detection rate ,surface marking accuracy and SLN diagnostic coincidence rate were increased gradually( F = 151 .75 , 1 .96 ,7 .49 ,5 .50 ; P = 0 .000 ,0 .143 ,0 .001 ,0 .005 ) . Conclusions The skill of the doctor is improved gradually when learning SLN CEUS . With the number of the cases increase ,the operating time of SLN CEUS is shorted ,and the SLN detection rate ,surface marking accuracy and SLN diagnostic coincidence rate of SLN-CEUS are gradually increased . It has an important clinical significance for beginners to learn the SLN CEUS technology .

Ultrasonographic manifestations of traumatic neuromas after neck dissection in papillary thyroid carcinoma / 中国医学影像技术

Objective To investigate the ultrasonographic manifestations of traumatic neuroma after neck dissection in papillary thyroid carcinoma (PTC).Methods A retrospective analysis was performed in 21 patients with 26 lesions who underwent neck dissection.The ultrasonographic characteristics were reviewed,including numbers,location,size,shape,margin,echogenicity,with or without direct continuity to the nerve fiber,the presence of internal hyperechogenicity and blood supply.Results Among the 26 lesions of 21 patients,25 lesions were in the lateral cervical area while the other one was in the central cervical area.The mean shortest diameter of the lesions was (3.5±1.0)mm and that of longest diameter was (9.1±2.9)mm.Totally 13 lesions were oval in shape and the other 13 were round.The clear margin was found in 13 lesions and fuzzy margin was observed in another 13 lesions.All the lesions were heterogeneously hypoechoic.The presence of internal hyperechoic areas were found in 16 lesions.The direct continuity with the nerve fiber was found in 20 lesions,while the other 6 lesions were not continued to the nerve directly.Color Doppler flow imaging showed that 20 of the 26 lesions existed a little blood flow signal and the other 6 lesions showed no flow signal.During the ultrasound-guided fine-needle aspiration biopsy (US-FNAB),21 patients complained about the intolerable serious pain and the pain relieved when the needle removed.Conclusion Traumatic neuromas are hypoecho lesions located in the operation area after neck dissection in PTC with distinctive ultrasonographic features,especially the direct continuity with the nerve fiber,as well as the clinical histories and sharp pain during US-FNAB,which can help to diagnose.

Application of two-dimensional ultrasound combined with three-dimensional imaging technology in the diagnosis of anal fistula / 中华超声影像学杂志

Objective To evaluate the clinical value of the real-time three-dimensional ultrasound in the diagnosis of the fistula-in-ano.Methods One hundred and eighteen fistula-in-ano patients were examined using conventional and three-dimensional ultrasound,the stereotaxis of interal opening and the shape of the fistula-in-ano were analyzed.Then the diagnosis results of ultrasound were compared with the surgery and pathology.Results In 1 1 8 patients,the accuracy of preoperative identifying internal opening by two-dimensional ultrasound was 85%,and 95% for three-dimensional ultrasound with statistically significant difference (χ2 =6.679,P <0.05).For complex anal fistula,the diagnostic accuracy rates of main fistula tract by three-dimensional ultrasound (100%,82/82 )was higher than that by two-dimensional ultrasound(95%,78/82),the difference was statistically significant (χ2 =4.100,P <0.05 ).In 82 cases of complex anal fistula,the diagnostic accuracy of branch fistula tract by two-dimensional ultrasound was 70%(57/82 ),the accuracy using three-dimensional ultrasound was 89% (73/82 ),there was statistically significance (χ2 =9.499,P < 0.05 ).Conclusions Three-dimensional ultrasound can accurately locate the interal opening of fistula-in-ano and determine the shape of fistula-in-ano,which provided the most intuitive information for clinical treatment and had high practical value.

Correlation between sonographic features of papillary thyroid microcarcinoma and cervical lymph node metastasis / 中华超声影像学杂志

Objective To evaluate the correlation between sonographic features of papillary thyroid microcarcinoma(PTMC) and cervical lymph node metastasis.Methods Preoperative sonographic features of 379 papillary thyroid microcarcinoma in 341 patients were retrospectively reviewed,and were divided into two groups,lymph node metastasis and lymph node non-metastasis according to pathology.Univariate and multivariate analyses were performed to analyze the sonographic features relevant to lymph node metastasis.Results Univariate analysis revealed that unclear border,microcalcification and multifocal PTMC were statistically significant(all P ＜0.05).Multivariate analysis revealed that microcalcification and multifocal PTMC were statistically significant (both P ＜0.05).Conclusions Microcalcification and multifocal PTMC are closely relevant to cervical lymph node metastasis.

The value of ultrasonography in the diagnosis of papillary thyroid microcarcinoma with Hashimoto's thyroiditis / 中华医学超声杂志（电子版）

ObjectiveTo investigate the value of ultrasonography in the diagnosis of the papillary thyroid microcarcinoma (PTMC) in patients with Hashimoto’s thyroiditis (HT).MethodsThis retrospective study used data from Ruijin Hospital of Shanghai Jiaotong University of Medicine during November 2012 to December 2013. A total of 111 small thyroid nodules (75 PTMC/36 benign nodules) with 107 HT cases which were pathologically conifrmed were included in this study. The sonographic characteristics of nodules were investigated, including nodule aspect ratio, shape, border, margin, acoustic halo, internal structure, echo level, microcalciifcations, rear acoustic attenuation, vascular pattern and extent of the blood supply and the types of thyroid tissue echogenicity. Chi-square test and Fisher′s exact probability method was used to compare the differences of the sonographic characteristics between the benign nodules and malignant nodules. With surgical pathology as the gold standard, computing the value of ultrasonography in the diagnosis of PTMC with HT, including the sensitivity, speciifcity, diagnostic accuracy, positive predictive value and negative predictive value.ResultsA total of 111 thyroid tiny nodules (75 PTMC/36 benign nodules) with 107 HT cases which were pathologically conifrmed were included in this study. The results showed 111 small thyroid nodules as solid hypoechoic. Four indexes between PTMC and benign nodules had statistical signiifcance, such as margin, microcalciifcations, vascular pattern and extent of the blood supply. The other six indexes between PTMC and benign nodules had no statistical significance, such as aspect ratio, shape, border, acoustic halo, rear acoustic attenuation and the types of thyroid tissue echogenicity. Ultrasound diagnostic accuracy of small tyroid nodules in patients with HT was 74.77% (83/111). The sensitivity, specificity, diagnostic accuracy, positive predictive value and negative predictive value of the ultrasound diagnosis of PTMC were 93.33% (70/75), 36.11% (13/36), 74.77% (83/111), 75.27% (70/93), and 72.22% (13/18), respectively.ConclusionsCompared with general population, some classic ultrasound features became less effective in patients with HT. However, ultrasonography has some differential diagnostic value in these cases.

Value of Ultrasound in diagnosing sclerosing adenosis of breast / 中华医学超声杂志（电子版）

Objective To study the sonographic features of mammary sclerosing adenosis (SA) and evaluate the diagnositic value of ultrasound. Methods Thirty-ifve patients with pathologically conifrmed SA in Ruijin Hospital from May 2009 to August 2013 were retrospectively analyzed. The Breast Imaging Reporting and Data System (BI-RADS) lexicon was introduced to describe the lesions. The diagnostic sensitivity was analyzed. Results The main sonographic ifndings of SA could be characterized into three types:(1) malignancy-looking nodule type (typeⅠ) (34%, 12/35). (2) benignity-looking nodule type (typeⅡ) (43%, 5/35). (3) architectural disorder type (typeⅢ) (23%, 8/35). Lack of blood supply has the greatest value in differential diagnosis among all sonographic features. The diagnositic sensitivity in typeⅠ, typeⅡ, typeⅢwere 0 (0/12), 93%(14/15), and 75%(6/8) respectively. The general sensitivity was only 57%(20/35). Conclusions There are no typical sonographic features in mammary sclerosing adenosis. Ultrasound doctors should improve their knowledge about this disease.

Common characteristic of papillary microcarcinoma of thyroid in ultrasound and pathology / 中华医学超声杂志（电子版）

Objective To explore the pathological basic of some common characteristic of papillary microcarcinoma of thyroid in ultrasound. Methods Totally 117 thyroid papillary microcarcinomas that were completed all thyroid ultrasound examinations before the surgical excisions were collected. Shape, border, internal echogenicity, halo, posterior echogenicity and calciifcation were observed in ultrasound. While the degree of inifltration of the tumor, the tumor’s internal structure as well as calciifcation was observed in pathology. Results IIrregular shape (87.18%, 102/117), unclear border (80.34%, 94/117), hypoechoic (90.60%, 106/117) and microcalciifcations (65.81%, 77/117) were recognized by ultrasound while the main pathological features were invasive growth (93.16%, 109/117), cell components internally (46.15%, 54/117) and calciifcation (56.41%, 66/117). Of the 109 neoplasms which were invasive growth in pathology, 102 (93.58%) nodules presented irregular shape in ultrasound while 91 (77.78%) presented unclear border. All of the 8 neoplasms which were not invasive growth in pathology showed regular shape in ultrasound. Thirteen nodules showed halos in ultrasound, and 8 of them showed visible ifbrous capsule surrounding the mass. Whatever the tumor’s internal structure was, most nodules presented hypoechoic. And the hyperechoic nodules were all found cell components internally. Of the 66 neoplasms which were found calciifcation by microscope, 35 (53.03%) nodules showed calciifcation in ultrasound and 31 (46.97%) did not. And of the 51 neoplasms in which calciifcation were not found by microscope, 42 (82.35%) nodules showed calciifcation in ultrasound and 9 (17.65%%) did not. Conclusions There is no doubt that all the performances of papillary microcarcinoma in ultrasound have bases in pathology. It is helpful to the judgment of a thyroid nodule if we could understand the correlation of performances in ultrasound and pathology.

Value of elastography in predicting central lymph nodes metastasis of papillary thyroid microcarcinoma / 中华医学超声杂志（电子版）

Objective To investigate the value of elasticity score and elasticity strain ratio (SR) in predicting the central lymph nodes metastasis of papillary thyroid microcarcinoma (PTMC). Methods This study conducted a retrospective analysis of ultrasonography ifndings of 236 thyroid lesions from 208 patients. All of them underwent surgery in Ruijin Hospital of Shanghai Jiao Tong University from June 2012 to March 2013. Totally 82 PTMC from 82 patients were included in this study. Among them 12 patients with 12 PTMC had central lymph nodes metastasis. The elasticity score and SR were compared between metastasis and non-metastasis groups, and the receiver operating characteristic (ROC) curve of SR was calculated. Results The differences of PTMC elasticity score between two groups showed no statistical signiifcance (χ2=5.00, P=0.08). The average SR of the group with central lymph nodes metastasis is 2.44±0.61, which is higher than the group without lymph nodes metastasis whose average SR is 1.67±0.42. Differences are statistically signiifcant (t=5.5, P=0.00). The area under curve of SR-ROC curve was 0.847. Using 2.01 as cutoff of SR, the sensitivity, speciifcity, accuracy of predicting central lymph nodes metastasis was 83.3%, 81.4%, 78.6%respectively. Conclusion The SR but not elasticity score could be a meaningful indicator for predicting lymph nodes metastasis.

Control study of sonographic assessment of artery using echo-tracking technique and pulse-Doppler in SD rats / 中华超声影像学杂志

Objective To ascertain the utility and difference of sonography with echo-tracking (ET) technique and pulse-Doppler to assess vascular stiffness in rats with hypercholesterolemia and atherosclerosis.Methods Sonography associated with ET technique and pulse-Doppler were used to measure stiffness parameter (β),arterial compliance (AC),distensibility coefficient (DC),one-point pulse wave velocity (PWVβ),resistence index(RI),peak systolic velocity(PSV),end-diastolic velocity(EDV) and EDV/PSV of the aorta in cholesterol-fed SD rats (group T1,n =10,for 4 weeks;group T2,n =10,for 12 weeks) and normal control rats(group C1,n =10;group C2,n =10).All parameters and blood biochemical markers[total cholesterol(TC),triglycerides(TG),low-density lipoprotein cholesterol(LDL-CH) and highdensity lipoprotein cholesterol (HDL-CH)] among groups were analyzed with ANOVE factor analysis.Correlation was analyzed with Pearson analysis.Light microscopic evaluation were used to demonstrate atherosclerotic changes in the aorta.Results The PWVβ value and PSV of the aorta between group T1 and T2 were significantly different (P =0.001,P ＜0.05).The β,PWVβ values of the aorta in group T1 and T2 were significantly higher than those of group C1 and C2 (P ＜0.05).AC and DC values of the aorta in group T1 and T2 were significantly lower than those of group C1 and C2 (P ＜0.05).Correlation analysis showsed that RI was positively correlated with systolic pressure(P ＜0.05).All parameters had correlated with each other among β,PWVβ,AC,DC,TG,TC,systolic pressure and diastolic pressure.DC and AC were negatively correlated with β and PWVβ,also DC was negatively correlated with TG.Light microscopy confirmed morphologic typical changes of aortic atherosclerosis in group T1 and T2.Conclusions Sonography with the ET method compared with pulse-Doppler is much more sensitive and it can be used to evaluate tissue elastic changes in arterial walls associated with atherosclerosis and hypercholesterolemia.PSV can reflect atherosclerosis of rat's abdominal aorta well,but pulse-Doppler is limited in the diagnosis of earlier atherosclerosis period.

“Taller-than-wide sign” of thyroid malignancy: comparison between transverse and longitudinal plane using ultrasound / 中华超声影像学杂志

ObjectiveTo evaluate the diagnostic value of “taller-than-wide sign” of thyroid malignancy in transverse and longitudinal plane using ultrasound.Methods708 thyroid lesions including 302 benign nodules and 406 malignant nodules ( 390 papillary carcinomas,12 medullary carcinomas,4 follicular carcinomas) that were diagnosed at surgery were included in this study.The sensitivity and specificity of “taller-than-wide sign” in transverse (A/TC ≥ 1 ) and longitudinal plane (A/TL ≥ 1 ) were evaluated using ultrasound.All thyroid malignant lesions were divided into three groups according to size of the nodules:group A≤1 cm; group B≤2 cm,group C＞2 cm.The sensitivity of each group was also evaluated.ResultsThe constituent ratio of “taller-than-wide sign” between benign and malignant nodules was significantly different (P＜0.001 ).The differences of sensitivity of A/TL ≥ 1 and A/TC ≥ 1 among three groups were also found( P ＜0.001),and the sensitivity of A/Tc≥1 was higher than A/TL≥1.ConclusionsA/TC≥1 found by ultrasound contributes to differentiate the thyroid carcinoma from benign nodules.For a large thyroid lesion,other indicators are needed to diagnose thyroid carcinoma.

Treatment of idiopathic hypogonadotropic hypogonadism with pulse infusion of gonadorelin via micro pump / 中华内分泌代谢杂志

Objective To explore the efficacy of pulse infusion of gonadorelin (LHRH) on the patients with idiopathic hypogonadotropic hypogonadism (IHH) via a micro infusion pump. Methods The protocol was designed as an open, self-controlled prospective study. 31 patients were enrolled and assigned to 3 groups: 23 males without gonadotropin-releasing hormone ( GnRH ) pulse ( group A), 2 males with GnRH pulse frequency insufficiency ( group B), and 6 females ( group C). All the subjects were admitted LHRH every 90 min via the micro infusion pump for 24 weeks. Sex hormones and related characteristics were compared before and after the treatment. Results After 24-weeks treatment, LH peak value reached ( 6. 92 ±5.66 ), ( 9. 55 ±0. 98 ), and ( 6. 93 ±4. 52 ) IU/L; and FSH peak value reached ( 7.44 ± 3. 80 ), ( 12. 85 ± 12. 80 ), and ( 7.38 ±4. 98 ) IU/L among 3 groups, respectively. The testosterone also reached ( 3.18± 1.81 ) and ( 5.78±4. 65 ) ng/ml in groups A and B ( all P＜0. 01 ). In groups A and B, the testis volumes were increased, seminal fluid production was found in 7 patients and spermatogenesis in 6 patients. In group C, uterus was enlarged 85.4%, as well as the ovaries of both sides. Menarche was reported in 5 patients. 19. 4% of the studied patients complained uncomfortable at the injection sites, all the symptoms were mild. Conclusion Pulse infusion of LHRH in IHH patients via a micro infusion pump is effective, while the medication system needs improving.

Ultrasound combined with microbubble enhanced eNOS expression and NO release in endothelial cells in vitro / 中华超声影像学杂志

Objective To assess the enhancement effect of diagnostic ultrasound combined with microbubbles in the generation of endothelial nitric oxide synthase(eNOS)and nitric Oxide(NO)in endothelial cells.Methods Normal cultured human umbilical vein endothelial cells(HUVEC)were divided into blank control group(A group),simple microbubble group(B group),simple ultrasound group(C group)and ultrasound combined with microbubble group(D group).According to different conditions,group D was divided into three sub-groups:different time groups(1 min,5 min,10 min);different machinery index(MI)groups(0.09,0.4,1.0),different microbubble concentration groups(5×10~8/ml,2.5×10~8/ml,1.25×10~8/ml).Cell morpha was observed in the light microscope immediately and 24 h after the intervention,respectively.RT-PCR was used to measure the relative expression of eNOS in cells.NO kit was used to measure the NO Ievels in culture medium.And statistical methods were used to analyse the experimental data.Results NO and eNOS were significantly higher in group D than the other three groups.When MI=1.0,microbubble concentration=2.5×10~8/ml,and irradiation time=10 min,the increase of eNOS and NO in group D was the most obvious.Furthermore,the cell morphology had no significant change in the light microscope immediately and 24 h after the intervention.Conclusions Ultrasound combined with microbubble can increase the generation of eNOS and NO in endothelial cells.

Study on carotid intima-media thickness and stiffness in type 2 diabetic patients / 中华内分泌代谢杂志

Objective To study the effect of blood glucose level and duration of type 2 diabetes mellitus on carotid intima-media thickness (CIMT) and quantitative carotid stiffness (QCS) in the patients with type 2 diabetes mellitus. Methods Two hundred and seventy-four type 2 diabetic patients (diagnosed according to the World Health Organization criteria) were involved in this study. The subjects were divided into three groups according to the HbAlclevels and duration of diabetes mellitus: 60 with duration ≤2 years (as newly diagnosed) , 96 with duration≥5 years and HbAlc <6.5%, and 118 with duration≥5 years and HbAlc≥6.5%. CIMT and QCS of the common carotid artery were assessed by the high-resolution B-mode ultrasound unit and an echo-tracking system integrated in an uhrasound unit respectively. Results (1) In categorical analyses, the mean level of CIMT was increased from 720 μm in subjects with a duration of diabetes mellitus ≤2 years to 770 μm in subjects with a duration of diabetes mellitus > 2 years and plasma HbAlc< 6.5% (P < 0.05), and to 800 μm in subjects with a duration of diabetes mellitus > 5 years and plasma HbAlc≥ 6.5 % (P < 0.01). The corresponding values for Q CS values were 4.5, 4.5 and 5.1 (P <0.05), respectively. (2) In multiple stepwise regression analyses, CIMT wassignificantly associated with the duration of diabetes mellitus, systolic blood pressure and serum concentration of total cholesterol, whereas QCS was significantly associated with age, duration of diabetes mellitus, smoking, HbAlc, systolic blood pressure (P < 0.05 or P < 0.01). Conclusion QCS is suitable in evaluating the impact of blood glucose on carotid artery, while CIMT is an appropriate tool for long-term follow-up of diabetic patients.

Experimental study of the injury of unilateral testicular torsion on the contralateral testes with contrast enhanced ultrasound / 中华超声影像学杂志

Objective To evaluate the injury of unilateral testicular torsion on the contralateral testes with contrast-enhanced ultrasound.Methods Twenty-eight male rabbits were enrolled in this study.They were randomly divided into the control group,the detorsion after 3 hours group,the detorsion after 6 hours group,the detorsion after 24 hours group and the permanent torsion group.There were 8 rabbits in the control group,and 5 rabbits in each of the other groups.Just before torsion,immediately after torsion,just before detorsion,immediately after detorsion,and delay(6-12 hours after detorsion.the permanent torsion group was also at the corresponding time),contrast-enhanced ultrasound was used to observe the perfusion of contralateral testes.The control group was also performed contrast-enhanced ultrasound just before the shame operation and immediately after that.The time-intensity curves were draw according to the contrastenhanced ultrasound images.The parameters including arrival time(AT),time to peak intensity(TTP),peak intensity(PI),half time of descending peak intensity(HT)were yielded automatically,and the changes of them were analyzed.Results①There was no significance of enhancement AT,TTP,PI,and HT between pre-operation and post-operation in the control group(P＞0.05).②When the parameters of immediately after torsion compared with those of before torsion in the groups of torsion,the perfusion was increased significantly displaying by PI increasing(P＜0.05).③The longer time the duration of unilateral testicular torsion,the more obviously the perfusion of the contralateral testes increased.Conclusions The timeintensity curve of contrast-enhanced ultrasound is valuable in assessing of the injury of unilateral testicular torsion on the contralateral testis.

Color Doppler ultrasonography for evaluation of cervical lymphadenopathy / 中华超声影像学杂志

Objective To evaluate the usefulness of color Doppler ultrasonography in differential diagnosis of cervical lymphadenopathy by depicting the intranodal vascular pattern. Methods One hundred and twenty lymph node lesions in 113 patients who underwent color Doppler flow imaging were grouped as reactive lymphadenitis ( n =25), tuberculosis ( n =14), lymphoma ( n =41), and metastasis ( n =40). The vascular patterns of hilar type, central type, peripheral type and mixed type were assessed. Results Most reactive lymph nodes( 92.0%) and lymphomatous nodes( 75.6%) showed hilar vessels,lymphomatous nodes also frequently demonstrated peripheral vessels( 75.6%).Central vessels or peripheral vessels were frequent in metastatic nodes( 60.0% and 57.5%, respectively).The intranodal vascular distribution in tuberculous nodes was simulated malignant disease. Avascularity was observed in 2 of 25 reactive lymph nodes and 1 of 14 tuberculous nodes. Conclusions Central vessels or peripheral vessels were mainly found in malignant lymphadenopathy,and the presence of hilar vessels is suggestive of benign lymphadenopathy. However, there is overlap of appearance between benign and malignant disease.

Application of 3-D ultrasound in bladder diseases / 中华泌尿外科杂志

Objective To evaluate the clinical application of 3 D ultrasound in the diagnosis of bladder diseases. Methods In 21 patients with bladder disease,3 D images were studied with a Voluson 530D diagnostic system.At first,the two dimensional images of lesions were collected,then defined 3 D volumes of interest were stored,reconstructed and analyzed. Results 3 D ultrasound provided a clear stereoscopic view and depicted the appearance of the 21 bladder diseases,displayed the internal structures,and showed invasive depth within and outside the bladder wall and also metastasis of the adjacent organs. Conclusions 3 D ultrasound can clearly demonstrate the morphologic characteristics and internal structures of the bladder disease and provide much more reliable information for the diagnosis of diseases.