Value Of Contrast-enhanced Ultrasonography Research Articles

The Value of Contrast-Enhanced Ultrasound (CEUS) in the Detection of Perfusion Disturbances in Abdominal Wall Hernias Compared with Surgical and Histological Assessment.

Purpose: This study aimed to evaluate the value of contrast-enhanced ultrasound (CEUS) in the evaluation of perfusion disturbance in irreducible abdominal wall hernias (AWHs). Methods: From 2006 to 2018, 50 patients with an irreducible AWH were examined using B-mode ultrasound (B-US) and CEUS. The ultrasound findings were correlated with subsequent surgical and histological results. The presence of non-enhanced areas (NEAs) in hernia contents on CEUS and the presence of non-perfused areas (NPAs) on surgical and histological evaluation were analyzed retrospectively. Results: On CEUS, 13/50 hernia contents (26.0%) revealed NEAs during complete CEUS examination and 37/50 (74.0%) revealed no NEAs during CEUS examination. On surgical and histological evaluation, NPAs in hernia contents were identified in 11/13 cases (93.3%) with NEAs on CEUS. CEUS was found to have a sensitivity of 100.0%, a specificity of 94.9%, a positive predictive value of 84.6%, and a negative predictive value of 100.0% for the identification of perfusion disturbance in AWHs. Conclusions: The findings of this study demonstrate that using CEUS as an imaging method may be helpful for evaluating the perfusion of hernia contents in incarcerated AWHs. On CEUS, the presence of NEAs may suggest perfusion disturbance in hernia contents.

Value of Contrast-Enhanced Ultrasound in the Preoperative Evaluation of Papillary Thyroid Carcinoma Invasiveness.

ObjectiveTo evaluate the diagnostic performance of preoperative contrast-enhanced ultrasound (CEUS) in the detection of extracapsular extension (ECE) and cervical lymph node metastasis (LNM) of papillary thyroid carcinoma (PTC) and the added value of CEUS in the evaluation of PTC invasiveness to conventional ultrasound (US).Materials and MethodsA total of 62 patients were enrolled retrospectively, including 30 patients with invasive PTCs (Group A, ECE or LNM present) and 32 patients with non-invasive PTCs (Group B). All patients underwent US and CEUS examinations before surgery. US and CEUS features of PTCs and lymph nodes were compared between groups. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of US, CEUS, and the combination of the two in the detection of ECE and LNM of PTCs were calculated. Logistic regression was used to analyze relationships between variables.ResultsThe PTC size was larger in group A on both US and CEUS (P = 0.001, P = 0.003). More PTCs showed hyper-enhancement in group A (P = 0.013) than in group B. More PTCs had >25% contact between PTC and the thyroid capsule and discontinued capsule on US and CEUS (all P < 0.05) in group A than in group B. More absent hilum and calcification of lymph nodes were observed in group A (both P < 0.05) than in group B on US. More centripetal perfusion and enlarged lymph nodes were observed in group A (both P < 0.05) than in group B on CEUS. CEUS alone and US combined with CEUS manifested higher diagnostic accuracy (79.0%) than US alone (72.6%) in the detection of ECE. The combination of US and CEUS manifested the highest diagnostic accuracy (95.2%) than CEUS alone (90.3%) and US alone (82.2%) in the detection of LNM. Diagnoses of ECE and LNM by the combination of US and CEUS were independent risk factors for PTC invasiveness [odds ratio (OR) = 29.49 and 97.20, respectively; both P = 0.001].ConclusionCEUS or US combined with CEUS is recommended for the detection of PTC ECE, while the combination of US and CEUS is most recommended for LNM detection. CEUS plays an essential role in the preoperative evaluation of PTC invasiveness.

Value of Contrast-Enhanced Ultrasound in Adjusting the Classification of Chinese-TIRADS 4 Nodules.

Objectives To explore the value of applying contrast-enhanced ultrasound (CEUS) in adjusting the classification of category 4 nodules in the Chinese-Thyroid Imaging Report and Data System (C-TIRADS). Methods The data of preoperative conventional ultrasound and CEUS examinations of 125 C-TIRADS 4 nodules in 109 patients were retrospectively analyzed. We divided the thyroid nodules into two groups based on whether recommend by the guide fine-needle aspiration (FNA). Group I included C-TIRADS 4A nodules with a maximum diameter ≤15 mm and C-TIRADS 4B and 4C nodules with a maximum diameter ≤10 mm, and Group II included C-TIRADS 4A nodules with a maximum diameter >15 mm and C-TIRADS 4B and 4C nodules with a maximum diameter >10 mm. In CEUS, thyroid nodules showing suspicious malignant features such as hypoenhancement or early washout were adjusted to a level higher in the C-TIRADS classification; thyroid nodules showing possible benign features such as iso- or hyperenhancement were adjusted to a level lower; and thyroid nodules showing no enhancement were adjusted to C-TIRADS 3. Taking the pathological results as the gold standard, the receiver operating characteristic (ROC) curves of the C-TIRADS classification before and after the adjustment based on CEUS were plotted, and the diagnostic efficiency was compared. Results The sensitivity, specificity, accuracy, and positive and negative predictive values of the C-TIRADS classification for the diagnosis of thyroid nodule malignancy before the adjustment based on the CEUS results were 83.6%, 63.8%, 74.4%, 72.7%, and 77.1%, respectively, and these values were 91.0%, 82.8%, 87.2%, 85.9%, and 88.9%, respectively, after the adjustment. The area under the ROC curve (AUC) was 0.737 and 0.869, respectively, showing a significant difference (Z = 3.288, P=0.001). The diagnostic efficiency of C-TIRADS classification after the adjustment based on the CEUS results in both groups was improved compared with the result before the adjustment, and the difference in Group II was significant (Z = 2.931, P=0.003). Conclusions CEUS significantly improved the diagnostic performance in the adjustment of C-TIRADS 4 nodule classification, especially for the nodules which needs FNA recommended by the C-TIRADS.

Value of Contrast-Enhanced Ultrasound in Partially Cystic Papillary Thyroid Carcinomas.

Partially cystic papillary thyroid carcinomas (PCPTCs) are rarely reported papillary thyroid carcinomas (PTCs) and are usually misdiagnosed as benign nodules. The objective of this study was to provide the various sonographic characteristics of partially cystic thyroid nodules for differentiation between malignant and benign nodules, including those for conventional ultrasound (US) and contrast-enhanced ultrasound (CEUS). Twenty-three PCPTC patients and 37 nodular goiter patients were enrolled in this study. We evaluated the size, cystic percentage, solid echogenicity, calcification, vascularity, and CEUS parameters for each nodule. The final diagnosis of all patients was confirmed via surgery. Univariate analysis demonstrated that compared with benign nodular goiters, PCPTCs more frequently presented with calcification, hypoechogenicity of the solid part, hypoenhancement, heterogeneous enhancement, centrifugal perfusion, peak intensity index <1, time to peak index ≥1, and area under the curve index <1 on preoperative US and CEUS. Binary logistic regression analysis demonstrated that heterogeneous enhancement, centrifugal perfusion, and peak intensity index <1 are independent CEUS characteristics related to malignant PCPTCs and can be used for their differentiation from benign nodular goiters (all p < 0.05). Our study indicated that preoperative CEUS characteristics may serve as a useful tool to distinguish malignant PCPTCs from benign thyroid nodules.

Value of Contrast-Enhanced Ultrasound in Differentiating Clinically Atypical Subacute Thyroiditis from Papillary Thyroid Carcinomas.

Our objective was to provide the various sonographic characteristics of clinically atypical subacute thyroiditis (CAST) in distinguishing CAST from papillary thyroid carcinomas (PTCs) by using conventional ultrasound (US) and contrast-enhanced ultrasound (CEUS). Forty-six CAST patients and 50 PTC patients were enrolled in this study. We evaluated the size, shape, margin, echogenicity, calcification, vascularity and CEUS parameters for each nodule. The final diagnosis of CAST was confirmed via fine-needle aspiration (FNA) or surgery. Of the 46 CASTs, 13 (28.3%) were confirmed by surgery to be benign, and 33 (71.7%) were proven by FNA to be benign. Univariate analysis indicated that compared with PTCs, CAST lesions more frequently had wider-than-taller shapes, blurred margins, the absence of microcalcifications, peripheral high echogenicity, the absence of internal vascularity, hypo-enhancement, centrifugal perfusion and a peak intensity index <1 and area under the curve index <1 on pre-operative US and CEUS. A multivariate analysis revealed that clear margins, microcalcifications and centripetal perfusion were independent characteristics related to PTCs for their differentiation from CAST (all p values <0.05). Our study indicated that the pre-operative multiparameter US characteristics may serve as a useful tool for distinguishing CAST from malignant thyroid nodules to avoid surgical excisions or unnecessary FNAs.

Comparative Study on Diagnosis Value of Contrast-Enhanced Ultrasound and Contrast-Enhanced Computed Tomography after Treating Advanced Renal Cancer Patients with Yiqi Jiedu Decoction.

Objective To compare and analyze the diagnosis value of contrast-enhanced ultrasound (CEUS) and contrast-enhanced computed tomography (CECT) after treating advanced renal cancer patients with Yiqi Jiedu decoction. Methods The case data of 60 patients diagnosed with advanced renal cancer from January 2013 to January 2021 at the Affiliated People's Hospital of Ningbo University were retrospectively analyzed, 30 patients who accepted the conventional treatment were included in the control group, and the rest treated with Yiqi Jiedu decoction on the basis of conventional treatment were included in the study group. After treatment, patients in both groups received the CEUS and CECT examinations, the diagnosis efficacy of both examinations was evaluated with the ROC curve, and the overall survival (OS) of patients was analyzed. Results No significant between-group differences in the general information were observed (P > 0.05); the clinical remission rate and disease control rate were not significantly different between the two groups (P > 0.05); the enhancement and attenuation, degree of enhancement, uniformity of enhancement, and pseudocapsule sign of the CEUS and CECT examinations were not remarkably different (P > 0.05); according to the results of CEUS and CECT examinations, the maximum diameters of tumor after treatment were smaller in the study group than in the control group, but with no significant between-group difference (P > 0.05); in addition, there were no obvious differences in determining the maximum diameter of tumor by CEUS and CECT (P > 0.05), and the results of the maximum diameter of tumor determined by CEUS, CECT, and pathological specimen were not statistically different (P > 0.05); as for the diagnosis efficacy, the result was CEUS + CECT > CEUS > CECT; and the OS of patients in the study group was longer than those in the control group. Conclusion The patients treated with Yiqi Jiedu decoction obtain longer OS, and the application value of CEUS combined with CECT in the treatment effect and prognosis of patients with advanced renal cancer is higher.

Values of Contrast-Enhanced Ultrasound in Classification and Diagnosis of Common Bile Duct and Superficial Organ Lesions under Compression Algorithm.

This work aimed to investigate values of contrast-enhanced ultrasound (CEUS) under DEFLATE in the classification and diagnosis of the common bile duct and superficial lymphoid lesions. 88 patients with lower common bile duct lesions and 126 patients with superficial lymphoid lesions were selected as the subjects investigated and examined by CEUS under DEFLATE to compare characteristics and diagnostic efficiency of CEUS in different types of lesions. The time-intensity curve (TIC) was for quantitative analysis on CEUS results. The results showed that there were statistically significant differences in the comparison of time to peak (TTP), area under the curve (AUC), and gradient (Grad) of common bile duct walls in patients from the malignant group (P < 0.05), while the comparison of three indicators of patients in the benign group was not statistically remarkable (P > 0.05). In addition, there were statistically great differences in TTP, AUC, and Grad among patients in the benign and malignant groups (P < 0.05). The sensitivity, specificity, accuracy, and positive/negative predictive value of CEUS + ultrasound (US) in the diagnosis of benign and malignant lymph nodes were 92.83%, 87.14%, 89.54%, 91.23%, and 86.43%, respectively. The values of maximal intensity (Imax) in the reactive hyperplasia group (group A), lymphoma group (group B), and metastatic lymph nodes group (group C) were compared, showing statistical differences (P < 0.05). The TTP and AUC of group B were higher than those of groups A and C, respectively (P < 0.05), and the base-to-peak ascending slope (KUP) and the absolute value of the semidescending slope (KDOWN) in group C increased hugely compared to group A (P < 0.05). It indicated that CEUS examination under DEFLATE could be applied in the qualitative diagnosis of lower common bile duct lesions and superficial lymphoid lesions, which was worthy of clinical application.

Value of Conventional Ultrasonography with Contrast-Enhanced Ultrasonography in the Differential Diagnosis of Partial Cystic Thyroid Nodules

The value of contrast-enhanced ultrasonography (CEUS) in the diagnosis of malignant partial cystic thyroid nodules (PCTNs) remains unclear. Thus, in the present study, the data of patients with pathologically proven PCTNs who underwent CEUS in the Chinese PLA General Hospital from January 2016 to February 2019 were retrospectively reviewed, and the imaging characteristics of benign and malignant PCTNs were compared. A total of 177 PCTNs were enrolled in this study, including 58 (32.7%) malignant nodules and 119 (67.2%) benign nodules. Six characteristics significantly differed between malignant PCTNs and benign PCTNs in univariate comparison: position of the solid portion (χ2 = 17.937, p < 0.001), microcalcifications (χ2 = 81.382, p < 0.001), boundaries (χ2 = 45.486, p < 0.001), echogenicity (χ2 = 11.152, p = 0.004), intensity of enhancement (χ2 = 40.656, p < 0.001) and uniformity of enhancement (χ2 = 19.933, p < 0.001). Among these, microcalcifications, boundaries, position of the solid portion, and uniformity of enhancement were independent risk factors in the multivariate comparison. A logistic regression model for predicting benign and malignant PCTNs was established with a sensitivity, specificity, positive predictive value, negative predictive value and accuracy of 89.0% (95% confidence interval [CI]: 0.788–0.961), 91.0% (95% CI: 0.830–0.946), 81.0% (95% CI: 0.715–0.881), 95.0% (95% CI: 0.892–0.974) and 90.0% (95% CI: 0.844–0.938), respectively. The area under the receiver operating characteristic curve was 0.967 (95% CI: 0.944–0.990), which was significantly higher than that of conventional ultrasound only (0.747, 95% CI: 0.663–0.831, Z = 2.090, p = 0.0366). CEUS can be used in the diagnosis of PCTNs, and the four characteristics of malignant PCTNs proven by our study were microcalcifications, unclear boundaries, eccentric distributions of the solid parts and heterogeneous enhancement.

Value of Contrast-Enhanced Ultrasound in Differential Diagnosis of Focal Liver Lesions

The article discusses the modern possibilities of identifying inflammatory bowel diseases using methods of radiation diagnosis. Methods of radiation diagnostics help determine the stages of inflammatory bowel diseases helping in timely diagnosis, prescription and timely correction of therapy. The use of an adequate amount of diagnostic measures allows early detection of complications requiring immediate surgical treatment, such as fibrostenotic lesions, fistulae, and abscesses.The sources of the review were publications included in peer-reviewed databases E-library, PubMed, GoogleScholar, conference materials and non-indexed publications, including web pages of conferences and repositories of scientific data from universities.

Value of contrast-enhanced ultrasonography in assessing the activity of idiopathic retroperitoneal fibrosis: a prospective study

We aimed to evaluate changes in the contrast-enhanced ultrasound (CEUS) parameters in patients with idiopathic retroperitoneal fibrosis (RPF) before and after treatment, and to analyse the value of CEUS to assess RPF activity. We performed a prospective study that included patients with idiopathic RPF who were treated for RPF at our hospital from April 2016 to April 2019. All patients underwent CEUS examination and some of them underwent positron emission tomography/computed tomography (PET/CT) examination simultaneously. CEUS parameters included tube wall and peripheral thickness, arterial wall intensity, and lumen intensity. The changes in CEUS parameters before and after treatment were evaluated, and their correlations with the standardised uptake value (SUVmax), erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) were analysed. Thirty-one active idiopathic RPF patients were enrolled, of whom 11 underwent PET/CT examination before treatment. Tube wall and peripheral thickness (r=0.743, p<0.01) and arterial wall intensity (r=0.702, p<0.05) both correlated significantly with SUVmax. Lumen intensity did not correlate significantly with SUVmax (r=0.544, p=0.084). The correlation coefficients between lesion thickness and ESR levels were 0.508 (p=0.037), between lesion thickness and CRP levels were 0.575 (p=0.016). Arterial wall intensity and lumen intensity were not significantly correlated with ESR or CPR levels. Tube wall and peripheral thickness, arterial wall intensity, decreased significantly after treatment (p=0.001), while the lumen intensity was not significantly changed after treatment. Our findings suggest that CEUS, a radiation-free and repeatable detection method, is effective for assessing idiopathic RPF disease activity.

Value of Contrast-Enhanced Ultrasound in the Differential Diagnosis of Focal Splenic Lesions.

PurposeTo identify and validate contrast-enhanced ultrasound (CEUS) features for differentiating malignant from benign splenic lesions.Patients and MethodsSplenic lesions in 123 patients who underwent conventional ultrasound (B-mode US) and CEUS were included in this study. Two radiologists evaluated the sonograms of B-mode and CEUS. Statistical analysis was performed to identify significant imaging predictors for splenic malignant lesions. Two other radiologists independently reviewed B-mode and CEUS sonograms and diagnosed the lesions based on proposed criteria as 1) benign, 2) probably benign, 3) probably malignant or 4) malignant. The diagnostic efficiency between B-mode US and CEUS was compared.ResultsCommon imaging findings of malignant lesions included hypoechoic, ill-defined margin, absence of cystic/necrotic portion, presence of splenomegaly on B-mode US, and hypoenhancement, rapid washout and presence of intralesional vessels on CEUS (P < 0.05). Among them, three independent features were identified using multivariate logistic regression analysis: hypoechoic pattern, hypoenhancement pattern and intralesional vessels. When three of these findings were combined as a predictor for splenic malignant lesions, 22 (55.0%) of 40 malignant splenic lesions were identified with a specificity of 100%. The diagnostic performance of two readers using receiver operating characteristic curve analysis was 0.622 and 0.533, respectively, for B-mode US, which was significantly improved to 0.908 and 0.906 for CEUS (P < 0.001). The degree of other diagnostic efficiency and inter-reader agreement also increased with CEUS compared to B-mode US.ConclusionCEUS may provide more useful information than B-mode US and improve the diagnosis efficiency for distinguishing malignant from benign splenic lesions.

Value of contrast-enhanced ultrasonography in radiofrequency ablation of secondary hyperparathyroidism

Objectives The purpose of the current study was to determine the performance of contrast-enhanced ultrasound (CEUS) in the assessment of radiofrequency ablation (RFA) of hyperplastic parathyroid glands due to secondary hyperparathyroidism (SHPT). Methods Thirty-two patients, each with ≥4 hyperplastic parathyroid glands due to SHPT, underwent RFA via hydro-dissection. CEUS was performed in each patient before and during RFA. The patients in whom the intact parathyroid hormone (iPTH) level did not decrease to 300 pg/ml were examined by CEUS. The iPTH, serum calcium, and serum phosphorus levels before and after RFA were compared. Results Ablation was achieved in all patients (131 ablated glands). The volume of the glands was 479.88 ± 549.3mm3. The pre-operative and day 1 post-operative iPTH levels were 2355 ± 1062 and 292.7 ± 306.8 pg/ml, respectively. Three nodules in three patients showed little enhancement on CEUS on post-operative day 1. The iPTH level was <300 pg/mL on post-operative day 1 in 23 patients, which indicated complete ablation; follow-up evaluations were therefore performed. The pre- and post-operative iPTH levels in the 23 patients were 2113 ± 787.2 and 106.2 ± 84.62 pg/ml, respectively (p < 0.05), and the 6- and 12-month post-operative iPTH levels were 111.1 ± 56.57 and 117.6 ± 97.08 pg/ml, respectively (p > 0.05). Conclusions CEUS-guided RFA is effective and feasible for the treatment of ≥4 hyperplastic parathyroid glands. CEUS was shown to assist the surgeon before, during, and after RFA. CEUS on post-operative day 2, but not immediately post-operatively, was shown to accurately reflect gland perfusion.

Incidentally Detected Liver Metastases during Pancreas Contrast-enhanced Ultrasound

Abstract Purpose: The purpose of current study was to investigate the value of the late-phase enhancement features of pancreas contrast-enhanced ultrasound (CEUS) in the detection of liver metastases in patients with pancreatic ductal adenocarcinomas (PDAC). Methods: From October 2020 to March 2021, 86 patients were prospectively enrolled. The gold standard of liver metastatic and PDAC lesions were based on histopathologically diagnoses and multiple imaging modalities results. B-mode ultrasound (BMUS) was performed to detect suspected liver metastases before CEUS. During the late phase of pancreas CEUS, the entire liver was scanned again to detect hypoenhanced liver metastases. Liver metastases were confirmed by biopsy and histopathological results. The number and size of liver metastases detected by BMUS and during CEUS late phase were recorded and compared. Results: Suspected liver metastases were detected in 14 patients by BMUS (n = 23). During the late phase of CEUS, hypoenhanced liver metastases were detected in 23 patients (n = 87). When compared with BMUS, whole-liver scan during the late phase of CEUS detected more isoechoic, small, or superficially located lesions. Compared with BMUS, the specificity, sensitivity, positive predictive value, and negative predictive value of CEUS in diagnosing of liver metastases in PDAC patients were significantly improved (96.72% vs. 100%, 48% vs. 92%, 85.71% vs. 100%, and 83.10% vs. 96.83%, respectively) (P &lt; 0.05). Conclusion: The late phase whole liver scan during CEUS of pancreas helps to detect more liver metastases, which is important for further clinical decision-making.

Evaluation of contrast-enhanced ultrasound in the differential diagnosis of benign and malignant lateral cervical lymph nodes

Objective: To investigate the value of contrast-enhanced ultrasound (CEUS) in the diagnosis of benign and malignant lateral cervical lymph nodes. Methods: One hundred and fifteen cases of suspected lymph nodes disease, 60 males, 55 females, between November 2018 and June 2019 from clinic and inpatient in Fujian Cancer Hospital were collected. Routine ultrasound and CEUS were performed in 115 cases of lateral cervical lymph nodes. All cases underwent ultrasound-guided biopsy, and were divided into two groups of benign and malignant lymph nodes according to pathological results. The differences between the two groups were analyzed and statistically analyzed. The rate and frequency were used to qualitatively describe the ultrasound performance and observed lymph node morphology between the two groups of routine ultrasound and CEUS. The sensitivity, specificity, accuracy, negative predictive value and positive predictive value were used to evaluate the efficacy of routine ultrasound and CEUS. Results: There were 37 cases of benign lymph nodes and 78 cases of malignant lymph nodes. In benign lymph nodes, 51.4% (19/37) showed uniform high enhancement, and 48.6% (18/37) showed uneven or circular enhancement with clear boundaries and no focal enhancement area. In malignant lymph nodes, 94.9% (74/78) showed uneven enhancement, and only 5.1% (4/78) showed uniform enhancement. The difference of ultrasonic contrast medium uniformities in differentiating benign from malignant was statistically significant (P<0.001). The sensitivity, accuracy, negative predictive value and positive predictive value of routine ultrasound to differentiate benign and malignant lymph nodes were 64.1%, 65.2%, 47.2%, and 66.7%, respectively, while the corresponding values of CEUS were 93.6%, 75.7%, 73.7% and 83.9%. Conclusion: CEUS may provide a valuable basis for the differential diagnosis of benign and malignant lateral cervical lymph nodes.

Diagnostic performance of contrast-enhanced ultrasound for acute pyelonephritis in children

The objective of our study was to evaluate the performance of renal contrast-enhanced ultrasound (CEUS) against the 99m-labeled dimercaptosuccinic acid (DMSA) scan and computed tomography (CT) in children for the diagnosis of acute pyelonephritis. We included children who underwent both renal CEUS and the DMSA scan or CT. A total of 33 children (21 males and 12 females, mean age 26 ± 36 months) were included. Using the DMSA scan as the reference standard, the sensitivity, specificity, positive predictive value, and negative predictive value of CEUS was 86.8%, 71.4%, 80.5%, and 80.0%, respectively. When CT was used as the reference standard, the sensitivity, specificity, positive predictive value, and negative predictive value of CEUS was 87.5%, 80.0%, 87.5%, and 80.0%, respectively. The diagnostic accuracy of CEUS for the diagnosis of acute pyelonephritis was 80.3% and 84.6% compared to the DMSA scan and CT, respectively. Inter-observer (kappa = 0.54) and intra-observer agreement (kappa = 0.59) for renal CEUS was moderate. In conclusion, CEUS had good diagnostic accuracy for diagnosing acute pyelonephritis with moderate inter- and intra-observer agreement. As CEUS does not require radiation or sedation, it could play an important role in the future when diagnosing acute pyelonephritis in children.

Clinical value of contrast-enhanced ultrasonography in assessment of T stage of rectal cancer before operation

Clinical value of contrast-enhanced ultrasonography in assessment of T stage of rectal cancer before operation

Contrast-Enhanced Ultrasonography Characteristics in the Evaluation of Different Nature of Carotid Artery Plaques

To investigate the value of contrast-enhanced ultrasonography (CEUS) in the evaluation of neovascular density in plaques with different carotid atherosclerosis. 97 patients with carotid plaques were observed by conventional ultrasound from January 2016 to December 2018. The CEUS test was used to grade and quantify the new blood vessels in the plaque. The results showed of the 97 patients with 101 plaques, 49 were soft plaques, 45 were mixed plaques, and 7 were hard plaques. CEUS clearly showed the continuity of plaque fibrous caps and found plaque ulcers that were easily missed by conventional ultrasound. The lower the echo of the plaque, the more obvious contrast enhancement in the plaques. Quantitative analysis of CEUS showed the peak time of soft plaques was shorter and the peak intensity of soft plaques was higher compared with mixed plaques. The difference was statistically significant (P &lt;0.01). The results displayed that carotid CEUS is a convenient and intuitive new technology that can better help analyze plaque morphology and determine and quantify the extent of neovascularization in plaque. It can be used for clinical evaluation of potential cerebrovascular risk and also provides an accurate and reproducible detection method for clinical efficacy evaluation.

超声造影对高原地区肝脏局灶性病变的临床诊断价值

超声造影对高原地区肝脏局灶性病变的临床诊断价值

The value of contrast-enhanced ultrasonography in differential diagnosis of orbit tumors in extraconal compartment

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). 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. Key words: Contrast-enhanced ultrasonography; Orbit tumors in extraconal compartment; Time-intensity curve; Dynamic vascular pattern

The value of contrast-enhanced ultrasonography in detection of prostatic infarction after prostatic artery embolization for the treatment of symptomatic benign prostatic hyperplasia.

We aimed to assess the clinical and predictive role of contrast-enhanced ultrasonography (CEUS) as the primary method for imaging evaluation of prostatic artery embolization (PAE) for the treatment of symptomatic benign prostatic hyperplasia (BPH). Thirty-one patients with symptomatic BPH, treated with PAE from October 2016 until February 2018, were enrolled in this prospective, single-center study. Microspheres (100-700 µm) were utilized for PAE. International prostate symptom score (IPSS), quality of life (QoL), maximum urinary flow (Qmax), prostatic volume (PV) and post void residual volume (PVR) were measured at baseline and at 1, 3, and 6 months post PAE. Unenhanced transabdominal US was utilized for PV and PVR measurements; prostatic enhancement was studied with transabdominal CEUS at baseline, during the procedure, 1 day and 1, 3, and 6 months post PAE. Technical success was defined as embolization of the PA of at least one pelvic side. Clinical success was based on the improvement of IPSS and QoL, with no need for any additional treatment. Follow-up time ranged from 6 to 18 months (mean, 9.7±4.3 months). Clinical success rates were calculated and changes in prostatic enhancement were correlated with the outcome parameters. Technical success rate was 90.3%. Clinical success rates at 3, 6, and 12 months post PAE were 85.7%, 85.7%, and 79.1% respectively. Improvement of outcome parameters (baseline vs. 6-month values) was statistically significant, with 12.4 points mean reduction of IPSS (50.4%, P = 0.003), 2.0 points mean reduction of QoL (45.4%, P < 0.001), 30.3 mL mean reduction of PV (30.2%, P < 0.001), 72.6 mL mean reduction of PVR (51.8%, P = 0.005) and 8.6 mL/s mean increase in Qmax (103%, P = 0.002). The most significant complications were bladder ischemia (n=1), and ischemic rectal ulcer (n=1), both attributable to nontarget embolization, with complete recovery. CEUS 1 day post PAE demonstrated prostatic infarcts in 26/28 (92.8%) patients. The percentage of prostatic infarction (pPI, defined as prostatic infarcted volume 1 day post PAE divided by baseline PV) was 1%-71%. There was a very strong positive correlation between pPI and prostate shrinkage (r=0.81, P < 0.001), but a weak correlation between pPI and the improvement of the other outcome parameters (r= 0.01-0.36; P = 0.093-0.965). However, in the subgroup of patients with indwelling bladder catheter (9/28 patients), successful removal of the catheter was achieved only in patients with pPI>10%. CEUS appears to be a practical method for the study of the local ischemic effect of PAE, with potential predictive value.