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Objective To compare the diagnostic performances of two elastography techniques, virtual touch tissue imaging quantification (VTIQ) and virtual touch tissue quantification (VTQ), in differentiating between benign and malignant thyroid nodules. Methods A total of 182 patients with 186 nodules evaluated by VTQ and VTIQ were enrolled in this study. Shear wave velocities (SWV) of benign and malignant nodules were measured and compared between different groups by t test . The receiver operating characteristic curve (ROC) was used to assess the value of VTIQ and VTQ in differentiating benign and malignant nodules. And the sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) of VTIQ and VTQ were calculated. According to areas under the curve (AUC), the diagnostic values of these two elastography techniques for thyroid nodules′ qualitative diagnosis were compared by Z test. Results In pathology, 104 thyroid nodules were benign and 82 were malignant. AUC of VTIQ SWV mean, VTIQ SWV median, VTQ SWV mean, VTQ SWV median were 0.848, 0.790, 0.759, 0.717, respectively. In the VTIQ and VTQ techniques, the SWV mean had higher diagnostic efficacy than the SWV median (VTIQ techniques: Z=2.104, P=0.0354; VTQ techniques: Z=2.190, P=0.0285). There were statistical differences in the diagnosis performance between VTIQ SWV mean and VTQ SWV mean (Z =2.115, P=0.0344). The VTIQ SWV mean value in the nodule had the best diagnostic value in comparison with other SWV values. The cut-off value of VTIQ SWV mean was 2.91 m/s. According to ROC curve analysis, the sensitivity, specificity, accuracy, PPV and NPV for VTIQ SWV mean were 72.12%, 87.80%, 79.03%, 88.24%, 71.29%, respectively. Conclusions The results demonstrated that VTQ and VTIQ have good diagnostic performance on distinguishing malignant from benign thyroid nodules. VTIQ SWV mean shows a better diagnostic performance than VTQ SWV mean.
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ObjectiveTo analyze the craniocerebrum ultrasonographic images of the infants born by women with hypertension in pregnancy and investigate the effect of hypertension in pregnancy on neonate brain injury and brain development.MethodsTo assess the brain injury and brain development, 106 infants born by women with hypertension in pregnancy (study group) and 200 infants born by women without high risk factors during perinatal period (control group) in the neonatal intensive care unit of First Affiliated Hospital of Harbin Medical University between 2013 and 2014 underwent brain ultrasonography. The abnormal ultrasound images and the constitution of abnormal ultrasound images distribution in two groups were compared. The relationship between the abnormal ultrasound images and the degree of hypertension in pregnancy were analyzed.ResultsThe brain ultrasonographic result of the infants : (1) In the group with hypertension in pregnancy, the abnormal ultrasound images were found in 78 cases (73.6%). For the preterm infants, the solitary abnormality was found in 41 cases (25 cases of cerebral white matter injury, 14 cases of peri-intraventricular hemorrhage and 2 case of brain hypoevolutism) and multiple abnormalities were found in 15 cases; for the full-term infants, the solitary abnormality was found in 17 cases (12 cases of peri-intraventricular hemorrhage, 3 cases of hypoxic-ischemic encephalopathy and 2 case of brain hypoevolutism) and multiple abnormalities were found in 5 cases. (2) In the group without high risk factors, abnormalities were found in 73 cases (36.5 %). For the preterm infants, abnormal ultrasound images were found in 45 cases, including solitary abnormality found in 30 cases (24 cases of cerebral white matter injury, 4 cases of peri-intraventricular hemorrhage and 2 case of brain hypoevolutism) and multiple abnormalities found in 15 cases; for the full-term infants, the abnormal ultrasound images were found in 30 cases, including solitary abnormality found in 24 cases (10 cases of peri-intraventricular hemorrhage and 14 cases of hypoxic-ischemic encephalopathy) and multiple abnormalities found in 6 cases. (3) There were obvious statistical significances between the comparativeness of two groups (χ2=38.119,P<0.001), but there were no statistical significances in the constitution of the abnormal ultrasound images distribution between the two groups (χ2=0.552,P=0.759). (4) There were statistical significances between the comparativeness of the abnormal ultrasound images and the degree of hypertensive disorder complicating pregnancy (P<0.001). ConclusionCraniocerebrum ultrasonography is the first choice to detect and monitor brain abnormal and can provide basis for clinical diagnosis, treatment and intervention at early stage for the infants born by women with hypertension in pregnancy.
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Objective To explore the application value of ultra -high frequency ultrasound in detection of femoral artery stenosis in rabbits.Methods Twenty-four healthy male New Zealand white rabbits (body weight 2.5 -3.0 kg) were randomly divided into three groups , 8 rabbits in each group.Preparation of femoral atherosclerosis model : the rabbits were fed with high fat diet for 4 weeks, 8 weeks and 12 weeks after femoral artery balloon injury , respectively.The changes of cholesterol level were observed .We used ultra-high frequency ultrasonic probe to observe the femoral artery , to assess the diameter stenosis rate and peak systolic velocity (SPV) at the symptomatic side, and the histological areal stenosis was evaluated.Results 1.The blood cholesterol levels were increased after fed high cholesterol diet , with a significant difference among the groups (P <0.001); 2.There was a stenosis to a different degree in the modeling artery after fed high cholesterol diet for 4 wks, 8 wks, and 12 wks, and the stenosis degree was increased gradually .At 12 w, the degree of stenosis was higher than that at 4 w and 8 w, respectively, showing statistical significance ( P <0.001).At the symptomatic side, the peak systolic flow velocity was increased , and it was higher at 12 w than that at 4w and 8 w, respectively.3.With the extension of time, the arterial stenosis rate was increased along with the time course (P <0.05). Conclusions 1.High fat diet combined with balloon injury can cause varying degrees of rabbit femoral artery stenosis ; 2. Ultrahigh frequency ultrasound can clearly show different degrees of rabbit femoral artery stenosis , and can be used for detecting the lesions in animal models of peripheral vascular diseases .
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Objective To study the sonographic features of papillary thyroid carcinoma (PTC) associated with cervical lymph nodes metastasis for early diagnosis and prediction of the invaded cervical lymph nodes. Methods The sonographic features of 170 patients with pathologically confirmed PTC in First Afifliated Hospital of Harbin Medical University between 2011 and 2013 were retrospectively reviewed. There were 59 cases with neck lymph nodes metastases and 111 cases without neck lymph nodes metastases. Receiver operating characteristic (ROC) curve was aaplied to analyze the cut-off values of resistance index (RI) and peak systolic velocity (PSV) for judging the presence or absence of cercical lymph node metastasis. The Chi-square test and rank sum test were used to compare the different sonographic features between each group. The Logistic regression analysis was used to obtain the relevant factors of PTCs with cervical lymph node metastasis. Results ROC curve analysis showed that the cut-off values of RI and PSV were 0.735,13.95 cm/s. The primary tumor diameter, the existence of halo, the involvement of thyroid upper pole, the microcalciifcation, the blood suply classiifcation and the RI, PSV were statistically signiifcantly different between PTCs with and without cervical lymph node metastasis, whereas no statistical signiifcance was detected between the primary tumor echo pattern, boundary and the longitudinal/transveral ratio between the metastatic and nonmetastatic group. Logistic regression analysis showed that the PTC primary tumor diameter and PSV were independent factors coorelated with cervical lymph node metastasis. Conclusion Some sonographic features of PTC are closely correlated with lymph nodes metastasis, which are valuable in predicting the cervical lymph nodes metastasis in patients with PTC pre-operatively.
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ObjectiveTo observe ultrasound images of normal full-term intracranial venous system,in order to provide reference images and guidelines for clinical practice.Methods Courser shape and spectrum characters by anterior fontanel acoustic window of 65 normal newborn infants had been observed.Results①The demonstration of subendymal vein,cerebral vein,Galen vein longitudinal sinus,straight sinus,lateral sinus confluence was 100％,that of basal vein and falcial sinus was 21％ (14/65) and 29％ (19/65),respectively.②The flow rate of a cranial vein decreased.③ In the overall 65 cases,9 ependymal veins,intracranial veins,Galen veins,62 sinus rectus,63 lateral sinuses,65 longitudinal sinuses and confluence sinuums had impulsive blood spectrum.A basal vein had impulsivity in 14 cases.4 of 19 falcial sinuses had impulsivity.Conclusions Color Doppler ultrasound can identify intracranial veins effectively,but some limitations must be taken into account.Blood flow rate of Galen vein sinus confluence is immeasurable.
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Objective To explore the inhibition effect on angiogenesis and plaque growth of carotid atherosclerosis by transfection of endostatin gene using microbubbles combined with ultrasound exposure.Methods Twenty rabbit models of carotid atherosclerosis were randomly divided into 3 groups:group A,microbubble+ ultrasound; group B, control plasmid + microbubble + ultrsound; group C, ES plasmid +microbubble+ ultrasound. Two weeks after surgery, ultrasound/microbubble mediated gene transfer was performed,and it was performed once again three weeks after the first transfection. Ultrasonography and digital subtraction angiography(DSA) were performed at the time of 14 weeks. The carotid arteries were taken to detect the neointima and angiogenesis, and the expression of endostatin was detected using pathological means. Results The imagings of ultrasound showed that the intima in group A and B were thick significantly with larger plaques, and the lumen became stenosis with the peak systolic velocity increasing,however,in group C,the parameters mentioned above were significantly less than those of group A and B ( P＜0.05). Pathological results displayed that intima-media thickness (IMT), intima thickness (IT), intima thickness/media thickness (IT/MT), intima area (IA), intima area/media area (IA/MA) and neointimal stenosis rates were greater in group A and B, however, they were less in group C ( P＜0.05).The number of neovascularization and vascular endothelial growth factor(VEGF) expression in group A and B were more than those of group C. There was more endostatin positive expression in carotid arteries and anterior tibial muscles of group C, while there was nearly no expression in group A and B. Conclusions Under the conditioned ultrasonic irradiation, ultrasound/microbubble mediated endostatin gene transfection can inhibit the development of carotid atherosclerosis in rabbits, which might provide a safe and effective strategy for gene therapy of atherosclerotic disease in future.
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Objective To evaluate the feasibility and the diagnostic value of virtual touch tissues quantification(VTQ) in discriminating breast benign and malignant solid tumors.Methods A total of 72 patients with 76 breast solid tumors and the normal glandular tissues were examined by means of VTQ technique.The reproducibility of VTQ values was analyzed with intraclass correlation coefficient (ICC).Compared with the pathologic diagnosis,the cut-off point of VTQ value was determined by receiver operating characteristic curve.Results All VTQ values measured in normal glandular tissue and solid tumors of patients were with good reproducibility.The cut off point of VTQ value was determined as 6.37 m/s,sensitivity was 96.3 ％,specificity was 91.8 ％ and accuracy was 93.4 ％.Conclusions It was stable for VTQ technique appling in breast,,which is a new quantitative and helpful method in discriminating breast benign and malignant solid tumors.
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Objective To explore the value of quantivtative intima-media thickness(QIMT) and quantitative arterial stiffness (QAS) technique on evaluating the elasticity of carotid artery in patients with essential hypertension.Methods One hundred and thirty-seven patients with primary hypertension were divided into two groups according with or without atherosclerotic plaques:hypertensive group without plaque (63 cases) and hypertensive group with plaque (74 cases),and 87 healthy aged subjects were selected as the control group.The intima media thickness (IMT) was tracted with QIMT software.The internal diameter (d),expansion (e),elastic coefficient α and β,compliance coefficient (CC),pulse wave velocity (PWV) and local systolic pressure (LOCPsys) were measured with QAS software.The differences of the parameters among the groups,and the relation with pressure and the correlation between the elastic indexs were analyzed.Results IMT,d,α,β,PWV and LOCPsys in hypertensive group increased,and CC decreased gradually with the lesion development of carotid aterial wall.There was difference in elastic indexs between the left and right carotid.The OR of α,β,PWV was comparatively large and the OR of β was the largest.There was positive relevance between the indexs of IMT,e,α,β,PWV,LOCPsys and systolic blood pressure and pulse pressure,and there was negative correlation between CC and systolic blood pressure and pulse pressure.The relevance between the elastic indexs was large.Conclusions The intima-media thickness of carotid increased gradually,and the elasticity decreased with the lesion development of carotid aterial wall in patients with hypertension.It can evaluate the arterial elasticity accurately and quantitavely using the QIMT and QAS technique.
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Objective To identify anal canal structures by dual plane transrectal ultrasound. Methods One anorectal specimen was observed by ultrasonography when needles were placed in different anal muscle layers respectively. Fifty patients with no anorectal or perianal diseases were examined by transrectal ultrasound to verify the sonographic features of anal canal, meanwhile the inner and outer sphincters and longitudinal combination muscle were measured. The ultrasound images of anal canal were compared with MR images. Fifty patients were divided into three groups according to the age: 25- 40 years old, 41 -55 years old,and ＞55 years old. Results The sonographic features of anal canal structures by transrectal ultrasound were identified. Anal canal sonographic images and MR images had consistency. The thickness of inner sphincter in each group was (0.19 ± 0.03)cm, (0.22 ± 0.02)cm, (0.24 ± 0.03)cm respectively,while outer sphincter (0.44 ± 0.03)cm, (0.49 ± 0.04)cm, (0.52 ± 0.04)cm, and longitudinal combination muscle (0.10±0.02)cm,(0.11 ± 0.02)cm,(0.11 ± 0.02)cm. Conclusions Transrectal ultrasound is a simple,efficient and non-invasive method to examine anal canal which can identify anal canal structures clearly.
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Objective To determine whether ultrasound (US) exposure combined with microbubble destruction could be used to enhance non-viral gene delivery in rat C6 glioma cells. Methods Microbubbles were prepared and gently mixed with plasmid DNA. The mixture of the DNA and microbubbles was administered to cultured C6 cells under different US/microbubble conditions. US parameters adopted in this study were frequency 1 MHz, output intensity 1 W/cm2, duty cycle 20%, exposure time 30 seconds. Transfection efficiency and cell viability were assessed by FACS analysis, confocal laser scanning microscopy, and Try pan blue staining. Results Microbubble with US exposure could significantly enhance the reporter gene expression as compared with other groups. No statistical significant difference was observed in the glioma cell viability between different groups. Conclusions US-mediated microbubble destruction has the potential to promote safe and efficient gene transfer into C6 cells,and it may be useful for safe clinical gene therapy of brain cancer without a viral vector system.
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Objective To assess three-dimensional color Doppler energy (3D-CDE) in the diagnosis of liver tumors.Methods Vascular pattern of 2D- and 3D-CDE were used to analyze 106 tumors of 96 patients,and their sensitivity and specify were calculated respectively.Three-dimensional volumetric measurement was used to calculate the volume,vessel counts of tumor,as well as the ratio of vessel counts and volume,whereas vascular index (VI) of both benign and malignant lesions were assessed.Results ①Using the vascular pattern of IE as diagnosis standard of liver malignant,the sensitivity and specificity of 2D-CDE and 3D-CDE were 21.33%,100% and 81.33%,100%,respectively) using the vascular pattern of II and Ⅲ,the sensitivity and specificity were 73.33%,67.74% and 100%,45.16%,respectively.②Mean VI was 0.38 counts/cm~3 of malignant tumors and 0.18 counts/cm~3 of 31 benign tumors (P0.30 counts/cm~3.Conclusion The vascular pattern of 3D-CDE HI and VI>0.30 counts/cm~3 may be taken as parameters for the diagnosis of malignant liver tumor.
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Objective To explore the value of the ultrasound contrast agent in conjunction with advanced contrast imaging techniques in the evaluation of the renal cortical perfusion. Methods The animal model was established with ligating renal artery to cause the renal cortical perfusion decrease of rabbits. Real-time harmonic gray scale imaging was performed to visualize the contrast enhancement of the renal cortex. After bolus injection of contrast agent SonoVue, dynamic image was observed and recorded during the first three minutes. According to the time-intensity curve (TIC), accelerating time (AT),Peak intensity (A), time to half of peak intensity (T), difference between peak and base (PBD), slope rate of the curve (β) and the product of A and β (A·β) were obtained before and after the renal artery operation. The t test and correlation analysis was used to examine the above parameters. Results Before the renal artery operation, renal cortex enhanced rapidly and obviously, the way of the enhancement was renal artery-cortex-pyramids. After ligation of renal artery, AT prolonged evidently (P<0.001), A decreased obviously (P<0.001), T obviously shortened (P<0.001), PBD decreased markedly (P<0.001), while the decline of βinduced (P<0.002) and A·βobvious dropped(P<0.001). AT, BPD and A·βcorrelated with stenosis level of renal artery. Compared with 31%－69% group, AT prolonged evidently (P<0.001). A decreased obviously (P<0.029), PBD decreased obviously (P<0.001), A·β was dropped markedly (P<0.02) in 70%-93% stenosis group. Conclusions Contrast agent combining with developed contrast specific imaging is able to detect changes of renal cortical microcirculation sensitively with the help of analysis of TIC.
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Objective To study the volume of lateral cerebral ventricle in neonates with threedimensional ultrasonography(3F-US),and to investigate the influence of sex,body weight(BW),head circumference(HC)and gestational age(GA) on it. Methods A total of 255 healthy neonates (GA 28~40 weeks) were examined with 3D cranial ultrasound. The ultrasonography was performed with anterior fontanel as the acoustic window,and the data were aquired at the deck of third ventricle on coronal section.The 3D image on the screen was constructed automatically and the volume of lateral cerebral ventricle was (P=0.809),and there was negative correlation between the volume of lateral cerebral ventricle and GA(r=-0.971). The correlation between the volume of lateral cerebral ventricle and HC was positive(r≥According to the relationships among HC(X 1),GA(X 2)and volume of lateral cerebral ventricle(Y),a linear regression equation Y=2.298-0.011 X1-0.04 X2 was obtained(the determinate coefficient R2 was accurately,which would be helpful to the evaluation on the cerebral maturity and the diagnosis of cerebral desease in neonates without wound.
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Objective To evaluate the effect of self-treatment and observe the change of heart morphology and function in patients with Keshan disease by echocardiography.Methods The left atrium diameter(LAd),left ventricular end-diastolic diameter(LVEDd),the thickness of interventricular septum in end diastolic(IVSTd),the thickness of left ventricular posterior wall in end-diastolic(LVPWTd),the left ventricular mass(LVM),the left ventricular mass index(LVMI),the relative wall thickness(RWT),the left ventricular ejection fraction(LVEF)and the mitral valve flow E/A ratio(E/A)were measured before the self treatment by echocardiography,and also measured on the 3rd month and 6th month after self-treatment with the same method,and observed the change of the parameters above.Results The LAd,LVEDd,IVSTd,LVPWTd,LVM,LVMI and RWT decreased on the 3rd month after self-treatment compared with prior self-treatment,and decreased on the 6th month further.There was significant difference between the prior self-treatment and post self-treatment(P＜0.05).The mitral valve flow E/A ratio and LVEF increased on the post self-treatment compared with the prior self-treatment slightly,but there was no statistical difference(P＞0.05).Conclusions Left ventricular hypertrophy and remodeling in patients with Keshan disease were prevented and reversed,and the cardiac function were improved after the self-treatment.Echocardiography can be used to evaluate the effect of self-treatment on patients with Keshan disease and can provide direction for clinical treatment.
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Objective To study the accuracy of an ultrasonographic characteristic diagnostic score system(UCDSS) which was used to classify the breast solid nodular lesions. Methods UCDSS were established by analyzing the ultrasonographic sign of the 205 breast solid nodular lesions. These lesions were classified according to the total scores of each ultrasonographie sign. ROC curve was used to evaluate the value of UCDSS. Results The area under ROC curve of UCDSS was 0. 977, the sensitivity and specificity was 92.0%, 92.3% respectively. Conclusions The classification based on the UCDSS may increase the diagnostic accuracy of the differentiation between benign and malignant breast solid nodular lesions.