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Objective To explore the feasibility and safety of radiofrequency ablation for difficult access liver cancer under percutaneous local anesthesia combined with contrast-enhanced ultrasonography.Methods 45 patients(62 lesions) in the experimental group were treated by percutaneous,local anesthesia combined with contrast-enhanced ultrasound and in some cases with artificial ascites assisted by radiofrequency ablation vs control group of 40 patients (54 lesions) receiving radiofrequency ablation guided by CT or ultrasound through laparoscopy or open surgery.The complications,and postoperative residual and recurrence rates were compared between the two groups.Results Of the all patients,4 cases suffered from severe complications.The pain scores and the blood loss were less significant in the experimental group.There was no significant difference in tumor residual rate between the two groups when evaluated on one month after the procedures,and in the recurrence rate after three and six months.Conclusion Radiofrequency ablation for difficult liver cancer by percutaneous local anesthesia combined with contrastenhanced ultrasonography is less traumatic and less of complications compared to traditional method with a similar tumor residual rate and recurrence rate.
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Objective The article was to discuss the correlation between three?dimensional volume ultrasound VOCAL parame?ters and pathological grading of mass type breast invasive ductal carcinoma. Methods 106 breast nodule patients admitted in our hospi?tal who were pathologically confirmed with histological grading from March 2014 to February 2016 were included in the study. The patients underwent three?dimensional volume ultrasound preoperatively. Vocal system in GE LOGIQ E9 was used in lesion analysis to obtain energy histograms:average gray scale (MG), average energy (MP), vascular index ( R) , blood flow index ( VFI) . Analysis was made in the differ?ence among MG, MP, R and VFI of ductal carcinoma in situ, invasive ductal carcinoma grade I, invasive ductal carcinoma grade II, invasive ductal carcinoma grade III and fibroadenoma. Results No sig?nificant difference was found in MG of ductal carcinoma in situ and IDC I, fibroadenoma and ductal carcinoma in situ, fibroadenoma and IDC I(P>0.05), but the difference was statistically significant between other pathological levels (P0.05) , but the difference was statistically significant between other pathological levels ( P<0.05) . Conclusion Three?dimensional volume ultrasonic VOCAL parameters of MG、MP、R、VFI can reflect gray?scale levels and blood flow perfusion in mass type breast nodules of different pathological level, and predict the pathological grading before operation, which provides objective evidence for the evaluation of mass type breast invasive ductal carcinoma and the development of individualized treatment plan.
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Objective To explore the value of intraoperative contrast-enhanced ultrasonography in radiofrequency ablation completeness evaluation in patients with hepatic carcinoma of differently sized nodules.Methods Fifty five patients (69 lesions) with hepatic carcinoma were included and were divided into the experimental group (20 cases,30 lesions in whom CEUS were used) and the control group (35 cases,39 lesions,conventional ultrasound was used).After RAF,the treatment effect of the two groups were evaluated by enhanced CT regularly.Differences between conventional ultrasound and CEUS were compared and their judgement on ablation residual tumor tissue was analyzed.Results After 1 to 24 months of follow-up,the total residual rate of the experimental group and the control group was 13.3％ (4/30) and 35.9％ (14/39) respectively.The significant difference was found in the residual rate between the experimental group and the control group (x2 =5.366,P ＜ 0.05).For the two groups (＞ 5 cm and ＜3-5 cm),the residual rate of the experimental group was 30.0％ and 10.0％,the residual rate of the control group was 87.5％ and 46.2％,there were statistically significant difference (respectively x2 =5.951,4.790,all P ＜ 0.05).The significant difference was found in the recurrence rate (the experimental group:20.0％ (4/30),the experimental group:75.0％ (6/8)),when the lesion was larger than 5 cm in diameter(x2 =5.445,P ＜ 0.05).Conclusions CEUS has advantage over conventional ultrasound for the detection of residual tumor tissues after radiofrequency ablation for hepatic carcinoma,it reduces after ablation tumor recurrence especially in large tumors.
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Objective: To investigate the diagnostic values of separated renal multi-locular cystic lesions color Doppler ultra-sound and contrast-enhanced ultrasound performance in multi-locular cystic renal cell carcinoma and cysts. Methods:A total of 53 pa-tients (54 lesions) with multi-locular cystic renal cell carcinoma and cysts were included in the study. The presence of carcinoma and cysts was confirmed via histopathology and tested using ultrasound. Contrast-enhanced ultrasound was applied in 24 (24 lesions) of the total number of patients, and the receiver operating characteristic (ROC) curve was used to analyze the numbers of separation, thick-ness, and type of blood flow patterns of the lesions. The contrast-enhanced ultrasound characteristics were also analyzed. We analyzed the diagnostic value of the color Doppler ultrasound in the separated renal multilocular cystic lesions and the contrast-enhanced ultra-sound performance in multi-locular cystic renal cell carcinoma and cysts. Results:Based on the analysis of the ROC curves of the sepa-ration number, thickness, and type of the blood flow of the lesions in 53 patients (54 lesions), the diagnostic specificity was relatively higher in the lesions where the separation number was≥5 strips (86%), the thicknesses were>3 and≤4 mm (95%), and blood flow was band-like (86%). The areas under the curve of the three indexes were 0.7621, 0.8331, and 0.7962, respectively, which indicate high diagnostic values. The separation number of 4 strips, the thicknesses of>2 and≤3 mm, and the point-like blood flow could be used as critical values for the diagnosis. The contrast enhancement, enhancement peak, and disappearance were (11.2 ± 3.4), (21.7 ± 3.8), and (32.1±4.0) s in 14 patients with multi-locular cystic renal cell carcinoma and (18.4±4.5), (37.8±8.0), and (51.3±9.0) s in 10 patients with multi-locular renal cysts, with statistically significant differences (t=4.47, t'=5.90, t'=6.31, respectively;P<0.05). Conclusion:The sepa-ration number, thickness, and type of blood flow of lesions have relatively higher specificity in multi-locular renal cysts than in multi-locular cystic renal cell carcinoma. The ROC curves show a high diagnostic value. Contrast-enhanced ultrasound of the lesions helped in the differential diagnosis of multi-locular cystic renal cell carcinoma and renal cysts.
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Objective:This study aims to evaluate the consistency between contrast-enhanced ultrasound (CEUS) and enhanced computed tomography (CT) in determining the effect of radiofrequency ablation (RFA) on hepatocellular carcinoma. Methods: RFA procedures guided by either ultrasound or CT were performed on 35 patients with 68 lesions. Enhanced CT and CEUS were regularly conducted after the procedures to evaluate the effect of RFA. The full ablation, residual, and recurrence rates of tumors, as well as the di-agnostic accuracies and kappa values of CEUS and enhanced CT, were determined. Results:The full ablation and residual rates of tumors for the 68 lesions diagnosed by CEUS were 84%and 16%, respectively;whereas those for the lesions diagnosed by enhanced CT were 90%and 10%, respectively. No significant difference was found between the obtained rates using the two diagnostic methods (χ2=0.576 3, P=0.447 8). Moreover, the two methods exhibited high consistency (K=0.882 9, Sk=0.120 4). Of the 68 lesions, 13 recurred within 24 months. The recurrence rate evaluated by CEUS was 19%(13/68). No significant difference was found between the detection rates of CEUS (92%, 12/13 lesions) and enhanced CT (100%, 13/13 lesions) in diagnosing recurrent lesions (P>0.05). Enhanced CT could be used as the gold standard for evaluating tumor residual and recurrence rates after RFA. The overall diagnostic accuracy of CEUS reached 92%(63/68 lesions). Conclusion:CEUS and enhanced CT exhibit high accuracy and consistency in evaluating the effect of RFA on hepatocellular carcinoma. CEUS can provide a reliable diagnostic proof for tumor patients after undergoing RFA procedure.
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Objective To assess the agreement of preoperative ultrasonography (US), CT, intraoperative ultrasonography(IOUS) and intraoperative palpation in the diagnosis of liver tumors. Methods The results of preoperative US,CT, IOUS and intraoperative palpation in the diagnosis of liver tumors in 70 patients were reviewed,and the agreement of them were evaluated. Results There was a moderate level of agreement between US and the pathology and follow-up in the diagnosis of liver tumors (Kappa = 0.63). There was a high level of agreement among CT, IOUS and the pathology and follow-up(CT vs the pathology and follow-up, Kappa = 0.72;IOUS vs pathology and follow-up, Kappa = 0. 89;CT vs IOUS, Kappa =0.53), whereas the level of agreement between intraoperative palpation and the pathology and follow-up (Kappa =0.38), US and intraoperative palpation (Kappa = 0.23), US and IOUS (Kappa = 0.23) was low. Conclusions In the assessment of liver tumors,CT and IOUS have a high agreement. Although the agreement of US and intraoperative palpation were low, they were still indispensable. Four methods were integrated, will contribute to the diagnosis and treatment of liver tumors.