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Objective:To explore the feasibility of prenatal ultrasound in predicting delivery mode of full-term primipara.Methods:The study prospectively enrolled primiparas with gestational age ≥37 weeks, singleton, cephalic and no contraindications to vaginal delivery who underwent routine prenatal examination in the Third Affiliated Hospital of Sun Yat-sen University from September 2020 to February 2021.In addition to routine fetal ultrasound examination, the transperineal ultrasound examination was performed to assess the angle of progression (AOP), head perineum distance (HPD), the angle of pubic arch and the anteroposterior diameter, left and right diameter, area and perimeter of levator ani hiatus of pregnant women in different states were measured; Cervical length (CL) was examined by transvaginal ultrasound. The delivery mode was tracked, and the indicators related to natural delivery were screened out. Receiver operating characteristic (ROC) curve was used to evaluate the effectiveness of relevant indicators in predicting natural delivery.Results:A total of 142 cases were included in this study, including 112 cases of natural delivery and 30 cases of manual intervention delivery. There were no significant differences in age, gestational weeks, biparietal diameter, head circumference, body mass index (BMI) and neonatal weight between the natural delivery group and the manual intervention delivery group (all P>0.05). Multivariate regression analysis showed that AOP was associated with natural delivery( OR=1.048, P=0.008). ROC curve analysis showed that the area under the curve was 0.648 with AOP 96.92° as the node, and the specificity and positive predictive values were 83.33% and 0.909 1 respectively. Conclusions:It is feasible to predict the mode of delivery by prenatal ultrasound in full-term primiparas. AOP is related to the mode of delivery, which can provide more reference information for clinical practice.
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Objective To evaluate the clinical value of artificial pleural effusion for percutaneous microwave ablation of liver cancer in the hepatic dome. Methods 28 difficult cases (total 34 lesions), all lesions were located in the hepatic dome and covered by lung. Infused with artificial pleural effusion by ultrasound real-time monitoring before percutaneous ultrasound-guided microwave ablation. The amount of artificial pleural effusion, the technique successful rate,the rate of lesions revealed, local treatment response and complications had been observed. Results The amount of artificial pleural effusionwas 200-1 000 mL [(388 ± 107)mL]. The technique successul rate of artificial pleural effusion was 100% (28 / 28), the rate of lesions revealed was 85.3%(29 / 34), the other 5 isoechoic lesions were revealed by contrast-enhanced ultrasound. All the 34 lesions was ablated completely, the complete ablation rate was 100%(34 / 34). the rate of complications was 2.9%(1 / 34), 1 patient was found a small amount of intraperitoneal hemorrhage after ablation. Conclusions Artificial pleural effusion assisted percutaneous microwave ablation of liver cancer in the hepatic dome is a safe , effective treatment, it broadened the percutaneous microwave ablation therapeutic range, and should be more widely used in clinically.
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Objective To study preliminarily on the value of real-time three-dimensional contrast-enhanced ultrasound (RT-3D-CEUS ) for the diagnosis of hepatic artery complications after liver transplantation.Methods From April to July in 201 4,a total of 1 8 liver transplant recipients were examined 29 times,by color doppler ultrasound,contrast-enhanced ultrasound (2D-CEUS)and RT-3D-CEUS.The successful rate of RT-3D-CEUS was calculated.And the image quality and the diagnosis of hepatic artery complications were evaluated.Results In the 29 times of RT-3D-CEUS examination,the successful rate was 93% (27 /29).The image quality of RT-3D-CEUS got 3 points for 1 4 times,2 points for 1 3 times and 1 point for 2 times.In 6 cases who were diagnosed hepatic artery stenosis by RT-3D-CEUS,4 cases were first diagnosed by RT-3D-CEUS and confirmed by CTA,and 2 cases were diagnosed by CTA or DSA before RT-3D-CEUS.Conclusions The RT-3D-CEUS examination can get intuitive and clear images,which has clinical application value in evaluating hepatic artery complications after liver transplantation.
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Objective To investigate the feasibility of three-dimensional contrast-enhanced ultrasonic cholangiography(3D-CEUSC) in isolated porcine liver specimens.Methods The lobes of 5 isolated porcine livers were taken as scanning units and the lobular bile branches were cannulated.3D-CEUSC was performed after the administration of diluted ultrasonic contrast agents(SonoVue) through the cannula.The images were assessed in term of maximum visualization of branching orders and image quality.The coincidence of morphous was compared between 3D-CEUSC and cholangiagraphy using fluoroscopy.Results Fourteen lobular biliary branches were cannulated successfully in 5 isolated porcine livers.The maximum visualization of branching orders from the third- to first-order branches were 42.9% (6/14) ,42.9% (6/14), 14.2% (2/14) in sequence.The image quality was 21.4% (3/14) graded as well, 57.2% (8/14) as moderate, and 21.4% (3/14) as poor.Compare with cholangiagraphy using fluoroscopy, the coincidence of morphous was 42.9%(6/14) for well,42.9% (6/14) for moderate,and 14.2% (2/14) for poor.Conclusions 3D-CEUSC could be a new imaging method to evaluate the biliary anatomy.
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Objective To determine the feasibility and safety of radiofrequeney(RF)ablation of entire prostate guided and monitored by contrast-enhanced transrectal ultrasound(CE-TRUS)in canine model.Methods Contrast ultrasound-guided RF ablation of entire prostate was preformed transrectally using Cool-tiptm electrodes in 7 normal canines under general anesthesia.The urethra/bladder and rectum were protected by infusion of cold distilled water through a Foley catheter and injection of cold distilled water into the prostate-rectum space,respectively.CE-TRUS findings were compared with TTC-stained pathologic results.Results All the 7 canines tolerated the ablation procedures.CE-TRUS clearly demonstrated hypoechoic thermal lesions as avascular/nonperfusion areas.The average number acquired for entire prostate ablation was 4.3(3 to 6).The average ablation volume achieved on pathology was 96.55%.There was no statistically significant difference when compared average ablative volumes between CE-TRUS and TTC-stained pathology[(9.16±5.20)cm3 vs(8.62±3.13)cm3,P=0.583].The coefficient correlation was 0.94(P=0.002).No thermal related injuries were found in anv of the bladder and rectum.The thermal related inj uries of the urethra were less than 1/4 quadrant.Conclusions It is feasible to ablate the entire prostate using RF thermal energy under CE-TRUS guidance.CE-TRUS plays a key role for achieving entire prostate ablation.The urethra and rectum can be protected by cooling of these structures during the procedure.
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Objective To discuss the use of contrast enhanced intraoperative uhrasound(CE-IOUS) in evaluating hepatic radiofrequency ablation(RFA)lesions.Methods Fifteen RFA lesions in twelve dogs were examined by IOUS and CE-IOUS 15 min and 30 min after RFA.IOUS and CE-IOUS images were compared with RFA specimen stained by TTC.Results Satisfactory images could be achieved bv CE-IOUS at 15 rain after RFA.Compared with IOUS,CE IOUS could depict the border of RFA lesions more clearly (P＜0.01).In CE-IOUS,93.3%(12/13)of RFA lesion images were consistent with that of TTC in shape,while in IOUS,only 13.3%(2/15)of the images were consistent with that of TTC in shape.The average areas of RFA lesions cross-section measured by IOUS,CE-IOUS and TTC were(4.82±1.49)cm2,(3.48±1.25)cm2 and(2.93±0.87)cm2.Statistical significance was found between the areas shown by IOUS and TTC staining(P=0.000),as well as between CE-IOUS and TTC staining(P=0.027).The areas shown by IOUS and TTC were not linear correlated(r=0.28,P=0.316),but the areas shown bv CE IOUS and TTC were wetl correlated(r=0.75,P=0.002). Conclusions CE-IOUS is a promising method for evaluating intraoperative RFA lesions and worthy of further clinical research.