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Objective To summarize the sonographic characteristics of high frequency ultrasound and elastography of thyroid microcarcinoma(TMC),and to analyze the causes of misdiagnosis.Methods The preoperative ultrasonic data of 245 suspicious TMCs in 202 patients,as confirmed by operation pathology,were retrospectively analyzed.Results Preoperative ultrasonography accurately diagnosed 221 TMCs,the diagnosis rate was 90.2％,and the misdiagnosis rate was 9.8％.Among the missed diagnosed lesions,18 lesions were nodular goiter,others were 3 nodular goiter with focal papillary hyperplasia of follicular epithelium,2 nodular goiter with adenomatous hyperplasia,1 focal lymphocytic thyroiditis,respectively.The thyroid lesions≤0.5 cm in diameter were more easily to misdiagnose.According to the importance of the ultrasonographic features of TMC,the order were aspect ratio (A/T) ≥ 1,irregular-shape,microcalcifications,low or very-low echo.Based on the above corresponding characteristics and considering other features together,the diagnostic accuracy rate were 94.1 ％,93.9％,92.4％ and 90.5％,respectively.Less blood supply and ill-defined boundary were the secondary sonographic signs of TMC.The elastographic scores of TMC were most showed 4 to 5 points.Diagnosis of TMC relied on elastography alone is less effective,but when elastograph diagnosis based on high frequency ultrasound,the diagnostic accuracy is much higher,especially when there is no calcification in the lesions.Conclusions High-frequency ultrasound has a very important value in the diagnosis of TMC,while elastography has certain assistant value on the basis of high-frequency ultrasonic diagnosis.
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Objective To investigate the differential diagnostic signiifcance of different calciifcation types in thyroid benign and malignant nodules with high-frequency ultrasound. Methods Totally 195 patients with thyroid lesions were examined on conventional high-frequency ultrasound pre-operatively. The evaluation was foucsed on the number and echo of thyroid nodules and the size, shape and distribution of calciifcation inside. Different calciifcation patterns were divided into 3 types:type 1 micro-calciifcation, type 2 coarse calciifcation, type 3 peripheral calciifcation. Results The calciifcation rate of thyroid malignant nodules 68.6%(81/118) was signiifcantly higher than that of benign nodules 40.0%(56/140) (χ2=21.096, P0.05). The incidence of type 3 calcification in malignant lesions 3.7%(3/81) was lower than that of benign nodules 21.4%(12/56) (χ2=10.669, P<0.05). The malignancy incidence of solitary thyroid nodule 85.3%(58/68) and extremely low echo nodules with calciifcation 76.2%(48/63) was higher than that of multiple thyroid nodules 33.3%(23/69) and other echo nodules 44.6%(33/74) (χ2=38.261, 14.057, both P<0.01). Conclusions There was potential risk of malignancy in each calciifcation of thyroid nodules. Different calciifcation types had important value for differential diagnosis of benign and malignant thyroid nodules.
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Objective To investigate the evaluation of virtual touch tissue quantification(VTQ)in differential diagnosis of thyroid benign and malignant nodules and its influence factors.Methods 127 patients with thyroid lesions and its adjacent normal thyroid tissue at the same depth were examined with VTQ.Test results were performed by shear wave velocity value (SWV) on the long axis dimension of the nodules.The maximum(Vmax),minimum(Vmin) value of SWV of thyroid lesions and the SWV(Vn) value of surrounding normal tissue were recorded.The mean value of SWV (Vm) and the ratio of Vm and Vn (Vm/n) were calculated.SWV value of benign and malignant nodules and different pathological types of nodules were analyzed.Receiver-operating characteristic curve(ROC) was drawn to assess the diagnostic efficiency.Results The Vmax,Vmin,Vm,Vm/n of malignant lesions [(4.61 ± 2.65) m/s,(2.74 ± 2.23) m/s,(2.99 ± 0.82)m/s,(1.69 ± 1.07)m/s,respectively] were obviously higher than that of benign nodules [(2.78 ± 0.96)m/s,(1.75 ± 0.60)m/s,(2.31 ± 0.38)m/s,(0.94 ± 0.23)m/s,respectively,P ＜0.01].The SWV value of thyroid papillary carcinoma was higher than that of nodular goiter,thyroid adenoma and Hashimoto's thyroiditis(P ＜0.05).The SWV value of Hashimoto's thyroiditis was higher than that of thyroid adenoma and nodular goiter (P ＜ 0.05).No significant differences of SWV value were found between thyroid adenoma and nodular goiter (P ＞ 0.05).Contrast the area under the receiver-operating curves above four groups of different SWV values,the results showed that Vm had the highest diagnostic value in diagnosis of benign and malignant thyroid nodules.When the best cut-off point of Vm was 2.48 m/s,the diagnostic value was highest and the sensitivity and specificity were 97％ and 81 ％.Conclusions VTQ could be used to quantify and evaluate the hardness of thyroid nodules and provided important value for the differential diagnosis of benign and malignant thyroid nodules.
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Objective To investigate the value of contrast enhanced ultrasound (CEUS) in diagnosing poor differentiated cholangiocarcinoma. Methods Sonograms of 11 patients with pathologically confirmed poor differentiated cholangiocarcinoma were retrospectively analyzed. The size, boundary, shape, echo, blood distribution and characteristics of the enhancement duration were observed. Results All lesions presented irregular shape (100%), most (9/11, 81.82%) with indefinite boundary, some (6/11, 54.55%) with low echo. No blood flow signal was found in the interior of masses, while grade 1 blood flow signal was detected in periphery of the lesions. Resistance index (RI) was ≥0.6 in spectral Doppler in 7 (63.64%) lesions. Marginal rim-like hyperechoic enhancement in the arterial phase was found without centripetal filling in all 11 patients, marginal rim-like hypoechoic enhancement was observed, but being hyperecho compared with interior part without medium in delayed phase. Conclusion The contrast-enhancement modality of poor differentiated cholangiocarcinoma is characteristic. Combined with two-dimensional ultrasonography and color Doppler ultrasound, the diagnostic rate will be improved.
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Objective To explore the effects of P85,microbubbles and ultrasound on plasmid DNA skeletal muscle gene transduction of mice in vivo. Methods Plasmid encoding green fluorescent protein (GFP) ,which conjugated with 0.05% P85 and/or microbubbles, 10% Optison,was injected into the tibialis anterior(TA) muscle of mice with or without ultrasound irradiation (1 MHz, 1 W/cm2 2 min,20% duty cycle). Mice were killed 1 week after injection. The TA muscles were removed and snap-frozen immediately in isopentane cooled by liquid nitrogen and sections 7 μm thick were cut at intervals. One set of sections mounted with DAPI were used to assess the transfection efficiency by counting the number of GFP-positive fibers under fluorescence microscopy,and the other set of sections were stained with haematoxylin and eosin to assess the tissue damage area. Results The P85 and Optison significantly enhanced the plasmid DNA skeletal muscle gene delivery in vivo separately (P<0.01, P<0.05).Ultrasound exposure could significantly enhance the efficiency of P85 induced gene delivery(P<0.01) but not of Option(P>0.05).The gene delivery efficiency induced by P85 was higher than that by Optison no matter with or without ultrasound irradiation(P<0.01). When the P85 conjugated with Optison, they could further significantly enhance gene delivery efficiency with ultrasound exposure (P<0.01). Meanwhile, ultrasound exposure could increase the muscle damage areas in the groups with microbubbles (P<0.01). Conclusions The P85,microbubbles and ultrasound exposure display synergistic effect to enhance plasmid DNA transduction in skeletal muscle of mice in vivo.
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The value of color Doppler flow imaging (CDFI) and intravenous contrast-enhanced ultrasound (CEUS) for assessing the transplanted liver and early diagnosing complications by examining hemodynamic changes was discussed. Seventy-five patients with orthotopic liver transplantation (OLT) underwent CDFI. The following parameters were measured: peak systolic velocity (PS), resistance index (RI) and Doppler perfusion index (DPI) of the hepatic artery (HA), time average velocity (TAV) of portal vein (PV) and velocity of hepatic vein (HV) in different stages postoperation. And 11 patients of them received CEUS. Thirty healthy subjects were enrolled as controls. The results showed that: (1) In 23 patients without obvious complications, TAV of PV within 15 days post-operation was significantly higher than in controls (P<0.05), PS and DPI of HA within 7 days postoperation were lower, but RI was higher than in controls (P<0.05); (2) When the hepatic artery thrombosis (HAT) occurred, PS and DPI of HA were obviously decreased, but TAV of PV significantly increased like a high saw-tooth wave; (3) While rejection occurred, both TAV of PV and PS of HA were decreased with the increase in RI of HA, and the triphasic wave of HV disappeared and displayed as saw-tooth wave; (4) The incidence of biliary complications in liver transplantation was increased when DPI was reduced; (5) Seven cases of hepatic carcinoma relapse after OLT demonstrated hyperecho in the arterial phase and hypoecho in the portal and later phase on CEUS; (6) In 2 cases of HA thrombus, there was no visualized enhancement in arterial phase of CEUS, but enhancement during the portal vein and parenchymal phase. It was concluded that the hemodynamic changes of PV, HA and HV in the transplanted liver are valuable for assessing the transplanted liver and early diagnosing complications on CDFI and CEUS.
Subject(s)
Bile Ducts/pathology , Contrast Media/administration & dosage , Hemodynamics , Hepatic Artery/pathology , Infusions, Intravenous/methods , Liver Transplantation/adverse effects , Liver Transplantation/methods , Liver Transplantation/diagnostic imaging , Perfusion , Postoperative Complications , Ultrasonography/methods , Ultrasonography, Doppler/methodsABSTRACT
To examine the role of ultrasound in gene delivery in vitro, three cells lines were exposed to the low-frequency ultrasound of varying intensities and for different durations to evaluate their effect on gene transfection and cell viability of the cells. Microbubble (MB), Optison (10%), was also used to observe the role of the microbubbles in gene transfection. The results demonstrated that as the ultrasound intensity and the exposure time increased, the gene transfer rate increased and the cell viability decreased, but at high energy intensities, the cell viability decreased dramatically, which caused the transfer rate to decrease. The most efficient ultrasound intensity for inducing gene transfer was 1 W/cm2 with duration being 20 s. At the same energy intensity, higher ultrasound intensity could achieve maximal gene transfer rate earlier. Microbubbles could increase ultrasound-induced cell gene transfer rate by about 2 to 3 times mainly at lower energy intensities. Moreover, microbubbles could raise the maximum gene transfer rate mediated by ultrasound. It is concluded that the low-frequency ultrasound can induce cell gene transfer and the cell gene transfer rate and viability are correlated with not only the ultrasound energy intensity but also the ultrasound intensity, the higher ultrasound intensity achieves its maximal transfer rate more quickly and the ultrasound intensity that can induce optimal gene transfer is 1 W/cm2 with duration being 20 s, and microbubbles can significantly increase the maximal gene transfer rate in vitro.
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To examine the role of ultrasound in gene delivery in vitro, three cells lines were exposed to the low-frequency ultrasound of varying intensities and for different durations to evaluate their effect on gene transfection and cell viability of the cells. Microbubble (MB), Optison (10%), was also used to observe the role of the microbubbles in gene transfection. The results demonstrated that as the ultrasound intensity and the exposure time increased, the gene transfer rate increased and the cell viability decreased, but at high energy intensities, the cell viability decreased dramatically, which caused the transfer rate to decrease. The most efficient ultrasound intensity for inducing gene transfer was 1 W/cm(2) with duration being 20 s. At the same energy intensity, higher ultrasound intensity could achieve maximal gene transfer rate earlier. Microbubbles could increase ultrasound-induced cell gene transfer rate by about 2 to 3 times mainly at lower energy intensities. Moreover, microbubbles could raise the maximum gene transfer rate mediated by ultrasound. It is concluded that the low-frequency ultrasound can induce cell gene transfer and the cell gene transfer rate and viability are correlated with not only the ultrasound energy intensity but also the ultrasound intensity, the higher ultrasound intensity achieves its maximal transfer rate more quickly and the ultrasound intensity that can induce optimal gene transfer is 1 W/cm(2) with duration being 20 s, and microbubbles can significantly increase the maximal gene transfer rate in vitro.
Subject(s)
Cricetinae , 3T3 Cells , CHO Cells , Cell Line , Cell Survival/genetics , Contrast Media/metabolism , Cricetulus , Microbubbles , Transfection/methods , UltrasonicsABSTRACT
The focal hepatic lesion caused by local injection of absolute alcohol in rats was evaluated with ultrasonic contrast agent and pathologic examination. Twenty adult Wistar rats weighing about 200 g were injected with absolute alcohol (0.05-0.1 mL each one) on the exterior left lobe of the liver under the monitoring of ultrasound. Pulse inversion harmonic imaging was used to evaluate the focal lesion after bolus injection of ultrasonic contrast agent (0.05 mL/200 g) through caudal vein. Seven days later, the focal lesion was studied again as before. The exterior left lobe of liver with focal lesion was incised and underwent pathologic examination. The results showed that all of the focal lesions could be defined clearly after bolus injection of the ultrasonic contrast agent under the mode of pulse inversion harmonic imaging. There was good correlation between the size of the focal lesion measured by ultrasound on the 7th day after the "ablation" under the mode of pulse inversion harmonic imaging and that gotten by pathologic examination (P = 0.39). The focus size measured by ultrasound right after the ablation was larger than that gotten by pathologic examination (P = 0.002). It was concluded that ultrasonic contrast agent plus pulse inversion harmonic imaging could be used to assess the size of the focal hepatic lesion caused by local injection of absolute alcohol in rats.
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The focal hepatic lesion caused by local injection of absolute alcohol in rats was evaluated with ultrasonic contrast agent and pathologic examination. Twenty adult Wistar rats weighing about 200 g were injected with absolute alcohol (0.05-0.1 mL each one) on the exterior left lobe of the liver under the monitoring of ultrasound. Pulse inversion harmonic imaging was used to evaluate the focal lesion after bolus injection of ultrasonic contrast agent (0.05 mL/200 g) through caudal vein.Seven days later, the focal lesion was studied again as before. The exterior left lobe of liver with focal lesion was incised and underwent pathologic examination. The results showed that all of the focal lesions could be defined clearly after bolus injection of the ultrasonic contrast agent under the mode of pulse inversion harmonic imaging. There was good correlation between the size of the focal lesion measured by ultrasound on the 7th day after the "ablation" under the mode of pulse inversion harmonic imaging and that gotten by pathologic examination (P=0.39). The focus size measured by ultrasound right after the ablation was larger than that gotten by pathologic examination (P= 0.002). It was concluded that ultrasonic contrast agent plus pulse inversion harmonic imaging could be used to assess the size of the focal hepatic lesion caused by local injection of absolute alcohol in rats.
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Objective To explore the ultrasonic diagnosis of fetal cleft palate.Methods By applying coronal,sagittal and transverse planes to scan the fetal facial anatomy routinely, 2125 pregnant women with 20 odd weeks′ gestation were examined.Results Complete cleft palate was diagnosed in 4 cases by ultrasonography, all of which were accompanied with complete cleft lip and alveolar process.Incomplete cleft palate were missed in 2 cases.Conclusions Complete cleft palate is accompanied mostly with cleft alveolar process and complete cleft lip, and cleft palate can be found out through cleft alveolar process.To those fetuses without cleft lip or with incomplete cleft lip,their palate cannot be explored by ultrasound,and their cleft palate cannot be displayed.
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Objective To study the regularity of blood type and Doppler parameters at the interior and surrounding of the hepatic carcinoma.Methods Seventy-five masses with blood flow signals were selected.The size,mean color density (MCD),flood flow type and Doppler parameters including velocity of peak systolic (PS) and resistance index (RI) were studied.Results ①In the interior of masses,the PS of branch and insert types was the highest,and the RI of branch and net types was the highest (P 0.05 ).Conclusions The parameter is associated with the blood type and grade closely in hepatic carcinoma.