ABSTRACT
Objective To compare the diagnostic value of DWI and ultrasound elastography(UE) in staging hepatic fibrosis in patients with chronic viral hepatitis B(CHB). Methods Fifteen healthy volunteers (control group) and 69 patients with CHB (disease duration more than 1 year) (patient group) were prospectively recruited. All of the subjects underwent DWI and UE experiments twice with the interval of less than 3 days. Liver ADC and shear wave velocity(SWV) values were obtained for subsequent analysis. Sixty?nine patients who had biopsy were grouped according to their pathological grading of fibrosis, from S0 to S4. One?way ANOVA was used to compare the ADC and SWV values between the five different fibrosis groups and control group. Spearman correlation analysis was used to analyze the correlations between the ADC and SWV values and those staging factors. Finally, receiver operating characteristic (ROC) curve analysis was performed to compare the diagnostic performance of ADC and SWV values in discriminating different stages of hepatic fibrosis. Results Based on the pathological results, the 69 patients were reclassified to five subgroups with 11, 13, 12, 15 and 18 patients in the S0, S1, S2, S3 and S4 groups respectively. ADC values were(1.39±0.09)×10-3,(1.39±0.08)×10-3,(1.38±0.10)×10-3,(1.20±0.06)×10-3,(1.12±0.07)×10-3 and(1.01±0.07)×10-3mm2/s for the control group and stages S0 to S4 respectively.SWV values were(1.17±0.07),(1.16±0.08),(1.23±0.10),(1.48±0.14),(1.85±0.14)and(1.97±0.12)m/s for stages S0 to S4 and the control group respectively. Statistically significant differences were observed among them (P<0.01). Both ADC (r=-0.894,P<0.01) and SWV (r=0.904,P<0.01) values were highly correlated with the stages of liver fibrosis. The area under ROC(AUC) for predicting fibrosis stages (≥S1, ≥S2, ≥S3 and S4) with ADC values was 0.893, 0.991, 0.966 and 0.952 respectively. Accordingly, the AUC for SWV values were 0.937, 0.993, 0.994 and 0.914. Conclusions The two imaging methods of DWI and UE showed good and similar diagnostic performance in discriminating the different stages of hepatic fibrosis.
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Objective To evaluate the value of three-dimensional (3D) ultrasonic imaging of vascular volume in assessing postoperative acute rejection(AR) of renal transplant patients. Methods Color Doppler flow imaging(CDFI) and 3D vascular volumetric parameters were collected and analyzed in 30 cases with stable renal function (control group) and 13 cases with AR of kidney transplantation (AR group). The diagnostic performances of each ultrasonic parameter were compared by receiver operating characteristic (ROC) curve. Results The parameters of resistance index(RI) and pulsatility index(PI) in AR group were significantly higher than those in control group( P <0.005 and P <0. 05, respectively). Analysis of the areas under ROC curve showed that the area under VFI curve was the largest;no significant difference( P > 0. 05) was found compared the area under VFI curve to those areas under VI,FI and MG curves;Comparing the area under VFI curve to those under RI, V and PI,there were significant differences( P <0. 05). Taking VFI≤18. 78% as the critical value, the sensitivity and specificity for the diagnosis of AR of transplanted kidneys were 70. 0% and 93. 3% ,and the positive and negative predictive values were 60. 8% and 93. 4%, respectively. Conclusions The sensitivity and specifity of 3D vascular volumetric imaging parameter VFI in the diagnosis of transplanted kidneys with AR were higher than those of blood flow parameters RI and PL VFI with the optimal critical value of ≤18. 78% might be a useful index for the early diagnosis of transplanted kidneys with AR.
ABSTRACT
Objective To evaluate contrast-enhanced ultrasound(CEUS) in the diagnosis of vascular complications of transplanted kidneys.Methods Twelve patients with vascular abnormalities after renal transplantation were observed and analyzed using CEUS, and the diagnosis of all cases was confirmed by means of operation,pathology or angiography.Results Five patients with renal artery stenosis,2 patients with renal artery thrombosis,3 patients with pseudoaneurysm, 1 patient with pseudophlebangioma, and 1 patient with intrarenal extensive microthrombus were found.The coincidence of CEUS was 100%.Conclusions CEUS is a new method with the characteristics of non-nephrotoxic damage to kidney and comparable with angiography in terms of dynamic imaging.