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Objective To evaluate the therapeutic efficacy and safety of radiofrequency ablation (RFA) combined with ethanol injection with a multipronged needle under ultrasound guidance for the treatment of hepatocellular carcinoma (HCC) larger than 3 cm in diameter.Methods 65 patients with 67HCC nodules ranging from 3.1 to 7.0 cm in diameter were treated percutaneously under ultrasound guidance.Tumor response and complications after treatment were observed.Results Complete ablation was achieved in 94.0％ (63/67) of HCC nodules.4 residual tumor nodules received complete ablation after additional treatment.Ablation-related major complications was occurred in 3 patients,including liver abscess in 1 case,abdominal bleeding in 1 case and massive ascites in 1 case,all were cured by conservative therapy.After a mean follow-up period of (20.0 ± 7.6) months (6.7-32.6 months),local-tumor progression was observed in 10 (14.9％) of 67 HCC nodules,and distant recurrence was observed in 32 (49.2％) of 65patients.The 1-year and 2-year survival rate were 93.1 ％ and 88.1％,respectively.Conclusions RFA combined with ethanol injetion with a multipronged needle is a safe and effective technique for the treatment of hepatocellular carcinoma larger than 3 cm,especially 3-5 cm in diameter.
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Objective To investigate the value of contrast-enhanced ultrasound (CEUS) in percutaneous nephrostomy for the treatment of complex renal calculi without hydronephrosis.Methods 22 patients with complex renal calculi underwent puncture and catheterization under the conventional ultrasound guidance,and then were injected with ultrasound contrast agent (SonoVue) through the needles and tubes to confirm appropriate puncture and catheterization.The display rates of puncture needle,renal pelvis,calyces,drainage tube body and distal end under CEUS were observed,and the results were compared with those of routine ultrasonography.The dosage of contrast agent,success rate and complications were also recorded.Results The display rates of puncture needle,renal pelvis,calyces,drainage tube body and distal end under routine ultrasonography were 63.64％,36.36％,63.64％,18.18％,as compared with CEUS the display rates were 100％,100％,100％,81.18％.The differences were statistically significant between CEUS and routine ultrasonography (P ＜ 0.05).Conclusions CEUS guided percutaneous catheterization makes up for the inadequacy of conventional ultrasound in patients of complex renal calculi without hydronephrosis,and it can be worthy for clinical application.
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Objective To compare the enhancement characteristic of the gallbladder diseases and to evaluate the diagnostic efficacy in differential diagnosis of the gallbladder diseases between contrast-enhanced sonography (CEUS) and contrast-enhanced computed tomography (CECT).Methods Seventy-two patiens with gallbladder lesions were examined by CEUS and CECT before operation and all final diagnoses were confirmed by surgery and/or pathological diagnosis.Results 1)In early phase,84.6％ (33/39) and 79.5％ (31/39) of benign diseases showed hyper-enhancement on CEUS and CECT,and 97.0％ (32/33) and 87.9％ (29/33) of malignant diseases showed hyper-enhancement on CEUS and CECT respectively (P =0.250).In later phase,91.2％ (31/34) and 88.2％ (30/34) of benign diseases showing hypo-enhancement (P =1.000),and 100％ of the malignant diseases showing hypo-enhancement on CEUS and CECT respectively.2)The time of enhancement from hyper-to hypo in CEUS for benign and malignant diseases were (39.9 ± 15.7)s and (29.9 ± 5.6)s respectively (t =3.61,P =1.000).3)The inhomogeneous enhancement on CEUS and CECT were 41.0％ (16/39) and 53.8％ (21/39) in the benign diseases respectively (P =0.063),84.8 ％ (28/33) and 97.0 ％ (32/33) in the malignant diseases respectively(P =0.125).4)The destruction of the gallbladder wall on CEUS and CECT are 87.9％ (29/33) and 90.9％ (30/33) respectively(P =1.000).5)The accuracy,diagnostic sensitivity,specificity of CEUS and CECT were 91.7％(66/72) and 87.5％(63/72),97.0％(32/33) and 93.9％(31/33),87.2％(34/39) and 82.15％ (32/39) respectively (P =0.250,1.000,0.500).Conclusions The enhancement pattern of the gallbladder diseases on CEUS and CECT were much similar.CEUS has equal diagnostic efficacy in comparison with CECT,but CEUS can supply more diagnostic information than CECT.
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Objective To investigate commence time of liver specific phase on Sonazoid contrastenhanced ultrasound.Methods Rats were administrated with saline (n =6),SonoVue (n =24) and Sonazoid(n =24),respectively.Liver perfusion was performed at 2 min,5 min,10 min and 20 min in situ.Changes of liver enhancement caused by perfusion were quantitatively analyzed.Results Degree of liver enhancement without administration of contrast agent increased after perfusion.In SonoVue group,liver enhancement decreased after perfusion at 2 min and 5 min and increased at 10 min and 20 min significantly.In Sonazoid group,liver enhancement decreased dramatically at 2 min after perfusion,but no changes were found at 5 min,10 min and 20 min after perfusion.Conclusions Liver specific phase on Sonazoid CEUS can begin as early as 5min after administration of contrast agent.
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Objective To investigate the feasibility and method of Sonazoid contrast-enhanced ultrasound (CEUS) for diagnosis of liver fibrosis/cirrhosis. Methods Liver cirrhosis was induced by oral administration of carbon tetrachloride to male wistar rats. Both conventional ultrasound and Sonazoid-CEUS were applied to each rat, respectively. Qualitative and quantitive analysis were performed, and the diagnostic performance of Sonazoid-CEUS on diagnosis of liver fibrosis/cirrhosis were analyzed. Results Twenty four rats were divided into three groups as group 1 (normal liver, n =5),group 2(fibrotic liver, n =6) and group 3 (cirrhotic liver, n =13). The Kupffer phase findings of Sonazoid-CEUS were as following: the enhancement level of normal liver was significantly higher than those of fibrotic/cirrhotic liver, and the difference between liver and spleen of fibrotic/cirrhotic liver was larger than those of normal liver with significant difference. Sonazoid-CEUS showed higher performance on diagnosis of liver fibrosis/cirrhosis than conventional US, with the sensitivity, specificity and accuracy were 84.2％, 100％ and 87.5％,respectively. The quantification data of liver and spleen further proved the characteristic findings of normal liver,fibrotic liver and cirrhotic liver in Kupffer phase. Conclusions Decrease of liver enhancement and increase of the difference between spleen and liver during Sonazoid-CEUS Kupffer phase are the typical findings of liver fibrosis/cirrhosis.
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Objective To evaluate the clinical value of percutaneous ultrasound (US)-guided thermal ablation of intrahepatic cholangiocarcinoma. Methods 14 patients (19 nodules) with histolog-ically proven intrahepatic cholangiocarcinoma (ICC) were treated with percutaneous US-guided thermal ablation from Oct. 1998 to Aug. 2009 in our hospital. The local treatment response, complication and survival were retrospectively analyzed. Results 18 (18/19, 94.7%) nodules had complete necrosis, and 1 (1/19, 5.3%) nodule had residual tumor after ablation. There was no mortality associated with thermal ablation. Only 1 (1/14, 7.1%) patient developed portal vein thrombosis. The follow-up ranged from 1.3 to 72.9 months (mean, 19.0±15.1 months; median, 7.25 months), 10 (10/14,71.4%) patients survived less than 1 year, 2 (2/14,14.3%) survived 1-5 years, and 2 (2/14,14.3%) survived more than 5 years. Of the 14 patients, 9 (9/14, 64.3%) had died and 5 (5/14,35.7%) were alive. The causes of death included tumor progression (8/9, 88.9%) and liver failure (1/9, 11.1%). 9 (9/14,64.3%) patients developed recurrence on follow-up. The disease-free survival ranged from 1.1 to 72. 9 months (mean 16.6±26. 3 months; median 4.1 months). Conclusion Percutaneous US-guided thermal ablation therapy using microwave ablation (MWA) or radiofrequency ablation (RFA) is a safe and effective therapy for intrahepatic cholangiocarcinoma.
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Objective To identify microbubbles targeted (MBt) to alpha(v)beta(3) (αvβ3) via biotin-avidin bridge and evaluate the adhesion to human umbilical vein endothelial cells (HUVECs) in vitro.Methods MBt produced via biotin-avidin bridge were validated using fluorescence in vitro.Adhesion of αvβ3-integrin targeted MBt (MBαvβ3) to HUVECs was tested using the parallel plate flow chamber (PPFC) test.Results Bright green fluorescence was observed on the biotinylated microbubbles(MBB) incubated with fluorescein isothiocyanate labeled streptavidin (FITC-SA) and on MBB-SA incubated with FITC labeled biotin.There was no fluorescence seen on non-targeted control microbubbles,MBB incubated with FITC labeled protein A and MBB-SA incubated with FITC labeled protein A. The adherent rate of MBαvβ3 was significantly higher than MBt with non-specific antibody (MBN) in PPFC test,with 9.9±3.1 of MBαvβ3 and 0.8±0.3 of MBN adhered to HUVECs,respectively(P<0.05).Conclusions Avβ3 targeted microbubbles using biotin-avidin bridging method is highly efficient and reliable for HUVECs.
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Objective To investigate the usefulness of parametric imaging of contrast-enhanced ultrasound(CEUS) in evaluating hepatocellular carcinoma ( HCC) and focal nodular hyperplasia(FNH). Methods Thirty clinically or pathologically proven HCCs and 30 pathologically proven FNHs that had undergone CEUS were randomly included. SonoLiver CAP software were used to quantitatively anlalyze the CEUS and reconstruct DVP parametric images. Results The rise time, time to peak and mean transit time in HCC and FNH were (16. 7 ± 11. 1)s and (21.9±9. 0)s (P = 0. 052) ,(29. 9 ± 14. l)s and (33. 2 ±11.1)s ( P =0. 322), (115. 0±90. 9)s and (271. 5 ± 147. 6)s ( P = 0. 000),respectively. The perfusion index was 90. 4 + 102. 5 in HCC and 42. 6 + 37. 1 in FNH( P = 0. 022). DVP curve and DVP parametric image could both be divided into three types: washout, non-washout and cystic type. In DVP curve, the percentages of which were 76. 7% (23/30),20. 0% (6/30),3. 3% (1/30) in HCC, and 43. 3% (13/30) , 53. 3% (16/30) , 3. 3%(l/30) in FNH,respectively ( P = 0. 023). In DVP parametric image, the percentages of which were 66. 7%(20/30) ,30. 0%(9/30) ,3. 3%(l/30) in HCC,and 33. 3%(10/30) ,60. 0%(18/30) ,6. 7%(2/30) in FNH,respectively ( P = 0. 033). 30. 0% (9/30) of FNH had a clear spoke-wheel pattern in DVP parametric image. Conclusions In parametric imaging of CEUS, the mean transit time of HCC was shorter than that of FNH,and the perfusion index of HCC was higher than that of FNH. The DVP parametric image can display the rapid change and detail of the enhancement clearly.
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Objective To investigate the usefulness of parametric imaging of contrast-enhanced ultrasound(CEUS) in imaging hepatocellular carcinoma (HCC) using dynamic vascular patterns (DVP). Methods Thirty clinically or pathologically proven HCCs that had undergone CEUS were randomly included. SonoLiver CAP sofeware was used to analyze the CEUS images and reconstruct DVP parametric images. Results The rise time, time to peak and mean transit time were (16. 72±11. 07) s, (29. 92±14. 13) s,(115. 03±90. 91)s in HCC versus (26. 59±9. 60) s, (41.67±12. 59) s, (159.26±123. 74) s in the surrounding liver parenchyma (all P <0. 05). The perfusion index was (90. 41±102. 49) % in HCC versus (54. 10±24. 99)% in surrounding liver parenchyma( P = 0.044). DVP curve and DVP parametric image could both be divided into three types:washout,non-washout and cystic type. The percentages of which were 76.7% (23/30), 20.0% (6/30) and 3.3% (1/30) in DVP curves, respectively, and 66.7% (20/30), 30.0% (9/30) and 3.3% (1/30) in DVP parametric images,respectively. Conclusions Parametric image of CEUS could demonstrates the difference of flow perfusion static between HCC and surrounding liver parenchyma dynamically and directly.
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Objective To compare contrast-enhanced ultrasound(CEUS)and contrast-enhaneed computed tomography(CECT)on the diagnosis of renal cell carcinoma(RCC). Methods CEUS and CECT were performed on 117 patients(87 men and 30 women)with 124 renal lesions(single nodule in 110 and two nodules in 7)from 2004 to 2008.Among them,there were 63 patients with 65 lesions diagnosed as RCC confirmed by pathology.The tumor enhancement pattern,extent,and dynamic change of CEUS and CECT were compared.The diagnostic efficacy of CEUS and the agreement of CECT and CEUS in diagnosing RCC were analyzed. Results The rate of displaying hypervascular performance on cortical phase,and pseudocapsule enhancement of the RCC lesions by CEUS and CECT were 87.7%(57/65)and 63.1%(41/65),89.2%(58/65)and 69.2%(45/65)(P<0.05).The rate of displaying heterogeneous enhancement were 72.3%(47/65)and 56.9%(37/65)(P>0.05)Using the diagnosis of CECT as reference diagnostic criteria,the sensitivity,specificity,positive predietive value,negative predictive value,and accuracy of CEUS in diagnosing RCC were 89.1%(57/64),91.7%(55/60),91.9%(57/62),88.7%(55/62)and 90.3%(112/124).The agreement of CECT and CEUS in diagnosing RCC was high(κ=0.806). Conclusions CEUS and CECT have the coordinate efficacy in diagnosing RCC.
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Objective To prepare targeted micorbubble with low immunogenicity. Methods The microbubbles were produced with different phospholipids and identified by the fluorescent method. Detect the level of C3a after reaction with human serum in vitro with enzyme-linked immunosorboent assay (ELISA) method and the number of microbubble binding with the streptavidin packed on the dish by using the parallel plate flow chamber. Results The level of C3a was (1.037±0.047)ng/ml in MBb group,(1. 326 ± 0. 042)ng/ml in MBe group and ( 1.004 ± 0.031 ) ng/ml in MBc group. The level of C3a in MBb group was significantly lower than that in MBe group( P ＜0.05),and there was no significantly difference between MBb group and MBc group ( P ＞ 0. 05). The parallel plate flow experiments showed that the number of MBb(15.2 ± 11.3) in each field of view binding with the streptavidin packed on the dish was significantly fewer than that of MBe ( 103.2 ± 28.3) ( P＜0.05 ), and there was no significantly difference between MBb and MBc(17.8 ± 11.9) ( P ＞0.05). Conclusions The targeted microbubble with low immunogenicity has been prepared successfully,which can be used for further experiment in vivo.
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Objective To evaluate the accuracy and utility of percutaneous ultrasonic cholangiography in Bismuth staging of hilar cholangiocarcinoma. Methods Thirty patients who underwent surgery and obtained pathologic diagnosis of hilar cholangiocarcincoma were perspectively ruled in this study. All patients with hilar obstruction underwent baseline ultrasound (BUS), percutaneous ultrasonic cholangiography (PUSC) and percutaneous transhepatic cholangiography(PTC) respectively. Taking operative findings as reference standard,the accuracy of the three imaging modalities in staging of hilar cholangiocarcinoma was compared. Results Among 30 patients, the accuracy of classification among BUS, PUSC and PTC was 23.3 % (7/30), 73.3 % ( 22/30 ), 73.3 % (22/30), respectively. There was statistically significant difference between BUS and PUSC, but the difference between PUSC and PTC was not statistically significant.Conclusions As a new technique for cholangiography, PUSC expands the application of ultrasound in evaluating hilar cholangiocarcinoma and is comparable to PTC in classifying hilar cholangiocarcinoma by Bismuth classification.
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Objective To evaluate the diagnostic performance of real-time contrast-enhanced ultrasound (CEUS)in characterizing complex cystic focal liver lesions(FLLs).Methods Sixty seven complex cystic FLLs in 65 patients were examined with baseline ultrasound(BUS)and CEUS.BUS and CEUS images were reviewed by a resident radiologist and a staff radiologist independently.Diagnostic performance was evaluated using receiver operating characteristic(ROC)analysis and the interobserver agreement was analyzed by weighted k statistics.Results After ROC analysis,the areas under the ROC curve(Az)were 0.917 for the staff radiologist and 0.774(P=0.044)for the resident radiologist on BUS,and were 0.935 and 0.922(P=0.42)on CEUS.A significant difference in Az between BUS and CEUS was found for the resident radiologist(0.774 versus 0.922,P=0.047),whereas not found for the staff radiologist(0.917 versus 0.935,P=0.38).Better results of specific diagnosis were obtained on CEUS[28.4%(19/67)before versus 58.2%(39/67)after review of CEUS images for resident radiologist,and 26.9%(18/67)versus 76.1%(51/67)for staff radiologist,both P＜0.001].Interobserver agreement was improved after review of CEUS images[K=0.325(95%confidence interval:0.214-0.436)on BUS versus k=0.774(95%confidence interval:0.688-0.860)on CEUS].Conclusions Real-time CEUS improves the capability of discrimination between malignant and benign lesions and specific characterization for complex cystic FLLs,as well as the interobserver agreement.
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Objective To investigate the features of hepatic angiomyolipoma(AML) on contrast enhanced ultrasound (CEUS). Methods Ten pathologically proved AML lesions in 9 patients were evaluated by using baseline ultrasound and CEUS. CEUS was performed with contrast pulse sequencing technique and the contrast agent of SonoVue. Results On baseline ultrasound, 7 lesions exhibited mixed echoic,which was obvious hyperechoic combined with partly of hypoechoie; 3 lesions exhitited obvious hypereehoic. On color Doppler flow imaging artery signals were detected in all lesions. And the lesions had plenty or slightly plenty of artery supply,with resistive index about 0.53 4±0.10 (0.48~0.62). On CEUS, in the arterial phase, 9 lesions exhibited hyper-enhanced. In the portal phase, 5 lesions exhibited iso-enhancement,1 lesion was slightly hyper-enhancement and 3 lesions was hypo-enhancement. In the late phase 6 lesions were iso-enhancement and 3 lesions were hypo-enhancement. One lesion was all hypo-enhancement in all three phases. Conclusions There are some characteristic manifestations of hepatic AML in CEUS, which are helpful for the diagnosis of hepatic AML in a way,but we still need more experiences.
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Objective To investigate the features of low grade dysplastic nodule(LGDN)and high grade dysplastic nodule(HGDN)in cirrhotic liver on the baseline ultrasound(BUS)and contrast-enhanced ultrasound (CEUS).Methods Seventeen LGDNs and 16 HGDNs which were pathologically proved underwent baseline and CEUS examination.CEUS was performed with contrast pulse sequence(CPS)and contrast harmonic imaging (CHI)and used SonoVue as contrast agent.Results Significant differences(all P>0.05)were not shown between LGDN and HGDN for manifestations on both the BUS and CEUS.After contrast agent injected, hyperenhancement in arterial phase and hyper-or iso-enhancement in late phase,hypo-enhancement in early arterial phase and iso-enhancement through late arterial,portal and late phase,hyper-enhancement in arterial phase and hypo-enhancement in late phase,iso-enhancement in arterial,portal and late phase,iso-enhancement in arterial phase and hypo-enhancement in late phase were showed in 10(30.3%),10(30.3%),8(24.3%),4(12.1%),1(3.0%)cases of DN, respectively.Conclusions LGDN and HGDN displayed similar feature on both the BUS and CEUS.There were complicated manifestations of DN on the CEUS and the main contrast-enhanced sonographic feature of DN was,different from regenerative nodule and hepatocellular carcinoma.CEUS was helpful in diagnosing DN in cirrhotic liver.
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Objective To prepare phospholipid-based sulfur hexafluoride gas-filled microbubbles, which were designed for targeting microbubbles. Methods The microbubbles composed of DSPC and mPEG2000-PE were produced by film-sonication method,and were compared with SonoVue. In the physical chemistry characteristics studies, the morphology, particle diameter, concentration, pH value and osmotic pressure were investigated. In the echogenicity studies, contrast harmonic imaging technique was used to investigate the enhancement of vitro water sac and normal rabbit kidney parenchyma. Results The lipid microbubbles were well-distributed, round with air holes. The average diameter of self-made microbubbles and SonoVue were 2.25 μm and 2.50μm respectively. The average diameter of self-made microbubbles and SonoVue distributed from 0.4 μm to 10 μm and 0.2 μm to 10 μm,and 90% were under 6 μm and 8 μm respectively,the concentration were 5 x 108～10 x 108/ml and 1 x I08～5 x 108/ml respectively with a stability of 6 hours. In vitro water sac, the gray scale of self-made lipid microbubbles and SonoVue were 121.67±6.76 and 122.33 ± 4.53 respectively( P>0.05). In normal rabbit kidney parenchyma, the peak video intensity of normal rabbit kidney parenchyma of self-made lipid microbubbles and SonoVue were 72.00 ± 7.21 and 74. 65± 10.93 respectively(P>0.05). Conclusions The lipid microbubbles have satisfactory physical chemistry characteristics and echogenicity.
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Objective To explore the optimal dose-effect relationship of gene transfer according to the expression of pEGFP in tumor cells under different parameters mediated by microbubble contrast agent and ultrasound in vivo.Methods C57BL/6J mice were inoculated subcutaneously in the middle of the right flank with hepal-6 tumor cells.The mixture of SonoVue and enhanced green fluorescent protein(EGFP)plasmid was injected into the tail vein of each mouse, groups were randomly established according to different output intensity( 1 W/cm2, 2 W/cm2, 3 W/cm2 ), exposure time ( 1 min, 5 min, 10 min) and volume of SonoVue(30 μl,60 μl,90 μl), the expression of EGFP in tumor cells under different parameter was examined by flow cytometry and fluorescence microscopy.Results The expression of pEGFP in tumor cells was significantly higher with the increase of exposure time,output intensity and volume of SonoVue (1 min vs 5 min, P＜0.05; 1 W/cm2 vs 2 W/cm2, P＜0.05 ; 30/μl vs 60 μl, P＜0.05).However, the transfection efficiency of EGFP can not be enhanced continuously with the increasing exposure time,output intensity and volume of SonoVue (5 min vs 10 min, P＞0.05; 2 W/cm2 vs 3 W/cm2, P＞0.05; 60 μl vs 90 μl, P＞0.05).The highest transfection effieieney was achieved under intensities was 2 W/cm2 [(21.02±1.45)%]with 5 min[(23.22±1.91)%] exposed to ultrasound, and 60 /μl SonoVue [ (21.02±1.45) % ].Conclusions Gene transfeetion efficiency changded with the difference parameters.2 W/cm2,5 min and 60 μl SonoVue led to the optimum dose-effect relationship of gene transfer in vivo .
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Objective To evaluate the value of contrast-enhanced ultrasound (CEUS) in the diagnosis of ischemie-type biliary lesion (ITBL) after liver transplantation. Methods Twenty-five liver transplantation recipients suspected with biliary complications were examined using CEUS. Percutaneous transhepatic cholangiography or endoscopic retrograde cholangiopancreatography confirmed the diagnosis. The enhancement patterns of the thickened hilum bile duct wall were observed. Results Enhancement patterns of bile duct wall could be divided into 3 sorts:① No-enhancement, six cases, showed no-enhancement all along. ②Hypo-enhancing level, four cases, presented hypo-enhancing at arterial phase and persistent hypo- or no-enhancing until late phase. ③Hyper-enhaneing level,fifteen cases,appeared as hyper- or iso-enhancing at arterial phase and persistent iso- or hypo-enhancing until late phase. The enhancement pattern of bile duct wall showed significant difference ( P = 0.00). Thirteen ITBL patients included 10 cases ( 76.9 % ) with no- or hypo-enhaneement, 3 patients (23.1 % ) with hyper-enhancement. However, all of 12 non-ITBL cases appeared hyper-enhancing. Conclusions CEUS provides a new and effective method to estimate the microcirculation of the bile duct wall. It may be help to early diagnosis of ITBL.
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Objective To compare the enhancement pattern of hilar cholangiocarcinoma on contrast-enhanced sonography(CEUS) and contrast-enhanced computed tomography(CECT). Methods Thirty-two hilar cholangiocarcinoma lesions in 32 patients were evaluated by CEUS and CECT. CEUS was performed with contrast agent of SonoVue and low mechanical index contrast specific mode. CECT was performed with contrast media of Ultravist and a standard biphasic helical CT scanning protocol. Results In arterial phase of CEUS and CECT,the numbers of the lesions showing hyper-enhancement were 14 (43.8 % ) and 12 (37.5 % ), iso-enhancement were 14 (43.8%) and 9(28. 1%),hypo-enhancement were 4(12.5%) and 11(34.4%),respectively (P = 0. 162).Three lesions (9.4%) showed periphery rim-like hyper-enhancement and 29 (90.6%) showed diffuse homogeneous or heterogeneous enhanced of the whole tumor on CEUS, whereas for CECT the number were 2 (6. 3%) and 30 (93. 8%) respectively ( P = 1. 000). In portal phase, the numbers of the lesions showing hypo-enhancement on CEUS and CECT were 30 (93.8 % ) and 23 ( 71.90% ), iso-enhancement were 1 ( 3.1 % ) and 8 ( 25.0 % ), hyper-enhancement were 1(3. 1%) and 1 (3. 1%), respectively ( P = 0. 046). The portal vein invasion was correctly detected in 16 ( 84. 2 % ), 17 (89. 5 % ), 15 (78.9 % ) lesions with baseline ultrasound, CEUS and CECT, respectively. CEUS and CECT correctly diagnosed 30(93.8% ) and 25 (78. 1% ) lesions prior to operation (P = 0. 125). Conclusions The enhancement pattern of hilar cholangiocarcinoma on CEUS was similar with that on CECT in arterial phase, whereas in portal phase hilar cholangiocarcinoma was prone to show hypo-enhancement on CEUS. CEUS and CECT has similar diagnostie efficacy prior to operation.
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Objective To conclude the characterization of renal cellular carcinoma(RCC)with contrast enhanced ultrasound.Methods Seventy patients(seventy-two nodules)with RCC,which were confirmed by operation and biopsy underwent conventional ultrasound and contrast-enhanced ultrasound(CEUS).Microbubble agents SonoVue and contrast pulse sequence(CPS)were used.The conventional uItrasonographic characterization and the enhancement patterns of lesions were analyzed.Results On baseline sonography,the numbers of lesions that showed hypoechogenicity,isoechogenicity,and hyperechogenicity were 44.4%(32/72),25.0%(18/72)and 30.6%(22/72),respectively.Only 28 lesions(38.9%)showed flow signals on color Doppler sonography,the mean maximum velocity of which WSS(43.7±16.8)cm/s(range,24.8-95 cm/s),and the mean resistance index was 0.635±0.11(range.0.52-0.83).Sixty-three(87.5%)lesions were hyper-vascular in cortical phase.Among them forty-eight(76.2%)lesions were hypo-enhanced,and fifteen(23.8%)lesions were still hyper-vascular in late phase.The remaining nine hypervascular nodules in cortical phase were still hyper-enhancing in late phase.Fifty-four(75.0%)lesions were inhomogeneous enhancement.and pseudocapsule was observed in sixty-three(87.5%)RCC lesions.Conclusions The enhancement patterns of RCC are characteristic,and CEUS may be helpful in differential diagnosis of focal renal lesions.