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Objective:To compare the diagnostic efficacies of Sonazoid contrast-enhanced ultrasound (CEUS) and contrast-enhanced magnetic resonance imaging (CE-MRI) in the diagnosis of focal liver lesions (FLLs), and to evaluate the clinical value of Sonazoid.Methods:A total of 58 FLLs in 50 patients who underwent Sonazoid-CEUS and CE-MRI examinations from July 2019 to January 2021 in the First Affiliated Hospital of Zhejiang University School of Medicine were enrolled in this study according to the inclusion criteria. The final diagnostic reference standard was decided by surgical pathology or ultrasound-guided biopsy pathology. Sonazoid-CEUS and CE-MRI features of benign and malignant FLLs were analyzed, and the sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic coincidence rate of the two tests were calculated respectively.Results:There was a statistically significant difference between benign and malignant FLLs in the imaging pattern of homogeneous or heterogeneous intratumoral enhancement in the artery-dominant phase and washout images in the late phase( P<0.001).9.8%(4/41) of the malignant lesions did not decrease until the late phase but decreased in the post-vascular phase. The sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic coincidence rate of the two tests were 97.6%, 52.9%, 83.3%, 90.0%, 84.5%(Sonazoid-CEUS) and 85.4%, 64.7%, 85.4%, 64.7%, 79.3%(CE-MRI), the differences of sensitivity and specificity were not statistically significant ( P=0.125, P=0.687). Conclusions:The vascular phase in Sonazoid-CEUS is still an important diagnostic sign of FLLs, and the unique Kupffer phase can provide additional information for the diagnosis. Sonazoid-CEUS has the same important value as CE-MRI in the diagnosis of FLLs.
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Objective To evaluate the clinical value of contrast-enhanced ultrasonography (CEUS) in the diagnosis of central lung cancer with obstructive atelectasis. Methods During the period from July 2015 to October 2017, 36 central lung cancer patients with atelectasis were admitted to the First People's Hospital of Hangzhou. All the patients were diagnosed by clinical pathology, and the lesions can be demonstrated by ultrasound. CEUS was performed on all the patients. After the examination, the time from which central lung cancer began to increase, the time at which the lungs began to inflate, and the peak and disappearance time of both were analyzed, and the enhancement pattern of the lesions were observed. Results CEUS clearly distinguished central lung cancer and atelectasis in all the 36 (100%) patients. CEUS showed central lung cancer as ″slow-in and fast-out″ mode in 32 of 36 patients, and as ″fast-out and fast-in″mode in the remaining four cases. Among all patients, 18 had uniform low enhancement, 12 had non-uniform low enhancement, 4 had uniform high enhancement, and 2 had non-uniform high enhancement. The onset enhancement time was 4-10 seconds in 32 patients, and 10-18 seconds in 4 cases. The onset enhancement time of the tumor tissue was 10-15 seconds. Conclusion CEUS can distinguish tumor tissue from atelectasis and is helpful in discovering tumor tissue hidden in atelectasis.
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Objective To study the value of virtual touch tissue imaging quantification (VTIQ) and real-time elastography technology in the differential diagnosis of benign and malignant Thyroid Imaging Reporting and Data System (TI-RADS) 4 thyroid nodules. Methods The real-time elastography imaging and touch tissue imaging quantitative (VTIQ) image features of 110 patients (117 nodules) with TI-RADS 4 thyroid nodules were retrospectively analyzed. The real-time elastic technology was used to measure strain ratio (SR) of nodules. VTIQ technique was used to measure the shear wave velocity (SWV) of nodules. The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of the two methods alone and in combination were calculated using postoperative pathology as the gold standard. Then, the ROC curve was drawn, and the area under the curve (AUC) and the optimal cut-off value were obtained. Results There were 43 benign nodules and 74 malignant nodules in 117 thyroid nodules. The specificity, accuracy, positive predictive value, negative predictive value, the area under the ROC curve of the two technologies alone and in combination were 80.3% vs 86.7% vs 83.7%,72.5% vs 82.3% vs 84.2%,76.1% vs 84.6% vs 87.5%,73.3% vs 83.4% vs 84.5%,79.7% vs 85.5% vs 88.7%,0.786 vs 0.869 vs 0.881.According to the ROC curve, the optimal cut-off value of SR was 3.3 and the optimal cut-off value of VTIQ was 3.03 m/s. The Z values and P values of the two methods alone and in combination were (Z=1.95, 1.83, 1.03, all P>0.05), respectively. There was no difference statistically among the three methods. Conclusion The two techniques alone or in combination are valuable in the differential diagnosis of TI-RADS 4 thyroid nodules with similar diagnostic value in the three methods.
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A 12-year-old girl presented with a history of cervical mass, and one week of throat discomfort and dyspnea. Five years ago, the patient was diagnosed as Hashimoto's thyroiditis and hyperthyroidism; she received antithyroid drug treatment, but the result was not satisfactory. B-ultrasonic showed that the size of thyroid gland was 8.1 cm×3.2 cm in the left and 8.2 cm×4.8 cm in the right. After iodine 131 combined with radiofrequency ablation (RFA) treatment, throat discomfort and recumbent breathing difficulties disappeared, and B-ultrasonic showed that the size of thyroid reduced to 2.3 cm×1.7 cm (left) and 2.8 cm×2.0 cm (right). No recurrence was observed during the two and a half years of follow-up.
Subject(s)
Child , Female , Humans , Ablation Techniques , Methods , Dyspnea , Therapeutics , Goiter , Diagnostic Imaging , Pathology , Therapeutics , Hashimoto Disease , Therapeutics , Hyperthyroidism , Therapeutics , Iodine Radioisotopes , Therapeutic Uses , Radio Waves , Therapeutic Uses , UltrasonographyABSTRACT
Objective To evaluate the feasibility and therapeutic efficacy of real-time virtual navigation system (RVS) combined with contrast-enhanced ultrasonography (CEUS) for hepatocellular carcinoma undetectable by conventional ultrasound and CEUS.Methods A total of 213 patients with 265 lesions (undetectable on conventional ultrasound but detectable by other imaging examinations) were enrolled in this study.CEUS was performed,and lesions which were detected with CEUS were given CEUS guided radio-frequency ablation (RFA) (CEUS group).RVS combined with CEUS was performed to locate the rest lesions and guide RFA (RVS + CEUS group).Diagnostic value and therapeutic efficacy of RVS + CEUS were assessed.Results In 256 lesions,174 (65.7％) could be detected with CEUS,and among the rest 91 lesions,82 (90.1％) lesions could be detected by RVS combined with CEUS.The technique effectiveness rate of RVS + CEUS was significantly higher than that of CEUS (x2 =18.85,P ＜0.0001).Complete ablation rate after one month in RVS+ CEUS group was 9t.5％ (75/82),which was significantly higher than that in CEUS group [86.2％ (150/174),P ＜0.05].Local progression in one year in CEUS group and RVS + CEUS group were 13.4％ and 10.9％,respectively.Conclusions RVS combined with CEUS is feasible for hepatocellular carcinoma undetectable by conventional ultrasonography and CEUS,and the therapeutic efficacy of RVS + CEUS guided RFA is satisfactory.
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<p><b>OBJECTIVE</b>To explore the value of ultrasono-portography using SonoVue in selective portal vein embolization (SPVE).</p><p><b>METHODS</b>Twenty-eight patients with malignant liver tumors underwent percutaneous ultrasound-guided SPVE. The procedure was performed under color Doppler ultrasound guidance in 11 cases (conventional group) and under guidance with ultrasono-portography using SonoVue in 17 cases (contrast group). Contrast-enhanced CT was performed 2-4 weeks after SPVE to evaluate the effect of embolization.</p><p><b>RESULTS</b>The procedure of SPVE was aborted in 3 cases in which ultrasono-portography showed contraindications. Postoperative contrast-enhanced CT showed ectopic embolization in 2 cases in the conventional group, and none of the cases in the contrast group showed ectopic embolization.</p><p><b>CONCLUSION</b>Ultrasono-portography using SonoVue can provide important assistance for SPVE.</p>
Subject(s)
Female , Humans , Male , Middle Aged , Carcinoma, Hepatocellular , Pathology , Therapeutics , Embolization, Therapeutic , Methods , Liver Neoplasms , Pathology , Therapeutics , Portal Vein , Portography , Methods , Ultrasonography, Doppler, ColorABSTRACT
<p><b>OBJECTIVE</b>To evaluate the application of contrast-enhanced ultrasonography (CEUS) in diagnosis of inflammatory pseudotumor of liver (IPL).</p><p><b>METHODS</b>The contrast-enhanced untrasonography was performed in 32 cases of IPL and the results were retrospectively analyzed.</p><p><b>RESULT</b>Among total 32 cases, 21 had absent contrast enhancement (type I); 6 had rimlike or stringlike enhancement during arterial phase and presented hypoechoic lesions during the late phase (type II); 2 had diffuse and homogeneous enhancement during early arterial phase,persisting hyperechoic during the late phase (type III); 3 had enhancement during arterial phases and washed out more quickly than liver parenchymal (type IV).</p><p><b>CONCLUSION</b>The perfusion pattern of IPL with CEUS varies, the predominant type is no contrast enhancement; type IV may be confused with atypical hepatic carcinoma, in that case the needle biopsy is necessary.</p>