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Objective To analyse appearances of contrast-enhanced ultrasound(CEUS) of breast local adenosis,and to explore the value of CEUS in the diagnosis of the local adenosis of breast.Methods The data of conventional ultrasound and CEUS of local adenosis of breast in 110 cases confirmed by operation and pathology were analysed.The enhancement patterns,border of the lesion,time-intensity curve were evaluated respectively.Results Totally 151 lesions were detected by conventional ultrasound in 110 cases,61 lesions were diagnosed by conventional ultrasound for adenopathy or adenosis tumor,the diagnosis coincidence rate was 40.4％ (61/151).By CEUS,106 lesions were diagnosed as adenopathy or adenosis tumor,the diagnosis coincidence rate was 70.2 ％ (106/151),higher than that of conventional ultrasound.The features of CEUS include:In contrast perfusion time to peak,103 lesions inhomogeneously enhanced in whole or in part (68.2 ％).The enhancement degree of 121 lesions (80.1 ％) were moderate enhancement or slightly high enhancement,a few lesions (11.9％,18/151) showed significantly enhanced,and very few lesions (7.9 ％,12/151) for low enhancement.In contrast perfusion peak,107 (70.9 ％) lesions had less clear boundary,no envelope,and had a certain continuity with the surrounding background breast tissue,in which 5 lesions were showed significantly increased in size by CEUS comparison with conventional ultrasound,and the boundary of 4 lesions was shaped like the burr,no regularity after enhancing.The boundary of 29.1％ (44/151) of the lesion was clear.In the lesions with moderate enhancement or slightly high enhancement,the time-intensity curve mainly displayed same washin and same wash out (60/151,39.7 ％) and fast washin and fast wash-out (65/151,43.0％).Conclusions CEUS image of focal breast adenosis has certain characteristics.CEUS can provide more evidences in diagnosis and differential diagnosis of breast adenosis,which can help to improve diagnostic confidence.
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ObjectiveTo assess the diagnosis ability of contrast-enhanced ultrasound (CEUS)between qualitative analysis and quantitative analysis in breast masses.Methods The contrast-enhanced ultrasound (CEUS) imagings of 73 cases breast masses (41malignant cases,32 benign cases) were analysed retrospectively,including qualitative indexes(obtained by eyes-watching method) and quantitative indexes (obtained by time-intensity curve).The relationship between these CEUS signs and pathology were evaluated by single variety and multiple variety analysis.The two logistic models on the basis of CEUS signs were obtained.According to the logistic regression results to create new variants pre-1 and pre-2,the two receiver operating characteristic (ROC) curves were created to assess the performance of the logistic models.ResultsBy qualitative analysis,the lesion enhanced features,lesion diameter expanding or not and the grades of lesion enhancement at the peak time entered the logistic regression.And the prediction accuracy to differential diagnosis the breast masses was 91.8％ and the area under the ROC was 91.3％.However,by quantitative analysis,only the relative peak intensity entered the regression,the prediction accuracy was 61.5 ％ and the area under the ROC was 75.7 ％.According to Z test,the areas difference under the two ROCs had statistically significant ( P ＜ 0.05).Conclusions To differential diagnosis the breast masses by CEUS,the qualitative indexes have more useful than the quantitative indexes.
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Objective To investigate the effect of flurbiprofen axetil on perioperative plasma levels of prostaglandin E2 (PGE2) and β-endorphine (β-EP) in patients after remifentanil-based anesthesia.Methods Sixty ASA Ⅱ patients of both sexes,aged 40-64 yr,weighing 50-75 kg,undergoing resection of esophageal cancer,were randomly divided into 3 groups (n =20 each):intralipid group (group A),flurbiprofen axetil pretreatment + postoperative analgesia with flurbiprofen axetil group (group B) and flurbiprofen axetil pretreatment group (group C).Anesthesia was induced with propofol,remifentanil and rocuronium and maintained with propofol,remifentanil and intermittent iv boluses of rocuronium.In group A,intralipid 0.2 ml/kg was injected intravenously at 30 min before operation and patient-controlled intravenous analgesia (PCIA) with fentanyl 15μg/kg + intralipid 0.2 ml/kg was used for postoperative analgesia.In group B,flurbiprofen axetil 2 mg/kg was injected intravenously at 30 min before operation and PCIA with fentanyl 15 μg/kg + flurbiprofen axetil 2 mg/kg was used for postoperative analgesia.In group C,flurbiprofen axetil 2 mg/kg was injected intravenously at 30 min before operation and PCIA with fentanyl 15 μg/kg + intralipid 0.2 ml/kg was used for postoperative analgesia.PCIA solution contained fentanyl 15 μg/kg,flurbiprofen axetil 2 mg/kg and intralipid 0.2 ml/kg in 100 ml of normal saline.The PCA pump was set up with a 0.5 ml bolus dose,a 10 min lockout interval and background infusion at a rate of 2 ml/h after a loading dose of 5 ml starting from 30 min before the end of operation.VAS score was maintained ＜ 3 after operation,and tramadol 50 mg was injected intravenously when VAS ≥ 4 after operation.The amount of remifentanil used during operation and the number of successfully delivered doses and the number of attempts,requirement for tramadol,apnea and severer hypotension were recorded within 48 h after operation.Blood samples were taken immediately before induction of anesthesia,at the end of operation,24 and 48 h after operation (T1-4) for determination of plasma β-EP and PGE2 concentrations.Results There was no significant difference in the amount of remifentanil used among the three groups (P ＞ 0.05).Compared with group A,the number of successfully delivered doses,the number of attempts and the requirement for tramadol were decreased,and the concentration of plasma PGE2 at T2,3 were significantly decreased in groups B and C,and the concentrations of plasma β-EP at T3,4 in group B and at T4 in group C were significantly increased (P ＜ 0.05).Compared with group B,the number of successfully delivered doses,the number of attempts and requirement for tramadol were significantly increased,and the concentration of plasma β-EP at T3,4 wassignificantly decreased in group C (P ＜ 0.05).Compared with the baseline value at T1,the concentrations of PGE2 were significantly increased at T2,3,and the concentration of plasma β-EP was significantly increased at T2,but decreased at T4 in group A,and the concentrations of β-EP at T3,4 were significantly increased in group B (P ＜ 0.05).There was no significant difference in the concentrations of PGE2 and β-EP between the four time points in group C (P ＞ 0.05).Apnea and severer hypotension were not found in the three groups.Conclusion The mechanism by which flurbiprofen axetil reduces postoperative opioid tolerance in patients after remifentanil-based anesthesia may be related to the decrease in PGE2 levels and increase in β-EP levels.
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Objective: To investigate the expression of Cyclooxygenase-2(COX-2) and vascular endothelial growth factor-C (VEGF-C) proteins,and their relationship with lymphatic metastasis of breast cancer.Methods: Immunohistochemical staining was used to detect the expression of COX-2 and VEGF-C proteins in 45 cases of breast cancer.The relationship was analyzed between the expression of VEGF-C,COX-2 and age,tumor size,the protein expression of estrogen receptor(ER) and progesterone receptor(PR),clinic phase,axillary lymph node metastasis.Results: The expression rates of COX-2 and VEGF-C in Ⅲ and Ⅳ stages of breast cancer were higher than those ofⅠand Ⅱ stages(P
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Objective:To investigate the relationship between the expression of vascular endothelial growth factor-C(VEGF-C) proteins and biological behavior of breast cancer.Methods:Immunohistochemical staining was used to detect the expression of VEGF-C proteins in 12 cases of mammary fibroma,35 cases of mammary cystic hyperplasia,45 cases of breast cancer.Results:VEGF-C protein was absent in mammary fibroma,the expression rate of VEGF-C protein in mammary cystic hyperplasia was 20.0%(7/35),The expression rate of VEGF-C in breast cancer was 71.1%(32/45),and it was significantly different compared with mammary cystic hyperplasia(P