A comparative study on the use of a three-dimensional visualization operative planning system in Ultrasound-guided percutaneous microwave ablation for large hepatic hemangiomas / 中华肝胆外科杂志

Objective@#To study the use of a three dimensional (3D) visualization operative planning system in Ultrasound-guided percutaneous microwave ablation (US-PMWA) for large hepatic hemangiomas (LHHs).@*Methods@#A total of 50 patients with LHHs from January 2011 to August 2018 were included in Department of Interventional Ultrasound, the First Medical Center, Chinese PLA General Hospital, including 12 males and 38 females (age from 28.0~60.0, mean age was 43.0). Fifty patients with LHHs were divided into the 3D and 2D groups (25 cases in each group). The therapeutic efficacy was assessed by contrast-enhanced imagings on follow-up. Hepatic and renal functions were studied. The complete ablation, tumor volume shrinkage and complication rates were analyzed.@*Results@#The levels of alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, and creatinine after ablation in the 3D group were significantly lower than the 2D group [(126.7±56.4)U/L vs. (204.7±76.5)U/L; (141.0±60.8)U/L vs. (206.6±77.4)U/L; (57.3±17.6)U/L vs. (86.2±46.1)U/L; (66.6±16.6)mmol/L vs. (86.8±42.8)mmol/L, P<0.05, respectively]. Compared with the 2D group, the ablation energy, ablation time and proportion of hemoglobinuria in the 3D group were all significantly less, while the complete ablation rate was significantly higher [(93.7±3.3)% vs. (97.7±2.4)%](all P<0.05).@*Conclusion@#The 3D visualization operative planning system provided a scientific, quantifiable, and individualized therapy for LHHs using US-PMWA.

A comparative study on the use of a three-dimensional visualization operative planning system in Ultrasound-guided percutaneous microwave ablation for large hepatic hemangiomas / 中华肝胆外科杂志

0bjective To study the use of a three dimensional(3D)visualization operative plan-ning system in Ultrasound-guided percutaneous microwave ablation(US-PMWA)for large hepatic hemangio-mas(LHHs).Methods A total of 50 patients with LHHs from January 201 1 to August 2018 were included in Department of Interventional Ultrasound,the First Medical Center,Chinese PLA General Hospital,inclu-ding 12 males and 38 females(age from 28.0～60,0,mean age was43.0).Fifty patients with LHHs were divided into the 3D and 2D groups(25 cases in each group).The therapeutic efficacy was assessed by con-trast-enhanced imagings on follow-up.Hepatic and renal functions were studied.The complete ablation,tumor volume shrinkage and complication rates were analyzed.Results The levels of alanine aminotrans-ferase,aspartate aminotransferase,alkaline phosphatase,and creatinine after ablation in the 3D group were significantly lower than the 2D group[(126.7±56.4)U/L VS,(204.7±76.5)U/L;(141.0±60.8)U/L vs.(206.6±77.4)U/L;(57.3±17.6)U/L vs.(86.2±46.1)U/L;(66.6±16.6)mmol/L VS.(86.8±42.8)mmol/L,P＜0.05,respectively].Compared with the 2D group,the ablation energy,abla-tion time and proportion of hemoglobinuria in the 3D group were all significantly less,while the complete ablation rate was significantly higher[(93.7±3.3)％VS.(97.7±2.4)％](all P＜0.05).Conclusion The 3D visualization operative planning system provided a scientific,quantifiable,and individualized therapy for LHHs using US-PMWA.

Efficacy of contrast-enhanced ultrasound-guided percutaneous microwave ablation treatment of renal carcinomas / 中华医学超声杂志（电子版）

ObjectiveTo assess the safety and efficacy of contrast-enhanced ultrasound (CEUS)-guided percutaneous microwave ablation (MWA) treatment of renal carcinomas.MethodsFifteen patients with 17 renal tumors were retrospectively analyze. The patients’ ages were in the range of 46-80 years (65.2±9.4 years), the tumor diameters were in the range of 1.1-3.9 cm (2.3±0.7 cm) and biopsy pathological results were renal cell carcinoma. All of the tumors were inconspicuous on conventional ultrasound, while conspicuous on contrast enhanced-computed tomography (CT) or magnetic resonance imaging (MRI). Seventeen tumors were ablated under the guidance of CEUS.ResultsAll tumors were successfully visualized on CEUS and MWA was performed under CEUS guidance. The durations of energy application for each tumor were in the range of 5-11 min (mean± SD 7.3±2.2 min). The mean session of CEUS-guided MWA for each tumor was 1.1±0.3. All patients were followed up for 3-49 months (median, 17 months) to observe the therapeutic effects and complications. There was no local tumor progress and major complication. ConclusionCEUS-guided PMWA is a safety, efficient and feasible therapy for patients with RCC which is inconspicuous on conventional US.

Clinical evaluation of ultrasound-guided percutaneous microwave ablation of splenic tumors / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the feasibility, safety and efficacy of ultrasound-guided percutaneous microwave ablation (MWA) of splenic tumors.</p><p><b>METHODS</b>Seven patients with 8 pathologically confirmed splenic tumors (including 2 metastases from the ovary and 4 from the lung, gastric adenocarcinoma, hepatocellular carcinoma, or rectal carcinoma; 1 hemangioma and 1 inflammatory pseudotumor) with sizes ranging from 1.3 to 6.2 cm (mean 3.1 ± 1.9 cm) were treated with MWA. A cooled shaft needle antenna was percutaneously inserted into the tumor under ultrasound guidance. A thermocouple was placed about 0.5 cm away from the tumor to monitor the temperature in real time during the ablation. The microwave emitting power was set at 50-60 W. The treatment efficacy was assessed by contrast-enhanced imaging at 1, 3 and 6 months following the procedure, and every 6 months thereafter.</p><p><b>RESULTS</b>All the tumors were completely ablated in a single session and no complications occurred. No local tumor progression was observed during a median follow up time of 13 months (4 to 92 months). The ablation zone, well defined on contrast-enhanced imaging, was gradually reduced with time. A new metastatic lesion was detected in the spleen at 11 months after the ablation in a ovarian carcinoma patient and was successfully treated by a second MWA. The post-ablation survival of the patients with splenic metastasis was 13 months (range 4 to 92 months). No complications other than fever and abdominal pain were observed in these patients.</p><p><b>CONCLUSION</b>Ultrasound-guided percutaneous MWA is a safe and effective minimally-invasive technique for treatment of splenic tumors in selected patients.</p>

Percutaneous microwave ablation for renal cell carcinoma：evaluation of therapeutic effect with contrast-enhanced ultrasound / 介入放射学杂志

Objective To evaluate low-mechanical-index contrast-enhanced ultrasound (CEUS) in assessing the clinical efficacy and feasibility of percutaneous microwave ablation (MWA) for the treatment of renal cell carcinoma (RCC). Methods From March 2006 to July 2013, a total of 105 RCC patients with 109 lesions, mean size being (3.1 ± 1.3) cm, were treated with ultrasound-guided percutaneous MWA. CEUS results obtained on the third day after MWA were compared with the contrast-enhanced CT/MRI and biopsy findings in the corresponding period. Follow-up examinations with CEUS and CT/MRI were carried out 1, 3 and 6 months after the treatment and once every 6 months thereafter to evaluate the short-term and the long-term therapeutic effectiveness. Results Three days after MWA, CEUS showed that 94 of 109 lesions (86.2%) were completely ablated, and residual tumor tissue was seen in 15 of 109 lesions (13.8%). Among the 15 lesions with residual tumor tissue, 13 (86.7%) were proved by contrast-enhanced CT/MRI and/or biopsy performed in the corresponding period. The sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) of CEUS for the evaluation of the short-term MWA effectiveness were 100%, 97.9%, 98.2%, 86.7% and 100%, respectively. Patients were followed up for 3 - 90 months with a median period of 24.6 months. During the follow - up period, CEUS detected recurrence in 7 patients, and 6 of them were consistent with CT/MRI results. The sensitivity, specificity, accuracy, positive and negative predictive value of CEUS for the evaluation of the long-term MWA effectiveness were 85.7%, 99.0%, 98.2%, 85.7% and 99.0%, respectively. Conclusion For the evaluation of the effectiveness of percutaneous microwave ablation in treating renal cell carcinoma, CEUS is a sensitive, reliable and convenient technique.

Value of real-time contrast-enhanced ultrasound in diagnosis of renal solid renal lesions / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the value of real-time contrast-enhanced ultrasound (CEUS) in the diagnosis and differential diagnosis of renal solid renal lesions (RSLs).</p><p><b>METHODS</b>We retrospectively analyzed 140 cases of 152 RSLs with a mean diameter 3.1∓1.9 cm. CEUS was performed and the perfusion characteristics were analyzed using contrast pulse sequences (CPS) technique. CEUS findings were compared with biopsy histopathologic findings.</p><p><b>RESULTS</b>A total of 137 malignant lesions (including 127 renal clear cell carcinomas, 8 renal papillary carcinomas and 2 chromophobe cell carcinomas) and 15 benign lesions (13 angiomyolipomas and 2 renal oncocytomas) were detected. Of the 137 malignant lesions, 98 (71.5%) showed contrast agent fast perfusion and hyper-enhancement or iso-enhancement in cortical phase, 104 (75.9%) showed hypo-enhancement in later corticalmedullary and late phase, and 125 (91.2%) showed rim-like enhancement. Tumors with a diameter ≤2 cm presented with homogeneous enhancement, and those ranging from 2 to 4 cm showed heterogeneous enhancement with a honeycomb feature; tumors greater than 4 cm featured heterogeneous enhancement with large no-enhancement necrotic areas. Of the benign lesions, 13 angiomyolipomas and 2 renal oncocytomas showed slow wash-in and slow wash-out mode. The diagnostic specificity, accuracy and positive predictive value of CEUS for RSLs were 94.9%, 96.1%, and 73.7%, as compared to 72.3%, 71.1%, and 19.1% with conventional US, respectively (P<0.001). The sensitivity and negative predictive value of CEUS were 93.3% and 99.2%, respectively, significantly higher than those of conventional US (60% and 94.3%, P=0.084, and 0.062, respectively).</p><p><b>CONCLUSION</b>Real-time CEUS can provide valuable information for improving the diagnosis and differential diagnosis of RSLs.</p>

The clinical value of ultrasound elastography in evaluating uterine leiomyomas and adenomyosis treated with percutaneous microwave ablation / 中华超声影像学杂志

ObjectiveTo study the clinical value of ultrasound elastography in evaluating the ablated zone and morphology of uterine leiomyoma and adenomyosis treated with percutaneous microwave ablation treatment(PMAT) under ultrasound guidance.MethodsEighteen patients were randomly chosen from 150 patients with symptoms uterine leiomyomas or adenomyosis who were treated with PMAT.Contrastenhanced Ultrasound(CEUS) and ultrasound elastography were performed before and immediately after PMAT.Compared with contrast enhanced MR were performed at 1 - 2 d after PMAT,the accuracy of ultrasound elastography and CEUS in evaluating the ablated range of PMA were analysed.Results Ultrasound elastography showed that the ablated zone was blue and the boundary with the surrounding tissues was clear.The ablated zone showed no enhancement with CEUS and enhanced MR.The mean diameter of the ablated zone in ultrasound elastography,CEUS,and contrast enhanced MR was (4.90 ±1.12)cm,(4.64 ± 0.93) cm,and (4.89 ± 1.02) cm,respectively.The diameter in ultrasound elastography was slightly larger than that in CEUS ( P =0.02) and had no statistical difference with that in contrast enhanced MR ( P =0.44).ConclusionsUltrasound elastography can accurately show the coagulation range immediately after PMAT and is supposed to be a method to evaluate the ablated zone noninvasively immediately after PMAT.

Clinical study of raise ultrasonic display rate for calcification in breast lesions / 中华超声影像学杂志

ObjectiveTo evaluate the value of MicroPure software system in the display of calcification and diagnostic accuracy of breast carcinoma.MethodsSixty-three patients with 68 breast lesions were checked by conventional ultrasound,X-ray and MicroPure software technique.The calcification was described and the lesions were classified with BI-RADS.All cases were pathologically confirmed by biopsy or operation.Results ①Compared to the detection rate for calcification of X-ray,the display rate of conventional ultrasound was 80.6% ,and the display rate of MicroPure software technique was 100%.②The area under the curve of diagnosing benign and malignant of breast lesions was 0.916,0.857 and 0.970 respectively with ultrasound,X-ray and MicroPure software technique.③Three lesions was classified Ⅲ in BI-RADS with conventional ultrasound,and Ⅳ in BI-RADS with MicroPure software.The pathologic results were malignant.ConclusionsMicroPure software system obviously raised the ultrasonic display rate of calcification,meanwhile,it raised the diagnostic accurate rate of breast cancer.It especially raised the tendency rate for the patients who were classified between Ⅲ and Ⅳ in BI-RADS.

Localization diagnosis of insulinoma by contrast-enhanced ultrasonography compared with laparoscopic ultrasonography / 中华超声影像学杂志

Objective To compare the value of contrast-enhanced ultrasonography (CEUS) with that of laparoscopic ultrasonography (LUS) in localization diagnosis of insulinoma. Methods Thirty-three patients with insulinoma,who received operation, were retrospectively reviewed. All cases were examined by both CEUS and LUS before the tumor removed. Both imaging modalities in diagnosis of insulinoma were analyzed. Results By this study the sensitivity and accuracy of CEUS were 92.31% and 90.0% respectively. Those of LUS were consistent with pathologic findings completely. The accuracy of CEUS was not different with that of LUS (χ2 = 4.21, P = 0. 04). Conclusions CEUS can be used for location diagnosis of insulinoma. For the patients expecting laparoscopic treatment, combination of CEUS with LUS will be suggested before insulinoma is removed.

Design of ultrasound PACS image system based on B/S mode / 医疗卫生装备

Objective To construct the ultrasound PACS image system based on B/S mode.Methods The modern internet technology was used to build the PACS image system based on B/S mode.The B/S mode was typical three layer structures,namely,client presentation layer,middle service logic layer and storage layer.Results Client presentation layer was a figure surface to provide application service for clients.The function of service logic layer was performing application strategy and packaging application mode which was shown to client application program.Storage layer was used to define,service,visit and update data.Conclusion The versatility of B/S mode is good.Besides,the software is easy to operate and upgrade with low cost.