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[This corrects the article DOI: 10.1016/j.apsb.2021.03.002.].
ABSTRACT
[This corrects the article DOI: 10.1016/j.apsb.2021.03.002.].
ABSTRACT
Objective To discuss the diagnostic value of contrast-enhanced ultrasonography in differentiating benign and malignant tumor of pelvic cavity.Methods From October 2014 to January 2016,abdominal ultrasonography or trans-vaginal ultrasonography were performed among outpatients and inpatients in the First Affiliated Hospital of Kunming Medical University.We found 62 cases with pelvic cavity tumors with 64 lumps,which were detected at cystic mass,cystic-solid mass,and solid mass in conventional ultrasonography.We made the diagnosis of all the lumps by performing contrast-enhanced ultrasonography,observing the infusion process and analyzing perfusion pattern,the intensity of perfusion and time intensity curve.By contrasting the diagnosis and the pathologic and long-term follow-up results,we classified the tumors into two groups,benign and malignant.Then we analyzed the time intensity curve and imaging parameters of the two groups.Restlts Among the total 64 lumps,43 was found in the group of benign tumor and 21 in the group of malignant tumor.Sixty-two were proved by pathologic results and 2 were proved by long-term follow-up results.Benign tumors showed that the infusion flowed from the peripheral to the center and enhanced equably and the vessels were regularly shaped.Malignant tumor showed that the infusion infiltrated from the center to the peripheral and enhanced quickly and unequally,and vessels were distorted.In the time intensity curve,group of benign tumors presented a gently slow raise and fall type,and group of malignant tumors showed a quickly raise and fall type.Rise time (RT) of malignant group (7.70 ± 2.56s) was shorter than benign group (11.40 ± 6.77s) (P<0.05).Peak intensity (PI) of malignant group (16.30 ± 7.41dB) was higher than benign group (12.12 ± 6.70dB) (P<0.05).Area Under the Curve (AUC) of malignant group (981.65 ± 548.04 dB s) was bigger than benign group (715.22 ± 651.04dB s) (P< 0.05).No difference was found between two groups in Time to Peak (TP) and Mean Transit Time (MTF) (P> 0.05).The sensitivity,specificity,positive and negative predictive value of contrast-enhanced ultrasonography were 95.2%,93.0%,86.9%,and 97.5% respectively.Conclusion Contrast-enhanced ultrasonography ean show an eligible blood perfusion and vascularity of lumps.Analyzing perfusion pattern,time intensity curve,and other parameters can improve capacity of diagnosing and differentiating benign tumor and malignant tumor of pelvic cavity.
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BACKGROUND: Intrapulmonary vascular abnormalities result in the right-to-left shunting and severe hypoxemia in liver transplantation candidates. Currently, a convenient, sensitive and effective method is absent to screen the intrapulmonary vascular dilatations.OBJECTIVE: To evaluate the role of contrast-enhanced echocardiography on clinical diagnosis of intrapulmonary shunting in liver transplantation candidates.DESIGN, TIME AND SETTING: The experiment, prospective controlled observation based on cases, was performed at the Hepatology Unit of the 458 Hospital of PLA (Guangzhou, Guangdong, China) from February 2004 to February 2006.PARTICIPANTS: Twenty-four consecutive liver transplantation candidates were recruited from the Hepatology Unit of the 458Hospital of PLA.METHODS: Routine examination was conducted under the condition without any regimen of vascular dilatation drugs.Contrast-enhanced echocardiography was applied to detect the prevalence of right-to-left shunting in the patients with end-stage liver disease. The microvesicle of the left ventricle in patients was qualitatively assessed by a score from 1+ to 3+. Accordingly, all patients were divided into two groups: intrapulmonary shunting and non-intrapulmonary shunting.MAIN OUTCOME MEASURES: The prevalence of right-to-left shunting and clinical characteristics of liver transplantation candidates were determined.RESULTS: Ten (41.7%) of 24 patients with positive contrast-enhanced echocardiography were proved to develop the intrapulmonary right-to-left shunting, including 6 for l+ and 4 for 2+ by left ventricle abnormality, which emerged after 6-10 cardiac cycles of right ventricle abnormality. There were no significant differences in age, gender, arterial blood gas analysis and liver function tests between the two groups (P > 0.05). Echocardiography results demonstrated that, the upper digestive tract hemorrhage,spleen thickness that indicated portal hypertension, pulmonary artery systolic pressure and Tei index were significandy higher in the patients of intrapulmonary shunting than in those of non-intrapulmonary shunting (P<0.05-0.01 ).CONCLUSION: Intrapulmonary vascular dilatation occurs frequently in liver transplantation candidates associated with intrapulmonary shunting but without hypoxemia. Contrast-enhanced echocardiography is a sensitive and non-invasive method for the early diagnosis of intrapulmonary vascular dilatation. The pathogenic cause is portal hypertension. Tel index can be used as an important parameter for evaluating right ventricular function in patients of intrapulmonary vascular dilatation.