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Objective:To evaluate the effectiveness of contrast-enhanced ultrasound in the differential diagnosis of atypical adenomyosis and fibroids using a decision tree model.Methods:The data of cases with difficulty in differentiating atypical adenomyosis from fibroids on conventional ultrasound examination at Shengjing Hospital of China Medical University from April 2021 to April 2022 were selected and analyzed. Ninety-five patients with contrast-enhanced ultrasound examination were finally selected, including 64 patients in the pathologically confirmed adenomyosis group and 31 patients in the fibroids group. The data from the qualitative analysis and the quantitative analysis of the time-intensity curve (TIC) curve were collected separately, including the temporal variability of contrast entry into the lesion, i.e.the difference between the time when the contrast agent started to enter the lesion and the time when the contrast agent finally filled the lesion completely. Indicators were first screened for inclusion in the decision tree model by univariate and multifactorial analyses, and decision tree models based on qualitative analysis indicators, and qualitative and TIC-based analyses were developed to further assess the diagnostic efficacy of both models.Results:Through the univariate analysis, it showed that the qualitative analysis indicators of lesion onset enhancement pattern, enhancement intensity, intra-lesion contrast distribution, and post-contrast lesion border were of statistical significance (all P<0.05) between the two groups. The differences in contrast arrive time (AT), contrast time to peak (TTP), |ΔAT|, and |ΔTTP| in the TIC curve analysis indexes were statistically significant between the two groups (all P<0.05). The difference in lesion temporal phase variability was statistically significant between the two groups ( P<0.05). After further screening by multifactorial analysis, the accuracy and misdiagnosis rates were 87.40% and (17.90±3.90)% in the qualitative analysis-based decision tree model respectively, and 90.50% and (21.10±4.20) % in the qualitative and TIC curve-based analysis decision tree model respectively. The ROC curves were plotted according to the two groups of models, and the areas under the curves were 0.915 and 0.931 respectively. Conclusions:A decision tree model based on ultrasonographic image analysis has diagnostic value for the differential diagnosis of atypical adenomyosis and uterine fibroids.
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Objective : To evaluate the value of contrast-enhanced ultrasound quantitative analysis in the differential diagnosis of benign and malignant breast intraductal lesions. Methods ¡¤ A retrospective analysis was made on the characteristics of conventional ultrasound and the time-intensity curve (TIC) of contrast-enhanced ultrasound (CEUS) of 71 breast intraductal lesions in 63 patients, which were surgically resected and pathologically confirmed in Shanghai Tenth People’s Hospital from January 2016 to December 2018. The parameters of CEUS perfusion in the lesion area were obtained. Independent sample t test was used to analyze the differences of quantitative parameters between benign and ma-lignant lesions. The receiver operating characteristic (ROC) curve was used to evaluate the value of conventional ultrasound, quantitative analysis of CEUS and their combination for the differential diagnosis of benign and malignant intraductal lesions of breast. Results ¡¤ There were 42 benign lesions and 29 malignant lesions. Among the quantitative parameters of CEUS, time to peak (t=2.072, P=0.042), peak intensity (t=-2.629, P=0.011), rise slope rate (t=3.015, P=0.004) and the area under the curve (AUC) (t=3.308, P=0.001) were statistically significant. The sensitivity, specificity, accuracy, positive predictive value, negative predictive value and area under the ROC curve of conventional ultrasound were 31.03%, 90.48%, 66.20%, 69.20%, 65.50% and 0.608. Those of quantitative analysis of CEUS were 75.86%, 71.43%, 73.24%, 64.70%, 81.10% and 0.776. And those of their combination were 86.21%, 97.62%, 92.96%, 96.15%, 91.11% and 0.943. Conclusion ¡¤ Conventional ultrasound is of limited value in the diagnosis of breast intraductal lesions, and quantitative analysis of CEUS is of great significance in differentiating benign from malignant breast intraductal lesions. The combination of conventional ultrasound and quantitative analysis of CEUS can significantly im-prove the diagnostic value.
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Objective@#To provide a reference for differential diagnosis of orbit tumors in extraconal compartment by analyzing the parameters of contrast-enhanced ultrasonography (CEUS).@*Methods@#A total of 76 patients with orbit tumors in extraconal compartment who underwent CEUS examination were retrospectively analyzed. These patients were divided into two groups depending on histological diagnosis including 27 cases with malignant tumor and 49 cases with benign tumor. CEUS images were analyzed using Sonoliver software. The time-intensity curve (TIC) and dynamic vascular pattern curve (DVPC) were acquired and the characteristics of the arterial flow infusion of these were analyzed. The related parameters such as time of arrival time(AT), rise time (RT), time to peak(TTP), mean transit time(mTT), slope of rise(K1), the absolute value for slope of down (K2) were also obtained. The differences of DVPC, TIC and quantitative parameters between the two groups were compared. Receiver operating curve analysis was used to acquire the cut-off values of these parameters for differential diagnosis.@*Results@#①TICs of the benign tumors were mainly fast rise and slow drop and DVPCs were mainly positive biphasic, while TICs of the malignant tumors were mainly fast rise and fast drop and DVPCs were mainly biphasic. ②The differences of quantitative parameters IMAX, K1, K2, mTT and RT of TICs were statistically significant between the two groups (P<0.05), while those of AT and TTP were not (P>0.05). ③IMAX=456.2%, K1=109.6, K2=35.2, RT=7.9 s, mTT=28.1 s were the best cut-off values for differential diagnosis. Among these parameters, mTT with 28.1 s had the highest diagnostic value(sensitivity: 81%, specificity: 77%).@*Conclusions@#The quantitative CEUS parameters can provide effective reference for differential diagnosis of orbit tumors in extraconal compartment.
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Objective To provide a reference for differential diagnosis of orbit tumors in extraconal compartment by analyzing the parameters of contrast‐enhanced ultrasonography ( CEUS) . Methods A total of 76 patients with orbit tumors in extraconal compartment w ho underwent CEUS examination were retrospectively analyzed . T hese patients were divided into two groups depending on histological diagnosis including 27 cases with malignant tumor and 49 cases with benign tumor . CEUS images were analyzed using Sonoliver software . T he time‐intensity curve ( T IC ) and dynamic vascular pattern curve ( DVPC ) were acquired and the characteristics of the arterial flow infusion of these were analyzed . T he related parameters such as time of arrival time( AT ) ,rise time ( RT ) ,time to peak( T T P) ,mean transit time( mT T ) ,slope of rise( K1 ) ,the absolute value for slope of down ( K 2 ) were also obtained . T he differences of DVPC ,TIC and quantitative parameters between the two groups were compared . Receiver operating curve analysis was used to acquire the cut‐off values of these parameters for differential diagnosis . Results ① T ICs of the benign tumors were mainly fast rise and slow drop and DVPCs were mainly positive biphasic ,w hile T ICs of the malignant tumors were mainly fast rise and fast drop and DVPCs were mainly biphasic . ② T he differences of quantitative parameters IM AX ,K 1 ,K2 ,mT T and RT of T ICs were statistically significant between the two groups ( P ＜0 .05) ,w hile those of A T and T T P were not ( P ＞ 0 .05 ) . ③ IM AX＝ 456 .2% ,K1 ＝109 .6 ,K2 ＝35 .2 ,RT＝7 .9 s ,mT T＝28 .1 s were the best cut‐off values for differential diagnosis . Among these parameters ,mT T with 28 .1 s had the highest diagnostic value ( sensitivity :81% ,specificity :77% ) . Conclusions The quantitative CEUS parameters can provide effective reference for differential diagnosis of orbit tumors in extraconal compartment .
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Objective To investigate the application value of CEUS combined with biopsy in qualitative diagnosis of pe ripheral pulmonary lesions.Methods A total of 158 patients with peripheral pulmonary lesions underwent percutaneous puncture biopsy.Among them,97 cases underwent CEUS before biopsy (experiment group),and 61 cases underwent conventional ultrasound (control group).Puncture times,positive rate of samples pathological diagnosis and occurrence rate of complications were compared between the two groups.The time intensity curve (TIC) was used to obtain the rise time (RT),time to peak (TTP),wash-in slope (WIS) and peak intensity (PI).The parameters of TIC between the two groups were compared.The enhanced morphology of lesions was also observed and recorded.Results The positive rate of samples pathological diagnosis was 94.85 ％ (92/97) in experiment group and 83.61％ (51/61) in control group.The difference of the positive rate was significant between the two groups (P=0.02).In experiment and control group,the average puncture times were 2.11±0.48 and 2.20±0.44;While the occurrence rate of complications were 2.06％ (2/97) and 4.91％ (3/61).No significant difference was found of the average puncture times and the occurrence rate of complications between the two groups (both P＞0.05).While the statistical differences of RT,PI and WIS were found between benign and malignant lesions (all P＜0.05) in experiment group.And no statistical difference of TTP was found (P =0.08).Totally 77.50％ (31/40) of the benign lesions showed inhomogeneous enhancement,while the proportion was 88.46％ (46/52) in malignant lesions.There was no statistical difference of enhanced morphology between benign and malignant lesions (P=0.16).Conclusion CEUS is helpful in distinguishing benign and malignant peripheral pulmonary lesions.And it has great value in guiding percutaneous biopsy in peripheral pulmonary lesions.
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Objective:To discuss the endometrial and sub-endometrial perfusion by using contrast-enhanced ultrasound (CEUS) so as to assess the clinical value of endometrial receptivity.Methods: 86 cases, that were divided into healthy group (49 healthy females) and infertility group (37 patients with infertility), were enrolled in the research. All of cases received detection of color doppler flow imaging (CDFI) and CEUS per vaginam at later period of proliferation, ovulatory period and window phase of implantation, respectively. In these cases, 20 healthy females and 18 patients received endometrial biopsy. The microvessel density (MVD) and time intensity curve (TIC) were analyzed.Results: At the later period of proliferation, the endometrial and sub-endometrial perfusion of the healthy females were significantly more abundant than that of the infertility females as the results of CDFI (x2=4.575,P<0.05). As the results of biopsy for later period of proliferation and ovulatory period, the endometrial MVD of infertility females were significantly lower than that of healthy females (t=7.821, t=8.659,P<0.05). As the results of CEUS for later period of proliferation and ovulatory period, the endometrial and sub-endometrial perfusion peak intensity (Pi) value and area under the curve (AUC) value of healthy females were significantly higher than that of infertility females (t=8.004,t=1.269,t=6.581,t=6.759,P<0.05). Besides, the sub-endometrial Pi were positive correlation with MVD at healthy group and infertility group, respectively.Conclusion:The CEUS can assess the endometrial receptivity through accurately detected endometrial and sub-endometrial perfusion. Therefore, it is worthy to be popularized in clinical practice.
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Objective To provide a reference for differential diagnosis of thyroid microcarcinoma classified as TI-RADS 3-4 grade using contrast-enhanced ultrasound.Methods SonoLiver software was used to analyze the process of contrast-enhanced ultrasound of 112 thyroid small nodules classified as TI-RADS 3-4 grade.The dynamic vascular pattern curve(DVPC)and the time-intensity curve(TIC)were automatically acquired for summarization of the types and characteristics of the two curves.The relevant parameters such as the rise time(RT),time to peak(TTP),maximum intensity(IMAX%),mean transit time(mTT),area under curve(AUC)and perfusion index(PI)were acquired and calculated using the software.Receiver operating curve (ROC) analysis was used to achieve the cut-off value of these parameters for differential diagnosis.Results For thyroid microcarcinoma which TI-RADS assessment of grade 3-4,TIC showed as slow rise and slow drop wave or slow rise and fast drop wave,DVPC showed negative waveform or negative-positive bi-directional waveform.ROC analysis demonstrated that IMAX of 96.5%,AUC of 443.08 and PI of 47.64 were the best cut-off values for the differential diagnosis of benign and malignant nodules.When IMAX<96.5%,AUC<443.08,PI<47.64,the nodules were highly likely to be thyroid microcarcinoma.Conclusions The contrast-enhanced ultrasound parameters can provide effective reference for the differential diagnosis of thyroid carcinoma with grade 3-4 in TI-RADS classification.
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Objective To investigate the application value of contrast-enhanced ultrasound(CEUS) time-intensity curve in the radiofrequency ablation treatment of hepatocellular carcinoma.Methods Seventy-six patients with hepatocellular carcinoma (118 tumor lesions) conducted the ultrasound-guided radiofrequency ablation therapy.The acoustic quantitative analysis software was employed to dynamically analyze the residual ablation lesions,which were compared with the examination results of synchronous enhanced MRI,with the pathology as the gold standard,the benign and malignant tumor residual ablation lesions were performed the statistically comparative analysis.Results The accuracy of CEUS effect after liver radiofrequency ablation therapy was 82.2 ％,which of enhanced MRI was 83.9 ％;the difference between CEUS and enhanced MRI had no statistical significance(P＞ 0.05),their examination results had higher consistency;the benign residual ablation lesions after radiofrequency ablation had blood perfusion characteristics different from malignant residual lesions,the time-intensity curve showed that IMAX benign residual lesions were smaller than malignant residual lesions(P＜0.01).The benign residual lesions of RT and TTP were longer than the malignant residual lesions(P＜0.01);diagnosing benign and malignant had no statistical difference between CEUS and enhanced MRI (P＞0.05).Conclusion CEUS combined with the time-intensity curve can dynamically,intuitively and quantitatively reflect the blood perfusion differences among inactivated focus,benign and malignant residual lesions,and the surrounding liver parenchyma.
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Objective To investigate the application value of contrast-enhanced ultrasound(CEUS) time-intensity curve in the radiofrequency ablation treatment of hepatocellular carcinoma.Methods Seventy-six patients with hepatocellular carcinoma (118 tumor lesions) conducted the ultrasound-guided radiofrequency ablation therapy.The acoustic quantitative analysis software was employed to dynamically analyze the residual ablation lesions,which were compared with the examination results of synchronous enhanced MRI,with the pathology as the gold standard,the benign and malignant tumor residual ablation lesions were performed the statistically comparative analysis.Results The accuracy of CEUS effect after liver radiofrequency ablation therapy was 82.2 ％,which of enhanced MRI was 83.9 ％;the difference between CEUS and enhanced MRI had no statistical significance(P＞ 0.05),their examination results had higher consistency;the benign residual ablation lesions after radiofrequency ablation had blood perfusion characteristics different from malignant residual lesions,the time-intensity curve showed that IMAX benign residual lesions were smaller than malignant residual lesions(P＜0.01).The benign residual lesions of RT and TTP were longer than the malignant residual lesions(P＜0.01);diagnosing benign and malignant had no statistical difference between CEUS and enhanced MRI (P＞0.05).Conclusion CEUS combined with the time-intensity curve can dynamically,intuitively and quantitatively reflect the blood perfusion differences among inactivated focus,benign and malignant residual lesions,and the surrounding liver parenchyma.
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Objective To investigate the application value of contrast-enhanced ultrasound in the diagnosis of ovarian masses.Methods Ninety-four patients with ovarian masses were observed and undetermined by conventional ultrasound examinations who were underwent contrast-enhanced ultrasound examinations and were made the time-intensity curve.By analyzing the perfusion characteristics and the quantitative parameters of time-intensity curve,we compared the difference of different masses.Results The perfusion characteristics and the quantitative parameters of the time-intensity curve were different.The arrival time and the time to peak intensity of benign masses were later than those of malignant tumors.The peak iniensity of benign masses was lower than that of malignant tumors.There was a significant difference between the two groups.The arrival time and the time to peak intensity of benign tumors were later than those of malignant tumors.The peak intensity of benign tumors was lower than that of malignant tumors.There was a significant difference between the two groups.The time to peak intensity of non-tumorous lesions was later than that of malignant tumors.The peak intensity of non-tumorous lesions was lower than that of malignant tumors.There was a significant difference between the two groups.The arrival time of non-tumorous lesions was earlier than that of benign tumors.There was a significant difference between the two groups.Conclusion The perfusion characteristics and the quantitative parameters that draw from the time-intensity curve of different masses are different.Contrast-enhanced ultrasound is contributive to the diagnosis and the differential diagnosis of different masses.Contrast-enhanced ultrasound also has great clinical values to those ovarian masses whose ultrasonic appearance is complex and difficult to diagnose qualitatively.
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This study evaluated whether renal perfusion changes can be noninvasively estimated by using contrast-enhanced ultrasonography (CEUS) in renal ischemia-reperfusion injury and investigated the correlation between renal perfusion measured by CEUS and necrosis and apoptosis of renal tubular epithelial cells. In six dogs with experimentally induced renal ischemia-reperfusion injury, changes in time to peak intensity, peak intensity, and area under the curve were measured on CEUS. Peak intensity and area under the curve of the renal cortex began to decrease on day 1 (about 20% lower than baseline) and reached the lowest levels (about 50% of baseline) on day 4. They then gradually increased until day 10, at which time peak intensity was about 87% and area under the curve was about 95% of baseline; neither fully recovered. Both parameters were strongly correlated with the necrosis scores on histopathologic examination on day 4 (r = −0.810 of peak intensity and r = −0.886 of area under the curve). CEUS allowed quantitative evaluation of perfusion changes in acute renal ischemia-reperfusion injury, and CEUS results were correlated with renal tubular damage on histopathologic examination. Thus, CEUS could be a noninvasive, quantitative diagnostic method for determining progress of renal ischemia-reperfusion injury.
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Animals , Dogs , Apoptosis , Epithelial Cells , Evaluation Studies as Topic , Methods , Necrosis , Perfusion , Reperfusion Injury , UltrasonographyABSTRACT
Objective To analyze the characteristics and clinical value of time intensity curve (TIC) of contrast-enhanced ultrasound (CEUS) in recurrent small hepatocellular carcinoma (RSHCC) and primary small hepatocellular carrcinoma (PSHCC). Methods Sixty-five cases of RSHCC (all lesions ≤3 cm) were devided into group B1 with 42 cases of RSHCC (≤2 years ) , and group B2 with 23 cases of RSHCC ( > 2 yeras ) and group A invloved 49 cases of PSHCC (all lesions ≤3 cm). Enhancement patterns in arterial, portal and delayed phase were evaluated respectively in three groups through CEUS and analytic software Sonoliver was applied to obtain quantitative features of CEUS in the region of interest. Receiver operating characteristic (ROC) was drawn and the area under curve (AUC) was calculated. Results CEUS showed hyper-enhancement difference in arte-rial phase in group B2 (72.4%) and group A (94.8%)(P′ = 0.008) showed statistical significance, but no sig-nificance was found in enhanced iso in portal phase (P = 0.078). Hypo-enhancement in the delayed phase in group B2 (75.9%), group A (96.6%) and group B1 (95.3%) (P′ = 0.003, P′ = 0.005). TIC showed HT difference (half time of descending) in B2 group, A group and B1 group (P′ = 0.007, P′ = 0.013) indicated statistical significance but RT, TTP, MTT(P = 0.319,P = 0.104, P = 0.461) showed no difference. AUC was 0.841 (half time of descending). Conclusions Enhancement patterns of CEUS (RSHCC) are related to recur-rent time . En hancement patterns of RSHCC (> 2 years ) is not typical so CEUS should be combined with quanti-tative analysis of TIC to provide reference for its treatment and prognosis.
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Objective To investigate the effects of contrast dose and region of interest (ROI) depth on quantitative analysis of liver by contrast-enhanced ultrasound (CEUS) during clinical application.Methods After bolus injection of contrast agent,the change of quantitative parameters [including echo mean(EM),rise time(RT),peak intensity(PI),mean transit time(MTT),area under the curve(AUC),time from peak to one half(TPH),wash in slope(WIS),time to peak(TTP)] of time-intensity curves were analyzed based on groups from different doses (1.0 ml and 1.6 ml) and different depth (＜30 mm,30-60 mm,and ≥60 mm).Results MTT and TPH were increased with dose increasing from 1.0 ml to 1.6 ml (P＜0.05).With the dose 1.0 ml,TPH,WIS,PI,AUC and MTT showed significant difference when the depth of the ROI changes (P ＜0.05),with the depth increased,TPH,WIS,PI,and AUC all decreases and MTT increases.For all the other parameters,no significant changes were found (P ＞0.05).Conclusions CEUS and its imaging process can directly influence the accuracy of the parameters from the quantitative analysis.Standardization of contrast agent with predefined dose and depth can potentially facilitate future clinical studies in liver CEUS.
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Objective The purpose of this study was to evaluate the value of contrast-enhanced ultrasound in diagnosis of renal cell carcinoma subtyping.Methods 206 cases with renal tumors were confirmed by pathology and surgery from June 2012 to June 2014,including 113 male cases and 93 female cases.The mean age was 54 years (range 23-80 years).The subtype of renal tumor included clear cell carcinoma in 147 cases,papillary cell carcinoma in 32 cases,chromophobe cell carcinoma in 27 cases.All patients were received the CEUS before operation.The enhancement patterns,degree of enhancement,the appearance of necrosis and the time-intensity curve by contrast-enhanced ultrasound were analyzed.Results Enhancement patterns of CEUS were showed by fast in and fast out in 63.9％ (94/147)cases with clear cell carcinoma,59.4％ (19/32) cases with papillary cell carcinoma,51.9％ (14/27) cases with chromophobe cell carcinoma.Statistical significant diference was shown among those subtype groups (P ＜ 0.05).Most of the clear cell carcinomas (127/147,86.4％) showed hyperenhancing.While,the papillary renal cell carcinoma (22/32,68.8％) and chromophobe cell carcinoma (15/27,55.6％) showed hypoenhancing (P ＜ 0.05).The rate of necrosis in clear renal cell carcinoma was 62.6％ (92/147),and 59.4％ (19/32) in papillary cell carcinoma.necrosis area accounted for only 18.5％ (5/27)in chromophobe cell carcinoma (P ＜ 0.05).In the time-intensity curve analysis,the initial time,the average arrival time,the time to peak and area under the curve in renal cortex was (11.06 ± 2.75) s,(23.42 ± 2.79) s,(27.47 ± 3.02) dB,(35.01 ± 2.94)dB,respectively.Significant differences in those items were found in clear cell carcinoma,which was(8.01 ± 1.89) s,(20.05 ± 3.01) s,(30.03 ± 2.98) dB,(37.64 ± 4.01) dB respectively,compared with those in cortex (P ＜ 0.05).The arrival time,time to peak,peak intensity and area under the curve in papillary cell carcinoma were (1 1.12 ± 2.43) s,(27.29 ± 3.54) s,(20.13 ± 2.67) dB,(34.67 ±3.24) dB,respectively.The curve showed the time to peak was higher and the peak intensity were lower than those of renal cortex (P ＜0.05).The arrival time,time to peak,peak intensity and area under the curve in chromophobe cell carcinoma were (11.32 ± 2.90) s,(22.21 ± 3.62) s,(22.02 ± 2.52) dB,(28.67 ± 3.65) dB,respectively.The curve demonstrated peak intensity and area under the curve were lower than those of surrounding renal cortex (P ＜ 0.05).The increase of tumor diameter after contrast-enhanced ultrasound in clear cell carcinoma was about (0.35 ± 0.11)cm and in nonclear cell carcinoma was about (0.23 ± 0.10) cm (P ＜ 0.05).Conclusion The contrast-enhanced ultrasound played an important role in diagnosis and subtype renal cell carcinoma.
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Purpose To explore the value of ultrasound contrast time-intensity curves in hepatic tumor qualitative diagnosis and evaluation of tumor ablation effect. Materials and Methods Forty-two patients who were clinically diagnosed as hepatic cancer or cirrhosis underwent contrast enhanced ultrasound for the tumor lesions within the liver, dynamic analysis of the lesions were executed with software SonoLiver CAP, the nature of the tumors were determined and the results were compared with those of the enhanced MRI. Ultrasound guided biopsy was followed with radiofrequency ablation treatment, two-dimensional and contrast enhanced ultrasound were executed two weeks after the ablation, and the results were compared with enhanced MRI findings during corresponding period. Results 52 tumor nodules were found with two-dimensional and color Doppler ultrasound, 65 (33 hyperplastic nodules, 32 malignant lesions) with CEUS, 65 (21 hyperplastic nodules, 44 malignant lesions) with ultrasound contrast time-intensity curves, and 61 (20 hyperplastic nodules, 41malignant lesions) with contrast enhanced MRI; pathological examination revealed that 26 of the lesions were benign and 39 were malignant;there was statistically significant difference (χ2=4.561, P0.05) was found between ultrasound contrast time-intensity curves and enhanced MRI for the assessment of the nature of tumor;there was statistically significant difference (χ2=5.298, P<0.05) between ultrasound contrast time-intensity curves and simple contrast enhanced ultrasound for the assessment of whether the tumor was malignant or benign, when taking biopsy results as the reference standard. Conclusion With ultrasound contrast time-intensity curves, dynamical, intuitive, and quantitative evaluation can be obtained for the perfusion differences between the lesion and the surrounding liver parenchyma, which provides more accurate information for qualitative diagnosis of hepatic tumors thus contains great application value in the evaluation of the effects of radiofrequency ablation for hepatic tumors.
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Microvessel density (MVD) is the gold standard to evaluate tumor angiogenesis. Contrastenhanced sonography has been developing fast in recent years. By measuring perfusion parameters, it can represent the degree of new angiogenesis of gynecologic malignant tumors indirectly, and evaluate the biobehavior and prognosis of tumor. The advances of correlations between contrast-enhanced sonographic appearance and MVD of gynecologic malignant tumors were reviewed.
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Objective To evaluate the role of gamma curve fitting technique of contrast-enhanced ultrasound in quantitative analysis of microcirculation in renal solid lesions. Methods A total of fifty patients with renal parenchyma solid lesions were performed contrast-enhanced ultrasound. The images were analysed by computer with gamma fitting analysis of contrast-enhanced ultrasonic system. The quantitative parameters were obtained by the time-intensity curves, such as ascending slope (a3), descending slope (a2), arrival time (AT), time to peak intensity (TTP), basic intensity (BI), peak intensity, amplification (AMP), area under the curve (AUC), mean transit time (MTT) and perfusion index (PI). The parameters were compared between renal malignant and benign solid lesions. Results Fast-in and fast-out was the main perfusion mode in renal malignant tumors while slow-in and slow-out was found in renal angiomyolipoma (AML). The perfusion modes in renal malignant tumors and renal AML were fast-in and fast-out in 28 cases and 0 case, fast-in and slow-out in 4 cases and 1 case, slow-in and fast-out in 5 cases and 1 case, and slow-in and slow-out in 1 case and 10 cases, respectively. There were significant differences in the quantitative parameters such as a2, AUC and PI between renal malignant tumors and renal AML obtained by the time-intensity curves (P<0.05). Conclusion Gamma fitting analysis of contrast-enhanced ultrasound system can provide quantitative information of microcirculation of renal tumors, which helps to differentiate benign renal tumors from malignant ones.
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Objective To analyse the sonographie characteristics of thyroid nodules after injection and investigate the contrast enhanced ultrasonography. Methods Analysed the sonographic characteristics in 32 cases and observed the dynamic enhancement pattern of nodules by the time-intensity curve(TIC). The evaluated parameters were arrival time (AT), time to peak(TTP), peak intensity(PI). Results Thyroid cancer (12 cases) showed early wash in an early wash out in comparison with the adjacent thyroid parenchyma, and the enhancement intensity [AT(7.49 ± 4.45), TIP( 17.41 ± 2.84), PI( 18.56 ± 5.24) s] were lower than nodular goitre (20 cases) [ AT ( 13.22 ± 3.30), TIP (20.92 ± 2.59), PI ( 19.15 ± 5.47 ) s ] (P < 0.05 ). Conclusion The contrast enhanced ultrasonography may provide a useful method for the diagnosis of thyroid cancer.
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Objective To observe the enhancement pattern and time-intensity curve of endometrial carcinomas by using contrast-enhanced ultrasound(CEUS). Methods Altogether 30 endometrial carcinomas were evaluated with real-time gray-scale CEUS, using pulse inversion harmonies technique. The enhancement patterns were observed. Twenty tumors were compared for the size between traditional ultrasound and CEUS. In 21 cases, the parameters of time-intenaity curve were compared between the endometrial lesion and un-involved myometrium. Results The contrast agent arrived at the feeding vessels firstly and then branched into the endometrial tumors. All of the endometrial tumors were enhanced completely except for the necrosis area. In 73.3 % (22/30) of cases, the tumors washed out earlier than the un-involved myometrium. By using CEUS 76. 7% (23/30) of cases showed the feeding vessels of tumor. 43.3% (13/30) of cases showed more clearly than traditional ultrasound in tumor base, position and boundary. The mean enhancement sizes of tumor were bigger than the size showed by traditional ultrasound in 85% of cases by (0. 62±0.50)cm. More than 90% cases showed the tumors start to enhance and wash-out earlier than or at the same time as myometrium. The arrival time and peak time of cancer group were significantly earlier than myometrium group. The peak intensity, enhancement intensity and the rising rate of the tumor group were significantly higher than those of the myometrium group. Conclusions There are some characteristic points in CEUS of endometrial carcinomas. CEUS can provide richer information in tumor imaging than traditional ultrasound and has certain clinical value.