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Purpose To evaluate the diagnostic value of high-frequency ultrasonography (HFUS) in the diagnosis of rheumatoid arthritis (RA) Achilles tendinopathy.Materials and Methods The Achilles tendon HFUS findings in 67 cases including a total of 93 feet were analyzed retrospectively,among which,11 cases including 22 feet were set as healthy control group (group A),36 cases including 40 feet as RA Achilles tendon group (group B) and 20 cases including 31 feet as non RA Achilles tendon group (group C).HFUS was used to observe the gray-scale imaging (GSI) and power Doppler imaging (PDI) features of the Achilles tendon:① the positive rate of Achilles tendon GSI abnormality.② The thickness and width of the starting point,mid point and ending point of Achilles tendon.③ The detection rate of retrocalcaneal bursal effusion.④ The detection rate of blood flow signal in the internal Achilles tendon.⑤ The level of blood flow signal.The data of each group were compared and analyzed.Restlts ① The positive rate of Achilles tendon GSI abnormality:there was no significant difference between group A and group B (x2=0.064,P＞0.05).Compared with group A and group B,group C had higher rate of abnormalities (x2=31.601 and 39.256,P＜0.05).② The thickness and width of Achilles tendon:the thickness of each point increased in group C than that in group A and group B (P＜0.05),and there was no significant difference in width between groups (P＞0.05).③ The detection rate of retrocalcaneal bursal effusion:negative in group A.The detection rate of group B (55％) was higher than that of group C (19.4％),the difference was statistically significant (P＜0.05).④ The detection rate of blood flow signal in the Achilles tendon:negative in group A.The detection rate of group B (97.5％) was higher than that of group C (45.2％),the difference was statistically significant (P＜0.05).⑤ The level of blood flow signal:level Ⅰ signal detection rate in group B (7.5％) was lower than that in group C (35.5％),while level Ⅱ signal detection rate in group B (35.0％) was higher than that of group C (9.7％),the differences were statistically significant (P＜0.05).Level Ⅲ signal was detected in only group B (45.0％) while not detected in group C.In addition,aspiration biopsy was performed on 3 patients of whom the fat pad of Achilles tendon was involved by level Ⅲ blood flow signal in PDI,and the pathological findings were consistent with ultrasonic manifestations.Conclusion HFUS is of great value in the diagnosis of RA Achilles tendinopathy and it can also be used to distinguish from non-RA Achilles tendinopathy.Moreover,it helps to achieve early diagnosis and early treatment in clinic to avoid Achilles tendon rupture and other bad progresses.
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Objective To evaluate the diagnostic value of shear wave elastography(SWE)and Breast Ima-ging Reporting and Data System -Ultrasonograpy(BI -RADS -US)in benign and malignant breast lesions.Methods 180 patients with pathological -confirmed benign and malignant breast lesions without any treatment were underwent ultrasonography scoring with BI -RADS and the quantitative elasticity parameters was measured by shear wave elastography 1week before operation.Pathological results were regarded as the gold standard,receiver operating characteristic curve(ROC)was used to determine cutoff values of quantitative parameters and diagnostic performance of two methods.Results Maximum elastic value(Emax)and mean elastic value(Emean)of benign breast lesions were (39.17 ±11.48)kPa and (21.56 ±9.68)kPa,which were significantly lower compared with the malignant breast lesions of (121.38 ±28.97)kPa and (62.92 ±18.49)kPa,respectively(t =23.668,P =0.000;t =18.194, P =0.000).Taking 43.79kPa and 65.15 kPa as the threshold of the Emean and Emax value,the sensitivity,specificity and accuracy of SWE were 92.59%,90.78% and 94.84%,respectively.The areas under the curve(AUC)of the SWE and BI -RADS -US were 0.942 and 0.883 (P =0.042).Conclusion SWE can improve the accuracy of ultrasonography in differentiation of benign from malignant breast lesions by quantitative elasticity parameters,which has important significance for clinical treatment.
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Objective To evaluate the value of contrast-enhanced ultrasound and ultrasonic elastography in the diagnosis of breast lesions with BI -RADS Ⅲ -Ⅴ.Methods 169 patients with BI -RADS Ⅲ -Ⅴ breast lesions were underwent contrast -enhanced ultrasound and ultrasonic elastography 1 week before surgery.Pathological findings were used as the gold standard to evaluate the diagnostic accuracy of contrast -enhanced ultrasound and ultrasonic elastography in diagnosis of BI -RADS Ⅲ -Ⅴ breast lesions.Results The combination of contrast -enhanced ultrasound and ultrasonic elastography in diagnosis of BI -RADS Ⅲ -Ⅴ breast lesions,with the sensitivi-ty,specificity and accuracy of 96.15%,94.34%,and 95.11%,respectively.The difference was statistical signifi-cance compared with single method(χ2 =4.659,P =0.032,χ2 =4.146,P =0.041).Conclusion The combination of contrast -enhanced ultrasound and ultrasonic elastography improves the diagnostic accuracy of Ⅲ-Ⅴ breast lesions.
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Objective To estimate the intima-media thickness and the wall resilience of common carotid arteries using QIMT and QAS in patients with hypertension,hyperlipidemia,transient ischemic attack and impaired glucose tolerance.Methods The IMT and vessel stiffness parameters including stillness paranleter(β) and compliance coeficient(CC) were obtained in 123 patients with hyperlipidemia,20 patients with hyperlipidemia,21 patients with transient ischemic attack and 36 patients with impaired glucose tolerance,the results were compared with normal control group.Results The IMT [(785.12 ± 114.72) μm,(757.89 ± 86.24) μm,(785.67 ± 143.43) μm,(790.12 ± 163.06) μm] and β in patients [(12.59 ± 0.85),(12.28 ± 1.08),(12.59 ± 0.87),(12.60 ± 1.15)] were higher than those in the control group[(546.30 ± 119.34) μm,(6.80 ±0.90)],CC in patients [(1.01 ± 0.28) mm2/kPa,(0.96 ± 0.24) mm2/kPa,(1.01 ± 0.22) mm2/kPa,(1.02 ± 0.30) mm2/kPa] was lower than that of the control group[(1.29 ± 0.26) mm2/kPa],there was significant difference(all P ＜ 0.01).Conclusion QIMT and QAS technique have advantages of real-time,high degree of accuracy to detect common carotid artery early structural and functional changes,which have certain value for the early diagnosis of AS.
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Objective To investigate the clinical value of hysterosalpingo-contrast-sonography (HyCoSy) with high-pressure syringe injection and time-intensity curve analysis in the diagnosis of women infertility due to tube obstruction.Methods Fifty-six women with infertility underwent HyCoSy with compressive injection of SonoVue with a balloon catheter and high-pressure syringe.Time-intensity curve based on Autotracking Contrast Quatification (ACQ) software was analyzed in all patients.The arrival time (AT) of microbubbles from uterine cavity to tube fimbria was analyzed between partially obstructed tube group and control group.Results The AT in the group of partially obstructed tubes was (3.49 ± 1.70) s,while the AT in the group of freely patent tubes was (1.14-± 0.37)s,there was statistical difference of AT between the group of partially obstructed tubes and the group of freely patent tubes (P =0.000).According to ROC results,the optimization point of AT was 1.65 s,the sensitivity,specificity,positive predictive value and negative predictive value were 92.6％,93.3％,96.2％ and 87.5％,respectively.Conclusions High-pressure syringe injection in HyCoSy is useful for regular administration and high image quality.The AT could be considered as the diagnostic indices in the evaluation of fallopian tube patency for infertile women.
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Objective To evaluate the color Doppler ultrasonography and contrast enhanced ultrasound (CEUS) findings of congenital intrahepatic portosystemic venous shunts (IPSVS).Methods Nineteen patients of congenital IPSVS were examined with color Doppler ultrasonography and CEUS.All patients were confirmed by CT angiography.The hepatic artery arrival time (HAAT),portal vein arrival time (PVAT),and hepatic vein arrival time (HVAT) on CEUS were recorded.The interval time between hepatic artery arrival time and hepatic vein arrival time (HA-HVTT) and the interval time between portal vein arrival time and hepatic vein arrival time (PV-HVTT) were calculated.Results The types of IPSVS between portal and systemic veins were based on Park's classification.Color Doppler ultrasonography showed abnormal communication between the portal vein branch and the hepatic veins,duplex Doppler ultrasonography showed abnormal spectral pattern from the portal vein such as undulating,triphasic waveform mimicked that of the hepatic vein.CEUS demonstrated abnormal communication between portal vein branch and hepatic vein.HVAT,HA-HVTT,and PV-HVTT were shorter statistically in congenital IPSVS group than those in cirrhosis and normal groups.Conclusions Congenital IPSVS is a rare vascular abnormality that is usually asymptomatic.Color Doppler ultrasonography is a useful tool for diagnosis of congenital IPSVS.CEUS provides helpful data for the diagnosis and differential diagnosis of congenital IPSVS.
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Objective To explore the value of real time contrast-enhanced ultrasound (CEUS) in differential diagnosis of benign and malignant adrenal lesions.Methods Totally,57 adrenal lesions (26malignant and 31 benign) underwent conventional ultrasound and real-time CEUS.The enhancement patterns including types of time-intensity curve,centripetal fill-in,homogeneity and intensity of enhancement were analyzed.Results The enhancement pattern of normal adrenal gland was homogeneous,centrifugal and rapid perfusion from the medulla to the cortex.Four enhancement patterns were significantly different between benign and malignant adrenal lesions (P ＜0.05).If enhancement in the early arterial phase and rapid washout was suggestive of malignancy,the sensitivity and specificity of CEUS were 96.2％ and 77.4％,respectively.If peripheral to central filling was suggestive of malignancy,the sensitivity and specificity of CEUS were 76.9 ％ and 80.7 ％,respectively.Conclusions The patterns of real-time CEUS are helpful in differential diagnosis of malignant and benign adrenal lesions.
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Objective To explore oral contrast-enhanced ultrasonography findings in superior mesenteric artery syndrome (SMAS).Methods Twenty-nine patients with SMAS were examined using oral contrast-enhanced ultrasonography,which was confirmed by contrast-enhanced spiral computerized tomography.Results Abdominal ultrasonography with oral contrast-enhanced ultrasonography revealed a significant reduction of the SMA angle and diminished SMA-aorta distance in 29 subjects.Duodenum was showed the indentation and funnel shaped or dumbbell shaped findings which was caused by pressure of the SMA in patients with recumbent position.The proximal part of duodenum expanded distinctively with contrast media movement fro.Ultrasonography and CT examinations had a good agreement in diagnosing pathological aortomesenteric angle and distance.Conclusions Oral contrast-enhanced ultrasonography presents characteristic findings in patients with SMAS,which is useful in epidemiological screening of suspicious cases of SMAS in children.
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Objective To probe into the anatomy and clinical application of the facial nerve canal surface by multislice spiral CT image curved planar reformation. Methods Fifty patients with facial nerve disease were selected as study group from January to November in 2010, 50 healthy subjects were selected as control group, using models of multislice spiral CT scan for the patient, scanning from the upper edge of the orbital under external auditory canal edge of the connection as a horizontal line, ranging from the lower edge of mastoid process to the petrous bone on the edge of the data obtained in the Wizard workstation reconstruction. All the measurements were more than two measurements of the average physician. Results Normal facial nerve canal in control group could be displayed clearly in an image, display rate was 100.00%(50/50), and the segment data could be accurately measured; axial reconstruction, reconstruction of coronal and sagittal reconstruction of the three comparison of measured direction, fan sections, horizontal and vertical segments of the length and diameter were not significantly different (P＞0.05), and the first and second bending angle of bending angle was no significant difference (P ＞ 0.05 ). Compared with control group, the patients with vascular disease in study group showed significantly decreased rate, the difference was significant (P ＜ 0.05). Conclusion Curved planar reformation of multislice spiral CT diagnosis of facial nerve canal disease has great clinical significance, should be widely applied.
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Objective To investigate the value of contrast enhanced ultrasound (CEUS) in diagnosing metastatic adrenal carcinoma. Methods Twenty two metastatic adrenal carcinoma lesions in 18 patients were examined using CEUS. The features and detected rate of gray scale and CEUS were analysed and compared. Results Fourteen lesions of metastatic adrenal carcinoma were detected by two dimensional ultrasonography(2DU), the detected rate of 2DU was 58. 3%. While 20 lesions were detected by CEUS, the detected rate was 83. 3%. There was a significant difference of detected rate between 2DU and CEUS (P<0.05). The adrenal metastatic carcinomas were enhanced rapidly with the peek intensity slightly low or same to the surrounding liver or renal parenchyma. The lesions number, size and range were clearly presented by CEUS. Conclusions CEUS can markedly improve detected rate of metastatic adrenal carcinoma compared with 2DU.
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Objective To assess the value of hysterosalpingo-contrast-sonography (HyCoSy) with the contrast agent SonoVue in the diagnosis of women infertility. Methods Thirty-six cases of infertility underwent HyCoSy using SonoVue and compared with laparoscopie hydrotubation. Resnlts Among 69 fallopian tubes,22 of them were diagnosed to be obstructive by HyCoSy. Compared with laparoscopic hydrotubation, the sensitivity and specificity of HyCoSy were 90. 5 % and 93.8 %, respectively. Conclusions HyCoSy is a convenient, non-invasive, non-radiative method,which may be regarded as an effective tool to assess the fallopian tubes in patients with infertility.