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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 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 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.