Diagnostic value of contrast-enhanced ultrasound in hepatic epithelioid hemangioendothelioma / 中华肝脏病杂志

Objective: To investigate the features of contrast-enhanced ultrasound (CEUS) in hepatic epithelioid hemangioendothelioma (HEHE) in order to improve the preoperative diagnosis rate. Methods: CEUS images of 32 pathologically-proven cases of hepatic epithelioid hemangioendothelioma from January 2004 to August 2021 were collected. Lesions were analyzed to observe the features of enhancement mode, enhancement intensity, and distinct enhancement phases. Results: Among the 32 cases, one had a solitary lesion, 29 had multiple lesions, and two had diffuse-type lesions. Contrast-enhanced ultrasound revealed a total of 42 lesions in 32 cases. In terms of arterial phase enhancement, 18 lesions had overall enhancement, six lesions had uneven dendritic enhancement, 16 lesions had rim-like enhancement, and two lesions had just slight peripheral spot enhancement around the lesions. Among the three cases, there were multiple lesions that had overall enhancement and ring enhancement. In terms of the enhancement phase, 20 lesions showed "fast progression", 20 lesions showed "same progression", and two lesions showed "slow progression". During the late arterial or early portal venous phases with rapid washout, all lesions manifested as hypoechoic. With peaked enhanced intensity, 11 lesions had a lower enhancement intensity than the surrounding normal liver parenchyma; 11 lesions had the same enhancement degree as the surrounding normal liver parenchyma; and 20 lesions had a higher enhancement degree than the surrounding normal liver parenchyma. All 16 ring-enhancing lesions had marked hyperenhancement. In the typical enhancing lesions, four showed hyperenhancement, five showed low enhancement, and nine showed isoenhancement. In the dendrite-enhancing lesions, there were two isoenhancing and four hypoenhancing. Contrast-enhanced ultrasound delineated the boundaries of all lesions more clearly than two-dimensional ultrasound. Conclusion: Contrast-enhanced ultrasound has certain value in the diagnosis of hepatic epithelioid hemangioendothelioma.

Evaluation of Liver Metastases Using Contrast-Enhanced Ultrasound: Enhancement Patterns and Influencing Factors

BACKGROUND/AIMS: To evaluate the enhancement patterns of liver metastases and their influencing factors using dynamic contrast-enhanced ultrasound (CEUS). METHODS: A total of 240 patients (139 male and 101 female; 58.5±11.2 years of age) diagnosed with liver metastases in our hospital were enrolled in this study to evaluate tumor characteristics using CEUS. A comparison of enhancement patterns with tumor size and primary tumor type was performed using the chi-square test. The differences between quantitative variables were evaluated with the independent-sample t-test and one-way analysis of variance. RESULTS: The enhancement patterns of liver metastases on CEUS were categorized as diffuse homogeneous hyperenhancement (133/240, 55.4%), rim-like hyperenhancement (80/240, 33.3%), heterogeneous hyperenhancement (10/240, 4.2%), and isoenhancement (17/240, 7.1%). There were significant differences in the enhancement patterns during the arterial phase based on the nodule size (p=0.001). A total of 231 of the nodules showed complete washout during the portal phase, and 237 nodules were hypoenhanced during the delayed phase. The washout time was correlated with tumor vascularity, with a longer washout time observed in hypervascular metastases compared to hypovascular metastases (p=0.033). CONCLUSIONS: Diffuse homogeneous hyperenhancement followed by rapid washout was the most common enhancement pattern of liver metastases on CEUS and was affected by the nodule size and tumor vascularity. Small metastases were prone to show diffuse homogeneous hyperenhancement. Hyper-vascular metastases showed a significantly longer washout time compared to hypovascular metastases.

Treatment timing for kyphoplasty with bone cement injection in patients with thoracolumbar vertebral compression fractures / 中国组织工程研究

BACKGROUND:Related studies have shown that after kyphoplasty with bone cement injection, the vertebral height restoration is closely related to the injury time. Surgical timing also has an important influence on the incidence of postoperative complications. OBJECTIVE:To compare the clinical efficacy of kyphoplasty with bone cement injection at 2 and 2-4 weeks after thoracolumbar vertebral compression fractures, and to investigate the best timing for kyphoplasty. METHODS:Eighty-two thoracolumbar fracture patients, aged 55-85 years old, were included. Thirty-nine cases were subjected to kyphoplasty with bone cement injection within 2 weeks after injury. Another 43 cases were subjected to kyphoplasty with bone cement injection within 2-4 weeks after injury. The visual analog scale score, restoration of anterior and central vertebral height, volume and leakage of bone cement after treatment were compared between two groups. At 6 months after treatment, the daily activities of patients in the two groups were evaluated using Oswestry disability index. RESULTS AND CONCLUSION:Immediately and at the 6th month after treatment, the scores on the visual analog scale and the Oswestry disability index were lower than those before treatment (P < 0.05). The visual analog scale score immediately after treatment in the treatment group within 2 weeks was higher than that in the treatment group within 2-4 weeks (P< 0.05). After 6 months of treatment, there was no significant difference in the restoration rate of anterior and central vertebral height between these two groups, but the loss rate of the anterior and central vertebral height in the treatment group within 2 weeks was lower than that in the treatment group within 2-4 weeks (P< 0.05). Bone cement injection volume and leakage rate had no significant differences between two groups. These results demonstrate that patients appeared to have obvious pain after percutaneous kyphoplasty with bone cement injection within 2 weeks, but the percutaneous kyphoplasty with bone cement injection had smal influence on the short-term loss rate of vertebral height. Therefore, percutaneous kyphoplasty with bone cement injection with 2 weeks after injury is the optimal treatment timing for patients with thoracolumbar compression fractures.

Diagnosis of atypical liver abscesses with real-time contrast-enhanced ultrasound / 中国医学科学院学报

<p><b>OBJECTIVE</b>To investigate the value of real-time harmonic contrast-enhanced ultrasound (CEUS) in the diagnosis of atypical liver abscesses.</p><p><b>METHODS</b>We used Technos DU8 system with CEUS technique to examine 32 patients with suspected liver masses. Mechanical index was set at 0.08- 0.11. The contrast agent SonoVue was injected as a bolus (2.4 ml, < 5s) in the antecubital vein.</p><p><b>RESULTS</b>A total of 36 lesions were studied in 32 patients, including 30 patients with single nodule and 2 patients with multiple nodules. All lesions with liver abscess were confirmed by biopsy. The whole-enhanced pattern in all lesions was clearly displayed in the arterial phase after the administration of SonoVue. The mean time of the beginning enhancement was (14.48 +/- 3.62) s, the mean peak enhancement time was (22.92 +/- 4.35) s, and the mean time of hypoechoic appearance of lesion was (80.30 +/- 35.30) s. The lesions with hypoechoic pattern (37.5%, 12/32) and isoechoic pattern (62.5%, 20/32) in the portal phase were detected by CEUS. The characteristic sign with honeycomb pattern on CEUS was shown in 30 (93.8%) liver abscess lesions.</p><p><b>CONCLUSION</b>CEUS is valuable in the diagnosis of atypical liver abscesses.</p>

ANALYSIS OF PYROLYSIS GAS CHROMATOGRAPHY OF SALMONELLA TYPHI / 微生物学通报

The chromatograms of pyrolysis gas chromatography (PGC) of fifteen strains of Salmonella typhi were reported to see if there is any possible relation of the graphs to serological typing and drug-resistance spectra of the bact. In the fifteen strains there were fourteen clinical strains and one reference strain (Hg01). The results indicated that the clinical strains might be divided into group A and B (7 strains each) by PGC. The graphs drawn from group A organisms were entirely the same in shape while those of group B showed only basic similarity. According to the diversity of graphs of group B organisms, the group B organisms, may be subdivided into group B1 (4 strains), B2 (2 strains) and B3 (1 strain). The graphs within each subgroup were completely the same and those of subgroup B1 exhibited close similarity to that of the reference strain. Albeit no regular connection of chromatograms with serological types and drug-resistance could be seen, the graphs yet provided useful reference for founding a bank of chromatograms, compaed with which salmonella typhi graph could then be identified.