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Objective To investigate the influencing factors for ribavirin (RBV)-induced hemolytic anemia in the treatment of chronic hepatitis C, and to provide a reference for the early prediction of ribavirin-related hemolytic anemia in clinical practice. Methods A total of 49 patients with chronic hepatitis C who attended or were hospitalized in Hebei Petrochina Central Hospital from January 2018 to July 2019 and received antiviral therapy with direct-acting antiviral agent (DAA) and RBV were enrolled, with a major allele of C allele and a minor allele of A allele at the rs1127354 locus of the inosine triphosphate pyrophosphatase (ITPA) gene, and the patients with AA and AC genotypes were compared with those with CC genotype. During treatment, RBV was reduced to 600 mg when hemoglobin (Hb) level was < 100 g/L and was withdrawn when Hb level was < 85 g/L. Routine blood test, liver function, liver stiffness measurement, HCV RNA, HCV genotype, and ITPA genotype were measured before antiviral therapy, and the routine blood test was performed at weeks 2, 4, 8, and 12 of treatment. The Mann-Whitney U test was used for comparison of non-normally distributed continuous data between groups. Results A total of 49 patients were enrolled in this study, among whom 22 had chronic hepatitis C and 27 had liver cirrhosis, with a sustained virologic response (SVR) rate of 95.9%. The dose of RBV was reduced in 3 patients (2 in the AA/AC group and 1 in the CC group) due to anemia, and RBV was withdrawn in 3 patients (1 in the AA/AC group and 2 in the CC group); all these 6 patients had liver cirrhosis and finally achieved SVR. During the anti-HCV therapy with DAA+RBV, there was relatively mild RBV-related hemolysis, and the maximum reduction in Hb from baseline was compared between the patients with AA/AC genotype at ITPA rs1127354 and those with CC genotype, which showed no significant difference between the two groups ( Z =-0.18, P =0.87). Conclusion During the treatment with RBV+DAA, RBV is withdrawn or reduced for liver cirrhosis patients due to anemia, and no obvious statistical relation is observed between ITPA genotype and the maximum reduction in Hb from baseline. Therefore, detection of ITPA genotype before the application of RBV does not improve safety during treatment, and it is not recommended to perform conventional detection of ITPA gene polymorphisms.
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Objective To investigate the influencing factors for ribavirin (RBV)-induced hemolytic anemia in the treatment of chronic hepatitis C, and to provide a reference for the early prediction of ribavirin-related hemolytic anemia in clinical practice. Methods A total of 49 patients with chronic hepatitis C who attended or were hospitalized in Hebei Petrochina Central Hospital from January 2018 to July 2019 and received antiviral therapy with direct-acting antiviral agent (DAA) and RBV were enrolled, with a major allele of C allele and a minor allele of A allele at the rs1127354 locus of the inosine triphosphate pyrophosphatase (ITPA) gene, and the patients with AA and AC genotypes were compared with those with CC genotype. During treatment, RBV was reduced to 600 mg when hemoglobin (Hb) level was < 100 g/L and was withdrawn when Hb level was < 85 g/L. Routine blood test, liver function, liver stiffness measurement, HCV RNA, HCV genotype, and ITPA genotype were measured before antiviral therapy, and the routine blood test was performed at weeks 2, 4, 8, and 12 of treatment. The Mann-Whitney U test was used for comparison of non-normally distributed continuous data between groups. Results A total of 49 patients were enrolled in this study, among whom 22 had chronic hepatitis C and 27 had liver cirrhosis, with a sustained virologic response (SVR) rate of 95.9%. The dose of RBV was reduced in 3 patients (2 in the AA/AC group and 1 in the CC group) due to anemia, and RBV was withdrawn in 3 patients (1 in the AA/AC group and 2 in the CC group); all these 6 patients had liver cirrhosis and finally achieved SVR. During the anti-HCV therapy with DAA+RBV, there was relatively mild RBV-related hemolysis, and the maximum reduction in Hb from baseline was compared between the patients with AA/AC genotype at ITPA rs1127354 and those with CC genotype, which showed no significant difference between the two groups ( Z =-0.18, P =0.87). Conclusion During the treatment with RBV+DAA, RBV is withdrawn or reduced for liver cirrhosis patients due to anemia, and no obvious statistical relation is observed between ITPA genotype and the maximum reduction in Hb from baseline. Therefore, detection of ITPA genotype before the application of RBV does not improve safety during treatment, and it is not recommended to perform conventional detection of ITPA gene polymorphisms.
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Purpose@#The aim of this study was to evaluate the value of elastography in the differential diagnosis of benign versus malignant testicular lesions. @*Methods@#The PubMed, Cochrane Library, and Embase databases were searched for relevant studies. The diagnostic accuracy of elastography was evaluated using pooled sensitivity, specificity, likelihood ratio, post-test probability, diagnostic odds ratio, and by summarizing the area under the hierarchical summary receiver operating characteristic (HSROC) curve. @*Results@#Seven studies with 568 lesions were included. The pooled sensitivity and specificity were 87% (95% confidence interval [CI], 81% to 92%) and 81% (95% CI, 65% to 90%), respectively. The pooled estimates of the positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio were 4.48 (95% CI, 2.37 to 8.47), 0.16 (95% CI, 0.10 to 0.25), and 28.11 (95% CI, 11.39 to 69.36), respectively. The area under the HSROC curve was 90% (95% CI, 88% to 93%). @*Conclusion@#Elastography is useful for assessing the stiffness of testicular lesions and for differentiating benign from malignant lesions. Elastography can be an effective supplement to conventional ultrasonography.
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Objective:To explore the differential diagnostic value of ultrasonic elastography for breast nodules with acoustic attenuation.Methods:A total of 105 cases with breast nodules with posterior echo attenuation from June 2017 to October 2019 in Shenzhen People′s Hospital were enrolled. Routine ultrasound examination and elastography were performed and maximum of elastography(Emax), mean of elastography value(Emean), minimum of elastography value(Emin) and strain ratio of fat/strain ratio of nodules(B/A) were recorded. With the pathological results as the diagnosed gold standard, elastic parameters different between benign and malignant breast nodules with posterior echo attenuation were compared. And the Emax value of elastic imaging was analyzed by the ROC curve.Results:There were 65 cases of benign nodules and 40 cases of malignancy. The difference of ultrasound E imaging were statistically significant for judging benign and malignant breast nodules with acoustic attenuation( P<0.05). When Emax 95 kPa was set as the cut-off value for the differential diagnosis of benign and malignat breast nodules, the area under the ROC curve was 0.817, and the sensitivity was 88% and the specificity was 72%. Conclusions:Ultrasonic elastrography is of great value for differential diagnosis of benign and malignant breast nodules with acoustic attenuation, and it is important for the decision making of clinical treatment plan.
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Objective@#To prepare a kind of lipid nanoparticle ultrasound contrast agents with the ability to target to viable myocardium for diagnosis.@*Methods@#The agent was a biotinylated, fluorescent-labelled, lipid-coated, liquid perfluorocarbon emulsion. Physico-chemical properties of the agent were measured, including size distribution, Zeta Potential, concentration and so on. Ischemia-reperfusion models were created in rats, and then exposed to biotinylated anti-MCP-1 monoclonal antibody, rhodamine avidin and biotinylated, FITC-labelled nanoparticles, respectively. Echocardiography was taken before and after injection. Frozen sections of their hearts were observed under fluorescence microscope.@*Results@#The particle diameter, zeta potential and concentration of lipid nanoparticles were (172.30±52.06)nm, (-33.10±6.50)mV and (2.28±0.46)×1011/ml, respectively. From the short-axis view, the myocardium under endocardium of anterior wall was enhanced obviously. While myocardium of other walls were still. The lipid nanoparticles located in the myocardium of anterior wall and gave out bright green and red fluorescence under fluorescence microscope, while neither lipid nanoparticles nor fluorescence were found in other sites of ventricular myocardium.@*Conclusions@#The viable myocardium can be targeted and acoustically enhanced by the self-made nano-scale ultrasound contrast agent. This new agent has potential to improve sensitivity and specificity for noninvasive identifying viable myocardium.
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Objective To prepare a kind of lipid nanoparticle ultrasound contrast agents with the ability to target to viable myocardium for diagnosis . Methods T he agent was a biotinylated ,fluorescent‐labelled ,lipid‐coated , liquid perfluorocarbon emulsion . Physico‐chemical properties of the agent were measured ,including size distribution ,Zeta Potential ,concentration and so on . Ischemia‐reperfusion models were created in rats ,and then exposed to biotinylated anti‐MCP‐1 monoclonal antibody ,rhodamine avidin and biotinylated ,FITC‐labelled nanoparticles ,respectively . Echocardiography was taken before and after injection . Frozen sections of their hearts were observed under fluorescence microscope . Results T he particle diameter ,zeta potential and concentration of lipid nanoparticles were ( 172 .30 ± 52 .06) nm ,( －33 .10 ± 6 .50) mV and ( 2 .28 ± 0 .46 ) × 1011/ml ,respectively . From the short‐axis view ,the myocardium under endocardium of anterior wall was enhanced obviously . While myocardium of other walls were still . T he lipid nanoparticles located in the myocardium of anterior wall and gave out bright green and red fluorescence under fluorescence microscope ,w hile neither lipid nanoparticles nor fluorescence were found in other sites of ventricular myocardium . Conclusions The viable myocardium can be targeted and acoustically enhanced by the self‐made nano‐scale ultrasound contrast agent . T his new agent has potential to improve sensitivity and specificity for noninvasive identifying viable myocardium .
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Objective To explore the diagnostic value of high frequency three-dimensional (3D) ultrasound in breast masses.Methods Seventy-seven cases of breast lesions were selected by 2D ultrasonic scan,and all the cases had been examined by 3D ultrasound and accepted surgical treatment in Shenzhen People's Hospital.With pathological results as the gold standard for diagnosis,the convergence sign in diagnosis of breast masses was used as malignant standard for 3D ultrasound coronal plane.The sensitivity and specificity were analyzed of 3D ultrasound in the diagnosis of benign and malignant breast tumors.Results A total of 77 cases of breast lesions included 46 malignant and 31 benign.3D ultrasound convergence sign was used to judge the benign and malignant breast tumors with statistical significance (x2 =26.790,P ＜ 0.01).The diagnostic sensitivity and specificity were 69.7％,and 90.3％,respectively.Conclusions High frequency 3D ultrasonography has certain value in differential diagnosis of benign and malignant breast tumors,and has important significance for the formulation of treatment plan.
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Objective To investigate the association of apolipoprotein E (ApoE) gene polymorphism in patients with mild cognitive impairment.Methods The patients aged 60-85 years were randomly selected from the outpatient,hospital or community age of Xinjiang Medical University Affiliated Hospital of traditional Chinese medicine in January 2015-June 2016,and cognitive function assessment for the patients.A total of 100 cases of mild cognitive impairment (MCI) patients were selected as case group,and 139 cases with normal cognitive function were the control group.The polymorphism of ApoE gene was analyzed in all patients.The final data were analyzed by Pearson chi square test.Results Compared to the control group,the proportion of genotype T/T in the genotype distribution of rs429358 loci was lower than that of the control group,T/C and C/C were higher than those in the control group,Allele C was a risk factor for MCI disease (OR value =2.100).The epsilon 4 allele was significantly higher than that of the control group,and the epsilon 3 allele was significantly higher than that of the control group (P ＜ 0.05).Conclusions The polymorphism of the ApoE gene is associated with the pathogenesis of MCI,in which the ApoE-E4 allele may be a risk gene for MCI.This suggests that the detection of ApoE gene polymorphism may provide useful information for the early diagnosis of MCI.
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Objective To discuss the feasibility and reproducibility of left ventricular volume and function of patients with left atrial remodeling and left ventricular remodeling by 3-dimensional echocardiography HeartModel (3D-HM).Methods Three-dimensional images of 156 subjects were collected under HMACQ imaging mode.They were assigned into three groups:① control group (group A,n =70);② group of left ventricular remodeling after,acute myocardial infarction (group B,n =17);③group of hypertension left atrial remodeling (group C,n =69).3D-HM method was used for quantifying left ventricular end-diastolic volume (LVEDV),left ventricular end-systolic volume (LVESV),left atrial end-systolic volume (LAESV) and left ventricular ejection fraction (LVEF),and the results were compared with conventional 3D-manual results.The reproducibility of the 3D-HM method within one group and among different groups was evaluated.Results There was a significant difference in all the parameters measured with the 3D-HM method in different groups(P ＜0.05).LVEDV,LVESV,and LAESV in group B were higher than those in group A and group C(P ＜0.05),and LVEF was lower than that in group A and group C(P ＜0.05),LAESV of group C was higher than that of group A(P ＜0.05).The difference in the measurements of LVEDV and LVESV between the two methods was greatest in group B compared with group C and group A(P ＜0.05).In group C,the measured value difference of LAESV between two methods was greater than that of group A (P =0.03).There was closer correlation among LVEDV,LVESV,LAESV and LVEF measured values of 3D-HM method as well as measured values of the 3D-manual method (r =0.94,0.97,0.91 and 0.90).The data post-processing time of 3D-HM was significantly shorter than that of 3D-manual (P ＜0.05).The inter-observer and intra-observer difference of measured values of 3D-HM method had no statistical significance (P ＞0.05).Conclusions 3D-HM is a fast and feasible technique with high reproducibility for quantifying the left ventricular volume and function in patients with left atrial remodeling and left ventricular remodeling.
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Objective To evaluate the clinical significance of prenatal ultrasonography in diagnosis of retroaortic left innominate vein ( LINV ) . Methods Thirty fetus with retroaortic LINV were involved , including 17 cases of isolated retroaortic LINV and 13 cases of complicated retroaortic LINV . Three-vessel and trachea ( 3VT ) view was focused in the routine second trimester ultrasound screening to observe whether LINV existing or not . And then the transducer was rotated to the fetal sagittal view to assess the relationship between LINV and aortic arch and the convergence of left subclavian vein and left internal jugular vein into the LINV . Results The characteristic feature of retroaortic LINV was the LINV converge into right superior vena cava ( SVC) under the aortic arch ,not above the aortic arch . The most important plane to detect the retroaortic LINV was the 3VT view ,which revealed the abnormal vein lying to the left of pulmonary artery . The abnormal vein then could be traced and revealed its connection with the right SVC beneath the aortic arch on the transverse plane inferior to the 3VT view and on the fetal sagittal plane . Conclusions The whole course of retroaortic LINV can be revealed by ultrasound prenatally ,which can not only account for the abnormal vein to the left of pulmonary artery on 3VT view ,but also play an important role in surgery decision and future cardiac intervention treatment .
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Objective To investigate the influence of chronic pain on the sleep quality in the patients with Parkinson′s disease (PD) .Methods 232 cases of PD in the neurology department of this hospital from March 2009 to March 2013 were selected and di‐vided into the pain PD group (PPD group ,106 cases) and the non‐pain PD group (NPPD group ,126 cases) according to whether accompanying chronic pain .Contemporaneous 140 individual of healthy physical examination were selected as the control group .The Pittsburgh Sleep Quality Index Scale (PSQI) and the fatigue scale (FS‐14) were used to judge whether sleep disorders existing . Then the differences in the sleep quality and fatigue condition were compared among three groups .The related factors of sleeping disorders were also analyzed .Results The scores of PSQI and FS‐4 had statistically significant differences among 3 groups (P<0 .05) ,in which the differences in the aspects of sleep latency ,subjective sleep quality ,sleep continuity ,habitual sleep efficiency and sleep disorders also were statistically significant (P<0 .05) .The influencing factors of sleeping disorders were the Hoehn‐Yahr stage (r = -0 .79 ,P<0 .05) ,dopamine dose (r = -0 .38 ,P=0 .04) ,presence of pain (r = -0 .57 ,P<0 .05) and severity of de‐pression (r = -0 .63 ,P<0 .05) .Conclusion The PD patients accompanying pain are more susceptible to develop sleep disorders , the sleep quality accompanying pain is worse than that without accompanying pain .Therefore the early intervention should be well conducted in clinic .
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Objective To develop and validate a ultrasonographic (US)imaging agent with targeted microbubbles that attaches to chemokine receptor 2 (CCR2)and to compare the US single obtained from targeted microbubble with that from control microbubble in murine breast tumor model.Methods The microbubble which carried CCR2 antibody (MBCCR2 )and isotype-macthed immunoglobulin G-labled control microbubble (MBcontrol ) were prepared. The microbubble size and distribution were assessed by AccuSizer780.Binding specificities of targeted microbubble compared with control microbubble were tested with murine microvascular endothelial cells (bEnd.3 ).Orthotopic breast tumor model was estabished in BALB/c mice with mouse breast cancer 4T1 cell.In vivo imaging signals of contrast material-enhanced ultrasound by use these two different types of microbubble which were injected respectively into each mouse at random order and 30 min interval.Tumor tissue was stained for CCR2 and CD3 1 .Results Automatic Particle Sizer showed size uniform of two kinds of microbubbles,and narrow distribution of particle size (mean diameter of about 1 -2 μm),which were not significantly different (P >0.05).Adhension to bEnd. 3 endothelial cells was significantly higher (P < 0.001 )for MBCCR2 (mean,9.50 ± 1 .5 1 )than that for MBcontrol (mean,0.01 ±0.01).Imaging signal in the murine tumor model was significantly higher for MBCCR2 [mean,(6.76±0.26)dB]than that for MBcontrol [mean,(1 .06 ±0.62)dB,P <0.001 ].Immunofluorescence confirmed expression of CCR2 on tumor vasculature.Conclusions The targeted microbubbles with CCR2 monoclonal antibody had been successfully prepared,which precisely targeted to CCR2 of tumor angiogenesis in the murine breast cancer xenograft tumor models in vivo.These results suggest that the targeted microbubbles as a kind of ultrasound molecular imaging agent with a better specificity can be used for both evaluating tumor neovascularization and monitoring therapeutic effect of anti-angiogenesis.
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Objective To prepare Integrin αvβ3/CCR2 dual targeted microbubble,test physical-chemical properties,enhancement effect and targeting ability in vitro.Methods The dual targeted microbubbles (MBdual-target )with FITC labled iRGD and PE labled CCR2 were prapared,and non-target microbubbles as control (MBcontrol ) were prapered.Physical and chemical properties of two groups of microbubbles were tested,connectivity of peptides/antibodies and microbubbles were detected by fluorescence microscope and flow cytometry instrument.Enhancement effect and the stability of two groups of microbubbles was observed and compared in vitro.The affinity of MBdual-target and MBcontrol for bEnd.3 cells was investigated with light and fluorescent microscope.Results ①The particle size of MBdual-target was (0.93±0.23)μm,with no statistically significant difference compared with MBcontrol (P >0.05).②MBcontrol showed no fluorescent,while MBdual-target showed both clear green and red light,under fluorescent microscope.③There was no significant difference of gray scale of enhancement between MBdual-target and MBcontrol in vitro.④ It was showed that MBdual-target adhered to bEnd.3 cells in vitro experiment.Conclusions Integrinαvβ3/CCR2 dual targeted targeted microbubbles was successfully prepared and proved having good enhancement effect and targeting ability in vitro.
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Objective To describe an intelligent three-dimensional technique for automatic visualization of the fetal cranial mid-sagittal view to allow for the differential diagnosis of fetal midline anomalies.Methods Two hundred and twenty pregnant women with singleton pregnancies were imaged to display the mid-sagittal view of fetal head using a new 3D program (Smart MSP) developed by our team.Results The mid-sagittal view of the fetal head was successfully visualized in 190 normal cases (95％) and 18 abnormal cases (90％) by Smart MSP program.The total successful rate was 94.5％ (208/220).Conclusions Smart MSP is a novel and feasible method for the automatic visualization of fetal cranial midsagittal plane and may become a potential tool for routinely screening the fetal midline anomalies.
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ObjectiveTo summarize the echocardiographic diagnosis, clinical classification and prognosis of different types of fetal congenital cardiac malformation (FCMH).MethodsThe echocardiography sonogram characteristics for 429 cases with FCMH were summarized and analyzed by pathological findings and postnatal following-up.ResultsThe incidence of FCMH was 1.3% (429/33 800). In one hundred and seventy-seven caese of single structure malformation, there were 5 cases of Atrial septal defect and 55 cases of interventricular septal defect (34.5%, 61/177). The others including (116 cases): 10 cases of single atrium and 34 cases of single ventricle, 20 cases of Ebstein’s anomaly, 11 cases of tricuspid atresia and 6 cases of pulmonary atresia with intact ventricular seprum, 20 cases of pulmonary stenosis, 10 cases of coarctation of aortic arch and 4 cases of interruption of aortic arch, 1 case of pulmonary artery sling. In two hundred and thirty-three cases of symphysic teratism, there were 41 cases of double-outllet right or left ventricle (17.5%, 41/233) and Tetralogy of Fallot (40 cases, 17.2%, 40/233). The others (152 cases) including: 16 cases of complete and 18 cases of corrected transposition of great arteries, 38 cases of atrioventricular septal defect, 30 cases of truncus arteriosus persistens, 8 cases of total and 10 cases of partial abnormal pulmonary venous drainage, 14 cases of hypoplastic right heart and 6 cases of left heart syndrome, 9 cases of pulmonary artery atresia with ventricular septal defect, 2 cases of plysplenia and 1 case of plenia syndrome. Nineteen cases of instructure cardiac anomalies including 16 cases of heart tumor and 3 cases of endocardial ifbroelastosis. Nine cases were missed diagnosis and 7 cases were misdiagnosis. A total of 136 cases couldn′t be cured with an unfavorable outcome. Nighty three cases with severe FCMH could be cured. Fifty four cases needed emergent treatment postnatal, and 146 cases with mild abnormality.ConclusionsFetal congenital malformation of heart diagnosed by antenatal echocardiography is valuable for guiding the clinical decision in prevetion and treatment it can also reduce perinatal mortality with congenital malformation of heart.
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Objective To investigate the application potentiality of dynamic three-dimensional contrast-enhanced ultrasound (3D-CEUS) in showing vascular patterns of hepatic tumors.Methods Total of 65 hepatic tumors were examined with two-dimensional contrast-enhanced ultrasound (2D-CEUS) and dynamic 3D-CEUS and make statistical comparison between two imaging modes in aspects of enhancement patterns,spatial relationships of tumors and vascularity of different hepatic tumors.Results Dynamic 3D-CEUS showed the same enhancement patterns with 2D-CEUS.However,Dynamic 3D-CEUS was superior to 2D-CEUS in the display of spatial relationships of hepatic tumors and vascularity(P ＜0.05).The vascularity between benign and malignant hepatic tumors was statistically significant (P ＜ 0.05).Conclusions Dynamic 3D-CEUS is a useful technique in the differential diagnosis of hepatic tumors as well as 2D-CEUS,and dynamic 3D-CEUS displays the spatial relationship of hepatic tumors and vascularity more visually and comprehensively,which provides additional beneficial information for the diagnosis and therapy of hepatic tumors.
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Evaluating the volume of liver is very important to diagnose and cure some liver diseases. We have proposed a method in which ultrasound liver image and 3D standard liver model are combined to estimate the liver volume. The key to estimate liver volume lies in the accuracy of image registration between ultrasound liver curve and corresponding 3D liver model. Because the ultrasound liver curve and 3D model outline did not have the same scale, we used scale invariant signature based on the integral of curvature (SISIC) to carry out the curve matching. This method is not affected by the different scales between the two curves, and the results indicated that the proposed method implements a good performance.
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Humanos , Algoritmos , Interpretação de Imagem Assistida por Computador , Métodos , Imageamento Tridimensional , Métodos , Fígado , Diagnóstico por Imagem , Tamanho do Órgão , Reconhecimento Automatizado de Padrão , Métodos , UltrassonografiaRESUMO
To explore the clinical value of contrast-enhanced ultrasound (CEUS) in differentiating benign and malignant focal liver lesions (FLLs) with SonoVue, CEUS was used to examine 113 pa- tients with focal liver lesions (FLLs) in our hospital during July 2005 to December 2006. All the pa- tients underwent contrast-enhanced CT (CECT) or contrast-enhanced MRI(CEMRI). Except for pa- tients with focal fatty sparings (n=18) and with hemangiomas (n=8), all the patients were confirmed by operation or ultrasonic-guided liver puncture biopsy. A sulfur hexafluoride gas-based contrast agent was used with a MI of 0.15 to 0.17. Forty-eight cases of malignant FLLs, including 30 hepato- cellular carcinomas (HCCs), 2 cholangiocarcinomas and 16 metastatic tumors, were detected. Sev- enty-eight cases of benign FLLs, including 33 hemangiomas, 9 focal nodular hyperplasias (FNHs), 19 focal fatty sparings, 5 abscesses, 7 regenerative nodules and 2 inflammatory pseudo-tumor, were in- volved. The contrast pattern of benign and malignant FLLs was quite different. CEUS has higher specificity and sensitivity than conventional ultrasound in differentiating benign and malignant FLLs.
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To explore the clinical value of contrast-enhanced ultrasound (CEUS) in differentiating benign and malignant focal liver lesions (FLLs) with SonoVue, CEUS was used to examine 113 patients with focal liver lesions (FLLs) in our hospital during July 2005 to December 2006. All the patients underwent contrast-enhanced CT (CECT) or contrast-enhanced MRI (CEMRI). Except for patients with focal fatty sparings (n=18) and with hemangiomas (n=8), all the patients were confirmed by operation or ultrasonic-guided liver puncture biopsy. A sulfur hexafluoride gas-based contrast agent was used with a MI of 0.15 to 0.17. Forty-eight cases of malignant FLLs, including 30 hepatocellular carcinomas (HCCs), 2 cholangiocarcinomas and 16 metastatic tumors, were detected. Seventy-eight cases of benign FLLs, including 33 hemangiomas, 9 focal nodular hyperplasias (FNHs), 19 focal fatty sparings, 5 abscesses, 7 regenerative nodules and 2 inflammatory pseudo-tumor, were involved. The contrast pattern of benign and malignant FLLs was quite different. CEUS has higher specificity and sensitivity than conventional ultrasound in differentiating benign and malignant FLLs.
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Adulto Jovem , Carcinoma Hepatocelular/diagnóstico por imagem , Meios de Contraste , Diagnóstico Diferencial , Hemangioma/ultraestrutura , Aumento da Imagem/métodos , Hepatopatias/diagnóstico por imagem , Neoplasias Hepáticas/ultraestrutura , Imageamento por Ressonância Magnética , Sensibilidade e EspecificidadeRESUMO
<p><b>OBJECTIVE</b>To evaluate applicability of power Doppler sonography (PDS) in differential diagnosis of small hepatocellular carcinoma (SHCC) and adenomatous hyperplastic nodule (AHN).</p><p><b>METHODS</b>Twenty-two cases of SHCC and 15 cases of AHN were investigated by PDS and the findings were compared with those of digital subtraction angiography (DSA).</p><p><b>RESULTS</b>The rates of arterial and portal flow in an afferent tumor vessel were 86.4% and 40.9% in SHCCs, respectively. The rate of portal flow in an afferent tumor vessel was 60.0% in AHNs, while no arterial flow was detected (P < 0.01). In addition, PDS revealed a constant flow in an efferent tumor vessel (50.0%) continuing to a portal branch in 10 (45.5%) of the 22 SHCCs cases to a hepatic vein in 1 (4.5%) of the 22 SHCCs, but to nothing else in the AHNs (P < 0.01).</p><p><b>CONCLUSIONS</b>Power Doppler sonography is of value in distinguishing SHCC from AHN, and arterial afferent tumor vessels from constant flow efferent tumor vessels at PDS.</p>