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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 To investigate the application of contrast-enhanced ultrasonograhy CEUS in the early assessment of antiangiogenic treatment in metastatic colorectal cancer Methods Among 41 colorectal cancer patients with liver metastases enrolled in this study 25 patients received treatment of antiangiogenic treatment bevacizumab combined with chemotherapy BV group and 16 patients received chemotherapy only non-BV group To assess the treatment responses in the liver lesions between and within these two groups CEUS scans were performed before the treatment T0 or??baseline on the day 2 T1 and on the day 7 T2 after the treatment The percentage differences were evaluated according to the CEUS quantitative parameters such as 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 and time to peak TTP Results On T1 both the RT and MTT increased within the BV group and decrease within the non-BV group when compared with their own baselines the differences were statistically significant P 0 05 Conclusions CEUS can be used to assess the treatment response in liver metastatic patients with colorectal cancer by monitoring the change of the tumor perfusion before and after the treatment.
RESUMO
Objective To study the utility of acute gastrointestinal injury (AGI) grading system in the strategy of diagnosis and treatment of severe acute pancreatitis (SAP) in patients for the guidance of nutritional support.Methods Forty-five patients with SAP admitted to the ICU from January 2012 to December 2013 were enrolled for study.The diagnosis of SAP was made as per the 2013 Chinese guideline of dliagnosis and treatment of acute pancreatitis.The patients with aged ＜ 18 years,length of hospital stay ＜72 h,and those included in other experimental study were excluded.The patients were divided into two groups:AGI group (n =24) and control group (n =21).There were no statistically significant differences in age,gender,APACHE Ⅱ between two groups (P ＞ 0.05).The length of hospital stay,in-hospital mortality,the incidence of complications such as infection,the time of starting enteral nutrition (EN) and reaching caloric goal were compared between the two groups.The t test or Mann-Whitney U test was used for continuous variables and x2 test or Fisher exact test was used for categorical variables,and P ＜ 0.05 was considered statistically significant.Results (1) Between two groups,there were statistically significant differences in the time of starting EN (2.0 d vs.5.7 d,Z =-4.149,P ＜0.01) and reaching caloric goal (5.5 d vs.10.4 d,Z =-3.392,P =0.001).(2) Between two groups,there were statistically significant differences in the incidence of pneumonia (25％ vs.57.14％,P =0.028 1) and catheterrelated infection (0％ vs.23.81％,P =0.039 4).(3) Between two groups,there was no statistically significant difference in in-hospital mortality (16.67％ vs.33.33％,P =0.194 3).In addition,there was significant difference in length of hospital stay between two groups (23.13 ± 10.58) d vs.(31.10 ± 15.33) d,P =0.046.Conclusions The diagnosis and treatment strategy based on AGI grading system is associated with earlier initiation of EN and reaching caloric goal,and partly reduces the incidence of infections and shortens the length of hospital stay,in the meantime,provides guidance for the rationale of nutritional support in the patients with SAP.