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Objective:To investigate the correlation of hepatocellular carcinoma (HCC) classified by contrast-enhanced ultrasound (CEUS) Liver Imaging Data and Report System (LI-RADS) with differentiation degree and Ki-67 index.Methods:A multicenter, retrospective study was conducted.The clinical and CEUS imaging data of 208 patients with 208 HCC lesions from December 2017 to December 2020 in China CEUS database were included and analyzed. According to the CEUS LI-RADS version 2017 proposed by the American College of Radiology, the HCC was classified. The diagnosis and pathological information of all lesions were confirmed by pathology. The differentiation degree of HCC and the distribution of Ki-67 index in different LI-RADS categories were evaluated, and their correlation was analyzed.Results:The degree of differentiation and Ki-67 index among HCC of different CEUS LI-RADS were statistically significant ( P<0.001, P=0.009). LI-RADS M HCC was more likely to be poorly differentiated and showed a higher Ki-67 index. The category of LI-RADS was positively correlated with the degree of tumor differentiation (tau-b=-0.250, P<0.001) and the Ki-67 index (tau-b=0.178, P=0.002), that is, the higher the category of LI-RADS, the lower differentiation degree and the higher the Ki-67. Conclusions:The CEUS LI-RADS classification of HCC is correlating with the degree of differentiation and Ki-67 index.
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Objective To confirm whether strain ratio should be added after evaluation of lesions with 5-point elasticity scoring for differentiating breast lesions on ultrasonic elastography(UE).Methods Eight hundred and forty-six consecutive female patients with 1 071 breast lesions were recruited into a multicenter retrospective study,which involved 8 centers across China.All the patients underwent the UE procedure and the strain ratios were calculated.The sensitivity,specificity,accuracy,PPV and NPV were calculated for each of the two evaluation systems and the areas under the ROC curve were compared.Results The strain ratios of 559 benign lesions(2.7±1.4)and 512 malignant lesions(8.1±5.9)were significantly different (P<0.001).When the cutoff point was 3.03,strain ratio method had 81.6% sensitivity,89.7% specificity,81.7% accuracy,80.2% PPV and 84.2% NPV.The areas under the ROC curve with the strain ratio method and 5-point scoring method were 0.865 and 0.862,respectively(P =0.622).For the lesions with elasticity score 3 and 4,the areas under the ROC curve of the two Methods were 0.71 1 and 0.629, respectively(P = 0.020).Conclusions Although the two UE Methods have similar diagnostic performance,separate calculation of the strain ratios seems compulsory,especially for the lesions with elasticity score 3 and 4.
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Objective To compare the diagnostic efficiency of superb microvascular imaging (SMI) and contrast-enhanced ultrasonographic microvascular imaging (MVI) for differentiating breast lesions.Methods One hundred and sixteen patients with 116 breast lesions were first examined by grayscale ultrasound.Then SMI and MVI were performed on all patients.Microvascular architectures of breast lesions were depicted by both methods.The lesions were evaluated based on their microvascular architectures.The diagnostic efficacy of both methods were compared.Results The diagnostic sensitivity,specificity,and accuracy of SMI and MVI were 79.24％,90.48 ％,85.35％ and 88.68％,87.30％,87.93％,respectively.The areas under the curve of SMI and MVI were 0.888 and 0.926.The diagnostic values of SMI and MVI were not statistically different (P =0.212).Conclusions SMI can detect tiny vessels and depict microvascular architecture of breast lesions as MVI do,which is beneficial for breast tumor differentiation.The diagnostic efficacy of SMI is almost the same as MVI.
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Purpose To compare the value of contrast-enhanced ultrasound (CEUS), contrast-enhanced CT (CECT) and contrast-enhanced MRI (CEMRI) in the diagnosis of renal space-occupying lesions. Materials and Methods Seventy-eight patients whose 80 kidney space-occupying lesions were conifrmed by traditional ultrasound underwent CEUS examination. Among those patients, 39 patients also underwent CECT, 28 had CEMRI, and 5 had CECT and CEMRI examination together. Taken pathologic findings as gold standard, the value of conventional ultrasound, CEUS, CECT and CEMRI was compared in the diagnosis of renal space-occupying lesions. Results Among 80 renal masses, 57 lesions were malignant and the rest 23 lesions were benign. The diagnostic sensitivity, speciifcity, positive predictive value and negative predictive value were 93.0%, 69.6%, 88.3%, 80.0%for CEUS;those for CECT were 96.4%, 72.7%, 90.0%, 88.9%respectively;and for CEMRI were 86.4%, 66.7%, 90.5%, 57.1%respectively;and the diagnostic value among the three means showed no difference (P>0.05). Conclusion CEUS, CECT and CEMRI are all effective in the diagnosis of renal space-occupying lesions, We may select suitable examination means for patients according to their features. A combination of these techniques provides more information for the diagnosis of renal space-occupying lesions.
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Objective To establish the model and software for quality assessment of fetal nuchal translucency ultrasound image using computer image recognition technology.Methods The proposed approach firstly divided the input image into four sub-image blocks:the nasal bone(NB) area,the nuchal translucency (NT) area,the midbrain area,and the jaw and chest area.For each sub-image block,the algorithm compared the image block with the corresponding area of the standard training image set,and then determined whether the current image block was the qualified one using the the Gabor feature and Bayesian decision.The input ultrasound image was determined to be qualified only if it had four qualified sub-image blocks.Results The difference between our automatic method and the manual screening by experts wasting small,the method obtained Kappa =0.795 and P ＜0.001.Moreover,the efficiency of our method was much higher than the manual screening method.Conclusions Image recognition technology can effectively assist the sonographer to assess the quality of fetal NT of ultrasound image.The proposed approach can reduce the subjectivity and randomness of the manual evaluation of NT image.
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Objective To assess the value of contrast enhanced ultrasound (CEUS) in diagnosing subtypes of postpartum placenta accreta.Methods 31 puerperal clinically diagnosed of postpartum placenta accreta were collected.They were inspected by using CEUS and 2-dimensional color Doppler ultrasound,respectively.The operation was used as a reference.Results Both 2-dimensional color Doppler and CEUS could identify the sizes of residual placenta for the patients,but CEUS showed more explicit boundary for placenta and uterus and the rich/poor blood flow areas in the placenta.Among the 31 patients,7,23 and 1 were classified of accreta,increta and percreta,respectively,by using 2-dimensional color Doppler ultrasound,while 11,16 and 4 were classified of accreta,increta and percreta,respectively,by using CEUS based on the myometrial thickness and contrast agent subsided time.With respect to operation,10 patients were confirmed of accrete,with the other diagnosed of increta and percreta.The misclassification rate of 2-dimensional color Doppler ultrasound was 19.6 ％,while CEUS had only 6.5 ％.CEUS had a good agreement with operation (Kappa =0.859,P ＜ 0.001).Conclusions CEUS has higher accuracy in diagnosing subtypes of postpartum placenta accrete compared with 2-dimensional color Doppler ultrasound.CEUS can increase the accuracy and reliability for diagnosing those who were clinically considered of postpartum placenta accrete,and can provide helpful guidelines for clinical treatment.
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Objective To compare the diagnostic value of sound velocity(SV) and real-time ultrasonic elastography in differentiating benign or malignant of breast lesions.Methods 75 patients with 99 lesions were examined with the zone speed index technique and real-time ultrasonic elastography respectively.Then the SVs of the lesions were calculated and elastography of the lesions were scored with 5-scoring method.The ROC curves were constructed with histology as the golden standard.Results There was significant difference between the SVs of benign and malignant breast lesions(P =0.0001).1561 m/s was the best cufoff point.And the areas under the curves (AUC) of SV and real-time ultrasonic elastography were 0.842 and 0.968,respectively.There was significant difference between the two methods of AUC (P =0.023).The sensitivity,specificity and accuracy for SV were 81.5％,91.7％,88.9％,respectively.There was no significant difference between sensitivity,specificity and accuracy of the two methods(P =1.0,P =0.125,P =0.146).Conclusions Both SV method and real-time ultrasonic elastography are helpful in the evaluation of benign or malignant of breast lesions.
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Objective To explore the application of contrast-enhanced scoring system in the diagnosis of breast tumor.Methods 249 patients with 260 lesions were examined by elastography and contrastenhanced ultrasound before surgery.All the lesions were scored according to the two different methods.Pathological results were made the golden criteria.The diagnosis accuracy of the two methods were compared.Results There were 145 benign and 115 malignant tumors.The diagnosis accuracy,specificity and sensibility of elastography were 85.0％,88.3％,80.1 ％ respectively.The critical value of contrastenhanced ultrasound was between 3 and 4.The diagnosis accuracy,specificity and sensibility of contrastenhanced ultrasound were 88.9％,87.6％,90.4％ respectively.Area under ROC curve of the two methods were 0.901 and 0.910,the difference was not statistically significant.Conclusions Contrast-enhanced ultrasound 5-point scoring system was an initial quantitative criterion for breast tumor diagnosis.The diagnosis accuracy was parallel to that of elastography.
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Objective To evaluate the diagnostic value of conventional ultrasound and ultrasonic elastography (UE) in differentiating benign and malignant hepatic lesions.Methods One hundred and forty-five patients with 159 hepatic tumors were included in the study.Conventional ultrasound scan and UE were performed on each patient.Pathological results were as the golden standard.The diagnostic performance of the 2 methods were evaluated with receiver operating characteristic (ROC) curves and the interobserver agreements were analysed.Results A better interobserver agreement was achieved in UE (κ =0.325 at conventional ultrasound versus κ =0.782 at UE).The area under ROC curve of conventional ultrasound,ultrasonic elastography and the combination of both methods were 0.76,0.77 and 0.87,respectively.After the combination of the 2 methods,the sensitivity and accuracy could be enhanced significantly ( P ＜0.05).Conclusions Conventional ultrasound combined with UE may be more helpful in differentiating malignant from benign hepatic tumors.
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Objective To investigate the value of ultrasonic elastography(UE) in diagnosing breast small masses (diameter≤10 mm). Methods The static sonograms of conventional ultrasound(US) and UE of the 274 breast small lesions which pathologically proved were reviewed. Images were assigned according to the B1-RADS criteria for US. The elastographic images were evaluated using improved 5-scoring system.Pathology was followed up as diagnostic criteria. The diagnostic performance of the 2 methods was evaluated with receiver operating characteristic curve(ROC). Results The areas under the ROC curve of the two modalities were 0. 891 (UE) and 0.742 (BI-RADS), respectively. The difference between them was significant. Conclusions UE is helpful in differentiating between malignant and benign breast small lesions.
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Objective To explore the value of improved elasticity scores in differentiating malignant and benign breast lesions. Methods A prospective study was done in 394 patients with 508 breast lesions confirmed by pathology and the elastographic images of the lesions were evaluated by using old and improved elasticity scores respectively. Results The elastographic images of the lesions could be evaluated and classified in all patients by improved elasticity scores but could not be evaluated and classified in 82 lesions by old elasticity scores. The accuracy of ultrasonic elastography for diagnosing benign and malignant breast lesions was 88.8% and 78.1%, respectively by old elasticity scores and improved elasticity scores. Conclusions The elastographic images of breast lesions were accurately evaluated by using improved elasticity scores, and the use of improved elasticity scores is helpful to reduce the biopsy which is not necessary.
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Objective To investigate the diagnostic value of strain ratio for differentiation breast benign and malignant solid lesions. Methods Two hundred and sixty-nine patients with 377 lesions (278 benign, 99 malignant) were included in the study. Ultrasonography found the lesions, then ultrasonic elastography got the strain images. By the strain ratio measure method equipped with the ultrasonic machine, strain ratio of the lesion was calculated. Compared with the pathologic diagnosis, the cut-off point of strain ratio was determined with receiver operating characteristic curve. Results There was significant difference between the strain ratio of benign and malignant lesions( P <0. 05). The cut off point of strain ratio was determined as 3. 08, Youden's index was 0. 88,sensitivity was 97. 38% ,and specificity was 91. 33%. Conclusions Strain ratio could be used to differentiate benign and malignant lesions in breast and would be a new diagnostic standard in future.
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Objective To analyze the value of color Doppler ultrasound in the diagnosis of lower extremity arterial disease in patients with type 2 diabetes mellitus.Methods A total of 800 patients with type 2 diabetes mellitus underwent color Doppler ultrasonography to examine anterior tibial artery (ATA),dorsalis pedis artery (DPA) and posterior tibial artery (PTA).Ultrasonic findings including vascular diameter,stenosis ratio and hemodynamics of lower extremity arterial disease were analyzed retrospectively.Results ATA and DPA had more plaques and stenosis than PTA.There was no statistical difference of vascular diameter,stenosis ratio and hemodynamics between left and right lower extremity artery in patients with type 2 diabetes mellitus including diabetic foot.Conclusion Color Doppler ultrasound is a useful method in the diagnosis of lower extremity arterial disease in patients with type 2 diabetes mellitus,providing information of stenosis ratio and hemodynamics of lower extremity artery,so as contributing to the clinical therapy of this disease.
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Objective To evaluate the application of the binary Logistic regression model to analyze ultrasonographie indexes of the solid breast tumors. Methods The indexes of two dimensional gray scale ultrasonography,two dimensional color Doppler flow imaging,three dimensional gray scale ultrasonography, three dimensional color Doppler flow imaging and ultrasonic elastography were evaluated in 151 breast lesions confirmed by surgical pathology. A Logistic regression model for predicting breast rnalignaney on the basis of ultrasonographic indexes was obtained. A receiver operating characteristic (ROC) curve was used to assess the performance of the Logistic regression model. Results Six ultrasonic indexes were finally entering the Logistic regression model. They were elasticity score, shape,internal echo, RI, enhancement of posterior acoustic alteration and the converging pattern in the coronal plane. The area under the ROC curve was 0. 996. The percentage correct of prediction was 97.35 %. Conclusions The multivariate analysis model of binary Logistic regression can describe and analyze the process of differential diagnosis of malignant and benign solid breast tumors by ultrasonography and can select out the valuable indexes of differential diagnosis.
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Objective To investigate the value of contrast-enhanced coded harmonic angio (CHA) in evaluating the therapeutic response to combinational treatment of transcatheter arterial embolization (TAE) and radiofrequency ablation (RFA) in hepatocellular carcinoma (HCC). Methods Nineteen patients with 28 HCCs underwent percutaneous RFA in one week after TAE. The therapeutic response was assessed by contrast-enhanced CHA and three-phase dynamic CT in one week before and after the treatment. Results After TAE and RFA, no enhancement was demonstrated in 20 HCCs (71.4%) on contrast-enhanced CHA, which were considered to be completely treated. of the 20 HCCs, no blood signal was identified in 18 on dynamic CT and the conclusion cannot be drawn in the other 2 nodules due to the retention of iodized oil. On contrast-enhanced CHA, enhanced blood signals or tumor stains were identified in the remaining eight HCCs, however, four of the eight could not be evaluated on dynamic CT because of the retention of iodized oil. Conclusions Contrast-enhanced ultrasound can effectively evaluate the treatment response of HCC in combinational therapies of TAE and RFA. It is superior to three-phase dynamic CT for no influence by retention of iodized oil.
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To evaluate the role of color Doppler flow imaging in the portal vein chemotherapy by ultrasound guided percutaneous transhepatic portal injection, the blood supply of liver tumor and portal hemodynamics were studied in 15 patients with primary hepatic carcinoma and one patient with secondary hepatic carcinoma. The continuous wave in the lesion and forward continuous wave in the portal vein seen by pulsed Doppler in nine cases, were indications for this therapeutic method. The distribution of the drugs in the liver could be observed by color Doppler flow imaging when injection was being done. The therapeutic efficacy of portal vein chemotherapy in liver tumor may be evaluated by color Doppler folw imaging and puncture biopsy.