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Objective To explore the diagnostic value of parametric imaging of CEUS in different cervical lymphatic diseases.Methods One hundred eleven patients diagnosed with cervical lymphadenopathy were included.All of the patients underwent parametric imaging of CEUS.According to the pathological results,all patients were divided into reactive hyperplasia group,tuberculosis group,metastasis group and lymphoma group.The features of perfusion phases (perfusion during the artery phase,or perfusion during the artery and parenchymal phase) and perfusion uniformity (homogeneous perfusion or heterogeneous perfusion) were compared among four groups.According to the pathological results,the reactive hyperplasia group and the tuberculosis group were merged into a benign group,and the metastasis group and the lymphoma group were merged into a malignant group.Then,the artery perfusion phase was regarded as benign,and the artery and parenchymal perfusion phase was regarded as malignant.The consistency between parametric imaging of CEUS and the pathological results was compared in two groups.Results The difference of perfusion phase and perfusion uniformity within the four groups had a statistical significance (all P＜0.05).The differences of perfusion phase between the reactive hyperplasia group and the metastasis group,the reactive hyperplasia group and the lymphoma group,the tuberculosis group and the metastasis group were statistical significant respectively (all P＜0.008).The differences of perfusion uniformity between the reactive hyperplasia group and the tuberculosis group,the reactive hyperplasia group and the lymphoma group,the lymphoma group and the tuberculosis group,the lymphoma group and the metastasis group were statistical significant respectively (all P＜0.008).The perfusion phase between the benign group and the malignant group had a statistical significance (P＜0.005),but the perfusion uniformity had no statistical significance in two groups.The consistency was good between the parametric imaging and the pathological results.Conclusion The parametric imaging of CEUS can offer valuable diagnostic information for the cervical lymph nodes underdetermined by conventional ultrasound.
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PURPOSE: The purpose of this study is to investigate the correlations of various kinetic parameters derived from the time intensity curve in a xenograft mouse model injected with a prostate cancer model (PC-3 and LNCaP) using an ultrasound contrast agent with histopathologic parameters. MATERIALS AND METHODS: Twenty nude mice were injected with human prostate cancer cells (15 PC-3 and five LNCaP) on their hind limbs. A bolus of 500 microL (1 x 10(8) microbubbles) of second-generation US contrast agent (SonoVue) was injected into the retroorbital vein. The region of interest was drawn over the entire tumor. The time intensity curve was acquired and then fitted to a gamma variate function. The maximal intensity (A), time to peak (Tp), maximal wash-in rate (washin), washout rate (washout), area under the curve up to 50 sec (AUC50), area under the ascending slope (AUC(in)), and area under the descending slope (AUC(out)) were derived from the parameters of the gamma variate fit. Immunohistochemical staining for VEGF and CD31 was performed. Tumor volume, the area percentage of VEGF stained in a field, and the count of CD31 (microvessel density, MVD) positive vessels showed correlation with the parameters from the time intensity curve. RESULTS: No significant differences were observed between the kinetic and histopathological parameters from each group. MVD showed positive correlation with A (r=0.625, p=0.003), washin (r=0.462, p=0.040), AUC50 (r=0.604, p=0.005), and AUC(out) (r=0.587, p=0.007). Positive correlations were also observed between tumor volume and AUC50 (r=0.481, p=0.032), washin (r=0.662, p=0.001), and AUC(out) (r=0.547, p=0.012). Washout showed negative correlations with MVD (r=-0.454, p=0.044) and tumor volume (r=-0.464, p=0.039). The area percentage of VEGF did not show any correlation with calculated data from the curve. CONCLUSION: MVD showed correlations with several of the kinetic parameters. CE-US has the potential for prediction of tumor vascularity in a prostate cancer animal model.