Diagnosis and treatment of submucous myoma of the uterus with interventional ultrasound.

The value of interventional ultrasound in the diagnosis and treatment of submucous myoma of the uterus was assessed to study the ultrasonographic features of modified sonohysterography for submucous polyp of uterus. A total of 25 patients diagnosed preliminarily as submucous myoma of the uterus via conventional ultrasound examination from June 2014 to December 2016 were enrolled in the study. The diagnosis was made via the comprehensive analysis of ultrasound-guided modified SHG, followed by ultrasound-guided needle biopsy and sclerotherapy of tumor. After modified SHG and ultrasound-guided needle biopsy, 96% (24/25) cases were confirmed pathologically as submucous myoma of the uterus. After treatment, the maximum diameter of myoma in patients with submucous myoma of uterus was significantly different, and the volume of myoma was significantly reduced. After treatment, the clinical symptoms of patients with submucous myoma of the uterus were obviously improved compared to before treatment (P<0.05). It was found in the follow-up after treatment that a small number of patients suffered from mild abdominal pain, increased secretion, slight vaginal bleeding, cold sweat, pale complexion, dizziness and other symptoms, which, however, disappeared after treatment for about 1 week. The score of 36 item Short-Form Health Survey Questionnaire of patients with submucous myoma of the uterus was significantly different before and after treatment (P<0.05). Interventional ultrasonography can effectively diagnose the submucous myoma of uterus. The treatment of submucous myoma of uterus with ultrasound-guided intratumor injection of lauromacrogol is characterized by simple operation, which can effectively reduce the tumor diameter and volume, improve the blood flow in patients, reduce the postoperative adverse reactions and alleviate the patient's pain, so it is a new type of minimally invasive treatment method of submucous myoma of the uterus, and it is worthy of clinical promotion and application.

Preoperative ultrasound features as prognostic factors for patients with hepatocellular carcinoma.

PURPOSE: Ultrasound is the most common imaging tool used to scan the tumours of hepatic carcinoma patients. However, very few studies have been performed to evaluate ultrasound imaging features for predicting tumour prognosis. Therefore, the goal of the current study was to evaluate preoperative ultrasound characteristics as prognostic factors that could affect survival rate after liver resection for hepatocellular carcinoma (HCC). MATERIALS AND METHODS: A total of 104 HCC patients who underwent resection were retrospectively reviewed with regard to their clinical data, preoperative ultrasound characteristics, and survival rate. Preoperative ultrasound parameters included cirrhosis, tumour site, size, echo pattern, portal vein thrombosis, intra-tumour blood flow signal, peak systolic velocity (V max), and resistance index (RI). The Kaplan-Meier method was used to calculate survival. Pre-resection prognostic factors were assessed using univariate log-rank test and a multivariate Cox proportional hazards model. RESULTS: The median survival was 37 months. The 1-, 3-, and 5-year disease-free survival (DFS) rates were 78.85, 53.85, and 26.92 %, respectively, and the overall survival (OS) rates at 1, 3, and 5 years were 85.58, 69.23, and 46.15 %, respectively. On univariate analysis, shorter survival was associated with mixed echo pattern, larger tumour size, portal vein thrombus, affluent flow signal, and higher V max. Application of the Cox multivariate proportional hazards model indicated that tumour size and blood flow signal in the tumours were independent prognostic factors. CONCLUSIONS: The overall survival for HCC patients undergoing hepatic resection can be stratified on a sonographic basis of tumour size and intra-nodular vasculature. These prognostic factors may be useful to determine appropriate treatment for HCC patients.

Comparison of the effectiveness and safety of ultrasound- and CT-guided percutaneous radiofrequency ablation of non-operation hepatocellular carcinoma.

To retrospectively compare the effectiveness and safety of ultrasound (US)- and computer tomography (CT)-guided percutaneous radiofrequency ablation (PRFA) in treating patients with non-operation hepatocellular carcinoma (HCC). Forty patients with non-operation HCC who were treated with US-guided PRFA (20 patients with 24 HCC lesions) or CT-guided PRFA (20 patients with 27 HCC lesions) were enrolled in this study. Follow-up was performed with US and CT/MRI. Complete ablation rate, local recurrence rate, and overall survival rate were used to evaluate the efficacy of the two therapeutic choices. The PRFA-related complications including hilar bile duct injury, sepsis, liver failure, renal dysfunction, peritoneal hemorrhage, and skin burn were assessed. The operation time of CT-guided group was significantly longer than that of the US-guided group (P < 0.05). The single ablation times for tumors with similar size showed no significant difference between the two groups (P > 0.05). The differences in complete ablation rate (79.2 vs. 88.9 %, P > 0.05) and local recurrence rate (16.7 vs. 14.8 %, P > 0.05) between US- and CT-guided groups were not statistically significant. In the US-guided group, the 1-, 2-, and 3-year overall survival rates were 85, 74, and 68 %, respectively, while they were 84, 72, and 58 % in the CT-guided group. The differences were not statistically significant (P > 0.05). No severe complications were found in the two groups. Both US- and CT-guided PRFA are safe and effective therapies for patients with HCC when surgical options are precluded.

[Evaluative effect of TVCDS in screening and preoperative phasing endometrial carcinoma].

OBJECTIVE: To examine the evaluative effect of preoperative transvaginal color Doppler sonography (TVCDS) screening and phasing of endometrial carcinoma. METHODS: A total of 713 jeopardized endometrial carcinoma patients were screened by TVCDS. The investigators observed the endometrium form, focus location, size and echo, measured the endometrium thickness, judged the regularity and integrity of edge, the integrity of faint echo halos at the interface between endometrium and muscularis and the blood flow inside focus, examined resistance index and determined endometrial carcinoma as well as muscularis infiltrating extent. According to the FIGO's phasing scheme in 1988, endometrial carcinoma was divided into I, II, III and IV phases so as to compare the results of TVCDS in screening and phasing of endometrial carcinoma with that of operative pathology. RESULTS: One hundred cases were diagnosed as endometrial carcinoma. Among which, 96 were proved by surgical pathology as endometrial carcinoma. The rates of TVCDS screening and phasing coincidence were 96% (96/100) and 94% (94/100) respectively. CONCLUSION: The application of TVCDS may diagnose and stage the cases of endometrial carcinoma. It is a valuable tool for selecting therapeutic regimens and making prognostic evaluations.