Enhanced Transrectal Ultrasound, Real-Time Sonoelastography, and Contrast-Enhanced Transrectal Ultrasound in Heavily Prescreened Chinese Men With Naive and Repetitive Biopsy: A Comparison of Detection Rate of Prostate Cancer Per Man and Per Lesion.

ABSTRACT: Multiparametric magnetic resonance imaging and targeted biopsy have been widely accepted as the most accurate technique to detect localize prostate cancer. It is a time-consuming and expensive option and may not be widely available in China, making ultrasound the first choice for the detection of prostate cancer. In this current retrospective study, the diagnostic values of enhanced transrectal ultrasound, contrast-enhanced transrectal ultrasound, and real-time sonoelastography were evaluated. Symptomatic 315 men older than 40 years with prostate-specific antigen level greater than 4.0 ng/mL, with abnormal digital rectal examinations, and with suspicious lesions for prostate cancer under enhanced transrectal ultrasound included in the study. Enhanced transrectal ultrasound was suspicious in all 315 men, with 189 of 315 men with prostate cancer according to the prostate biopsy report. Sonoelastography was suspicious in 294 of 315 men, with 166 of 315 men with prostate cancer according to the prostate biopsy report. Contrast-enhanced transrectal ultrasound was suspicious in 221 of 315 men, with 159 of 315 men with prostate cancer according to the prostate biopsy report. Real-time sonoelastography alone and contrast-enhanced transrectal ultrasound alone were missed in 27 (11%) and 39 (15%) lesions to report cancer through biopsies. Working area for enhanced transrectal ultrasound, real-time sonoelastography, and contrast-enhanced transrectal ultrasound for detection of prostate cancer were 0 to 1 diagnostic confidence, 0.11 to 0.895 diagnostic confidence, and 0.39 to 0.63 diagnostic confidence respectively. Real-time sonoelastography and contrast-enhanced transrectal ultrasound may improve the detection of prostate cancer in men with suspicious prostate lesions under enhanced transrectal ultrasound (Level of Evidence: III; Technical Efficacy Stage: 2).

Changes in Ocular Hemodynamics after Carotid Artery Angioplasty and Stenting (CAAS) in Patients with Different Severity of Ocular Ischemic Syndrome.

PURPOSE: To evaluate the effects of carotid artery angioplasty and stenting (CAAS) on patients who were diagnosed with ocular ischemic syndrome (OIS). METHODS: Sixty-four eyes of 64 OIS patients with ipsilateral internal carotid artery stenosis ≥70% were included in the study. The study eyes were divided into two groups according to the presence of iris neovascularization: NVI-absent group and NVI-present group, with 32 eyes, respectively. All patients received ocular treatment modality according to the presence of non-perfusion area (pan-retinal photocoagulation) and intraocular pressure (medical treatment included timolol maleate eye drops combined with brinzolamide eye drop; trabeculectomy and cyclophotocoagulation). All patients went through CAAS surgery for treatment of internal carotid artery stenosis. Best-corrected visual acuity (BCVA); intraocular pressure (IOP), slit lamp examination, iris fluorescence angiography, fundus fluorescein angiography and color Doppler ultrasound of the internal carotid artery (ICA), ophthalmic artery (OA), central retinal artery (CRA), and short posterior ciliary arteries (PCA) were performed pre-operatively and 1 month, 3 months, 6 months, and 12 months post-operatively. RESULTS: There was no significant BCVA change postoperatively in the NVI-absent group, while postoperative BCVA in the INV-present group decreased significantly. There was no significant BCVA difference at pre-operative and 1month post-operative follow-up between the two groups. However, post-operative BCVA of NVI-present group starting from 3-months follow-up was significantly worse than NVI-absent group. Arm-retinal artery circulation time and arteriovenous circulation time decreased significantly in NVI-absent group, while showed no statistical difference in NVI-present group during the 12-months follow-up. Postoperative peak systolic velocity (PSV) of the ophthalmic artery, the central retinal artery, and short posterior ciliary artery showed significant increases at 1 month, 3 months, 6 months and 12 months follow-up in both groups. CONCLUSION: CAAS can greatly improve ocular blood in OIS patients with and without iris neovascularization. However, CAAS improved BCVA only in patients without iris neovascularization.

Clinical Values of Studying Kidney Elasticity with Virtual Touch Quantification in Gestational Hypertension Patients.

BACKGROUND The aim of this study was to investigate the differences in shear wave velocity (SWV) in renal cortex, renal medulla, and renal sinuses between gestational hypertension and normal pregnant women. MATERIAL AND METHODS Ninety patients with gestational hypertension and 30 women with normal pregnancy were enrolled in this study. Kidney biopsy was performed within 6 weeks to 3 months postpartum to determine the pathological nature of renal injury. According to the classification criteria for gestational hypertension, the patients were divided into 3 groups. Gestational hypertension only patients were classified as Group A; patients with mild preeclampsia as group B; patients with severe preeclampsia as group C; normal pregnant women as a control group. Virtual Touch Quantification technique was used to measure renal shear wave velocity; blood pressure, urine analysis, and renal function were also tested. RESULTS There was no difference in renal function between patients in group A and the control group (p>0.05), but there was a significant difference in renal function among patients in group A, B, and C, and there was a significant difference in renal function between patients in group B and C versus control (p<0.05 for all comparisons). There was also a significant difference in SWV values of the renal cortex, renal medulla, and renal sinus between patients in group A, B, and C versus control group (p<0.05). CONCLUSIONS The SWV values of the renal cortex, renal medulla, and renal sinus in patients with gestational hypertension were smaller than those of normal pregnant women, and the more severe the kidney injury, the smaller the SWV value.

[Color Doppler ultrasonic measurements of normal mesenteric lymph nodes in healthy children].

OBJECTIVE: To assess the value of color Doppler ultrasound in evaluating the mesenteric lymph nodes in healthy children. METHODS: The mesenteric lymph nodes were examined with color Doppler ultrasonography for 730 randomly selected healthy children under 14 years of age, including 410 boys and 298 girls who did not report any recent medical conditions. RESULTS: Abdominal lymph node detection rate was higher in boys than in girls. Abdominal lymph nodes were detected most often in children between the ages of 1 and 4 years, and the lymph node size decreased gradually with age. CONCLUSION: Color Doppler ultrasonography is valuable for evaluating abdominal lymph nodes in children.

[Enlarged mesenteric lymph nodes in children: a clinical analysis with ultrasonography and the implications].

OBJECTIVE: To compare the enlarged mesenteric lymph nodes in healthy children with those children with mesenteric lymphadenitis. METHODS: According to the diagnostic criteria defining lymph node enlargement as a 5-mm enlargement or greater in the short diameter, 137 healthy children and 148 children with mesenteric lymphadenitis were retrospectively analyzed for mesenteric lymph node enlargement based on the ultrasonographic data. RESULTS: The distribution of enlarged mesenteric lymph nodes was detected in the right lower quadrant (RLQ) in 46.3%, in the para-aortic areas in 19.2%, and in the left lower quadrant (LLQ) in 13.6% of the children. The clusters of lymph nodes between the two groups showed no significant difference in the distribution, age, L/W, longitudinal diameter or clusters, only the short diameter differed significantly between them. CONCLUSION: Enlarged mesenteric lymph nodes are present in many healthy children, which does not necessarily suggests any abnormalities. The mesenteric lymph nodes increase with the age until 6 years and then decrease. The lymph nodes with a short diameter larger than 8 mm may indicate the condition of mesenteric lymphadenitis.

[The analysis of fundus fluorescein angiography, indocyanine green angiography and hemodynamics of retrobulbar blood vessels in central serous chorioretinopathy].

OBJECTIVE: To analyze the characteristics of the retrobulbar blood vessels' hemodynamics changes and the choroidal circulation disorder, and to observe the relations between retinal pigment epithelium's (RPE) pathological changes and them. METHODS: It was a case control study. For 57 (57 affected eyes and 57 contralateral eyes) unilateral eye affected patients and 25 (50 eyes) normal health adults, we examined ophthalmic arteries (OA), posterior ciliary arteries (PCA) and short posterior ciliary arteries (SPCA) by color Doppler flow Imaging (CDFI), and recorded the peak systolic velocities (PSV), end diastolic velocities (EDV) and resistance indexes (RI) of them. We compared each hemodynamic parameter of the normal eyes with it of the affected eyes and contralateral eyes in patients group respectively, and contrasted them between affected eyes and contralateral eyes of the patients. Fundus fluorescein angiography (FFA) and indocyanine green angiography (ICGA) were performed simultaneously on 57 patients with Heidelberg retina angiography, and the images were analyzed in contrast. We used SPSS 12.0 statistics software was used in the study. To the PSV, EDV and RI of the OA, PCA and SPCA in affected eyes and contralateral eyes of the patients, we used paired t-test for the same sample to compare their hemodynamic parameters; to compare normal health adults' eyes with the affected eyes and the contralateral eyes of patients group respectively, we used two-group t-test. When the P-value was less than 0.05, there was a statistical significance. RESULTS: There was a more significant decrease of the hemodynamic parameters in both PSVs and EDVs of temporal PCAs (PSV: t = 3.044, P = 0.005; EDV: t = 3.731, P = 0.001) and temporal SPCAs (PSV: t = 2.822, P = 0.008; EDV: t = 3.194, P = 0.003) compared the patients group's affected eyes with normal health adults group eyes, there was a more significant decrease of them of temporal PCAs (PSV: t = 3.219, P = 0.003; EDV: t = 3.807, P = 0.001) and temporal SPCAs (PSV: t = 3.931, P = 0.000, EDV: t = 3.145, P = 0.003) compared the patients group's contralateral eyes with normal health adults group eyes, and there was a statistical significance of them (P < 0.05). There was no difference in hemodynamic parameters of both PSVs and EDVs of temporal PCAs (PSV: t = 0.608, P = 0.548; EDV: t = 0.122, P = 0.904) and temporal SPCAs (PSV: t = 0.730, P = 0.470; EDV: t = 0.109, P = 0.914) between affected eyes and contralateral eyes of the patients, and there was no statistical significance of them (P > 0.05). The results of FFA and ICGA showed that all the RPE's leaks of 57 affected eyes appeared at the hypofluorescent regions of relative choroids; 52 cases of 57 affected eyes were followed by choroidal vessels dilatation at the early hypofluorescent regions, and appeared hyperfluorescence leakages in the late phase images; At the all regions of RPE's transmitted fluorescences of affected eyes and contralateral eyes, the corresponding choroids showed hyperfluorescence in the late phase images in ICGA; There were no RPE's transmitted fluorescences at the regions of 20 affected eyes and 16 contralateral eyes in FFA, which showed hyperfluoresceince leakages in the late phase images of choroids in ICGA. CONCLUSIONS: CSC is possibly a bilateral disease associated with systemic pathologic conditions. Hypoperfusion and ischemia are the basal characteristics of retrobulbar blood vessels' circulation disorder and choroidal ultracirculation disorder. The damage of RPE is following to the choroidal circulation disorder.