A New Method for Discriminating between Bronchial and Pulmonary Arterial Phases using Contrast-Enhanced Ultrasound.

This study aimed to explore the value of a real-time comparative observation method using contrast-enhanced ultrasound (CEUS) for discriminating between bronchial and pulmonary arterial phases in diagnosing lung diseases. Forty-nine patients with 50 pulmonary lesions (45 peripheral lesions and five central lesions with obstructive atelectasis, including 36 malignant tumors, five tuberculomas, four inflammatory pseudotumors and five pneumonia lesions) detected via computed tomography and visible on ultrasonography were enrolled in this study. The arterial phases were determined by comparing contrast agent arrival time (AT) in the peripheral lung lesion with that in adjacent lung tissue, referred to as a real-time comparative observation method. Detection rates of this observation method were 100% (50/50) for pulmonary arterial phase and 88% (44/50) for bronchial arterial phase. Using the instrument's built-in graphing and analysis software, a time-intensity curve was constructed based on a chosen region of interest within the lesion where enhancement was the most obvious. Commonly used perfusion indicators in CEUS, such as AT, time-to-peak and peak intensity, were obtained from the time-intensity curve. Percutaneous puncture biopsies were performed under ultrasound guidance, and specimens of all 50 lesions were examined pathologically. AT was significantly shorter in patients with pneumonia than in those with malignant tumors or chronic inflammation (p < 0.05), whereas no difference was seen between those with malignant tumors and those with chronic inflammation. No significant differences in time-to-peak or peak intensity were seen among those with various lung diseases (p > 0.05). This is the first description of a real-time comparative observation method using CEUS for determining the arterial phases in the lungs. This method is accurate, simple to perform and provides a direct display. It is expected to become a practical and feasible tool for diagnosing lung diseases.

Diagnositic value of trascranial sonography in detection of Parkinson disease / 中华医学超声杂志（电子版）

Objective To evaluate the clinical value of trascranial sonography (TCS) in measuring hyperechogenic substantia nigra ( SN) area and area ratio of SN to midbrain ( S/M) for the diagnosis of Parkinson′s disease( PD).Methods A total of 109 PD patients ( PD group) and 115 normal controls (control group) underwent TCS.The area of midbrain and SN and the area ratio of S/M were measured and compared between PD group and control group .Statistical analysis of the two parameters in predicting PD was performed with receive operating characteristic ( ROC) curves.The sensitivity and specificity of each parameter and their combination were calculated .Results The hyperechogenic SN area and S/M were (0.34 ±0.27)cm 2 and (12.15 ±4.57)%in PD group,whereas (0.14 ±0.08)cm 2 and (6.37 ±3.30)%in control group respectively .The difference between the two groups was statistically significant (t=82.68, 100.83,both P7.52%,the sensitivity was 80.4%and the specificity was 78.6%.Conclusions TCS is a fast, convenient,effective and useful tool for screening PD .The combination of the SN area and S/M provided the best diagnostic parameters.