Comparison of transcranial color Doppler sonography without and with contrast enhancement for detection and characterization of intracranial aneurysms.

OBJECTIVE: To compare the diagnostic value of transcranial color Doppler sonography (TCCS) with contrast-enhanced transcranial color Doppler sonography (CE-TCCS) for the detection and characterization of intracranial aneurysms. METHODS: Thirty patients highly suspected of having an intracranial aneurysm were imaged using TCCS and CE-TCCS. The ability to detect the aneurysms and determine their size and location accurately was compared with findings from digital subtraction angiography. RESULTS: The overall sensitivity of CE-TCCS was greater than that of TCCS (24/30 versus 20/30, respectively) (p = 0.125), but the difference was not significant. Neither TCCS nor CE-TCCS could detect the three small (≤5 mm diameter) aneurysms. The detection rate for larger aneurysms (5-15 mm diameter, n = 17) was nonsignificantly greater with CE-TCCS (14/17) than with TCCS (11/17) (p = 0.438). Similarly, CE-TCCS detected more large or giant aneurysms (>16 mm diameter) than TCCS (10/10 versus 9/10, respectively) but the difference was not significant (p = 1.000). The benefit of contrast enhancement was identical for aneurysms ≥10 mm or <10 mm in diameter. All (7/7) middle cerebral artery aneurysms were detected by both TCCS and CE-TCCS. CE-TCCS yielded similar or slightly better results than TCCS for all other aneurysm locations. CONCLUSION: CE-TCCS can improve the sensitivity and detection rate of intracranial aneurysms ≥5 mm in size.

Sonography in the 29th Olympic and Paralympic Games: a retrospective analysis.

OBJECTIVE: The purpose of this study was to evaluate the application of sonography at the polyclinic of the Olympic/Paralympic village during the Olympic/Paralympic Games. METHODS: We retrospectively reviewed 759 consecutive patients who underwent sonography at the ultrasound division of the polyclinic in the Olympic/Paralympic village from July 20, 2008, to September 20, 2008. Prevalence of emergency sonography after sports injury and non-sports-related urgent conditions during the games was analyzed. The benefit of sonographic services in large sporting events was discussed. RESULTS: There were 759 patients (484 athletes, 101 coaches, 88 team officials, and 86 volunteers; 462 men and 297 women) in the ultrasound division at the polyclinic. The indications for sonography included abdominal pain (315 cases, 41.50%), muskuloskeletal disorders (228 cases, 30.04%), gynecology related (104 cases, 13.70%), cardiac conditions (49 cases, 6.46%), small parts (29 cases, 3.82%), and vascular problems (34 cases, 4.48%). The rates of positive findings on sonography were 46.03% in the abdomen, 70.17% in musculoskeleton, 41.34% in gynecology, 10.20% in the heart, 75.86% in small parts, and 38.24% in vessels, respectively. CONCLUSION: Sonography plays an important role in the medical services at the polyclinic in the Olympic/Paralympic village. The benefits of sonography in such large sporting events are accuracy, fast result, portability, and noninvasiveness.

Doppler parameters in renal transplant dysfunction: correlations with histopathologic changes.

OBJECTIVES: The aim of this study was to assess the relationship between intrarenal Doppler parameters and histopathologic changes shown on kidney biopsy in renal transplant dysfunction. METHODS: We retrospectively reviewed the records of 113 patients (61 men and 52 women; age range, 22-76 years; mean age ± SD, 50.9 ± 12.7 years) who underwent both transplanted kidney sonography and biopsy from May 1, 2007, to May 31, 2009. Doppler parameters of the interlobar arteries, including the peak systolic velocity (PSV), end-diastolic velocity (EDV), and resistive index (RI), were compared with kidney biopsy findings. According to histopathologic findings, the 113 patients were divided into two groups: 1, interstitial fibrosis/tubular atrophy and vascular/glomerular sclerosis (n = 79); and 2, edematous changes in glomeruli without fibrosis (n = 34). The correlations between Doppler parameters and histopathologic findings were statistically analyzed. RESULTS: There were statistically significant differences in the PSV and EDV of the interlobar arteries between groups 1 and 2. Both the PSV and EDV in group 1 were significantly lower than those in group 2 (P < .001). There was no significant difference in the RI of the interlobar arteries between the two groups (P > .05). There were no significant differences in the PSV, EDV, and RI of the main renal artery between the two groups (all P > .05). CONCLUSIONS: The PSV and EDV of the interlobar artery have statistical correlations with histopathologic types in renal transplant dysfunction. Both the PSV and EDV in interstitial fibrosis/tubular atrophy and vascular/glomerular sclerosis seem lower than those in glomerulopathy without fibrosis. Hence, the PSV and EDV of the interlobar artery may potentially be used as hemodynamic indicators for monitoring the progress of renal transplants.

Intraoperative contrast-enhanced ultrasound for brain tumors.

OBJECTIVE: The purpose of this study was to investigate the feasibility and value of the intraoperative contrast-enhanced ultrasound (CEUS) in resection for brain tumors. MATERIALS AND METHODS: Intraoperative CEUS was performed in 29 patients with brain tumors pre-resection, in whom 9 (of 29) patients underwent second intraoperative CEUS for assessing remained tumor tissue after initial resection. Gray-scale and color-flow images of the brain tumors on both conventional and CEUS were analyzed and compared with the results of surgical pathology. RESULTS: The border of the tumor and remained tumor tissue was more distinguishable from healthy brain on CEUS than that on conventional ultrasound during the operation. Improving definition of the tumor tissue from normal brain with CEUS was demonstrated in all cases. CONCLUSION: Intraoperative CEUS has the potential to be a very useful imaging technique not only in defining the border between the tumor and healthy brain pre resection but also in detecting remained tumor tissues after the initial resection.

Ultrasonography-guided percutaneous microwave ablation of peripheral lung cancer.

OBJECTIVE: The aim of this study was to evaluate the feasibility and therapeutic effectiveness of ultrasonography (US)-guided percutaneous microwave ablation (PMA) in the treatment of peripheral lung cancer. METHODS: From December 2002 to September 2003, 12 Chinese patients with 16 histologically proven lung malignant tumors (6 primary and 10 metastatic) were treated with US-guided PMA. All tumors were located at the peripheral portions of the lung where the tumors were in direct contact with visceral pleura and visualized on US. A total of 21 insertions with 25 applications was administered to the 16 tumors. There was no radiation or chemotherapy combined with PMA. RESULTS: Based on the follow-up period of 6-40 months (average=20 months), seven patients survived without serious complications and five patients died from metastasis after PMA. The size of treated tumors was decreased in all cases (10 tumors with moderate to remarkable area reduction and 6 tumors with mild area reduction). Blood flow in the tumors became either invisible or diminished on color Doppler flow imaging, which showed 9 tumors with no enhancement and 7 tumors with partially decreased enhancement on contrast-enhanced computed tomography after PMA. All patients experienced improvement of clinical symptoms after PMA treatment. CONCLUSIONS: Ultrasonography-guided PMA, a mildly invasive procedure, is an effective, safe, and feasible method for treating peripheral lung tumors. Percutaneous microwave ablation provides an alternative therapy for patients with inoperable peripheral lung cancer as well as for patients who refuse radiation or chemotherapy.