Objective To compare features between color Doppler flow imaging(CDFI) and contrast-enhanced ultrasonography(CEUS) in the diagnosis of small renal cell carcinoma(SRCC) and investigate the diagnostic value of CEUS. Methods The images of CDFI and CEUS examination were retrospectively analyzed in forty-five SRCC (≤3 cm in diameter) which were confirmed sequentially by operation and pathology. Inner echoes,boundary,dark-ring and color flow of tumors were observed by CDFI. The degree of tumor vascularity was subjectively graded from 0 to Ⅳ. Enhancement patterns and phases on uhrasonography were reviewed, including enhancement start time, peak time, wash-out time and enhancement appearances of SRCC. Results The images were observed as homogeneous or relatively homogeneous (19) and heterogeneous or relatively heterogeneous(26), clear boundaries(37, including 10 with dark-ring) and ill-defined margins(8). The tumor vascularity was showed as grade 0(5) ,grade Ⅰ (6),grade Ⅱ (14),grade Ⅲ (14),grade Ⅳ(6) on CDFI. All lesions were showed mean enhancement start time (13.84±3.80) seconds,peak time (19.49±4.73) seconds,wash-out time (26.91±5.86) seconds respectively on CEUS. All cases were observed as simultaneous wash-in(39) and gradually wash-in(6),hyperechoic(14) and isoechoic(22) and hypoechoic(9) in peak time, simultaneous wash-out (19) and rapidly wahs-out (19) and gradually wahs-out(7). After contrast medium injection, tumors were detected partly non-enhaneement or cellular enhancement (25) and pseudocapsule (20). Conclusions CEUS is effective in improving the sonographic visualization of tumoral vascularity ,internal structure and pseudocapsule. It plays an important role in the diagnosis of SRCC.

Objective To explore the diagnostic value of contrast-enhanced ultrasonography (CEUS) in ureteral lesions.Methods The ultrasonogram of conventional ultrasound and CEUS were retrospectively analyzed in 19 confirmed ureteral lesions cases by operation and pathology.The size,inner echoes,boundary and color blood signal of ureteral lesions were observed by conventional ultrasound.The modality and phases of enhancement,including arrival time,peak time,washout time and appearance of internal structure,were observed by CEUS.Results The 19 ureteral tumors were of maximum widths between 2.1 to 7.7 cm.Conventional ultrasound showed 7 hypoechoic masses,10 isoechoic masses,1 hyperechoic mass and 1 unclear mass.Color Doppler flow imaging showed fairly rich blood signal in 8 tumors,a small amount of blood signal around tumor in 6 tumors and no blood signal in the rest.In early phase,CEUS showed enhancement in all 19 ureteral lesions,including synchronously enhancement in 8 tumors and delayed enhancement in 11 tumors.In peak time,hypoechogenicity compared to the normal renal cortex was shown in 3 tumors,hyperechogenicity in 11 tumors and isoechogenicity in 5 tumors.In late phase,fast wash-out was displayed in 16 tumors,isochronously wash-out in 1 tumor,delayed wash-out in 1 tumor and unclear in 1 tumor.The detection rates of blood supply and clear boundary in ureteral lesions and the diagnostic sensitivity for ureteral cancer were 74% (14/19),16% (3/19),50% (8/16) by conventional ultrasound respectively.The detection rates of blood supply and clear boundary in ureteral lesions and the diagnostic sensitivity for ureteral cancer were 100% (19/19) ,58% (11/19) ,94% (15/16) by CEUS respectively.The change of these performances was statistically significant between conventional ultrasound and CEUS.Conclusions CEUS can improve blood supply,boundary and the diagnostic sensitivity of ureteral lesions.

Objective To investigate the enhancement patterns of hypervascularized breast tumors with real time contrast-enhanced ultrasound (CEUS) and to evaluate the accuracy of CEUS in comparison with power Doppler in the discrimination purpose. Methods CEUS was preoperatively performed in 35 patients with 37 hypervascular breast lesions detected on power Doppler. The patterns of enhancement were analyzed and compared with morphological characteristics of the vessels displayed by power Doppler. Results Considering initial lump enhancement and peripheral flake enhancement as a criterion suggesting malignancy, CEUS showed a sensitivity of 90.9% ,a specificity of 73.3% and an accuracy of 75.70/00. While the morphological characteristics of the vessels demonstrated by power Doppler showed no significant difference between benign and malignant lesions, Conclusions CEUS is more accurate than power Doppler ultrasound in the assessment of blood flow of hypervascular breast tumors and more helpful in the differentiation role.

Objective To compare the application value of three different planes obtained by automated breast volume scanner for the observation of margin characteristics of breast masses.Methods Two hundred and eight women patients with 237 masses (120 benign and 1 1 7 malignant,confirmed by pathology)were included in this study.The detection rates of mass margin characteristics in three different planes were compared.The diagnostic performance of mass margin characteristics in differentiating benign and malignant breast masses in three different planes was compared by area under the ROC curve (AUC). Results The detection rate of angular margins for malignant masses in sagittal planes(41 .9%)was higher than that in coronal planes(22.2%)and axial planes(26.5%)with statistical difference (P =0.001 ,0.013);the detection rate of spiculated margins for malignant masses in coronal planes(42.7%)was higher than that in sagittal planes (1 1 .1 %)and axial planes (1 7.1 %)with statistical difference (both P < 0.001 ).No significant difference was found between any two of the three planes in the detection rates of margin characteristics for benign masses.The AUC of angular margins in sagittal planes (0.693)was higher than that in coronal planes (0.607)and axial planes (0.624);the AUC of spiculated margins in coronal planes (0.697)was higher than that in sagittal planes (0.55 1 )and axial planes (0.573 );the AUC of indistinct margins in axial planes(0.606)was higher than that in coronal planes (0.552)and sagittal planes (0.552);the AUC of microlobulated margins in axial planes (0.825)was higher than that in coronal planes (0.778) and sagittal planes (0.81 7).Conclusions Three different planes of ABVS have their own advantages for the observation of margin characteristics of breast masses.

Objective To explore the value of convergence symptom in predicting the treatment sensitivity and the prognosis of patients with breast infiltrating ductal carcinoma (IDC).Methods A retrospective review was performed in 46 women with 47 IDC lesions.Correlation between clinicopathological characteristics and convergence symptom was analyzed.Clinicopathological characteristics included tumor size,tumor grade,axillary lymph node state and the expression of ER,PR and H ER2.Results There was no obvious difference within different IDC groups by tumor size or axillary lymph node state in the presentation of convergence symptom (P ＞ 0.05).The convergence symptom was more common in grade Ⅱ IDC lesions than in grade Ⅲ IDC lesions and the difference was statistically significant (P =0.008).No difference was found between the presentation of convergence symptom and the expression of ER (P =0.055).Significant correlations were found between the presentation of convergence symptom and the expression of PR and HER2 (P ＜0.05).Conclusions Convergence symptom is helpful in predicting the treatment sensitivity and the prognosis of patients with breast infiltrating ductal carcinoma.