Objective To investigate the value of quantitative analysis in the diagnosis of renal lesions with contrast-enhanced ultrasound.Methods Sixty cases with renal lesions confirmed by surgery and pathology underwent contrast-enhanced ultrasound preoperatively and quantitative analysis retrospectively.The Sonoliver software was applied in the analysis of CEUS imaging and in the recoustruction of quantitative parameter,s.Five parameters were calculated,including the maximum intensity (IMAX),rise time (RT),time to peak (TTP),mean transit time (mTT) and area under the curve (AUC).Results There were statistically differences in parameters RT,mTT and AUC ( P ＜ 0.05) and significant differences in parameter IMAX ( P ＜0.01).In malignant tumors,the RT and mTT were less than that of the benign while IMAX and AUC were more than that of the benign.Conclusions Contrast-enhanced ultrasound using a quantitative parametric analysis offers more information and is a promising tool in the diagnosis and differentiation of renal masses.

Objective To investigate the relationship between hemodynamic parameters from quantitative analysis of contrast-enhanced ultrasonography (CEUS) on hepatocellular carcinoma (HCC) and pathological tumor differentiated grades. Methods Seventy-seven HCC lesions were examinated and off-line analyzed with dynamic images. Quantitative parameters such as slope of decrease to half of peak (SD), increased signal intensity (ISI), area under the curve (AUC) and blood flow coefficient (BF) were acquired, and the standardized values (sISI, sAUC and sBF) included the ratio of parameters from tumor to those from hepatic parenchyma. These quantitative parameters were correlated with tumor grades according to Edmonson criteria. Results There was significant difference (P＜0.05) of SD, AUC and BF, as well as standardized values (sISI, sAUC and sBF) between different grades of HCC. AUC, BF, sISI, sAUC and sBF were negative correlated with differentiated grades, respectively (P＜0.05). Well-differentiated HCC had significantly higher perfusion values than HCC of other grades (P＜0.05). Conclusion Quantitative analysis of CEUS can assess differentiation of HCC indirectly, and might reveal biological behavior of malignant tumors.

Objective To evaluate the contrast-enhanced ultrasonography (CEUS) in quantitative diagnosis of chronic renal insufficiency. Methods Correlation of CEUS indexes with glomerular filtration rate (GFR) detected by 99mTc-DTPA renography was examined. Thirty-three cases of clinical chronic renal insufficiency were enrolled in the study. They were 15 males and 18 females with average age of (43.33±6.78) years. After intravenous bolus injection of 1 ml SonoVue,CEUS of renal cortex blood perfusion was performed successfully, and a time-intensity curve (TIC)was created with PHILIPS iU22 system's QLAB software. A 148 to 222 MBq dose of 99mTc-DTPA was injected as a bolus from antecubital vein. Renal scintigraphic images were collected immediately and GFR was obtained. Results The significant correlation coefficients between GFR and CEUS quantitative indexes were as follows: rAUC (area under curve)=0.886 (P＜0.05), rA (slope rate of ascending curve, A) =0.804(P＜0.05). However, rDPI (derived peak intensity, DPI)=0.021 (P＞0.05), rTTP (time to peak, TTP) =0.043 (P＞0.05), rα (slope rate of descending curve,α)=0.039 (P＞0.05). Conclusion CEUS can precisely display the hemodynamic change of chronic renal insufficiency, which is well correlated with GFR by 99mTc-DTPA renography.

ular perfusion in tumors objectively, which is potential in monitoring tumor vascular response to antiangiogenic therapy.

0.05). Conclusions CEUS can accurately display the perfusion changes of CIRD model of dogs,it's more sensitive than the BUN and SCr. DPI and TTP are the most sensitive quantitative indexes of CEUS.

Objective To evaluate the value of quantitative analysis of real-time elastosonography in the differential diagnosis of benign and malignant thyroid nodules. Methods The elastograms of eight-six patients with 98 thyroid nodules were observed. The strain ratio of each lesion and the averages of those of benignancy and malignancy were calculated. With the ROC curve, the critical point of the strain ratio of different lesions was gotten. All the lesions were confirmed with surgery and pathologic examination. Results The average of strain ratio of benign nodules was 2. 18,while that of malignancy was 8. 48. The strain ratio of benign and malignant lesions were of significant difference statistically (P <0.05). According to ROC curve, the critical point of strain ratio between benign and malignant lesions was 3. 3. Conclusions The quantitative analysis of real-time elastosonography is a newly valuable technique of ultrasonography which is helpful in the differential diagnosis of thyroid lesions.

Objective To investigate enhancement appearance of hepatic focal nodular hyperplasia(FNH) at real-time gray-scale contrast enhanced ultrasonography(CEUS),and evaluate the value of CEUS in the diagnosis of FNH. Methods Thirty-four patients (36 lesions) with histologically proved FNH were examined by ultrasonography. Appearance on conventional ultrasonography and the enhancement pattern on CEUS were investigated. Results Thirty-six lesions were mostly hypoechoic.39% (14/36) of lesions had peripheral hypoechogenic circle. Color Doppler flow imaging showed a asteroid-like or spoke-and-wheel pattern in 65% (20/ 31) of lesions.Three enhancement patterns were observed in the early arterial phase: whole-enhancement pattern (28%, 10/36), gushing-spring enhancement pattern (44%, 16/36), and spoke-and-wheel enhancement pattern (28%,10/36).The frequency of central scar on CEUS was 17% (6/36), and detection rate of central scar by CEUS compared with pathology was 40% (6/15).Regarding one of the features (gushing-spring enhancement, spoke-and-wheel enhancement and scar) as standard of FNH, the coincidence of CEUS in this group was 78% (28/ 36) ,which was significantly higher than that of conventional ultrasonography 28% (10/36).Conclusions CEUS can be as a important method for diagnosing FNH.

Objective To investigate the correlations between quantitative parameters of contrast-enhanced ultrasonography(CEUS) and histopathological stage of liver fibrosis.Methods Sixty cases of hepatic fibrosis diagnosed pathologically were examined with CEUS.The dynamic images of CEUS were analyzed off-line with a quantitative software.Region of interest (ROI) were drawn separately in hepatic artery(HA),liver parenchyma(PA),main portal vein(PV) and right hepatic vein(HV).The time intensity curve(TIC) and some quantitative parameters,including arrival time,increased signal intensity(ISI),peak intensity(PI) and area under curve(AUC) were acquired.Intrahepatic transit time of contrast agents were calculated as the arrival time difference between hepatic artery(HA) and HV(HA-HVTT),between PV and HV(PV-HVTT) and between PA and HV (PA-HVTT).All the parameters were compared with histopathologic stage.Results All cases were grouped into mild fibrosis (S0 and S1,25 cases),moderate fibrosis (S2 and S3,17 cases) and severe fibrosis (S4,18 cases) according pathologic stage.HA-HVTT,PV-HVTT and PA-HVTT decreased with the development of liver fibrosis.The parameters of ISI,PI and AUC obtained from TIC of portal vein reduced with the progression of fibrosis,too(P＜0.05).Receive operating characteristic(ROC) curve analysis showed that the area under curve of HA-HVTT,PV-HVTT and PA-HVTT were 0.808,0.848,and 0.823 (S＞S1),and 0.856,0.903,and 0.806 (S＞S3),respectively.Conclusions Quantitative parameters of CEUS reflect the stage of liver fibrosis mediately.The parameters of HA-HVTT,PV-HVTT and PA-HVTT are closely correlated with the stage of liver fibrosis.

Objective To investigate the feasibility of contrast-enhanced ultrasonography(CEUS) in quantitative assessment of angiogenesis in patients with hepatocellular carcinoma(HCC).Methods Thirtythree patients with HCCs confirmed by pathology underwent CEUS in one week preoperatively.The presets and contrast dosage were fixed in all the studies.The new quantitative software with GAMMA fitting technique was used to analyze the dynamic images offline.The quantitative parameters such as baseline intensity,increased signal intensity(ASI),decent curvature(a2),up slope rate(a3),arrive time(AT), time to peak(TTP), accelerate time(ACT),peak intensity(PI),and area under curve(AREA) were calculated.The pathological specimen was stained with CD34 antibady and microvessel density (MVD) was calculated automatically.The correlation between parameters of CEUS and MVD was analyzed statistically.Results The parameters of ASI, a2, a3, AT, TTP, PI and ACT in the tumor were significantly different from those in liver parenehyma ( P＜0.01 ).The value of a2 in the tumor was correlated with MVD, the standardized ASI and AREA were correlated with MVD (P＜0.05).Conclusions The quantitative analysis with CEUS reflects the microvascular perfusion flow objectively.It provides a noninvasive imaging method to assess the angiogenesis in HCCs.

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.