Objective To explore the value of real time contrast-enhanced ultrasound (CEUS) in differential diagnosis of benign and malignant adrenal lesions.Methods Totally,57 adrenal lesions (26malignant and 31 benign) underwent conventional ultrasound and real-time CEUS.The enhancement patterns including types of time-intensity curve,centripetal fill-in,homogeneity and intensity of enhancement were analyzed.Results The enhancement pattern of normal adrenal gland was homogeneous,centrifugal and rapid perfusion from the medulla to the cortex.Four enhancement patterns were significantly different between benign and malignant adrenal lesions (P ＜0.05).If enhancement in the early arterial phase and rapid washout was suggestive of malignancy,the sensitivity and specificity of CEUS were 96.2％ and 77.4％,respectively.If peripheral to central filling was suggestive of malignancy,the sensitivity and specificity of CEUS were 76.9 ％ and 80.7 ％,respectively.Conclusions The patterns of real-time CEUS are helpful in differential diagnosis of malignant and benign adrenal lesions.

Objective To explore oral contrast-enhanced ultrasonography findings in superior mesenteric artery syndrome (SMAS).Methods Twenty-nine patients with SMAS were examined using oral contrast-enhanced ultrasonography,which was confirmed by contrast-enhanced spiral computerized tomography.Results Abdominal ultrasonography with oral contrast-enhanced ultrasonography revealed a significant reduction of the SMA angle and diminished SMA-aorta distance in 29 subjects.Duodenum was showed the indentation and funnel shaped or dumbbell shaped findings which was caused by pressure of the SMA in patients with recumbent position.The proximal part of duodenum expanded distinctively with contrast media movement fro.Ultrasonography and CT examinations had a good agreement in diagnosing pathological aortomesenteric angle and distance.Conclusions Oral contrast-enhanced ultrasonography presents characteristic findings in patients with SMAS,which is useful in epidemiological screening of suspicious cases of SMAS in children.

Objective To investigate the value of contrast enhanced ultrasound (CEUS) in diagnosing metastatic adrenal carcinoma. Methods Twenty two metastatic adrenal carcinoma lesions in 18 patients were examined using CEUS. The features and detected rate of gray scale and CEUS were analysed and compared. Results Fourteen lesions of metastatic adrenal carcinoma were detected by two dimensional ultrasonography(2DU), the detected rate of 2DU was 58. 3%. While 20 lesions were detected by CEUS, the detected rate was 83. 3%. There was a significant difference of detected rate between 2DU and CEUS (P<0.05). The adrenal metastatic carcinomas were enhanced rapidly with the peek intensity slightly low or same to the surrounding liver or renal parenchyma. The lesions number, size and range were clearly presented by CEUS. Conclusions CEUS can markedly improve detected rate of metastatic adrenal carcinoma compared with 2DU.

Objective To investigate the clinical value of hysterosalpingo-contrast-sonography (HyCoSy) with high-pressure syringe injection and time-intensity curve analysis in the diagnosis of women infertility due to tube obstruction.Methods Fifty-six women with infertility underwent HyCoSy with compressive injection of SonoVue with a balloon catheter and high-pressure syringe.Time-intensity curve based on Autotracking Contrast Quatification (ACQ) software was analyzed in all patients.The arrival time (AT) of microbubbles from uterine cavity to tube fimbria was analyzed between partially obstructed tube group and control group.Results The AT in the group of partially obstructed tubes was (3.49 ± 1.70) s,while the AT in the group of freely patent tubes was (1.14-± 0.37)s,there was statistical difference of AT between the group of partially obstructed tubes and the group of freely patent tubes (P =0.000).According to ROC results,the optimization point of AT was 1.65 s,the sensitivity,specificity,positive predictive value and negative predictive value were 92.6％,93.3％,96.2％ and 87.5％,respectively.Conclusions High-pressure syringe injection in HyCoSy is useful for regular administration and high image quality.The AT could be considered as the diagnostic indices in the evaluation of fallopian tube patency for infertile women.

Objective To compare the accuracy of endoscopic ultrasound (EUS) with double contrast enhanced ultrasound ( DCUS) in the preoperative staging of gastric malignancies. Methods This study included 162 patients with biopsy proven gastric cancer who underwent surgical resection as primary management of their malignancies. All patients underwent DCUS and EUS prior to surgical intervention with the results of the ultrasound findings compared with the pathological stages of the resected specimen. Results Among the 162 gastric cancer patients, there were 42 cases of T1, 49 cases of T2, 56 cases of T3, and 15 cases of T4 tumors. The overall accuracy of DCUS and EUS for the determination of loco-regional tumor infiltration ( T Staging) was 77. 2% and 74. 7% , (χ2 = 0. 273, P = 0. 603). Comparison of ultrasound techniques revealed that DCUS was superior to EUS only for a tumor depth of T3 (χ2 =5. 009, P = 0.025). Lymph nodes were correctly staged with DCUS and EUS in 78.4% and 57. 4% of cases, respectively ( χ2 = 16. 370,P =0.001). Using DCUS, the sensitivity of the technique was 78. 4% with a specificity of 78. 5%. In comparison, EUS had a sensitivity of 49. 5% with a specificity of 69. 2%. DCUS also detected a higher incidence of positive lymph nodes than EUS for poorly differentiated (81. 5% vs. 42. 6% ,χ2 =17. 338, P < 0. 01) and overall tumor types (78.4% vs. 49. 5% , χ2 = 17.523, P < 0. 01). Conclusions Double contrast-enhanced ultrasonography offers another noninvasive approach for the preoperative evaluation of gastric cancer. DCUS was comparable to EUS in tumor depth evaluation. DCUS offers an advantage in the detection of lymph node metastases, especially in poorly differentiated tumors.