Objective To evaluate the clinical application of color Doppler ultrasound in monitoring the complications of arterialvenous fistula in elderly patients. Methods The 36 hemodialysis patients over the age of 60 were enrolled, including 27 cases of autologous arteriovenous fistula and 9 cases of artificial vascular graft arteriovenous fistula. The ideal vascular access could not be established in the 9 cases due to their own conditions. Color Doppler ultrasonography was used to test the function of arteriovenous fistula and to observe its complications. Results The arteriovenous fistula in 26 cases (72.2 %) was patent in 36 elderly hemodialysis patients. The 6 cases (22.2 % ) in 27 of autogenous arteriovenous fistula and 4 cases (44.4 % ) in 9 of artificial arteriovenous fistula had complications. Conclusions Ultrasound can clearly show the position, pathway, lumen and blood flow dynamics of the transplanted autologous or artificial blood vessels in arteriovenous fistula so as to evaluate the effects of blood dialysis in elderly patients and to detect the complications for clinical reference.

Objective To evaluate the sonographic manifestations of iliac vein compression syndrome (IVCS)in elderly patients.Methods Sonographic data (including gray scale,color Doppler and spectral Doppler ultrasound)of 26 patients diagnosed with IVCS by venogram were analyzed retrospectively,and their sonographic manifestations were categorized.Results The sonographic manifestations of IVCS can be categorized into three types.Type one presented as iliac vein stenosis and an increase in focal blood flow velocity(5/26,19.2％).Type two presented as masses around the iliac vein and vein thrombosis(4/26,15.4％).Type three manifested thrombosis in the iliac vein and deep veins of lower extremity,without obvious masses or iliac vein stenosis (17/26,65.4％).Of all patients,nine were diagnosed with IVCS by ultrasound(9/26,34.6％).The other 17 patients were confirmed by venogram after suggestive ultrasound signs.Conclusions Ultrasound plays an important role in the early diagnosis of IVCS and can help decide on the need for further diagnostic tests.

Objective To observe the correlations of conventional ultrasound and contrast-enhanced ultrasound(CEUS)features with expression level of Ki-67 of intrahepatic cholangiocarcinoma(ICC).Methods A total of 77 patients with pathologically confirmed ICC were retrospectively enrolled.According to the expression level of Ki-67 of target lesions,the patients were divided into high expression group(Ki-67≥20%,n=53)and low expression group(Ki-67＜20%,n=24).The features showed on conventional ultrasound and CEUS were compared between groups,and the variables being significantly different were analyzed with multivariate logistic regression to select ultrasonic features being correlated with Ki-67 expression level of ICC.Results The mean maximum diameter of ICC in high expression group was larger than that in low expression group([6.2±2.0]cm vs.[5.2±1.9]cm,P=0.041),and the percentage of ICC with maximum diameter>5 cm in high expression group was higher than that in low expression group(66.04%vs.33.33%,P=0.007).No significant difference of the lesions shape,border nor the internal echogenicity showed on conventional ultrasound was found between groups(all P＞0.05).The percentage of ICC with peripheral rim enhancement and enlargement after enhancement in high expression group were both higher than those in low expression group(both P＜0.05),but no significant difference of the enhancement pattern,the presence or absence of non-enhance area within the lesion nor the peak intensity of lesions was found between groups(all P＞0.05).The maximum diameter larger than 5 cm(OR=5.612,P=0.004)and peripheral rim enhancement(OR=3.880,P=0.025)were both independent factors for predicting high Ki-67 expression level of ICC.Conclusion ICC with the maximum diameter larger than 5 cm and peripheral rim enhancement on CEUS might indicate high expression level of Ki-67,which was helpful for clinical treatment decisions.