Objective To discuss the contrast-enhanced ultrasonography diagnostic value of the liver low-density focus on contrast-enhanced CT. Methods The contrast-enhanced ultrasonography results of 47 cases of the liver low-density focus on contrast-enhanced CT. were retrospectively analyzed. Results The pathological diagnosis in 47 focuses was metastatic carcinoma 20 cases, inflammatory pseudotumour 9 cases,hepatic hemangioma 6 cases, primary liver carcinoma 4 cases, cyst 2 cases, abscess 2 cases, tuberculosis 2 cases, FNH (focal liver nodular hyperplasia) 1 case, local adipose tissue infiltration of liver 1 case. 45 cases of contrast-enhanced ultrasonography diagnosis was consistent with pathological or clinical diagnosis. Cysts and inflammatory pseudotumour had not ultrasound contrast enhancement in the entire phase, but the crossed blood vessels was observed in inflammatory pseudotumour. The local adipose infiltration of liver had synchronous ultrasound contrast enhancement accompanied with liver tissue enhancement. 80% (12/15) of liver metastases of lack of blood supply showed fast contrast enhancement around the tumour edge and homogeneous and light contrast enhancement in the tumour center. 80 % (4/5) of liver metastases of rich of blood supply showed heavy and rapid contrast enhancement in the whole tumour. The enhancement degree in bscess and tuberculosis in the ultrasound contrast enhancement was correlated with necrosis degree, which showed fast and uneven contrast enhancement, hepatic hemangioma showed gradually contrast enhancement from its edge to center, whose enhancement time lasted for longer time than that of metastatic tumour with a statistically difference. FNH showed a typical contrast enhancement pattern, fast enhancement and fast weakening from center to edge. Hepatic cell carcinoma showed fast enhancement and fast weakening in the whole tumour. Conclusion Contrast-enhanced ultrasonography have diagnostic value of CT liver focus of low-density, which is helpful for the differential diagnosis of such focus.

Objective To evaluate the value of ultrasound in diagnosing ductal carcinoma in situ (DCIS). Methods The sonographic characteristics of 12 DCIS which were confirmed by pathology were analyzed retrospectively. Results The ultrasound image of DCIS could be divided into four types;the solid mass nodule, mammary dysplasia, mix mass nodule, the dilated duct type. Micro calcification had high incidence rate. Ultrasonic diagnosis accordance rate was 50.0 %. On molybdenum target mammograms, the tumor appeared as a cluster of calcified spots in 8 cases, and the accuracy rate of diagnosis of was 66.7 %.Conclusion There are no typical characters of DCIS in ultrasound image. However, some characteristics are suggestive and can help to differentiate them from the benign tumors, such as small nodule, irregular shape,obscure boundary, and microcalcification. When sonography combine with molybdenum target mammography,the accuracy rate of diagnosis will be improved.

Objective To compare the value of intrarectal filling with water and filling in rubber sheath with water in endoluminal uhrasonography for preoperative staging of rectal tumors. Methods 215 cases of rectal tumors were divided into two groups. 120 cases using the method of filling in rubber sheath with water and 95 cases using intrarectal filling with water were diagnosed with uhrasonography. The results were compared with corresponding pathologic results for the judgment of their accuracy. Results The accuracy for the diagnosis of infiltration depth was 60.0 % in the first group and was 73.7 % in the second. The difference was statistically significant (P <0.05). The accuracy for diagnosis of metastases of perirectal lymph nodes was 82.5 % in the first group and was 80.0 % in the second. The difference has no statistical significance (P >0.50). Conclusion Intrarectai filling with water is better than filling in rubber sheath with water in the diagnosis of infiltration depth of rectal tumors, while there is no difference in the diagnosis of metastasis of perirectal lymph nodes.

Objective To evaluate the clinical value of transrectal ultrasound-guided 10 cores plus fixed-point prostate biopsy for diagnosing prostate cancer.Methods The serum PSA level of 181 patients were determined with ELISA.AU the patients underwent 10 cores plus fixed-point prostate biopsy under the guidance of transrectal ultrasound.Resuits 80 cases with prostate cancer(44.2%),63 cases with benign prostatic hypertrophy (34.8%),36 cases with prostatitis(19.9%),1 cage with tuberculosis(0.6%),and 1 cage with prostate leiomyoma(0.6%).When PSA WaS more than 20 μg/L,the incidence rate of prostate cancer was significantly higher than other PSA levels.Meanwhile,Gleason scores were increased with the advance of PSA levels (P＜0.001).Conclusion Transrectal ultrasound-guided systematic 10 cores plus fixed-point prostate biopsy could significantly enhance the prostate cancer detection rate, and it was important in diagnosing prostate cancer for patients,especially when PsA was more than 20 μg/L.

Objective To evaluate the clinical value of color Doppler ultrasound-guided percutaneous transhepatic cholangiol drainage(PTCD) for treating obstructive jaundice. Methods 248 cases of PTCD were performed in 224 patients under the guidance of color Doppler ultrasound. 118 PTCD cases were carried out passing through the inferior segmental biliary duet of Left laterallobe (Left drainage mode). Right lobe drainage mode (right drainage mode)was conducted in 130 patients. Left plus right lobe drainage mode in 16 patients. Results The total success rate was 99.59 %(247/248), and the success rate of the firs time PTCD was 92.33 %(229/248). The success rate of left drainage mode was significantly higher than righl lobe drainage (96.61% vs 88.46 %, P ＜0.05). Conclusion The technique of color Doppler ultrasound-guided PTCD is an efficient method in obstructive jaundice therapy, with the advantages of safety, convenience, minimal invasion, and higher success rate.

Objective To investigate the sonographic diagnostic value of poorly differentiated thyroid carcinoma and anaplastic thyroid carcinoma. Methods Ultrasonography of 22 cases with differentiated thyroid carcinoma and anaplastic thyroid carcinoma were observed with color doppler sonography.The shape,size,echo,boundary,microcalcifieation foci and blood stream distribution were studied,and contrasted with pathological diagnosis after operation.Lymphnode in cervical part and sulcus esophagus were examined.The characters of thyropathy according to the above sonographie features were judged. Results 16uhrasonography or before operation and biopsy,in which 9 were left,7 were right.6 cases were in both leaves.Ultrasound showed that 2 cases were poody differentiated thyroid carcinoma, 1 case was parathyroid carcinoma. 1 case was Hashimoto's thyroditis, and remainders were thyroid carcinoma. Conclusion Ultrasonography could enhance the detection rates and diagnose accordance rates of poorly differentiated thyroid carcinoma and anaplastic thyroid carcinoma.

Objective To review the clinical data of reduction mammoplasty by central pedicle technique,and to summarize all kinds of the complications to modify the technique for improvement of long term aesthetic effects.Methods The postoperative complications were analyzd and then an approach was used to investigate the pattern of the blood supply and the nerve distribution of breast.Based on the anatomical study,a modified double-circle reduction mammoplasty technique was designed to treat patients with hypertrophical breasts. Results With a follow-up for 3 months to 3 years,the patients who underwent this modified central pedicle technique,had an invisible scar,good projection,the better shape of breast and preserved their sensation of nipple-areola complex.Conclusions Modified central pedicle technique is a safe and reliable technique,especially ideal for Chinese women.The blood supply is rich and the sensation of nipple-areola complex is preserved.The fixation of the gland tissue is more important than the dermal-bra.

Objective To explore the factors affecting diagnosis accuracy on T stage of oral ultrasonic contrast agent examination on ulcerative gastric neoplasms.Methods Data from 82 patients were analyzed who were pathologically diagnosed as ulcerative gastric neoplasms ultrasounds data of oral ultrasonic contrast agent before surgery were compared to postoperative pathology,analysis had been done on influence of the lesion site,size of the T staging on ulcerative gastric neoplasms.Results The diagnosis accuracy rate of T stage on lesser curvature of stomach and gastric antrum were 91.3 ％ (21/23) and 85.7 ％ (24/28),compared with the pathological results were in good concordancy (Kappa =0.763,0.68,P ＜ 0.05).The accuracy rate of T stage on cardiac lesions was 68.0 ％ (17/25),compared with the pathological results consistency in general (Kappa =0.446,P ＜ 0.05).Further research on the effects of T stage accuracy would be necessary.The accuracy rate ofT staging on tumor size ≤ 5.0 cm group and ＞ 5.0 cm were 92.3 ％ (36/39) and 72.1％ (31/43),the difference was significant in two groups (x2 =5.591,P ＜ 0.05).Conclusion Oral ultrasonic contrast agent application is more accurate on lesser curvature of stomach,gastric antrum and lesions size ≤ 5.0 cm.

Objective To analyze the ultrasonic imaging characteristics of primary breast lymphoma and their significance for diagnosis.Methods Data of ultrasonograph from 21 cases of primary breast lymphoma were reviewed, and all cases had been certificated by pathology.Results All of 21 cases with primary breast lymphoma were solid mass.The contours of 16 cases were regular, and the boundaries of 9 cases were clear.20 cases were hypoechoic masses, besides 3 cases with lower echo like liquefactive degeneration.The internal echoes of 19 cases were disorderly, part of them with hyperechoic trabs.The rear echoes of 17 cases were neither enhanced nor fading.The surrounding tissues of 19 cases were not changed.13 cases had more than 3 blood vessels on color Doppler imaging.Conclusion There are some ultrasound characteristics in primary breast lymphoma, which would be helpful in the diagnosis of primary breast lymphoma.

Objective To investigate the effect of sufentanil combined with remifentanil on anesthesia in emergency traumatic brain injury . Methods Retrospective analysed a total of 80 the clinical data of patients with traumatic brain treated in Yuyao Municipal People’s Hospital from March 2015 to August 2016 received surgical treatment in emergency, accorded to the intraoperative anesthesia were divided into remifentanil group and combined anesthesia group(remifentanil combined with sufentanil anesthesia group).The changes of MAP,HR and stress indexes in two groups were observed,awakening quality and complication rate between the two groups were compared.Results Before anesthesia,there was no difference between the two groups of MAP and HR levels,10 minutes after the anesthesia,the beginning of the operation and the end of the operation,the combined anesthesia group was higher than that of the remifentanil group ( P<0.05 );there was no significant difference in blood glucose and cortisol levels between the two groups before and after anesthesia,and the indexes of 12h after operation were lower than those in the remifentanil group (P<0.05);two groups of patients with respiratory recovery time,recovery time,eye opening time command and extubation time showed no significant difference between the two groups;nausea and vomiting,incidence of bradycardia and other complications had no significant difference.Conclusion Sufentanil combined with remifentanil in emergency brain trauma surgery anesthesia was better,has little effect on the mean arterial pressure and heart rate,low complication rate.