Objective To assess value of contrast enhanced ultrasonography(CEUS)in diagnosis of extracranial carotid stenosis.Methods Baseline ultrasonography and CEUS were performed in 108 patients with extracranial carotid stenosis.The location and degree of stenosis were judged and compared with the results of digital subtraction angiography(DSA).Results Of 108 patients,DSA diagnosed 81 vessels in 62 cases of mildintermediate stenosis which consisted of 33 common carotid arteries(CCAs),43 internal carotid arteries(ICAs)and 5 external carotid arteries(ECAS),51 vessels in 39 cases Of severe stenosis(46 ICAs and 5 CCAs)and 7vessels in 7 cases of complete occlusion(7 ICAs).The surface of intima and the interface of media-adventitia were depicted clearly by CEUS.The consistent rates in diagnosis on mild-intermediate stenosis,severe stenosis and complete obstruction by baseline ultrasonography and CEUS were 76.5%and 9 1.4%(P＜0.05).60.8%and94.1%(P＜0.001),28.6%and 100%(P＜0.05)respectively when judged by DSA as the golden standard.CEUS and DSA were correlated significantly on calculating the stenosis rate(r=0.975,P＜0.001).Conclusions CEUS can assess the degree of extracranial carotid stenosis accurately and non-invasively which is superior to baseline ultrasonography and correlated significantly with DSA.

ObjectiveTo explore the clinical application of ultrasound guided percutaneous right internal jugular vein catheterization in hemodialysis,and to analyze the methods,precautions and prevention of complications of puncture.MethodsTotally 297 patients of chronic renal insufficiency with uremia underwent ultrasound guided percutaneous right internal jugular vein catheterization according to technical points of increasing the success rate of puncture.ResultsThe total successful rate of puncture was 100％.The first puncture succeeded in 244 patients (244/297,82.15 ％),the second in 30 (30/297,10.10％) and the third in 23 (23/297,7.74％) patients.The complication rate was 15.15％ (45/297).Poor adherence of catheter led to cited blood difficultly and inadequate flow in 31 patients.ConclusionUltrasound guidance can greatly improve the success rate of puncture in percutaneous right internal jugular vein catheterization,while reduce the incidence of complications.

Objective To study the nursing method about percutaneous biliary tract stent implantation to cure malignant obstructive jaundice.Methods Careful perioperative nursing cares and finished post-hospital direction were applied among 21 patients with malignant obstructive jaundice when by percutaneous biliary tract stent implantation.Results There were 20 patients obtained successful operation,the successful rate was 95%.The postoperative of glutamic pyruvic transaminase were(96.60?89.36) U/L,the total bilirubin was(137.96?103.95) ?mmol/L,the directed bilirubin was((85.67)?62.95) ?mmol/L and the indirected bilirubin was(56.76?37.37) ?mmol/L.All the indexes which have mentioned above were significant lower than those of before operative,P

Objective To investigate the imaging characteristics and differentiating value of hepatic perfusion disorders(HPD)in small focal liver lesions(≤3 cm),the transient hepatic hyperechoic enhancement(THHE),with contrast-enhanced ultrasonography(CEUS)during arterial phase and explore the potential mechanism.Methods Two hundred and sixty-eight small foeal liver lesions found in 215 patients who had undergone CEUS were retrospectively evaluated in this study.Hepatic parenchymal THHEs around those lesions were diagnosed and the CEUS characteristics as well as the detecting rate related to different lesions were analyzed.Results Forty-five among 268 lesions(16.8%)showed surrounding THHEs during CEUS and they exhibited fast wash-in to form hyperechoic area of different shape and range and then those area became fast washout to be isoechoic in contrast with peripheral liver parenchyma.According to the imaging morphology,THHEs could be divided into four types:type Ⅰ,wedge-or fan-shaped(51.1%);type Ⅱ,encircling-shaped(20.0%);type Ⅲ,nodule-like-shaped(11.1%);type Ⅳ,irregular-shaped(17.8%).According to the pathology,the liver focal lesions could be divided into three groups:benign group,which consisted of 88 lesions and 8(9.1%)lesions showed surrounding THHEs of which 87.5% presented type Ⅲ and Ⅳ;malignant group,which consisted of 141 lesions and 31(22.0%)lesions showed surrounding THHEs of which 67.7% presented type Ⅰ;tumor-like lesions group,which consisted of 39 lesions and 6(15.4%)lesions showed surrounding THHEs of which 66.7% presented type Ⅱ.There was significant difference in the composition of THHEs type among three groups(P＜0.001).The detecting rate of THHEs in benign group was lower than that in other groups(P＜0.05).Conclusions THHEs showed with CEUS in small liver focal lesions are representation of HPD and have different detecting rate and imaging morphology type in different lesions.It is very important to recognize and distinguish THHEs surrounding focal lesions,which could help to make differential diagnosis,avoid incorrect diagnosis and judge the size of lesions correctly.