Objective To investigate the value of contrast-enhanced ultrasonography (CEUS) in the diagnosis of small renal cell carcinoma (SRCC) and renal angiomyolipoma (AML) with minimal fat.Methods The images and data of conventional ultrasound (US) and CEUS were retrospectively reviewed in 47 cases of small renal cell carcinoma and 8 cases of AML with minimal fat (d ＜ 30mm),which were confirmed by operation and pathologicall study,including 39 males and 16 females.The mean age of the patients was (54.8 ± 9.8) years old,ranged from 31 to 73 years old.The size,echo,boundary and color flow signals of renal lesions were observed by conventional US.Then the modality and phases of enhancement were observed,including the arrival time,the peak time,the washout time and the appearance of internal structures.Results On contrast-enhanced sonography,fast wash-in and wash-off were observed in most of SRCC,while slow wash-off were observed in most of RAML with minimal fat.The statistically significant differences were found between SRCC and RAML with minimal fat in the values of TFP (time a to peak) and PI (peak-intensity).The occurrence of round pseudo-capsule and contrast-enhancement characteristics in SRCC was far more often than RAML with minimal fat.Conclusions Contrast-enhanced sonography combined with time-intensity analysis provides more useful information for the diagnosis of SRCC and AML with minimal fat.

Objective To evaluate the values of contrast-enhanced ultrasound in diagnosis of cystic renal cell carcino-ma. Methods A total of 73 patients with renal cystic lesions were included in this study. The image features of ultrasound and contrast-enhanced ultrasound examination were analysed. All of patients underwent surgical treatment and had patholog-ical results. The diagnostic values of the ultrasound and contrast-enhanced ultrasound were analyzed by evaluating the im-age features of cystic renal cell carcinoma. Results There were 64 cases of cystic renal cell carcinoma, 9 cases of benign cyst. With ultrasound and color doppler ultrasound,irregular shape, thickness wall, solid ingredients, divisions and more blood flow signals were found in cystic renal cell carcinoma. Renal cyst showed regular shape, few solid component and thin separation and inconspicuous blood flow signals. In contrast-enhanced ultrasound, cystic renal cancer contrast agent appear-ing time was (15.13±4.21)s, and reached the peak time (23.42±5.68)s, fade time was (28.42±4.27)s. The enhanced mode for fast in and fast out was found in 22 cases (34.3%), fast in and slow out in 30 cases (46.8%), slow in and fast out in 2 cases (3.2%), slow in and slow out in 4 cases (6.4%), and synchronously in and out in 6 cases (9.3%). The hyper-enhancement was found in 42 cases (65.6%), the iso-enhancement and hypo-enhancement in 22 cases (34.4%). In renal cyst, There were three cases out of contrast filling. In other 6 cases, the contrast agent appearing time was (16.67±2.73)s, the peak time was (25.83±3.06)s and fade time was (34.17±4.26)s. The enhanced mode for fast in and fast out was found in 1 case (16.7%), fast in and slow out in 1 case (16.7%) and synchronously in and out in 4 cases (66.6%). The hyper-enhancement was found in 2 cases (33.3%), the iso-enhancement and hypo-enhancement in 4 cases (66.7%). The sensitivity, specificity, positive predic-tive value, negative predictive value and accuracy of ultrasound were 85.9%, 66.7%, 94.8%, 40.0%and 83.6%. The sensitiv-ity, specificity, positive predictive value, negative predictive value and accuracy of contrast-enhanced ultrasound were 92.2%, 77.8%, 96.7%, 58.3%and 90.4%. Conclusion Contrast-enhanced ultrasound can be used in benign and malignan-cy identification of renal cystic lesion.

Objective To investigate the value of TI-RADS for sonographic diagnosis of papillary thyroid carcinoma (PTC) and follicular thyroid carcinoma (FTC) and to evaluate the sonographic findings of FTC compared to PTC.Methods The clinical and sonographic data of 363 cases of pathology confirmed thyroid nodules were retrospectively analyzed.The thyroid nodules were classified by TI-RADS grading criteria,the accuracy of TI-RADS and sonographic findings between FTC and PTC was analyzed.Results In 363 thyroid nodules,114 cases were confirmed as benign lesions;249 cases were confirmed as carcinomas,including 50 FTC cases and 199 PTC cases.The sensitivity,specificity,PPV,NPV,and accuracy of PTC were 97.0％ (193/199),85.1％ (97/114),91.9％ (193/210),85.8％ (97/113),95.7％ (290/303) respectively.The sensitivity,specificity,PPV,NPV,and accuracy of FTC were 97.0％(193/199),85.1％ (97/114),91.9％ (193/210),85.8％ (97/113),95.7％ (290/303) respectively.There were significant differences of nodule size,shape,margin,echogenecity,calcification,halo and flow between FTC group and PTC group (P ＜ 0.05).Conclusion TI-RADS has higher value in the sonographic diagnosis of PTC than that of FTC.FTC are greatly different from PTC in many sonographic findings making it less valuable for the diagnosis of FTC.

Objective To investigate the clinical value of color Doppler ultrasound (CDFI) in the diagnosis of carotid atherosclerosis lesion in patients with acute stroke.Methods Totally 60patients with acute cerebral infarction were examined with CDFI to observe vessel diameter and stenosis degree of common carotid artery,internal carotid artery and external carotid artery and the results were compared with digital subtraction angiography (DSA) test.Results Among 60patients,normal ultrasound diagnosis was in 28 cases,occlusion and stenosis in 32 cases,stenosis in 25 cases; mild,moderate and severe stenosis were in 18,20,12 vessels,occlusion in 7 cases,14vessels.DSA examination results showed normal in 29 cases,stenosis and occlusion in 31 cases,stenosis in 26 cases,mild,moderate and severe stenosis of the 18,16,18 vessels; occlusion in 5 cases,10 vessels.The consistency test results between carotid artery color Doppler ultrasound and DSA were Kappa=0.786,0.667(P＜0.05).All carotid DSA results were considered as gold standard,CDFI diagnosis of moderate to severe stenosis was in high accuracy compared with DSA.Conclusions CDFI in the diagnosis of different degrees of carotid stenosis is in good agreement with DSA diagnosis,and may replace invasive DSA diagnosis of moderate to severe stenosis.

Objective To explore the applied value of thyroid imaging reporting and data system (TI-RADS) strati?fication in diagnosing thyroid nodules in patients with different ages.Methods A total of 527 patients with thyroid nod?ules (aged 26-65) were divided into four groups:aged 26-35 group, aged 36-45 group, aged 46-55 group and aged 56-65 group. TI-RADS was used to evaluate patients in four groups. The results of TI-RADS were compared with the pathologic di?agnostic analysis. Results For the low aged groups (aged 26-35 group and aged 36-45 group), the positive predictive val?ue, the negative predictive value and accuracy rate were more than 90%. With regard to the patients aged 46-55, the positive and negative predictive values and accuracy rate were 81.5%, 87.5%, and 81.9%, respectively. The positive and negative predictive values, accuracy rate were 76.6%,88.8%and 77.9%for patients aged 56-65 group. The diagnostic rate of TI-RADS in patients with thyroid lesions was lower in aged 56-65 group than that of other groups. Conclusion TI-RADS method is affected by age. The diagnostic rate is lower in the high age group than that of the low age group.

Renal cell carcinoma is one of the most common tumors in the urinary system. Most of these tumors are malignant. The incidence of renal tumors has increased in recent years. Contrast-enhanced ultrasound examination is increasingly applied in clinics and has become a common diagnostic method for renal lesions. Contrast-enhanced ultrasound can clearly show the organization of tu-mor blood vessels and capillaries and provide dynamic observation of the blood perfusion status of normal human tissues and tumor tis-sues. This review discusses the situation and value of contrast-enhanced ultrasound in renal tumor treatment.

Objective The purpose of this study was to evaluate the value of contrast-enhanced ultrasound in diagnosis of renal cell carcinoma subtyping.Methods 206 cases with renal tumors were confirmed by pathology and surgery from June 2012 to June 2014,including 113 male cases and 93 female cases.The mean age was 54 years (range 23-80 years).The subtype of renal tumor included clear cell carcinoma in 147 cases,papillary cell carcinoma in 32 cases,chromophobe cell carcinoma in 27 cases.All patients were received the CEUS before operation.The enhancement patterns,degree of enhancement,the appearance of necrosis and the time-intensity curve by contrast-enhanced ultrasound were analyzed.Results Enhancement patterns of CEUS were showed by fast in and fast out in 63.9％ (94/147)cases with clear cell carcinoma,59.4％ (19/32) cases with papillary cell carcinoma,51.9％ (14/27) cases with chromophobe cell carcinoma.Statistical significant diference was shown among those subtype groups (P ＜ 0.05).Most of the clear cell carcinomas (127/147,86.4％) showed hyperenhancing.While,the papillary renal cell carcinoma (22/32,68.8％) and chromophobe cell carcinoma (15/27,55.6％) showed hypoenhancing (P ＜ 0.05).The rate of necrosis in clear renal cell carcinoma was 62.6％ (92/147),and 59.4％ (19/32) in papillary cell carcinoma.necrosis area accounted for only 18.5％ (5/27)in chromophobe cell carcinoma (P ＜ 0.05).In the time-intensity curve analysis,the initial time,the average arrival time,the time to peak and area under the curve in renal cortex was (11.06 ± 2.75) s,(23.42 ± 2.79) s,(27.47 ± 3.02) dB,(35.01 ± 2.94)dB,respectively.Significant differences in those items were found in clear cell carcinoma,which was(8.01 ± 1.89) s,(20.05 ± 3.01) s,(30.03 ± 2.98) dB,(37.64 ± 4.01) dB respectively,compared with those in cortex (P ＜ 0.05).The arrival time,time to peak,peak intensity and area under the curve in papillary cell carcinoma were (1 1.12 ± 2.43) s,(27.29 ± 3.54) s,(20.13 ± 2.67) dB,(34.67 ±3.24) dB,respectively.The curve showed the time to peak was higher and the peak intensity were lower than those of renal cortex (P ＜0.05).The arrival time,time to peak,peak intensity and area under the curve in chromophobe cell carcinoma were (11.32 ± 2.90) s,(22.21 ± 3.62) s,(22.02 ± 2.52) dB,(28.67 ± 3.65) dB,respectively.The curve demonstrated peak intensity and area under the curve were lower than those of surrounding renal cortex (P ＜ 0.05).The increase of tumor diameter after contrast-enhanced ultrasound in clear cell carcinoma was about (0.35 ± 0.11)cm and in nonclear cell carcinoma was about (0.23 ± 0.10) cm (P ＜ 0.05).Conclusion The contrast-enhanced ultrasound played an important role in diagnosis and subtype renal cell carcinoma.

Objective To compare contrast-enhanced ultrasonography (CEUS), contrast-enhanced CT (CECT) and combined detection of two methods in the diagnosis of small renal masses, and differential diagnosis of different types of small renal masses by CEUS. Methods In 95 cases of small renal masses, there were 79 patients with small renal cell carcinoma and 16 patients with benign tumor. The diagnostic results of the three methods were compared based on the pathological results, which were used as thegold standardfor the diagnostic efficacy. The ROC curve was drawn, and the area under the curve (AUC) was compared. The characteristics of the two groups were analyzed and compared by Q-Lab software in CEUS. The angiographic parameters included arrival time (AT), time to peak (TTP) and peak intensity (PI). CEUS patterns for several pathologic types of renal tumors with larger sample sizes were compared. The characteristic manifestations of small renal masses under CEUS were analyzed. Results The accuracy, sensitivity, specificity, positive predictive value, negative predictive value and AUC of CEUS were 87.37%, 93.67%, 56.25%, 91.36%, 64.29%and 0.750, the values for CECT were 88.42%, 93.67%, 62.50%, 92.50%, 66.67%and 0.775, and the values for combined detection of two methods were 95.79%, 98.73%, 81.25%, 96.30%, 92.86%and 0.869 respectively. The sensitivities of the three methods were high, but the specificities were the same. The combined detection showed better diagnostic efficacy than that of single diagnostic method. The AT and TTP of CEUS were earlier in small renal carcinoma group than those of benign nephrotic group, and PI was higher than that of benign nephrotic group (P<0.05). There were significant differences in the contrasts ofcontrast enhancement methods between clear cell carcinoma, papillary cell carcinoma, chromophobe cell carcinoma, and angiomyolipoma (P<0.01). There was little difference in contrast enhancement between the other types of carcinoma. False envelope can be observed by CEUS.'Cystic area'of the detection rate was increased significantly by CEUS than that of conventional ultrasound. Conclusion Combined detection of CEUS and CECT can improve the diagnostic accuracy of small renal tumors. CEUS has great clinical value in the differential diagnosis of small renal masses, which is worthy of clinical promoting.

Objective To explore the diagnostic value of ultrasound guided fine needle aspiration biopsy (US-FNAB) for thyroid imaging reported and data system (TI-RADS) 4 class ≤ 10 mm thyroid nodules.Methods The preoperative ultrasound features of patients with thyroid nodule who received USFNAB examination were retrospectively analyzed,the malignant risk of each nodule was evaluated and classified according to TI-RADS.TI-RADS 4a class thyroid nodules and diameter ≤ 10 mm of 365 patients were classified as suspicious nodules and received US-FNAB examination.The nodules were classified as ＜5 mm and 5-10 mm groups.The results of cytologic diagnosis were compared with the pathological diagnosis,and the differences for nodules with different size were analyzed.Results Among 365 TI-RADS 4 class thyroid nodules diagnosed by the cytology,68 nodules were malignant;81 nodules were suspicious of malignancy;193 nodules were benign;6 nodules were unsatisfactory;and 17 nodules were undetermined.According to postoperative pathology or follow-ups,153 nodules were malignant and 212 nodules were benign.The difference between US-FNAB results and pathology was not significant (P ＞ 0.05).Cytologic positive rate and actually malignant rate of the nodules in 5-10 mm group were higher than ＜ 5 mm groups (P ＜ 0.05).The sensitivity,specificity,positive predictive value,negative predictive value,and accuracy of US-FNAB cytological diagnosis of TI-RADS 4 class thyroid nodule were 92.2％,96.2％,94.6％,94.4％and 94.5％,respectively.Conclusion US-FNAB examination is valuable for the diagnosis of TI-RADS 4a class thyroid nodules and improves the preoperative diagnosis.

Objective To evaluate the application of pooling HIV nucleic acid amplification testing (NAAT) among men who had sex with men (MSM) population, and to investigate suitable HIV screening strategy and the feasibility of calculation of HIV incidence using pooling NAAT among MSM population in China.Methods Four thousand eight hundred and fifty-six samples were collected from MSM population from April 2008 to September 2009 among with 4 156 were in Heilongjiang province and 700 were in Beijing in China. After standard testing with an HIV ELISA and WB confirmation testing, HIV antibody-negative samples were pooled and screened for HIV using NAAT.A three-stage pooling strategy was adopted.The HIV positive rate estimated by the four HIV screening strategies was calculated.In addition, 4 156 HIV positive specimens from Heilongjiang province were screened with the BED capture enzyme immunoassay (BED-CEIA).The HIV-1 incidences were estimated by BED-CEIA assay and pooling NAAT individually.ResultsOne hundred and forty-three of 4 856 subjects were HIV infected.130 were 3rd and 4th generation ELISA positive; 13 were antibody-negative but acutely HIV infected.According to the evaluation of four HIV screening strategies, routine HIV screening test together with pooling NAAT was more effective than other strategies for screening out window period generation ELISA+WB+pooling NAAT' were 2.68%(95% confidence interval CI=2.22%-3.14%), 2.82%(95%CI=2.35%-3.29%), 2.94%(95%CI=2.46%-3.42%) and 2.94%(95%CI=2.46%-3.42%), respectively.The differences were not significant (χ2=0.854 3, P=0.836 4).Of the 88 HIV positive samples from Heilongjiang province, 44 participants were tested as recent HIV infections by BED-CEIA assay. The estimated HIV-1 incidence was 2.36% (95%CI=1.63%-3.08%) and 2.92% (95%CI=1.01%-4.83%) based on BED-CEIA assay and pooling NAAT,respectively.Conclusions Pooling NAAT is a effective screening test in HIV negative population to detect window period infection among MSM population in China.