1.Ultrasonic diagnostic value and classification of splenic lymphoma
Zhenhu LIN ; Liwu LIN ; Enshen XUE ; Yimi HE ; Shangda GAO
Chinese Journal of Ultrasonography 2008;17(9):773-775
Objective To probe the ultrasonic diagnostic value in splenic lyrnphoma and classify the sonographic appearance of splenic lymphoma.Methods The clinical datas and ultrasonic appearances of 31 patients with splenic lymphoma were compared with the pathology.The ultrasonic images were classified.Results Among the 31cases,3 cases with splenic lymphoma and 5 cases with splenic infiltration of splenic lymphoma were correctly diagnosed by ultrasound.The diagnostic correct rate was 25.8%.The sonographic appearances of 31 cases were divided into four types.Homogeneous splenomegaly type(12.9%,4/31),showed homogeneous splenomegaly without mass in the spleen.Multiple nodule type(16.2%,5/31),showed multiple hypoechoic nodules diffused in the spleen.Solitary mass type(29.0%,9/31),showed solitary mass larger than 3 cm with or without necrosis in the spleen.Comples type(41.9%,13/31),showed splenomegaly,hypoechoic masses and nodulars of different sizes in the spleen.Conclusions The sonographic diagnosis of splenic lymphoma is valuable to the clinic.The ultrasound-guided splenic biopsy could be carry out if necessary.
2.Ultrasound-guided chemical ablation using compound lauromacrogol in treatment of tumor xenograft
Zhenpeng QU ; Zhikui CHEN ; Yimi HE ; Ensheng XUE ; Liwu LIN
Chinese Journal of Ultrasonography 2014;23(1):62-65
Objective To investigate the tumor chemical ablation and analgesic effects of compound lauromacrogol,and to explore a new method for ultrasound-guided tumor ablation.Methods 18 VX2 tumorbearing rabbits were randomly divided into saline group,ethanol group and compound lauromacrogol group,and the medicine was intratumoral injected guided by ultrasonography.After 4 times treatment,tumor contrast-enhanced ultrasonography,tumor growth inhibition rate and tumor tissue pathology were performed to evaluate the antitumor effects.The analgesic effect was evaluated using the pain model induced by formaldehyde test.Results Ultrasound-guided intratumoral injection of compound lauromacrogol showed significant antitumor effects with a tumor growth inhibition rate of 63.3 %,which was higher than that of ethanol group.No apparent enhancement was found under contrast-enhanced ultrasonography,and pathology results confirmed wide necrosis.In saline,ethanol and compound lauromacrogol groups,the average accumulated points were 62.25 ± 9.79,21.00 ± 9.13 and 9.87 ± 3.10,respectively by formaldehyde test.Conclusions Ultrasound-guided chemical ablation using compound lauromacrogol showed complete antitumor and strong analgesic effects,which would be a new method for tumor ablation.
3.Analysis of ultrasonic diagnosis and misdiagnosis of breast fibroadenoma
Jiajia YANG ; Ensheng XUE ; Liwu LIN ; Yimi HE ; Qin YE
Chinese Journal of Medical Imaging Technology 2017;33(5):666-669
Objective To explore the atypical ultrasonic appearances of breast fibroadenoma and analyze the cause of mis diagnosis.Methods A total of 493 lesions in 485 patients of breast fibroadenoma detected by ultrasound examination andconfirmed by pathology were retrospectively analyzed.Atypical appearances were analyzed and misdiagnosis rate were cal-culated.Statistical methods were taken to compare the misdiagnosis rates in lesions with various atypical appearances andthose with none or single atypical appearance.Misdiagnosis rates in lesions with different sizes and pathological types wereanalyzed statically.Then misdiagnosing causes were analyzed.Results A total of 404 lesions were diagnosed correctly,in-cluding 99 lesions with atypical appearances,and the other 89 lesions were misdiagnosed,which showed atypical appear-ances.The misdiagnosis rate of lesions with ≥2 atypical features was higher than that with none or single atypical feature(x2 =256.40,P< 0.05).Large lesions (maximum diameter> 3 am) showed higher misdiagnosis rates than small ones(maximum diameter ≤3 cm,x2=6.73,P<0.05),and complex fibroadenoma lesions also showed higher misdiagnosisrate than simple ones (x2 =188.01,P<0.05).Conclusion The lesions with various atypical appearances,large size andcomplex fibroadenoma in pathology are easy to be misdiagnosed.
4.Value of gastroduodenal water window in diagnosis of ampulla carcinoma
Shangda GAO ; Liwu LIN ; Yimi HE ; Ensheng XUE ; Lizu WU
Chinese Journal of Ultrasonography 2003;0(09):-
Objective To probe the value of gastroduodenal water window in ultrasonic diagnosis of ampulla carcinoma. Methods Sixty-three patients were divided into the conventional ultrasonic examination group(including 35 patients) and the gastroduodenal water window ultrasonic examination group(including 28 patients), all being detected before and after drinking. The results of ultrasonic examination of the groups were divided into Ⅰ, Ⅱ and Ⅲ grades. The diagnostic accurate rates and the rates of Ⅰ, Ⅱ and Ⅲ grades of the ultrasonic examination of the groups were compared respectively. Results The diagnostic accurate rate of the gastroduodenal water window group after drinking was 96.43%(27/28), which was markedly higher than that of the same group before drinking and the conventional group which were 60.71%(17/28) and 54.29%(19/35) respectively. The rates of Ⅰ, Ⅱ and Ⅲ grades of the ultrasonic examination of the gastroduodenal water window group after drinking were also markedly higher than those of the same group before drinking and the conventional group respectively (all P 0.05). Conclusions The gastroduodenal water window ultrasonic examination can effectively raise the ultrasonic diagnostic rate of ampulla carcinoma. It is of significance in the clinic.
5.Study of ultrasonography of intrahepatic duct cystic tumor
Shangda GAO ; Liwu LIN ; Yimi HE ; Ensheng XUE ; Qin YE
Chinese Journal of Ultrasonography 1993;0(02):-
Objective To probe the characteristics of the ultrasonography of the intrahepatic duct cystic tumor(IDCT).Methods The ultrasonography of 12 patients with IDCT was analysed.The results were compared with the operation and pathology.Two of them were intraductal papillary adenomas,six were papillary adenocarcinomas,two were biliary cystadenomas and two were biliary cystadenocarcinomas.Results The ultrasonic diagnostic rate was 75%(9/12).The bile ducts of 10 cases(83%) were cystically dilated.Seven cases(58%) with thick walls of bile ducts were all malignant.Six tumors(50%) with intraluminal papillate echoes could be malignant or benign.The tremellose echoes were detected in 7 cases(58%) and the common bile ducts of six cases were obstructed by the tremellose substance.Conclusions It is the important diagnostic basis of IDCT that the bile ducts in some liver lobal or segment are dilated without reasons,with the thick bile duct wall and the poor ultrasound penetration,especially when the bile ducts are full of tremellose substance and the papillomas are detected in the ducts.It is of significance in the clinic to raise the early diagnostic rate of IDCT by ultrasound.
6.Ultrasonic Characteristics of Complex Fibroadenoma of Breast and Its Differential Diagnosis from Invasive Ductal Carcinoma
Meilian ZHANG ; Hu CHEN ; Ensheng XUE ; Liwu LIN ; Yimi HE
Chinese Journal of Medical Imaging 2017;25(5):365-369
Purpose To explore ultrasonic characteristics of complex fibroadenoma (CF) of breast and its differential diagnosis from invasive ductal carcinoma (IDC).Materials and Methods Sixty-one patients with CF and 81 patients with IDC from January 2010 to February 2016 in the Affiliated Union Hospital of Fujian Medical University were enrolled,and the CF and IDC were confirmed by pathology after operation.The preoperative sonographic findings of CF and IDC were retrospectively analyzed and compared.Results Fifty-nine cases with CF were detected by ultrasonography in 61 cases.Ultrasonic findings of 59 cases of CF showed as follows:79.7% (47/59) of the CF cases with an aspect ratio <0.7;79.7% (47/59) with blood flow signal of 0 to 1 level;72.9% (43/59) with liquid dark area,including 67.8% (40/59) with round or oval cystic fluid area showing local sievelike or diffused distribution;72.9% (43/59) with irregular shape;61.0% (36/59) with obscure boundary;61.0% (36/59) with the largest diameter of tumor <2 cm;59.3% (35/59) with calcifications,including 33.9% (20/59) with coarse calcification,25.4% (15/59) with microcalcification and 85.7% (30/35) with distribution of calcified lesions along the linear high echo zone;54.2% (32/59) with echo heterogenicity showing linear high echo and high echo in the middle and low echo.There were significant differences in the detection rates of internal regular fluid area,internal linear high echo or high echo area,and alcification distribution along the linear high echo between CF and IDC lesions (all P<0.01).Compared with IDC,there were higher rates in CF for detecting lesions of largest diameter of tumor <2 cm,more regular shape,more clear border,poorer blood flow signal (P<0.05),but there were lower rates in CF for detecting axillary lymph node enlargement,lesions with edge or spiculation and hyperechoic halo (P<0.01).Conclusion Color Doppler ultrasonography is of great value in the diagnosis of CF and its differential diagnosis from IDC.
7.Application of ultrasonography in diagnosing and preoperative TNM staging for neuroendocrine breast cancer
Xiaoshuang CHEN ; Liwu LIN ; Ensheng XUE ; Zhikui CHEN ; Yimi HE
Chinese Journal of Ultrasonography 2015;24(10):894-897
Objective To investigate the value of ultrasonography in diagnosis and preoperative TNM staging for neuroendocrine breast cancer(NEBC).Methods The ultrasonic characteristics of 12 NEBC and 104 invasive ductal carcinoma(IDC) confirmed by pathology,as well as the metastatic lymph nodes were analyzed retrospectively.The TNM-staging for NEBC by preoperative ultrasonography was evaluated according to pathology.And the relation between lesions size and Ki-67 was then analyzad.Results NEBC lesions mainly showed solid and heterogeneous hypoechoic(66.67%),irregular shape(66.67%),clear border (58.33 %),posterior enhancement(58.33 %) and internal blood flow(grade 0-Ⅰ) (66.67 %).The detection rate of unclear border,irregular edge,hyperechoic halos and uneven internal echo was lower than IDC(P < 0.05).Meanwhile,NEBC had a lower detection rate of calcification and internal blood flow(grade Ⅱ-Ⅲ)than IDC (P >0.05).And the detection rate of more round or oval lesions were higher in NEBC than that in IDC (P =0.001).According to pathology,the ultrasonic coincidence rate for T staging of NEBC and pathology was 75%,and for T1-staging was 100%,for T2-staging was 80%.The sensitivity,specificity,positive predictive value and negative predictive value of ultrasonic diagnosis on lymph node metastases was 66.67%,88.89%,66.67% and 88.89%,respectively.There was a positive correlation between focal maximum diameter with Ki-67 (r=0.026,P=0.004).Conclusions It shows certain value of ultrasonography in diagnosis and preoperative TNM staging for NEBC.
8.Acoustic image typing of thyroglossal duct cyst by high frequency ultrasonography and its diagnosis value
Qin YE ; Liwu LIN ; Ensheng XUE ; Xueying LIN ; Yimi HE ; Lizu WU ; Rongxi LIANG
Chinese Journal of Ultrasonography 2009;18(5):432-434
Objective To probe the clinical diagnosis value of high frequency ultrasonography (HFUS) in thyroglossal duct cyst(TDC). Methods Forty-one TDC were taken HFUS and the location, boundary,shape,interal echo of lesions and the relation to hyoid bone were observed. The periphery and internal blood flow signal were detected by color Doppler flow imaging. The results of HFUS were compared with those of pathology after operation. The cases were divided into groups according to pathological types and were compared with acoustic image shows. Results All cases were diagnosed TDC by pathology after operation. Internal walls of 9 TDC consist of cilium columnar epithelium, 19 consist of stratified pavement epithelium and 13 consist of this two epitheliums. HFUS showed different pathological types had different ultrasonic appearances. In this study, 77.8%(7/9) TDC with columnar epithelium showed echoless,84.2 (16/19) TDC with pavement epithelium showed similar solid echopattern and TDC with two epitheliums mainly showed similar solid echopattern and multi-room cyst. Hyperechogenicity of hyoid bone displayed around the lesion in 80.5%(33/41)TDC. No blood flow signal showed in 41 TDC and a little punctiform blood flow signal showed in the periphery of 5 TDC. The diagnose accordance rate of HFUS in TDC was 95.1%(39/41). Conclusions HFUS can clearly show the location, boundary, shape,interal echo of TDC and its relation to hyoid bone. HFUS is important for diagnosis and differential diagnosis of TDC.
9.Animal experiment of the echo tracking technique in evaluating artery elasticity
Xuejun DUAN ; Liwu LIN ; Ensheng XUE ; Yimi HE ; Shangda GAO ; Liyun YU
Chinese Journal of Ultrasonography 2009;18(3):257-260
Objective To assess the value of echo tracking(ET) technique on atherosclerosis in the rabbit models, and to probe the pathological foundation of its indexes changes and the usefulness in evaluating arterial elasticity. Methods Thirty New Zealand rabbits were divided into 3 groups randomly: group A was the control group;group B,C were fed with high lipid feedstuffs for 8 weeks and 12 weeks, respectively. The ET examination of abdominal aorta was performed in group A and group B at the end of 8 weeks,it was performed in group A and group C at the end of 12 weeks. The parameters of elasticity were measured including pressure-strain elastic modulus (Ep), stiffness parameters(β), pulse wave velocity (PWVβ), augmentation index (AI), arterial compliance (AC), etc. Two dimensional ultrasound and pathological examination of abdominal aorta were performed at the same time. Results No obvious plaque and arterial wall thickness were seen in the abdominal aorta. Ep,β,PWVβ of group C were higher than that of group A and B, while AC of group C was lower than that of group A and B, and the difference had statistical significance (P<0.05). AI had no significant difference in all groups (P>0.05). Pathological examinations indicated that foam cell formation was seen in the abdominal aorta intima, the elastic fiber layer and smooth muscle layer were kept well in B group. Lots of cholesterol crystal formation was seen in the abdominal aorta intima and the two layer were obvious destroyed in group C. Conclusions ET can detect the atherosclerosis earlier than two-dimensional ultrasound. ET can detect the elasticity changes only when the elastic fiber layer and smooth muscle layer were destroyed . So it can be concluded that the destroy of elastic fiber layer and smooth muscle layer may be the pathological foundation of ET elasticity parameters changes.
10.Experimental study of sonography in predicting contralateral testicular damage after unilateral testicular torsion
Liang YU ; Ensheng XUE ; Liwu LIN ; Rongxi LIANG ; Yimi HE ; Shangda GAO ; Xiaodong LIN
Chinese Journal of Ultrasonography 2009;18(1):75-78
Objective To investigate the dependability between ultrasonic appearances of different degree of acute testicular hemodynamic disorder and contralateral testicular damage.Methods Thirty two white rabbits were randomly divided into 4 groups.Group A-C were subjected to testicular ischemia and color Doppler sonography were continuoully performed in each case.The testes were reperfused when the ultrasonic appearances were as follows:homogeneous appearance with reducing of blood perfusion(group A),increased echogenicity and heterogeneity with little blood perfusion(group B).inhomogeneous appearance with small pieces of low echogenic areas and no blood perfusion(group C).Group D was the control group.Histologic structure changes of contralateral testes were observed after reperfusion for a month.The contralateral testes in all the cases underwent contrast-enhanced ultrasonography(CEUS)before reperfusion of unilateral testes.Results CEUS time-intensity curve of contralateral testes showed no statistical significance between the four groups(P>0.05).Focal and mild pathological and ultrastructural changes were observed in contralateral testes in group A-C.But Johnsen score showed no statistical significance between the control group and group A-C(P>0.05).The total number of appotosis cells per 100 seminiferous tubules in group B(38.75±8.88)were significantly more than the control group(18.63±3.81)as well as group A(20.50±6.12)and group C(18.00±4.47)(P<0.001),but there were no statistical significances between group A,group C and the control group(P>0.05).Conclusions Ultrasonic appearances of acute testicular hemodynamic disorder are help for the prediction of contralateral testicular damage.As blood flow in contralateral testes were unaffected after acute testicular hemodynamic disorder,it seems to have no role in contralateral testicular damage.