Objective To evaluate the charateristics of biliary stricture after orthotopic liver transplantation(OLT) by ultrasound. Methods Diametes,thickness,characteristic echo of bile were observed by ultrasound in 41 patients with biliary stricture after OLT,and the results were compared with those of 46 patients without biliary complication after OLT.Results The diameter of intrahepatic bile,thickness of bile,incidence of intrahepatic bile dilation or hyperechogenicity in biliary stricture patiens were higher than those in patients without biliary complication,there were significant differences between two groups(P＜0.05).Conclusions The series of ultrasonographic character such as bile dilation,thickeness or hyperechogenicity of biliary wall,thin of bile duct are available to diagnose biliary stricture.

Objective To investigate the application value of transperineal ultrasound in female urethras and pathological change of circum-urethras.Methods 403 female patients were examined by transperineal ultrasound in condition of resting and maximum Valsalva,female urethras and pathological changes of circum-urethras were observed and ultrasonic manifestation were concluded.Results By transperineal ultrasound the images of normal urethras and pathological change of circum-urethras were clearly discernible.403 female patients were examined,380 normal.18 urethral calcification,there was hyperecho stripe in urethras.2 urethral cyst,there was round anechoic area in circum-urethras and no fistula between round anechoic area with urethras.2 urethral diverticulum,there was round anechoic area in circumurethras and a fistula between round anechoic area with urethras.1 urethrovaginal fistula,there was irregular hypoechoic area between urethras with vagina,the irregular hypoechoic area both communicate with urethras and vagina.Conclusions Transperinealr ultrasound can be used for examination urethras and pathological change of circum-urethras in female patients and may provide more reliable information for clinical diagnosis.

Objective To investigate the application value of transperineal ultrasound in female patients with cystocele.Methods Transperineal ultrasound were performed in 36 female patients with cystocele and the bladder neck movement degrees (BND),retrovesical angle and the degree of urethral rotation were observed at maximum Valsalva.The ultrasonic manifestation of 36 female patients with cystocele were summarized.Results On maximal Valsalva bladder neck mobility all increased in 36 patients,32 patients with open retrovesical angle (≥140°) and 30 female patients with urethral rotation ≥ 45°.There were 6 cases with type Ⅰ,bladder neck was lower than inferoposterior margin of the symphysis pubis,cystocele with open retrovesical angle (≥140°) and urethral rotation ＜45°.There were 26 cases with type Ⅱ,bladder neck was lower than inferoposterior margin of the symphysis pubis,cystocele with open retrovesical angle (≥140°) and urethral rotation ≥45°.There were 4 cases with type Ⅲ,bladder was lower than inferoposterior margin of the symphysis pubis,cystocele with intact retrovesical angle (＜ 140°) and urethral rotation ≥45°.Conclusions The transperineal ultrasound can be used for classification of cystocele in female patients and which may provide more reliable information for clinical diagnosis.

Objective To study the repeatability and consistency of normal female pelvic floor structure using transperineal real‐time three‐dimensional ultrasound .Methods Forty‐two cases of normal adult female were evaluated by two different experience operator ,using the real‐time three‐dimensional ultrasound diagnostic apparatus .The bladder neck movement degrees and the levator hiatus area were observed after Valsalva condition .Differences between the groups were compared .Intraclass correlation coefficient (ICC) ,the coefficient of variation (CV) and Bland‐Altman analysis of consistency were evaluated . Results The bladder neck movement degrees and the levator hiatus area measured by the experienced operator (operator 1) and less experienced operator(operator 2) were (18 4.8 ± 5 8.4)cm and (17 7.9 ± 5 4.8) cm ,(17 5.3 ± 3 9.5)cm2 and (17 3.1 ± 4 3.2)cm2 ,respectively .There was no significant difference between the two operators ( P > 0 0.5) .The intra‐ICC were 0 8.9 and 0 9.0 ,CV were 7 2.6% and 3 0.3% .Experienced operator repeatability (ICC= 0 9.9 ,0 9.4) was slightly higher than the less experienced researchers (ICC 0 9.2 ,0 8.1) .The analysis results of Bland‐Altman image showed good consistency between two different operators .Conclusions The current study proves real‐time three‐dimensional ultrasound is a reproducible method for female pelvic floor structure assessment ,and the reproducibility is very well .The detection performance of experienced operator slightly better than the one with less experience ,strengthen the training of junior doctors may further improve the accuracy of measurement .

ObjectiveTo explore the feasibility of hilar bile duct using ultrasonography (US) in identification of different types of biliary strictures after orthotopic liver transplantation.MethodsThe US images of hilar bile duct of 62 patients with non-anastomotic biliary stricture (NAS) and 30 patients with anastomotic biliary stricture (AS) were reviewed.Four US feathers including the presence of hilar biliary dilatation,the display of hilar biliary lumen,the thickening of bile duct wall and the echo of bile duct wail were assessed.Results The presence of hilar biliary dilatation,the display of hilar biliary lumen,the thickening of bile duct wall showed a significant difference between NAS and AS groups (P＜0.001).The feature with the greatest performance in the diagnosis of NAS was unclear displayed hilar biliary lumen.The sensitivity,specificity and accuracy were 93.7％,86.7％ and 92.3％,respectively.Conclusions The observation of hilar bile duct has great vaule in identification of different types of biliary strictures after orthotopic liver transplantation.The display of hilar biliary lumen is more likely to differentiate between NAS and AS

Objective To explore the application value of Golgi protein-73 (GP73)and AFP in single and combining form in the diagnosis of primary hepatocelluar carcinoma (PHC).Methods Eighty PHC,65 liver cirrhosis,54 chronic hepatitis patients and 50 controls were selected in the First Afiliated Hospital in Xinjiang Medical University from May to September in 2011,GP73 was detected by ELISA and AFP was measured by clinical chemiluminescence.The sensitivity and specificity of each parameter in single and combining form were evaluated.Results Serum GP73 in PHC group 282.0(163.6-366.7) μg/L,liver cirrhosis group 211.8(107.5-295.7) μg/L,chronic hepatitis group 100.3(61.8-191.3) μg/L and control group 58.3(43.4-83.6) μg/L was tested by Kruskal-Wallis(H =106.6,P ＜0.01).GP73 in PHC group was further compared with liver cirrhosis group,chronic hepatitis group and control group using MannWhitney test,significance was found,(U was 1796.0,826.5,154.0,respectively,all P ＜0.01).In the single form,the sensitivity of GP73 [82.5％ (66/80)] was higher than AFP [66.3％ (53/80),x2 =4.65,P ＜0.05],but the specificity of GP73 [63.3％ (107/169)] was lower than AFP [88.7％ (150/169),x2 =28.91,P ＜0.05].There were 27 AFP negative cases in PHC group,but 22 of them were GP73 positive,making the positive rate of GP73 [81.5％ (22/27)] in PHC patients with AFP negative.There were 14 GP73 negative cases of in PHC group,but 9 of them were AFP positive,making the positive rate of AFP [64.3％ (9/14)] in PHC patients with GP73 negative.In series diagnostic test,the specificity of combining form [95.9％ (162/169)] was higher than AFP [88.7 ％ (150/169),x2 =6.00,P ＜ 0.05] ; in parallel diagnostic test,the sensitivity of combining form [93.8％ (75/80)] was higher than GP73 [82.5％(66/80),x2 =4.84,P ＜0.05].In PHC group,52 patients with HBV infection,10 patients with HCV infection and 18 patients without virus infection,GP73 was 309.5 (170.5-370.5) μg/L,351.0 (274.7-397.9) μg/L and 210.1 (156.8-306.7) μg/L,respectively,no significance was found (H =4.0,P ＞0.05).Conclusion GP73 and AFP have a complementary feature of sensitivity and specificity in the early diagnosis of PHC,some PHC cases with AFP negative can be avoided missing efficiently by parallel diagnostic test.

Objective To explore the value of contrast-enhanced ultrasound (CEUS) in the differential diagnosis of subserous myoma (SM) and ovarian fibroma.Methods CEUS was performed on 58 patients with SM and 26 patients with ovarian fibroma.The enhancement pattern was observed.The diagnostic performance was evaluated by using diagnostic test.Results SM exhibited homogeneous isoenhancement synchronously with the myometrium in early phase.In the late phase,the pseudocapsule remained hyper-enhancement with obvious membraniform sign.Some myomas showed the feeding artery from uterus.Ovarian fibroma demonstrated hyper-enhancement at the periphery portion and hypoenhancement inside.Conclusions The SM and ovarian myomas showed different enhancement patterns,which may provide us some exact information in the differential diagnosis between the two diseases.

Objective To evaluate the feasibility and accuracy of the transvaginal real-time three-dimensional hysterosalpingo-contrast sonography(RT 3D-HyCoSy) with SonoVue in the assessment of tubal patency.Methods Tubal patency was investigated by RT 3D-HyCoSy in 96 unselected infertile patients (a total of 191 tubes).The image quality of RT 3D-HyCoSy was evaluated.Laparoscopy was performed in 35 cases (a total of 70 tubes) of them.The efficacy of the procedure was compared with laparoscopy.Results The mean score of image quality of RT 3D-HyCoSy in ninety-six cases was 2.94 ± 0.26.The accordance between RT 3D-HyCoSy and laparoscopy was good,with the Kappa value was 0.802.Sensitivity,specificity,positive predictive value,negative predictive value and accuracy in diagnosing tubal patency by using RT 3D-HyCoSywas 87.5％ (14/16),94.4％ (51/54),82.3％ (14/17),96.2％ (51/53),92.9％ (65/70),respectively.Conclusions Transvaginal RT 3D-HyCoSy is a good imaging technique which can display the morphological character of fallopian tube and assess the patency.

ObjectiveTo assess the diagnostic performance of contrast-enhanced ultrasound(CEUS)in characterization of adnexal masses in comparison with baseline ultrasound.MethodsOne hundred and thirty-seven masses were examined by CEUS and baseline ultrasound.Two independent investigators reviewed the images before and after contrast agent administration.The diagnostic performances were evaluated using receiver operating characteristic (ROC) analysis and the interobserver agreement was analyzed.ResultsAfter review of CEUS,ROC analysis revealed significant improvement in differentiating between malignant and benign pelvic masses that the areas under the ROC curve were 0.731 and 0.738 at baseline ultrasound versus 0.891 and 0.903 at CEUS ( P ＜0.01 ).The accuracy for both investigators also improved significantly after reviewing CEUS.A better interobserver agreement was achieved after reviewing of CEUS (g =0.681 at baseline ultrasound versus κ =0.893 at CEUS) and a better result of specific diagnosis was obtained (73.2％ and 74.2％ at baseline ultrasound versus 90.7％ and 91.2％ at CEUS)(all P ＜ 0.01 ).Conclusions Real-time CEUS improves the diagnostic performance in adnexal masses for discrimination between malignancy and benignity and improves the capability in specific diagnosis compared with baseline ultrasound.

Objective To investigate the contrast enhanced ultrasound(CEUS)features of ovarian tumor torsion(OTT).Methods Seventeen cases with OTT were evaluated using CEUS.CEUS was performed with low mechanical index and the contrast agent of Sono Vue.Results Thirteen cases with total torsion of ovarian tumor appeared as no enhancement.Four cases with partial torsion showecl hyperechoic enhancement in the early phase and hypoechogenicity in the late phase.Conclusions The enhancement of OTT has characteristic,which would be helpful for the diagnosis and differential diagnosis of OTT.