Objective To study the features and values of ultrasound and Helical computed tomography (CT) in diagnosis of cystic renal cell carcinoma. Methods Twenty patients were preoperatively examined by B-mode ultrasound, color Doppler ultrasound and helical CT. Results All the cases were confirmed by operation and pathology,including 12 cases on the left side and 8 cases on the right side. On B-mode ultrasound images, all lesions appeared as unilocular or multilocular cyst in 5 cases, intratumoral septum in 10 cases,intratumoral nodule in 4 cases,solid-like mass in 1 case. Color blood flow was showed within tumors in 18 patients,in which 17 cases showed the arterial spectrum with a mean resistance index of 0.66. On enhanced CT scans, all the lesions appeared as the early uneven enhancement(19 cases), septal enhancement(6 cases) and mural nodular enhancement(4 cases) respectively. The accuracy of conventional ultrasound combined with color Doppler ultrasound was 85%, while the accuracy of the enhanced CT was 80%.Conclusions Conventional ultrasound combined with color Doppler ultrasound and enhanced CT plays an important role in diagnosis of cystic renal cell carcinoma.

Objective To analyze the hemodynamic changes with color Doppler flow imaging(CDFI) after liver transplantation. Methods One hundred fifty-six patients with transplanted livers were included. Hepatic morphology and parenehyma was investigated with B-mode ultrasound, and the patency of hepatic anastomosis was assessed with CDFI. Hemodynamic parameters were also measured. Results It showed increased parenchyma echogenicity during the early period after liver transplantation. Hepatic hemodynamies changed as follows: peak systolic velocity of portal vein was high in the first day after operation, and then it progressively decreased; the peak systolic velocity of hepatic artery was not changed during the follow-up period;the resistance index of hepatic artery was a little higher in the first day after liver transplantation, then it decreased ( P<0.05 ). Conclusions CDFI is valuable in evaluating hepatic hemodynamic changes after liver transplantation.

Objective To investigate the effect of gene transfection to mice's muscle combining polyethyleneimine (PEI) with ultrasound (US)-targeted microbubble (MB) destruction (UTMD).Methods Twenty-five female Balb/c mice were divided into 5 groups (5 mice per group) randomly.Plasmid DNA (20 μg) encoding green fluorescent protein (GFP) was used as expresion vector.The transfection materials were injected into the bilateral tibialis anterior muscles of mice respectively and delivered as follows:(a) untreated control,(b) plasmid + US,(c) plasmid + US + MB,(d) plasmid + PEI,(e) plasmid + PEI + US,(f) plasmid + PEI + MB+ US.SonoVue MB was used at a final concentration of 30％ (v/v).The acoustic intensity and duty cycle were optimized before the study and set at 2.0 W/cm2 and 50％ respectively.Transfection efficiency was assessed by counting the number of GFP-positive fibers under fluorescence microscopy 10 days after gene delivery.Hematoxylin-Eosin staining was performed on separate specimen and examined with light microscopy for tissue damage.Results No GFP-positive fiber was found in the untreated control group.There were 14 ± 3,58 ± 6,96 ± 7,119 ± 11 and 158 ± 18 GFP-positive fibers respectively found in plasmid+ US,plasmid + MB + US,plasmid + PEI,plasmid + PEI + US,and plasmid + PEI + MB + US groups.The plasmid + PEI + MB + US group had the maximal GFP-positive fibers,the differences were significant compared with other groups (P ＜0.05).No evidence of inflammation or necrosis was revealed in histological examination with hematoxylin-eosin staining.Conclusions PEI combining with UTMD can significantly improve efficiency of gene transfection in vivo and has great potential in gene therapy.

Objective To investigate the value of quantitative analysis in the diagnosis of renal lesions with contrast-enhanced ultrasound.Methods Sixty cases with renal lesions confirmed by surgery and pathology underwent contrast-enhanced ultrasound preoperatively and quantitative analysis retrospectively.The Sonoliver software was applied in the analysis of CEUS imaging and in the recoustruction of quantitative parameter,s.Five parameters were calculated,including the maximum intensity (IMAX),rise time (RT),time to peak (TTP),mean transit time (mTT) and area under the curve (AUC).Results There were statistically differences in parameters RT,mTT and AUC ( P ＜ 0.05) and significant differences in parameter IMAX ( P ＜0.01).In malignant tumors,the RT and mTT were less than that of the benign while IMAX and AUC were more than that of the benign.Conclusions Contrast-enhanced ultrasound using a quantitative parametric analysis offers more information and is a promising tool in the diagnosis and differentiation of renal masses.

Objective To evaluate the feasibility of three-dimensional contrast-enhanced ultrasound (3D-CEUS) in showing vascular patterns of renal tumors.Methods The images of 3D-CEUS examination were retrospectively analyzed in one hundred and twenty one renal tumors which were confirmed sequentially by pathology.3D-CEUS was performed after conventional ultrasound and contrast-enhanced ultrasound (CEUS).The 3D-CEUS images were reconstructed by QLAB workstation and classified into 4 grades based on the blood supply characteristics.Results All the tumors were confirmed by pathology and operations,including clear cell renal cell carcinoma (CCRCC) (n=91),papillary renal cell carcinoma (PRCC) (n=5),chromophobe renal cell carcinoma (CRCC) (n=5),renal angiomyolipoma (RAML) (n=19),and cystic nephroma (n=1).Three-dimensional reconstruction could provide clear stereoscopic views of the interested structures and morphological characteristics of lesions.The three-dimensional ultrasonography of a particular renal tumor could be a mixture of different basic grades.There were significant differences between benign and malignant renal tumors in 3D-CEUS.The image quality was the best in early parenchymal phase comparing to other phases.In early parenchymal phase,84 RCCs (83.17%) were tortuous expansive reticular or irregular messy dendritic,61 cases (60.40%) with filling defect areas and 15 cases (14.85%) with pseudocapsules.Grade Ⅲ and Grade Ⅳ were the main vascular patterns in maglinant tumors.In early parenchymal phase,6 RAMLs (31.58%) were nebulous with dendritic in part,12 cases(63.16%) were reticular on the basis of nebulous with homogeneous internal structures.The vascular pattern was shown better in 3D-CEUS than CEUS.Conclusions 3D-CEUS can provide clear stereoscopic structures and morphological characteristics of the lesions,it is a useful adjuvant of CEUS for the diagnosis of renal tumors.

Objective To compare enhancement features of hepatic tumors on SonoVue-enhanced real-time gray-scale ultrasonography and contrast-enhanced helical CT.Methods SonoVue-enhanced real-time gray-scale ultrasonography and contrast-enhanced helical CT were performed on 49 patients with 54 focal liver lesions,including 29 primary liver carcinomas,4 metastatic liver tumors,11 hepatic carvernous hemangiomas,7 focal nodular hyperplasias,2 focal fatty sparing,1 cirrhotic.Results Contrast-enhanced ultrasonography and helical CT showed consistent results in demonstrating hemodynamics of hepatic tumors.In the differentiating of malignant tumors and benign tumors,the sensitivity,specificity and accuracy of contrast-enhanced ultrasonography were(90.9)%(30/33),(90.5)%(19/21) and(90.7)%((49/54)),respectively.Those of contrast-enhanced CT were(90.9)%(30/33),(95.2)%(20/21) and(92.6)%((50/54)),respectively.Conclusions Both of the two imaging methods are valuable for differential diagnosis of liver tumors.

Objective To evaluate the diagnosis value of contrast-enhanced real-time harmonic gray scale imaging in the diagnosis of renal artery stenosis.Methods Sixteen patients with renal artery stenosis including 4 patients after stent placement were enrolled.Ultrasound contrast agent SonoVue was used.All patients were examined with conventional color Doppler sonography and real-time harmonic gray scale imaging.The diagnostic results were divided into three scales:①no diagnosis result;②doubted diagnosis;③unequivocal diagnosis. The results were compared with those of digital subtraction angiography,CT and MRI.Results Unequivocal diagnosis were achieved in 50.0% (8/16) patients,doubted diagnosis in 31.3% (5/16),no diagnostic result in 18.7% (3/16) on conventional color Doppler sonography;the ratio was 81.3% (13/16), 12.5% (2/16), 6.2% (1/16),respectively on contrast-enhanced real-time harmonic gray scale imaging.The sensitivity,specificity and accuracy of conventional color Doppler scanning were 63.6% (7/11), 40.0% (2/5) and 56.3% (9/16),respectively;those of real-time harmonic gray scale imaging were 83.3% (10/12),100%(4/4) and 87.5% (14/16),respectively.Conclusions Contrast-enhanced real-time harmonic gray scale imaging depicts the margin of the vascular lumen and outer wall directly.Therefore real-time harmonic gray scale imaging may be more helpful in the diagnosis of renal artery stenosis.

Objective To evaluate the value of contrast-enhanced ultrasound (CEUS) with high mechanical index(MI) in the diagnosis of renal artery stenosis(RAS). Methods Twenty-one patients with RAS including 3 patients after renal transplantation were studied. Ultrasound contrast agent SonoVue was used and MI was set at about 1 when the CEUS was performed. All patients were examined with conventional color Doppler sonography and CEUS. The diagnostic results of ultrasound were compared with those of intravenous digital subtraction angiography ( DSA), CT angiography(CTA) and MR angiography (MRA). Results The sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of conventional color Doppler sonography were 85. 7%, 57. 1 % , 80. 0% , 66. 7% and 76. 2%, respectively, those of CEUS were 100%, 66.7%, 88.2%, 100% and 90.5%, respectively. Conclusions CEUS with high MI which improves the imaging of renal artery depicts the margin of the vascular lumen directly and clearly. It may be more helpful in the diagnosis of RAS.

Objective To investigate the value of contrast-enhanced ultrasonography(CEUS) for differential diagnosis of focal splenic solid lesions.Methods Thirty-two patients with 32 focal splenic lesions were examined with CEUS.The enhancement phases and perfusion were observed.Each group has 16 patients.Results The contrast media extincted more quickly in malignant lesions than in benign ones.The peak time and initial decreasing time of the malignant lesions were (19.7±4.5)s and (29.7±10.9)s.The opposite time of the benign lesions were (24.2±4.4)s and (50.9±22.8)s.The initial decreasing time of the malignant lesions was earlier than that of the benign ones.The enhancement pattern was similar between the two groups.More lesions can be detected after CEUS.The number of the lesions was 111 before CEUS and 142 after CEUS.Conclusions CEUS is useful in the differential diagnosis of splenic lesions.

2, but precise estimation of stenoses was impossible on CDUS. The stenosis degree and the length of stenosis measured by contrast-enhanced harmonic gray scale imaging were correlated well with those of DSA(r= 0.94 and 0.63 , respectively). Conclusions Microbubbles fill the arterial lumen with echoes at contrast-enhanced harmonic gray scale imaging. The ability to visualize the inner and outer surfaces of the vascular wall improved the evaluation of luminal abnormalities.