Objective To observe the position and mobility of the tape after tension-free vaginal tape-obturator(TVT-O) surgery using transperineal two and three dimensional ultrasonography in patients with stress urinary incontinence.Methods A total of 32 patients with stress urinary incontinence who had TVT-O surgery and cured were enrolled.Transperineal two and three dimensional ultrasonography were performed after operation 3 months later.Both the position,morphology and mobility of the tape at rest and during Valsalva menuaver were observed.Results The tapes were mainly located in the 1/3 connection of the middle and distal urethra.The length of the urethra and the length of the urethra between the bladder neck and the proximal tape at valsalva menuaver were longer than those at rest.The tapes moved front-down at valsalva manuaver according to the mean distance between the tape and the symphysis pubis.The angles of the tapes were smaller at valsalva manuaver without significant difference.Conclusion It is useful to observe the position,morphology and mobility of the tape using transperineal two and three dimensional ultrasonography.The changes of the position and morphology of the tapes at valsalva menuaver were not significant.But the tapes can strengthen the urine control in the middle of urethra.

Objective To explore the value of monitoring in vertebral and spinal cord operation by the real-time monitoring of the spinal cord in the process of operation.Methods Nineteen cases were included by the real-time monitoring of spinal cord in the process of operation.Japanese Orthopaedic Association(JOA) score was used to evaluate the clinical efficacy during following-up before and discharge after operation,6 months and 12 months after operation.Results Intraoperative ultrasound monitoring in the 19 patients had no symptom of spinal cord injury and other complications within the plant without loosening fracture occurred were bony fusion; the average JOA scores in the patients before operation,discharge after operation,6 months and 12 months after operation were 8.80±1.60,14.00±1.57,14.60±1.61 and 14.80±1.58,respectively.The improvement rate of JOA score for discharge after operation,6 months and 12 months after operation were individually 51.6%,61.3%,and 64.5%.The JOA score after operation was obviously higher than that before operation.The significant difference between the two groups was observed in the experiment (P<0.05).The cervical spinal canal sagittal diameter significantly increased after operation (mean sagittal diameter of the expansion of 6.6 mm),compared with that before the trial (P<0.05).Conclusion The real-time monitoring with ultrasonography during operation can identify the change of spinal cord and provide the image evidence of operative efficiency to avoid the injury in vertebral and spinal cord operation.

Objective To measure the renal tissue texture or flexibility with virtual touch quantization (VTQ) and to tentatively examine its clinical application in patients with chronic kidney disease(CKD).Methods A total of 750 patients (1500 kidneys) were performed with VTQ,including 400 cases in the control group,and 350 cases in the CKD group.A conventional ultrasound examination (two-dimensional,color Doppler) were first taken,and then the shear wave velocity (Vs) was measured which reflected the textural elastic.Results In both groups the Vs was the highest in renal cortex with significant difference (P<0.05); renal cortical region Vs in CKD group was lower than those in control group (P<0.05),while Vs of renal medulla and renal sinus had no significant difference in the two groups.The severity of renal dysfunction was increased along with a Vs decrease of renal cortex.Conclusion VTQ is helpful to assess renal function of patients with CKD.

Objective To investigate the effects of different standard cross sections and angles on the measurement accuracy of induced postnatal fetal long bones. Methods Fetal long bones (femori and humeri) in 30 cases with induced abortion were measured utilizing ultrasound from different angles and /or at different directions. The values measured from different sections and angles with vernier calipers were compared prenatally and postnatally. Results There was no apparent difference between the pre-induced abortion and those of the post-induced abortion. The results in the 30 cases showed that: (1) the values measured from anterior 90 degree, the long bone length would best match with the bare long bone length up to 96.7%, the match rate of other angles and/or directions was up to 80%; (2) no apparent statistical difference was between the length of left and right bone and no difference was found using 4 different directions and 3 different angles; (3)there was no difference between the left and right femuri and humeri.Conclusions Though the measured value from anterior 90 degree direction was the most accurate one, the statistical analtical results showed no difference among 12 values measured from 3 different angles and/or 4 different directions.

Objective To investigate the change of cardiac function in elderly hypertensive patients with heart valve degenerative by echocardiography.Methods A total of 126 cases were divided into a valve disease group and non-valve disease group groups.The parameters of trial size,cardiac function and pulmonary artery pressure were detected.Results Of all 126 cases were the patients with hypertension including 28.6% (36/126) of valve disease group and 71.4% (90/126) of non-valve disease.There were 31 cases with mitral valve disease,22 cases with tricuspid valve disease; 26 cases with aortic valve disease; 36 cases with double or three alvular lesions in valve disease group.There was a significant difference in ventricle size and systolic function among valve disease group and non-valve disease group and control group.But there was no significant difference in thickness of ventricular wall between valve disease group and non-valve disease group.Conclusion The elderly hypertensive patient with valve disease was an independent factor for the development of congestive heart failure.

Objective To assess longitudinal segmental myocardial strain and displacement of left ventricle (LV) in patients with dual chamber pacing (DDD) using velocity vector imaging (VVI) and to explore the clinical application value of VVI in assessing left ventricular motion.Methods A total of 23 patients before and after DDD pacemaker implantation were enrolled in this study.The peak systolic strain and displacement of ventricular segments were measured with VVI and compared before and after pacemaker implantation.Results Compared to the values at the baseline,the strain and displacement of lateral,interventricular septum,anterior and posterior wall of LV in patients with pacing were significantly decreased.The strain,displacement of basal and mid segments with pacing were decreased as well(P＜0.01).The left ventricular strain and displacement in patients with pacing were significantly decreased than those of patients at the baseline(P＜0.05).Left ventricular longitudinal displacement before and after DDD pacing was significantly decreased from basal,mid to apical segments.But no significant difference was found in longitudinal strain from basal,mid to apical segments of LV.Conclusions (1) Left ventricular strain and displacement in patients with pacing were different between those before and after DDD pacing.(2) VVI can accurately assess left ventricular strain and displacement in patients with DDD pacing,and can become a powerful mean to assess the regional myocardial function.

Objective To investigate the perfusion characteristics of intraductal breast lesion by real-time gray-scale contrast ultrasound and to determine the value of real contrast ultrasound in the diagnosis of breast masses.Methods A total of 30 breast lumps by ultrasound contrast enhancement were observed from the enhanced level.An enhanced mode and enhanced border were observed when the lesion was clear.The perfusion characteristics were compared between the benign and malignant lesions.Results Thirty breast lumps include 17 benign lumps and 13 benign lumps by pathological operation.After injected with the microbubble contrast medium,all breast lumps enhanced to varied extent.And malignant lesions showed significant enhancement for more than 3 grade(69.2%,9/13).The radial enhancement around lesion were mainly observed in the malignant lesions (P＜0.05).Conclusion The microvascular perfusion of breast intraductal lesions can be clearly displayed by real-time gray-scale contrast-enhanced ultrasound.The feasibility of differentiation between benign and malignant lesions according to their perfusion characteristics appears to be promising.

Objective To explore the methods and clinical value of transrectal ultrasound (TRUS) in detecting rectal gastrointestinal stromal tumor(GIST) with head scanning probe.Methods A total of 12 patients had the ultrasonic examination through the rectum with the head scanning probe.Preoperative ultrasonic findings were compared with the pathological results.Results Of the 12 patients,the patients were divided into three groups,including 3 cases with low-degree severity,6 cases with moderate-degree severity and 6 cases with high-degree severity.The lymph node metastasis was not found near intestines.Rectal GIST appeared as a hypoechoic mass with clear limit、regular form and expanded growth under TRUS.The CDFI showed abundant flow in the tumor and TRUS had an overall accuracy rate of 75.0%(9/12)in the diagnosis of rectal GIST.The accuracy of TRUS in the staging diagnosis of rectal GIST was 83.3%(10/12).Conclusion The TRUS with the head scanning probe is of great value for pre-operative diagnosis and staging of rectal GIST.Rectal water window and felicitous check-up technique can enhance the accuracy of TRUS.

Objective To observe the injury of high intensity focused ultrasound combined with radiotherapy (RT) to the pancreas,the unintended abdominal tissues and organs of swine in vivo.MethodsAccording to the criterion to grade the gross and histological injury of the pancreas and the unintended tissue,the scores of injury between the groups to get the data of safety and feasibility of high intensity focused ultrasound(HIFU)combined with RT were compared.Results There was a better tolerance in each group and no fatal complication was observed.For the pancreas there was significant difference for the combined group compared with the other groups.For the unintended target tissue there was no significance difference except the control group with the other groups.Conclusion HIFU combined with RT can increase the injury to the pancreas of the swine compared with HIFU alone; while there was no increase for the injury to the unintended target tissue.The main toxicity of combination treatment is the toxicity of RT and can be tolerated by the animals.If the HIFU treatment is strictly controlled,the combination of HIFU and RT is safe and feasible.

Objective To assess the radiofrequency ablation (RFA) lesions in canine prostate with real-time harmonic gray-scale contrast-enhanced ultrasonography and investigate the feasibility to predict these lesions.Methods A total of 5 male beagle dogs took RFA of the prostate.Radiofrequency (RF) was delivered under transrectal ultrasound (TRUS) guidance.A lesion was created in the right and left lateral lobes of canine prostate,respectively.The examination of conventional gray-scale ultrasonography,power Doppler ultrasonography,real-time harmonic gray-scale contrast-enhanced ultrasonography were performed immediately after RF procedure.All animals were subsequently sacrificed and the prostates were harvested for pathologic analysis.Thermal lesion volume was calculated based on expected shape of ellipsoid using equation.The volumes of the calculated thermal lesion on contrast-enhanced ultrasonography in dogs were compared with the volumes obtained from the pathological specimens.Results The RFA lesions could not be imaged accurately with real-time conventional gray-scale or power Doppler ultrasonography.However,contrast-enhanced low MI perfusion imaging was able to have real-time monitoring for the lesion (no blood flow).The volume of lesions was measured with contrast-enhanced ultrasonography without significant difference with those of pathologic results.Ultrasonic imaging(conventional gray-scale or power Doppler sonography)of the ablation areas also had its own characteristics.Conclusion The real-time harmonic gray-scale contrast-enhanced ultrasonography appears to be an accurate modality for assessment of RFA lesions.Conventional gray-scale and power Doppler sonography had their own characteristics to evaluate the RFA lesion.