ObJective To evaluate the value of contrast-enhanced ultrasonography microflow imaging (MFI) in detecting prostate cancer. Methods Sixty-five patients with serum prostate-specific antigen levels higher than 4.00 μg/L were evaluated with transrectal gray-scale,power Doppler,and MFI ultrasonography and then biopsy guided by ultrasonography. Biopsy was performed at twelve sites in the base,the mid gland and the apex in each patient. In these three transverse sections, when any of the three methods showed abnormality,the biopsy site was directed to the abnormal foci. Diagnostic efficiency of the three methods for prostate cancer detection was compared based on biopsy results according to patient and biopsy site. Results Overall prostate cancers were detected in 230 (29.5 %) of 780 specimens in 36(55.4%) of 65 patients. MFI could detect more patients(34) than gray-scale(26) and power Doppler(28) (P = 0.021, P = 0.031), 6(16.7%)of the 36 patients diagnosed with cancer were identified only by MFI. By biopsy site, MFI had higher sensitivity and overall accuracy (80.0% and 83.0%) than gray-scale (47.0% and 76.8%) and power Doppler (37.4% and 74.6%) ultrasonography(P <0.001, P<0.001 ; P = 0.001, P <0.001), while the specificity of MFI was 84.4%, lower than gray-scale (89.3%) and power Doppler (90.2%) ultrasonography(P = 0.009, P < 0.001). Conclusions MFI could detect more patients and improve sensitivity and overall accuracy by biopsy site than conventional uhrasonography.

Objective To explore the value of improved elasticity scores in differentiating malignant and benign breast lesions. Methods A prospective study was done in 394 patients with 508 breast lesions confirmed by pathology and the elastographic images of the lesions were evaluated by using old and improved elasticity scores respectively. Results The elastographic images of the lesions could be evaluated and classified in all patients by improved elasticity scores but could not be evaluated and classified in 82 lesions by old elasticity scores. The accuracy of ultrasonic elastography for diagnosing benign and malignant breast lesions was 88.8% and 78.1%, respectively by old elasticity scores and improved elasticity scores. Conclusions The elastographic images of breast lesions were accurately evaluated by using improved elasticity scores, and the use of improved elasticity scores is helpful to reduce the biopsy which is not necessary.

Objective To explore the clinical value of color Doppler flow imaging(CDFI) combined with quantitative analysis technique to evaluate renal flow perflusion. Methods Twenty patients with different renal diseases matched with healthy control subjects were examined with Philips iU22 CDFI system. CDFI system and Qlab quantitative technique were used to measure renal restrictive index(RI), vascularization index(VI), flow index(FI), vascularization-flow index (VFI). The patients all received renal single-photon emission computed tomography (SPECT) examination. Results The RI of 32 kidney with lower flow perfusion in SPECT were higher than in the contol group (P <0.01). VI,FI, VFI were lower than those in control(VI, VFI, P <0.01 ;FI, P <0.05). Conelusious The renal blood flow perfusion of patients with renal diseases are lower than that of healthy people. It has high clinical value using CDFI combined with quantitative analysis technique to evaluate the renal perfusion of the patients with renal diseases.

Objective To probe into the color Doppler echocardiographic characteristics of bilocular heart (BH) and associated malformations. Methods Twenty patients of BH were examined with color Doppler echocardiography (CDE) and the characteristics were observed. All the CDE results were compared with angiocardiography and 14 were confirmed by operation. Results Nineteen cases were properly diagnosed based on the CDE characteristics,1 case were misdiagnosed as mitral atresia. CDE characteristics of BH were obvious:① Apical four-chamber view of two-dimensional echocardiography (2DE) showed total echo dropout in both the interatrial septum and the interventricular septum and disappearance of the intracardiac "cross". The common atrioventricular valve closed during systole and appeared as figure "8", named 2DE "8" sign. During diastole, the common atrioventricular valve opened to a common ventricle. ② Color Doppler flow imaging (CDFI) showed common intra-atrial flow signal entereda common ventricle through common atrioventricular valve during diastole in all patients and colorful reflux through common atrioventricular valve during systole in 15 cases. ③ Among the 20 eases, 16 of the common atria were situs solitus,4 were situs inversus; 10 of the common ventricles were type A,2 were type B and 8 were type C. According to the spatial relationship of the great arteries,there were 4 type Ⅰ ,7 type Ⅱ and 9 type Ⅲ.There were 18 pulmonary stenosis and 2 pulmonary hypertension. ④ In the presence of pulmonary stenosis, CDFI showed colorful shunt signals through pulmonary artery during systole. Conclusions BH and associated malformations have obvious echocardiographic characteristics. CDE has a specific value in diagnosing BH and associated malformations.

Objective To evaluate the value of echocardiography in patients with isolated anomalous origin of right pulmonary artery from ascending aorta. Methods The eehoeardiographie results of five patients with isolated anomalous origin of right pulmonary artery from ascending aorta were reviewed retrospectively. Results Severe pulmonary hypertension occurred in all the patients,besides accompanied with patent duetus arterious, no other congenital malformations combined. Three patients underwent operation. Patent ductus arterious was missed in one patient's diagnosis. Another patient was missed isolated anomalous origin of right pulmonary artery from ascending aorta in several echoeardiographic examinations, once misdiagnosed as complete transposition of the great arteries. Conclusions There are many anatomic and hemodynamic similarities in patients with isolated anomalous origin of right pulmonary artery from ascending aorta. Grasping their common charaeters and exploring multi-position and multi-section are helpful to make correct diagnosis.

Objective To appraise the clinical value of velocity vector imaging(VVI) by analyzing the peak systolic velocities,strain and strain rate of ventricular segments in patients with DDD pacing. Methods eventeen patients with DDD pacing were enrolled in this study. The peak systolic velocities, strain andstrain rate of ventricular segments were measured with VVI. The difference at baseline and after pacemaker implantation was analyzed. Results Left and right ventricular (LV and RV) longitudinal peak velocities at baseline and after DDD pacing were significantly decreasing from basal, mid to apical segments. But no significant difference was found in longitudinal strain,strain rate and radial motion characteristic of LV. The mean systolic velocities and strain rate at baseline and after pacemaker implantation and strain with pacing of RV posterior septum and free wall were higher than those of posterior septum and lateral segment of LV respectively. The mean strain and strain rate of RV after pacing were higher than that of LV. Compared with the values at baseline, mean strain of LV with pacing was lower significantly. Conclusions VVI can accurately assess ventricular systolic function in patients with DDD pacing, and can become a powerful means in assessing the regional myocardial function.

Objective To study the formations of several ridges in peripheral artery velocity tracing. Methods The experimental models of constrainting limb and adrenaline were performed in 6 juvenile susscrota domesticas,tbe variations of the external lilac artery velocity tracing observed,and the parameters of peak systolic velocity (PSV), minimum post-systolic velocity (MPV), peak diastolic velocity(PDV) and end diastolic velocity(EDV) were obtained. Results With the increase of downstream circulation resistance, systolic waveshape inclined to acumination, MPV gradually degraded to zero and negatively increased subsequently, diastolic wave amplitude lowered, and EDV gradually decreased to zero. The stronger vasoconstriction was, the more striking the variations were. Conclusions Cardiac ejection forms systolic dominant wave, post-systolic backward ware is the result of backstreaming because of elastic recoil of downstream artery,and diastolic forward ware is the result of blood transient acceleration caused by elastic recoil of upstream artery. Systemic vascular resistance has significant effect on diastolic waveshape,and the occurrence of post-systolic backward ware implies downstream circulation resistance obviously increases.

Objective To investigate the effects of ultrasound irradiating hydroxycamptothecin (HCPT)-loaded microbubbles on apoptosis in human hepatoma SMMC-7721 cells, and to clarify its probable mechanism. Methods The SMMC-7721 cells were randomly divided into six groups as follows: control group, blank liposome microbubbles plus ultrasound, HCPT-loaded microbubbles, HCPT, HCPT plus ultrasound,and HCPT-loaded microbubbles plus ultrasound. Apoptosis was ascertained by Annexin V-Fire/ PI and TUNEL methods. The expression of Bcl-2 and Bax protein was detected by immunocytochemistry staining technique. Results In the group of HCPT-loaded microbubbles plus ultrasound,the apoptosis rate at early term was found to reach (12.18 ± 1.38)% by Annexin V-Fitc/PI assay, brown-colored positive apoptotic cells were observed and the apoptosis rate at advanced term was found to reach (34.25 ± 1.83)% with TUNEL method. The expression of Bcl-2 was found to decrease,the expression of Bax increase,and the ratio of Bcl-2/bax significantly decrease by immunocytochemistry staining technique in the same group. Differences with other groups were significant. Conclusions The method of ultrasound irradiating HCPT-loaded microbubbles can notability induce human hepatoma SMMC-7721 cells apoptosis. The decrease in the ratio of Bcl-2 to Bax might be responsible for cells apoptosis.

Objective To explore the value of contrast-enhanced ultrasound(CEUS) in diagnosis of placental accrete,placental increta and placental percreta. Methods Twenty suspected patients of placental accrete, placental increta and placental percreta were examined with CEUS after routine ultrasound examination. Sono Vue was injected intravenously as bolus and a real time CEUS was performed to observe the characteristics. Results Comparison of 15 CEUS cases with uterine curettage, 8 cases had a clear relationship between the residual disease of the uterine cavity and uterine wall,7 cases had a thin thickness (2-4 mm) between the residual disease of the uterine cavity and uterine wall. Five of the 20 cases performed cesarean cesion,3 cases of the uterine serosa of placenta affixing part were very thin,incomplete and rough, demonstrating placenta increta and placenta percreta, 1 case of uterine rupture showed non-invasiveness between uterine wall and uterine serosa,and 1 case of placenta increta pathologically proven, initially suspected gestational trophoblastic disease by the CEUS. Conclusions CEUS provides an important diagnostic message for placental accrete, placental increta and placental percreta by showing the different characteristics of the perfusion image.

Objective To compare the differences in histological morphology and hemodynamics between benign and malignant tumor, as well as differences between the different perfusional regions in tumors of the same type. Methods Thirty cases with malignant breast carcinoma and 30 cases with fibroadenoma were inspected by contrast enhanced ultrasound with time-intensity quantitive analysis. Perfusion index like peak intensity(PI), area under the curve(AUC), time to peak(TTP) and wash-out time (WOT) were collected both inside and at the margin of focus. The ultrastructures of new microvessesl were observed routinely with microscopy and transmission electron microscopy. Results The curve of malignant tumor group was characterized as ascend rapidly and drop slowly while the benign group presented as ascend slowly and drop rapidly. The AUC and WOT of malignant tumor group were significantly higher than that of benign group,while the PI and TTP had no statistical difference. In malignant tumor group,PI, AUC and WOT of the margin of focus were significantly higher than that of inside region of focus,while TTP was the opposite. However,there was no statistical differences between the perfusion parameter inside and outside of focus in benign group. The ultrastructures of newly built blood vessels in malignant group had strong ability to split,which was different from normal endothelium cells but was similar to other tumor foci. The margin of foci were characterized with dilatating and distorting vessels,and the center of the foci were occupied by narrow,occlusive new vessels and contracted anamorphic endothelium cells and pericytes. Rich microvessel areas located in the margin of foci. Conclusions The perfusion pattern,modality of time-intensity curve, mean perfusion parameter and variance of regional perfusion parameters are valuable diagnostic basis in discriminating benign and malignant breast tumor. The density,modality,distribution,structure and function of new microvessels in tumor focus are also keystone factors when tumors are assessed by means of imaging.