Objective To explore the value of oral ultrasonic contrast agent on preoperative T staging of gastric cancer.Methods 62 patients diagnosed with gastric neoplasms by operation and pathology were analyzed retrospectively.Patients were treated by oral ultrasonic contrast agent and conventional ultrasonography before surgery,two methods were compared with postoperative pathology.Results Oral ultrasonic contrast agent and conventional ultrasound detection rates of gastric neoplasms were 100.0 ％(62/62)and 64.5 ％ (40/62),The difference was significant between the two examination methods(x2 =24.369,P ＜ 0.05).The oral ultrasonic contrast agent and conventional ultrasound with T1,T4 staging accuracy rates were 85.7 ％(6/7),0,92.3 ％(36/39),59.0 ％(23/39),there were significant differences(both P ＜ 0.05).T2,T3 staging accuracy rate were 75.0 ％(3/4),0,83.3 ％(5/6),33.3 ％(2/6),the differences were not significant(P =0.143,P =0.242).Conclusion Oral ultrasonic contrast agent in preoperative T staging diagnosis has higher accuracy rate in gastric neoplasms,it could guide clinical rational therapy.It is worth promoting non-invasive,convenient means of stomach diseases census.

Objective To discuss the contrast-enhanced ultrasonography diagnostic value of the liver low-density focus on contrast-enhanced CT. Methods The contrast-enhanced ultrasonography results of 47 cases of the liver low-density focus on contrast-enhanced CT. were retrospectively analyzed. Results The pathological diagnosis in 47 focuses was metastatic carcinoma 20 cases, inflammatory pseudotumour 9 cases,hepatic hemangioma 6 cases, primary liver carcinoma 4 cases, cyst 2 cases, abscess 2 cases, tuberculosis 2 cases, FNH (focal liver nodular hyperplasia) 1 case, local adipose tissue infiltration of liver 1 case. 45 cases of contrast-enhanced ultrasonography diagnosis was consistent with pathological or clinical diagnosis. Cysts and inflammatory pseudotumour had not ultrasound contrast enhancement in the entire phase, but the crossed blood vessels was observed in inflammatory pseudotumour. The local adipose infiltration of liver had synchronous ultrasound contrast enhancement accompanied with liver tissue enhancement. 80% (12/15) of liver metastases of lack of blood supply showed fast contrast enhancement around the tumour edge and homogeneous and light contrast enhancement in the tumour center. 80 % (4/5) of liver metastases of rich of blood supply showed heavy and rapid contrast enhancement in the whole tumour. The enhancement degree in bscess and tuberculosis in the ultrasound contrast enhancement was correlated with necrosis degree, which showed fast and uneven contrast enhancement, hepatic hemangioma showed gradually contrast enhancement from its edge to center, whose enhancement time lasted for longer time than that of metastatic tumour with a statistically difference. FNH showed a typical contrast enhancement pattern, fast enhancement and fast weakening from center to edge. Hepatic cell carcinoma showed fast enhancement and fast weakening in the whole tumour. Conclusion Contrast-enhanced ultrasonography have diagnostic value of CT liver focus of low-density, which is helpful for the differential diagnosis of such focus.

Objective To discuss the characteristics of ultrasonic images obtained by color Doppler per rectum after intrarectal pouring and the advantages of this method.Methods 40 cases who were diagnosed as rectal carcinoma prior to surgeries were investigated.The rectum was cleand and then was poured with normal saline before examination.Color Doppler ultrasonography per rectum was performed with intrarectal probe touching the inferior edge of the tumor.The 2-dimensional images and color Doppler images were then analyzed.Results The accurate typing of rectal tumors(detailedly,the ulcerative,intumescent,and confined types)can be obtained with this method.Within the 40 cases,24 were ulcerative,12 were intumescent and 4 were confined.Only one case with ulcerative tumor was misdiagnosed as intumescent.The total accuracy rate was 97.5%.As with rectal tumors less than 5cm,there was no significant difference between the measurement by ultrasonography and that by pathologic methods (P＞0.05).While for tumors larger than 5cm,the measurement by ultrasonography was significantly different from that by pathologic methods (P＜0.05).There was no significant correlation between the bloodstream signal of color Doppler and pathological grading(P＞0.05).The method can be applied for patients who have a narrow rectal duct or are suffering from agonies which prevent the passage of the colonoscope.For cases failing to detect the margin and surface of the tumor with routine method,or ultrasonic probe failing to pass the confined area leading to illegible 2-dimensional images,This method is competent as well.Conclusion Color Doppler ultrasonography per rectum after intrareetal pouring can be applied for the diagnosis of rectal tumors of all types.

Objective To analyze the ultrasonic imaging characteristics of primary breast lymphoma and their significance for diagnosis.Methods Data of ultrasonograph from 21 cases of primary breast lymphoma were reviewed, and all cases had been certificated by pathology.Results All of 21 cases with primary breast lymphoma were solid mass.The contours of 16 cases were regular, and the boundaries of 9 cases were clear.20 cases were hypoechoic masses, besides 3 cases with lower echo like liquefactive degeneration.The internal echoes of 19 cases were disorderly, part of them with hyperechoic trabs.The rear echoes of 17 cases were neither enhanced nor fading.The surrounding tissues of 19 cases were not changed.13 cases had more than 3 blood vessels on color Doppler imaging.Conclusion There are some ultrasound characteristics in primary breast lymphoma, which would be helpful in the diagnosis of primary breast lymphoma.

Objective To explore the factors affecting diagnosis accuracy on T stage of oral ultrasonic contrast agent examination on ulcerative gastric neoplasms.Methods Data from 82 patients were analyzed who were pathologically diagnosed as ulcerative gastric neoplasms ultrasounds data of oral ultrasonic contrast agent before surgery were compared to postoperative pathology,analysis had been done on influence of the lesion site,size of the T staging on ulcerative gastric neoplasms.Results The diagnosis accuracy rate of T stage on lesser curvature of stomach and gastric antrum were 91.3 ％ (21/23) and 85.7 ％ (24/28),compared with the pathological results were in good concordancy (Kappa =0.763,0.68,P ＜ 0.05).The accuracy rate of T stage on cardiac lesions was 68.0 ％ (17/25),compared with the pathological results consistency in general (Kappa =0.446,P ＜ 0.05).Further research on the effects of T stage accuracy would be necessary.The accuracy rate ofT staging on tumor size ≤ 5.0 cm group and ＞ 5.0 cm were 92.3 ％ (36/39) and 72.1％ (31/43),the difference was significant in two groups (x2 =5.591,P ＜ 0.05).Conclusion Oral ultrasonic contrast agent application is more accurate on lesser curvature of stomach,gastric antrum and lesions size ≤ 5.0 cm.

Objective To compare the value of intrarectal filling with water and filling in rubber sheath with water in endoluminal uhrasonography for preoperative staging of rectal tumors. Methods 215 cases of rectal tumors were divided into two groups. 120 cases using the method of filling in rubber sheath with water and 95 cases using intrarectal filling with water were diagnosed with uhrasonography. The results were compared with corresponding pathologic results for the judgment of their accuracy. Results The accuracy for the diagnosis of infiltration depth was 60.0 % in the first group and was 73.7 % in the second. The difference was statistically significant (P <0.05). The accuracy for diagnosis of metastases of perirectal lymph nodes was 82.5 % in the first group and was 80.0 % in the second. The difference has no statistical significance (P >0.50). Conclusion Intrarectai filling with water is better than filling in rubber sheath with water in the diagnosis of infiltration depth of rectal tumors, while there is no difference in the diagnosis of metastasis of perirectal lymph nodes.

Objective To investigate the endoluminal ultrasonographie characteristics of adenoearcinoma and mucous adenocareinoma of the rectum. Methods The ultrasonographie characteristics of thirty eases of advanced adenoeareinoma of the rectum and twenty-eight eases of rectal mucous adenoearcinoma were analyzed retrospectively in comparison with their eorresponding pathologic images. Results In advanced adenocareinoma of the rectum, 28 eases manifested rough endoluminal surface, of which 19 marked by thickened changes without arrangement of layers, 10 had indistinct arrangement of layers in some areas and one had clear arrangement of layers. In the deepest margin of infiltration, 17 eases manifested sentus, homed or knot-like protuberance, while 5 marked by wavy margins, and 8 cases had clear and fiat margins. In 25 eases of rectal mucous adenocareinoma, 20 manifested smooth endoluminal surface. With regard to infiltration of tumors to rectal wall, 6 cases manifested clear arrangement of layers, while 13 had clear arrangement of layers in part and 6 had no clear arrangement. In the deepest part of infiltration, 8 eases manifested slippery and fiat margins and 10 manifested wavy margins and 7 had a few sentus, homed or knot-like protuberance locally. According to ultrasonic results of the depth of infiltration to rectal wall in comparison with pathologic findings, 25 eases were diagnosed accurately, while in two cases the diagnosis was too shallow and in three eases it was too deep. In rectal mucous adenocarcinoma, 10 cases got correct diagnosis and 14 were diagnosed superficially and one got too deep. The accuracy of ultrasonic diagnosis on rectal mueoas adenoearcinoma was apparently lower than that of adenoeareinoma and most of the misdiagnosis were too superfieiai. Conclusion There are different ultrasonographie characteristics of rectal adenoeareinoma and rectal mucous adenoeareinoma, which can be helpful for the typing of rectal carcinoma and avoiding excessively superficial misdiagnosis.

Objective To evaluate the clinical value of color Doppler ultrasound-guided percutaneous transhepatic cholangiol drainage(PTCD) for treating obstructive jaundice. Methods 248 cases of PTCD were performed in 224 patients under the guidance of color Doppler ultrasound. 118 PTCD cases were carried out passing through the inferior segmental biliary duet of Left laterallobe (Left drainage mode). Right lobe drainage mode (right drainage mode)was conducted in 130 patients. Left plus right lobe drainage mode in 16 patients. Results The total success rate was 99.59 %(247/248), and the success rate of the firs time PTCD was 92.33 %(229/248). The success rate of left drainage mode was significantly higher than righl lobe drainage (96.61% vs 88.46 %, P ＜0.05). Conclusion The technique of color Doppler ultrasound-guided PTCD is an efficient method in obstructive jaundice therapy, with the advantages of safety, convenience, minimal invasion, and higher success rate.

Objective To investigate ultrasonographic features of different pathological types of mucinous breast carcinomas (MBC), and to improve the diagnosis rate of MBC. Methods The ultrasonographic features of 42 MBC cases between January 2014 and December 2015 in Shanxi Provincial Cancer Hospital were retrospectively analyzed according to pathological types. Results There were 24 cases of simple type and 18 cases of mixed type in 42 MBC cases (46 lesions in total). The coincidence rate of preoperative ultrasound diagnosis for cancerous lesions was 93.5 % (43/46), including 24 cases of 27 simple type lesions with oval form or lobulated (20/27, 74.1 %), clear boundary (21/27, 77.8 %), uniform internal echo (17/27, 63.0 %), posterior echo enhancement (11/27, 40.7 %), and 18 cases of 19 mixed type lesions with irregular shape (14/19, 73.7 %), unclear border (16/19, 84.2 %), uneven internal echo (13/19, 68.4 %), posterior echo attenuation (13/19, 68.4 %). The differences between the two types of ultrasound images were statistically significant (both P＜0.05). Of 42 cases, 76 axillary lymph nodes were transferred in 13 cases. Preoperative ultrasonography showed that 32 axillary lymph nodes enlargement were abnormal in 12 cases, and the detection rate was 42.1 % (32/76). The positive rates of estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER-2) were 87.5 % (21/24), 79.2 % (19/24), 8.3 % (2/24) in simple type and 83.3 % (15/18), 88.9 % (16/18), 5.6 % (1/18) in mixed type respectively. There was no significant difference in the positive rates of 3 kinds of molecular markers among two types (all P＞0.05). Conclusions Due to the different tissue components in different types of MBC, ultrasonic features show several differences. Simple type is similar to benign masses, while mixed type shows the characteristics of invasive carcinomas.

Objective: To investigate the location, size, ultrasonic characteristics and clinical significances of normal parathyroid glands. Methods: A total of 350 healthy subjects with no relevant diseases in Shanxi Provincial Cancer Hospital from January 2017 to December 2017 were selected. The age ranged from 9 to 83 years old. They were divided into seven groups according to age, with 50 in each group. The position, size, shape, echo, boundary, and blood flow signal characteristics of the normal parathyroid glands in these healthy subjects examined by ultrasound were retrospectively analyzed, and the differences among the different groups were compared. Results: The detection rate of normal parathyroid glands in 350 subjects was 95.4% (1 335/1 400). The normal parathyroid glands were oval, fusiform or irregular shape hyperechoic or isoechoic nodules, with homogeneous echoes and clear borders. There was no obvious blood flow signal in most glands. The proportion of fusiform shape in upper parathyroid glands (24.4%, 161/659) was higher than that in lower parathyroid glands (18.4%, 125/676), the difference was statistically significant (χ ² = 6.99, P < 0.05). The superior parathyroid gland was mainly located in the superior thyroid region, while the inferior parathyroid gland was mainly located in the inferior thyroid region, especially within the range of 2 cm from the inferior thyroid pole. In the age ≤ 20 years old group, the proportion of patients with upper parathyroid gland in the upper thyroid region (80.4%, 74/92) was higher than that in the other age groups, and the proportion of patients with lower parathyroid gland in the subthyroid region (30.6%, 30/98) was higher than that in the other age groups, the difference was statistically significant (χ ² = 3.35, P < 0.05). There was no significant difference in the size of parathyroid gland among different age groups (P > 0.05). Conclusions The detection rate of normal parathyroid glands is high, and they mainly located in the upper and lower thyroid regions within 2 cm from the lower margin of the thyroid. Ultrasound images are mainly characterized by the clear elliptical shape and the uniform high echo. The ultrasonic characteristics of normal parathyroid glands are conducive to preoperative localization of parathyroid glands and provides a reliable basis for finding and retaining parathyroid glands in thyroid surgery.