Objective:To evaluate the perfusion defect of superficial lesions by high-frequency contrast-enhanced ultrasound through comparing the results of low-frequency and high-frequency contrast-enhanced ultrasound,and to put forward the preliminary countermeasures.Methods:Twenty-three patients(9 male and 14 female,aged 45.87?9.32 years,ranging 34-73 years)with 6 sorts of superficial lesions,including 1 parotid pleomorphic adenoma,3 thyroid adenomas,5 thyroid adenocarcinomas,5 cervical metastases,7 breast carcinomas and 2 of testicular seminomas,were examined by both low-frequency and high-frequency contrast-enhanced ultrasounds.CEUS with SonoVue under CPS-Cadence mode was performed for each lesion using abdominal probe(low-frequency probe)5 min before small parts probe(high-frequency probe).ACQ software was used to determine the peak intensity(PI)and the results were analyzed by Student's t test in pairs.Results:The PI values of all the 6 types of lesions were significantly lower in high-frequency contrast-enhanced ultrasound images than those in the low-frequency contrast-enhanced ultrasound images(P

Objective: To assess the clinical application of transabdominal ultrasonography for the diagnosis of achalasia. Methods: The subjects were divided into 3 groups, with 8 patients suffered from achalasia as patient group, 10 normal individuals and 8 patients with cardiac carcinoma as controls. All subjects received water provocative test to study the lower esophagus and cardia. Sonographic findings were compared between the 3 groups. After treatment by administration of drugs, pneumatic balloon dilation, or intrasphincteric injection of botulinum toxin, the 8 patients were re examined by TAUS for longitudinal comparison. Results: (1)The normal subjects had no dilation of cardia and lower esophagus before drinking water, but their cardias opened rapidly with the drinking action. (2)All the patients of achalasia were found to have dilation of lower esophagus before taking water. During 10 min continuous TAUS scanning, 5 of 8 demonstrated absence of relaxation of cardias and absence of water from the esophagus into the stomach. The other 3 showed slight and intermittent relaxation of cardias with water flow into the stomach. Thirty minutes after water provocative test, all the 8 patients had water retardation within the lower esophagus. (3)The patients of cardiac carcinoma had an ultrasound feature of cardiac ring enlargement and thickening of cardiac wall without dilation of lower esophagus before water provocative test. Water passed the cardia more slowly. Conclusion: TAUS is a readily accepted examination. It can quickly give reliable diagnostic clues to achalasia. TAUS can also be used for making assessment of therapeutic effect on achalasia. [

Objective: To evaluate the value of high resolution ultrasonography for diagnosis of secondary hyperparathyroism(HPT) in uremia and its relationship with serum parathyroid hormone(PTH). Methods: Ultrasonography was used to examine parathyroid gland and serum PTH, calcium,phosphorus in 55 cases of uremic patients. Results: Totally 64 parathyroid glands in 52 patients(94%) and over 2 glands in 11 cases(20%) were found. The volumes of parathyroid gland was larger and the value of PTH was abviously increased in over 2 glands than in single gland( P

Objective: To assess the clinical application of transabdominal ultrasonography for the diagnosis of achalasia. Methods: The subjects were divided into 3 groups, with 8 patients suffered from achalasia as patient group, 10 normal individuals and 8 patients with cardiac carcinoma as controls. All subjects received water provocative test to study the lower esophagus and cardia. Sonographic findings were compared between the 3 groups. After treatment by administration of drugs, pneumatic balloon dilation, or intrasphincteric injection of botulinum toxin, the 8 patients were re-examined by TAUS for longitudinal comparison. Results: (1)The normal subjects had no dilation of cardia and lower esophagus before drinking water, but their cardias opened rapidly with the drinking action. (2)All the patients of achalasia were found to have dilation of lower esophagus before taking water. During 10 min continuous TAUS scanning, 5 of 8 demonstrated absence of relaxation of cardias and absence of water from the esophagus into the stomach. The other 3 showed slight and intermittent relaxation of cardias with water flow into the stomach. Thirty minutes after water provocative test, all the 8 patients had water retardation within the lower esophagus. (3)The patients of cardiac carcinoma had an ultrasound feature of cardiac ring enlargement and thickening of cardiac wall without dilation of lower esophagus before water provocative test. Water passed the cardia more slowly. Conclusion: TAUS is a readily accepted examination. It can quickly give reliable diagnostic clues to achalasia. TAUS can also be used for making assessment of therapeutic effect on achalasia.

Objective: To investigate the ultrasonographic features of hyperplastic parathyroid glands in patients with secondary hyperparathyroidism. Methods: Fifty-nine uremic patients accompanied with hyperparathyroidism underwent high resolution parathyroid ultrasonography. On 3 of them ultrasound-guided parathyroid biopsies were performed. The ultrasonographic manifestations of the hyperplastic parathyroids were compared with the optical histology from biopsy. Results :(1) The overall detection rate of parathyroid glands was 83.1% by high resolution ultrasonography, and among those 93. 9% were found to have 1 to 2 glands detectable. (2) Five kinds of manifestations were found, among which the homogeneous internal hypoechoes and multiple hyperechoic rings of calcification in the parathyroid parenchyma were characteristic. (3) One patient showed coexistence of adenoma hyperechoes and hyperplasia hypoechoes in a single parathyroid gland. (4) Lithonephria occured in the transplanted kidney in a patient received renal treated by a successful transplantation, which was indicative of tertiary hyperparathyroidism. Conclusion: High resolution ultrasonography is sensitive and specific to detect the abnormalities of parathyroid glands in the patients with secondary hyperparathyroidism. It is complementary to the laboratory tests of serum parathyroid hormone and serum calcium, and it is valuable for the diagnosis and followup evaluation of hyperparathyroidism. It may be used for the screening of presence or future development of secondary hyperparathyroidism in uremic candidates.

Objective To study and evaluate the diagnostic procedures and the treatment strategy of adrenal tumors. Methods The accurate rate of localization and qualitative diagnosis of various imaging procedures for 117 cases of adrenal tumors were analyzed and the treatment efficacy studied. Results The accurate localization rate of the tumors was 84.6% for B ultrasonography,90.6% for CT,98.1% for MRI and the accurate qualitative diagnosis rate 39.2%,69.6% and 79.6% respectively.107 of the 117 cases were surgically cured,of which 30 were considered as large tumors with a volume exceeding 10 cm?5 cm?4 cm,the largest being 20 cm?15 cm?10 cm.9 patients underwent intervention therapy and no surgical procedure has been undertaken in 1. Conclusions Imaging procedures are very helpful for the localization and qualitative diagnosis of adrenal tumors.B ultrasonography can be used as a screening procedure.CT and MRI are high in accurate localization rate.As to the accurate qualitative diagnosis rate MRI is a little higher than CT.Accurate surgical incision is of prime importance for a surgical success.Adequate perioperative preparation can minimize complications to occur.Laparoscopic ultrasonography should be on schedule whenever laparoscopic adrenalectomy is contemplated.

Objective To evaluate the efficacy, safety, and patient acceptance of a vacuum-assisted, hand-held biopsy device(Mammotome) in minimally traumatic percutaneous removal of multiple breast masses in female patients under real-time ultrasound guidance. Methods Forty-three women with 99 low-risk multiple palpable masses were involved in the study. Forty-one breast lesions with the diameter between 9 and 20mm, and 58 with the diameter between 21 and 33mm, were removed by the aid of a vacuum-assisted, hand-held biopsy device with 11-gauge or 8-gauge probes. The pathological examination and follow-up evaluation were performed after the procedure. Results The imaged lesions were completely removed successfully from 27 patients and 16 patients using the 8-guage probe and 11-gauge probe, respectively. Most of the lesions were proved to be breast fibroadenoma by pathological examination. No evidence of recurrence was found by physical examination and the ultrasound evaluation during the follow-up period. Most patients were satisfied with the incision, postoperative breast appearance, and the procedure results. Conclusions Minimally traumatic percutaneous removal of palpable benign breast masses using the Mammotome system with ultrasound guidance is feasible, safe, and yields high patient satisfaction.

Objective: To study the anatomy of parathyroid gland for high-resolution ultrasonography and interventional ultrasound. Methods: Dissection of parathyroid gland was done on 20 adult cadavers with careful determination of the locations, numbers and size of identified glands. Results: There were 65 parathyroid glands identified in total, with an average of 3.25 glands per cadaver. In 8 cadavers(40%), both the superior and inferior parathyroid were single. In another 7 cadavers (35%), either the superior or the inferior parathyroid were found in pair. Four among 20 cadavers (20%) showed paired superior glands with a single inferior one, while in only one cadaver(5%) the inferior glands were in pair and the superior gland in single. Conclusion: Acquaintance of detailed parathyroid anatomy may help to conduct parathyroid ultrasonography and establish a safe and effective puncture route.

Objective: To better understand the high-resolution ultrasound features of normal parathyroid glands for making correct diagnosis of parathyroid abnormalities and performing interventional therapy. Methods: Fifty normal adult volunteers were enrolled in this investigation on out-patient base. A high-resolution transducer (10 MHz) was used to scan their necks bilaterally from the upper pole of thyroid downwards closely to the clavicle. The shape, size, location, number and internal echoes of parathyroid gland were carefully documented. Results: One hundred and forty parathyroid glands were detected. Eight people had 4 glands detected(16%), 33 people 3 glands (66%), 7 people 2 glands(14%) and 2 had only 1 gland(4%) found. Among the 140 glands, 78(55.7%) were superior parathyroid glands(right 42 and left 36) and the rest 62(44.3%)were inferior parathyroid glands(right 33 and left 29). Conclusion: (1) 10 MHz high-resolution ultrasound can be used for detection of normal parathyroid glands. (2) In most cases the ultrasound findings are 3 parathyroid glands. The superior glands are more easily found than the inferior glands, and those inferior glands deep in the mediastinum can not be detected by ultrasound. (3) The knowledge of small size, oval or round shape, internal hypoechoes and the anatomic site of parathyroid gland helps the ultrasonographer to determine appropriately.

OBJECTIVE:To observe therapeutic efficacy and safety of tegafur,gimeracil and oteracil potassium combined with oxaliplatin assisting with radiofrequency ablation(RFA)in the treatment of liver metastases after radical operation of rectal cancer. METHODS:A total of 130 patients with liver metastases after radical operation of rectal cancer were randomly divided into control group and observation group,with 65 cases in each group. After RFA one week,control group was given Oxaliplatin injection 130 mg/m2 intravenously,d1,more than 3 h. Observation group was additionally given Tegafur capsule,for consecutive 14 d,drug with-drawal of 7 d,as a treatment course. A treatment course lasted for 3 weeks,and both groups received 2 courses of treatment. Short-term efficacies of 2 groups were observed as well as complete ablation rate,local recurrence rate,survival rate and the occur-rence of toxic reaction. RESULTS:The total remission rate,disease control rate,complete ablation rate,1-year,2-year and 3-year survival rates of observation group were significantly higher than those of control group,and local recurrence rate was significantly lower than control group,with statistical significance(P<0.05). There was no statistical significance in the incidence of toxic reac-tion between 2 groups(P>0.05). CONCLUSIONS:Tegafur,gimeracil and oteracil potas siucn combined with oxaliplatin assisting with RFA shows significant therapeutic efficacy for liver metastase after radical operation of rectal cancer,and can significantly de-lay disease progression,reduce local recurrence rate and prolong survival time,and does not increase the occurrence of toxic reac-tion.