Objective To evaluate the accuracy of intraoperative ultrasonography (IUS) in judging the relationship between central bronchogenic carcinoma and pulmonary vessels and in predicting the resectability of the tumor. Methods Intraoperative ultrasonograpy(IUS) and preoperative CT scanning were performed in 30 patients of central bronchogenic carcinoma. The relationship between vessel and tumor as assessed by IUS and preoperative CT were quantified and scored with a ranging from 0-4 respectively, and then the resectability of the tumor and optimal surgical method were predicted according to the scores. Results The accuracy of CT and IUS to determine tumor-vessel relationship was 72.3%(141/195) and 81.0%(171/211), respectively (P=0.037). The sensitivity of CT and IUS in predicting the resectability of tumor was 91.3%(21/23) and 95.6%(22/23), respectively, the specificity was 28.6%(2/7) and 57.1%(4/7), respectively, and the accuracy was 76.7%(23/30) and 86.7%(26/30), respectively. The accuracy of CT and IUS in predicting surgical strategy was 53.3%(16/30) and 63.3%(19/30), respectively(P=0.432). Conclusion IUS is a useful method in predicting the resectability of centrally located bronchogenic carcinoma.

Objective To correlate the ultrasound imaging of atherosclerotic carotid in vivo and in vitro with the histological analysis, and to evaluate the usefulness of gray scale ultrasound densitometry analysis of ultrasound images. Methods Twenty-two carotid plaque lesions of 20 patients were examined by high resolution B-mode ultrasound pre- and post operatively, and the images of carotid plaque were quantitatively analyzed by 256 gray scale ultrasound densitometry. The transverse pathological sections of the plaques were made, and matched and compared with the images of ultrasound. Results Ultrasound density measurement of calcium, fibrous tissue, hemorrhage / thrombus and lipid deposits was 89?12, 53?8, 37?6, and 39?3 respectively in vivo, and was 168?11, 136?12, 85?12 and 89?10 respectively in vitro. Besides the comparison between hemorrhage and lipid deposits, there were significant statistic differences of density measurement between different components. Conclusions Gray scale ultrasound densitometry analysis can provide quantitative measurement of atherosclerotic carotid plaque, and is useful for evaluate the stability of the plaque.

Objective To evaluate the value of intraoperative ultrasonography (IUS) in detecting the lymph nodes in mediastinum and hilum during lung cancer surgery. Methods Lymph nodes were detected in every part of the mediastinum and hilum by IUS in 33 cases with lung cancer during surgery. The number, size and location of lymph nodes were recorded, and the metastasis to lymph nodes was predicted by the sonographic features and geometric measurement respectively. Mediastinum was explored and lymph nodes resection was performed in each case, and each resected lymph node was sent for pathological examination. Results The sensitivity of IUS in detecting lymph nodes in mediastinum and hilum was 83.6% (163/195) and the positive predictive value was 97.0%(165/168). The result of detecting lymph nodes with IUS was influenced by their location and size. The sensitivity, specificity and accuracy of IUS in diagnosing lymphatic metastasis with respect to geometric measurement were 70.3%, 71.7%, 71.2%, respectively, and were 85.7%, 75.0%, 83.3%, respectively, with respect to sonographic features. Conclusions IUS was an effective method for lung cancer surgery in detecting mediastinum lymph nodes.

Objective To study the clinical value of VACORA vacuum-assisted rotation system in the treatment of benign breast lesions. Methods Under the screening of dynamic ultrasound,122 beast lesions in 93 patients diagnosed as benign lesions from ultrasound were treated with VACORA vacuum-assisted rotation system,and all the patients were examined for follow-up. Results All the lesions were totally rotated and 119 lesions demonstrated to be benign and 3 lesions were atypical hyperplasia from pathologic examination. In the benign lesions, 72 cases were demonstrated to be fibroadenoma, 39 cases were demonstrated to be fibrosis adenosis,4 cases were intraductal papilloma,2 cases were duct inflammation, 1 case was epithelial hyperplasia of the duct and 1 case was lymphode. In 8 cases,bleeding was seen along the needle tract,which was stopped after compression. Small hematoma was formed in 10 patients in the second day of follow-up, which was disappeared in the 3 to 6 months of the follow-up. And all patients had no remnant lesions in the local area and the incisions were not clear in the skin 3 to 6 months of the follow-up. Hypoechoic focuses were detected out at the original location in the 3 benign cases, which were possibly residual focuses. Conclusions Benign breast lesions could be clearly resected with VACORA rotation system under the screening of ultrasound, which is safe, minimal invasive, prosthetic, and has little complications.

Objective To explore the clinical value of thermal tomography (TT) in the diagnosis of breast diseases.Methods Totally 222 breast diseases patients underwent examinations by color Doppler ultrasound and TT.Some stable TT images were selected,and the TT curves of the lesions were analyzed according to the malignant tumor TT curve diagnosing standard,so that the benign and malignant tumors could be determined.Color Doppler ultrasound was used to describe the site,size and property of the lesion.Results Pathological examination found 95 cases of malignant tumors and 127 benign ones.TT had 198 results coincident with those by pathological examination while the remained 24 ones not,with 15 false positive results and 9 false negative ones.When compared with pathological examination,TT had the accuracy,sensitivity and specificity being 89.19％,90.43％ and 88.28％ respectively.Conclusion TT is non-invasive,accurate and sensitive when used to screen and diagnose breast diseases,and should be applied if possible in medical facilities.

Objective To explore the value of percutaneous injection of hemostatic agents under the guidance of contrast-enhanced ultrasound(CEUS)for grade Ⅲ-Ⅳ hepatic trauma patients.Methods Eleven patients with severe hepatic trauma were treated using percutaneous focal injection of hemostatic agents.Five of these patients were hepatic injury of grade Ⅲ,and others were grade Ⅳ according to AAST.Results Out of all patients with severe hepatic trauma,9 patients were cured by once percutaneous injection of hemostatic agents under the guidance of CEUS,and 1 patient was cured by twice injection,and 1 patient was switched to surgery because of complicated pancreatic injury and the increase of free intraperitoneal fluid.Conclusions CEUS can display the site and severity of liver injury.Combining with interventional technology,injection of hemostatic agents under the guidance of CEUS can save life and avoid to resect organ,and it can win time for treating other compound injury.

Objective To detect all methods of localization in the insulinomas,and promote the rate of localization in insulinomas.Methods Between April 1990 and April 1999,28 patients of insulinomas that confirmed by operation and pathology.US,CT,MRI and DSA were used for preoperative diagnosis,IOUS,PVS and touching were used for intraoperative diagnosis,and analyzed the results of operation.Results The rates of localization were 28.6% with US,32.2% with CT,41.7% with MRI,50.0% with DSA,82.1% with touching,and 92.3% with IOUS and PVS.The rates of preoperative were higher than that intraoperative.Conclusion The rates of localization were so lower in preoperative diagnosis that did not be detected repeatedly,but intraoperative diagnosis was very vital.IOUS not only to promote the localizative sensitivity,but also to discrease the rates of operative complication.

Objective To evaluate the value of supersonic shear wave elastrography(SWE) in the diagnosis of benign and malignant breast lesions.Methods SWE was performed on 134 breast lesions of 123 female patients and 74 normal breast glands to determine the values of overall elastic modulus and dispersion,and ROC curves were used to assess the diagnosis boundary value of two kinds of data respectively.Results According to the diagnostic gold standard-histopathology,the values of overall elastic modulus and dispersion were statistically significant when comparing benign lesions and malignant lesions with normal glands.ROC curve displayed that,when the Youden index reached to maximum,the diagnosis boundary value of overall elastic modulus was 41.01 kPa,the sensitivity and specificity of the value were 68.5％ and 83.8％ respectively; the diagnosis boundary value of dispersion was 12.25 kPa,the sensitivity and specificity of the value were 87.0％ and 88.7％ respectively.Conclusions The values of overall elastic modulus and dispersion for solid breast lesions can be used to reflect the elastic characteristics of lesions quantificationally,which is useful to diagnose benign and malignant breast lesions in clinical.

Objective Comparing the enhancement of contrast-enhanced ultrasound(CEUS) with the intensity of the blood signals of breast masses, and producing the parameter of peak intensity (PI), to determine whether they can reflect the differentiation of the benign breast masses from the malignant ones.Methods Fifty patients with the breast masses (25 benign,25 malignant) were implemented the contrastenhanced ultrasound inspection.The blood signals of the masses could be got before performing the CEUS,then the CEUS was performed.The enhancement of the masses was divided into 4 grades according to the enhancement of breast which was around the mass (no enhancement, low enhancement, equal enhancement,and high enhancement as well).The PIs of all masses and high enhanced massed were calculated by software in machine,then them were compared according to "the groups which had been classified by their maximal diameters.Results Forty-one of 50 cases showed an obvious enhancement using CEUS compared with the routine CDFI.Malignant masses were more obviously than that of benign ones ( P＜0.05).In the 50 cases,the no enhanceed ones( n = 2) and equal enhanced ones( n = 5) were benign,and 1 case of the low enhanced masses( n = 9) was malignant.The high enhanced masses ( n = 34) were malignant or benigh.About the high enhanced masses, there were statistics meanings using the parameter of PI for the masses whose maximal diameters＜2 cm( P＜0.05),and no statistics meanings when their maximal diameters≥2 cm(P＞0.05).Conclusions The CEUS of breast can improve the appreance of the tumor' s blood vessel obviously, especially for malignant masses.The PI of the breast benign masses are different from the malignant ones.Combination of them can help to discriminate benign masses from malignant ones.The parameter of PI is useless for differentially diagnosing the breast masses if their maximal diameters≥2 cm and the blood flow grade Ⅲ before CEUS.

Objective To evaluate the relationship between the grey scale ultrasonographic feature and estrogen receptor(ER),progesterone receptor(PR)or human epidermal growth factor receptor-2(HER-2)expression in infiltrating ductal cancer(IDC)of breast.Methods Seventy-three patients with IDC confirmed pathologically were involved in this study.The specimens wete examined immunohistochemistically to judge the expression of the related factors.ER,PR and HER-2 expression of the mastectomy specimens were determined with immunohistochemical staining technique.The correlation between the ultrasonographic features and ER,PR or HER-2 positive expression was analyzed. Results The ER positive rate in lesions with the spicule sign,echogenic halo or posterior shadowing were higher than in lesions without the spicule sign,echogenic halo or posterior shadowing(P＜0.01).The HER-2 positive rate in lesion with the calcifications and lymphadenectasis in axillary was higher than that in lesions without calcifications,or lymphadenectasis in axillary(P＜0.05).Conclusions A certain correlation exists between the ultrasonographic features and ER,HER-2 expression in patients with IDC.