Objective To assess the agreement of preoperative ultrasonography (US), CT, intraoperative ultrasonography(IOUS) and intraoperative palpation in the diagnosis of liver tumors. Methods The results of preoperative US,CT, IOUS and intraoperative palpation in the diagnosis of liver tumors in 70 patients were reviewed,and the agreement of them were evaluated. Results There was a moderate level of agreement between US and the pathology and follow-up in the diagnosis of liver tumors (Kappa = 0.63). There was a high level of agreement among CT, IOUS and the pathology and follow-up(CT vs the pathology and follow-up, Kappa = 0.72;IOUS vs pathology and follow-up, Kappa = 0. 89;CT vs IOUS, Kappa =0.53), whereas the level of agreement between intraoperative palpation and the pathology and follow-up (Kappa =0.38), US and intraoperative palpation (Kappa = 0.23), US and IOUS (Kappa = 0.23) was low. Conclusions In the assessment of liver tumors,CT and IOUS have a high agreement. Although the agreement of US and intraoperative palpation were low, they were still indispensable. Four methods were integrated, will contribute to the diagnosis and treatment of liver tumors.

Objective To explore the value of direct and indirect ultrasonographic signs in diagnosis of small breast cancer. Methods The sonographic features of 103 small breast lesions (47 malignant, 56 benign) were retrospectively analyzed and divided into direct and indirect signs according to the pathology.The results of ultrasonography were compared with pathology. Agreement was measured with K statistics between ultrasonographie signs and pathology. Results Compared with the malignant and benign small breast noplasms, there was statistical significance of the direact signs of micro calcifications, grade Ⅱ- Ⅲ flow,resistance index (RI)≥0.7 and the indireact signs of changes of superficial fascia (P<0.01).Agreement was moderate for micro calcifications, grade Ⅱ-Ⅲ flow, RI≥0.7, changes of superficial fascia (0.7> K≥0.4) ,and substantial for the combination of direct and indirect signs(K=0.726). Conclusions Combination of direct and indirect ultrasonographie signs was significant in diagnosis of small breast cancer.

Objective: To investigate the diagnostic values of separated renal multi-locular cystic lesions color Doppler ultra-sound and contrast-enhanced ultrasound performance in multi-locular cystic renal cell carcinoma and cysts. Methods:A total of 53 pa-tients (54 lesions) with multi-locular cystic renal cell carcinoma and cysts were included in the study. The presence of carcinoma and cysts was confirmed via histopathology and tested using ultrasound. Contrast-enhanced ultrasound was applied in 24 (24 lesions) of the total number of patients, and the receiver operating characteristic (ROC) curve was used to analyze the numbers of separation, thick-ness, and type of blood flow patterns of the lesions. The contrast-enhanced ultrasound characteristics were also analyzed. We analyzed the diagnostic value of the color Doppler ultrasound in the separated renal multilocular cystic lesions and the contrast-enhanced ultra-sound performance in multi-locular cystic renal cell carcinoma and cysts. Results:Based on the analysis of the ROC curves of the sepa-ration number, thickness, and type of the blood flow of the lesions in 53 patients (54 lesions), the diagnostic specificity was relatively higher in the lesions where the separation number was≥5 strips (86%), the thicknesses were>3 and≤4 mm (95%), and blood flow was band-like (86%). The areas under the curve of the three indexes were 0.7621, 0.8331, and 0.7962, respectively, which indicate high diagnostic values. The separation number of 4 strips, the thicknesses of>2 and≤3 mm, and the point-like blood flow could be used as critical values for the diagnosis. The contrast enhancement, enhancement peak, and disappearance were (11.2 ± 3.4), (21.7 ± 3.8), and (32.1±4.0) s in 14 patients with multi-locular cystic renal cell carcinoma and (18.4±4.5), (37.8±8.0), and (51.3±9.0) s in 10 patients with multi-locular renal cysts, with statistically significant differences (t=4.47, t'=5.90, t'=6.31, respectively;P<0.05). Conclusion:The sepa-ration number, thickness, and type of blood flow of lesions have relatively higher specificity in multi-locular renal cysts than in multi-locular cystic renal cell carcinoma. The ROC curves show a high diagnostic value. Contrast-enhanced ultrasound of the lesions helped in the differential diagnosis of multi-locular cystic renal cell carcinoma and renal cysts.

Objective To explore the value of intraoperative contrast-enhanced ultrasonography in radiofrequency ablation completeness evaluation in patients with hepatic carcinoma of differently sized nodules.Methods Fifty five patients (69 lesions) with hepatic carcinoma were included and were divided into the experimental group (20 cases,30 lesions in whom CEUS were used) and the control group (35 cases,39 lesions,conventional ultrasound was used).After RAF,the treatment effect of the two groups were evaluated by enhanced CT regularly.Differences between conventional ultrasound and CEUS were compared and their judgement on ablation residual tumor tissue was analyzed.Results After 1 to 24 months of follow-up,the total residual rate of the experimental group and the control group was 13.3％ (4/30) and 35.9％ (14/39) respectively.The significant difference was found in the residual rate between the experimental group and the control group (x2 =5.366,P ＜ 0.05).For the two groups (＞ 5 cm and ＜3-5 cm),the residual rate of the experimental group was 30.0％ and 10.0％,the residual rate of the control group was 87.5％ and 46.2％,there were statistically significant difference (respectively x2 =5.951,4.790,all P ＜ 0.05).The significant difference was found in the recurrence rate (the experimental group:20.0％ (4/30),the experimental group:75.0％ (6/8)),when the lesion was larger than 5 cm in diameter(x2 =5.445,P ＜ 0.05).Conclusions CEUS has advantage over conventional ultrasound for the detection of residual tumor tissues after radiofrequency ablation for hepatic carcinoma,it reduces after ablation tumor recurrence especially in large tumors.

Objective To find the spectacular indexes in the diagnosis of acute rejection of renal transplantation with color Doppler ultrasonography. Methods Forty-two patients with renal rejection were confirmed with percutaneous needle biopsy and 115 patients with stable renal function were confirmed with following-up (>1 year) and clinical examination. The length, width, thickness, cortex thickness and resistive index (RI) of two groups were analyzed statistically. Then the specificity, sensitivity, misdiagnosis rate, false negative rate and consistency rate of renal volume, pyramid swelling, echo weakening, RI＜0.7, RI≥0.7 and RI≥0.8 were calculated. Results The length, width and thickness were statistically different in two groups (P＜0.05). In patients with renal rejection, the marginal blood vessels in renal cortex decreased, and the blood velocity reduced obviously in the diastolic phase and RI increased obviously (P＜0.05). The sensitivity of the above indexes were 55.30%, 55.20%, 42.10%, 57.90%, 31.60%, respectively, while the specificity were 71.30%, 87.10%, 25.70%, 74.20% and 98.20%, respectively. Conclusion Enlargement of renal volume, swelling of renal pyramids, echo weakening and RI increasing are specific indexes for diagnosis of acute rejection of renal transplantation.

Objective The article was to discuss the correlation between three?dimensional volume ultrasound VOCAL parame?ters and pathological grading of mass type breast invasive ductal carcinoma. Methods 106 breast nodule patients admitted in our hospi?tal who were pathologically confirmed with histological grading from March 2014 to February 2016 were included in the study. The patients underwent three?dimensional volume ultrasound preoperatively. Vocal system in GE LOGIQ E9 was used in lesion analysis to obtain energy histograms:average gray scale (MG), average energy (MP), vascular index ( R) , blood flow index ( VFI) . Analysis was made in the differ?ence among MG, MP, R and VFI of ductal carcinoma in situ, invasive ductal carcinoma grade I, invasive ductal carcinoma grade II, invasive ductal carcinoma grade III and fibroadenoma. Results No sig?nificant difference was found in MG of ductal carcinoma in situ and IDC I, fibroadenoma and ductal carcinoma in situ, fibroadenoma and IDC I(P>0.05), but the difference was statistically significant between other pathological levels (P<0.05). Significant difference was found in MP between pathological levels ( P<0.05) . No significant difference was found in R and VFI between ductal carcinoma in situ and fibroadenoma( P>0.05) , but the difference was statistically significant between other pathological levels ( P<0.05) . Conclusion Three?dimensional volume ultrasonic VOCAL parameters of MG、MP、R、VFI can reflect gray?scale levels and blood flow perfusion in mass type breast nodules of different pathological level, and predict the pathological grading before operation, which provides objective evidence for the evaluation of mass type breast invasive ductal carcinoma and the development of individualized treatment plan.

Objective:This study aims to evaluate the consistency between contrast-enhanced ultrasound (CEUS) and enhanced computed tomography (CT) in determining the effect of radiofrequency ablation (RFA) on hepatocellular carcinoma. Methods: RFA procedures guided by either ultrasound or CT were performed on 35 patients with 68 lesions. Enhanced CT and CEUS were regularly conducted after the procedures to evaluate the effect of RFA. The full ablation, residual, and recurrence rates of tumors, as well as the di-agnostic accuracies and kappa values of CEUS and enhanced CT, were determined. Results:The full ablation and residual rates of tumors for the 68 lesions diagnosed by CEUS were 84%and 16%, respectively;whereas those for the lesions diagnosed by enhanced CT were 90%and 10%, respectively. No significant difference was found between the obtained rates using the two diagnostic methods (χ2=0.576 3, P=0.447 8). Moreover, the two methods exhibited high consistency (K=0.882 9, Sk=0.120 4). Of the 68 lesions, 13 recurred within 24 months. The recurrence rate evaluated by CEUS was 19%(13/68). No significant difference was found between the detection rates of CEUS (92%, 12/13 lesions) and enhanced CT (100%, 13/13 lesions) in diagnosing recurrent lesions (P>0.05). Enhanced CT could be used as the gold standard for evaluating tumor residual and recurrence rates after RFA. The overall diagnostic accuracy of CEUS reached 92%(63/68 lesions). Conclusion:CEUS and enhanced CT exhibit high accuracy and consistency in evaluating the effect of RFA on hepatocellular carcinoma. CEUS can provide a reliable diagnostic proof for tumor patients after undergoing RFA procedure.

Objective To explore the diagnostic value of parametric imaging of CEUS in different cervical lymphatic diseases.Methods One hundred eleven patients diagnosed with cervical lymphadenopathy were included.All of the patients underwent parametric imaging of CEUS.According to the pathological results,all patients were divided into reactive hyperplasia group,tuberculosis group,metastasis group and lymphoma group.The features of perfusion phases (perfusion during the artery phase,or perfusion during the artery and parenchymal phase) and perfusion uniformity (homogeneous perfusion or heterogeneous perfusion) were compared among four groups.According to the pathological results,the reactive hyperplasia group and the tuberculosis group were merged into a benign group,and the metastasis group and the lymphoma group were merged into a malignant group.Then,the artery perfusion phase was regarded as benign,and the artery and parenchymal perfusion phase was regarded as malignant.The consistency between parametric imaging of CEUS and the pathological results was compared in two groups.Results The difference of perfusion phase and perfusion uniformity within the four groups had a statistical significance (all P＜0.05).The differences of perfusion phase between the reactive hyperplasia group and the metastasis group,the reactive hyperplasia group and the lymphoma group,the tuberculosis group and the metastasis group were statistical significant respectively (all P＜0.008).The differences of perfusion uniformity between the reactive hyperplasia group and the tuberculosis group,the reactive hyperplasia group and the lymphoma group,the lymphoma group and the tuberculosis group,the lymphoma group and the metastasis group were statistical significant respectively (all P＜0.008).The perfusion phase between the benign group and the malignant group had a statistical significance (P＜0.005),but the perfusion uniformity had no statistical significance in two groups.The consistency was good between the parametric imaging and the pathological results.Conclusion The parametric imaging of CEUS can offer valuable diagnostic information for the cervical lymph nodes underdetermined by conventional ultrasound.