Objective To evaluate the value of metal spring ring for localization of breast lesions. Methods Thirteen cases of nonpalpable breast benign lesion and 41 cases of breast cancer that had been treated by neoadjuvant chemotherapy were enrolled in this study. The lesion was localized with the margin being marked under the guidance of ultrasonography. Metal spring rings with proper length was used according to the maximum diameter of the lesion; and then via a 18G puncture needle, the metal spring ring was place exactly to the two ends of the biggest cross-section of the lesion by using a guide wire. Afterwards, the lesions were resected with the spring ring. The 41 patients with breast cancer received 2-to 3-week chemotherapy after the operation. Results For the 13 cases of benign breast lesion, the mass was resected accurately and completely with the spring rings. In the 41 cases of breast cancer, no residual tumor cells were found in the tissues around the margin of resection. During the postoperative chemotherapy, ultrasonography showed that the mass was reduced in 39 of the cases, among which 9 had no clear margin of the tumor before the operation shown by ultrasonography. Off the 9 cases, postoperative pathological examination found no tumor cells in the successive sections. Conclusions Localization of breast lesions under the guidance of ultrasonography is a new method for diagnosis and treatment of nonpalpable breast lesions. It is valuable for follow-up by ultrasonography, evaluation of chemotherapy, and postoperative biopsy, especially for the breast cancer patients who have received preoperative chemotherapy.

Objective To explore the feasibility of laparoscopic splenectomy (LS) in the management of ruptured spleen. Methods Laparoscopic splenectomy was performed in 8 cases of ruptured spleen in this hospital from August 2004 to May 2005. Results Laparoscopic splenectomy was accomplished successfully in 7 cases and a conversion to hand-assisted laparoscopic splenectomy (HALS) was needed in 1 case. The operation time was 150~200 min (mean, 180 min). The intraoperative blood loss was 600~5 500 ml (mean, 2 200 ml). There were 5 cases of type Ⅱ rupture and 3 cases of type Ⅲ rupture. The postoperative recovery was uneventful and no complications were encountered. Conclusions[WTBZ] Laparoscopic splenectomy is a safe and feasible option for the management of ruptured spleen.

Cardiovascular disease is the first cause of death in Chinese residents. Arterial elasticity is an important and independent predictor for mortality of cardiovascular disease, and pulse wave velocity (PWV) is the most frequently used measurement index. It has been widely used in clinical practice. Traditional methods detecting PWV have some disadvantages, such as arteries distribution not clear, branch affect and only obtain global and average, instead of regional PWV. Now, the measurement of local pulse wave velocity has played an important role in the study of arterial elasticity. The common methods of detecting regional pulse wave velocity include echo tracking technique, UltraFast imaging technique and pulse wave imaging technique. This article reviews the recent advances in pulse wave velocity evaluating vascular elasticity.

Objective To assess the clinical value of ultrasound-guided popliteal vein puncture in the treatment of lower extremity deep venous thrombosis.Method We performed ultrasound-guided catheterization through popliteal vein in 71 patients with lower extremity deep venous thrombosis who were supposed to receive catheter-directed thrombolysis.Results Catheter sheathes were successfully inserted in 69 patients.No severe complication was observed.and a good curative effect after the treatmeut of thrombolysis and anticoagulation was found.Insertions of guide-wires failed in 2 patients because of organizatioo of the thrombus.Conclusion Ultrasound-guided popliteal vein puncture is safe and easy to operate,and is worth popularizing.

Objective To explore the value of ultrasound-guided core needle biopsy (CNB) in diagnosis of thyroid nodules.Methods The clinical data of 395 patients with thyroid nodules who underwent ultrasound-guided CNB were retrospectively analyzed,and the results of CNB pathology of 278 patients who endured surgery were compared with postoperative wax pathology results.Results All patients completed CNB successfully and satisfaction rate for tissue samples was 100％.Local hematoma occurred in one case and relieved by conservative therapy.The CNB pathology results of 278 cases of patients were as follows:92 cases were malignancy,including 91 cases of papillary thyroid carcinoma,lcase of medullary thyroid carcinoma; 182 cases were benign,including lcase of parathyroid adenoma,48 cases of adenoma,and 133 cases of nodular goitre and other nodular affection.In 278 patients who underwent surgery,the CNB pathology results in 273 cases,including 90 malignancy cases and 183 benign cases,were consistent with postoperative wax pathology results and false positive occurred in 1 cases,ambiguous occurred in 4 cases.So the accuracy,sensibility,specificity,missed diagnosis rate,and misdiagnosis rate of ultrasound-guided CNB for differential diagnosis of thyroid malignant nodules from benign nodules were 98.20％ (273/278),95.79％ (91/95),99.45％ (182/183),4.21％ (4/95) and 0.55％ (1/183).Conclusion Ultrasound-guided CNB has important value on differential diagnosis of thyroid nodules.It is safe and effective.

ObjectiveOne hunred and twenty-four To probe into application value of ultrasound guided Catheterization in internal jugular vein. MethodsOne hundrel and twenty-four guided by ultrasound puncture holder, single-channel or three-channel catheter was embedded into jugular vein. ResultsThe catheter was inserted successfully by only one procedure in all the 124 patients. There was no complication. ConclusionsThe catheterization becomes safer, convenient and quickly with ultrasound puncture holder guidance, decreasing failure rate and complication of the procedure.

Objective To discuss the feasibility of non-invasive quantitative evaluation of hepatic fibrosis by contrast-enhanced ultrasonography (CEUS) parameters. Methods CEUS of liver and liver biopsy were performed in 86 patients. CEUS parameters including area under curve of portal vein/hepatic artery(Qp/Qa) ,perfusion intensity of portal vein/hepatic artery(Ip/Ia), decreasing rate of liver parenchyma perfusion (β) and perfusion time of portal vein (Tp) were calculated based on CEUS images. Differences of the four parameters among stages of hepatic fibrosis were analyzed by ANOVA and Spearman rank correlation test was applied to analyze correlation between parameters and hepatic fibrosis stages. Areas under receiver operating characteristic (ROC) curves were calculated to evaluate the diagnostic accuracy of parameters. Results Tp and β had increasing tend while Ip/Ia and Qp/Qa had declining tend from S0 to S4.They were significantly correlated with fibrosis stage( P ＜0.05＝. The areas under ROC curves of Ip/Ia were 0.931 (≥S1) ,0.884(≥S2 ) ,0.820(≥S3 ) and 0.846(S4 ) respectively. The areas under ROC curves of Qp/Qa were 0.914(≥S1),0.813(≥S2),0.845(≥S3) and0.869 (S4) respectively. Conclusions CEUS parameters of liver parenchyma Ip/la, Qp/Qa, Tp and β are related to fibrosis stages. Ip/Ia and Qp/Qa provide a reliable,non-invasive method for evaluating fibrosis stages.

Objective To investigate the safety and efficiency of large-dose alcohol sclerotherapy in treating simple hepatic cyst. Methods Patients with hepatic cyst were divided into two groups. One group with 49 patients was treated with small-dose (<80 ml) absolute alcohol instillation. The other one with 32 patients was treated with large-dose (≥80 ml) absolute alcohol instillation. Blood alcohol concentration (BAC) was recorded right after and 30 rain, 1 h,2 h,3 h after the treatment. Diameter of cyst as a parameter of efficiency was recorded and compared between two groups during 1 year follow-up visit. Results Large-dose group was significantly more efficient in treating hepatic cyst than small-dose group. All BAC records were within the safe range and below the legal limit after drinking. BAC reached its peak 30 minutes after the treatment began and then decreased gradually. A significant correlation was found between BAC and the alcohol dosage. Conclusions Ultrasound-guided sclerotherapy with repeated large-dose absolute alcohol instillation is a safe and efficient treatment for simple hepatic cyst from the perspective of BAC.

Objective To evaluate the value of contrast-enhanced uhrasound(CEUS)for liver fibrosis.Methods Ninty-two chronic hepatitis B patients with histology diagnosis and fifteen health control were detected by CEUS,dynamic images and the time-intensity curve were analyed.Results Hepatic veinartery transit(HV-ATT)became shorter in the early hepatic cirrhosis patients [(7.5±2.1)s]compared to the control[(11.8±2.7)s].However,there was no difference between the fibrosis patients [(13.0±2.2)s]and the control.Furthermore,HV-ATT of the fibrosis patients with S1 to S3 stage were(11.7±2.7)s(S1),(11.8±3.0)S(S2),(11.8±2.3)s(S3)without significant difference.Conclusions CEUS is valuable in diagnosing earlier hepatic cirrhosis,but not fibrosis.

ObjectiveTo study the diagnostic value of sonographic “Leopard pattern” sign in breast hyperplasia.MethodsTwo hundred and twenty-three female patients in Beijing Friendship Hospital from October 2012 to April 2013 were choosen. All the cases were diagnosed as mammary gland hyperplasia clinically, and their breast ultrasound images show the breast imaging-reporting and data system (BI-RADS) grad was 0 or 1. These patients were divided into 3 groups according to their age, Group A: 20 to 35 age (36 cases), Group B: 36 to 50 age (102 cases), and Group C: order than 50 year-old (85 cases). The pathological diagnosis were obtained by ultrasound guided breast biopsy. With pathological diagnosis as the gold standard and “Leopard sign” as ultrasound diagnostic criteria, the sensitivity, specificity, accuracy, positive predictive value and negative predictive value were calculated. The consistency between the ultrasonic and the pathological diagnosis were analyzed by Kappa statistical test.ResultThe diagnostic consistency test of the total sample of 223 cases: in terms of the ultrasonic Leopard sign” for the diagnosis of breast hyperplasia, the sensitivity was 69% (59/85),the specificity was 46% (64/138), the accuracy was 55% (123/223), the positive predictive value was 44% (59/133), the negative predictive value was 71% (64/90), the consistency was poor (Kappa=0.14,P<0.05). Group A:the sensitivity was 90% (18/20), the specificity was 50% (8/16),the accuracy was 72% (26/36), the positive predictive value was 69% (18/26), the negative predictive value was 80% (8/10), the consistency was good (Kappa=0.42, P<0.05);Group B:the sensitivity was 70% (33/47), the specificity was 49% (27/55),the accuracy was 59% (60/102), the positive predictive value was 54% (33/61), the negative predictive value was 66% (27/41), the consistency was poor (Kappa=0.19,P<0.05); Group C: the sensitivity was 44% (8/18), the specificity was 43% (29/67), the accuracy was 44% (37/85), the positive predictive value was 17% (8/46), the negative predictive value was 74% (29/39), the consistency was poor (Kappa=0.08,P<0.05).Conclusion“Leopard pattern” sign is not suitable as an independent standard in diagnosing breast hyperplasia disease.