Objective To probe the value of gastroduodenal water window in ultrasonic diagnosis of ampulla carcinoma. Methods Sixty-three patients were divided into the conventional ultrasonic examination group(including 35 patients) and the gastroduodenal water window ultrasonic examination group(including 28 patients), all being detected before and after drinking. The results of ultrasonic examination of the groups were divided into Ⅰ, Ⅱ and Ⅲ grades. The diagnostic accurate rates and the rates of Ⅰ, Ⅱ and Ⅲ grades of the ultrasonic examination of the groups were compared respectively. Results The diagnostic accurate rate of the gastroduodenal water window group after drinking was 96.43%(27/28), which was markedly higher than that of the same group before drinking and the conventional group which were 60.71%(17/28) and 54.29%(19/35) respectively. The rates of Ⅰ, Ⅱ and Ⅲ grades of the ultrasonic examination of the gastroduodenal water window group after drinking were also markedly higher than those of the same group before drinking and the conventional group respectively (all P 0.05). Conclusions The gastroduodenal water window ultrasonic examination can effectively raise the ultrasonic diagnostic rate of ampulla carcinoma. It is of significance in the clinic.

Objective To discuss the value of color Doppler ultrasonography in the diagnosis and differential diagnosis of urinary tract urothelial carcinoma (UTUC).Methods Color Doppler ultrasonography exam was practiced in 84 UTUC patients preoperatively.According to ultrasound characteristics,lesions was classified into nodular type,wall thickening type and solid mass type,which were confirmed by pathology in all cases postoperatively.Results In the total of 84 cases (76 transitional-cell carcinoma,5 adenocarcinoma and 3 epidermoid carcinoma),lesions infiltrated laminae propria and surrounding tissue in 65 cases.In the nodular type of UTUC,there were nodules raising into lumen.Wall thickening type of UTUC was characterized by irregularly wall thickening,lumen narrowing,truncating and breaking.Similarly,obstruction broke off the ureteral lumen suddenly in solid mass type of UTUC.A clear demarcation could be found between the pipe wall and surrounding tissue in nodular type.However,such clear demarcation could not be found in wall thickening type and solid mass type.The accordance rate of ultrasonographic located diagnosis were 92.9 ％ (78/84),with 6 missed diagnosis cases.The accordance rate of qualitative diagnosis were 89.7％ (70/78).Conclusions As result of color Doppler ultrasonography,there were different relationship between lesion and the peripheral tissue in different types of UTUC.In types of wall thickening and solid mass,the demarcation was unclear and it is easier to violate the surrounding tissue.Color Doppler ultrasonography can provide more effective information for diagnosis and therapy UTUC.

Objective To investigate the sonographic features of follicular variant of papillary thyroid carcinoma (FV-PTC) and to decrease misdiagnosis rate. Methods Thirty-one patients with 35 FV-PTCs and 66 patients with 75 conventional PTCs (C-PTCs) were enrolled in this study. The sonographic features were reviewed retrospectively between the two groups with universally accepted standards. Results The sonographic features of 35 FV-PTCs included irregular shapes (6/35), anteroposterior to transverse diameter ratio A/T > 1 (7/35), spiculated margins (25/35), marked hypoechogenicity (0/35), hypoechogenicity (18/35), isoechogenicity (16/35), no calcification (15/35), microcalcifications (11/35), macrocalcification (9/35), color Doppler lfow patternⅠ(20/35), color Doppler lfow patternⅡ(10/35), color Doppler lfow patternⅢ(5/35). Irregular shapes, A/T>1, spiculated margins, marked hypoechogenicity, microcalciifcations, and color type Ⅱ were rarer in FV-PTCs than in C-PTCs, while isoechogenicity, no calciifcation, macrocalciifcation, and color type Ⅲwere more frequent in FV-PTCs than in C-PTCs. The differences of the above features were statistically significant [χ2=4.276, P=0.039; χ2=8.125, P=0.004; P=0.009 (Fisher′ s exact test); χ2=8.548, P=0.003;χ2=4.898, P=0.027,χ2=7.796, P=0.005;χ2=5.462, P=0.019;P=0.001 (Fisher′s exact test)] . During the preoperative ultrasonography, 20 of 35 FV-PTCs were diagnosed as malignancy, and others were misdiagnosed as benign nodules (misdiagnosis rate was 43%). The lymphatic metastasis rate of FV-PTCs was 29%(9/31), significantly lower than C-PTCs [62%(41/66),χ2=9.246, P=0.002]. In terms of the sonographic features of metastatic lymph nodes, there was no marked difference between FV-PTCs and C-PTCs. Conclusions Some FV-PTCs are lack of malignant features, and tend to be misdiagnosed frequently when coexisting with benign thyroid nodules. Observing the echogenicity, color lfow characteristics and other features of each thyroid nodule and cervical lymph node with multiple views may decrease the misdiagnosis rate.

Objective To probe the clinical diagnosis value of high frequency ultrasonography (HFUS) in thyroglossal duct cyst(TDC). Methods Forty-one TDC were taken HFUS and the location, boundary,shape,interal echo of lesions and the relation to hyoid bone were observed. The periphery and internal blood flow signal were detected by color Doppler flow imaging. The results of HFUS were compared with those of pathology after operation. The cases were divided into groups according to pathological types and were compared with acoustic image shows. Results All cases were diagnosed TDC by pathology after operation. Internal walls of 9 TDC consist of cilium columnar epithelium, 19 consist of stratified pavement epithelium and 13 consist of this two epitheliums. HFUS showed different pathological types had different ultrasonic appearances. In this study, 77.8%(7/9) TDC with columnar epithelium showed echoless,84.2 (16/19) TDC with pavement epithelium showed similar solid echopattern and TDC with two epitheliums mainly showed similar solid echopattern and multi-room cyst. Hyperechogenicity of hyoid bone displayed around the lesion in 80.5%(33/41)TDC. No blood flow signal showed in 41 TDC and a little punctiform blood flow signal showed in the periphery of 5 TDC. The diagnose accordance rate of HFUS in TDC was 95.1%(39/41). Conclusions HFUS can clearly show the location, boundary, shape,interal echo of TDC and its relation to hyoid bone. HFUS is important for diagnosis and differential diagnosis of TDC.

Objective To probe the value of color Doppler ultrasonography (CDU) in differential diagnosis of the pure mucinous adenocarcinoma of breast (PMAB) and adenofibroma of breast (AFB).Methods Twenty-five cases of PMAB and 30 cases AFB were examined by CDU. The sonographic appearance, interior and peripheral blood flow distribution and Doppler frequency of the tumors were observed and analyzed. The results of the diagnoses of CDU and the pathologies were compared. Results The diagnostic rates of PMAB and AFB by CDU were 76.0% and 93.3%, respectively. The clear peplos was observed in 90% of AFB, and internal even echoes. Yet no peplos was observed in PMAB, and the internal echoes of most PMAB were confused and disordered. The detection rate of Ⅰ ～ Ⅱ stage blood flow in adenofibroma of breast was only 40% and that of Ⅰ ～ Ⅲ stage blood flow in PMAB was high to 76%.The detection rate of blood flow stage and the resistant index (RI) of the blood flow frequency spectrum of PMAB and AFB were significantly different. Conclusions CDU has significant clinical value in differential diagnosis of pure mucinous adenocarcinoma and adenofibroma of breast.

Objective To probe the significance of ultrasonographic characteristics of cholangiectasis in differential diagnosis of the diseases of bile duct obstruction (DBDO) .Methods A total of 164 patients with DBDO were divided into 4 groups:bile duct calculi (n=52) ,cholangiocarcinoma (n=56) ,cystic dilatation of biliary duct (n=32) and bile duct papilloma (n=24) .The ultrasonographic characteristics of cholangiectasis were classified as regular type,abnormal type,cystic dilated type and bile lake type.The average value of the largest diameter of the bile duct (DBD) and the percentage of each type of the cholangiectasis of each group were compared.Results The accuracy of ultrasound for the diagnosis of 164 DBDO was 98.17% (161/164) .DBD of both bile ducts of calculi and cholangiocarcinoma were different from that of cystic dilatation of biliary duct and bile duct papilloma,respectively (P＜0.01) ,as well as between cystic dilatation of biliary duct and bile duct papilloma (P＜0.01) .The percentage of regular type of cholangiectasis in bile duct calculi (65.38%,34/52) ,abnormal type in cholangiocarcinoma (83.93%,47/56) ,cystic dilated type in cystic dilatation of biliary duct (81.25%,26/32) and bile lake type in bile duct papilloma (83.33%,20/24) was different from those of others,respectively (P＜0.01) .Conclusion Different ultrasonographic characteristics of cholangiectasis has important clinical significance in the differential diagnosis of DBDO.

Objective To probe the value of color Doppler flow imaging(CDFI) in diagnosis of borderline ovarian epithelial tumors (BOET).Methods Thirty-six cases of BOET,139 cases of ovarial cystadenoma and 66 cases of ovarial cystadenocarcinoma were diagnosed pathologically.All cases were preoperatively detected by CDFI.Tumor sign CA125 was also detected.The size,boundary,internal echo and internal flow distribution were observed.The results of CDFI of different diseases were contrasted.Results Ultrasonic diagnosis rate was 75 ％ (27/36) in BOET,90.6 ％ (126/139) in ovarial cystadenoma and 92.4 ％ (61/66) in ovarial cystadenocarcinoma.Positive rate of CA125 of ovarial cystadenocarcinoma was obviously higher than those of BOET and ovarial cystadenoma.Positive rate of CA125 of ovarial cystadenocarcinoma containing solid was especially higher than that of BOET containing solid.Ovarial cystadenoma mainly showed single cavity,few or without solid as well as hematoasthenia or asanguineous.BOET and ovarial cystadenocarcinoma mainly showed multi-cavity,more solid as well as plentiful blood flow.Blood flow of BOET distributed regularly comparing with ovarial cystadenocarcinoma.Conclusions Characteristics of CDFI combining results of CA125 can provide powerful reference for diagnosise and differentiate diagnosis of BOET and more information diagnostic information for clinic to chosing treatment scheme and postoperative long-term follow-up.

To discuss the value of color Doppler ultrasonography in the diagnosis and differential diagnosis of ureteral polyps ( U P) . Methods Ninety‐five cases with pathologically proven U P and 104 cases with pathological confirmed urinary tract urothelial carcinoma ( U T UC) were enrolled in the study . T heir positive rate of color Doppler ultrasonography exam preoperatively were retrospectively analyzed and compared with pathological findings . Results Compared with pathological diagnosis , the accordance rate of color Doppler ultrasonography localization were 82 .1% ( 78/95) and 80 .8% ( 84/104) for U P and U T UC respectively ,the accordance rate of qualitative diagnosis were 69 .2% ( 54/78 ) and 90 .5%( 76/84) . Color Doppler ultrasonographic features of U P displayed a clear demarcation between the pipe wall of ureter and surrounding tissue .However ,such clear demarcation could not be found in U T UC . T he accordance rate between two groups has statistically significant difference ( P ＝0 .000 6 ) . Color Doppler ultrasonographic image showed no blood flow in the ureteral polyps ,while mainly minor or medium amount of blood stream signals were found in most tumors of U T UC . According to Adler blood flow grading and the blood flow detective rate ,the two groups demonstrated statistically significant difference ( P ＜0 .05 ) . Conclusions With high resolution color Doppler ultrasonography and flexible operation technique ,it can clearly observe the internal structure of ureter at obstruction end as well as boundary conditions of peripheral tissue ,w hich will play a profound role in preoperative diagnosis and differential diagnosis of U P .