Adenocarcinoma ; diagnosis ; pathology ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Biopsy, Needle ; methods ; Carcinoma, Squamous Cell ; diagnosis ; pathology ; False Negative Reactions ; Female ; Granuloma ; diagnosis ; pathology ; Humans ; Lung Diseases ; diagnosis ; pathology ; Lung Neoplasms ; diagnosis ; pathology ; Male ; Middle Aged ; Radiography, Interventional ; Tomography, X-Ray Computed ; Tuberculosis, Pulmonary ; diagnosis ; pathology ; Young Adult

Objective To evaluate the value of contrast-enhanced ultrasound (CEUS) in the diagnosis of ischemie-type biliary lesion (ITBL) after liver transplantation. Methods Twenty-five liver transplantation recipients suspected with biliary complications were examined using CEUS. Percutaneous transhepatic cholangiography or endoscopic retrograde cholangiopancreatography confirmed the diagnosis. The enhancement patterns of the thickened hilum bile duct wall were observed. Results Enhancement patterns of bile duct wall could be divided into 3 sorts:① No-enhancement, six cases, showed no-enhancement all along. ②Hypo-enhancing level, four cases, presented hypo-enhancing at arterial phase and persistent hypo- or no-enhancing until late phase. ③Hyper-enhaneing level,fifteen cases,appeared as hyper- or iso-enhancing at arterial phase and persistent iso- or hypo-enhancing until late phase. The enhancement pattern of bile duct wall showed significant difference ( P = 0.00). Thirteen ITBL patients included 10 cases ( 76.9 % ) with no- or hypo-enhaneement, 3 patients (23.1 % ) with hyper-enhancement. However, all of 12 non-ITBL cases appeared hyper-enhancing. Conclusions CEUS provides a new and effective method to estimate the microcirculation of the bile duct wall. It may be help to early diagnosis of ITBL.

Objective To evaluate the clinical value of three-dimensional contrast-enhanced ultrasonography(3D-CEUS) of hepatic arteries in liver transplant candidates.Methods Twenty-six liver transplantation donors and recipients were examined using two-dimensional contrast-enhanced ultrasound (2D-CEUS) and 3D-CEUS.The 3D image's qualities, reconstruction successful rates, and the diagnostic level of hepatic artery complications were estimated. Results Twenty-one hepatic arteries were reconstructed successfully (80.8%).The 3D images showed artery trees continuous, spatial relationship definite, fine and circuitous branches distinct, and the segmental hepatic arteries' origin could be recognized.In 4 of 5 hepatic artery complications,both 2D-CEUS and 3D-CEUS made the correct diagnoses.However,2D-CEUS made a false positive diagnosis and 3D-CEUS retrieved it.Conclusions The 3D-CEUS images of the hepatic arteries are direct and distinct.In evaluating hepatic artery complications, when artery spatial relationship is complicated, the 3D-CEUS could provide more information, and confirm or correct some diagnosis of 2D-CEUS.

s parameters of CEUS between ITBL group and control groups reflect the characterization of flow perfusion in ITBL, which can provide the objective evidence in the diagnosis of ITBL.

Objective To evaluate the usefulness of baseline ultrasound(BUS) and contrast-enhanced ultrasound(CEUS) in diagnosis of portal vein(PV) patency and to explore the indication of CEUS. Methods The diagnostic capability of BUS and CEUS were assessed in 64 cases according to definition of PV on BUS,which was divided into high, moderate and low definition. Results Thirty-five patients with portal vein thrombosis(PVT) and 29 patients with normal portal vein were confirmed. The diagnostic accuracies by using BUS and CEUS were 93.1% and 96.6% with high definition of PV,56.3% and 87.5% with moderate definition,and 68.4% and 89. 5% with low definition, respectively. Conclusions In the case of high definition of PV,the validity of diagnosing of PV patency with BUS may be similar to that with CEUS,thus introduction of CEUS would probably not be necessary. Otherwise CEUS is recommended.

Objective To study the enhancement patterns of hilar bile duct wall of ischemic-type biliary lesion (ITBL) on contrast-enhanced ultrasound (CEUS).Methods Eighteen healthy subjects,18 orthotropic liver transplantation (OLT) recipients without complications,and 36 patients,which were subdivided into 2 groups according to the final diagnosis:patients with (n =24) and without (n =12)ITBL,were enrolled in this study.The patients without ITBL had anastomotic biliary stricture (n =3),cholangitis (n =4),biliary sludge (n =1),and acute rejection (n =4),respectively.The images of baseline sonography and CEUS were retrospectively analyzed in consensus by 2 readers.The enhancement time and level of hilar bile duct wall,hepatic artery and liver parenchyma were recorded.Results Hilar bile duct wall became enhancing earlier than liver parenchyma in all of 4 groups.During arterial phase,hyper-or isoenhancing bile duct walls were present in most cases in the groups of healthy subjects,OLT recipients without complications and patients without ITBL.However,non-or hypo-enhancement of hilar bile duct wall were present in 16 (66.7％) ITBL patients,which is different from the other groups (P ＜0.05).Conclusions The main features of ITBL differing from the other groups were non-or hypo-enhancement of hilar bile duct wall in arterial phase.It may be a diagnostic index to apply in detecting ITBL with CEUS.

Objective To compare the performances of baseline ultrasound(BUS),contrast-enhanced ultrasound (CEUS) and spiral computed tomography (CT) in characterizing of portal vein thrombosis (PVT).Methods The capability of differentiation of benign and malignant thrombi by using BUS,CEUS and spiral CT scan were assessed in 43 patients with PVT.Results The diagnostic accuracies of benign and malignant PVT were 100％ with CEUS,60.5％ with BUS and 76.7％ with CT,respectively.There were significant difference between every two groups( P ＜0.05).Conclusions CEUS is superior to BUS and CT in distinguishing benign and malignant PVT,thus it is recommended.

ObjectiveTo explore the feasibility of hilar bile duct using ultrasonography (US) in identification of different types of biliary strictures after orthotopic liver transplantation.MethodsThe US images of hilar bile duct of 62 patients with non-anastomotic biliary stricture (NAS) and 30 patients with anastomotic biliary stricture (AS) were reviewed.Four US feathers including the presence of hilar biliary dilatation,the display of hilar biliary lumen,the thickening of bile duct wall and the echo of bile duct wail were assessed.Results The presence of hilar biliary dilatation,the display of hilar biliary lumen,the thickening of bile duct wall showed a significant difference between NAS and AS groups (P＜0.001).The feature with the greatest performance in the diagnosis of NAS was unclear displayed hilar biliary lumen.The sensitivity,specificity and accuracy were 93.7％,86.7％ and 92.3％,respectively.Conclusions The observation of hilar bile duct has great vaule in identification of different types of biliary strictures after orthotopic liver transplantation.The display of hilar biliary lumen is more likely to differentiate between NAS and AS

Objective To assess the difference between two-dimensional contrast-enhanced ultrasonography ( 2D-CEUS ) and three-dimensional contrast-enhanced ultrasonography ( 3D-CEUS ) in evaluating hepatic arteries in the liver transplantation. Methods Both 2D-CEUS and 3D-CEUS were used to examine 26 liver transplantation donors and recipients. Fifteen patients who were confirmed by CTA or DSA or MRA were analyzed. The image' s quality and diagnostic levels of 2D-CEUS and 3D-CEUS were compared, and the diagnostic information about anatomic features of hepatic arteries provided by the two methods was evaluated. Results 1) The image' s quality of 2D-CEUS and 3D-CEUS were 3. 62 ± 0. 41, 2. 52 ± 0. 93, respectively. The difference between them was statistically significant ( P <0. 05). 2)When evaluating anatomic features ,2D-CEUS and 3D-CEUS had no significant difference in common hepatic artery (CHA) and proper hepatic artery (PHA). But 3D-CEUS was prior to 2D-CEUS in left hepatic artery (LHA) ,right hepatic artery(RHA) and segmental hepatic artery(SHA) ( P <0. 05). 3)Five hepatic artery complications were discovered by CTA or DSA or MRA in 15 patients. In 4 patients (80%) ,both 2D-CEUS and 3D-CEUS made the affirmative diagnoses in accordance with the results. However, 2D-CEUS made a false positive diagnosis and 3D-CEUS corrected it. Conclusions The 3D-CEUS could provide more diagnostic information,could confirm or correct some diagnosis of 2D-CEUS,but,its image's quality is not as good as 2D-CEUS. Therefore,combining the 3D-CEUS with 2D-CEUS has practical clinical value in liver transplantation.

Objective To evaluate the value of contrast-enhanced ultrasound (CEUS) in diagnosing ischemic-type biliary lesion (ITBL) and analyze the relation between the enhancement patterns of bile duct wall of ITBL and its outcome.Methods 36 patients confirmed with ITBL (24 cases),anastomotic biliary stricture (3 cases),cholangitis (4 cases),biliarysludge (1 cases),and acute rejection (4 cases),who underwent CEUS examination,were enrolled in this study.The images were retrospectively analyzed in consensus by 2 readers.After reviewing the images,the readers were asked to make a diagnosis of ITBL.The diagnostic standard was hypo-or non-enhancement of hilar bile duct wall in arterial phase on CEUS.Results The diagnostic sensitivity,specificity,accuracy,positive predictive value and negative predictive value were 66.7％,83.3％,72.2％,88.9％,and 55.6％ for reader 1;62.5％,83.3％,69.4％,88.2％,and 52.6 ％ for reader 2,respectively.The interobserver agreement was good (κ =0.83).In 24 ITBL patients,the ratio of mortality or retransplantation with non enhancing hilar bile duct wall in arterial phase was much higher than that with enhancing hilar bile duct wall (non-enhancement 54.5％,hypo-enhancement 20％,hyper-or iso-enhancement 12.5％).Conclusions CEUS had diagnostic value of ITBL.Non-enhancing hilar bile duct wall in arterial phase on CEUS predicated the poor outcome.