Objective To investigate the value of quantitative analysis in the diagnosis of renal lesions with contrast-enhanced ultrasound.Methods Sixty cases with renal lesions confirmed by surgery and pathology underwent contrast-enhanced ultrasound preoperatively and quantitative analysis retrospectively.The Sonoliver software was applied in the analysis of CEUS imaging and in the recoustruction of quantitative parameter,s.Five parameters were calculated,including the maximum intensity (IMAX),rise time (RT),time to peak (TTP),mean transit time (mTT) and area under the curve (AUC).Results There were statistically differences in parameters RT,mTT and AUC ( P ＜ 0.05) and significant differences in parameter IMAX ( P ＜0.01).In malignant tumors,the RT and mTT were less than that of the benign while IMAX and AUC were more than that of the benign.Conclusions Contrast-enhanced ultrasound using a quantitative parametric analysis offers more information and is a promising tool in the diagnosis and differentiation of renal masses.

Objective To evaluate the value of contrast-enhanced ultrasonography (CEUS) in quantitative diagnosis of chronic kidney dysfunction(CKD) by comparing it with color Doppler imaging (CDFI). Methods Tirty-three cases (15 males and 18 females) of clinical confirmed CKD (stage Ⅲ～Ⅴ)were included. Forty-five healthy volunteers were performed as control group. CEUS and CDFI were performed on each patient. After intravenous bolus injection of 1ml SonoVue each side,CEUS of renal cortex blood perfusion was collected successively,and a time-intensity curve(TIC) was created with Philips iU22 system's QLAB software. Resistance index(RI) and peak systolic velocity(PSV) of renal partial arteries were also tested. Results Compared with normal kidney,CKD patients had delayed perfusion and decreased intensity. Changes of area under curve(AUC), derived peak intensity(DPI), slope rate of ascending curve(A)and time to peak(TTP) were statistically significant ( P ＜0. 05). Sensitivities of AUC,DPI,A and TTP in diagnosis of CKD (stage Ⅲ～Ⅴ ) were 91.2% ,84. 9% ,90.9% and 85.3%, their specificities were 95.4%,88.9% ,93.3% and 90.9%, their accuracies were 93.6%, 87. 2%, 92.3% and 88. 5%, respectively. The results of CEUS were better than RI in CDFI (sensitivity 70.4%, specificity 37. 8%, accuracy 52.2%).Conclusions CEUS can precisely display the hemodynamic change in CKD ( stage Ⅲ～Ⅴ ), and is more sensitive than CDFI.

Objective To investigate the feasibility of contrast-enhanced ultrasonography(CEUS) in quantitative assessment of angiogenesis in patients with hepatocellular carcinoma(HCC).Methods Thirtythree patients with HCCs confirmed by pathology underwent CEUS in one week preoperatively.The presets and contrast dosage were fixed in all the studies.The new quantitative software with GAMMA fitting technique was used to analyze the dynamic images offline.The quantitative parameters such as baseline intensity,increased signal intensity(ASI),decent curvature(a2),up slope rate(a3),arrive time(AT), time to peak(TTP), accelerate time(ACT),peak intensity(PI),and area under curve(AREA) were calculated.The pathological specimen was stained with CD34 antibady and microvessel density (MVD) was calculated automatically.The correlation between parameters of CEUS and MVD was analyzed statistically.Results The parameters of ASI, a2, a3, AT, TTP, PI and ACT in the tumor were significantly different from those in liver parenehyma ( P＜0.01 ).The value of a2 in the tumor was correlated with MVD, the standardized ASI and AREA were correlated with MVD (P＜0.05).Conclusions The quantitative analysis with CEUS reflects the microvascular perfusion flow objectively.It provides a noninvasive imaging method to assess the angiogenesis in HCCs.

Objective To compare and analyze the similarities and differences of the blood perfusion characteristics of the renal pelvic carcinoma displayed by contrast-enhanced ultrasonography(CEUS) and contrast-enhanced computed tomography(CECT).Methods The characteristics of CEUS and CECT were anzlyzed retrospectively in 40 confirmed renal pelvic carcinoma cases by operation and pathology.The modality and phases of enhancement,including wash-in and washout time,as well as the perfusion appearances,were observed by CEUS and CECT.Results CEUS detected the cortical phase enhancement in all renal pelvic tumors,including synchronously enhancement in 14 tumors and delayed enhancement in 26 tumors.At peak times,hypoechogenicity compared to the normal renal cortex was shown in 31 tumors,hyperechogenicity in 4 tumors and isoechogenicity in 5 tumors.Fast wash-out in medulla phase was displayed in 35 tumors,isochronously wash-out in 2 tumors and delayed wash-out in 3 tumors.The minimum diameter in 40 renal pelvic tumors was 1.5 cm.CECT showed the enhancement in 38 tumors,mostly mild to moderate homogeneous enhancement,and enhancement was lower than the surrounding renal parenchyma.The diagnostic accuracy of CEUS was 77.5％ (31/40),and the diagnostic accuracy of CECT was 82.5 ％ (33/40).The difference was not statistically significant between CEUS and CECT ( P ＞0.05).Conclusions CEUS and CECT have higher diagnostic accuracy of the renal pelvic carcinoma,so the joint detection can increase the detection rate of early diagnosis of the renal pelvic carcinoma.

Objective To evaluate the contrast-enhanced ultrasonography (CEUS) in quantitative diagnosis of chronic renal insufficiency. Methods Correlation of CEUS indexes with glomerular filtration rate (GFR) detected by 99mTc-DTPA renography was examined. Thirty-three cases of clinical chronic renal insufficiency were enrolled in the study. They were 15 males and 18 females with average age of (43.33±6.78) years. After intravenous bolus injection of 1 ml SonoVue,CEUS of renal cortex blood perfusion was performed successfully, and a time-intensity curve (TIC)was created with PHILIPS iU22 system's QLAB software. A 148 to 222 MBq dose of 99mTc-DTPA was injected as a bolus from antecubital vein. Renal scintigraphic images were collected immediately and GFR was obtained. Results The significant correlation coefficients between GFR and CEUS quantitative indexes were as follows: rAUC (area under curve)=0.886 (P＜0.05), rA (slope rate of ascending curve, A) =0.804(P＜0.05). However, rDPI (derived peak intensity, DPI)=0.021 (P＞0.05), rTTP (time to peak, TTP) =0.043 (P＞0.05), rα (slope rate of descending curve,α)=0.039 (P＞0.05). Conclusion CEUS can precisely display the hemodynamic change of chronic renal insufficiency, which is well correlated with GFR by 99mTc-DTPA renography.

Objective To investigate the diagnostic value of the single detection and combined detection of Epstein-Barr virus (EBV) VCA-IgM ,aspartate transaminase (AST) and alanine transaminase (ALT) in EBV current infection .Methods The VCA-IgM positive simples tested by chemiluminescence from January to October 2016 were collected .EBV-DNA was detected by RT-PCR .AST and ALT were detected by using the enzyme rate method .Then samples were divided into the EBV-DNA positive group and EBV-DNA negative group .SPSS22 .0 was used for conducting the non-parametric test .Then each indicator was analyzed by the Logistic regression and receiver operating characteristic (ROC) curve .Results The levels of VCA-IgM ,AST and ALT in the EBV-DNA positive group were higher than those in the EBV-DNA negative group ,the difference was statistically significant (P<0 .05) . VCA-IgM ,AST and ALT showed a correlation with EBV-DNA (P<0 .05) .The areas under curve (AUC) of VCA-IgM ,AST and ALT single indicator detection curve were 0 .803(95% CI:0 .735 -0 .872) ,0 .788(95% CI:0 .708 -0 .868) ,and 0 .752(95% CI:0 .671-0 .832) ,respectively ;AUC of 3-indicator combined detection were 0 .830(95% CI:0 .765 -0 .896) ,which was high than AUC of each single indicator detection .Conclusion Among the indicators in EBV current infection ,VCA-IgM is of great diagnostic value ,and is superior to AST or ALT .Furthermore ,the combined detection of these three indicators is better than single indicator detection ,which contributes to the diagnosis and prevention of EBV infection and other complicating infection .

Objective To investigate the infection status of Helicobacterpylori (HP) in the physical examination population and the contents of pepsinogen Ⅰ (PGⅠ),pepsinogen Ⅱ (PGⅡ) and gastrin-17 (G-17) in serumand the association with HP infection.Methods In this study,781 cases of physical examination were included.Serum HP antibody typing,PGl,PGⅡ and G-17 were measured by Helicobacter pylori antibody kit and enzyme-linked immunosorbent assay.The levels of PGⅠ,PGⅡ,PGⅠ/PGⅡ and G-17 were analyzed by SPSS22.0 analysis system,and the difference of HP infection rate between HP infection group and non-infected patients and different types of infection was analyzed.Analysis of the infection rate and the difference of each age group.Results There was no significant difference between the two groups (x2 =0.284,P=0.594),and there was significant difference between different age groups (x2 =8.523,P=0.014).The levels of PGⅠ,PGⅡ,PGR and G-17 in serum were statistically significant (Z=8.616～ 14.125,P=0.000) compared with those of HP positive and negative.There were significant differences in serum PGⅡ and PGR levels between HP Ⅰ type and HP Ⅱ type infection (Z=3.444,3.385,P=0.001).The levels of PGⅠ and PGⅡ in serum were significantly higher than those in other groups (Z=5.012,4.478,P=0.000).PGⅠ and PGⅡ were higher in women than in females (Z=0.444～0.941,P＞0.05),with the increase of age,PGⅠ,PGⅡ and G-17 has an upward trend,while PGR showed a downward trend.Conclusion The level of serum PG was closely related to gender,age and HP infection,and was closely related to HP infection classification.The combination of HP antibody typing and serum PG and G-17 as a routine test of gastric function is of great significance in the screening and evaluation of early gastric diseases.

Objective To explore the diagnostic value of contrast-enhanced ultrasonography (CEUS) in ureteral lesions.Methods The ultrasonogram of conventional ultrasound and CEUS were retrospectively analyzed in 19 confirmed ureteral lesions cases by operation and pathology.The size,inner echoes,boundary and color blood signal of ureteral lesions were observed by conventional ultrasound.The modality and phases of enhancement,including arrival time,peak time,washout time and appearance of internal structure,were observed by CEUS.Results The 19 ureteral tumors were of maximum widths between 2.1 to 7.7 cm.Conventional ultrasound showed 7 hypoechoic masses,10 isoechoic masses,1 hyperechoic mass and 1 unclear mass.Color Doppler flow imaging showed fairly rich blood signal in 8 tumors,a small amount of blood signal around tumor in 6 tumors and no blood signal in the rest.In early phase,CEUS showed enhancement in all 19 ureteral lesions,including synchronously enhancement in 8 tumors and delayed enhancement in 11 tumors.In peak time,hypoechogenicity compared to the normal renal cortex was shown in 3 tumors,hyperechogenicity in 11 tumors and isoechogenicity in 5 tumors.In late phase,fast wash-out was displayed in 16 tumors,isochronously wash-out in 1 tumor,delayed wash-out in 1 tumor and unclear in 1 tumor.The detection rates of blood supply and clear boundary in ureteral lesions and the diagnostic sensitivity for ureteral cancer were 74% (14/19),16% (3/19),50% (8/16) by conventional ultrasound respectively.The detection rates of blood supply and clear boundary in ureteral lesions and the diagnostic sensitivity for ureteral cancer were 100% (19/19) ,58% (11/19) ,94% (15/16) by CEUS respectively.The change of these performances was statistically significant between conventional ultrasound and CEUS.Conclusions CEUS can improve blood supply,boundary and the diagnostic sensitivity of ureteral lesions.

Objective To evaluate contrast-enhanced ultrasound imaging of carotid atherosclerosis with different stenostic degree as a clinical tool to study intraplaque neovascularization.Methods Fifty-eight patients suspected of carotid stenosis with 73 plaques were studied by standard and contrast-enhanced ultrasound.Plaque echogenicity at standard ultrasound were evaluated.Contrast enhancement within the plaques was categorized as 0 - 4 degree and compared to the stenosis degree and the plaque echogenicity.The degree of stenosis was determined by intravenous digital subtraction angiography.Results In the group with stenosis less than 90% ,stenosis degree was not associated with the grade of contrast enhancement (P =0.358),while the grade of enhancement was significantly higher in the group with sever stenosis(＞90%).The grades of enhancement were significantly different between plaques with different echogenicity (P =0.000).Conclusions Contrast-enhanced real-time ultrasound imaging can demonstrate the enhancement of carotid plaques non-invasively,which is helpful for assessing intraplaque neovascularization and provide valuable information for plaque risk stratification

Objective To investigate the relationship between hemodynamic parameters from quantitative analysis of contrast-enhanced ultrasonography (CEUS) on hepatocellular carcinoma (HCC) and pathological tumor differentiated grades. Methods Seventy-seven HCC lesions were examinated and off-line analyzed with dynamic images. Quantitative parameters such as slope of decrease to half of peak (SD), increased signal intensity (ISI), area under the curve (AUC) and blood flow coefficient (BF) were acquired, and the standardized values (sISI, sAUC and sBF) included the ratio of parameters from tumor to those from hepatic parenchyma. These quantitative parameters were correlated with tumor grades according to Edmonson criteria. Results There was significant difference (P＜0.05) of SD, AUC and BF, as well as standardized values (sISI, sAUC and sBF) between different grades of HCC. AUC, BF, sISI, sAUC and sBF were negative correlated with differentiated grades, respectively (P＜0.05). Well-differentiated HCC had significantly higher perfusion values than HCC of other grades (P＜0.05). Conclusion Quantitative analysis of CEUS can assess differentiation of HCC indirectly, and might reveal biological behavior of malignant tumors.