Objective To quantitatively assess the neovascularization within human carotid atheroclerltic soft plaque in patients with cerebral infarction using real-time contrast-enhanced uhrasonography. Methods One hundred and forty-two patients with carotid athemselerotic soft plaque were divided into two groups: cerebral infarction group (n = 44)and control group (n = 98).Real-time contrast-enhanced ultrasonography was examined. Acoustics quantitative analysis was made by auto-tracking contrast quantification (ACQ)technology. Results The enhanced intensity (EI)in cerebral infarction group was significandy higher than that in control group[(14.58±4.19)dB vs (11.26±3.77)dB, P< 0.01]. The difference of arrival time (DAT)and the difference of time to peak (DTrP)in cerebral infarction group was significantly shorter than those in control group [(2.21±0.42)s vs (2.46±0.51)s,(2.13 + 0.37)s vs (2.43±0.48)s, P all < 0.01]. Conclusions The real-time contrast-enhanced uhrasonography can provide a new non-invasire and quantitative tool to assess the neovascularizafion within carotid atheroselerofic soft plaque. EI is re-garded as an independent risk factor correhtes strongly with cerebral infarction.

Objective To evaluate the efficacy of radiofrequency ablation combined with absolute ethanol injection in the treatment of hepatocellular carcinoma (HCC), and to study the value of contrast-enhanced ultrasound in the evaluation of therapeutic effect.Methods From May 2015 to May 2017, 60 patients with liver cancer (72 lesions) were treated in our hospital.The patients were divided into 3 groups, the RFA treatment group (n=20), 24 lesions, the PEI treatment group (n=20), 22 lesions, and the RFA+PEI treatment group (n=20) with26 lesions.3 groups of patients were treated with contrast-enhanced ultrasound (CEUS), routine color Doppler ultrasound (CDUS), enhanced CT to evaluate the specific situation of the tumor, and evaluate the therapeutic effect again after operation.The rates of necrosis, lesion inactivation and residue were evaluated in each group.Results The necrosis rate of RFA group, PEI group and RFA+PEI group were66.67%,81.82% and 96.15%, respectively.The necrosis rate of CT group was the highest, and the difference was statistically significant (P<0.05) in RFA+PEI group.Comparison of different imaging to assess the sensitivity and specificity of CDUS, to evaluate the sensitivity and specificity were 81.36% and 53.85%;CEUS to evaluate the sensitivity and specificity were 98.31% and 84.62%, significant difference was statistically significant (P<0.05).Conclusion RFA+PEI treatment program is better than RFA and PEI alone treatment, the treatment effect is better, CEUS in the evaluation of RFA+PEI treatment effect, has higher clinical value.

Objective To determine staging accuracy of double contrast-enhanced ultrasonography (DCUS)after neoadjuvant chemotherapy,and to evaluate effect during neoadjuvant chemotherapy for advanced gastric carcinoma(AGC).Methods A total of 29 patients with AGC diagnosed by endoscopy were examined and staged using ultrasound after taking oral contrast agent and bolus injection of SonoVue (DCUS)pre-and post-neoadjuvant chemotherapy.T-stage accuracy of post-neoadjuvant chemotherapy and pathological T status of postoperative were compared.All of the subjects were divided into two groups according to RECIST(Response Evaluation Criteria in Solid Tumors):chemotherapy benefit group(22cases,including:complete response 0 cases.partial response 14 cases,stable disease 8 cases)and progressive group(7 cases).The findings of DCUS of AGC tissues were assessed by auto-tracking contrast quantification(ACQ)software.The baseline intensity(BI)and peak intensity(PI)of gastric carcinoma tissues were measured automatically,and the enhanced intensity(EI)of gastric carcinoma tissues was calculated manually(EI =PI-BI).The quantitative analysis findings of DCUS of each patient pre-and postneoadjuvant chemotherapy between two groups were compared adopting repeated measures method.Results The overall accuracy of T staging in AGC patients after neoadjuvant chemotherapy were 65.52％ by DCUS,and 0,42.86％and 92.86％respectively for T2 stage,T3 stage and T4 stage.The agreement of this method was weak between T-stage accuracy post-neoadjuvant chemotherapy and pathological T status of postoperative.The Kappa value was 0.33.The difference value of PI and EI between pre-and postneoadjuvant chemotherapy in AGC patients for benefit group was more than that in progressive group.The main effect of BI in AGC tissues between pre-and post-neoadjuvant chemotherapy was no significant difference between two groups(P＞0.05).Conclusions Restaging by DCUS after neoadjuvant chemotherapy in AGC patients was found to be inaccurate.However,the difference value of PI and EI between pre-and post-neoadjuvant chemotherapy in AGC tissues for benefit group was more than that in progressive group.Thus,the value of PI and EI by ICUS may be a useful clinical parameter with which to evaluate the effect during neoadjuvant chemotherapy and guide therapeutic regimen for AGC patients.

Objective To explore the relationship between pulse pressure and aortic relative pulse wave velocity in the patients with hypertension by Doppler tissue imaging.Methods Velocities of abdominal aortic wall motion were measured in ninety one patients with essential hypertension.Electro mechanical time(EMT),pre ejection period (PEP) and the patient height(H) were measured and recorded respectively,and pulse wave time (PWT) was defined as EMT-PEP and relative pulse wave velocity (RPWV) as H/PWT.Results RPWV in the patients with pulse pressure ≥60 mm Hg ( 1 mm Hg = 0.133 kPa) was significantly greater than that of the patients with pulse pressure

Objective To evaluate the diagnostic value of puncture feeling combined with fine-needle aspiration cytology (FNAC) for thyroid nodules.Methods One thousand and fourteen thyroid nodules were retrospectively analyzed.Eighty-six thyroid nodules were performed repeat FNAC.All nodules were confirmed by pathology,the agreement of puncture feeling at different time was evaluated by Kappa test.Results There were 751 malignant nodules and 263 benign nodules.Sensitivity and accuracy of FNAC combined with puncture feeling were higher than those of single FNAC or single puncture feeling (x2 =11.609,4.433 and P =0.00,0.04;x2 =19.369,6.697 and P =0.00,0.01,respectively).There were no statistically differences in the sensitively and accuracy between single FNAC and puncture feeling (x2 =1.230,0.242 and P =0.27,0.62,respetively).The Kappa values of inter-observer and intra-observer were 0.829(P =0.00) and 0.885(P =0.00) respectively with statistically significance.Conclusions Puncture feeling combined with FNAC can improve the sensitivity and accuracy in the diagnosis of thyroid nodules,the reproducibility of puncture feeling is excellent.

Objective To compare the application value of contrast enhanced ultrasound (CEUS) and contrast enhanced magnetic resonance angiography ( CEMRA ) in the diagnosis of carotid plaque characteristics . Methods Fourty-six patients ( 48 carotid plaques) were performed with carotid CEUS and CEMRA examination prior to carotid endarterectomy . The following characteristics of plaque including the surface of the plaque ,the presence of calcification ,the internal composition and the diameter stenosis were observed and measured ,which were compared with pathologic and digital subtraction angiography ( DSA ) results . Results There were 42 vulnerable plaques and 6 stable plaques in the 48 plaques . Fourty-seven carotid plaques had been correctly diagnosed by CEUS and CEMRA ,and one plaque had been misdiagnosed . The sensitivity ,specificity and accuracy between CEUS and CEMRA had no obvious differences in terms of the overall evaluation of plaque vulnerability ( P > 0 .05) ;CEUS and CEMRA in the diagnosion of the plaque surface situation had no statistical difference in terms of sensitivity ,specificity and accuracy compared with pathological results( P > 0 .05) ;There was no significant difference in diagnostic accuracy rate between two modalities ( P < 0 .05) ;In the diagnosis of plaque internal composition ,they had statistically differences in terms of specificity and accuracy ( P < 0 .05) ,while sensitivity had no obvious difference ( P > 0 .05) . With DSA examination results as the gold standard ,the accuracy of CEUS in the diagnosis of the diameter stenosis was 97 .92% (47/48) ,CEMRA was 100% (48/48) ,they had no significant difference between two groups ( P > 0 .05 ) . Conclusions CEUS and CEMRA in carotid plaques characteristic evaluation have respective advantages ,are highly complementary ,and combining two methods can systematically evaluate for plaque characteristics .

Objective To evaluate the association of the size of thyroid nodules and accuracy of fineneedle aspiration cytology in diagnose of thyroid nodules.Methods 691 thyroid nodules in 630 patients pathologically confirmed were retrospectively analyzed in our hospital.All imaging data of preoperative ultrasound-guided FNAC were collected in our review.Yields of FNAC were divided into six levels according to the classification criteria of the Bethesda system(level Ⅰ,insufficient material or nondiagnosed;level Ⅱ,benign ; level Ⅲ,atypical hyperplasia; level Ⅳ,follicular neoplasm ; level Ⅴ,suspicious for malignancy; level Ⅵ,malignant),＞level Ⅳ was the malignant cytologic criteria for diagnosis of thyroid nodules.According to the maximal diameter of thyroid nodules,the nodules were divided into group A(L≤0.5 cm),group B(0.5 cm＜L＜1.0 cm) and group C(L≥1.0 cm).Postoperative pathologic results were taken as the gold standard.Results Of 691 nodules,there were 176(25.47％),298(43.13％) and 217(31.40％) in group A,group B and group C respectively.Among the three groups,accuracy of ultrasound-guided FNAC in group B (90.94 ％) was higher than in group A(80.11％) and group C(83.41 ％),with statistically significant(P ＜0.05).There was not statistically different between group A and group C(P ＞0.05).The specificity,positive predictive value and negative predictive value were not statistically different among three groups(P ＞0.05).Conclusions The size of thyroid nodules was partly associated with accuracy of ultrasound-guided FNAC.

Objective To evaluate the diagnostic value of virtual touch tissue quantification (VTQ) for nonpalpable breast masses.Methods Two hundred and one nonpalpable breast masses in 176 women who had been scheduled for a sonographically guided core biopsy or operation were examined with the B-mode sonography and VTQ.The pathologic diagnosis was used as the golden standard.The diagnostic performances of the two methods were evaluated with receiver operating characteristic curve(ROC).Results The mean shear wave velocity (SWV) measurement values were (6.17 ± 1.95)m/s in malignant masses and (3.39± 1.82)m/s in benign masses(P ＜0.01),respectively.The area under the ROC curve was 0.789 for the VTQ and 0.840 for the BI-RADS-US,respectively.No statistically difference was found between them.The area under the ROC curve of the combination of the two methods was 0.934,the diagnostic performance of the combination was better than that of BLRADS-US(P ＜0.01)and VTQ alone (P ＜0.01).Conclusions VTQ is a good method for diagnosing nonpalpable breast lesions.The combination of BI-RADS-US and VTQ has better diagnostic perform ance for differentiation of nonpalpable breast lesions,which has important value in clinical application.

Objective To evaluate eutopic endometrial blood supply and vessels in patients with endometriosis(EMs) with contrast enhanced ultrasound (CEUS),to explore a newmethod to estimate vascularization of eutopic endometrium in EMs patients.MethodsThirty patients with EMs were enrolled and 20 patients who were diagnosed as other gynecological diseases as control.Informed consent of each case was obtained. AllcasesunderwentconventionalultrasoundexaminationandCEUSexamination.Characteristics of CEUS in each patients were observed and analyzed using off-line Qontrast software.Parameters of CEUS including peak intensity(PEAK),time to peak(TTP),regional blood volume(RBV),regional blood flow(RBF) were obtained automatically.ResultsComparing with control group,the eutopic endometrium in EMs group presented higher enhancement.The parameters of CEUS,including PEAK,TTP,RBV,RBF were (41.18 ± 3.29) dB,(29.01 ± 4.46) s,(29.07 ± 4.59) ml,(48.61 ± 5.35) ml/min in EMs group and (13.36 ± 2.34)dB,(24.59 ± 2.29)s,(26.51 ±- 3.80)ml,(48.71 ± 3.80)ml/min in controls respectively,the value of PEAK in EMs group was higher than that of controls ( P =0.000).Conclusions CEUS can be regarded as a new method which can be used to assess vascularization of eutopic endometrium in endometriosis.

Objective To determine whether low frequency ultrasound mediated microbubbles destruction (UMMD) could inhibit VX2 orthotopic hepatic tumor growth in rabbit models.Methods Twenty-four New Zealand white rabbits were implanted with VX2 tumor in left hepatic lobe to establish a homograft rabbit model of liver neoplasms in situ,which were randomly divided into four groups(6 rabbits in each group):group A (intravenous saline only),group B (intravenous microbubbles only),group C (intravenous saline+ low frequency focused ultrasound exposure),and group D (intravenous microbubbles+low frequency focused ultrasound exposure).After 3 days consecutive treatment,tumor volume(TV),and peak intensity (PI) were monitored by conventional ultrasound and contrast enhanced ultrasound(CEUS) on 0,1,7,14 and 21 days after treatment.The rabbits were euthanized at the end of the experiment.Tumor tissues were evaluated by HE stain.Results The parameters of TV and PI of each tumor had no significant difference among four groups before treatment(all P>0.05).TV had no significant difference among four groups on 1 day after treatment(all P>0.05);PI in group C and group D were significantly lower than those in group A and group B (all P<0.05).TV and PI in group D were significantly smaller than those in other groups on 7,14,21 days after treatment(all P<0.05).There was no statistical difference in TV and PI among group A,group B and group C(all P>0.05).The pathological changes of necrosis tissue,hemorrhagic damage of microvessel and thrombosis were observed in the tumors of group D only,whereas these changes occurred rarely in other groups.Conclusions UMMD can inhibit the growth of VX2 hepatic tumors in rabbits,and be used as a promising novel therapeutic strategy to liver neoplasms.