Objective:To study percutaneous transhepatic gallbladder drainage(PTGD) under color Doppler ultrasound in critically ill patients with acute calculus cholecystitis.Methods:A paracentetic needl was stuck into the cholecyst after going straight through 1.5-2.5 cm hepar under color Doppler ultrasound.The operator took out the bullet core,put in a guide wire,extracted the needl,inserted a central venous catheter along the guide wire,and then drew out the bile and clusised the cholecyst with metronidazole until the extracted fluid was clear and bright.Results:PTGD immediately relieved the pain in the of upper right quadrant in all the patients.Body temperature and WBC descended obviously 24 hours and returned to normal 5 days after the operation. Conclusion:Color Doppler ultrasound guided PTGD,easy to perform and with few complications and high suness rate,is an returned effective and reliable procedure for critically ill patients who are intolerant of cholecystectomy or for whom the operation is difficult to perform.

Arterial stenosis-induced hemodynamic changes and their evaluation have long been studied by lots of scholars by in vivo and in vitro experiments,clinical observation and improved experimental devices and methods,which has contributed a lot to the diagnosis and treatment of arterial stenosis.This review describes the current research results.

Objective To study the haemodynamics changes in the proximal upstream artery caused by different degrees of abdominal aorta extremity stenosis.Methods The lateral walls of the abdominal aorta extremity were pinched with the vascular clamp to achieve 1/4,1/2 and 3/4 stenosis or occlusion in 6 juvenile susscrota domesticas,the velocity tracing of the proximal artery recorded,and the parameters of the peak systolic velocity(PSV)and minimum diastolic velocity(MDV)were obtained and statistically analyzed for their correlation with different degrees of abdominal aorta extremity stenosis.Results The diastolic velocity tracing vanished when stenosis reached a certain degree,the needle ridge and low amplitude diastolic velocity tracing emerged when stenosis to a certain extent,and only the needle ridge was present when the abdominal aorta extremity was completely obstructed.PSV reduced with the aggravation of stenosis.Conclusions The proximal upstream artery systolic ridge caused by abdominal aorta extremity stenosis tends to be acUminate,which indicates serious stenosis of the downstream artery.The systolic needle ridge and the absence of diastolic velocity tracing would suggest a complete obstruction of the blood stream in the downstream lumina.

Objective To study the common femoral artery haemodynamics caused by different degrees of abdominal aorta extremity stenosis.Methods The lateral walls of abdominal aorta extremity were pinched with vascular clamp resulting in 1/3,1/2,2/3,3/4 stenosis by turns in 6 juvenile susscrota domesticas.The parameters of peak systolic velocity(PSV),minimum diastolic velocity(MDV),PSV/MDV(S/D)and MDV/PSV(D/S)of common femoral artery were obtained and their correlations with degrees of abdominal aorta extremity stenosis were confirmed by statistical analysis.Results The backwardware vanished or turned to forwardware when stenosis achieved certain degree.PSV had significant negative correlation with stenosis degree(R=0.985,R2=0.969),but D/S had significant positive correlation with stenosis degree when stenosis degree exceed 1/3(R=0.918,R2=0.843).Conclusions It can be concluded there is proximal stenosis disease and change of distal effective circulating blood volume according to the Doppler velocity tracing analysis.PSV and D/S are valuable parameters,however waveform should be ignored.

Objective To study the formations of several ridges in peripheral artery velocity tracing. Methods The experimental models of constrainting limb and adrenaline were performed in 6 juvenile susscrota domesticas,tbe variations of the external lilac artery velocity tracing observed,and the parameters of peak systolic velocity (PSV), minimum post-systolic velocity (MPV), peak diastolic velocity(PDV) and end diastolic velocity(EDV) were obtained. Results With the increase of downstream circulation resistance, systolic waveshape inclined to acumination, MPV gradually degraded to zero and negatively increased subsequently, diastolic wave amplitude lowered, and EDV gradually decreased to zero. The stronger vasoconstriction was, the more striking the variations were. Conclusions Cardiac ejection forms systolic dominant wave, post-systolic backward ware is the result of backstreaming because of elastic recoil of downstream artery,and diastolic forward ware is the result of blood transient acceleration caused by elastic recoil of upstream artery. Systemic vascular resistance has significant effect on diastolic waveshape,and the occurrence of post-systolic backward ware implies downstream circulation resistance obviously increases.

Objective To investigate the value of the diagnosis of contrast-enhanced ultrasound(CEUS) in renal tumors. Methods Nineteen patients with hyperechoic renal tumors detected by CEUS underwent resection for suspected renal malignant and benign tumors. The characterization of hyperechoic renal tumors on CEUS was evaluated. Results Histopathologic results of resected lesions showed benign tumors in 11 patients with angiomyolipoma and malignancy in 8 patients with clear cell carcinoma. Six patients with angiomyolipoma showed rapid wash in contrast enhancement and slow wash out on all tumor and focal tumor (6/11). One patient with angiomyolipoma was observed in rapid wash in and wash out (1/11). Four patients with angiomyolipoma showed rapid wash in and negative contrast enhancement after rapid wash out(negative contrast enhancement compared to renal cortex,4/11). Five patients with clear cell carcinoma showed rapid wash in and wash out (5/8). Two patients with clear cell carcinoma showed rapid wash in and delayed wash out (2/8). One patient with showed no enhancement on CEUS (1/8). The pseudocapsule could be seen at 5 patients with clear cell carcinoma. Wash in enhancement and wash out on clear cell carcinoma were significant in comparison to these of angiomyolipoma (P<0.05). Wash in enhancement,delayed wash out and negative contrast enhancement were no significant between clear cell carcinoma and angiomyolipoma (P>0.05). Conclusions CEUS is useful for discriminating between benign and malignant renal tumor.

Objective To investigate the effect of systematic health education on the ultrasound guided interventional therapy for pa -tients with cysts.Methods Totally 181 patients with cysts who received the ultrasound guided interventional therapy in our hospital ,were randomly divided into observation group and control group .The patients in the observation group received systematic health education ,while patients in control group received convention health education .Results The differences of pain score between two groups were statistical significance(P<0.05).By health education,the patients in the observation group had a deeper knowledge of the operation and became more cooperative(P<0.05).Conclusion Systematic health education could alleviate the pain and improve the psychological indisposition reac -tions of patients,and enhance therapeutic compliance of patients with ultrasound guided interventional therapy .In the meantime,systematic health education could improve the quality of work and enhance the diathesis of paramedic .

Objectives:To study the ultrasonogram, diagnosis and significance of testicular microlithiasis (TM). Methods:The clinical data and ultrasonographic outcomes of 97 patients with the genital system diseases were retrospectively analyzed. Results:Five patients with TM were found, and the prevalence of TM is 5.2%. of 5 cases, 2 cases were associated with infertility, 1 cases with orchitis,1 case with seminoma, and 1 case with mature teratoma. Three cases with varicocele,2 cases with atrophic testis, 1 case with hydrocele and 1 case with spermatocele, were found out with the use of a high frequency transducer. The sonographic appearance of TM is multiple tiny(1-3 mm),no acoustic shadowing hyperechoic foci that are randomly scattered throughout the testicular parenchyma. Conclusions:Testicular microlithiasis has been associated with a variety of clinical entities, and it is an uncommon condition in which calcified concretions fill the lumen of seminiferous tubule, commonly diagnosed by high frequency (5～10 MHz ) testicular ultrasound. The accepted standard of TM is multiple small nonshadowing hyperechoic foci up to 3 mm in size, with five or more evident on a single sonogram.

Objective: To observe the haemodynamic changes within ovarian stromal blood flow in patients with polycystic ovary syndrome(PCOS). Methods: 41 patients with PCOS and 10 ovulatory women underwent transrectal ultrasound associated with Doppler flow measurement of the artery within ovarian stroma during the early follicular phase (days 2-5 of the menstrual cycle) or any day in patients with amenorrhea . Results:The peculiar vascular pattern wich one prominent blood vessel showed passing through the ovarian stroma from ovary gate. This sign was observed in all ovaries in patients with PCOS.There was no significiant difference in Vmax、PI、RI between left and right ovary.The Vmax,PI,RI of the right ovarian stromal artery were (18.99?3.12)cm/s, 0.74?0.12, 0.50?0.03 respectively. The indices of the left ovarian stromal artery were (18.76?3.23)cm/s, 0.75?0.11, 0.49?0.04 respectively. Conclusion: Vascularization of the ovarian stroma is prominent in patients with PCOS than in the control. The decreased vascular resistance to ovarian stromal perfusion in patients with PCOS may lead to perfusion increasment. TRS can be used as a non-invasive, convenient, and sensitive method for assessing the blood flow within the ovarian stroma.

Objective To analyze the misdiagnosis reasons in renal tumors with contrast-enhanced ultrasound (CEUS) and to improve cognition on CEUS. Methods Two-hundred and eighty-five cases were compared with pathology, the images in 22 cases misdiagnosed on CEUS were reviewed retrospectively and the reasons were analyzed. Results The diagnosis accuracy and misdiagnosis rate of CEUS were 92. 28 % (263/285) and 7. 72%(22/285), respectively. In these 22 cases, 9 cases misdiagnosed as renal cell carcinoma (RCC) were conformed by pathology as renal angiomyolipoma(RAMD), showed 5 cases "fast wash-in and fast wash-out", 4 cases "fast wash-in and slowly wash-out". Seven cases were conformed as RCC, in which 5 were misdiagnosed as RAML, showed 4 cases "fast wash-in and slowly wash-out", 1 cases "simultaneously wash-in and simultaneously wash-out", and 2 were misdiagnosed as renal cyst with no enhancement founded. Four cases misdiagnosed as hematoma were conformed as pyelo-carcinoma, with no enhancement founded in renal pelvis. The remaining 2 cases misdiagnosed as inflammatory pseudotumor were conformed as RCC, showed "fast wash-in and slowly wash-out". Conclusions With the high diagnosis accuracy,CEUS is an important method in diagnosis of renal tumors. Analyzing the misdiagnosed reasons may improve the cognition on CEUS and decrease the misdiagnosis.