Objective To probe the differential diagnosis value of ultrasound-guided fine needle biopsy in portal vein tumor thrombosis(PVTT). Methods Twenty-two hepatocellular carcinoma (HCC) patients with portal vein thrombosis(PVT) and 8 hepatocirrhosis patients with PVT were studied by ultrasound-guided fine needle aspiration biopsy and 8 PVT filling portal vein embranchment of 30 PVT were examined by 18G automatic biopsy. The positive rates of aspiration biopsy cytology and histology were calculated and compared with that of automatic biopsy. Results The positive rates of fine needle aspiration biopsy cytology and histology were 93.3%(28/30) and 90.0%(27/30), respectively, and were not different markedly from that of automatic biopsy which was 91.7%(11/12). HCC cells were positive in 17 PVT ( 77.3%) and histology was positive in 18 PVT in aspiration biopsy. In total, twenty tumor thrombi were diagnosed. The other two were diagnosed as benign thrombosis. No HCC cells and/or tissue were observed in 8 hepatocirrhosis with PVT. Conclusions Ultrasound-guided fine needle biopsy in PVTT has comparable high positive rate and diagnosis value and its positive rate is not different from automatic biopsy apparently. So the cases that are not diagnosed by color Doppler and pulsed Doppler can be diagnosed early by ultrasound-guided fine needle aspiration biopsy.

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 probe the characteristics of the ultrasonography of the intrahepatic duct cystic tumor(IDCT).Methods The ultrasonography of 12 patients with IDCT was analysed.The results were compared with the operation and pathology.Two of them were intraductal papillary adenomas,six were papillary adenocarcinomas,two were biliary cystadenomas and two were biliary cystadenocarcinomas.Results The ultrasonic diagnostic rate was 75%(9/12).The bile ducts of 10 cases(83%) were cystically dilated.Seven cases(58%) with thick walls of bile ducts were all malignant.Six tumors(50%) with intraluminal papillate echoes could be malignant or benign.The tremellose echoes were detected in 7 cases(58%) and the common bile ducts of six cases were obstructed by the tremellose substance.Conclusions It is the important diagnostic basis of IDCT that the bile ducts in some liver lobal or segment are dilated without reasons,with the thick bile duct wall and the poor ultrasound penetration,especially when the bile ducts are full of tremellose substance and the papillomas are detected in the ducts.It is of significance in the clinic to raise the early diagnostic rate of IDCT by ultrasound.

Objective To probe the ultrasonic diagnostic value in splenic lyrnphoma and classify the sonographic appearance of splenic lymphoma.Methods The clinical datas and ultrasonic appearances of 31 patients with splenic lymphoma were compared with the pathology.The ultrasonic images were classified.Results Among the 31cases,3 cases with splenic lymphoma and 5 cases with splenic infiltration of splenic lymphoma were correctly diagnosed by ultrasound.The diagnostic correct rate was 25.8%.The sonographic appearances of 31 cases were divided into four types.Homogeneous splenomegaly type(12.9%,4/31),showed homogeneous splenomegaly without mass in the spleen.Multiple nodule type(16.2%,5/31),showed multiple hypoechoic nodules diffused in the spleen.Solitary mass type(29.0%,9/31),showed solitary mass larger than 3 cm with or without necrosis in the spleen.Comples type(41.9%,13/31),showed splenomegaly,hypoechoic masses and nodulars of different sizes in the spleen.Conclusions The sonographic diagnosis of splenic lymphoma is valuable to the clinic.The ultrasound-guided splenic biopsy could be carry out if necessary.

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 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 assess the value of echo tracking(ET) technique on atherosclerosis in the rabbit models, and to probe the pathological foundation of its indexes changes and the usefulness in evaluating arterial elasticity. Methods Thirty New Zealand rabbits were divided into 3 groups randomly: group A was the control group;group B,C were fed with high lipid feedstuffs for 8 weeks and 12 weeks, respectively. The ET examination of abdominal aorta was performed in group A and group B at the end of 8 weeks,it was performed in group A and group C at the end of 12 weeks. The parameters of elasticity were measured including pressure-strain elastic modulus (Ep), stiffness parameters(β), pulse wave velocity (PWVβ), augmentation index (AI), arterial compliance (AC), etc. Two dimensional ultrasound and pathological examination of abdominal aorta were performed at the same time. Results No obvious plaque and arterial wall thickness were seen in the abdominal aorta. Ep,β,PWVβ of group C were higher than that of group A and B, while AC of group C was lower than that of group A and B, and the difference had statistical significance (P<0.05). AI had no significant difference in all groups (P>0.05). Pathological examinations indicated that foam cell formation was seen in the abdominal aorta intima, the elastic fiber layer and smooth muscle layer were kept well in B group. Lots of cholesterol crystal formation was seen in the abdominal aorta intima and the two layer were obvious destroyed in group C. Conclusions ET can detect the atherosclerosis earlier than two-dimensional ultrasound. ET can detect the elasticity changes only when the elastic fiber layer and smooth muscle layer were destroyed . So it can be concluded that the destroy of elastic fiber layer and smooth muscle layer may be the pathological foundation of ET elasticity parameters changes.

Objective To investigate the dependability between ultrasonic appearances of different degree of acute testicular hemodynamic disorder and contralateral testicular damage.Methods Thirty two white rabbits were randomly divided into 4 groups.Group A-C were subjected to testicular ischemia and color Doppler sonography were continuoully performed in each case.The testes were reperfused when the ultrasonic appearances were as follows:homogeneous appearance with reducing of blood perfusion(group A),increased echogenicity and heterogeneity with little blood perfusion(group B).inhomogeneous appearance with small pieces of low echogenic areas and no blood perfusion(group C).Group D was the control group.Histologic structure changes of contralateral testes were observed after reperfusion for a month.The contralateral testes in all the cases underwent contrast-enhanced ultrasonography(CEUS)before reperfusion of unilateral testes.Results CEUS time-intensity curve of contralateral testes showed no statistical significance between the four groups(P＞0.05).Focal and mild pathological and ultrastructural changes were observed in contralateral testes in group A-C.But Johnsen score showed no statistical significance between the control group and group A-C(P＞0.05).The total number of appotosis cells per 100 seminiferous tubules in group B(38.75±8.88)were significantly more than the control group(18.63±3.81)as well as group A(20.50±6.12)and group C(18.00±4.47)(P＜0.001),but there were no statistical significances between group A,group C and the control group(P＞0.05).Conclusions Ultrasonic appearances of acute testicular hemodynamic disorder are help for the prediction of contralateral testicular damage.As blood flow in contralateral testes were unaffected after acute testicular hemodynamic disorder,it seems to have no role in contralateral testicular damage.

Objective To probe the characteristic ultrasonic appearances of hepatic adenoma.Methods The appearances of color Doppler flow imaging(CDFI)and contrast-enhanced ultrasound(CEUS)in 10 cases of hepatic adenoma were analyzed.Results Rich blood flow signals were found in all the hepatic adenoma lesions on CDFI.Large blood flow signals were detected in the periphery of all tumors.On CEUS,peritumoral feeding vessels displayed in early arterial phase and homogeneous enhancement in arterial phase was observed in all the 4 cases.The tumor capsule was enhanced continuously in all cases.One case with isoechoic enhancement in delayed phase was found the contrast agent wash out in portal phase.The other 3 cases showed the‘fast-in and slow-out'appearance.which was iso-echoic enhancement in portal phase and slightly hyperechoic enhancement in delayed phase.Conclusions The rich blood flow signals,early displaying of peritumoral feeding vessels,homogeneous enhancement in the arterial phase and continuously enhanced tumor capsule on CEUS are the distinctive appearances of hepatic adenoma.

Objective To evaluate the effectiveness and feasibility of riein-loaded thermosenaitive hydrogel in percutaneous intratumoral injection for treatment of hepatic carcinoma. Methods BALB/c-nu mice were inoculated subcutaneously in the right flank with human liver cancer cell line HepG2. A total of 32 male mice bearing subcutaneous hepatic carcinoma (7-10mm in diameter) were randomized into 4 groups. Each group of mice were administered percutaneous intratumoral injection of different agents as follows: salin, thermosensitive hydrogel,ricin, ricin-loaded thermosensitive hydrogel. The tumor volume was totally measured 3 times by high frequency ultrasound once a week. One mouse of each group was sacrificed to perform tumor histopathological examination on 7th day, 14th day, respectively, and survival time of the remaining mice was recorded. Results After intratumoral therapy,tumor volume in ricin group was smaller than that of saline group on 7th day, 14th day and 21st day( P<0.01 ),and mice got a life-prolonging rate of 36.8%. In ricin-loaded thermosensitive hydrogel group,obvious necrosis occurred in tumors treated since 5th day, and the tumor almost regressed on 21st day. Histopathological assay showed serious necrosis with a large number of leucocyte infiltration in tumor. All the remaining mice treated with riein-loaded thermosensitive hydrogel survived at the end of experiment sans tumor recurrence. Conclusions Percutaneous intratutnoral injection of ricin-loaded thermosensitive hydrogel could completely ablate hepatic carcinoma,which may provide an effective and feasible method for tumor ablation therapy.