Objective To estimate the value of diffusion weighted imaging with background body signal suppression(DWIBS)in tumors of intestinal tract and metastasis.Methods 15 cass with tumors of intestinal tract underwent MRI and DWIBS examinations.Four of them underwent CT scan.Results All primary tumors were showed by conventional MR sequences and DWIBS.DWIBS showed that 4 cases had the invasion of placenta percreta,5 cases had transcoelomic metastasis in abdominal cavity and 5 cases had lymphatic metastasis,while the conventional MR sequences showed the invasion of placenta percreta in 10 cases,the invasion of fat interspace in 8 cases,transcoelomic metastasis in abdominal cavity in 3 cases and lymphatic metastasis in 3 cases.Conclusion DWIBS is better than the conventional MR sequences and CT in detecting the primary tumor of intestinal tract,transcoelomic metastasis in abdominal cavity and lymphatic metastasis.However,the conventional MR sequences and CT is better than DWIBS in detecting the invasion of placenta percreta and fat interspace.

This study was aimed to investigate structured approach of traditional Chinese medicine (TCM) symptom information. Combining results of the Chinese Symptomatology Research and literature review, this study proposed a dual structure model of symptom. A total of 440 symptoms, which were screened out from the Chinese Terms in TCM and Pharmacy, were used for symptom structured attempt. The results showed that 9 symptoms and 9 attributes were identified, 201 main concept words of symptoms were extracted, and 420 symptoms with the dual structure model were structured. It was concluded that structural information model of TCM symptoms proposed in this study was feasible. However, the research methods and results are exploratory, which requires further verification.

Objective To observe the changes in fibrinolytic factors in rats with pulmonary thromboembolism (PTE) after recombinant prourokinase ( rPro-UK) treatment and its significance .Methods PTE was induced in male Sprague-Dawley (SD) rats by injecting heated 125iodine-labeled fibrinogen(Fib) autologous thromboemboli into external jugular veins.Twenty-eight rats were randomly assigned into following groups (7 rats each):①healthy control group;②PTE 5 d group,the rats in which were sacrificed at 5 d after the PTE model was made; ③ PTE3d receiving rPro-UK thrombolytic treament groups including multibolus treatment sub group ( rPro-UK was given in 1 mg/kg on the post-PTE third day followed by 2 consecutive days of a lower dose 0.25 mg/kg and rats were sacrificed 2 h after the last injection at the same time as PTE5d group) and single bolus treatment sub group ( rPro-UK was given in 1 mg/kg on the post-PTE third day followed by 2 consecutive days of 0.5 ml saline and rats were sacrificad at the same time as the former group ).The rats were quickly sacrificad at the fixed time through carotid bleeding and plasma samples were reserved for analysis of uroki -nase-type plasminogen activator (u-PA), urokinase-type plasminogen activator receptor (u-PAR), fibrinogen (Fib) andα2-antiplasmin (α2-AP) .Results ①Plasma concentrations of u-PA and u-PAR were increased were significantly in rPro-UK multibolus treatment sub group than in PTE 5 d group(Pu-PA <0.05,Pu-PAR <0.01)and rPro-UK single bolus treatment sub group(Pu-PA <0.01,Pu-PAR <0.05),correlated with the thrombolysis rate in rPro-UK multibolus treatment sub group (ru-PA =0.766,P<0.05;ru-PAR=0.785,P<0.05).② No difference of plasma Fib and α2-AP was seen between Pro-UK treatment groups and PTE 5 d group(P >0.05).Conclusion ① Plasma levels of endogenous u-PA and u-PAR are increased at different time points after PTE and are further enhanced after Pro-UK treatment, which promotes endogenous fibrinolysis and thrombus lysis .This is probably related to increased synthesis and secretion of endothelial cells which may be a key thrombolytic mechanism of Pro-UK.②Absence of systemic activation of the fibrinolytic system in Pro-UK multibo-lus treatment sub group means that the regimen is feasible and Pro-UK is fibrin specific .

Objective To investigate the features of quantitative analysis and parametric imaging of contrast-enhanced ultrasound (CEUS) in renal clear cell carcinoma (ccRCC).Methods Ninety-seven pathologically confirmed ccRCCs underwent conventional ultrasound and CEUS.Both quantitative parameters and dynamic vascular pattern (DVP) reconstructure were analyzed with Sonoliver software.Four types of DVP curves were described with type Ⅰ (Unipolar +),type Ⅱ (Bipolar + /-),type Ⅲ (Bipolar -/+) and type Ⅳ (Unipolar-),while the DVP parametric images,similarly,were divided into four types,with type Ⅰ,Ⅱ,Ⅲ and Ⅳ,respectively.Results As for the parameter of CEUS,there were statistical differences in maximum intensity (IMAX),area under the curve (AUC) and mean transit time (mTT) (P ＜0.05) and no statistic differences in rise time (RT) and time to peak (TTP) between ccRccs and peripheral renal parenchyma.Concerning of DVP of ccRCCs,type Ⅰ,Ⅱ,Ⅲ and Ⅳ accounted for 58.8％ (57/97),11.3％ (11/97),10.3％ (10/97) and 19.6％ (19/97) respectively.As for each type in DVP parametric images,the percentages were 58.8％ (57/97),11.3％ (11/97),8.2％ (8/97),21.7％ (21/97),respectively.Conclusions Quantitative analysis and parametric imaging can depict different features of vascularity in ccRCCs and improve the diagnosis of the tumors.

Objective To investigate the usefulness of acoustic radiation force impulse (ARFI) elastography for noninvasive evaluation of liver fibrosis in rats.Methods A total of 70 male Wistar rats were included in the group for dimethylnitrosamine (DMN)-induced liver injury,and 10 saline-injected rats were used as normal control.Hepatic injury was induced by a single intraperitoneal injection of DMN at a dose of 50 mg/kg of body weight.Several rats in the group with DNM injected and the normal control group were randomly selected and sacrificed at each of the following post-injection time:day 5,7,10,14,21,24,and 28.And their livers were taken for pathology analysis.All the rats underwent ARFI elastography before sacrificed in order to acquire a shear wave velocity (Vs) to represent liver stiffness.Correlation between Vs and the histological finding was analysed.ResultsAmong 58 successfully modeled rats,9,13,14 and 12 rats were found to be with S1,S2,S3 and S4 of liver fibrosis pathologically,respectively.And 10 rats were found to be with severe inflammatory activity without any fibrosis.Values of Vs increased with the stage of liver fibrosis ( P ＜0.05).There was a significant correlation between Vs and stage of liver fibrosis ( r =0.947,P =0.000).The areas under ROC curve for the diagnosis of fibrosis S≥S1,S≥S2,S≥S3 and S=S4 were 0.983,0.995,0.999 and 0.964,respectively;for the cutoff values of Vs were 1.59 m/s,2.13 m/s,2.33 m/s and 2.51 m/s,respectively,the sensitivity was 95.8％,92.3％,100％ and 84.6％,and specificity was 100％,100％,96.9％ and 95.6％,respectively.The values of Vs in the group with severe inflammatory activity were significantly higher than those in the control group ( P =0.000).ConclusionsARFI has a relatively high value in the evaluation of liver fibrfosis in rats,while severe inflammatory activity may affect its accuracy.

Objective To evaluate the clinical values of acoustic radiation force impulse(ARFI) elastography for liver fibrosis on hepatopath patients.Methods ARFI elastography was prospectively performed on 99 patients prepared to undergo hepatic surgery to get a shear wave velocity(Vs) which was the representative of liver stiffness.The fibrosis stages,inflammation grades and steatosis grades were evaluated histologically after surgery.Values of Vs were compared with the histological results.Results Values of Vs with fibrosis stage 0-4 was (1.14 ± 0.22) m/s,(1.30 ± 0.22) m/s,(1.36 ± 0.38) m/s,(1.47 ± 0.37)m/s and (1.87 ± 0.08) m/s,respectively.A significant difference was observed among them (P ＜0.001).There was a certain correlation between Vs and fibrosis stage(r =0.541,P ＜0.001).Vs was a significant predictor of stage ≥3 fibrosis with an area under the ROC curve of 0.812,sensitivity 73.2％ and specificity 81.4％ when 1.40 m/s was the cutoff value (P ＜ 0.001).Values of Vs with inflammation grade 0-3 was (1.17 ± 0.16)m/s,(1.43 ± 0.36) m/s,(1.59 ± 0.53) m/s and (1.89 ± 0.59) m/s,respectively,which were significantly different (P ＜ 0.001).A certain correlation was observed between Vs and inflammation grade(r =0.383,P ＜0.001).Values of Vs with steatosis grade 0-4 was (1.61 ±0.42) m/s,(1.47±0.58) m/s,(1.56 ± 0.71)m/s,1.13 m/s and (0.94 ± 0.95) m/s.Obvious difference didn't exist between Vs and steatosis grade (P =0.286).Obvious correlation wasn't observed between them,either (r =-0.177,P =0.080).Conclusions ARFI elastography has a certain value for the evaluation of liver fibrosis,while inflammation grade may affect its performance.

Objective To investigate the enhancement features of hepatic tumors between dynamic three-dimensional contrast-enhanced ultrasonography (3D-CEUS) and two-dimensional contrast-enhanced ultrasonography (2D-CEUS).MethodsTotally,65 patients with 67 focal liver lesions were examined with 2D-CEUS and dynamic 3D-CEUS.Enhancement patterns,sharpness or three-dimensional effect in different phases,definition of blood vessel in arterial phase and spatial relationships of tumor and vascularity of different hepatic tumors on the two imaging modes were compared statistically,the value of two modes in differential diagnosis of hepatic tumors was also evaluated.ResultsDynamic 3D-CEUS was similar to 2DCEUS with respect to enhancement patterns,sharpness or three-dimensional effect of tumor in arterial and portal phases( P ＞0.05).And there was no significant difference between the value of dynamic 3D-CEUS and 2D-CEUS in differential diagnosis of hepatic tumors:the sensitivity,specificity,positive predictive value and negative predictive value were 98.0％,81.3 ％,94.3 ％ and 92.9％ for 3D-CEUS,and were 96.1％,81.3％,94.2％ and 86.7％ for 2D-CEUS,respectively.However,3D-CEUS was superior to 2D-CEUS in the display of definition of blood vessel in arterial phase,and spatial relationships of hepatic tumor and vascularity( P ＜0.05).ConclusionsDynamic 3D-CEUS is a useful technique in the differential diagnosis of hepatic tumors as well as 2D-CEUS,and dynamic 3D-CEUS displays the spatial relationship of hepatic tumors and vascularity more visually and effectively,which provides additional information in the diagnosis and therapy of hepatic tumors.

ObjectiveTo investigate the diagnostic value of color Doppler ultrasound for peripheral intrahepatic cholangiocarcinoma (ICC).MethodsNinety- five patients with ICC which were confirmed histopathologically were retrospectively studied.The features on color Doppler ultrasound were analyzed.ResultsThere were 102 tumors which ranged from 20 mm× 20 mm to 130 mm× 100 mm in size.On gray-scale ultrasonic imaging,a large proportion of the tumors presented with inhomogeneous echo (n=75,73.5％), indefinite boundaries (n =70, 68.6％),and irregular shape (n=55,53.9％).On color Doppler ultrasonic imaging,most tumors had flow signals (75,73.5％) mainly in the shape of areatus,short- line and color-dot.Most flow signals had a resistant index greater than 0.6.Of the 102 tumors,thirty-seven (36.3％) were observed to produce streak hyperecho,twentynine (28.4％) slight attenuation in the rear and 22 (21.6％) unbilical depression.The coincidence rate with ultrasound was 84.2％(80/95). ConclusionsThe features of peripheral intrahepatic cholangiocarcinoma on color Doppler ultrasound are characteristic.To be able to appreciate these features is helpful to improve on the accuracy rate of ultrasound.

Objective To compare the hemodynamics features of recurrent hepatocellular carcinoma between contrast-enhanced ultrasonography (CEUS) and contrast-enhanced MRI (CEMRI).Methods Forty three recurrent hepatocellular carcinoma lesions in 39 patients were evaluated by CEUS and CEMRI.All lesions were proved by operation or needle biopsy.The dynamic enhancement and washout process on CEUS and CEMRI were analyzed.Results On both two methods,all lesions showed hyperenhancement.Among which,30.2％ (13/43) lesions showed hyperenhancement during arterial phase and no washout was found during portal venous phase,37.2 ％ (16/43) lesions hyperenhanced during arterial phase and washout during portal venous phase.During late phase,the enhancement of 60.5％ (26/43) lesions decreased and 7.0％ (3/43) lesions showed no washout on CEUS or CEMRI.The overall concordance ratio between two methods was 67.4％ (29/43).Difference of hemodynamics features between CEUS and CEMRI was not statistically significant.Conclusions CEUS can accurately display the hemodynamic features of recurrent hepatocellular carcinoma,and enjoy high consistence with CEMRI.

Objective To preliminarily evaluate the feasibility of elastography point quantification (ElastPQ) technology in the determination of liver stiffness as well as its impact factors.Methods Amount to 235 patients with liver neoplasms underwent liver stiffness measurement in the right lobe of liver using an ultrasound scanner (iU Elite,Philips).ElastPQ values were obtained and compared with the liver fibrosis stage (S),the grade of necroinflammatory activity (G) and steatosis assessed histologically as well as gender and age.The factors related to ElastPQ values were explored by stepwise regression in multiple linear regression analysis and the regression equation was established.Results In the multiple linear regression model of ElastPQ values,liver fibrosis and necroinflammatory activity were associated with ElastPQ (P ＜ 0.05) while other factors including age,gender and hepatic steatosis had no effect on ElastPQ statistically (P ＞0.05).The equation of linear regression was ElastPQ =1.205S + 1.075G + 4.537.Conclusions ElastPQ technique is a reliably noninvasive tool in the liver stiffness measurement.Liver fibrosis and necroinflammatory activity are the main factors affecting liver stiffness measured by ElastPQ.