Objective To evaluate the charateristics of biliary stricture after orthotopic liver transplantation(OLT) by ultrasound. Methods Diametes,thickness,characteristic echo of bile were observed by ultrasound in 41 patients with biliary stricture after OLT,and the results were compared with those of 46 patients without biliary complication after OLT.Results The diameter of intrahepatic bile,thickness of bile,incidence of intrahepatic bile dilation or hyperechogenicity in biliary stricture patiens were higher than those in patients without biliary complication,there were significant differences between two groups(P＜0.05).Conclusions The series of ultrasonographic character such as bile dilation,thickeness or hyperechogenicity of biliary wall,thin of bile duct are available to diagnose biliary stricture.

Objective To investigate the diagnostic parameters,criteria and diagnostic value of pelvic floor ultrasound in female stress urinary incontinence(SUI).Methods Simple factor logistic regression analysis was used to compare the difference of ultrasonic parameters between SUI patients(260 cases) and asymptomatic subjects(60 cases) to find the relevant diagnostic indexes,and to evaluate the diagnostic criteria and diagnostic value by the ROC curve.Results There were significant differences in urethral inclination angle and levator hiatus area in resting and bladder neck position,bladder position,urethral inclination angle,retrovesical angle,levator hiatus area in Valsalva state and urethral rotation angle,bladder neck mobility between the two groups (all P ＜ 0.05).There was no significant difference in age,BMI,bladder neck position,bladder position,retrovesical angle between resting in the two groups (all P ＞0.05).Using the ROC curve analysis,the cut-off points of urethral inclination angle and levator hiatus area in resting,bladder neck and bladder position,urethral inclination angle,retrovesical angle,levator hiatus area in Valsalva,bladder neck mobility and urethra rotation angle to diagnose SUI were 16.5°,13.5 cm2,3.5 mm,0.5 mm,29.5°,139.5°,19.5 cm2,24.5 mm,45.5°,respectively.The sensitivity/specificity were 54.6％/66.7％,49.2％/80.0％,68.1％/95.0％,64.2％/98.3％,67.3％/93.3％,73.5％/50.0％,68.8％/81.7％,70.0％/95.0％,67.2％/85.0％,respectively.The area under the curve were 0.625,0.668,0.855,0.854,0.817,0.622,0.811,0.866,0.817,respectively.Conclusions Pelvic floor ultrasound is a better way to diagnose stress urinary incontinence,and it provides an objective basis for the diagnosis of SUI.

ObjectiveTo assess the diagnostic performance of contrast-enhanced ultrasound(CEUS)in characterization of adnexal masses in comparison with baseline ultrasound.MethodsOne hundred and thirty-seven masses were examined by CEUS and baseline ultrasound.Two independent investigators reviewed the images before and after contrast agent administration.The diagnostic performances were evaluated using receiver operating characteristic (ROC) analysis and the interobserver agreement was analyzed.ResultsAfter review of CEUS,ROC analysis revealed significant improvement in differentiating between malignant and benign pelvic masses that the areas under the ROC curve were 0.731 and 0.738 at baseline ultrasound versus 0.891 and 0.903 at CEUS ( P ＜0.01 ).The accuracy for both investigators also improved significantly after reviewing CEUS.A better interobserver agreement was achieved after reviewing of CEUS (g =0.681 at baseline ultrasound versus κ =0.893 at CEUS) and a better result of specific diagnosis was obtained (73.2％ and 74.2％ at baseline ultrasound versus 90.7％ and 91.2％ at CEUS)(all P ＜ 0.01 ).Conclusions Real-time CEUS improves the diagnostic performance in adnexal masses for discrimination between malignancy and benignity and improves the capability in specific diagnosis compared with baseline ultrasound.

Objective To assess the diagnostic performance of contrast-enhanced ultrasound in characterization of pelvic masses.Methods Contrast-enhanced ultrasound was performed on 137 patients with pelvic masses.The results were compared to pathological diagnostic criteria.The diagnostic performance was evaluated by using diagnostic test.Results Sensitivity,specificity,positive predictive value,negative predictive value,accuracy and area under ROC curve in diagnosing complex pelvic masses by using contrast-enhanced ultrasound were as follows:85.3％ (29/34),93.2％ (96/103),80.6％ (29/36),95.0％ ( 99/101 ),91.2％ ( 125/137 ),0.892,respectively.Conclusions Contrast-enhanced ultrasound provides a simple and curate method for characterization of pelvic masses.

ObjectiveTo explore the feasibility of hilar bile duct using ultrasonography (US) in identification of different types of biliary strictures after orthotopic liver transplantation.MethodsThe US images of hilar bile duct of 62 patients with non-anastomotic biliary stricture (NAS) and 30 patients with anastomotic biliary stricture (AS) were reviewed.Four US feathers including the presence of hilar biliary dilatation,the display of hilar biliary lumen,the thickening of bile duct wall and the echo of bile duct wail were assessed.Results The presence of hilar biliary dilatation,the display of hilar biliary lumen,the thickening of bile duct wall showed a significant difference between NAS and AS groups (P＜0.001).The feature with the greatest performance in the diagnosis of NAS was unclear displayed hilar biliary lumen.The sensitivity,specificity and accuracy were 93.7％,86.7％ and 92.3％,respectively.Conclusions The observation of hilar bile duct has great vaule in identification of different types of biliary strictures after orthotopic liver transplantation.The display of hilar biliary lumen is more likely to differentiate between NAS and AS

Objective To evaluate the value of contrast-enhanced ultrasound (CEUS) in the diagnosis of ischemie-type biliary lesion (ITBL) after liver transplantation. Methods Twenty-five liver transplantation recipients suspected with biliary complications were examined using CEUS. Percutaneous transhepatic cholangiography or endoscopic retrograde cholangiopancreatography confirmed the diagnosis. The enhancement patterns of the thickened hilum bile duct wall were observed. Results Enhancement patterns of bile duct wall could be divided into 3 sorts:① No-enhancement, six cases, showed no-enhancement all along. ②Hypo-enhancing level, four cases, presented hypo-enhancing at arterial phase and persistent hypo- or no-enhancing until late phase. ③Hyper-enhaneing level,fifteen cases,appeared as hyper- or iso-enhancing at arterial phase and persistent iso- or hypo-enhancing until late phase. The enhancement pattern of bile duct wall showed significant difference ( P = 0.00). Thirteen ITBL patients included 10 cases ( 76.9 % ) with no- or hypo-enhaneement, 3 patients (23.1 % ) with hyper-enhancement. However, all of 12 non-ITBL cases appeared hyper-enhancing. Conclusions CEUS provides a new and effective method to estimate the microcirculation of the bile duct wall. It may be help to early diagnosis of ITBL.

Objective To investigate the contrast enhanced ultrasound(CEUS)features of ovarian tumor torsion(OTT).Methods Seventeen cases with OTT were evaluated using CEUS.CEUS was performed with low mechanical index and the contrast agent of Sono Vue.Results Thirteen cases with total torsion of ovarian tumor appeared as no enhancement.Four cases with partial torsion showecl hyperechoic enhancement in the early phase and hypoechogenicity in the late phase.Conclusions The enhancement of OTT has characteristic,which would be helpful for the diagnosis and differential diagnosis of OTT.

Objective To explore the value of contrast-enhanced ultrasound(CEUS)in the differential diagnosis of endometrial carcinoma and endometrial hyperplasia.Methods Forty-five patients with endometrial carcinoma and 21 patients with hyperplasia were studied by CEUS.Twenty-four normal women were enrolled as contrast group.Results In normal uterus, myometrium exhibited earlier enhancement later washout than the endometrium.Similar phenomenon was observed in patients with hyperplasia.In patients with endometrial carcinoma,the lesion showed wash-in and washout earlier, at least not later than the myometrium.Conclusions Endometrial carcinoma and hyperplasia showed different enhancement patterns,which may be helpful for the diagnosis of the two diseases.

Objective To investigate the application value of transperineal ultrasound in female patients with cystocele.Methods Transperineal ultrasound were performed in 36 female patients with cystocele and the bladder neck movement degrees (BND),retrovesical angle and the degree of urethral rotation were observed at maximum Valsalva.The ultrasonic manifestation of 36 female patients with cystocele were summarized.Results On maximal Valsalva bladder neck mobility all increased in 36 patients,32 patients with open retrovesical angle (≥140°) and 30 female patients with urethral rotation ≥ 45°.There were 6 cases with type Ⅰ,bladder neck was lower than inferoposterior margin of the symphysis pubis,cystocele with open retrovesical angle (≥140°) and urethral rotation ＜45°.There were 26 cases with type Ⅱ,bladder neck was lower than inferoposterior margin of the symphysis pubis,cystocele with open retrovesical angle (≥140°) and urethral rotation ≥45°.There were 4 cases with type Ⅲ,bladder was lower than inferoposterior margin of the symphysis pubis,cystocele with intact retrovesical angle (＜ 140°) and urethral rotation ≥45°.Conclusions The transperineal ultrasound can be used for classification of cystocele in female patients and which may provide more reliable information for clinical diagnosis.

Objective To study the repeatability and consistency of normal female pelvic floor structure using transperineal real‐time three‐dimensional ultrasound .Methods Forty‐two cases of normal adult female were evaluated by two different experience operator ,using the real‐time three‐dimensional ultrasound diagnostic apparatus .The bladder neck movement degrees and the levator hiatus area were observed after Valsalva condition .Differences between the groups were compared .Intraclass correlation coefficient (ICC) ,the coefficient of variation (CV) and Bland‐Altman analysis of consistency were evaluated . Results The bladder neck movement degrees and the levator hiatus area measured by the experienced operator (operator 1) and less experienced operator(operator 2) were (18 4.8 ± 5 8.4)cm and (17 7.9 ± 5 4.8) cm ,(17 5.3 ± 3 9.5)cm2 and (17 3.1 ± 4 3.2)cm2 ,respectively .There was no significant difference between the two operators ( P > 0 0.5) .The intra‐ICC were 0 8.9 and 0 9.0 ,CV were 7 2.6% and 3 0.3% .Experienced operator repeatability (ICC= 0 9.9 ,0 9.4) was slightly higher than the less experienced researchers (ICC 0 9.2 ,0 8.1) .The analysis results of Bland‐Altman image showed good consistency between two different operators .Conclusions The current study proves real‐time three‐dimensional ultrasound is a reproducible method for female pelvic floor structure assessment ,and the reproducibility is very well .The detection performance of experienced operator slightly better than the one with less experience ,strengthen the training of junior doctors may further improve the accuracy of measurement .