Microwave ablation(MA)has been one of the most quickly developed minimally invasive techniques for trearing hepatocellular carcinoma(HCC)in the last decade.Under accurate imaging guidance,MA shares the common advantages of thermal ablation such as flexible treatment approaches,good tolerability and the ability to consistently create reproducible and predictable necrotic areas.It also exhibits several particular advantages compared with other thermal ablation methods,including higher thermal efficiency,higher capability of coagulating blood vessels,faster ablation time,and an improved convention profile.Over the years,MA equipments,especially the antenna,have been refined for safety and to increase the coagulation zone.With the development of internally-cooled antenna and using the frequency of 915 MHz nficrowave,the technique is becoming safer and the coagulation zone increased significantly.Initially,MA was limited to the treatment of small HCC,but with the improvement of antenna and treatment strategV,large HCC(＞5 cm)can also be ablated effectively.For the"curative"treatment of HCC.the following eriteria need to be met:single HCC with the lesion of 6 am or smaller;three or fewer HCC lesions with a maximum diameter of 4 cm,and absence of portal vein thrombosis or extrahepatic metastases.A five-year cumulative survival rate has exceeded 50%,which is comparable with resection.Moreover,the local immune function is enhanced after MA.A change in immunocyte infiltration takes place in number,configuration and location after patients with HCC are treated with MA.Further research for MA may be focused on the improvement of the maneuverability of the equipment,increase of the accuracy of antenna puncture and consummate the clinical therapeutic standardization.

Objective To explore the value of 2 dimension and color Doppler flow imaging (2D CDFI) in detection of deep venous thrombosis of the lower limbs. Methods One hundred and one patients, 118 limbs clinically suspected as deep venous thrombosis were examined by CDFI and ascending phlebography. Results The sensitivity of ultrasonogram was 94 4% and accuracy was 98 4%. The highest incidence is 30 4% in the femoral vein. With the ratio 2 2∶1, the incidence of left lower limbs was much higher than the right. Because of different pathological changes in acute, subacute and chronic thrombosis, there are diverse character in 2D CDFI. Conclusions Deep venous thrombosis of the lower limbs can be diagnosed by 2D CDFI, which is a noninvasive, easy and accurate method.

Objective To evaluate the diagnostic advantages of contrast-enhanced ultrasonography in experimental abdominal blunt trauma in comparison of routine ultrasonogrphy. Methods Liver, spleen and kidney blunt trauma models were established in 10 canines and 12 rabbits. Both routine ultrasonography and contrast-enhanced ultrasonography were performed to identify the possible injury. Accuracy of the two ultrasonic technologies was compared in diagnosing each kind of organ and various injury degrees. Results Fifty-six trauma models including 22 livers, 14 spleens and 20 kidneys were established. There was significant difference between two ultrasonic methods in diagnosing liver, spleen and kidney injury (P<0.01);and contrast-enhanced ultrasonogarphy had particular advantage in detecting minor injuries of Ⅰ-Ⅱ scale (P<0.01). Conclusion Contrast-enhanced ultrasonography greatly enhances diagnostic accuracy of blunt abdominal solid organ trauma, especially in minor injuries.

Objective To assess the value and safety of SonoVue in ultrasonic diagnosis of abdominal diseases. Methods A total of 204 patients (149 male, 55 female) with abdominal examination of contrast-enhanced ultrasonography (CEUS) with SonoVue from August 2007 to February 2009 were reviewed. Results Definitive diagnosis were obtained 215 times in 204 patients (233 times) with abdominal CEUS. The diagnostic accuracy of CEUS was 92.27%, significant higher than that of conventional ultrasonography (62.23%). Anaphylactic shock happened 1 time (0.43%) in 1 patient. Conclusion CEUS with SonoVue can provide a high diagnostic accuracy with relatively safety of the possibility of serious adverse event.

Objective To observe the ultrasonic manifestation of metatarsal fatigue fractures and probe into the clinical values of ultrasonic diagnosis and follow-up to the disease.Methods The clinical data and sonographic features of 30 cases with metatarsal fatigue fracture confirmed by X-ray and CT were analyzed retrospectively.Results All the subjects in this study were metatarsals insufficiency fractures located in the second or third diaphysis.2D-ultrasound found microfracture in the cortex and the periosteal elevation by increased vascularity in the early stage.During the 3-month follow-up,thickened cortex and callus shown as the shape of mushroom or cauliflower and a great amount of neovascularisation were visualised with color Doppler flow imaging.Then,the cortex surface became gradually changing from rough to smooth and obvious posterior shadows were observed with the illness progression.Conclusions Ultrasonography could be used to detect the cortical continuity,callus characteristics and blood flow perfusion of fatigue fracture in the different damage stages.

Objective To construct the ultrasound PACS image system based on B/S mode.Methods The modern internet technology was used to build the PACS image system based on B/S mode.The B/S mode was typical three layer structures,namely,client presentation layer,middle service logic layer and storage layer.Results Client presentation layer was a figure surface to provide application service for clients.The function of service logic layer was performing application strategy and packaging application mode which was shown to client application program.Storage layer was used to define,service,visit and update data.Conclusion The versatility of B/S mode is good.Besides,the software is easy to operate and upgrade with low cost.

Objective To explore characteristics of the elements of syndrome, the disease position and the relationship between chemical indicators and TCM syndromes of type 2 diabetic encephalopathy. Methods 2 501 cases of type 2 diabetes clinical data were collected from Guang'anmen Hospital of China Academy of Chinese Medical Sciences, Beijing University of Chinese Medicine, Dongzhimen Hospital, Dongfang Hospital, etc. in nearly 3 years, among which, 342 cases were type 2 diabetic encephalopathy. The original clinical data were double entried in epidata by two people, establishment forms in excel, factor analysis and Bayesian networks were used as data mining research methods. Results 20 elements which characteristic root more than 1 were derived by factor analysis, 68.4% were covered. Of all 20 elements, five factors belong to Yin, five factors belong to blood stasis; lassitude, shortness of breath, stool frequency were appeared when fasting glucose abnormalities; lassitude, hemiplegia were appeared when 2-hour postprandial blood glucose abnormalities;lassitude, feverish palms and soles, stool frequency, more nocturnal enuresis when glycated hemoglobin abnormalities by Bayesian networks. Conclusion The Elements of the syndrome of type 2 diabetes encephalopathy were deficiency of Yin and blood stasis; and the main positions for diabetic patients were liver, spleen and kidney. Patients with impaired fasting glucose were Qi deficiency; Patients with impaired 2-hour postprandial glucose were Qi deficiency or pathogenic wind attacking collaterals; Patients with abnormal hemoglobin were Qi deficiency and Yin deficiency.

Objective To compare temperature curve and ablation zone between 915 MHz and 2450 MHz cooled shaft microwave antenna in ex vivo porcine livers.Methods The 915 MHz and 2450 MHz microwave ablation and thermal monitor system were used in this study.A total of 56 ablation zones and 280 temperature data were obtained in ex vivo porcine livers.The output powers were 50,60,70,and 80W and the setting time was 600s.The temperature curve of every temperature spot,the short- and long-axis diameters of the coagulation zones were recorded and measured.Results At all four power output settings,the peak temperatures of every temperature spot had a tendency to increase accordingly as the output power was increased,and except for 5 mm away from the antenna,the peak temperatures for the 915 MHz cooledshaft antenna were significantly higher than those for the 2450 MHz cooled-shaft antenna (P ＜0.05).Meanwhile,the short- and long-axis diameters for the 915 MHz cooled-shaft antenna were significantly larger than those for the 2450 MHz cooled-shaft antenna ( P ＜0.05).Conclusions The 915 MHz cooledshaft antenna can yield a significantly larger ablation zone and achieve higher temperature in ablation zone than 2450 MHz cooled-shaft antenna in ex vivo porcine livers.

Objective To evaluate the safety and efficacy of ultrasound-guided percutaneous microwave ablation of renal neoplasms.Methods Twenty-two patients with pathologically proven renal neoplasms(18 renal cell carcinoma,3 renal angiomyolipoma,1 oncocytoma)with diameters of 1.0 to 3.8 cm were treated by microwave ablation.Cooled-shaft needle antenna was percutaneously inserted into the tumors under ultrasound guidance.One antenna was used for tumors less than 2 cm,two antennas were used for tumors larger than 2 cm.One thermal couple was placed adjacent to the tumor monitoring temperature in real-time during ablation.Immediate treatment efficacy was assessed by contrast-enhanced ultrasound within 3 days after ablation.Short-term efficacy was assessed by contrast-enhanced CT and/or contrast-enhanced ultrasound at 1,3,6 months and every 6 months thereafter.Results Twenty tumors were completely ablated in a single session,2 tumors were completely ablated in 2 sessions.No complications occurred.No residual tumor or recurrence was observed during follow-up.Conclusions Ultrasound-guided pereutaneous microwave ablation appears to be a safe and effective technique for the management of renal neoplasms in selected patients.