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 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 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 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 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 explore techniques of endoscopic ultrasonography for nasal cavity and its accuracy. Methods Under the guidance of nasal endoscope, ultrasonography of nasal cavity was performed by using a 10 MHz,3. 3 mm section probes. Thirty nasal cavities of 15 normal canine were scanned under general anesthesia. The sink experiment was used to decrease the influence of the ultraphonic artifact and to correct the data error. Results In gray scale ultrasound,most mucous and submucous tissue within nasal cavity were hypoechoic, the septal cartilage was echoless, and the cartilaginous membrane of the septal cartilage showed a consecutive hyperechogenicity line. The average thickness of the nasal septum and the average thickness of the inboard mucous and submuous of the inferior turbinate were (1. 87 0. 33)mm and (2.96 0.36) mm respectively. The rich blood flowing signals were observed by CDFI in soft tissues mentioned above. Pulsed Doppler of the nasal septum showed a venous waveform with the velocity ranging from 3. 1 to 13.8 cm/s and the arterial waveform with the peak systolic velocity of 10 to 54.8 cm/s, resistance index ranged from 0. 31 to 0. 57. Pulsed Doppler of the inferior turbinate showed a venous waveform with the velocity ranging from 4. 0 to 17. 3 cm/s and the arterial waveform with the peak systolic velocity of 7.5 to 79.6 cm/s, resistance index ranged from 0.25 to 0.62. Conclusions With correction factor,nasal endoscopic ultrasonography was accurate in localizing structures with clear images and high resolution. It could be a new imaging modality of diagnosing nasal mucosal and submucosal disorderes.

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.