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Clinical application of radiofrequency ablation in gastric cancer liver metastasis

Chinese Journal of Interventional Imaging and Therapy.2017;14(9):571-575. doi:10.13929/j.1672-8475.201704005

Liver metastasis is the advanced stage of gastric cancer,which is a leading cause of death.Radiofrequency ablation (RFA) is an alternative method of comprehensive treatment in patients with gastric cancer liver metastasis due to its advantages of safety,minimal invasion and repetition.The efficacy of RFA alone,the efficacy of the combined treatment of RFA with other therapies and prognostic factors of RFA in gastric cancer liver metastasis were reviewed in this article.

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Application of 7-joint ultrasound score in evaluating efficiency of Chinese and western medicine in treatment of rheumatoid arthritis

Jiaojiao WU ; Xiangming ZHU ; Yifang HU ; Yan LI

Chinese Journal of Interventional Imaging and Therapy.2017;14(9):556-560. doi:10.13929/j.1672-8475.201703053

Objective To evaluate the value of the 7-joint ultrasound score (US7) in treatment of rheumatoid arthritis (RA) with Chinese and western medicine.Methods A total of 160 RA patients were divided into 2 groups based on different methods of treatment,including Yi Shen Qing Luo (YSQL) group and western medicine group.The patients were examined by grey scale ultrasound (GSUS) and power Doppler ultrasound (PDUS) with US7 at baseline and after 3 and 6 months later.There were 7 related joints and 5 single factors for scoring in US7 system.The joints included the wrist joints,the second/third metacarpophalangeal joints (MCP Ⅱ/Ⅲ),the second/third proximal interphalangeal joints (PIP Ⅱ / Ⅲ) and the second/fifth metatarsophalangeal joints (MTP Ⅱ/Ⅴ).And the factors included synovitis of GSUS,synovitis of PDUS,myotenositis/tenosynovitis of GSUS,myotenositis/tenosynovitis of PDUS and bone erosion (ES).Meanwhile,the laboratory index included C-reactive protein (C-RP) and erythrocyte sedimentation rate (ESR) were examined.And the clinical indexes as disease activity score in 28 joints (DAS28) were evaluated.Results The statistical differences of synovitis of GSUS,synovitis of PDUS,myotenositis/tenosynovitis of GSUS and myotenositis/tenosynovitis of PDUS scores in US7 system were found in both 2 groups at baseline,3 months and 6 months after treatment (all P＜0.01).There was no statistical difference of ES before and after treatment in all cases (P＞0.05).The factors of US7 were positively correlated with DAS28,C-RP and ESR in different extent.Condusion US7 is a viable tool for examining patients with RA.

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Expression of VEGF and apoptosis of tumor cells in different regions of VX2 tumor in rabbit liver after radiofrequency ablation

Ya LIU ; Weifu LYU ; Xianhai ZHU ; Changgao SHI ; Yaguang WANG ; Kaicai LIU ; Delei CHENG ; Chunze ZHOU ; Dong LU

Chinese Journal of Interventional Imaging and Therapy.2017;14(9):561-565. doi:10.13929/j.1672-8475.201701038

Objective To explore the expression of vascular endothelial growth factor (VEGF) and apoptosis of the tumor cells in the different regions of rabbit liver VX2 tumor after radiofrequency ablation (RFA).Methods Forty-eight experimental rabbits were implanted with VX2 tumor.After successfully established the model,the rabbits were randomly divided into control group (n=6) and RFA group (n=42).In the RFA group,7 rabbits at each time point were killed at immediately,1 day,2 days,1 week,2 weeks,3 weeks after RFA,and the tumor specimens were retained and performed with HE staining,VEGF,Annexin V-FITC/PI labeling,flow cytometry analysis.The changes of VEGF and apoptosis of the cells in different periods and different zones after RFA were observed.Results After the operation,the difference of the VEGF value of the needle zone,coagulation necrotic zone and junction zone had statistically significant (all P＜0.05).The difference of the VEGF value in each zone between immediately and the other time points after operation by pairwise comparisons were significantly different (all P＜0.05).The VEGF value of the needle zone and coagulation necrotic zone reached the peak after operation immediately,which declined from 1 day to 3 weeks after operative.And VEGF of the junction zone increased from immediately to 1 week after operation,and declined 2 weeks after operation.There were significant differences in the apoptosis rate of the three zones after RFA compared with control group (all P＜0.05).The apoptosis rate in all zones were at the peak on the 1 day after operation,and then showed a downward trend.Conclusion The reduction of VEGF and apoptosis of tumor cells in the needle zone and coagulation necrotic zone are significant,but tumor remnant remains visible in the junction zone.In the third week after RFA,the proliferation of the remaining tumor cells can be recurrent to preoperative levels,which suggests that the further treatment should be performed at this period.

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Application of high frequency ultrasound in triangular fibrous cartilage complex injury of wrist joint

Donglin WANG ; Bingyan LIU ; Shaoqing FU ; Tangna WU

Chinese Journal of Interventional Imaging and Therapy.2017;14(9):552-555. doi:10.13929/j.1672-8475.201701019

Objective To discuss the ultrasonic features and diagnostic value of high frequency ultrasound in the diagnosis of the injury of triangular fibrous cartilage complex (TFCC) of wrist joint.Methods The ultrasonic features of 32 patients with pathology confirmed unilateral TFCC injury were retrospectively analyzed.The preoperative MRI and ultrasound data were complete.The difference between the two methods in diagnosis of TFCC injury were contrasted.Results The major ultrasonic features of the injure of TFCC included form swelled,structures disorganized,inhomogeneous echoes,irregular echoless in damaged place.The flow signals could be displayed from the tear opening edge of the injured TFCC by CDFI.Among 32 cases of TFCC injury,there were 26 cases (26/32,81.25％) diagnosed by ultrasound and 27 cases (27/32,84.38％) diagnosed by MRI.There was no significant difference in the detection rate of the two methods for TFCC injury (x2 =0.143,P=0.706).Conclusion High frequency ultrasound can be used to diagnose the injury of TFCC accurately,and can provide imaging evidence simply and rapidly for clinical therapy.

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Application of real-time three-dimensional ultrasound Bi-plane technology in assessment of foramen ovale blood

Wenjia LEI ; Run ZHANG ; Ying ZHANG ; Yu WANG ; Xue SUN

Chinese Journal of Interventional Imaging and Therapy.2017;14(9):548-551. doi:10.13929/j.1672-8475.201703046

Objective To explore the application value of the real-time three-dimensional ultrasound Bi plane technology in evaluation of the foramen ovale blood in fetus.Methods The coronal plane of inferior vena cava entering the right atrium in 186 normal fetuses were obtained.The dimensions of foramen ovale (DFO) and inferior vena cava at the entrance of right atrium (DIVC) were measured in the coronal plane.The ratio of DFO and DIVC (DFO/DIVC) was calculated.The correlation be tween DFO/DIVC and gestational age was analyzed.Results There was no correlation between DFo/DIvc and gestational age (r=0.228,P＞0.05).There were 155 cases during second trimester (21 28 weeks),and the DFO was (4.46±0.57)mm,DIVC was (4.55±1.22)mm,DFO/DIVC was 1.03±0.22.There were 31 cases during late pregnancy (29-36 weeks),and the DFO was (5.20±0.43)mm,DIVC was (5.90±1.33)mm,DFO/DIVC was 0.92±0.17.The mean 95％ confidence interval of DFO/DIVC was (0.98,1.04),the 95％ normal reference range was (0.80,1.44).Conclusion The coronal plane of inferior vena cava entering the right atrium can be obtained with real-time three-dimensional ultrasound Bi-plane technology,the flow from the inferior vena cava enters right atrium which is divided by the upper atrial septum can be observed,which is important in evaluating the foramen ovale blood.

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Quantitative analysis of CEUS in staging of small hepatocellular carcinoma

Haibin TU ; Jia GUO ; Jianling LIN ; Zhiheng CHEN

Chinese Journal of Interventional Imaging and Therapy.2017;14(9):543-547. doi:10.13929/j.1672-8475.201703049

Objective To investigate the value of CEUS quantitative analysis in diagnosis of different pathological stages of small hepatocellular carcinoma (HCC).Methods Data of 112 patients with HCC confirmed by surgical or biopsy were analyzed retrospectively.All the diameter of single tumor or the sum of the largest two lesions in multiple tumors were within 3 cm.Three groups were classified based on the Edmonson stage:High differentiation group (n=50,stage Ⅰ or Ⅱ),median differentiation group (n=30,stage Ⅲ),low differentiation group (n=32,stage Ⅳ).Qontraxt ultrasound imaging analysis software was utilized to measure CEUS parameters,including the maximum intensity of tumor (TMAX),nontumor's intensity (NT),maximum intensity of nontumor (NTMAX),appear time,time to peak,washout time,and the ratio of TMAX/NT and TMAX/NTMAX were calculated.The differences among the three groups was compared by statistics test.Results The values of TMAX,TMAX/NTMAX and washout time were statistically different among the three groups (all P＜0.05).The maximum values of TMAX,TMAX/NTMAX and the shortest washout time were found in the low differentiation group.And the minimum values of TMAX,TMAX/NTMAX and the longest washout time were found in the high differentiation group.There were no statistical differences of NT,NTMAX,TMAX/NT,appear time and time to peak among the three groups (all P＞0.05).Conclusion The quantitative parameters of CEUS is helpful in distinguishing different Edmonson stage of small HCC.

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Influence of region of interest size on performance of shear wave elastography in breast masses

Rui CONG ; Jing LI

Chinese Journal of Interventional Imaging and Therapy.2017;14(9):534-538. doi:10.13929/j.1003-3289.201702010

Objective To explore the influence of ROI size on the diagnostic performance of shear wave elstography (SWE) of breast masses.Methods A total of 225 consecutive patients with 239 solid breast masses underwent SWE before surgery,and then quantitative SWE parameters,including the maximum stiffness (Emax),mean stiffness (Emean),ratio of stiffness of the mass to stiffness of surrounding fat (Eratio) and standard deviation (SD),were measured by two methods,one method was using larger ROI to include the largest part of a mass,and the other was placing fixed ROI=2 mm over the stiffest part of the lesion to measure.The diagnostic performance of the two methods were evaluated by ROC curve,and the cut-off value,sensitivity and specificity of each SWE parameter were obtained.Results There were no statistically significant differences between the performance of Emax,Emean and SD from the two different methods (all P＞ 0.05),the performance of Eratio of the two methods showed significant difference (P=0.046).The significantly higher specificity of Emax and Emean in the larger ROI were found,and the significantly higher sensitivity of SD and Eratio in the ROI=2 mm was found.Furthermore,the diagnostic performance of combination of SWE and BI-RADS were not greatly affected by the ROI size,the difference had no statistical significance (all P＞0.05).Conclusion The ROI size only affects the diagnostic performance of Eratio,and donot affect the diagnostic performance of the quantitative SWE parameters (Emax,Emean,SD) and combination of SWE and BI-RADS.

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Multiple interventional models combined via anterior tibial veins in treatment of acute deep venous thrombosis

Xinqiang HAN ; Zhu WANG ; Wenming WANG ; Yingjiang XU ; Yuguo SHENG ; Chao MA ; Xingang JI ; Mengpeng ZHAO

Chinese Journal of Interventional Imaging and Therapy.2017;14(9):530-533. doi:10.13929/j.1672-8475.201704012

Objective To explore the efficacy of multiple interventional models combined through anterior tibial veins approach in treatment of acute deep venous thrombosis (DVT).Methods The clinical data and the imaging materials of 10 patients with acute DVT were analyzed retrospectively,and the interventional treatment strategies were discussed.Results The percutaneous mechanical thrombectomy (PMT) was performed after a temporary inferior vena cava filter implanted in all patients,and thrombus clearance rate of grade Ⅲ was obtained in 7 patients while 3 patients reached grade Ⅱ criteria.There were 7 patients underwent angioplasty,then the inferior vena cava filter was retrieved during the same procedure in 5 patients while 4 patients in the second stage and 1 patient rejected to retrieve the filter.All swelling limbs alleviated significantly after those procedures.There was no critical complications occured.The total hospital stay ranged from 4 to 7 days,with a mean time of (6.00±0.94) days.All patients were followed up with a mean time of (3.60± 1.84) months (ranged from 1 to 6 months).No thrombus recurrences of the previously affected vessels were reported.Conclusion The multiple interventional models combined via anterior tibial veins for acute DVT is simple,safe and effective,combined with mechanical thrombectomy device can reduce thrombus burden quickly,and combined with angioplasty can consolidate the therapeutic effect,all those methods combined can shorten the overall hospitalization time.

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Evaluation of endovascular radiofrequency ablation combined with TACE in treatment of portal vein tumor thrombus of primary hepatocellular carcinoma

Zhongwu CHEN ; Zhengyu LIN ; Zhibo ZHANG ; Yiping CHEN ; Jin CHEN

Chinese Journal of Interventional Imaging and Therapy.2017;14(9):525-529. doi:10.13929/j.1672-8475.201703021

Objective To cvaluate the efficacy and safety of HabibTM VesOpen intravascular radiofrequency catheter percutaneous radiofrequency ablation combined with TACE in the treatment of portal vein tumor thrombus of primary hepatocellular carcinoma.Methods Thirty-nine patients with primary hepatocellular carcinoma complicated with portal vein thrombosis were treated with HabibTM VesOpen intracavitary catheter ablation combined with TACE.The postoperative success rate,complication,blood index,α-fetoprotein (AFP),portal vein patency and tumor thrombus imaging changes were assessed.Results All of 39 patients underwent surgery successfully without occurrence of perforation,infection,hepatapostema,intra-abdominal hemorrhage nor other complications associated with surgery.Blood routine examinations (WBC,RBC,PLT) after 2 weeks and 4 weeks of surgery had no statistical difference compared with those of preoperation.Liver function indexes including ALT,AST,ALB had statistical difference before and after the surgery except for TBIL.AFP had statistical difference before and after surgery.Doppler ultrasonography after 4 weeks showed blood flow in original blocked portal vein.Enhanced CT or MR examinations after 8 weeks on the abdomen,suggested that tumors were shrinked or disappeared.Conclusion Radiofrequency catheter ablation with intracavitary radiofrequency catheter of HabibTM VesOpen is an effective method in the treatment of portal vein tumor thrombus in primary hepatocellular carcinoma.

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Research progresses of caudal block guided by ultrasound

Yikun LIU ; Yuanyi ZHENG

Chinese Journal of Interventional Imaging and Therapy.2017;14(9):580-583. doi:10.13929/j.1672-8475.201704014

Caudal block has much advantages such as simple operation,less complications,obvious effect,flat and low anesthesia.For those reasons,caudal block is widely used in pain treatment and clinical anesthesia.The traditional way of sacral canal anesthesia is based on osseous marks.However,because of variable anatomical structure in sacral canal and the sacral horns,the traditional method has many defects.In recent years,as a new operation method,caudal block under the guidance of ultrasound has began to be applied gradually.The advantages,application progresses of this method were reviewed in this paper.

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