Objective:To explore the value of 3D/4D translabial ultrasound in the diagnosis and differential diagnosis of female urethral diverticulum.Methods:The paired chi-square test was used to compare the diagnostic accuracy of 2D translabial ultrasound and 3D/4D translabial ultrasound in 21 suspected urethral diverticulum patients who visited the Third Affiliated Hospital of Sun Yat-Sen University from November 2013 to January 2020. And Kappa consistency test was used to evaluate the consistency between these two methods and the pathological results.Results:All 21 patients with suspected urethral diverticulum were diagnosed by postoperative pathology, of which 16 cases were urethral diverticula and 5 cases were paraurethral cysts. The typical appearance of urethral diverticulum on 3D/4D translabial ultrasound was a cystic structure traversing the urethral rhabdosphincter. Additionally, septa, calcification or solid neoplasm can also be seen in some cases. The sensitivity/specificity of 2D translabial ultrasound and 3D/4D translabial ultrasound were 75.00%/100% and 93.75%/100%, respectively, no statistical differences were found both in sensitivity and specificity between these two methods(all P>0.05). The Kappa consistency test showed that the consistency between 2D translabial ultrasound and pathological diagnosis was general (Kappa=0.588, P=0.003), while the consistency between 3D/4D translabial ultrasound and pathological diagnosis was good (Kappa=0.877, P<0.001). Conclusions:3D/4D translabial ultrasound has a high value in the diagnosis of female urethral diverticulum, and it is worthy of clinical application.

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.

Objective To investigate the therapeutic effect of high intensity focused ultrasound (HIFU) ablation combined with homemade liquid fluorocarbon nanoparticles on cervical cancer in nude mice.Methods The cell experiment was divided into three groups:a,control group;b,HIFU group;c, HIFU + PFB nanoparticle group,and the viability of cells was detected using CCK-8 reagent.The mice were also divided into three groups:A,0.9% NaCI group;B,HIFU + 0.9% NaCI group;C,HIFU + PFB nanoparticle group. The tumors were removed and underwent triphenyl tetrazolium chloride(TTC) staining,and the necrosis area was measured.Histopathological changes of the tumors were examined by light microscopy.Results After HIFU irradiation,the viability rate of group c was (40.5 ±9.7)%,it was lower than that of group b (77.7 ±8.5)% (P <0.05) and that of group a(100 ±4.8)% (P <0.05). TTC staining of tumor showed a large scale of necrotic tissue in group C.The necrosis ratio of the three groups was 0%,(34.14±12.2)% and (65.97 ±25.1)%,respectively (P <0.05).HE staining showed karyorrhexis or an absence of nuclei in group B and group C,which demonstrated the coagulation necrosis. Conclusions HIFU ablation combined with liquid fluorocarbon nanoparticles can effectively treat the xenograft model of the human cervical carcinoma in nude mice.

Objective To investigate the relation between hepatic arterial abnormity and biliary complications after liver transplantation with the use of color Doppler ultrasonography. Methods Clinical data of 98 patients undergoing liver transplantation in the Third Afifliated Hospital of Sun Yat-sen University from October 2004 to October 2013 were analyzed retrospectively. According to whether the patients suffered from biliary complications after liver transplantation, they were divided into biliary complication group and non-biliary complication group. There were 52 cases in biliary complication group [49 males,3 females, mean age:(49±24) years old]. There were 46 cases in non-biliary complication group [41 males, 5 females, mean age:(46±29) years old]. The informed consents of all patients were obtained and local ethical committee approval had been received. Color Doppler ultrasonography was performed to examine the liver graft 90 d after liver transplantation and the blood lfow parameters of intra-, extrahepatic bile duct and hepatic artery were observed. The comparison of blood lfow parameters between two groups was conducted using t test.The comparison of incidence of hepatic arterial abnormity was conducted using Chi-square test. Results In biliary complication group, hepatic artery stenosis was observed in 6 cases, hepatic artery thrombosis in 3 cases and hepatic artery stenosis combined with intrahepatic arteriovenous ifstula in 1 case. The incidence of hepatic arterial abnormity was 19% (10/52), which was significantly higher than that in non-biliary complication group [2%(1/46)] (χ2=24.96, P<0.05). The maximum velocity of the proper hepatic artery in biliary complication group [(90±21) cm/s] was significantly higher than that in non-biliary complication group [(67±17)cm/s] and the resistance index of intrahepatic artery in biliary complication group (0.55±0.14) was signiifcantly lower than that in non-biliary complication group (0.64±0.08) (t=9.74, -16.96; P<0.05). Conclusions Biliary complications after liver transplantation are associated with hepatic arterial abnormity. Monitoring the hemodynamic variation of hepatic artery after liver transplantation with color Doppler ultrasonography helps to diagnose the biliary complications early.

ObjectiveTo investigate the application value of ultrasonography in biliary complications after liver transplantation.MethodsClinical data of 52 patients who developed biliary complications after liver transplantation and treated in the Third Afifliated Hospital of Sun Yat-sen University between October 2003 and January 2010 were retrospectively studied. The informed consents of all patients were obtained and the local ethical committee approval had been received. Among the 52 patients, 49 were males and 3 were females with the average age of (48±18) years old. Liver grafts were thoroughly examined with color Doppler ultrasound (CDUS). The observation indexes included dilationof bile duct, thickening of bile duct wall, echo enhancement of bile duct wall, narrowing of hilar biliary duct lumen, intraductal echo and acoustic shadow as well as intrahepatic and extrahepatic local dark areas.ResultsThe major ultrasonographic manifestations of biliary complications after liver transplantation were 96% (50/52) dilation of bile duct, 75% (39/52) echo enhancement of bile duct wall,62% (32/52) thickening of bile duct wall, 54%(28/52) narrowing of biliary duct lumen and 37% (19/52) formation of intrahepatic biliary sludge and biliary calculus. The direct ultrasonographic sign of biliary stricture was the narrowing of biliary duct lumen and the indirect signs included dilation of bile duct, thickening of bile duct wall and echo enhancement of bile duct wall. Formation of intrahepatic biliary sludge and biliary calculus manifested a local or diffuse acoustic shadow behind the medium or high echo mass. Bile leakage manifested a local dark space in portal hepatis or subhepatic space. Biloma manifested a dispersed intrahepatic patchy high-echo area or low-echo dark area.ConclusionsBiliary complications after liver transplantation have typical ultrasonographic signs. Ultrasonography may provide diagnostic evidence for biliary complications after liver transplantation.

Objective To investigate the application value of transperineal ultrasound in female urethras and pathological change of circum-urethras.Methods 403 female patients were examined by transperineal ultrasound in condition of resting and maximum Valsalva,female urethras and pathological changes of circum-urethras were observed and ultrasonic manifestation were concluded.Results By transperineal ultrasound the images of normal urethras and pathological change of circum-urethras were clearly discernible.403 female patients were examined,380 normal.18 urethral calcification,there was hyperecho stripe in urethras.2 urethral cyst,there was round anechoic area in circum-urethras and no fistula between round anechoic area with urethras.2 urethral diverticulum,there was round anechoic area in circumurethras and a fistula between round anechoic area with urethras.1 urethrovaginal fistula,there was irregular hypoechoic area between urethras with vagina,the irregular hypoechoic area both communicate with urethras and vagina.Conclusions Transperinealr ultrasound can be used for examination urethras and pathological change of circum-urethras in female patients and 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 .

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 assess the value of ultrasonography in the diagnosis of biliary stricture after liver transplantation (LT). Methods A total of 127 patients after LT in Liver Transplantation Center, the Third Afifliated Hospital of Sun Yat-sen University from January 2004 to March 2011 were included in this prospective study [116 males, 11 females;average age:(49±8) years old]. The informed consents of all patients were obtained and the ethical committee approval was received. Firstly, color Doppler ultrasound examination was performed in the patients. The ultrasound images were blindedly analyzed by two senior sonographers. The diagnostic indicators of biliary stricture ofter LT were hilar bile duct lumen narrowing, dilatation of bile duct, bile duct wall thickening, echo enhancement of bile duct wall. The endoscopic retrograde cholangiopancreatography (ERCP) or percutaneous transhepatic cholangiography (PTC) results were taken as the gold standard for diagnosing biliary stricture after LT. The diagnostic sensitivity and speciifcity of the 4 single indicators and combined indicators were observed. Results The diagnostic sensitivity and speciifcity of the 4 single indicators hilar bile duct lumen narrowing, dilatation of bile duct, bile duct wall thickening, echo enhancement of bile duct wall were 0.68 and 1.00, 1.00 and 0.73, 0.71 and 0.87,0.80 and 0.70. The diagnostic sensitivity and speciifcity of combined indicators dilatation of bile duct+bile duct wall thickening or echo enhancement of bile duct wall reached 0.80 both. Conclusions Ultrasonography is useful in the diagnosis of biliary stricture after LT. Hilar bile duct lumen narrowing can be used as a direct indicator in the diagnosis of biliary stricture after LT. And the combined indicators dilatation of bile duct+bile duct wall thickening or echo enhancement of bile duct wall have higher reference value.

Objective To evaluate the feasibility and accuracy of the transvaginal real-time three-dimensional hysterosalpingo-contrast sonography(RT 3D-HyCoSy) with SonoVue in the assessment of tubal patency.Methods Tubal patency was investigated by RT 3D-HyCoSy in 96 unselected infertile patients (a total of 191 tubes).The image quality of RT 3D-HyCoSy was evaluated.Laparoscopy was performed in 35 cases (a total of 70 tubes) of them.The efficacy of the procedure was compared with laparoscopy.Results The mean score of image quality of RT 3D-HyCoSy in ninety-six cases was 2.94 ± 0.26.The accordance between RT 3D-HyCoSy and laparoscopy was good,with the Kappa value was 0.802.Sensitivity,specificity,positive predictive value,negative predictive value and accuracy in diagnosing tubal patency by using RT 3D-HyCoSywas 87.5％ (14/16),94.4％ (51/54),82.3％ (14/17),96.2％ (51/53),92.9％ (65/70),respectively.Conclusions Transvaginal RT 3D-HyCoSy is a good imaging technique which can display the morphological character of fallopian tube and assess the patency.