Summary: To study reliability and reliable indices of quantitative assessment of right ventricular systolic function by time-intensity curve (TIC) with right ventricular contrast, 5 % sonicated human albumin was injec...Summary: To study reliability and reliable indices of quantitative assessment of right ventricular systolic function by time-intensity curve (TIC) with right ventricular contrast, 5 % sonicated human albumin was injected intravenously at a does of 0.08 ml/kg into 10 dogs at baseline status and cardiac insufficiency. Apical four-chamber view was observed for washin and washout of contrast agent from right ventricle. The parameters of TIC were obtained by curve fitting. The differences of parameters were analyzed in different states of cardiac functions. Among the parameters derived from TIC, the time constant (k) was decreased significantly with decline of cardiac function (P<0.001). But half-time of decent of peak intensity (HT) and mean-transit-time (MTT) of washout were increased significantly (P<0.001). The k was strongly related to cardiac output of right ventricle (CO) and ejection fraction (EF) of left ventricle and fractional shortening (FS) of left ventricle. Right ventricular systolic function could be assessed reliably by the parameters derived from TIC with right ventricular contrast echocardiography. The k, HT and MTT are reliable indices for quantitative assessment of right ventricular systolic function.展开更多
BACKGROUND Non-invasive differential diagnosis between hepatocellular carcinoma(HCC)and other liver cancer(i.e.cholangiocarcinoma or metastasis)is highly challenging and definitive diagnosis still relies on histologic...BACKGROUND Non-invasive differential diagnosis between hepatocellular carcinoma(HCC)and other liver cancer(i.e.cholangiocarcinoma or metastasis)is highly challenging and definitive diagnosis still relies on histological exam.The patterns of enhancement and wash-out of liver nodules can be used to stratify the risk of malignancy only in cirrhotic patients and HCC frequently shows atypical features.Dynamic contrast-enhanced ultrasound(DCEUS)with standardized software could help to overcome these obstacles,providing functional and quantitative parameters and potentially improving accuracy in the evaluation of tumor perfusion.AIM To explore clinical evidence regarding the application of DCEUS in the differential diagnosis of liver nodules.METHODS A comprehensive literature search of clinical studies was performed to identify the parameters of DCEUS that could relate to histological diagnosis.In accordance with the study protocol,a qualitative and quantitative analysis of the evidence was planned.RESULTS Rise time was significantly higher in HCC patients with a standardized mean difference(SMD)of 0.83(95%CI:0.48-1.18).Similarly,other statistically significant parameters were mean transit time local with a SMD of 0.73(95%CI:0.20-1.27),peak enhancement with a SMD of 0.37(95%CI:0.03-0.70),area wash-in area under the curve with a SMD of 0.47(95%CI:0.13-0.81),wash-out area under the curve with a SMD of 0.55(95%CI:0.21-0.89)and wash-in and wash-out area under the curve with SMD of 0.51(95%CI:0.17-0.85).SMD resulted not significant in fall time and wash-in rate,but the latter presented a trend towards greater values in HCC compared to intrahepatic cholangiocarcinoma.CONCLUSION DCEUS could improve non-invasive diagnosis of HCC,leading to less liver biopsy and early treatment.This quantitative analysis needs to be applied on larger cohorts to confirm these preliminary results.展开更多
In the current study, we sought to evaluate the diagnostic efficacies of conventional ultrasound（US）, contrastenhanced US（CEUS）, combined US and CEUS and magnetic resonance imaging（MRI） in detecting focal solid ...In the current study, we sought to evaluate the diagnostic efficacies of conventional ultrasound（US）, contrastenhanced US（CEUS）, combined US and CEUS and magnetic resonance imaging（MRI） in detecting focal solid breast lesions. Totally 117 patients with 120 BI-RADS category 4A-5 breast lesions were evaluated by conventional US and CEUS, and MRI, respectively. SonoVue was used as contrast agent in CEUS and injected as an intravenous bolus; nodule scan was performed 4 minutes after bolus injection. A specific sonographic quantification software was used to obtain color-coded maps of perfusion parameters for the investigated lesion, namely the time-intensity curve.The pattern of contrast enhancement and related indexes regarding the time-intensity curve were used to describe the lesions, comparatively with pathological results. Histopathologic examination revealed 46 benign and 74 malignant lesions. Sensitivity, specificity, and accuracy of US in detecting malignant breast lesions were 90.14%, 95.92%, and 92.52%, respectively. Meanwhile, CE-MRI showed sensitivity, specificity, and accuracy of 88.73%, 95.92%, and91.67%, respectively. The area under the ROC curve for combined US and CEUS in discriminating benign from malignant breast lesions was 0.936, while that of MRI was 0.923, with no significant difference between them, as well as among groups. The time-intensity curve of malignant hypervascular fibroadenoma and papillary lesions mostly showed a fast-in/fast-out pattern, with no good correlation between them（kappa 〈0.20）. In conclusion, the combined use of conventional US and CEUS displays good agreement with MRI in differentiating benign from malignant breast lesions.展开更多
目的利用超声造影(CEUS)定量分析技术获取不同甲状腺结节的定量参数,评价其对低增强型亚急性甲状腺炎(SAT)与甲状腺乳头状癌(PTC)的鉴别诊断价值。方法选择32例SAT患者作为SAT组,其中男性6例,女性26例;年龄36~66岁,平均年龄50.37岁;结...目的利用超声造影(CEUS)定量分析技术获取不同甲状腺结节的定量参数,评价其对低增强型亚急性甲状腺炎(SAT)与甲状腺乳头状癌(PTC)的鉴别诊断价值。方法选择32例SAT患者作为SAT组,其中男性6例,女性26例;年龄36~66岁,平均年龄50.37岁;结节大小6.0~36.7 mm,平均最大径13.54 mm。同期选择经术后病理诊断证实39例PTC患者作为PTC组,其中男性9例,女性30例;年龄33~66岁,平均年龄48.28岁;结节大小7.0~23.0 mm,平均最大径11.94 mm。运用SonoLiver软件分析记录各结节整体(W)、边缘(P)和中央(C)的不同感兴趣区(ROI)的CEUS定量参数,包括最大峰值强度(IMAX)、始增时间(RT)、达峰时间(TTP)和平均渡越时间(mTT),并计算周围正常组织各定量参数与结节不同部位定量参数的相对值(△值),对比分析SAT和PTC两组结节之间CEUS定量参数的差异,并用受试者工作特性(ROC)曲线获得截断值。结果SAT组结节定量参数IMAX_(W)和△mTT_(W)大于PTC组(0.53±0.18 vs 0.43±0.23;P<0.05。-1.26±7.35 vs-1.44±2.38;P<0.05);△TTP_(P)在SAT组小于PTC组(-0.42±0.66 vs 0.06±0.75。P<0.05);SAT组定量参数IMAX_(C)、△RT_(C)及△mTT_(C)均高于PTC组(0.49±0.19 vs 0.31±0.28;P<0.05。0.24±0.62 vs-0.28±1.11;P<0.05。1.31±4.32 vs-1.62±4.35;P<0.05)。ROC曲线分析显示定量参数IMAX_(C)及△mTT_(C)的最佳截断值分别为0.27和0.50,曲线下面积分别为0.849和0.837。结论CEUS定量分析有助于低增强型SAT与PTC的鉴别,有一定的临床应用价值。展开更多
Contrast enhanced ultrasound(CEUS)has been widely implemented in clinical practice because of the enormous quantity of information it provides,along with its low cost,reproducibility,minimal invasiveness,and safety of...Contrast enhanced ultrasound(CEUS)has been widely implemented in clinical practice because of the enormous quantity of information it provides,along with its low cost,reproducibility,minimal invasiveness,and safety of the secondgeneration ultrasound contrast agents.To overcome the limitation of CEUS given by the subjective evaluation of the contrast enhancement behaviour,quantitative analysis of contrast kinetics with generation of time-intensity curves has been introduced in recent years.The quantification of perfusion parameters[named as dynamic-CEUS(D-CEUS)]has several applications in gastrointestinal neoplastic and inflammatory disorders.However,the limited availability of large studies and the heterogeneity of the technologies employed have precluded the standardisation of D-CEUS,which potentially represents a valuable tool for clinical practice in management of gastrointestinal diseases.In this article,we reviewed the evidence exploring the application of D-CEUS in gastrointestinal diseases,with a special focus on liver,pancreas,and inflammatory bowel diseases.展开更多
文摘Summary: To study reliability and reliable indices of quantitative assessment of right ventricular systolic function by time-intensity curve (TIC) with right ventricular contrast, 5 % sonicated human albumin was injected intravenously at a does of 0.08 ml/kg into 10 dogs at baseline status and cardiac insufficiency. Apical four-chamber view was observed for washin and washout of contrast agent from right ventricle. The parameters of TIC were obtained by curve fitting. The differences of parameters were analyzed in different states of cardiac functions. Among the parameters derived from TIC, the time constant (k) was decreased significantly with decline of cardiac function (P<0.001). But half-time of decent of peak intensity (HT) and mean-transit-time (MTT) of washout were increased significantly (P<0.001). The k was strongly related to cardiac output of right ventricle (CO) and ejection fraction (EF) of left ventricle and fractional shortening (FS) of left ventricle. Right ventricular systolic function could be assessed reliably by the parameters derived from TIC with right ventricular contrast echocardiography. The k, HT and MTT are reliable indices for quantitative assessment of right ventricular systolic function.
文摘BACKGROUND Non-invasive differential diagnosis between hepatocellular carcinoma(HCC)and other liver cancer(i.e.cholangiocarcinoma or metastasis)is highly challenging and definitive diagnosis still relies on histological exam.The patterns of enhancement and wash-out of liver nodules can be used to stratify the risk of malignancy only in cirrhotic patients and HCC frequently shows atypical features.Dynamic contrast-enhanced ultrasound(DCEUS)with standardized software could help to overcome these obstacles,providing functional and quantitative parameters and potentially improving accuracy in the evaluation of tumor perfusion.AIM To explore clinical evidence regarding the application of DCEUS in the differential diagnosis of liver nodules.METHODS A comprehensive literature search of clinical studies was performed to identify the parameters of DCEUS that could relate to histological diagnosis.In accordance with the study protocol,a qualitative and quantitative analysis of the evidence was planned.RESULTS Rise time was significantly higher in HCC patients with a standardized mean difference(SMD)of 0.83(95%CI:0.48-1.18).Similarly,other statistically significant parameters were mean transit time local with a SMD of 0.73(95%CI:0.20-1.27),peak enhancement with a SMD of 0.37(95%CI:0.03-0.70),area wash-in area under the curve with a SMD of 0.47(95%CI:0.13-0.81),wash-out area under the curve with a SMD of 0.55(95%CI:0.21-0.89)and wash-in and wash-out area under the curve with SMD of 0.51(95%CI:0.17-0.85).SMD resulted not significant in fall time and wash-in rate,but the latter presented a trend towards greater values in HCC compared to intrahepatic cholangiocarcinoma.CONCLUSION DCEUS could improve non-invasive diagnosis of HCC,leading to less liver biopsy and early treatment.This quantitative analysis needs to be applied on larger cohorts to confirm these preliminary results.
基金supported by the Natural Science Foundation of Jiangsu University(14KJB320003)
文摘In the current study, we sought to evaluate the diagnostic efficacies of conventional ultrasound（US）, contrastenhanced US（CEUS）, combined US and CEUS and magnetic resonance imaging（MRI） in detecting focal solid breast lesions. Totally 117 patients with 120 BI-RADS category 4A-5 breast lesions were evaluated by conventional US and CEUS, and MRI, respectively. SonoVue was used as contrast agent in CEUS and injected as an intravenous bolus; nodule scan was performed 4 minutes after bolus injection. A specific sonographic quantification software was used to obtain color-coded maps of perfusion parameters for the investigated lesion, namely the time-intensity curve.The pattern of contrast enhancement and related indexes regarding the time-intensity curve were used to describe the lesions, comparatively with pathological results. Histopathologic examination revealed 46 benign and 74 malignant lesions. Sensitivity, specificity, and accuracy of US in detecting malignant breast lesions were 90.14%, 95.92%, and 92.52%, respectively. Meanwhile, CE-MRI showed sensitivity, specificity, and accuracy of 88.73%, 95.92%, and91.67%, respectively. The area under the ROC curve for combined US and CEUS in discriminating benign from malignant breast lesions was 0.936, while that of MRI was 0.923, with no significant difference between them, as well as among groups. The time-intensity curve of malignant hypervascular fibroadenoma and papillary lesions mostly showed a fast-in/fast-out pattern, with no good correlation between them（kappa 〈0.20）. In conclusion, the combined use of conventional US and CEUS displays good agreement with MRI in differentiating benign from malignant breast lesions.
文摘目的利用超声造影(CEUS)定量分析技术获取不同甲状腺结节的定量参数,评价其对低增强型亚急性甲状腺炎(SAT)与甲状腺乳头状癌(PTC)的鉴别诊断价值。方法选择32例SAT患者作为SAT组,其中男性6例,女性26例;年龄36~66岁,平均年龄50.37岁;结节大小6.0~36.7 mm,平均最大径13.54 mm。同期选择经术后病理诊断证实39例PTC患者作为PTC组,其中男性9例,女性30例;年龄33~66岁,平均年龄48.28岁;结节大小7.0~23.0 mm,平均最大径11.94 mm。运用SonoLiver软件分析记录各结节整体(W)、边缘(P)和中央(C)的不同感兴趣区(ROI)的CEUS定量参数,包括最大峰值强度(IMAX)、始增时间(RT)、达峰时间(TTP)和平均渡越时间(mTT),并计算周围正常组织各定量参数与结节不同部位定量参数的相对值(△值),对比分析SAT和PTC两组结节之间CEUS定量参数的差异,并用受试者工作特性(ROC)曲线获得截断值。结果SAT组结节定量参数IMAX_(W)和△mTT_(W)大于PTC组(0.53±0.18 vs 0.43±0.23;P<0.05。-1.26±7.35 vs-1.44±2.38;P<0.05);△TTP_(P)在SAT组小于PTC组(-0.42±0.66 vs 0.06±0.75。P<0.05);SAT组定量参数IMAX_(C)、△RT_(C)及△mTT_(C)均高于PTC组(0.49±0.19 vs 0.31±0.28;P<0.05。0.24±0.62 vs-0.28±1.11;P<0.05。1.31±4.32 vs-1.62±4.35;P<0.05)。ROC曲线分析显示定量参数IMAX_(C)及△mTT_(C)的最佳截断值分别为0.27和0.50,曲线下面积分别为0.849和0.837。结论CEUS定量分析有助于低增强型SAT与PTC的鉴别,有一定的临床应用价值。
文摘Contrast enhanced ultrasound(CEUS)has been widely implemented in clinical practice because of the enormous quantity of information it provides,along with its low cost,reproducibility,minimal invasiveness,and safety of the secondgeneration ultrasound contrast agents.To overcome the limitation of CEUS given by the subjective evaluation of the contrast enhancement behaviour,quantitative analysis of contrast kinetics with generation of time-intensity curves has been introduced in recent years.The quantification of perfusion parameters[named as dynamic-CEUS(D-CEUS)]has several applications in gastrointestinal neoplastic and inflammatory disorders.However,the limited availability of large studies and the heterogeneity of the technologies employed have precluded the standardisation of D-CEUS,which potentially represents a valuable tool for clinical practice in management of gastrointestinal diseases.In this article,we reviewed the evidence exploring the application of D-CEUS in gastrointestinal diseases,with a special focus on liver,pancreas,and inflammatory bowel diseases.
