Antidiastole Value of Three-dimensional Ultrasonography and Power Doppler between Uterine Parenchyma Lumps and Endometrial Cancer:A Retrospective Study

Sometimes endometrial polyps,submucosal myomas,and endometrial cancer show similar findings under ultrasonography.The aim of this study was to assess the antidiastole value of blood flow parameters using three-dimensional(3D)power Doppler ultrasonography angiography(PDA)between endometrial cancer and uterine parenchyma lumps.The data of the blood flow indices in 3D-PDA including the vascularization index(VI),flow index(FI),and vascularization flow index(VFI)in 40 patients with endometrial cancer and 41 patients with uterine parenchyma lumps(endometrial polyps and submucosal myomas)were retrospectively analysed and compared utilizing Virtual Organ Computer-aided AnaLysis(VOCAL)software.The results showed that all the blood flow parameters(VI,FI,VFI)were significantly higher in women with endometrial cancer than in those with uterine parenchyma lumps(P<0.001).The area under the curve of ROC of VI,FI,and VFI was 0.98,0.84,and 0.97,respectively.Thus,the best predictor of endometrial carcinoma was VI with a sensitivity of 97.0% and a specificity of 91.0%.The optimal cutoff value of VI was 4.06%.Our data demonstrated that all of the blood flow signal parameters(including VI,FI,and VFI)in 3D power Doppler ultrasonography had significant antidiastole values between endometrial cancer and uterine parenchyma lumps to assist clinicians in properly diagnosing patients.

Changes in three-dimensional power Doppler ultrasound features before and after neoadjuvant chemotherapy for cervical cancer and their relationship with malignant molecule expression

Objective:To study the changes in three-dimensional power Doppler ultrasound features before and after neoadjuvant chemotherapy for cervical cancer and their relationship with malignant molecule expression.Methods: The patients who were diagnosed with cervical cancer and received neoadjuvant chemotherapy in Wuhan Red Cross Hospital between March 2015 and October 2017 were selected as the cervical cancer group, and the patients who received cervical biopsy and were diagnosed with stage I cervical intraepithelial neoplasia by pathological findings during the same period were selected as the control group. Before biopsy, three-dimensional power Doppler ultrasonography was performed to measure VI, FI and VFI;the tissues of cervical cancer group before and after chemotherapy as well as the biopsy tissues of control group were collected to measure the expression of proliferation genes, invasion genes and angiogenesis genes.Results: The VI, FI and VFI levels as well as the Piwil2 gene (Piwil2), CyclinD1, N-Myc downstream regulated gene 3 (NDRG3), CXC chemokine ligand 5 (CXCL5), cathepsin-L (CAT-L), EGF-containing fibulin-like extracellular matrix protein 1 (EFEMP1), angiotensin (Ang)1, Ang2 and angiopoietin-like protein 4 (ANGPTL4) mRNA expression levels in the tissues of cervical cancer group before and after chemotherapy were all significantly higher than those of control group whereas the thrombospondin 2 (THBS2), Smac gene (Smac), large tumor suppressor kinase 1 (LATS1), reversion-inducing-cysteine-rich protein with kazal motifs (RECK) and plas minogen activator inhibitor 1 (PAI-1) mRNA expression levels in the tissues were all significantly lower than those of control group, and the VI, FI and VFI levels as well as the Piwil2, CyclinD1, NDRG3, CXCL5, CAT-L, EFEMP1, Ang1, Ang2 and ANGPTL4 mRNA expression levels in the tissues of cervical cancer group after chemotherapy were all significantly lower than those before chemotherapy whereas the THBS2, Smac, LATS1, RECK and PAI-1 mRNA expression levels were all significantly higher than those before chemotherapy;the VI, FI and VFI levels in cervical cancer tissues were positively correlated with the Piwil2, CyclinD1, NDRG3, CXCL5, CAT-L, EFEMP1, Ang1, Ang2 and ANGPTL4 mRNA expression levels, and negatively correlated with the THBS2, Smac, LATS1, RECK and PAI-1 mRNA expression levels.Conclusion: The changes in the three-dimensional power Doppler ultrasound parameters before and after neoadjuvant chemotherapy for cervical cancer can reflect the changes in proliferation, invasion and angiogenesis gene expression in the lesions.

三维彩色能量成像评价正常妊娠胎盘血流灌注

目的探讨三维彩色能量成像(3DCPA)测量胎儿胎盘的三维能量多普勒指数与孕龄的相关关系及其临床意义。方法采用Voluson730expert三维超声成像系统的3DCPA测量130例20～40周的胎儿胎盘的血管化指数(VI),血流指数(FI),血管化血流指数(VFI),并与孕龄比较分析。结果胎儿胎盘的三维能量多普勒指数与孕龄呈直线相关,以孕龄为自变量,胎儿胎盘的三维能量多普勒指数为因变量的直线回归公式为VI=0.297×GA-3.428(r=0.59,n=130,P<0.0001)FI=0.23×GA+27.516(r=0.32,n=130,P<0.0001),VFI=0.115×GA-1.509(r=0.59,n=130,P<0.0001)。结论3DCPA可以作为妊娠中观察胎盘血管树发育的工具,胎儿胎盘的三维能量多普勒指数与孕龄的增长以及胎儿各生长参数积极相关。

定量三维能量多普勒超声对正常妊娠胎盘血流灌注的监测价值

目的在二雏超声的基础上应用三雏彩色能量多普勒超声成像（3D—CPA）及其定量参数VOCAL功能，探讨三雏彩色能量多普勒超声成像（3D—CPA）测量的胎儿胎盘的三雏能量多普勒指数与孕龄、脐动脉收缩期峰值流速（US）、S／D值的相关关系并评价其临床意义。方法采用GE公司VOLUSON730三雏超声成像系统的三雏能量多普勒测量154例20～40孕周的胎儿胎盘的血管化指数（VI）血流指数（FI），血管化-血流指数（VFI），并与孕龄、脐动脉收缩期峰值流速、S／D值作比较分析，计算它们之间的相关系数。结果所有的胎儿胎盘的三雏能量多普勒指数与孕龄相关性良好，以孕龄为自变量胎儿胎盘的三雏能量多普勒指数为因变量的直线回归方程如下：VI=0．280×GA-2．622（r=0．663，n=154，P〈0．0001）、FI=0．298×GA＋27．021（r=0．351，n=154，P〈0．0001）、VFI=0．113×GA-1．278（r=0．680，n=154，P〈0．0001）与脐动脉收缩期峰值流速（US）、S／D值亦有良好的相关性，同时胎儿胎盘的三雏能量多普勒指数与本研究观察的胎儿生长参数积极相关。结论三雏彩色能量多普勒超声成像（3D-CPA）技术是一项妊娠中观察胎盘血管树发育的非常实用的方法。胎儿胎盘的三维多普勒指数与孕龄胎儿部分生长参数及脐动脉多普勒血流参数正相关。

The correlation of vascularization index and flow index of thyroid cancer ultrasound with tumor malignancy

Objective:To study the correlation of ultrasound vascularization index and flow index of thyroid cancer with tumor malignancy.Methods: A total of 140 patients with thyroid nodule who accepted surgical resection in our hospital between May 2013 and June 2016 were selected as the research subjects, the patients with malignant thyroid nodule were included in the malignant group of the research and patients with benign thyroid nodule were included in the benign group of research. Three-dimensional power Doppler ultrasonography was conducted before operation to determine vascularization index (VI), flow index (FI) and vascularization flow index (VFI);tumor tissues were collected after operation to detect the expression of angiogenesis as well as cell proliferation, apoptosis and invasion-related molecules.Results:VI, FI and VFI levels of tumor tissue of malignant group were significantly higher than those of benign group;VEGF, MK, Ang-2, IGF-Ⅱ, Bcl-2, Livin, Wip1, S100A4, TCF,β-catenin and SATB1 protein expression in tumor tissue of malignant group were significantly higher than those of benign group and positively correlated with VI, FI and VFI levels while CCNG2 and p27 protein expression were significantly lower than those of benign group and negatively correlated with VI, FI and VFI levels.Conclusion:Ultrasound vascularization index and flow index of thyroid cancer increase significantly and are closely related to the angiogenesis as well as cell proliferation, apoptosis and invasion.

应用三维彩色能量多普勒血管超声成像评价正常妊娠胎盘的血流灌注

目的探讨三维彩色能量多普勒血管超声成像(three-di mensional color power angiographic,3D-CPA)及其定量指标,在评价正常妊娠胎盘血流灌注中的使用价值。方法选取2006年1月至2009年12月在本院门诊进行产前检查的20+1～40孕周、胎盘位于前壁的单胎妊娠孕妇为研究对象。将其分为20+1～28孕周(中期妊娠)组(A组,n=100)及28+1～40孕周(晚期妊娠)组(B组,n=104)(本研究程序符合本院人体试验委员会所制定的伦理学标准,得到该委员会批准,并与受试者签署临床医学研究知情同意书)。采用三维彩色多普勒超声成像系统Voluson730D(GE公司,美国)测量204例20+1～40孕周受试者的胎盘的血管化指数(vascularization index,VI)、血流指数(flow index,FI)和血管化-血流指数(vascularization-flowindex,VFI),并与胎儿部分生长参数作比较分析,计算参数间相关系数。同时,给出妊娠中期及晚期正常胎盘三维彩色能量血管超声成像参数的正常参考值范围。结果正常妊娠胎盘内血管呈立体树枝状,且晚期妊娠组较中期妊娠组明显增多、增粗。从直方图观察,晚期妊娠组较中期妊娠组血流强度直方图分布范围广,峰值后移,高强度血流明显增多。胎盘的三维彩色能量多普勒血管超声成像参数与胎儿生长参数呈正相关关系。结论三维彩色能量多普勒血管超声成像是一项观察妊娠胎盘血管树发育的非常实用的方法 ,其能量多普勒参数,使定量评估胎盘血流灌注成为可能,为降低围生期胎儿发病率及死亡率提供了具有临床价值的重要辅助检查指标。