Ultrasonic diagnosis of biliary atresia: A retrospective analysis of 20 patients

AIM: To investigate the clinical value of ultrasono-graphic diagnosis of biliary atresia (BA), a retrospective analysis of the sonogram of 20 children with BA was undertaken. METHODS: Ultrasonography (US) was performed in 20 neonates and infants with BA, which was confirmed with cholangiography by operation or abdominoscopy. The presence of triangular cord, the size and echo of liver, the changes in empty stomach gallbladder and postprandial gallbladder were observed and recorded. RESULTS: The triangular cord could be observed at the porta hepatis (thickness: 0.3-0.6 cm) in 10 cases. Smaller triangular cord (0.2-0.26 cm) can be observed in 3 cases. The gallbladder was not observed in 2 cases, and 1 case showed a streak gallbladder without capsular space. The gallbladders of 15 cases were flat and small. The gallbladders of 2 cases were of normal size and appearance, however, there was no postprandial contraction. The livers of all cases showed hepatomegaly and hetreogeneous echogenicity. Statistical analysis was performed to compare the hepatomegaly and hetreogeneous echogenicity and the stage of hepatic fibrosis. CONCLUSION: The presence of the triangular cord atthe porta hepatis is specific. However, it is not the only diagnostic criterion, since flat and small gallbladder and poor contraction are also of important diagnostic and differential diagnostic significance. The degree of hepatomegaly and hetreogeneous echogenicity is proportional with liver fibrosis, and able to indicate the duration of course and prognosis.

A complementary comment on primary hepatic angiosarcoma:A case report

BACKGROUND This article examines primary hepatic angiosarcoma(PHA)and fat-poor angiomyolipoma(AML),two uncommon vascular cancers.Clinical decisions in these situations are frequently aided by pathology reports and imaging techniques.Uncommon malignant tumors of the vascular endothelium include PHA.Another diagnosis that should not be overlooked when employing contrastenhanced MR and contrast-enhanced computed tomography(CT)imaging techniques is fat-poor AML,one of the uncommon vascular tumors of the liver.In both conditions,biopsy is the primary means of diagnosis.CASE SUMMARY In our article,besides the diagnosis of PHA,fat-poor AML,one of the other rare vascular tumors of the liver,is mentioned.In the case,a 50-year-old female patient with VHL Syndrome was admitted to our hospital with nonspecific lesions such as right upper quadrant pain,weight loss,and nausea.Abdominal ultrasonography(US)revealed a hypoechoic heterogeneous lesion with occasional faint contours.In computed tomography,it was observed as a hyperdense nodular lesion in segment 4.Magnetic resonance imaging(MRI)revealed that the lesion did not contain fat.In connection with the known history of VHL Syndrome,we first evaluated the possibility of AML.Thereupon,a histopathological sample was taken and the diagnosis was made as fat-poor AML with 5%fat content.CONCLUSION In conclusion,PHA in our case report and fat-poor AML in our clinic are two uncommon liver vascular malignancies with comparable incidences.Important imaging techniques like contrast-enhanced US(CEUS),CECT,and CEMRI give us substantial advantages in both cases.However,a biopsy is used to provide the final diagnosis.

Primary hepatic angiosarcoma: A case report

BACKGROUND Primary hepatic angiosarcoma(PHA)is a rare malignant tumor of the vascular endothelium.Clinical manifestations and laboratory and imaging examinations often lack specificity for PHA.We report a case of PHA,and describe the ultrasound characteristics and characteristic changes in laboratory values associated with PHA.CASE SUMMARY A 75-year-old woman presented with right upper quadrant abdominal pain for half a month.Magnetic resonance imaging(MRI)at a local hospital revealed multiple liver space-occupying lesions,and she was admitted to our hospital for further diagnosis.Contrast-enhanced ultrasound(CEUS)revealed multiple slightly hyperechoic nodules in the liver,which were suspected to be of malignant vascular origin.Contrast-enhanced computed tomography revealed multiple lowdensity nodules in the liver,considered to be metastatic hematopoietic malignancies.Contrast-enhanced MRI showed that the multiple liver nodules shared features with infectious lesions.Laboratory examination revealed normal alpha-fetoprotein levels,slightly increased other liver enzymes,decreased platelets,and significantly increased D-dimer levels.Liver biopsy and histopathology confirmed the presence of PHA.CONCLUSION CEUS can provide valuable clues for the diagnosis of PHA and greatly improve the success rate of puncture biopsy.

Influence of oligohydramnios on late pregnancy outcome

Oligohydramnios of late pregnancy is an extremely important signal of a life threatening to the fetus, which severely affect the prognosis of perinatal and makes perinatal mortality rate 5 times higher. [1].As one of the conditions that should be prevented in late pregnany, timely discovery and treatment of oligohydramnios can significantly reduce the perinatal mortality rate and improve the quality ofperinatal [2] We will make a summary on the influence of oligohydramnios in late pregnancy outcome in this article. Normally, amniotic fluid volume increases with the passes of gestational week and the volumes increases to about 800ml during late pregnancy to full-term pregnancy.We call it oligohydramnios when if the volume is less than 300m1.[3].

A Rare Novel Copy Number Variation of Xp22.33-p11.22 Duplication is Associated with Congenital Heart Defects

Congenital heart defect （CHD） is the most common fetal defects. Copy nmnber variations （CNVs） were demonstrated to be involved in the etiology of CHDs. We report three cases from a family diagnosed as CHDs with a rare novel duplication ofXp22.33-p I 1.22. A 30-year-old woman, gmvida 2 para 0. Her first pregnancy at 2012 was diagnosed to be dichorionic twin pregnancy and her second pregnancy at 2014 was a singleton pregnancy. After a routine ultrasound scan at 22 week＇s gestation, all the fetuses were diagnosed with critical CHDs. The first fetus （male） exhibited tetralogy of Fallot, atrial septal defect, persistent left superior vena cava, and coronary sinus dilatation while the examination of the second fetus （male） revealed atrioventricular septal detect and hypoplastic left heart syndrome. The third fetus （t^male） was also diagnosed with an atrioventricular septaI defect and hypoplastic left heart syndrome. The parents decided to terminate the wegnancy.