AIM:Pelvic magnetic resonance imaging(MRI)and endoanal ultrasound which are established imaging methods for perianal inflammatory lesions in patients with Crohn's disease require expensive specialized equipments a...AIM:Pelvic magnetic resonance imaging(MRI)and endoanal ultrasound which are established imaging methods for perianal inflammatory lesions in patients with Crohn's disease require expensive specialized equipments and expertise.We investigated the feasibility and sensitivity of transcutaneous perianal ultrasound(PAUS)using regular ultrasound probes in the imaging of perianal inflammatory lesions.The sonographic findings were correlated to pelvic MR]-scans. METHODS:We performed PAUS in 25 patients with Crohn's disease and clinical signs of perianal inflammatory disease. Wibhin a median of 10 d(range 0-75)these patients underwent MRI of the pelvis.Regular convex and linear high resolution probes were used for PAUS.The sonographic findings were correlated to the MRI findings by blinded investigators. RESULTS:The sonographic investigations were well tolerated by all patients.Fistulae typically presented as hypoechoic tracks.Twenty-nine fistulae were detected in 22 patients.Abscesses were detected in 7 patients and presented as hypo-or anechoic formations.Twenty-six of 29 fistulae and 6 of 7 abscesses could be confirmed by MRI.Kappa statistics showed an excellent agreement (kappa>0.83)between the two imaging methods. CONCLUSION:PAUS is a simple,painless,feasible,real- time method that can be performed without specific patient preparation which is comparable in its sensitivity to pelvic MRI in the detection of perianal fistulae and/or abscesses. PAUS can especially be recommended as a screening tool in acute perianal disorders such as perianal abscess and for follow-up studies of perianal inflammatory disease.展开更多
Objective:To compare the reliability of transvaginal ultrasonography with pelvic arteriography in the assessment of patients with gestational trophoblastic disease. Methods. Transvaginal ultrasonography was performed ...Objective:To compare the reliability of transvaginal ultrasonography with pelvic arteriography in the assessment of patients with gestational trophoblastic disease. Methods. Transvaginal ultrasonography was performed in 24 patients with gestational trophoblastic tumour. Within one week after ultrasound investigation, pelvic arteriography was carried out in each patient. Of 24 cases, 16 patients hadn’t been treated by chemical reagent, 5 had accepted 2 to 5 courses of chemotherapy, and 3 had achieved complete remission before both investigations performed. Results. In 3 patients with complete remission, 2 had no evidence of abnormal findings either on transvaginal ultrasonography or on pelvic arteriography, 1 showed intramyometrial lesions by both methods. In the remaining 21 patients, all demostrated a abnormal uterine image, and 5 of them accompanied with the finding of parametrium metastatic signs by transvaginal ultrasonography; these abnormal results were confirmed by pelvic arteriographic imaging. However, in two cases without clinical and ultrasonic signs of parametrium metastasis, pelvic arteriography indicated the early metastasis of parametrium ves- sels. Conclusions. Even though it is difficult to predict the early parametrium metastasis in patients with gestational trophoblastic disease by B-ultrasonic investigation, our data would support the introduction of transvaginal ultrasonography in the diagnosis and evaluation of gestational trophoblastic tumour.展开更多
AIM:To study the role of time-intensity curve(TIC) analysis parameters in a complex system of neural networks designed to classify liver tumors.METHODS:We prospectively included 112 patients with hepatocellular carcin...AIM:To study the role of time-intensity curve(TIC) analysis parameters in a complex system of neural networks designed to classify liver tumors.METHODS:We prospectively included 112 patients with hepatocellular carcinoma(HCC)(n = 41),hypervascular(n = 20) and hypovascular(n = 12) liver metastases,hepatic hemangiomas(n = 16) or focal fatty changes(n = 23) who underwent contrast-enhanced ultrasonography in the Research Center of Gastroenterology and Hepatology,Craiova,Romania.We recorded full length movies of all contrast uptake phases and post-processed them offline by selecting two areas of interest(one for the tumor and one for the healthy surrounding parenchyma) and consecutive TIC analysis.The difference in maximum intensities,the time to reaching them and the aspect of the late/portal phase,as quantified by the neural network and a ratio between median intensities of the central and peripheral areas were analyzed by a feed forward back propagation multi-layer neural network which was trained to classify data into five distinct classes,corresponding to each type of liver lesion.RESULTS:The neural network had 94.45% training accuracy(95% CI:89.31%-97.21%) and 87.12% testing accuracy(95% CI:86.83%-93.17%).The automatic classification process registered 93.2% sensitivity,89.7% specificity,94.42% positive predictive value and 87.57% negative predictive value.The artificial neural networks(ANN) incorrectly classified as hemangyomas three HCC cases and two hypervascular metastases,while in turn misclassifying four liver hemangyomas as HCC(one case) and hypervascular metastases(three cases).Comparatively,human interpretation of TICs showed 94.1% sensitivity,90.7% specificity,95.11% positive predictive value and 88.89% negative predictive value.The accuracy and specificity of the ANN diagnosis system was similar to that of human interpretation of the TICs(P = 0.225 and P = 0.451,respectively).Hepatocellular carcinoma cases showed contrast uptake during the arterial phase followed by wash-out in the portal and first seconds of the late phases.For the hypovascular metastases did not show significant contrast uptake during the arterial phase,which resulted in negative differences between the maximum intensities.We registered wash-out in the late phase for most of the hypervascular metastases.Liver hemangiomas had contrast uptake in the arterial phase without agent wash-out in the portallate phases.The focal fatty changes did not show any differences from surrounding liver parenchyma,resulting in similar TIC patterns and extracted parameters.CONCLUSION:Neural network analysis of contrastenhanced ultrasonography-obtained TICs seems a promising field of development for future techniques,providing fast and reliable diagnostic aid for the clinician.展开更多
AIM： To assess the ability of endoscopic ultrasonography （EUS） to differentiate neoplastic from non- neoplastic polypoid lesions of the gallbladder （PLGs）.METHODS： The uses of EUS and transabdominal ultrasonogra...AIM： To assess the ability of endoscopic ultrasonography （EUS） to differentiate neoplastic from non- neoplastic polypoid lesions of the gallbladder （PLGs）.METHODS： The uses of EUS and transabdominal ultrasonography （US） were retrospectively analyzed in 94 surgical cases of gallbladder polyps less than 20 mm in diameter.RESULTS： The prevalence of neoplastic lesions with a diameter of 5-20 mm was 27.2% （10/58）; 22-15 mm, 25.4% （4/26）, and 16-20 mm, 50% （5/20）. The overall diagnostic accuracies of EUS and US for small PLGs were 80.9% and 63.9% （P 〈 0.05）, respectively. EUS correctly distinguished 12 （63.2%） of 19 neoplastic PLGs but was less accurate for polyps less than 1.0 cm （4/10, 40%） than for polyps greater than 1.0 cm （8/9, 88.9%） （P = 0.02）.CONCLUSION： Although EUS was more accurate than US, its accuracy for differentiating neoplastic from non-neoplastic PLGs less than 1.0 cm was low. Thus, EUS alone is not sufficient for determining a treatment strategy for PLGs of less than 1.0 cm.展开更多
One hundred and twenty-four patients with heart disease(75 cases of rheumatic heart disease,26 cases of congenital heart disease,13 cases of aortic disease and 10 cases of other disease)were examined by Omniplane tran...One hundred and twenty-four patients with heart disease(75 cases of rheumatic heart disease,26 cases of congenital heart disease,13 cases of aortic disease and 10 cases of other disease)were examined by Omniplane transesophageal echocardiography(TEE).The result showed that Omniplane TEE transducer can be rotated from 0°to 180°in probe and had the advantages of broader scope,obtaining more information,less stimulation to esophagus and easy to manipulate.It suggests that Omniplane TEE is a efficient technique in clinical diagnosis and can be extensively used in the future.展开更多
Objective To assess the value of transvaginal CDFI in the diagnosis of malignant ovariantumors and to discriminate the benign from malignant ovarian tumors. Methods 96 patients pelvic masses were studied by transvagin...Objective To assess the value of transvaginal CDFI in the diagnosis of malignant ovariantumors and to discriminate the benign from malignant ovarian tumors. Methods 96 patients pelvic masses were studied by transvaginal ultrasonograph mass scoring, and by CDFI through pulsatility index (PI) and resistance index (RI) of peripheral blood flow of mass analyses. Results Mass ultrasonic scoring : scoring >9, 91.9% masses were malignant tumors. Scoring ≤<9, 91.5% masses were benign tumors. PI and Rl of peripheral blood flow of masses were detected by CDFI: Pl< 1 .0 . 92.5% cases; RI<0.5, 97.4% cases were malignant tumors. The diagnosis match rate of malignant ovarian tumors was 97.0% . The diagnosis match rate of benign ovarian tumor was 96 .2% . The diagnosis match rate was improved. Conclusion Ovarian mass ultrasonic scoring>9 and PI< 1 .0 , RI<0 .5 of mass peripheral blood flow are the special ultrasonic features of malignant ovarian tumor and the better methods to distinguish the benign ovarian tumor from the malignant one.展开更多
文摘AIM:Pelvic magnetic resonance imaging(MRI)and endoanal ultrasound which are established imaging methods for perianal inflammatory lesions in patients with Crohn's disease require expensive specialized equipments and expertise.We investigated the feasibility and sensitivity of transcutaneous perianal ultrasound(PAUS)using regular ultrasound probes in the imaging of perianal inflammatory lesions.The sonographic findings were correlated to pelvic MR]-scans. METHODS:We performed PAUS in 25 patients with Crohn's disease and clinical signs of perianal inflammatory disease. Wibhin a median of 10 d(range 0-75)these patients underwent MRI of the pelvis.Regular convex and linear high resolution probes were used for PAUS.The sonographic findings were correlated to the MRI findings by blinded investigators. RESULTS:The sonographic investigations were well tolerated by all patients.Fistulae typically presented as hypoechoic tracks.Twenty-nine fistulae were detected in 22 patients.Abscesses were detected in 7 patients and presented as hypo-or anechoic formations.Twenty-six of 29 fistulae and 6 of 7 abscesses could be confirmed by MRI.Kappa statistics showed an excellent agreement (kappa>0.83)between the two imaging methods. CONCLUSION:PAUS is a simple,painless,feasible,real- time method that can be performed without specific patient preparation which is comparable in its sensitivity to pelvic MRI in the detection of perianal fistulae and/or abscesses. PAUS can especially be recommended as a screening tool in acute perianal disorders such as perianal abscess and for follow-up studies of perianal inflammatory disease.
文摘Objective:To compare the reliability of transvaginal ultrasonography with pelvic arteriography in the assessment of patients with gestational trophoblastic disease. Methods. Transvaginal ultrasonography was performed in 24 patients with gestational trophoblastic tumour. Within one week after ultrasound investigation, pelvic arteriography was carried out in each patient. Of 24 cases, 16 patients hadn’t been treated by chemical reagent, 5 had accepted 2 to 5 courses of chemotherapy, and 3 had achieved complete remission before both investigations performed. Results. In 3 patients with complete remission, 2 had no evidence of abnormal findings either on transvaginal ultrasonography or on pelvic arteriography, 1 showed intramyometrial lesions by both methods. In the remaining 21 patients, all demostrated a abnormal uterine image, and 5 of them accompanied with the finding of parametrium metastatic signs by transvaginal ultrasonography; these abnormal results were confirmed by pelvic arteriographic imaging. However, in two cases without clinical and ultrasonic signs of parametrium metastasis, pelvic arteriography indicated the early metastasis of parametrium ves- sels. Conclusions. Even though it is difficult to predict the early parametrium metastasis in patients with gestational trophoblastic disease by B-ultrasonic investigation, our data would support the introduction of transvaginal ultrasonography in the diagnosis and evaluation of gestational trophoblastic tumour.
文摘AIM:To study the role of time-intensity curve(TIC) analysis parameters in a complex system of neural networks designed to classify liver tumors.METHODS:We prospectively included 112 patients with hepatocellular carcinoma(HCC)(n = 41),hypervascular(n = 20) and hypovascular(n = 12) liver metastases,hepatic hemangiomas(n = 16) or focal fatty changes(n = 23) who underwent contrast-enhanced ultrasonography in the Research Center of Gastroenterology and Hepatology,Craiova,Romania.We recorded full length movies of all contrast uptake phases and post-processed them offline by selecting two areas of interest(one for the tumor and one for the healthy surrounding parenchyma) and consecutive TIC analysis.The difference in maximum intensities,the time to reaching them and the aspect of the late/portal phase,as quantified by the neural network and a ratio between median intensities of the central and peripheral areas were analyzed by a feed forward back propagation multi-layer neural network which was trained to classify data into five distinct classes,corresponding to each type of liver lesion.RESULTS:The neural network had 94.45% training accuracy(95% CI:89.31%-97.21%) and 87.12% testing accuracy(95% CI:86.83%-93.17%).The automatic classification process registered 93.2% sensitivity,89.7% specificity,94.42% positive predictive value and 87.57% negative predictive value.The artificial neural networks(ANN) incorrectly classified as hemangyomas three HCC cases and two hypervascular metastases,while in turn misclassifying four liver hemangyomas as HCC(one case) and hypervascular metastases(three cases).Comparatively,human interpretation of TICs showed 94.1% sensitivity,90.7% specificity,95.11% positive predictive value and 88.89% negative predictive value.The accuracy and specificity of the ANN diagnosis system was similar to that of human interpretation of the TICs(P = 0.225 and P = 0.451,respectively).Hepatocellular carcinoma cases showed contrast uptake during the arterial phase followed by wash-out in the portal and first seconds of the late phases.For the hypovascular metastases did not show significant contrast uptake during the arterial phase,which resulted in negative differences between the maximum intensities.We registered wash-out in the late phase for most of the hypervascular metastases.Liver hemangiomas had contrast uptake in the arterial phase without agent wash-out in the portallate phases.The focal fatty changes did not show any differences from surrounding liver parenchyma,resulting in similar TIC patterns and extracted parameters.CONCLUSION:Neural network analysis of contrastenhanced ultrasonography-obtained TICs seems a promising field of development for future techniques,providing fast and reliable diagnostic aid for the clinician.
文摘AIM： To assess the ability of endoscopic ultrasonography （EUS） to differentiate neoplastic from non- neoplastic polypoid lesions of the gallbladder （PLGs）.METHODS： The uses of EUS and transabdominal ultrasonography （US） were retrospectively analyzed in 94 surgical cases of gallbladder polyps less than 20 mm in diameter.RESULTS： The prevalence of neoplastic lesions with a diameter of 5-20 mm was 27.2% （10/58）; 22-15 mm, 25.4% （4/26）, and 16-20 mm, 50% （5/20）. The overall diagnostic accuracies of EUS and US for small PLGs were 80.9% and 63.9% （P 〈 0.05）, respectively. EUS correctly distinguished 12 （63.2%） of 19 neoplastic PLGs but was less accurate for polyps less than 1.0 cm （4/10, 40%） than for polyps greater than 1.0 cm （8/9, 88.9%） （P = 0.02）.CONCLUSION： Although EUS was more accurate than US, its accuracy for differentiating neoplastic from non-neoplastic PLGs less than 1.0 cm was low. Thus, EUS alone is not sufficient for determining a treatment strategy for PLGs of less than 1.0 cm.
文摘One hundred and twenty-four patients with heart disease(75 cases of rheumatic heart disease,26 cases of congenital heart disease,13 cases of aortic disease and 10 cases of other disease)were examined by Omniplane transesophageal echocardiography(TEE).The result showed that Omniplane TEE transducer can be rotated from 0°to 180°in probe and had the advantages of broader scope,obtaining more information,less stimulation to esophagus and easy to manipulate.It suggests that Omniplane TEE is a efficient technique in clinical diagnosis and can be extensively used in the future.
文摘Objective To assess the value of transvaginal CDFI in the diagnosis of malignant ovariantumors and to discriminate the benign from malignant ovarian tumors. Methods 96 patients pelvic masses were studied by transvaginal ultrasonograph mass scoring, and by CDFI through pulsatility index (PI) and resistance index (RI) of peripheral blood flow of mass analyses. Results Mass ultrasonic scoring : scoring >9, 91.9% masses were malignant tumors. Scoring ≤<9, 91.5% masses were benign tumors. PI and Rl of peripheral blood flow of masses were detected by CDFI: Pl< 1 .0 . 92.5% cases; RI<0.5, 97.4% cases were malignant tumors. The diagnosis match rate of malignant ovarian tumors was 97.0% . The diagnosis match rate of benign ovarian tumor was 96 .2% . The diagnosis match rate was improved. Conclusion Ovarian mass ultrasonic scoring>9 and PI< 1 .0 , RI<0 .5 of mass peripheral blood flow are the special ultrasonic features of malignant ovarian tumor and the better methods to distinguish the benign ovarian tumor from the malignant one.
