AIM:To investigate the sonographic features and diagnostic value of endoscopic ultrasonography (EUS) for duodenal lipomas (DLs).METHODS:A total of eight consecutive patients with DL diagnosed pathologically were inclu...AIM:To investigate the sonographic features and diagnostic value of endoscopic ultrasonography (EUS) for duodenal lipomas (DLs).METHODS:A total of eight consecutive patients with DL diagnosed pathologically were included in the study.One EUS expert reviewed the ultrasonic images for all lesions,including the original layer of the duodenal wall,the echo intensity and the echo homogeneity.The size of the lesions and the perifocal structures were also investigated.The diagnosis by EUS was compared with the histological results.RESULTS:Using routine endoscopy,only one case was correctly diagnosed as DL.Four cases were classified as submucosal tumors,and three cases were mistaken for stromal tumors.All tumors appeared as round or oval intensive hyperechoic lesions with distinct anterior borders that originated from the submucosal layer on EUS.Tumors ranged from 8 to 36 mm in size,with an average size of 16 mm.Homogeneous echogenicity was seen in all cases except one that had a tubular structure inside the tumor.Echo attenuation was observed only in the area behind the tumors in five cases,and it was observed both inside and behind the tumors in three cases in which the posterior border was obscure or invisible.Seven (87.5%) cases were correctly diagnosed as DL,and one (12.5%) was mistaken as Brunner's gland adenoma by EUS.Pathologically,all tumors originated from the submucosal layer and consisted of mature fat cells without heteromorphism.Among the fat cells,there was a small amount of thick-wall vessels infiltrating the lymphocytes,and abundant fibrous connective tissues.CONCLUSION:On EUS,DL is featured as an intensive homogeneous hyperechoic submucosal lesion with marked echo attenuation and without involvement of the mucosa.展开更多
Color Doppler flow imaging(CDFI) was performed in 24 patients with Graves' disease and the results were compared with those from 8 patients with Hashimoto's disease, 6 patients with simple diffuse goiter, and ...Color Doppler flow imaging(CDFI) was performed in 24 patients with Graves' disease and the results were compared with those from 8 patients with Hashimoto's disease, 6 patients with simple diffuse goiter, and 15 normal volunteers. All cases were confirmed by clinical, laboratory tests or pathology. CDFI of Graves' disease showed diffuse or localized hypoechoes within the thyroid glands, rich flow signals in the hypoechoes, accelerated flow velocity, and decreased resistance in the superior thyroid arteries(STA) and arteries within the glands. These appearances were characteristic as compared with the controls. The rate of flow in STA of Graves' disease patients was 8 to 10 times higher than that in the normal volunteers. This study demonstrates that CDFI is convenient and efficient as compared with isotope scan and some other laboratory tests, and can be widely used in the diagnosis of Graves' disase.展开更多
Objective. To evaluate the diagnostic criteria for the localization of acquired arteriovenous fistulas (AVFs) by color Doppler flow imaging (CDFI) based on the features of their hemodynamic changes. Methods. The shape...Objective. To evaluate the diagnostic criteria for the localization of acquired arteriovenous fistulas (AVFs) by color Doppler flow imaging (CDFI) based on the features of their hemodynamic changes. Methods. The shape and hemodynamic changes of involved vessels which could be helpful to localize the sites of fistulas were studied according to the observation of 10 cases of acquired AVFs. Results. The sites of the fistulas could be shown by two dimensional ultrasonography and color flow imaging in 40%and 80%cases, respectively. In all cases, turbulent high velocity flow was present at the sites of the fistulas, low resistant flow was present in the arteries proximal to the fistulas, and artery like flow was detected in the veins. Conclusion. CDFI was accurate for the localization of acquired AVFs, which were mainly localized by their hemodynamic changes shown by pulse Doppler ultrasound.展开更多
Objective To analyze the clinical and ultrasonographic imaging features of intraductal papillary mutinous neoplasm （1PMN） of the pancreas. Methods Twelve patients with IPMN underwent surgery between May 2005 and De...Objective To analyze the clinical and ultrasonographic imaging features of intraductal papillary mutinous neoplasm （1PMN） of the pancreas. Methods Twelve patients with IPMN underwent surgery between May 2005 and December 2008, including 4 （33.3%） with adenoma and 8 （66.7%） with adenocarcinoma. IPMN was classified preoperatively into 3 types based on sonographic findings of different sites： main duct, branch duct, and combined type. All clinical presentations and ultrasonographic findings of those paticnts were reviewed and the correlation be- tween ultrasonographic hndings and histopathological results was analyzed. Results There were 9 men and 3 women with a mean age of 60.1±9.6 years （range, 32-73）. OF all the 12 patients with IPMN, 9 （75.0%） had experienced some symptoms of epigastric discomfort and/or pain as cell as backache; 7 cases were with medical history of acute pancreatitis, 5 cases with diabetes, 4 cases with elevated CA19-9, and 2 cases with steatorrhea. All lesions of IPMN have been revealed by transabdominal ul- trasonography. The mean diameters of the lesions were 1.4±0.8 cm （range, 0.5-2.0） and 6.3±6.0 cm （range, 2.0-20.0） in adenomas and adenocarcinomas, respectively. And the mean diameters of the main duct in adelnomas and adenocarcinomas were 1.0±0.8 cm and 1.6±1.0 cm, respectively. Among the 4 adnomas, 3 （75.0%） cases were classified as branch type based on sonographic findings, and 2 were demonstrated as mural nodules in which no color signals was detected. Among the 8 adenocarcinomas, 5 （62.5%） cases were classifled as main duct type, and 3 （37.5%） as combined type. In 7 of the 8 adcnocarcinomas, mural nodules were detected within the dilated ducts or cysts of the lesions in which color flow signals were detected. Conclusions Transabdominal ultrasonography can reveal the pancreatic cystic lesions of IPMN as well as dilated pancreatic： ducts. Some characteristics should be noticed as suggesting the possibility of malignancy： clinical symptoms of pancreatic insufficiency, large tumor size, and mural nodules with color Doppler flow signals. Transabdominal ultrasonography could be a useful tool to help diagnose and make appropriate management of IPMN.展开更多
基金Supported by Medical and Health Research Fund of Zhejiang Province,China,No. 491010-W10495
文摘AIM:To investigate the sonographic features and diagnostic value of endoscopic ultrasonography (EUS) for duodenal lipomas (DLs).METHODS:A total of eight consecutive patients with DL diagnosed pathologically were included in the study.One EUS expert reviewed the ultrasonic images for all lesions,including the original layer of the duodenal wall,the echo intensity and the echo homogeneity.The size of the lesions and the perifocal structures were also investigated.The diagnosis by EUS was compared with the histological results.RESULTS:Using routine endoscopy,only one case was correctly diagnosed as DL.Four cases were classified as submucosal tumors,and three cases were mistaken for stromal tumors.All tumors appeared as round or oval intensive hyperechoic lesions with distinct anterior borders that originated from the submucosal layer on EUS.Tumors ranged from 8 to 36 mm in size,with an average size of 16 mm.Homogeneous echogenicity was seen in all cases except one that had a tubular structure inside the tumor.Echo attenuation was observed only in the area behind the tumors in five cases,and it was observed both inside and behind the tumors in three cases in which the posterior border was obscure or invisible.Seven (87.5%) cases were correctly diagnosed as DL,and one (12.5%) was mistaken as Brunner's gland adenoma by EUS.Pathologically,all tumors originated from the submucosal layer and consisted of mature fat cells without heteromorphism.Among the fat cells,there was a small amount of thick-wall vessels infiltrating the lymphocytes,and abundant fibrous connective tissues.CONCLUSION:On EUS,DL is featured as an intensive homogeneous hyperechoic submucosal lesion with marked echo attenuation and without involvement of the mucosa.
文摘Color Doppler flow imaging(CDFI) was performed in 24 patients with Graves' disease and the results were compared with those from 8 patients with Hashimoto's disease, 6 patients with simple diffuse goiter, and 15 normal volunteers. All cases were confirmed by clinical, laboratory tests or pathology. CDFI of Graves' disease showed diffuse or localized hypoechoes within the thyroid glands, rich flow signals in the hypoechoes, accelerated flow velocity, and decreased resistance in the superior thyroid arteries(STA) and arteries within the glands. These appearances were characteristic as compared with the controls. The rate of flow in STA of Graves' disease patients was 8 to 10 times higher than that in the normal volunteers. This study demonstrates that CDFI is convenient and efficient as compared with isotope scan and some other laboratory tests, and can be widely used in the diagnosis of Graves' disase.
文摘Objective. To evaluate the diagnostic criteria for the localization of acquired arteriovenous fistulas (AVFs) by color Doppler flow imaging (CDFI) based on the features of their hemodynamic changes. Methods. The shape and hemodynamic changes of involved vessels which could be helpful to localize the sites of fistulas were studied according to the observation of 10 cases of acquired AVFs. Results. The sites of the fistulas could be shown by two dimensional ultrasonography and color flow imaging in 40%and 80%cases, respectively. In all cases, turbulent high velocity flow was present at the sites of the fistulas, low resistant flow was present in the arteries proximal to the fistulas, and artery like flow was detected in the veins. Conclusion. CDFI was accurate for the localization of acquired AVFs, which were mainly localized by their hemodynamic changes shown by pulse Doppler ultrasound.
文摘Objective To analyze the clinical and ultrasonographic imaging features of intraductal papillary mutinous neoplasm （1PMN） of the pancreas. Methods Twelve patients with IPMN underwent surgery between May 2005 and December 2008, including 4 （33.3%） with adenoma and 8 （66.7%） with adenocarcinoma. IPMN was classified preoperatively into 3 types based on sonographic findings of different sites： main duct, branch duct, and combined type. All clinical presentations and ultrasonographic findings of those paticnts were reviewed and the correlation be- tween ultrasonographic hndings and histopathological results was analyzed. Results There were 9 men and 3 women with a mean age of 60.1±9.6 years （range, 32-73）. OF all the 12 patients with IPMN, 9 （75.0%） had experienced some symptoms of epigastric discomfort and/or pain as cell as backache; 7 cases were with medical history of acute pancreatitis, 5 cases with diabetes, 4 cases with elevated CA19-9, and 2 cases with steatorrhea. All lesions of IPMN have been revealed by transabdominal ul- trasonography. The mean diameters of the lesions were 1.4±0.8 cm （range, 0.5-2.0） and 6.3±6.0 cm （range, 2.0-20.0） in adenomas and adenocarcinomas, respectively. And the mean diameters of the main duct in adelnomas and adenocarcinomas were 1.0±0.8 cm and 1.6±1.0 cm, respectively. Among the 4 adnomas, 3 （75.0%） cases were classified as branch type based on sonographic findings, and 2 were demonstrated as mural nodules in which no color signals was detected. Among the 8 adenocarcinomas, 5 （62.5%） cases were classifled as main duct type, and 3 （37.5%） as combined type. In 7 of the 8 adcnocarcinomas, mural nodules were detected within the dilated ducts or cysts of the lesions in which color flow signals were detected. Conclusions Transabdominal ultrasonography can reveal the pancreatic cystic lesions of IPMN as well as dilated pancreatic： ducts. Some characteristics should be noticed as suggesting the possibility of malignancy： clinical symptoms of pancreatic insufficiency, large tumor size, and mural nodules with color Doppler flow signals. Transabdominal ultrasonography could be a useful tool to help diagnose and make appropriate management of IPMN.
