用声诺维超声造影检查诊断输卵管堵塞的准确性评价

目的 :探讨用声诺维超声造影检查诊断输卵管堵塞的准确性。方法 :对近年来在我院就诊的40例输卵管堵塞患者(共有80条输卵管发生堵塞)的临床资料进行回顾性研究。这40例患者的病情均经手术探查被确诊为输卵管堵塞。我们将这40例患者随机分为声诺维组和双氧水组,每组各有20例患者。我院对声诺维组患者进行了声诺维超声造影检查,对双氧水组患者进行了双氧水超声造影检查,然后对比两组患者检查结果的准确性和不良反应的发生率。结果 :声诺维组患者检查结果的准确率明显高于双氧水组患者,其不良反应的发生率明显低于双氧水组患者,二者相比差异具有显著性(P<0.05)。结论 :用声诺维超声造影检查诊断输卵管堵塞具有准确率高和安全性好的优点。此检查方法可作为临床上诊断输卵管堵塞的优选方法。

Non-thermal ablation of rabbit liver VX2 tumor by pulsed high intensity focused ultrasound with ultrasound contrast agent:Pathological characteristics

AIM： To investigate the pathological characteristics of non-thermal damage induced by pulsed high intensity focused ultrasound （PHIFU） combined with ultrasound contrast agent （UCA）, SonoVue （Bracco SpA, Milan, Italy） in rabbit liver VX2 tumor. METHODS： Liver VX2 tumor models were established in 20 rabbits, which were divided randomly into PHIFU combined with ultrasound contrast agent group （PHIFU ＋ UCA group） and sham group. In the PHIFU ＋ UCA group, 0.2 mL of SonoVue was injected intravenously into the tumor, followed by ultrasound exposure of Isp 5900 W/cm^2. The rabbits were sacrificed one day after ultrasound exposure. Specimens of the exposed tumor tissues were obtained and observed pathologically under light microscope and transmission electron microscope. The remaining tumor tissues were sent for 2,3,5-Triphenyltetrazolium chloride （TTC） staining. RESULTS： Before Trc staining, tumor tissues in both the sham and the PHIFU ＋ UCA groups resembled gray fish meat, After TIC staining, the tumor tissues were uniformly stained red, with a clear boundary between tumor tissue and normal tissue, Histological examination showed signs of tumor cell injury in PHIFU ＋ UCA group, with cytoplasmic vacuoles of various sizes, chromatin margination and karyopyknosis. Electron microscopic examination revealed tumor cell volume reduction, karyopyknosis, chromatin margination, intercellular space widening, the presence of high electro＇n-density apoptotic bodies and vacuoles in cytoplasm. CONCLUSION： The non-thermal effects of PHIFU combined with UCA can be used to ablate rabbit liver VX2 tumors.

A case of eosinophilic cholangitis:Imaging findings ofcontrast-enhanced ultrasonography, cholangioscopy, andintraductal ultrasonography

A 38-year-old woman was referred to our institution due to epigastralgia. She presented with obstructive jaundice and eosinophilia. Endoscopic retrograde cholangiopancreatography showed diffuse narrowing from the distal common bile duct to the bifurcation of the hepatic ducts. An endoscopic plastic biliary stent was inserted; the specimen obtained from the common bile duct wall revealed dense infiltration by eosinophils. Treatment was started with prednisolone 60 mg daily. The patient's biliary stenosis and eosinophilia gradually improved. Eosinophilic infiltration in the lungs or stomach is relatively common, but it is rare in the common bile duct. Most of the reported cases of eosinophilic cholangitis presented with eosinophilia; our patient's eosinophil count was over 1000/mm3. Since our patient had allergies to pollen and house dust, a relationship between the allergies and the eosinophilic cholangitis was suspected, but no cause was identified.

CHARACTERISTICS OF TWO－DIMENSIONAL AND COLOR DOPPLER ULTRASONOGRAPHY IN GRAVES＇DISEASE

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.

Role of acoustic interface layer during high intensity focused ultrasound therapeutics

After interface layer was simulated by the magnetic nano-particles in the egg white phantom, high intensity focused ultrasound （HIFU） at the same dosage was introduced to radiate the phantom in different depths to blow the acoustic interface layer to mimic ＂point＂ exposure. The results showed that the volumes of biological focal region （BFR） were enlarged when the acoustic focal region （AFR） is close with interface layer. This meant that the magnetic nano-particles enhanced the therapeutic efficiency of HIFU. When the distance of the AFR from the interface layer was 10 mm, the size and shape of the BFR were similar with those of the control group, but a larger lesion at the interface, which was harmful for treatment, was observed. When the distance of the AFR to the interface layer increased to 30 mm, the size and shape of the BFR were also similar to those of the control group. When the thickness of the interface layer diminished, the utility of enhancement decreased. Continuous increase of the safe area for treatment and decrease of the utility of enhancement were observed along with the abatement of the thickness of the interface layer

The ultrasound diagnosis of fetal gastric teratoma

Objective: The aim of the study was to discuss the value of ultrasound examination in the diagnosis of fetal gastric teratoma. Methods: We retrospectively analyzed 2 cases with fetal gastric teratoma in our hospital (Department of Gynecology and Obstetrics, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China). It involved clinical, ultrasonic, X-ray, CT and MRI, biochemical, pathological, karyotype and immunohistochemical data. Results: There both were hybrid echo masses in the abdominal of the fetus with the sonography and the ultrasound features which mostly like the teratomas. Two cases were dead after induced abortion. The pathological results of the mass were gastric immature teratoma in one, and stomach mature teratoma in another. Conclusion: Fetal gastric teratoma is rarely seen and easily be misdiagnosed in clinic. The diagnosis depends finally on pathological examination. Ultrasound scan as the easy and direct method is helpful to clew the diagnosis of fetal gastric teratoma.

Experimental system for perfusion imaging and time-intensity processing based on ultrasound contrast agent

Objective： To present a self-developed experimental system for basic studies of blood perfusion imaging and time-intensity evaluating based on ultrasound contrast agent. Methods ： The experimental system performed the image reconstruction and time-intensity processing with radio frequency signals. The system was comprised of ultra-high speed hardware data acquisition interface and low computational cost algorithms. The self-made contrast agent ,blood mimic phantom and capillary phantom model were used to validate the experimental system. Results： The images acquired in blood phantoms with linear-array and curve-array transducers were given. The time-intensity curves corresponding to selected region of interestsequence were demonstrated. It was also shown the time-intensity based decay curves and a decay of ultrasound contrast agent under different ultrasound powers. Conclusion： Several suited from two in vitro phantom models show that the experimental system can be used to f blood perfusion and further clinical studies of microvasculature perfusion.

Role of echo Doppler ultrasonography in the evaluation of postprandial hyperemia in cirrhotic patients

AIM: To assess the role of echo-Doppler ultrasonography in postprandial hyperemia in cirrhotic patients by comparing the results with the hepatic vein catheterization technique.METHODS: Patients with cirrhosis, admitted to the portal hemodynamic laboratory were included into the study. After an overnight fast, echo-Doppler ultrasonography (basal and 30 min after a standard meal) and hemodynamic studies by hepatic vein catheterization (basal, 15 min and 30 min after a standard meal) were performed. Ensure Plus (Abbot Laboratories, North Chicago, IL) was used as the standard liquid meal. Correlation analysis of the echo-Doppler and hepatic vein catheterization measurements were done for the basal and postprandial periods.RESULTS: Eleven patients with cirrhosis (5 Child A, 4 Child B, 2 Child C) were enrolled into the study. After the standard meal, 8 of the 11 patients showed postprandial hyperemia with increase in portal blood flow, portal blood velocity and hepatic venous pressure gradient. Hepatic venous pressure gradient in the postprandial period correlated positively with postprandial portal blood velocity (r = 0.8, P < 0.05) and correlated inversely with postprandial superior mesenteric artery pulsatility index (r = -1, P < 0.01).CONCLUSION: Postprandial hyperemia can be efficiently measured by echo-Doppler ultrasonography and the results are comparable to those obtained with the hemodynamic studies.

EVALUATION OF THE DIAGNOSTIC CRITERIA FOR THE LOCALIZATION OF ACQUIRED ARTERIOVENOUS FISTULAS BY COLOR DOPPLER FLOW IMAGING

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.

Microbubble ultrasound contrast agent with three esters and carboxylic methyl cellulose as main shell materials: Its preparation and imaging evaluation

Objective: To study on the preparation process of a new surfactant-based microbubble ultrasound contrast agent and to evaluate its contrast effects in vivo. Methods: Microbubble ultrasound contrast agent with three ester surfactants and other additives as its shell materials was prepared by sonication. Sulfur hexafluoride was adopted as the inner gas of the microbubbles. New methods through the combination of optical microscope and some softwares were used to measure the size distribution and the concentration of the microbubbles. Some parameters such as the pH value of the phosphate buffer, quantity of the carboxylic methyl cellulose in the shell materials, selection of the ultrasound power and process time, were studied. Six hybirded dogs were used to verify the in vivo contrast imaging of the contrast agent using second harmonic power Doppler modality. Safety and persistent time of the agent inner animal body were also investigated. Results: Ultrasound contrast agent prepared in the experiment had an average microbubble diameter of 3.95 microns with concentration of 3.6×109 microbubbles per millilitre. Carboxylic methyl cellulose was found as an important shell material which had obviously effect on the microbubble stability and production even with a little quantity. The buffer pH value also had a key role on the microbubble formation and the final production. When the buffer pH value reached 7.4, there was no microbubble produced. Under the approximate microbubble production, process time could be shorten with the increasing ultrasound power. The obvious ultrasound contrast imaging effects were detected in the dog's heart chamber and liver as well as kidney using only one millilitre agent when diluted. The agent was found safe to the dogs. At the same time, persistent time of the agent was found over 20 min in the dog's body. Conclusion: The new ultrasound contrast agent prepared in the experiment has high microbubble production and concentration, narrow microbubble size distribution ranging in several microns, well stability, little dosage needed in the contrast, well safety to the dogs and long persistent time, obvious contrast imaging effect in the dog's heart chamber, kidney and liver. These experiment data indicate that the new ultrasound contrast agent with three ester surfactants and carboxylic methyl cellulose as its main shell materials can be further developed for clinical purposes.

Application of ultrasound in the diagnosis of clinical anesthesia

During the past 10 years, the rapid development of ultrasound technology in clinical anesthesia has become one of the hot clinical researches. Researches in this area home and abroad also made great progress. On the one hand due to improved high-resolution portable ultrasound instrument and probe technology, ultrasound changed from a purely clinical diagnostic into the operating room; on the other hand, with the traditional method of anesthesia increasingly unable to meet the clinical requirements, it is an objective need of technological innovation for clinical anesthesia. And ultrasound has non-invasive, real-time, visible and repeatable characteristics which are able to provide accurate data and rich means for preoperative assessment, intraoperative monitoring and treatment of pain in pre-clinical anesthesia

Acupuncture Effects on Endocranial Hemodynamics of Patients with Takayasus Arteritis （Brachiocephalic Artery Type）

Objective： To discuss the action mechanisms of Takayasus arteritis （brachiocephalic artery type） of acupuncture. Methods： We applied acupuncture therapy with the principle of “warming Yang and supplementing Qi, removing obstruction in the meridians and recovering pulse”, to treat patients with takayasus arteritis （brachiocephalic artery type）. Before and after treatment, we detected the TCD （Transcranial Doppler） changes of the average velocity of blood flow （AVBF） and arterial pulsatility index （PI） of related arteris. Results： After treatment, acupuncture and moxibustion can regulate the abnormal blood flow rate in endocranial correlated arteries by two sides, in the AVBF while, elevate the elasticity of endocranial vessels. Conclusion： Acupuncture and moxibustion can regulate cerebrovascular function of patients with takayasus arteritis （brachiocephalic artery type）, increase the perfusion of cerebral blood flow, and adjust abnormal state of endocranial hemodynamics. This is possibly the important action mechanisms acupuncture in treating this disorder.