To characterize features of organized hematoma (OH) that may cause considerable diagnostic difficulties.Case series with chart review.Tertiary medical center.Eighty-four patients with pathologically confirmed OH over a 10-year period were retrospectively reviewed for clinical features, imaging findings, pathologic characteristics, and treatment modalities.This study included 39 males and 45 females who presented with frequent epistaxis and nasal obstruction. There were 62 (74%) patients >40 years old (mean, 50; range, 9-81). OH mainly originated in the maxillary sinus (n = 82) or nasal cavity (n = 2) unilaterally, and most were expansile masses (n = 73) that extended into nasal cavity (n = 71) or choanae (n = 17). Several lesions were locally aggressive and simulated a malignant process that involved the ethmoid sinus (n = 22), orbit (n = 11), pterygopalatine fossa (n = 16), infratemporal fossa (n = 9), cheek (n = 3), and hard palate (n = 3). Internal architecture on computed tomography (CT) scans showed OH with expansile remodeling of the maxillary wall (82.1%) and smooth bony destruction (70.2%), whereas T2-weighted magnetic resonance (MR) images showed inhomogeneity with a notable hypointense peripheral rim in all lesions. CT and MR contrast-enhanced images revealed patchy heterogeneous enhancement that could be interpreted according to histopathologic findings of hemorrhage and neovascularization. OH was successfully removed with endoscopic surgery, although 5 cases recurred.OH can be successfully treated by endoscopic surgery. CT and MR examination provide characteristic findings for prediction and careful surgical planning.
[Objective] To observe the effect of enhanced ultrasonography on normal rabbit abdominal aorta rising self-made perfluorocarbon ultrasound contrast agent arid the time-intensity curve changes by different injection methods. [Methods] Self-made contrast agent was injected via rabbit ear vein at a dose of 0.5mL/kg, real-time abdominal aorta enhancement was observed by conventional imaging, and changes of time-intensity curves were quantitatively analyzed rising triggered imaging by bolus injection and infusion (0.1mL/s). [Results] Gray-scale and Doppler signal of abdominal aorta were significantly enhanced by contrast agent. Peak intensity and descending slope were much increased by bolos compared with by infusion, but mean transit time was reduced (P＜0.001); while mean transit time was longer using infusion (P＜0.001). [Conclusion] Self-made perfluorocarbon ultrasound contrast agent can significantly enhance blood flow display, it is importance to choice ideal injection method according to checking aim to improve the effect of enhanced ultrasonography.
Objective
To investigate the renal cortical perfusion parameters assessed by contrast-enhanced ultrasound(CEUS)in elderly patients with moderate-to-severe renal artery stenosis(RAS), and relationship of those with glomerular filtration rate(GFR).
Methods
A total of 59 elderly patients with unilateral moderate to severe RAS(50%-99%)admitted into Beijing Hospital during June 2017 to December 2018 were consecutively enrolled in the cross-sectional and self-control study.Based on the GFR assessed by radionuclide renal dynamic imaging, patients were divided into the mild-(35>GFR≥25 ml/min, n=18), moderate-(25>GFR≥15 ml/min, n=37)and severe renal dysfunction(GFR<15 ml·min-1, n=4)groups.CEUS evaluated-renal cortical perfusion parameters, including area under curve(AUC), ascending slope(A), derived peak intensity(DPI), time to peak(TTP)and mean transit time(MTT), were compared among different levels of severity of renal dysfunction groups.Pearson correlation analysis was used to evaluate the relationship between CEUS imaging-evaluated renal cortical perfusion parameters and radionuclide renal dynamic imaging-assessed GFR.
Results
Compared with the mild renal dysfunction group, the moderate renal dysfunction group showed a reduced AUC and A(P<0.05), and the severe renal dysfunction group showed more markedly reduced AUC, A, DPI, TTP and MTT(P<0.05). Compared with the moderate renal dysfunction group, the severe renal dysfunction group showed a reduced AUC, A and GFR(P<0.05), while no significant differences in TTP and MTT were found.As far as relationship between renal cortical perfusion parameters and GFR were concerned, Pearson correlation analysis demonstrated that AUC(r=0.804), A(r=0.813)and DPI(r=0.733)were significantly and positively correlated with GFR(all P<0.05). However, renal function(r=-0.721), TTP(r=-0.744)and MTT(r=-0.743)were negatively correlated with GFR(P<0.05). And the degree of renal artery stenosis was poorly correlated with GFR(r=-0.462).
Conclusions
For elderly patients with unilateral moderate to severe RAS, contrast-enhanced ultrasonography can display the changes of renal cortical blood perfusion parameters along with the aggravation of renal function impairment.AUC and A are strongly positively correlated with GFR.The degree of renal artery stenosis is poorly correlated with renal function.And more studies are needed to confirm these findings.
Key words:
Renal artery obstruction; Ultrasonography; Glomerular filtration rate
To investigate the value of high frequency and color Doppler ultrasonography in detection of synovitis and the intra-articular vascularization in the knee joint of patients with newly-diagnosed rheumatoid arthritis (RA).Forty-one patients (30 women, 11 men) with newly-diagnosed RA were recruited to a cross sectional study (RA group). Forty-one age and gender-matched healthy volunteers were used as control group. The thickness of hydatid fluid, synovium hyperplasia, color flow imaging, peak systolic velocity (PSV), end diastolic velocity (EDV), resistance index (RI), venous blood flow and intra-articular perfusion were evaluated by high frequency and color Doppler ultrasonography.Totally 91.46% knee joints with synovial hyperplasia (> 2 mm) were found in 41 patients with RA (75/82 knee joints), and the thickness of the synovial membrane was 2.2 - 19.7 mm (average 6.3 ± 3.4 mm). In aspect of blood flow, the percentage of 0 to 3 grade were 18.67% (14/75), 29.33% (22/75), 45.33% (34/75) and 6.67% (5/75), respectively; the results of arterial blood were indicated with PSV (10.82 ± 3.71 cm/s), EDV (3.86 ± 1.12 cm/s) and RI (0.61 ± 0.07), while the average of venous blood velocity was 2.72 ± 1.02 cm/s. Joint effusion was found in 69 joints (84.15%) with the anteroposterior diameter 2.4 - 16.1 mm (average 6.9 ± 3.2 mm). The thickness of synovial membrane was 1.2 - 1.8 mm (average 1.4 ± 0.4 mm) and no significant difference were observed in joint effusion, signal of blood flow and thickness of synovial membrane in the control group.High frequency and power Doppler ultrasonography may be a valuable and optimal clinical tool to accurately and objectively detect synovial hyperplasia, vascular pannus formation and joint effusion in the knee joint of patients with RA.
Based on the ultrasonic imaging and endoscopic resection of the intelligent segmentation algorithm, this study is aimed at exploring whether nursing intervention can promote the good recovery of patients with colon polyps, hoping to find a new method for clinical treatment of the colon polyps. Patients with colon polyps were divided into an experimental group (fine nursing) and a control group (general nursing). The colonoscopy polyp ultrasound image was preprocessing to select the seed points and background points. The random walk decomposition algorithm was applied to calculate the probability of each marked point, and then, the marked image was outputted. The accuracy of the intelligent segmentation algorithm was 81%. The incidence of complications in the experimental group was 4.83%, which was lower than 16.66% in the control group, and the difference was statistically obvious (P < 0.05). Perioperative refined nursing intervention for colon polyp patients undergoing endoscopic electrosurgical resection can decrease postoperative adverse reactions; reduce postoperative mucosal perforation, blood in the stool, abdominal pain, and small bleeding; lower the incidence of postoperative complications; and allow patients to recover quickly, enhancing the life comfort of patient.
Objective To investigate the technical feasibility and clinical significance of non-vascular contrast-enhanced ultrasound(NVCEUS) in screening pyelogenie cyst out of simple renal cysts so as to avoid damage to the urinary tract from absolute ethanol while undergoing percutaneous aspiration and ethanol sclerotherapy(PAEST). Methods Following an inclusion criteria 23 patients with renal cysts were selected to receive NVCEUS scanning by means of administrating SonoVue contrast agents through puncture needle into their renal cyst lumen prior to the injection of absolute ethanol for sclerosing treatment. By the demonstration of hyperechoic contrast agents leaving from intra cyst into renal collecting system,a pyelogenic cyst was defined. The patients with this kind of cyst was not allowed for further ethanol sclerotherapy. Results NVCEUS made 3 patients with pyelogenic cyst resembling simple ones free from ethanol selerotherapy,and 4 patients suspicious of pyelogenic cyst due to weird cyst configuration remain in the list of simple cyst for further selerotherapy. Conclusions NVCEUS of renal cyst is highly capable of differentiating pyelogenie cyst from simple cyst and highly valuable in increasing the safety for the procedure of PAEST.
Key words:
Ultrasonography; Microbubbles; Kidney disease; Cysts
Objective
To explore the estimated value of color Doppler flow imaging (CDFI) in detecting the incidence of lower limb deep vein thrombosis (DVT) during perioperative period and follow-up phase in the elderly patients with orthopedic trauma.
Methods
Forty-five elderly patients undergoing orthopedic surgery in our hospital from January 2014 to July 2015 were retrospectively studied. They were diagnosed with lower limb DVT by CDFI. The CDFI manifestations on both thrombus formation time and location, the embolism degree and vessel recanalization were observed during perioperative period and 1 to 6 months after surgery.
Results
Among the 45 patients receiving ultrasonography screening, DVT developed in 6 (13.3%) patients within 7 days before surgery; DVT developed in 30 (66.7%) patients within 1-14 days 〔(6.03±2.57) days at average〕 postoperatively; and DVT developed in 7 (15.6%) patients within 3 days after surgery, with the earliest thrombosis detected at 1 day after surgery. DVT developed in 20.0%(9/45) patients within 2 months after discharge. Thrombus was more common in distal venous, which accounted for 82.2%(37/45). The highest occurrence rate of DVT was 64.4% (29/45) in calf muscular veins. And 1 to 6 months (3.42 ± 1.42)months follow-up study in 45 patients after surgery showed that the rate of vessel recanalization was 53.3%(24/45).
Conclusions
CDFI can earlier and effectively detect asymptomatic DVT, and is convenient for screening new or recurrent thrombus and vascular recanalization during bedside examination and dynamic monitoring periods. Ultrasonography provides reliable evidence for clinical early diagnosis, assessment of anticoagulate efficiency and can standard the treatment for elderly orthopedic trauma patients with low limb DVT.
Key words:
Ultrasonography; Wounds and injuries; Bones; Venous thrombosis
Objective To summarize the sonographic characteristics of parathyroid adenomas(PAs) and investigate the diagnostic values and best diagnostic thinking for an early detection. Methods Sixteen cases finally proved with PAs were retrospectively analyzed of their clinical complaints, the department for their initial consultation,indicative ultrasound findings for neck scanning, major manifestations of PAs on a series of three-mode ultrasound imagings,association of adenoma sizes to serum parathyroid hormone(PTH) levels. Results On multimode ultrasound images, the PAs were multidisciplinary morphologic, homogenously hypoeehoic,absent of calculus and necrosis,highly vascularized with color signals,and similar to thyroid in contrast agents perfusion. Serum PTH levels were elevated in accordance with increase of adenomas' size. Among the 16 cases 12 were defined as with parathyroid incidentalomas, to which liver or/ and kidney stones were contributed as indicatives. Conclusions High frequency ultrasound with multiple imaging modes are most suitable for scanning and detection of neck PAs. For those with stones in liver and urinary tracts, unknown bone fracture etc, ultrasound scanning of the neck parathyroids used to reveal latent PAs.
Key words:
Ultrasonography; Parathyroid neoplasms; Adenoma
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