Quantitative evaluation of benign meningioma and hemangiopericytoma with peritumoral brain edema by 64-slice CT perfusion imaging

Background Hemangiopericytomas （HPCs） have a relentless tendency for local recurrence and metastases,differentiating between benign meningiomas and HPCs before surgery is important for both treatment planning and the prognosis appraisal.The purpose of this study was to evaluate the correlations between CT perfusion parameters and microvessel density （MVD） in extra-axial tumors and the possible role of CT perfusion imaging in preoperatively differentiating benign meningiomas and HPCs.Methods Seventeen patients with benign meningiomas and peritumoral edema, 12 patients with HPCs and peritumoral edema underwent 64-slice CT perfusion imaging pre-operation.Perfusion was calculated using the Patlak method.The quantitative parameters, include cerebral blood volume （CBV）, permeability surface （PS） of parenchyma, peritumoral edema among benign meningiomas and HPCs were compared respectively.CBV and PS in parenchyma, peritumoral edema of benign meningiomas and HPCs were also compared to that of the contrallateral normal white matter respectively.The correlations between CBV, PS of tumoral parenchyma and MVD were examined.Results The value of CBV and PS in parenchyma of HPCs were significantly higher than that of benign meningiomas （P〈0.05）, while the values of CBV and PS in peritumoral edema of benign meningiomas and HPCs were not significantly different （P 〉0.05）.MVD in parenchyma of HPCs were significantly higher than that of benign meningiomas （P〈0.05）.There were positive correlations between CBV and MVD （r=0.648, P〈0.05）, PS and MVD （r=0.541, P〈0.05） respectively.Furthermore, the value of CBV and PS in parenchyma of benign meningiomas and HPCs were significantly higher than that of contrallateral normal white matter （P〈0.05）, the value of CBV in peritumoral edema of benign meningiomas and HPCs were significantly lower than that of contrallateral normal white matter （P〈0.05）, while the value of PS in peritumoral edema of benign meningiomas and HPCs were not significantly different with that of contrallateral normal white matter （P 〉0.05）.Conclusions CT perfusion imaging can provide critical information on the vascuiarity of HPC and benign meningiomas.Determination of maximal CBV and corresponding PS values in the parenchyma may be useful in the preoperative differentiating HPC from benign meningiomas.     

Hemodynamic Changes on Color Doppler Flow Imaging and Intravenous Contrast-enhanced Ultrasound for Assessing Transplanted Liver and Early Diagnosis of Complications

The value of color Doppler flow imaging （CDFI） and intravenous contrast-enhanced ultrasound （CEUS） for assessing the transplanted liver and early diagnosing complications by examining hemodynamic changes was discussed. Seventy-five patients with orthotopic liver transplantation （OLT） underwent CDFI. The following parameters were measured： peak systolic velocity （PS）, resistance index （RI） and Doppler perfusion index （DPI） of the hepatic artery （HA）, time average velocity （TAV） of portal vein （PV） and velocity of hepatic vein （HV） in different stages postoperation, And 11 patients of them received CEUS. Thirty healthy subjects were enrolled as controls, The results showed that： （1） In 23 patients without obvious complications, TAV of PV within 15 days post-operation was significantly higher than in controls （P〈0.05）, PS and DPI of HA within 7 days postoperation were lower, but RI was higher than in controls （P〈0.05）; （2） When the hepatic artery thrombosis （HAT） occurred, PS and DPI of HA were obviously decreased, but TAV of PV significantly increased like a high saw-tooth wave; （3） While rejection occurred, both TAV of PV and PS of HA were decreased with the increase in RI of HA, and the triphasic wave of HV disappeared and displayed as saw-tooth wave; （4） The incidence of biliary complications in liver transplantation was increased when DPI was reduced; （5） Seven cases of hepatic carcinoma relapse after OLT demonstrated hyperecho in the arterial phase and hypoecho in the portal and later phase on CEUS; （6） In 2 cases of HA thrombus, there was no visualized enhancement in arterial phase of CEUS, but enhancement during the portal vein and parenchymal phase. It was concluded that the hemodynamic changes of PV, HA and HV in the transplanted liver are valuable for assessing the transplanted liver and early diagnosing complications on CDFI and CEUS.     

Preliminary Application of WCX Magnetic Bead-Based Matrix-Assisted Laser Desorption Ionization Time-of-Flight Mass Spectrometry in Analyzing the Urine of Renal Clear Cell Carcinoma

Objective To evaluate the application of weak cation exchange (WCX) magnetic bead-based Matrix-Assisted Laser Desorption Ionization Time-of-Flight Mass Spectrometry (MALDI-TOF MS) in detecting differentially expressed proteins in the urine of renal clear cell carcinoma (RCCC) and its value in the early diagnosis of RCCC. Methods Eleven newly diagnosed patients (10 males and 1 female, aged 46-78, mean 63 years) of renal clear cell carcinoma by biopsy and 10 healthy volunteers (all males, aged 25-32, mean 29.7 years) were enrolled in this study. Urine samples of the RCCC patients and healthy controls were collected in the morning. Weak cation exchange (WCX) bead-based MALDI-TOF MS technique was applied in detecting differential protein peaks in the urine of RCCC. ClinProTools2.2 software was utilized to determine the characteristic proteins in the urine of RCCC patients for the predictive model of RCCC. Results The technique identified 160 protein peaks in the urine that were different between RCCC patients and health controls; and among them, there was one peak (molecular weight of 2221.71 Da) with statistical significance (P=0.0304). With genetic algorithms and the support vector machine, we screened out 13 characteristic protein peaks for the predictive model. Conclusions The application of WCX magnetic bead-based MALDI-TOF MS in detecting differentially expressed proteins in urine may have potential value for the early diagnosis of RCCC.     

Evaluation with low-dose dual-phase helical computed tomography of patients with thyroid lesions

Background The incidence of thyroid cancer has been increasing.Our aim was to evaluate the efficacy of low-dose dualphase helical computed tomography （CT） in the characterization of thyroid lesions,and to discuss the relationship between image characteristics and their pathology.Methods One hundred and six patients with thyroid lesions underwent low-dose dual-phase helical CT after the injection of contrast material.CT scans were obtained at arterial and venous phase with delays of 25 and 65 seconds,and tube current of 60 and 120 mA,respectively.The attenuation change in the lesion between the arterial and venous phase was analyzed and categorized as ＂increased,＂ ＂decreased,＂ ＂mixed＂ or ＂no change.＂ Results Histopathologic diagnosis was obtained by surgery in 106 patients （115 lesions）.Of the 106 patients,45 had nodular goiter,5 thyroid adenoma,6 thyroiditis,and 50 papillary thyroid carcinoma （PTC） （59 lesions）.The attenuation value showed a significant difference （P ＜0.05） between the arterial and venous phase for the high attenuation area.There was statistical significant difference in terms of attenuation value in high attenuation areas at both phases and in low attenuation areas on arterial phase between nodular goiter and PTC （P ＜0.05）.However,there was no significant difference in attenuation value between adenoma and PTC.Twenty-nine cases （76.3％） of goiter manifested mixed type,3 cases （3/5） of adenoma showed decreased type,6 cases （6/6） of thyroiditis showed increased type,and 55 cases （93.2％） of PTC showed decreased type attenuation.The sensitivity,specificity for thyroid carcinoma by dual-phase CT were 94.9％ and 80.4％ respectively.The overall diagnostic accuracy for thyroid lesions by dual-phase CT was 87.8％.Conclusions The performance of dual-phase helical CT is related to the pathological structure of the lesions.The analysis of enhancement patterns by using dual-phase helical CT will be helpful in the differential diagnosis of thyr     

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.     

Impact of microbubble enhanced, pulsed, focused ultrasound on tumor circulation of subcutaneous VX2 cancer

Background Intravascular microbubble-enhanced acoustic cavitation is capable of disrupting the vascular walls of capillaries and small vessels. This study was designed to investigate the impact of microbubble-enhanced, pulsed and focused ultrasound （MEUS） on the blood perfusion of subcutaneous VX2 tumors in rabbits. Methods Subcutaneous VX2 cancers in twenty New Zealand rabbits were treated by combining high-pressure amplitude, pulsed and focused therapeutic ultrasound （TUS） and intravenous microbubble injections. The TUS transducer was operated with a peak negative pressure of 4.6 MPa and a duty cycle of 0.41%. Controls were subcutaneous VX2 cancers treated with TUS or microbubbles only. Contrast-enhanced ultrasound （CEUS） and intravenous Evans Blue （EB） perfusion were performed to assess the tumor circulation. The tumor microvascular disruption was assessed by histological examination. Results CEUS showed that the tumor circulation almost vanished after MEUS treatment. The average peak grayscale value （GSV） of tumor CEUS dropped significantly from 84.1±22.4 to 15.8±10.8 in the MEUS-treated tumors but no significant GSV changes were found in tumors in the two control groups. The mean tumor EB content of the MEUS-treated tumors was significantly lower than that of the controls. Histological examination found scattered tumor microvascular disruption with intercellular edema after MEUS treatment. Conclusion The tumor circulation of VX2 cancers can be arrested or significantly reduced by MEUS due to microvascular disruption. Chin M~.cl ,I 2014：127 （14）： 2605-2611     

Quantitative analysis of myocaridal perfusion in rabbits by tansthoracic real-time myocardial contrast echocardiography

To evaluate the feasibility of real-time myocardial contrast echocardiography （RTMCE） by quantitative analysis of myocardial perfusion in rabbits, transthoracic RTMCE was performed in 10 healthy rabbits by using continuous infusion of SonoVue into the auricular vein. The short axis view at the papillary muscle level was obtained. The duration of the time that the contrast took to appear in right heart, left heart and myocardium was recorded. The regional myocardial signal intensity （SI） versus re-filling time plots were fitted to an exponential function： y（t） =A（1–e–β（t–t0）） ＋ C, where y is SI at any given time, A is the SI plateau that reflects myocardial blood volume, and β is the slope of the refilling curve that reflects myocardial microbubble velocity. The A, β and A×β values at different infusion rate of SonoVue were analyzed and the A, β and A×β values in each segment in the short axis view at the papillary muscle level were compared. All the animal experiments were successful and high-quality im-ages were obtained. The best intravenous infusion rate for SonoVue was 30 mL/h. The contrast appeared in right heart, left heart and myocardium at 7.5±2.2 s, 9.1±2.4 s and 12.2±1.6 s respectively. After 16.6±2.3s, myocardial opacification reached a steady state. The mean A, β and A×β value in the short axis view at the papillary muscle level were 9.8±3.0 dB, 1.4±0.5 s-1 and 13.5±3.6 dB×s-1 respectively. A, β and A×β values showed no significant differences among 6 segments. It was suggested that RTMCE was feasible for quantitative analysis of myocardial perfusion in rabbits. It provides a non-invasive method to evaluate the myocardial perfusion in rabbit disease models.     

Analysis of Pathological data of renal biopsy at one single center in China from 1987 to 2012

Background In China,the prevalence of chronic kidney disease has increased significantly.Many studies shows that the spectrum of kidney disease had changed in recent years.We retrospectively analyzed the pathological types of renal biopsy and its spectrum change at the General Hospital of the Chinese People＇s Liberation Army from December 1987 to December 2012,in order to offer new supporting evidences for further specifying the distribution of renal pathological types in China.Methods According to the ＂Revised Protocol for the Histological Typing of Glomerulopathy＂ （WHO,1995）,pathological diagnosis of renal biopsy was classified,detection rate of each pathological type was summarized （i.e.,percentage of total renal biopsy cases）,study period was divided at an interval of 5 years,and age-stratified distribution change of main pathological types was analyzed.Results The proportion of pathological types in 11 618 cases of renal biopsy was as follows：primary glomerulonephritis （PGN,70.7％）,secondary glomerulonephritis （SGN,20.7％）,tubular-interstitial nephropathy （4.0％）,hereditary/rare nephropathy （0.3％）,end-stage renal disease （0.9％）,and unclassified renal disease （3.3％）.Among PGN,there was IgA nephropathy （IgAN,37.0％）,membranous nephropathy （MN,11.8％）,mesangial proliferative glomerulonephritis （MsPGN,8.9％）,minimal change disease （MCD,6.6％）,and focal segmental glomerulosclerosis （3.9％）.Among SGN there was lupus nephritis （LN,5.5％）,Henoch-Sch（o）nlein purpura glomerulonephritis （5.3％）,hepatitis B virus-associated nephritis （HBVAN,3.03％）,diabetic nephropathy （2.2％）,and hypertension/malignant hypertension-associated renal damage （1.9％）.Pathological data were analyzed from 1987-1992 to 2008-2012 （after age adjustment）.Detection rate of IgAN tended to rise （P ＜0.001）.Detection rates of MN and MCD rose significantly （P ＜0.001）,but detection rate of MsPGN dropped significantly （P ＜0.001）.Among SGN,detection rate of HBVAN tended to drop （P ＜0.001）.Conclusion In China,PGN was the most common glomerulopathy （mostly IgAN）,LN was the most common SGN,and detection rate of MN and MCD rose significantly.     

Investigation on the optical scan condition for imaging of multi-slice spiral CT liver perfusion in rats

Background Multi-slice CT liver perfusion has been widely used in experimental studies of hemodynamic changes in liver lesions, and is usually performed as an adjunct to a conventional CT examination because of its high temporal and spatial resolution, simple protocol, good reproducibility, and ability to measure hemodynamic changes of liver tissues at the capillary level. Experimental rat models, especially those of induced liver cancer, are often used in studies of hemodynamic changes in liver cancer. Carcinogenesis in rats has a similar pathological progression and characteristics resembling those in human liver cancer; as a result, rat models are often used as ideal animal models in the study of human liver cancer. However, liver perfusion imaging in rats is difficult to perform, because rats＇ livers are so small that different concentrations, flow rates, and dose of contrast agents during the CT perfusion scanning can influence the quality of liver perfusion images in rats. The purpose of this study, therefore, was to investigate the optimal scan protocol for the imaging of hepatic perfusion using a deconvolution mathematical method in rats by comparing the results of rats in different injection conditions of the contrast agent, including concentration, rate and time. Methods Plain CT scan conditions in eighty 2-month-old male Wistar rats were 5.0 mm slice thickness, 5.0 mm interval, 1.0 pitch, 120 kV tube voltage, 60 mA tube current, 512x512 matrix, and FOV 9.6 cm. Perfusion scanning was carried out with different concentrations of diatrizoate （19%, 38%, 57%, and 76%）, different injection rates （0.3 and 0.5 ml/s）, and different injection times （1, 2-3, 4-5, and 6 seconds）. The above conditions were randomly matched and adjusted to determine the best perfusion scan protocol. Three-phase contrast-enhanced scanning was performed after CT perfusion. Histological examination of the liver tissues with hematoxylin and eosin stains was done after CT scanning. Results When the concentration of the contrast agent was 19% or 38%, no pseudo-color map was created. The viscosity increased when the concentration of the contrast agent was 76%; so it is difficult to inject the contrast agent at such a high concentration. Also no pseudo-color map was generated when the injection time was short （1, 2-3, and 4-5 seconds） or the injection rate was low （0.3 ml/s）. The best perfusion images and perfusion parameters were obtained during 50 seconds scanning. Each rat was given an injection of 57% diatrizoate at 0.5 mils via the tail vein using a high-pressure syringe for 6 seconds. The perfusion parameters included hepatic blood flow （HBF）, hepatic blood volume （HBV）, mean transit time （MTT） of the contrast agent, capillary permeability-surface area product （PS）, hepatic arterial index （HAl）, hepatic artery perfusion （HAP）, and hepatic portal perfusion （HPP）. All these parameters reflected the perfusion status of liver parenchyma in normal rats. Three phases of enhancement were modified according to the time-density curves （TDCs） of the perfusion imaging： hepatic arterial phase （7 seconds）, hepatic portal venous phase （15 seconds）, and a delayed phase （23-31 seconds）. On examination by microscopy, the liver tissues were pathologically normal. Conclusions The appropriate protocol with multi-slice spiral CT liver perfusion reflected normal liver hemodynamics in rats. This study laid a solid foundation for further investigation of the physiological characteristics of liver cancer in a rat model, and was an important supplement to and reference for conventional contrast-enhanced CT scans.     

肝硬化增生小结节的超声造影定量分析及在定性诊断中的意义

目的分析探讨在肝硬化背景下的增生小结节（SRNs）（直径≤3．0cm）超声造影（CEUS）的血流灌注模式和超声造影参数在其定量诊断中的意义,进一步探讨超声造影在SRNs（≤3．0cm）诊断中的应用价值。方法回顾性分析32例（46个病灶）经细针穿刺有病理结果的SRNs的超声造影灌注模式,对实时超声造影图像运用时间一强度曲线进行分析,并比较SRNs造影前后诊断率。结果超声造影SRNs呈4种灌注模式：模式（1）：26／46个（56．52％）,“同进同出”;模式（2）：16／46个（34．78％）,“慢进同出”;模式（3）：3／46个（6．52％）,“快进慢出”;模式（4）：1／46个（2．17％）,“无增强无退出”。上升支及下降支斜度、平均强度各参数在SRNs与肝硬化实质鉴别中有显著差异,峰值时间无显著差异。常规超声的诊断率为65．79％,超声造影的诊断率为88．37％。结论CEUS对SRNs检出率明显优于常规超声,可有效动态地评价SRNs的血管化程度,尤其对于常规超声扫描未显示的小病灶进行定性、定量诊断,同时对血流灌注特点进行分析,超声造影对有恶变倾向的SRNs的早期诊断具有更重要的临床意义。     

超声造影技术对糖尿病肾病患者早期肾功能改变的评估及其临床意义

目的：通过超声造影（CEUS）定量分析糖尿病肾病（DN）患者肾血流灌注参数改变,探讨该技术在诊断DN患者早期肾功能改变中的价值。方法：40例糖尿病患者根据Mogensen分期标准分为正常白蛋白尿组（Ⅰ组）及早期DN组（Ⅱ组）,15例健康志愿者为对照组（N组）。所有检查者均行肾CEUS灌注成像,并用QontraXt图像分析软件在肾皮质选取感兴趣区域（ROI）,生成时间-强度曲线（TIC）,获得肾血流灌注参数。结果：CEUS能清晰显示造
影剂在肾脏的灌注过程,与N组比较,Ⅰ组患者肾脏局部血容量（RBV）增多、达峰时间（TTP）和平均渡越时间（MTT）延长,差异有统计学意义( P<0.05 ),而达峰强度（DPI）及局部血流量（RBF）组间比较差异无统计学意义(P＞0.05 );与N组及Ⅰ组比较,Ⅱ组患者RBV、TTP和MTT 明显增高,DPI、RBF明显降低,差异均有统计学意义( P< 0.05 )。结论：CEUS技术分析早期DN患者血流灌注参数的改变,可以评估DN患者早期肾功能异常。     

超声造影时间-强度曲线在肝癌射频消融的应用研究

目的 探讨超声造影时间-强度曲线在肝癌射频消融治疗效果的应用价值.方法 对76例肝癌患者共118个肿瘤病灶行超声引导下射频消融治疗,消融术后1个月使用声学定量分析软件对残余消融灶行动态分析,并与同期增强磁共振成像(MRI)检查结果进行比较,以病理为金标准,对肿瘤残余消融病灶良恶性进行统计对比分析.结果 肝脏射频消融治疗后超声造影疗效的准确性为82.2％,增强MRI为83.9％;超声造影与增强MRI间比较差异无统计学意义(P＞0.05),其检查结果一致性较高;消融术后良性残留消融灶与恶性残留灶血流灌注特点不同,时间强度曲线示峰值强度(IMAX)良性残留消融灶小于恶性残留灶(P＜0.01),峰值强度上升时间(RT)及达峰时间(TTP)良性残留消融灶长于恶性残留灶(P＜0.01);超声造影与增强MRI判断残余病灶良恶性比较差异无统计学意义(P＞0.05).结论 超声造影结合时间强度曲线可以动态、直观、定量地反映灭活灶及良恶性残留灶与周围肝实质血流灌注的差异.     

超声造影在肾脏良恶性肿瘤诊断中的价值探讨

目的探讨超声造影再肾脏良恶性肿瘤诊断中的价值。方法选取经阳原县人民医院B超室检查,并行超声引导性穿刺活检或手术取病变组织行病理检查确诊为肾脏占位性病变患者47例,对其行SonoVue超声造影检查,并运用时间-强度曲线分析软件对储存的动态图像进行定量分析。结果恶性病变主要表现为快速增强、快速减退,良性病变主要表现为慢速增强、慢速减退。恶性肿瘤超声造影峰值时间低于良性病变,两者对比差异有统计学意义(P<0.05)。恶性肿瘤超声造影时间-强度曲线中峰值强度、曲线尖度以及曲线下面积均高于良性病变,比较差异有统计学意义(P<0.05)。结论超声造影时间-强度曲线定量分析肾脏占位性病变,有助于肾脏良恶性肿瘤的诊断和鉴别诊断。     

肾脏占位性病变的超声造影强化特征

目的 探讨肾脏占位病变的超声造影(CEUS)强化特征。 方法 对78例肾脏占位性病变患者行CEUS检查,观察CEUS增强特征、增强与减退情况及假包膜征等超声特点,分析良恶性占位病变超声造影时间-强度曲线(TIC)相关定量参数。 结果 78例肾脏占位性病变中,50例为恶性占位病变,另28例为良性占位。恶性占位病变均有不同程度增强,肾透明细胞癌主要表现为弥漫或厚环状增强并呈"快进快退",乳头状细胞癌、嫌色细胞癌与肾盂癌则主要表现为弥漫性低增强并呈"慢进快退"。假包膜征主要出现于肾透明细胞癌。良性占位病变中,肾囊肿无增强,肾错构瘤主要为弥漫性低增强并呈"慢进慢退",且均无假包膜征。恶性占位病灶达峰时间(TTP)早于良性占位组(P<0.05),且峰值强度(PI)与曲线下面积(AUC)均高于良性占位(P<0.05)。 结论 不同性质的肾脏占位病变CEUS强化特征不同,CEUS有助于病变性质的确定。     

超声造影在乳腺癌早期诊断中的临床应用

目的探讨超声造影在乳腺癌早期鉴别诊断中的临床应用价值。方法107例超声BI-RADS®分类3或4类的乳腺小肿块
（直径小于等于10 mm）术前行超声造影检查,观察肿块及其周边在超声造影全程中的强化范围、强化类型、强化方式,并应用时
间一强度曲线（TIC）分析TIC曲线类型、肿块增强模式、基础强度、峰值强度、强化强度、上升斜率、强化强度指数以及曲线类型,
分析上述结果在良恶性肿块间的差异。结果乳腺良恶性肿块的超声造影峰值强度、增强强度指数以及峰值时间差异有统计学
意义（t=-2.310、-2.592、-2.127,P=0.021、0.010、0.033）;强度差值及上升斜率差异有统计学意义（t=-3.422、-3.388,P=0.001、
0.001）。乳腺良恶性肿块的超声造影TIC 曲线类型、强化方式、强化类型以及强化范围差异有统计学意义（P<0.001）。结论超
声BI-RADS®分类3或4类且病灶直径小于等于10 mm的乳腺良恶性肿瘤超声造影在TIC曲线上差异主要表现在超声造影峰
值强度、增强强度指数以及峰值时间等方面。更多乳腺增生结节超声造影表现为无明显强化,97.8%的无强化病例为乳腺良性
病变。有强化的乳腺结节中,乳腺恶性病变更多的表现为快进快出型和快进慢出型,其中以快进慢出型多见;而良性病变更多
表现为慢进慢出型。乳腺恶性结节较多表现为强化范围大于二维范围。
     

相对超声造影参数在肾脏良恶性肿瘤鉴别诊断中的价值

目的：分析肾脏良恶性肿瘤超声造影（CEUS）时间-强度曲线（TIC）特点,探讨相对超声造影参数在鉴别肾脏良恶性肿瘤中的临床应用价值。方法对大连医科大学附属第一医院的67例经病理证实的肾脏肿瘤行CEUS检查,获取TIC曲线和多个定量参数,包括峰值强度（ Peak）、达峰时间（ Tp）、曲线下面积（ AUC）及造影剂平均通过时间（ MTT）,比较相对造影参数在肾脏良恶性肿瘤之间的差异。结果恶性肿瘤的相对Peak和相对AUC均明显高于良性肿瘤;恶性肿瘤的相对MTT短于良性肿瘤,差异有显著性意义（P＜0．05）。相对Tp在良恶性肿瘤之间比较差异无显著性意义（P＞0．05）。结论超声造影定量参数分析能够提供更多的血流灌注特征,可为肾脏良恶性肿瘤的诊断及鉴别诊断提供重要的参考依据。     

超声造影评价右美托咪定对兔肾缺血/再灌注损伤时微循环灌注的影响

目的应用超声造影定量分析技术评价右美托咪定（DEX）对兔肾缺血/再灌注（I/R）损伤时微循环灌注的影响。方法新西 兰家兔24 只随机分成3 组（每组8 只）：对照组、肾缺血/再灌注损伤组（I/R组）和右美托咪定组（DEX组）。I/R 组和DEX 组切 除右肾建立左肾缺血再灌注损伤模型。DEX 组在肾缺血前30 min 腹腔注射10 μg/kg 右美托咪定。再灌注24 h 后,测定肾脏 大小和肾血流阻力（RI）,超声造影观察肾皮质灌注,时间-强度曲线定量分析达峰时间（TTP）、峰值强度（PSI）、曲线上升斜率 （Grad）和曲线下面积（AUC）。取肾脏观察病理改变。结果与对照组比较,I/R 组和DEX 组肾大小和病理改变明显,RI 增高, TTP 延长,PSI 和Grad 降低,AUC 显著增加（P<0.05）;与I/R 组比较,DEX 组肾大小和病理改变明显改善,RI 降低,TTP 缩短, PSI 和Grad 增高,AUC 减少（P<0.05）。结论超声造影结合时间-强度曲线参数能动态定量分析右美托咪定改善兔肾缺血/再灌 注损伤时的微循环灌注。     

超声造影与核素肾动态显像在评价兔肾缺血再灌注损伤中的对比研究

目的：探讨超声造影及核素肾动态显像在评价兔肾缺血再灌注损伤中的诊断价值,并比较两种检测手段的优劣势。方法：建立肾缺血再灌注损伤模型,分别于缺血前及缺血再灌注后24h行超声造影及核素动态显像检查,并对造影的时间-强度曲线（TIC）各参数以及核素肾动态显像的肾小球滤过率（GFR）进行分析,比较其前后变化。结果：超声造影检查组缺血前TIC曲线上升支斜率（Grad）明显高于缺血再灌注24h组,开始增强时间（arrival time,AT）、灌注峰值时间（time to peak,TTP）、曲线下面积（AUC）明显低于缺血再灌注后24h。而肾皮质灌注峰值强度变化（amplitude of peak intensity,A）值在缺血前及再灌注24h后无明显改变。核素动态显像组所得GFR值在缺血再灌注后24h较缺血前明显降低。结论：核素肾动态显像可以直接反映肾功能状态,但具有放射性损伤且误差较大。超声造影诊断能对肾脏局部血流灌注进行定量分析,间接评价肾功能状态,具有安全、费用低、重复性强、无明显禁忌症和并发症等优点。     

不同肝背景下原发性肝癌超声造影灌注特征的定量分析

目的: 探讨正常肝、肝硬化及脂肪肝背景下原发性肝癌的超声造影表现,定量分析3种肝背景下原发性肝癌的血流灌注特征。 方法: 选择137例原发性肝癌患者共137个原发病灶,依据肝背景不同分为正常肝背景组(45例)、肝硬化背景组(51例)和脂肪肝背景组(41例)。观察3种肝背景下病灶的超声造影特征;应用时间-强度曲线分析3种肝背景组原发性肝癌的灌注参数,包括始增时间、达峰时间、峰值强度、梯度和灌注期曲线下面积。 结果: 本组137个病灶均表现为动脉相快速高增强,绝大多数病灶表现为典型的"快进快退"增强模式;但在正常肝背景组有6.7%、肝硬化背景组有31.4%的病灶表现为门脉相和延迟相呈等增强,甚至部分病灶内出现局部高增强的表现,即呈"快进慢退"增强模式;时间-强度曲线分析,3组肝背景下任2组病灶的始增时间、达峰时间、峰值强度、梯度及灌注期曲线下面积比较差异均无统计学意义 (P>0.05)。 结论: 3种肝背景下原发性肝癌的超声造影表现存在差异,但灌注参数无明显差异,应用时间-强度曲线能够客观准确地分析原发性肝癌超声造影的灌注参数,对病灶做出正确诊断。