Junlai Li

Contrast-Enhanced Ultrasonography for Assessment of Tumor Vascularity in Hepatocellular Carcinoma

Studies have shown that angiogenesis is a critical factor for tumor growth and metastasis in a variety of human tumors. Although various methods have been tried to assess vessels in tumors, including microvessel density (MVD), assessment of tumor vessels by radiologic techniques is not well established. The aim of this study was to investigate the efficacy of contrast‐enhanced ultrasonography (CEUS) in determining the tumor vascularity of hepatocellular carcinoma (HCC).

Undetermined focal liver lesions on gray‐scale ultrasound in patients with fatty liver: Characterization with contrast‐enhanced ultrasound

Background and Aim:  The purpose of this study was to assess the clinical value and potential impact of contrast‐enhanced ultrasound (CEUS) in the characterization of undetermined focal liver lesions (FLLs) in patients with fatty liver.

Comparison of Gray-Scale Contrast-Enhanced Ultrasonography with Contrast-Enhanced Computed Tomography in Different Grading of Blunt Hepatic and Splenic Trauma: An Animal Experiment

To compare the diagnostic value of contrast-enhanced ultrasonography (CEUS) with contrast-enhanced computed tomography (CECT) for the detection of different grading of solid organ injuries in blunt abdominal trauma in animals. A self-made miniature tools were used as models to simulate a blunt hepatic or splenic trauma in 16 and 14 anesthetized dogs, respectively. Baseline ultrasound, CEUS and CECT were used to detect traumatic injuries of livers and spleens. The degree of injuries was determined by CEUS according to the American Association for the Surgery of Trauma (AAST) scale and the results compared with injury scale based on CECT evaluation. CEUS showed 22 hepatic injury sites in 16 animals and 17 splenic injury sites in other 14 animals. According to AAST scale, 2 grade I, 4 grade II, 3 grade III, 5 grade IV and 2 grade V hepatic lesions were present in 16 animals; 2 grade I, 4 grade II, 6 grade III and 2 grade IV splenic lesions in 14 animals. On CECT scan, 21 hepatic and 17 splenic injuries were demonstrated. According to Becker CT scaling for hepatic injury, 1 grade I, 2 grade II, 4 grade III, 5 grade IV and 2 grade V hepatic injuries were present. On the basis of Buntain spleen scaling, 2 grade I, 5 grade II, 5 grade III, 2 grade IV splenic injuries were showed. After Spearman rank correlation analysis, the agreement of CEUS with CECT on the degree of hepatic and splenic injury is 93.3% and 92.9%, respectively. CT is currently considered as the reference method for grading blunt abdominal trauma, according to experiment results, CEUS grading showed high levels of concordance with CECT. CEUS can accurately determine the degree of injury and will play an important role in clinical application.

Percutaneous injection therapy for blunt splenic trauma guided by contrast-enhanced ultrasonography.

Objective. The purpose of this study was to investigate the application of contrast‐enhanced ultrasonography (CEUS) in managing blunt splenic trauma and the effectiveness of CEUS‐guided percutaneous injection therapy. Methods. Six patients with grade 3 or 4 splenic injuries as determined by CEUS and contrast‐enhanced computed tomography were given hemocoagulase atrox and absorbable cyanoacrylate percutaneously, which were injected into the injury region and active bleeding site, respectively, under CEUS guidance. Immediately after the procedure and 1 and 3 days, 1 and 2 weeks, and 1 and 6 months after the procedure, follow‐up CEUS up was performed in all patients. Results. Among the 6 patients, 4 cases of CEUS‐guided hemostatic injection were successful without complications. Rehemorrhage occurred in 1 patient, and a traumatic arteriovenous fistula occurred in another; repeated injection therapy in these 2 patients was effective. During the follow‐up, there were no complications, and spleen perfusion recovered gradually. Conclusions. Contrast‐enhanced ultrasonography can be used to guide percutaneous injection therapy and therefore achieve the goal of using interventional ultrasonography in managing splenic trauma.

Contrast-enhanced Gray-scale Transrectal Ultrasound-guided Prostate Biopsy in Men with Elevated Serum Prostate-specific Antigen Levels

RATIONALE AND OBJECTIVES Our goal was to evaluate the role of contrast-enhanced gray-scale transrectal ultrasound (CETRUS)-guided prostate biopsy in patients with elevated serum prostate-specific antigen (PSA) levels. MATERIALS AND METHODS A total of 115 men (mean age, 70 years; range, 47-85) with serum PSA levels of greater than 4.0 ng/ml were assessed using gray-scale transrectal ultrasound (TRUS), power Doppler ultrasound (PDU), and CETRUS. Subsequently, these patients underwent systematic sextant transrectal biopsy and additional biopsies for positive sites on gray-scale TRUS, PDU, and CETRUS. The cancer detection rates of the three techniques were compared. RESULTS Cancer was detected in 63 of the 115 patients (55%). CETRUS was positive in 50 patients, 35 of whom (70%) had prostate cancer; CETRUS had a higher sensitivity, specificity, and accuracy of 65% (41/63), 83% (43/52), and 73% (84/115), respectively. CETRUS could have saved a significant number of patients from undergoing unnecessary biopsies, compared to TRUS and PDU. However, no significant correlation was found between the Gleason score and CETRUS grade. CONCLUSIONS The use of CETRUS in detecting prostate cancer might reduce the number of unnecessary needle biopsies of the prostate in patients with abnormally high serum PSA levels and increase the detection rate of clinically significant prostate cancer.

Peripheral Zone Hypoechoic Lesions of the Prostate Evaluation With Contrast-Enhanced Gray Scale Transrectal Ultrasonography

The purpose of this study was to evaluate the efficacy of contrast‐enhanced gray scale transrectal ultrasonography (TRUS) for detection of prostate cancer in peripheral zone hypoechoic lesions of the prostate.

Correlation Between Hypoechoic Nodules on Ultrasonography and Benign Hyperplasia in the Prostatic Outer Gland

The purpose of this investigation was to study the correlation between hypoechoic nodules detected on ultrasonography and benign hyperplasia in the prostatic outer gland (POG) diagnosed by transrectal ultrasonography (TRUS)‐guided biopsies.

Gray-scale contrast-enhanced utrasonography in detecting sentinel lymph nodes: An animal study

OBJECTIVE To investigate the usefulness of gray-scale contrast-enhanced ultrasonography for detecting sentinel lymph nodes. METHODS Contrast-enhanced ultrasonography was performed in five normal dogs (four female and one male) after subcutaneous administration of a sonographic contrast agent (Sonovue, Bracco, Milan, Italy). Four distinct regions in each animal were examined. After contrast-enhanced ultrasonography, 0.8 ml of blue dye was injected into the same location as Sonovue and the sentinel lymph nodes were detected by surgical dissection. The findings of contrast-enhanced ultrasonography were compared with those of the blue dye. RESULTS Twenty-one sentinel lymph nodes were detected by contrast-enhanced ultrasonography while 23 were identified by blue dye with surgical dissection. Compared with the blue dye, the detection rate of enhanced ultrasonography for the sentinel lymph nodes is 91.3% (21/23). Two patterns of enhancement in the sentinel lymph nodes were observed: complete enhancement (5 sentinel lymph nodes) and partial enhancement (16 sentinel lymph nodes). The lymphatic channels were demonstrated as hyperechoic linear structures leading from the injection site and could be readily followed to their sentinel lymph nodes. Histopathologic examination showed proliferation of lymphatic follicles or lymphatic sinus in partial enhanced sentinel lymph nodes while normal lymphatic tissue was demonstrated in completely enhanced sentinel lymph nodes. CONCLUSIONS Sonovue combined with gray-scale contrast-enhanced ultrasonography may provide a feasible method for detecting sentinel lymph nodes.

Gray-scale contrast-enhanced ultrasonography of sentinel lymph nodes in a metastatic breast cancer model.

RATIONALE AND OBJECTIVES Previous studies showed it was possible to employ sonographic contrast agent for identification of the sentinel lymph nodes (SLNs). This study is to investigate the usefulness of SonoVue (a sonographic contrast agent) and gray-scale contrast-enhanced ultrasonography (CEUS) for detecting the SLNs in a metastatic breast cancer model. MATERIALS AND METHODS CEUS was performed in 12 female rabbits with breast VX2 tumor after subcutaneous administration of SonoVue. The site, number, and pattern of enhancement of the SLNs were observed and recorded. After CEUS, 0.5 mL of blue dye was injected into the same location as SonoVue and the SLNs were detected by surgical dissection. The findings of CEUS were compared with those of blue dye. RESULTS Of the 12 tumors assessed, a total of 17 enhanced SLNs were detected by CEUS. Among them, a single SLN was detected in eight tumors, two SLNs in three tumors, and three SLNs in one tumor. All the SLNs showed partial enhancement on CEUS. Nineteen SLNs were identified by blue dye with surgical dissection. There were no false-positive CEUS findings in terms of SLN detection. The overall sensitivity of CEUS for detecting SLNs was 89.5% (17/19). Among the 17 SLNs detected by CEUS, tumor metastases were identified histopathologically in 4 SLNs, whereas proliferation of lymphatic tissue was identified in the other 13 SLNs. CONCLUSIONS CEUS combined with SonoVue is useful for detecting SLNs, although it may not be helpful for detecting metastases in SLNs.

Does benign prostatic hyperplasia originate from the peripheral zone of the prostate? A preliminary study.

To compare the histological characteristics, cell proliferation, apoptosis and biological features in benign prostatic hyperplasia (BPH) in the peripheral (PZ) and transition zone (TZ) of the prostate.