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Noninvasive imaging of hepatic dysfunction: A state-of-the-art review

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World Journal of Gastroenterology 2022年第16期28卷 1625-1640页

作者： Ting Duan Han-Yu Jiang wen-wu ling Bin Song Department of Radiology West China HospitalSichuan UniversityChengdu 610041Sichuan ProvinceChina Department of Medical Ultrasound West China Hospital of Sichuan UniversityChengdu 610041Sichuan ProvinceChina

Hepatic dysfunction represents a wide spectrum of pathological changes,which can be frequently found in hepatitis,cholestasis,metabolic diseases,and focal liver *** hepatic dysfunction is often clinically silent until advanced stages,there remains an unmet need to identify affected patients at early stages to enable individualized intervention which can improve *** liver function tests include biochemical parameters and clinical grading systems(e.g.,the Child-Pugh score and Model for End-Stage Liver Disease score).Despite widely used and readily available,these approaches provide indirect and limited information regarding hepatic *** quantitative tests of liver function are based on clearance capacity tests such as the indocyanine green(ICG)clearance ***,controversial results have been reported for the ICG clearance test in relation with clinical outcome and the accuracy is easily affected by various *** techniques,including ultrasound,computed tomography,and magnetic resonance imaging,allow morphological and functional assessment of the entire hepatobiliary system,hence demonstrating great potential in evaluating hepatic dysfunction *** this article,we provide a state-of-the-art summary of noninvasive imaging modalities for hepatic dysfunction assessment along the pathophysiological track,with special emphasis on the imaging modality comparison and selection for each clinical scenario.

关键词： Hepatic dysfunction Ultrasound Computed tomography Magnetic resonance imaging

Diagnosis of upper gastrointestinal perforation complicated with fistula formation and subphrenic abscess by contrast-enhanced ultrasound:A case report

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World Journal of Clinical Cases 2021年第29期9卷 8858-8863页

作者： Ting-Ting Qiu Rong Fu Yan Luo wen-wu ling Department of Medical Ultrasound West China Hospital of Sichuan UniversityChengdu 610041Sichuan ProvinceChina

BACKGROUND Gastrointestinal perforation complicated by subphrenic abscess is a surgical *** diagnosis relies mainly on X-ray or computed tomography(CT),while the value of ultrasound,especially contrast-enhanced ultrasound(CEUS),has been *** SUMMARY A 37-year-old man presented with fever and edema of the lower extremities for 10 *** had a history of laparoscopic repair of gastroduodenal perforation 6 mo *** first-time intravenous CEUS indicated a diagnosis of subphrenic *** received antibiotic therapy and ultrasound-guided percutaneous drainage of the ***,second-time intravenous CEUS revealed an unsatisfactory therapeutic *** CEUS was proposed,and this examination detected communication between the abscess and the *** gastrointestinal perforation complicated by fistula formation and subphrenic abscess was diagnosed with the help of *** CT and esophagogastroduodenoscopy confirmed the *** patient recovered after the perforation was repaired by *** Intravenous and intracavitary CEUS provides helpful information for the diagnosis of upper gastrointestinal perforation complicated by fistula formation and subphrenic abscess.

关键词： Contrast-enhanced ultrasound Gastrointestinal perforation Fistula Abscess Diagnosis Case report

Non-invasive evaluation of liver stiffness after splenectomy in rabbits with CCl_4-induced liver fibrosis

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World Journal of Gastroenterology 2016年第46期22卷 10166-10179页

作者： Ming-Jun Wang wen-wu ling Hong Wang ling-Wei Meng He Cai Bing Peng Department of Pancreatic Surgery West China Hospital Sichuan University Department of Ultrasound West China Hospital

AIM To investigate the diagnostic performance of liver stiffness measurement(LSM) by elastography point quantification(Elast PQ) in animal models and determine the longitudinal changes in liver stiffness by Elast PQ after splenectomy at different stages of *** Liver stiffness was measured in sixty-eight rabbits with CCl4-induced liver fibrosis at different stages and eight healthy control rabbits by Elast PQ. Liver biopsies and blood samples were obtained at scheduled time points to assess liver function and degree of fibrosis. Thirty-one rabbits with complete data that underwent splenectomy at different stages of liver fibrosis were then included for dynamic monitoring of changes in liver stiffness by Elast PQ and liver function according to blood *** LSM by Elast PQ was significantly correlated with histologic fibrosis stage(r = 0.85, P < 0.001). The optimal cutoff values by Elast PQ were 11.27, 14.89, and 18.21 k Pa for predicting minimal fibrosis, moderate fibrosis, and cirrhosis, respectively. Longitudinalmonitoring of the changes in liver stiffness by Elast PQ showed that early splenectomy(especially F1) may delay liver fibrosis *** Elast PQ is an available, convenient, objective and non-invasive technique for assessing liver stiffness in rabbits with CCl4-induced liver fibrosis. In addition, liver stiffness measurements using Elast PQ can dynamically monitor the changes in liver stiffness in rabbit models, and in patients, after splenectomy.

关键词： Fibrosis stages Splenectomy Elastography point quantification Liver stiffness Non-invasive technique

Diagnostic value of contrast enhanced ultrasound for splenic artery complications following acute pancreatitis

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World Journal of Gastroenterology 2014年第4期20卷 1088-1094页

作者： Di-Ming Cai Shyam Sundar Parajuly wen-wu ling Yong-Zhong Li Yan Luo Department of Ultrasound West China Hospital Sichuan University

AIM: To assess the value of contrast-enhanced ultrasound (CEUS) in diagnosing splenic artery complications (SACs) after acute pancreatitis (AP). METHODS: One hundred and eighteen patients with AP were enrolled in the study. All patients were examined by CEUS and contrast-enhanced computed tomography (CECT). CECT was accepted as a gold standard for the diagnosis of SACs in AP. The diagnostic accuracy of splenic CEUS and pancreatic CEUS was compared with that of CECT. Splenic infarction was the diagnostic criterion for splenic artery embolism and local dysperfusion of the splenic parenchyma was the diagnostic criterion for splenic arterial stenosis. The incidence of splenic sub-capsular hemorrhage, splenic artery aneurysms, and splenic rupture was all lower than that of SACs. RESULTS: Nine patients were diagnosed as having SACs after AP by CECT among the 118 patients. The patients with SACs were diagnosed with severe acute pancreatitis (SAP). Among them, 6 lesions were diagnosed as splenic artery embolism, 5 as splenic artery aneurysms, and 1 as splenic arterial stenosis. No lesion was diagnosed by pancreatic CEUS and 5 lesions were diagnosed by splenic CEUS. By splenic CEUS, 4 cases were diagnosed as splenic artery embolism and 1 as splenic arterial stenosis. The accuracy of splenic CEUS in diagnosis of SACs in SAP was 41.7% (5/12), which was higher than that of pancreatic CEUS (0%). CONCLUSION: Splenic CEUS is a supplementary method for pancreatic CEUS in AP patients, which can decrease missed diagnosis of SACs. (C) 2014 Baishideng Publishing Group Co., Limited. All rights reserved.

关键词： Acute pancreatitis Severe acute pancreatitis Contrast enhanced ultrasound Splenic artery complications Splenic contrast-enhanced computed tomography

Can contrast enhanced ultrasound differentiate intrahepatic cholangiocarcinoma from hepatocellular carcinoma?

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World Journal of Gastroenterology 2020年第27期26卷 3938-3951页

作者： Jia-Yan Huang Jia-wu Li wen-wu ling Tao Li Yan Luo Ji-Bin Liu Qiang Lu Department of Medical Ultrasound West China Hospital of Sichuan UniversityChengdu 610041Sichuan ProvinceChina Department of Anesthesiology West China Hospital of Sichuan UniversityChengdu 610041Sichuan ProvinceChina Department of Radiology Thomas Jefferson UniversityPhiladelphiaPA 19107United States

BACKGROUND Hepatocellular carcinoma(HCC)and intrahepatic cholangiocarcinoma(ICC)differ in treatment and prognosis,warranting an effective differential diagnosis between *** LR-M category in the contrast-enhanced ultrasound(CEUS)liver imaging reporting and data system(LI-RADS)was set up for lesions that are malignant but not specific to ***,a substantial number of HCC cases in this category elevated the diagnostic *** To investigate the possibility and efficacy of differentiating ICC from HCC classified in the LR-M category according to the CEUS *** Patients with complete CEUS records together with pathologically confirmed ICC and LR-M HCC(HCC classified in the CEUS LI-RADS LR-M category)between January 2015 and October 2018 were included in this retrospective *** ICC was assigned a category as per the CEUS *** enhancement pattern,washout timing,and washout degree between the ICC and LR-M HCC were compared using theχ2 *** regression analysis was used for prediction of *** operating characteristic(ROC)curve analysis was used to investigate the possibility of LR-M criteria and serum tumor markers in differentiating ICC from LR-M *** A total of 228 nodules(99 ICCs and 129 LR-M HCCs)in 228 patients were *** mean sizes of ICC and LR-M HCC were 6.3±2.8 cm and 5.5±3.5 cm,respectively(P=0.03).Peripheral rim-like arterial phase hyperenhancement(APHE)was detected in 50.5%(50/99)of ICCs vs 16.3%(21/129)of LR-M HCCs(P0.05).Marked washout was observed in 23.2%(23/99)of ICCs and 7.8%(10/129)of LR-M HCCs(P=0.002),while this feature did not show up alone either in ICC or LR-M *** hyperenhancement was detected in 15.2%(15/99)of ICCs and 37.2%(48/129)of LR-M HCCs(P<0.001).The logistic regression showed that rim APHE,carbohydrate antigen 19-9(CA 19-9),and alpha fetoprotein(AFP)had significant correlation

关键词： Diagnosis Contrast enhanced ultrasound Hepatocellular carcinoma Intrahepatic cholangiocarcinoma Liver imaging reporting and data system

Contrast-enhanced ultrasonographic findings of hepatic paragonimiasis

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World Journal of Gastroenterology 2013年第13期19卷 2087-2091页

作者： Qiang Lu wen-wu ling Lin Ma Zi-Xing Huang Chang-Li Lu Yan Luo Department of Ultrasound Chinese Evidence-Based Medicine CenterWest China Hospital of Sichuan University Department of Ultrasound West China Hospital of Sichuan University Sichuan University Department of Radiology West China Hospital of Sichuan University Department of Pathology West China Hospital of Sichuan University

AIM: To investigate the features of hepatic paragonimiasis on contrast-enhanced ultrasound (CEUS) imag- ing. METHODS: Fifteen patients with hepatic paragonimiasis who were admitted to our hospital between March 2008 and August 2012 were enrolled to this study. The conventional ultrasound and CEUS examinations were performed with a Philips IU22 scanner with a 1-5-MHz convex transducer. After conventional ultrasound scanning was completed, the CEUS study was performed. Pulse inversion harmonic imaging was used for CEUS. A bolus injection of 2.4 mL of a sulfur hexafluoride-filled microbubble contrast agent (SonoVue) was administered. CEUS features were retrospectively reviewed and correlated with pathological findings. RESULTS: In total, 16 lesions were detected on CEUS. The mean size of the lesions was 4.4 ± 1.6 cm (range, 1.7-6.6 cm). Subcapsular location was found in 12 lesions (75%). All the lesions were hypoechoic. Six lesions (37.5%) were of mixed content, seven (43.8%) were solid with small cystic areas, and the other three (18.8%) were completely solid. Ten lesions (62.5%) were rim enhanced with irregular tract-like nonenhanced internal areas. Transient wedge-shaped hyperenhancement of the surrounding liver parenchyma was seen in seven lesions (43.8%). Areas with hyperor iso-enhancement in the arterial phase showed contrast wash-out and appeared hypoenhanced in the late phase. The main pathological findings included: (1) coagulative or liquefactive necrosis within the lesion, infiltration of a large number of eosinophils with the formation of chronic eosinophilic abscesses and sporadic distribution of Charcot-Leyden crystals; and (2) hyperplasia of granulomatous and fibrous tissue around the lesion. CONCLUSION: Subcapsular location, hypoechogenicity, rim enhancement and tract-like nonenhanced areas could be seen as the main CEUS features of hepatic paragonimiasis.

关键词： Paragonimiasis Liver Infection Contrastenhanced ultrasonography

Contrast-enhanced ultrasound:Improving the preoperative staging of hepatocellular carcinoma and guiding individual treatment

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World Journal of Gastroenterology 2014年第35期20卷 12628-12636页

作者： Xiao-Yun Zhang Yan Luo Tian-Fu wen Li Jiang Chuan Li Xiao-Fei Zhong Jing-Yi Zhang wen-wu ling Lu-Nan Yan Yong Zeng Hong wu Department of Liver Surgery and Liver Transplantation Centre West China Hospital of Sichuan University Department of Sonography West China Hospital of Sichuan University

AIM: To investigate the clinical role of contrast-enhanced ultrasound (CEUS) combined with contrast-enhanced computed tomography (CE-CT) or magnetic resonance imaging to improve the preoperative staging of hepatocellular carcinoma (HCC) and guide surgical decision-making. METHODS: Sixty-nine patients who underwent liver resection for HCC in our center were enrolled prospectively in the study. CEUS and CE-CT/MRI were performed before surgery. Intraoperative ultrasound (IOUS) was carried out after liver mobilization. Lesions depicted by each imaging modality were counted and mapped. To investigate the impact of tumor size on the study, we divided the patients into two groups, the 'Smaller group'(S-group, 5 cm in diameter). The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of CE-CT/MRI, CEUS, IOUS, CEUS+CE-CT/MRI and the tumor node metastasis staging of tumors were calculated and compared. Changes in the surgical strategy as a result of CEUS and IOUS were analyzed. RESULTS: One hundred and twenty-seven nodules, comprising 94 HCCs confirmed by histopathology and 33 benign lesions confirmed by histopathology and follow-up, were identified in 69 patients. The overall diagnostic sensitivity rates of CE-CT/MRI, CEUS, IOUS and CEUS+ CE-CT/MRI were 78.7%, 89.4%, 89.4% and 89.4%, respectively. There was a significant difference between CEUS + CE-CT/MRI and CE-CT/MRI (P = 0.046). Combining CEUS with CT or MRI increased, the diagnostic specificity compared with CT/MRI, CEUS and IOUS, and this difference was statistically significant (100%, 72.7%, 97.0%, and 69.7%, P = 0.004, P = 0.002, P = 0.002, respectively). The diagnostic accuracy was significantly higher for CEUS + CT/MRI compared with CT/MRI (92.1% vs 77.2%, P = 0.001). The TNM staging of tumors based on CEUS + CE-CT/MRI approximated to the final pathological TNM staging (P = 0.977). There was a significant difference in t

关键词： Hepatocellular carcinoma Contrast-enhanced ultrasound Tumor node metastasis staging Intraoperative ultrasound Liver resection

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SMS4密码算法的差分故障攻击

计算机学报 2006年第9期29卷 1596-1602页

作者：张蕾吴文玲中国科学院软件研究所信息安全国家重点实验室北京100080 中国科学院研究生院信息安全国家重点实验室北京100049

SMS4是用于WAPI的分组密码算法,是国内官方公布的第一个商用密码算法.由于公布时间不长,关于它的安全性研究尚没有公开结果发表.该文研究SMS4密码算法对差分故障攻击的安全性.攻击采用面向字节的随机故障模型,并且结合了差分分析技术.... 详细信息

SMS4是用于WAPI的分组密码算法,是国内官方公布的第一个商用密码算法.由于公布时间不长,关于它的安全性研究尚没有公开结果发表.该文研究SMS4密码算法对差分故障攻击的安全性.攻击采用面向字节的随机故障模型,并且结合了差分分析技术.该攻击方法理论上仅需要32个错误密文就可以完全恢复出SMS4的128比特种子密钥.因为实际中故障发生的字节位置是不可能完全平均的,所以实际攻击所需错误密文数将略大于理论值;文中的实验结果也验证了这一事实,恢复SMS4的128bit种子密钥平均大约需要47个错误密文.文章结果显示SMS4对差分故障攻击是脆弱的.为了避免这类攻击,建议用户对加密设备进行保护,阻止攻击者对其进行故障诱导.

关键词： SMS4密码算法差分分析差分故障攻击故障模型差分表

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基于SM4轮函数设计的认证加密算法

电子学报 2018年第6期46卷 1294-1299页

作者：张建吴文玲中国科学院软件研究所可信计算与信息保障实验室北京100190 中国科学院大学北京100190

认证加密算法,作为一种对称密码算法,能够同时保护数据的机密性和完整性,在信息安全领域有着重要作用.现有的认证加密算法大多是基于分组密码的工作模式设计的,底层需要调用全轮的分组密码,效率受到很大限制.本文主要考虑从基本部件出... 详细信息

认证加密算法,作为一种对称密码算法,能够同时保护数据的机密性和完整性,在信息安全领域有着重要作用.现有的认证加密算法大多是基于分组密码的工作模式设计的,底层需要调用全轮的分组密码,效率受到很大限制.本文主要考虑从基本部件出发直接设计一个高效的认证加密算法.首先结合国产分组密码标准SM4与广义Feistel结构给出了一种通用的结构设计.然后以抵抗碰撞攻击为安全性目标,利用混合整数规划(MILP)方法搜索得到了一些状态大小和效率各不相同的结构,这些结构可以被用来构造消息认证码和认证加密算法.最后,利用目前搜索得到的状态大小和效率较优的结构设计了一个认证加密算法,并进行了初步的安全性分析和软件实现,其速度约为SM4-GCM速度的10倍.

关键词：认证加密算法算法设计广义Feistel结构混合整数规划(MILP) SM4算法 SM4-GCM