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Response Evaluation Using Contrast-Enhanced ultrasound for Unresectable Advanced Hepatocellular Carcinoma Treated With Tyrosine Kinase Inhibitors Plus Anti-PD-1 Antibody Therapy

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Nomogram based on liver stiffness and spleen area with ultrasound for posthepatectomy liver failure:A multicenter study

ultrasound in Medicine and Biology 2024年第1期50卷 142-149页

作者： Zhao C.-K. Guan X. Pu Y.-Y. Zhou B.-Y. Wang L.-F. Sun Y.-K. Yin H.-H. Xia H.-S. Wang X. Han H. Xu H.-X. Department of ultrasound Zhongshan Hospital Institute of Ultrasound in Medicine and Engineering Fudan University Shanghai China Shanghai Institute of Medical Imaging Shanghai China Central Laboratory and Department of Medical ultrasound Sichuan Academy of Medical Sciences Sichuan Provincial People's Hospital University of Electronic Science and Technology of China Chengdu China

Objective: The aim of the work described here was to evaluate the role of contrast-enhanced ultrasound (CEUS) in response evaluation for unresectable advanced hepatocellular carcinoma (HCC) treated with tyrosine kinase inhibitors (TKIs) plus anti-programmed cell death protein-1 (PD-1) antibody therapy. Methods: A prospective cohort of consecutive patients with HCC who received combined TKI/anti-PD-1 antibody treatment for unresectable HCC between January 2022 and October 2022 was included in this study. The patients underwent unenhanced ultrasound (US) and CEUS examinations before treatment and at follow-up. Changes in the largest diameters of the target tumor on unenhanced US and the largest diameters of the enhancing target tumors on CEUS were evaluated. Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1 with unenhanced US and magnetic resonance imaging/computed tomography (MRI/CT) and modified RECIST (mRECIST) with CEUS and CEMRI/CT were used to assess treatment response. Results: A total of 24 HCC patients (23 men and 1 woman; mean age: 56.5 ± 8.5 y; Barcelona Clinic Liver Cancer stage C, 62.5%; 29 intrahepatic target tumors) were studied. Calculations of degree of necrosis in the target tumors revealed no significant differences between CEUS and CEMRI/CT (44.5 ± 36.2% vs. 45.3 ± 36.8%, p = 0.862). As for the differentiation of responders from non-responders, the agreement between RECIST version 1.1 of unenhanced US and mRECIST-CEUS was poor (κ coefficient = 0.233). Meanwhile, there was a high degree of concordance between mRECIST-CEUS and mRECIST-CEMRI/CT (κ coefficient = 0.812). Conclusion: CEUS proved to be superior to baseline US and is comparable to CEMRI/CT in defining treatment outcome for combined TKI/anti-PD-1 antibody therapy. © 2023 World Federation for ultrasound in Medicine & Biology

关键词： Anti-angiogenic therapy Anti-PD-1 antibody Contrast-enhanced ultrasound Hepatocellular carcinoma

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World Journal of Gastroenterology 2024年第27期30卷 3314-3325页

作者： Guang-Wen Cheng Yan Fang Li-Yun Xue Xiao-Hui Qiao Xue-Qi Li Yan Zhang Jia Guo Xiao-Yan Xie Hong Ding Department of ultrasound Huashan HospitalFudan UniversityShanghai 200040China Department of ultrasound Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese MedicineShanghai 201203China Department of Medical Ultrasonics Institute of Diagnostic and Interventional UltrasoundSun Yat-sen University First Affiliated HospitalGuangzhou 510080Guangdong ProvinceChina Institute of ultrasound in Medicine and Engineering Shanghai Cancer CenterShanghai 200040China Department of ultrasound Eastern Hepatobiliary Surgical HospitalSecond Military Medical UniversityShanghai 200433China Department of ultrasound National Clinical Research Center for Aging and MedicineHuashan HospitalFudan UniversityShanghai 200040China

BACKGROUND Liver stiffness(LS)measurement with two-dimensional shear wave elastography(2D-SWE)correlates with the degree of liver fibrosis and thus indirectly reflects liver function *** size of the spleen increases due to tissue proliferation,fibrosis,and portal vein congestion,which can indirectly reflect the situation of liver fibrosis/*** was reported that the size of the spleen was related to posthepatectomy liver failure(PHLF).So far,there has been no study combining 2D-SWE measurements of LS with spleen size to predict *** prospective study aimed to investigate the utility of 2D-SWE assessing LS and spleen area(SPA)for the prediction of PHLF in hepatocellular carcinoma(HCC)patients and to develop a risk prediction *** To investigate the utility of 2D-SWE assessing LS and SPA for the prediction of PHLF in HCC patients and to develop a risk prediction *** This was a multicenter observational study prospectively analyzing patients who underwent hepatectomy from October 2020 to March *** 1 wk before partial hepatectomy,ultrasound examination was performed to measure LS and SPA,and blood was drawn to evaluate the patient’s liver function and other *** absolute shrinkage and selection operator logistic regression and multivariate logistic regression analysis was applied to identify independent predictors of PHLF and develop a *** performance was validated *** diagnostic performance of the nomogram was evaluated with receiver operating charac-teristic curve compared with the conventional models,including the model for end-stage liver disease(MELD)score and the albumin-bilirubin(ALBI)*** A total of 562 HCC patients undergoing hepatectomy(500 in the training cohort and 62 in the validation cohort)were enrolled in this *** independent predictors of PHLF were LS,SPA,range of resection,blood loss,international normalized ratio,and total *** diagnostic performanc

关键词： Shear-wave elastography Spleen Hepatectomy Posthepatectomy liver failure Hepatocellular carcinoma

Hepatic cystic lesions mimicking liver abscess on imaging: A report oftwo cases

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Hepatobiliary & Pancreatic Diseases International 2024年第1期23卷 86-89页

作者： Yun-Wen Jiang Yong-Hong Yu Tian-An Jiang Shu-Yuan Tian Department of ultrasound Medicine Tongde Hospital of Zhejiang ProvinceHangzhou 310012China Department of ultrasound Medicine the First Affiliated HospitalZhejiang University School of MedicineHangzhou 310003China

Hepatic cystic lesions include congenital dysplasia,inflammatory cystic lesions,neoplastic cystic lesions and parasitic cystic *** different treatment modalities can be chosen for these lesions,differential diagnosis is particularly important[1].Clinical features or imaging findings of cystic lesions of the liver are typical;for instance,liver abscess often shows thick-walled enhancement on contrast-enhanced CT.

关键词： lesions Hepatic cystic

Real-time shear wave elastography combined with biochemical indicators for evaluating liver injury in patients with chronic kidney disease

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中国医学影像技术 2024年第8期40卷 1221-1225页

作者： FAN Xiangyang ZHANG Yan HE Xiao WANG Ziwei YU Jing Department of ultrasound the First Affiliated Hospital of Zhengzhou UniversityZhengzhou 450052China

Objective To observe the value of real-time shear wave elastography(SWE)combined with biochemical indicators for evaluating liver injury in patients with chronic kidney disease(CKD).Methods Totally 210 patients with CKD(CKD group)and 64 healthy subjects(control group)were retrospectively *** in CKD group were further divided into CKD1—5 subgroups according to CKD *** parameters of liver and kidney,including mean value,the maximum value and the median value of Young's modulus(EQI mean,EQI max and EQI med)were compared between CKD subgroups and control *** correlation analysis were performed to explore the correlations of liver and kidney SWE parameters with CKD stage,as well as of liver SWE parameters with biochemical *** logistic regression analysis was used to screen independent predictors of liver injury in CKD *** operating characteristic curves were drawn,the area under the curves(AUC)were calculated to evaluate the efficacy of the independent predictors alone and their combination for assessing liver injury in CKD *** Significant differences of liver and kidney SWE parameters were found among CKD subgroups and control group(all P≤0.001).Pairwise comparison showed that liver SWE parameters in CKD5 subgroup and liver EQI max in CKD4 subgroup were all higher than those in control group(all P<0.003).Kidney SWE parameters in CKD3 subgroup were all higher than those in control group,while in CKD4 subgroup were all higher than those in control group and CKD1—3 subgroup(all P<0.003).Kidney EQI mean and EQI med in CKD5 subgroup were all higher than those in control group and CKD1—4 subgroup,while kidney EQI max in CKD5 subgroup were higher than those in control group and CKD1—3 subgroup(all P<0.003).Liver and kidney SWE parameters were lowly-moderately and positively correlated with CKD stages(r=0.364—0.665,all P<0.001).Liver SWE parameters of CKD were weakly and positively correlated with al

关键词： renal insufficiency,chronic hepatic insufficiency ultrasonography

Right heart modified myocardial performance index and ductus venosus spectrum parameters in pre-eclampsia fetuses for predicting adverse pregnancy outcomes

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中国医学影像技术 2024年第8期40卷 1146-1150页

作者： GAO Jing LI Hezhou WANG Ming WU Juan WANG Xinxia LIU Yun ZHU Ziqi Department of ultrasound the Third Affiliated Hospital of Zhengzhou UniversityZhengzhou 450052China

Objective To observe the values of changes of right heart modified myocardial performance index(Mod-MPI)and ductus venosus(DV)spectrum parameters in pre-eclampsia fetuses for predicting adverse pregnancy *** Eighty-one pregnant women diagnosed as pre-eclampsia were prospectively enrolled and divided into severe pre-eclampsia(SPE)group(n=39)and mild pre-eclampsia(MPE)group(n=42),while 85 healthy pregnant women were taken as controls(control group).Fetal right heart function parameters,including right ventricular isovolumetric relaxation time(IRT),isovolumetric contraction time(ICT),ejection time(ET),total spent time(TST),Mod-MPI,tricuspid valve peak flow velocity ratio in early and late diastole(TV-E/A),as well as blood flow velocities in each waveform of DV spectrum(S,V,D,and A wave)were obtained,and the pulsatility index(PI)and the ratio of blood flow velocities in each waveform of the DV(S/V,S/D,S/A,V/D,V/A,D/A)were *** fetal distress,preterm delivery,neonatal asphyxia and newborn with low weight were considered as adverse pregnancy *** correlations of right heart Mod-MPI and TV-E/A with DV parameters in pre-eclampsia fetuses were assessed,and their predictive efficacies for adverse pregnancy outcomes were evaluated for right heart Mod-MPI and DV using the receiver operating characteristics(ROC)and the area under the curves(AUC).Results Compared with control group and MPE group,fetal right heart IRT,ICT and Mod-MPI increased and ET decreased in SPE group(all P0.05).Fetal DV A-wave velocity and V/D values progressively decreased but PI progressively increased in control,MPE and SPE groups(all P<0.05).Fetal right heart Mod-MPI in pre-eclampsia was moderately positively correlated with DV PI(r=0.637,P=0.016),while TV-E/A was weakly negatively correlated with DV V/D(r=-0.355,P=0.043).Adverse pregnancy outcomes were noticed in 59 pre-eclampsia

关键词： pre-eclampsia fetal heart ventricular function ultrasonography,prenatal prospective studies

Correlations of transcranial sonography of substantia nigra characteristics with MRI iron deposition on substantia nigra in patients with Parkinson disease

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中国医学影像技术 2024年第8期40卷 1160-1163页

作者： ZOU Quan CHEN Fei MENG Wenyu ZHENG Hong Department of ultrasound Medicine the First Hospital of Lanzhou UniversityLanzhou 730000China

Objective To explore the correlations of transcranial sonography of substantia nigra(SN-TCS)characteristics with MRI iron deposition on substantia nigra in patients with Parkinson disease(PD).Methods Data of SN-TCS and craniocerebral MRI in 120 PD patients were retrospectively *** patients were divided into iron deposition positive group(positive group,n=46)and iron deposition negative group(negative group,n=74)according to quantitative susceptibility mapping(QSM)*** parameters of SN-TCS and MRI were compared between groups(both P0.05).Strong echo area of substantia nigra and S/M based on SN-TCS were both low-medium positively correlated with substantia nigra QSM value showed on MRI(r=0.497,0.529,both P<0.001).Conclusion SN-TCS characteristics of PD patients were correlated with MRI iron deposition on substantia nigra,among which strong echo area and S/M were valuable for evaluating iron deposition on substantia nigra.

关键词： Parkinson disease substantia nigra iron ultrasonography magnetic resonance imaging

Contrast-enhanced ultrasound for predicting differentiation degree of hepatocellular carcinoma

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中国医学影像技术 2024年第8期40卷 1199-1203页

作者： REN Youxiang LING Wenwu LUO Yan YANG Lulu Department of ultrasound West China HospitalSichuan UniversityChengdu 610041China

Objective To explore the value of contrast-enhanced ultrasound(CEUS)for predicting differentiation degree of hepatocellular carcinoma(HCC).Methods Totally 86 HCC patients confirmed by postoperative pathology were retrospectively enrolled and divided into poorly differentiated,moderately differentiated and highly differentiated groups according to postoperative Edmondson-Steiner *** CEUS parameters were compared among groups,and binary logistic regression was used to analyze CEUS-related independent predictors of HCC with different *** receiver operating characteristic curves of parameters being significant different among groups were drawn,the areas under the curve(AUC)were calculated,and the efficacy for predicting HCC with different differentiation degree was *** There were 29 cases in poorly differentiated group,37 in moderately differentiated group and 20 cases in highly differentiated *** arrival time of contrast agent in poorly differentiated group was earlier than that in moderately and high differentiated groups(both P0.05).The washout grade were significantly different between each 2 groups(all P<0.05).The arrival time of contrast agent and washout grade were independent predictors of highly or poorly differentiated,moderately or poorly differentiated,moderate-highly or poorly differentiated HCC,and washout grade also was independent predictor of highly or moderately differentiated HCC(all P<0.05).The AUC of the arrival time of contrast agent for predicting highly or moderately differentiated,highly or poorly differentiated,moderately or poorly differentiated,moderate-highly or poorly differentiated HCC was 0.615,0.787,0.690 and 0.724,respectively,while of washout grade was 0.801,0.927,0.795 and 0.841,*** CEUS could be used to effectively predict differentiation de

关键词： carcinoma,hepatocellular ultrasonography pathological differentiation

Ultrafast pulse wave velocity technique for evaluating changes of carotid artery elasticity in Hashimoto thyroiditis patients with euthyroidism

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中国医学影像技术 2024年第8期40卷 1179-1182页

作者： JIANG Yanhui LIU Meiling XIE Jingwen ZHANG Jianxing Department of ultrasound the Second Affiliated Hospital of Guangzhou University of Chinese MedicineGuangzhou 510120China

Objective To explore the value of ultrafast pulse wave velocity(UFPWV)technique for evaluating changes of carotid artery elasticity in Hashimoto thyroiditis(HT)patients with *** Conventional ultrasound and UFPWV for carotid artery were prospectively performed in 91 HT patients with euthyroidism(HT group)and 81 healthy subjects(control group).Clinical data and ultrasonic parameters were compared between *** correlation analysis was performed to observe the correlations of carotid pulse wave velocity in end of systole(PWV-ES)with clinical indexes and other ultrasonic parameters in HT *** stepwise linear regression analysis was used to screen the independent impact factors of increased carotid PWV-ES in HT *** Significant differences of thyroid peroxidase antibody(TPOAb),thyroglobulin antibody(TgAb),total cholesterol(TC),low density lipoprotein and neutrophil-lymphocyte ratio(NLR)were found between groups(all P0.05).Carotid PWV-ES in HT group was positively correlated with patients'age,body mass index,TPOAb,TC,triglyceride,NLR and CIMT(r=0.217—0.707,all P<0.05).Patients'age,TPOAb and NLR were all independent impact factors of increased carotid PWV-ES in HT patients with euthyroidism(all P<0.05).Conclusion UFPWV technique could be used to evaluate changes of carotid artery elasticity in HT patients with euthyroidism,among which PWV-ES was relatively sensitive.

关键词： Hashimoto disease carotid arteries ultrasonography prospective studies

Gastrointestinal contrast-enhanced ultrasonography for diagnosis and treatment of peptic ulcer in children

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World Journal of Gastroenterology 2024年第7期30卷 705-713页

作者： Yu-Hua Zhang Zhi-Hua Xu Shuang-Shuang Ni Hong-Xia Luo Department of ultrasound The Second Affiliated Hospital of Wenzhou Medical UniversityWenzhou 325000Zhejiang ProvinceChina

BACKGROUND The detection rate of peptic ulcer in children is improving,with development of diagnostic *** is the gold standard for the diagnosis of peptic ulcer,but it is an invasive *** contrast-enhanced ultrasonography(CEUS)has the advantages of being painless,noninvasive,nonradioactive,easy to use,and *** To investigate the clinical value of CEUS for diagnosis and treatment of peptic ulcer in *** We investigated 43 children with digestive tract symptoms in our hospital from January 2021 to June *** children were examined by routine ultrasound,gastrointestinal CEUS,and *** pathological results of gastroscopy were taken as the gold *** ultrasonography was performed before gastrointestinal *** ultrasound showed the thickness of the gastroduodenal wall,gastric peristalsis,and the adjacent organs and tissues around the abdominal *** CEUS recorded the thickness of the gastroduodenal wall;the size,location and shape of the ulcer;gastric peristalsis;and adjacent organs and tissues around the abdominal *** results of routine ultrasound and gastrointestinal ultrasound were compared with those of gastroscopy to evaluate the diagnostic results and coincidence rate of routine ultrasound and gastrointestinal *** children received informed consent from their guardians for *** study was reviewed and approved by the hospital medical ethics *** Among the 43 children,17(15 male,2 female)were diagnosed with peptic ulcer by *** were 26 children with nonpeptic *** were eight cases of peptic ulcer and 35 of nonpeptic ulcer diagnosed by conventional *** diagnostic coincidence rate of peptic ulcer in children diagnosed by conventional ultrasound was 79.1%(34/43),which was significantly different from that of gastroscopy(P=0.033).It indicates that the coincidence rate of gastrointestinal contrast-enhanc

关键词： Contrast-enhanced ultrasound Peptic ulcer Children Gastrointestinal tract Abdominal pain Acoustic contrast agent