目的探讨超声造影定量分析技术在评价下肢深静脉血栓置管溶栓术疗效中的应用价值。方法选取40例混合型或中央型急性下肢深静脉血栓患者,超声引导下行下腔静脉滤器植入及患侧腘静脉穿刺置管术,术后以60万U/d微注泵向溶栓导管持续推注尿激酶。分别在腘静脉置管术后1、3、5 d通过溶栓导管注入稀释的超声造影剂,观察患者下腔静脉内造影剂灌注情况;定量分析软件获取时间-强度曲线及相关灌注参数:达峰时间(TTP)、峰值强度(DPI)及曲线上升支斜率(C)。40例患者按治疗效果分为治愈组、显效组及有效组,对各组超声造影灌注参数进行比较。结果 40例患者中,治愈组18例,显效组13例,有效组9例。1术后组内不同时间点比较:各组术后5 d与术后1 d比较,TTP、DPI及C差异均有统计学意义(均P<0.01);术后3 d与术后1 d比较,DPI、C差异均有统计学意义(均P<0.05),TTP差异无统计学意义。2术后组间相同时间点比较:显效组、有效组与治愈组比较,术后3、5 d DPI、C差异均有统计学意义(均P<0.05);显效组与有效组比较,术后3 d DPI、C差异无统计学意义,术后5 d DPI、C差异均有统计学意义(均P<0.05)。结论超声造影定量分析技术能发现下肢静脉血栓患者血管再通后血流灌注的细微改变,超声造影灌注参数可作为评价下肢静脉血栓置管溶栓疗效的量化指标。
The correlations between shear wave velocity(SWV)calculated from virtual touch tissue imaging quantification(VTIQ)technique and histological prognostic factors of invasive ductal carcinoma was investigated.A total of 76 breast tumors histologically confirmed as invasive ductal carcinomas were included in this study.SWV values were measured by VTIQ for each lesion preoperatively or prior to breast biopsy.The maximum values were recorded for statistical analysis.Medical records were reviewed to determine tumor size,histological grade,lymph node status and immunohistochemical results.Tumor subtypes were categorized as luminal A,luminal B,human epidermal growth factor receptor 2(HER2)positive and triple negative.The correlations between SWV and histological prognostic factors were analyzed.It was found that tumor size showed positive association with SWV(r=0.465,P<0.001).Larger tumors had significantly higher SWV than smaller ones(P=0.001).Histological grade 1 tumors had significantly lower SWV values than those with higher histological grade(P=0.015).The Ki67 expression,tumor subtypes and lymph node status showed no statistically significant correlations with SWV,although triple negative tumors and lymph node-positive tumors showed higher SWV values.It was concluded that tumor size was significantly associated with SWV.Higher histological grade was associated with increased SWV.There was no statistically significant correlations between SWV and other histological prognostic factors.
Summary： This study aimed to examine the optimal conditions of laser-induced interstitial ther- motherapy （LITT） via a single-needle delivery system, and the ablation-related pathological and ultra- sonic changes. Ultrasound （US）-guided LITT （EchoLaser system） was performed at the output power of 2--4 Wattage （W） for 1-10 min in ex vivo bovine liver. Based on the results of the ex vivo study, the output power of 3 and 4 W with different durations was applied to in vivo rabbit livers （n=24）, and VX2 tumors implanted in the hind limbs of rabbits （n=24）. The ablation area was histologically determined by hematoxylin-eosin （HE） staining. Traditional US and contrast enhanced ultrasound （CEUS） were used to evaluate the treatment outcomes. The results showed： （1） In the bovine liver, ablation disruption was grossly seen, including a strip-like ablation crater, a carbonization zone anteriorly along the fiber tip, and a surrounding gray-white coagulation zone. The coagulation area, 1.2 cm in length and 1.0 cm in width, was formed in the bovine liver subjected to the ablation at 3 W for 5 min and 4 W for 4 rain, and it extended slightly with the ablation time. （2） In the rabbit liver, after LITT at 3 W for 3 min and more, the coagulation area with length greater than or equal to 1.2 cm, and width greater than or equal to 1.0 cm, was found. Similar coagulation area was seen in the implanted VX2 carcinoma at 3 W for 5 min. （3） Gross examination of the liver and carcinoma showed three distinct regions： ablation cra- ter/carbonization, coagulation and congestion distributed from the center outwards. （4） Microscopy re- vealed four zones after LITT, including ablation crater/carbonization, coagulation, edema and conges- tion from the center outwards. A large area with coagulative necrosis was observed around a vessel in the peripheral area with edema and hyperemia. （5） The size of coagulation was consistent well to the CEUS findings. It was concluded that EchoLaser system
