Objective To determine the value of contrast-enhanced ultrasound (CEUS) in the differentiation of primary liver cancer (PLC) and hepatic alveolar echinococcosis (HAE). Methods The data of 56 patients with PLC or HAE were collected between January 2010 and May 2015. Grayscale and CEUS features of the patients were analyzed retrospectively. The frequency of each imaging finding, including calcification, arterial enhancement, and internal enhancement were evaluated and compared. Results Statistically significant difference of the proportion of gender and age were detected between the two groups (P=0.013, 0.002). Thirty-eight PLC lesions were detected in 32 patients. The diameters of PLC lesions were 3-10 cm with an average of (5.6±2.1) cm. Thirty-two HAE lesions were found in 24 patients. The diameters of HAE lesions were 4-12 cm with an average of (9.1±4.4) cm. Statistically significant difference of lesion size and the incidence rate of calcification (5.3% vs. 75.0%) were seen between PLC and HAE (P<0.001). Peripheral enhancement were seen in 100.0% (38/38) PLC lesions, including 84.2% (32/38) hyperenhancement and 15.8% (6/38) dendritic hyperenhancement. All PLC lesions demonstrated hypoenhancement in late phase. Irregular peripherally hyperenhancement both in arterial and late phase were detected in 43.8% (14/32) HAE lesions. The other 56.2% (18/32) HAE lesions showed no peripheral enhancement both in arterial and late phase. No internal enhancement were seen in HAE lesions. The presence of arterial enhancement (100.0% vs. 43.8%) and absence of internal enhancement (0 vs. 100.0%) were significantly different between PLC and HAE (P<0.001). Conclusions PLC is predicted by arterial phase hyperenhancement and late phase hypoenhancement on CEUS. HAE is predicted with calcification on baseline sonography and internal non-enhancement on CEUS. Arterial phase enhancement is less common and less intensive in HAE than in PLC which also contributes to the differentiation of these lesions.
Objective To investigate the ultrasonographic characteristics of acute Stanford type A aortic dissection (ATAAD) involving renal artery and its relationship with renal function. Methods The patients with ATAAD admitted to our hospital from February 2013 to May 2023 were selected. According to whether dissection involved renal artery, the patients were divided into a renal artery involved group and a renal artery uninvolved group. The general data and ultrasonic characteristics of the two groups were compared, and the relationship between ultrasonic characteristics and renal artery involvement in ATAAD patients was analyzed by logistic regression analysis and correction model. Receiver operating characteristics (ROC) curve was used to evaluate the predictive value of ultrasonic characteristics for renal artery involvement in ATAAD patients. In addition, according to blood urea nitrogen (BUN) and Serumcreatinine (Scr), patients with renal artery involvement were divided into a normal renal function group and an abnormal renal function group. The general data of the two groups were compared, and the risk effect of ultrasonic characteristics involving renal artery in renal function was analyzed by Log-binomial model. Pearson correlation analysis was used to analyze the correlation between ultrasonic features involving renal artery and renal function indexes. Results Finally 163 patients were collected, including 154 males and 89 females, aged 20 to 85 (50.06±10.46) years. There were significant differences in gender, Scr and BUN between the renal artery involved group and the non-involved group (P<0.05). Compared with the non-involved group, the ascending aorta diameter, the proportion of patients with left ventricular wall thickening and renal perfusion difference in the involved group were greater (P<0.05). Logistic regression analysis showed that after adjusting for confounder, the ultrasonic characteristics and OR values of renal artery involvement in ATAAD patients were 1.916, 2.578 and 1.969, respectively. Ascending aortal diameter, left ventricular wall thickening and poor renal perfusion were independent influencing factors of renal artery involvement (P<0.05). The ultrasonic features were effective in predicting renal artery involvement in ATAAD patients. The combined prediction of the three factors involved renal artery, and the prediction efficiency was higher. Compared with normal renal function group, BUN, Scr, ascending aorta diameter, proportion of ascending aorta widening patients and renal perfusion difference in abnormal renal function group were greater (P<0.05). Log-binomial model analysis showed that the risk ratio of increasing ascending aorta diameter, widening ascending aorta and increasing renal perfusion difference had statistical significance before and after significant adjustment (P<0.05). The results of Pearson correlation analysis showed that ascending aorta diameter, ascending aorta widening and renal perfusion difference were closely related to renal function indexes (P<0.05). ConclusionThe ultrasonic features of ATAAD involving renal artery can affect renal function and have a certain correlation, and the increase of ascending aorta diameter, widening of ascending aorta and renal perfusion difference are independent risk factors for renal function abnormalities.