Review Article

Progress in Imaging Diagnosis and Image-guided Puncture Biopsy of Prostate Cancer

Lixue Zhai, MD, Xiaojuan Zhang, MD, Yuxiu Gao, MD, Zhaoyan Ding, MD, Haiyang Yu, MD, Cheng Zhao, MD

2019, 3 (4): 175-181. DOI:10.37015/AUDT.2019.191223

Abstract ( 525 ) HTML ( 121 ) PDF ( 600KB ) ( 394 ) 　　

The current standard technique for diagnosing prostate cancer (PCa) in men at risk relies on a transrectal ultrasound (TRUS)-guided needle biopsy due to its real-time nature and simplicity to obtain systematic histological specimens of the prostate. Also several magnetic resonance imaging (MRI)-based techniques have been employed due to their high detection rate of clinically significant PCa (csPCa). MRI-TRUS fusion imaging contains both the information of MRI and TRUS images for prostate biopsies. This technique combines the strengths of these two techniques, including the superior sensitivity of MRI for targeting cancerous lesions the real time and practicality of TRUS. This review briefly introduces the development of TRUSguided biopsy, MRI-guided biopsy and MRI-TRUS fusion imaging techniques for prostate cancer.

Original Research

Dual Modal Ultrasound Elastography of the Sternocleidomastoid Muscle in Healthy Infants: A Prospective Study

Na Xu, MD, Bei Xia, MD, Wei Shi, MD, Ningning Tang, MD, ZhiXia Wu, MD, Binxuan Huang, MD, Hongwei Tao, MD

2019, 3 (4): 182-186. DOI:10.37015/AUDT.2019.191219

Abstract ( 477 ) HTML ( 12 ) PDF ( 480KB ) ( 1101 ) 　　

Objective: To evaluate the reliability of ultrasonographic (US) elastography of the sternocleidomastoid (SCM) muscle and to define normal strain ratio and shear wave velocity (SWV) values in healthy infants.
Methods: Two hundred healthy infants (mean age ± standard deviation, 1.64±1.78 month; 113 boys and 87 girls) were included in this prospective study. The thickness of bilateral SCM muscles was measured by B-mode ultrasonography, and the stiffness of SCM muscles was measured in both the longitudinal and transverse sections, symmetrical and extensional supine position, by using strain and shear wave elastography. The correlation between thickness and elastic values of the SCM muscle and the following possible influential factors were evaluated: sex, different sides of SCM muscle, different ultrasonic sections and different infant positions.
Results: Both sex and the side of SCM muscle did not show significant correlation with the thickness or stiffness of the SCM muscle (P > 0.05). The stiffness of SCM muscle in the longitudinal section was significantly greater than in the transverse section (P < 0.05). The measurements of the SCM muscle in the stretching position were significantly greater than those in the symmetrical position (P < 0.05).
Conclusion: The stiffness of SCM measured by US elastography is affected by relative positions of the infants. Therefore, the factor should be taken into account when measuring the stiffness of SCM by US elastography. US elastography can evaluate the stiffness of SCM, which is helpful for clinical diagnosis and treatment of children with torticollis.

Differences Between Type I and Type II Papillary Renal Cell Carcinoma on Ultrasound

Qing Zhang, MD, Shuping Wei, MD, Bin Yang, MD, Xiaoqin Qian, MD

2019, 3 (4): 187-192. DOI:10.37015/AUDT.2019.191220

Abstract ( 253 ) HTML ( 9 ) PDF ( 436KB ) ( 307 ) 　　

Objective: To identify the characteristics and differences between type I and type II papillary renal cell carcinoma (PRCC) using ultrasound.
Methods: Twenty-five patients with PRCC, including 16 cases of type I and 9 cases of type II PRCC, were enrolled in this study. All lesions were surgically resected and pathologically confirmed. A conventional ultrasound and a contrast-enhanced ultrasound were performed on each of the 25 patients with PRCC before the operation. Both ultrasounds were performed by a single highlyqualified doctor with more than 10 years of experience. Features, including maximum diameter, boundary, shape, and growth pattern of the mass, color Doppler flow image (CDFI), enhancement pattern, degree, and uniformity, arrival time; and time to peak, obtained from the conventional and contrast-enhanced ultrasounds, were analyzed and compared between type I and type II PRCC.
Results: On conventional ultrasound, type II PRCCs were significantly larger (P = 0.000), less clear (P = 0.001) and more irregular (P = 0.004) than type I PRCCs. There was also a statistically significant difference in growth pattern (P = 0.019) and enhancement uniformity (P = 0.016) between type I and II PRCC.
Conclusion: There are statistically significant differences in sonographic features between the two types of PRCC. This knowledge could assist clinicians when choosing surgical procedures.

Case Report

Real-time Ultrasound Volume Navigation Guided Transforaminal Percutaneous Endoscopic Lumbar Discectomy in Anatomic Variation: A Case Report

Yingying Li, MM, Peng Huang, MD, Shoupeng Li, MM, Mingbo Zhang, MD

2019, 3 (4): 193-196. DOI:10.37015/AUDT.2019.191232

Abstract ( 362 ) HTML ( 6 ) PDF ( 358KB ) ( 471 ) 　　

Percutaneous endoscopic lumbar discectomy (PELD) has become a mature and mainstream minimal invasive surgical technique in the treatment of lumbar disc herniation (LDH). During the operation, transforaminal puncture is considered as a critical and complicated step which is usually carried out under the guidance of X-ray. However, radiation exposure brings a potential threat to the health of the patients and the surgeons. Besides, nerve roots and vessels may be injured since they are invisible on X-ray. So we still need a real-time accurate image guiding system, especially in difficult cases with anatomic variation. Here we report a case to describe a new method, volume navigation with fusion of real-time ultrasound and CT images, to guide PELD in a patient with right L4-L5 LDH who had anatomic variation of lumbar sacralization. Ultrasound volume navigation guided puncture and cannulation process lasted only 10 minutes and the operation decompression time lasted 60 minutes. The total emission radiation dose was 9mGy. The straight leg elevation increased from 50 to 80 degrees after PELD. The Visual Analog Scale (VAS) of low back pain reduced from 5 to 1 and leg pain reduced from 7 to 1 immediately after PELD. This is the first case of ultrasound volume navigation in guidance of the postural lateral transforaminal puncture and cannulation process of PELD.

Differences in CEUS and CE-MRI Appearance of HCC: A Case Report

Li Ma, MD, Wenzhao Liang, MD, Yupeng Zhu, MD, Yingqiao Zhu, MD, Dezhi Zhang, MD

2019, 3 (4): 197-199. DOI:10.37015/AUDT.2019.191208

Abstract ( 324 ) HTML ( 23 ) PDF ( 471KB ) ( 353 ) 　　

Hepatocellular carcinoma (HCC) is the most common liver cancer, accounting for more than 90% of liver cancers. It results in between 250,000 and 1 million deaths globally per annum. Unlike other cancers, HCC can usually be diagnosed on imaging studies only, without tissue sampling confirmation. Nowadays, contrast-enhanced ultrasound (CEUS) is usually used to detect HCC in the clinic because it’s more applicable for the characterization of a known lesion. But the sensitivity of CEUS is less than 50% for small tumors.