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ABSTRACT: Objectives- To study the effect of local interventional treatment of unruptured ectopic pregnancies with multiple-drug injection guided by color Doppler sonography. Methods- In this retrospective analysis, 49 patients with an unruptured ectopic pregnancy were treated with two different local injection methods administered under sonographic guidance. The patients were divided into single-drug (n = 23) and multiple-drug (n = 26) injection groups, and they received a locally administered injection of methotrexate alone or a combination including methotrexate, hemocoagulase, antibiotics, and anti-inflammatory drugs, respectively. Overall, local injection treatment was successful in 44 patients. The 5 patients with failed treatment underwent laparotomy about 1 week after single-drug injection. Serum β-human chorionic gonadotropin (β-hCG ) levels, ectopic pregnancy mass sizes, blood flow at various points after treatment, the incidence of pelvic bleeding, and the time for serum β-hCG levels to return to normal and the mass to resolve were analyzed in the remaining 44 patients. Results- Single-drug treatment was successful in 18 patients; 10 of 23 had low to moderate pelvic bleeding after treatment, and 5 were referred for surgery. All 26 patients were successfully treated by multiple-drug injection. Only 2 patients had a small amount of pelvic bleeding. Differences between groups were statistically significant (P < .05) for surgery rates, the incidence of pelvic bleeding, transient increases in serum β-hCG levels, mean days to normal β-hCG levels, mean days of mass resolution, and mean mass diameters 1 to 6 weeks after treatment. Conclusions- Local multiple-drug injection under color Doppler guidance is a new, safe, and effective method for treating unruptured ectopic pregnancies. It accelerates the serum β-hCG decline and facilitates mass resolution. This regimen is associated with a very low rate of pelvic bleeding, improves the success rate of conservative treatment, and, therefore, has value as an important clinical application.
Journal of ultrasound in medicine: official journal of the American Institute of Ultrasound in Medicine 10/2012; 31(10):1627-34. · 1.25 Impact Factor
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ABSTRACT: The aim of this study was to determine the effectiveness of ultrasound-guided interventional therapy in the treatment of postoperative recurrent chocolate cysts. The 198 patients enrolled in this study were divided into three groups. In group 1, the saline washing group, the cavity of the cyst was washed thoroughly with warm saline. In group 2, the ethanol short-time retention group, after washing with saline, the cyst was injected with 95% ethanol with a volume of half of the fluid aspirated from the cyst. Ten minutes later, the rest of the ethanol was aspirated. In group 3, the ethanol retention group, the procedures were the same as with the ethanol short-time retention group, except that 95% of the ethanol was retained in the cyst. An ultrasound examination was performed in the third, sixth and 12th months after therapy. The chocolate cyst cure rate was significantly higher in the ethanol retention group (96%, 66/69) than in the ethanol short-time retention group (82%, 56/68) and no case was cured in the first group (saline washing). We conclude that ultrasound-guided injection and 95% ethanol retention are an effective therapy for the treatment of postoperative recurrent chocolate cysts.
Ultrasound in medicine & biology 08/2011; 37(10):1596-602. · 2.02 Impact Factor
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ABSTRACT: Renal clear cell carcinoma (RCCC) is the most common malignant renal tumor. It is highly malignant, does not cause clinical symptoms in its early stages, and cannot be diagnosed using conventional ultrasound. This study was aimed to investigate the contrast-enhanced ultrasound (CEUS) mode and characteristics of the time-intensity curve for RCCC and its pathological basis.
Forty-two patients with pathologically diagnosed RCCC underwent CEUS examination before surgery. The patients' kidneys were visualized after injection of contrast agents using the Technos MPX DU8. We analyzed the CEUS mode, time-intensity curve, and pathological findings.
The detection rate of RCCC with conventional ultrasound was about 71%, while the rate using CEUS was 100%. Larger tumors (33 cases) showed non-uniform enhancement with defective filling. CEUS modes were divided into 4 types: type I, "quick in and out" (26.19%, 11/42); type II, "quick in and slow out" (40.48%, 17/42); type III, "Simultaneous in and out" (16.67%, 7/42); and type IV "slow in and out" (16.67%, 7/42). All types had a close correlation to the pathological basis. Time-intensity curve of CEUS consisted of 3 phases, the perfusion phase, regression phase, and lag phase. Cases of types I and III only had a perfusion and regression phase, those of type II and IV had a perfusion phase, regression phase, and lag phase. Quantitative analysis of the time-intensity curve showed that the time-to-peak (TTP) of the lesions was shorter than that of normal renal parenchyma (P < 0.0001), the mean value of the up slope rate of the absolute value of lesions was higher than that of the ipsilateral normal renal parenchyma (P < 0.0001), and that the mean value of descent slope rate of the absolute value of lesions was lower than that of the ipsilateral normal renal parenchyma (P < 0.0001).
CEUS is useful in detecting small vessels in tumors. Although there are several different CEUS modes, type I "quick in and out" and type II "quick in and slow out" accounted for the most cases that had a close correlation to pathologic angiogenesis. Time-intensity curves also showed some special characteristics. These data could provide valuable information for the clinical diagnosis of RCCC.
Chinese medical journal 05/2009; 122(10):1179-83. · 0.86 Impact Factor
