Purpose: The study aimed to examine the Sonazoid contrast-enhanced ultrasound (CEUS) characteristics of breast mass lesions and to create a flowchart for differential diagnosis between benignancy and malignancy.
Subjects and Methods: The patients studied had breast mass lesions and had undergone CEUS between August 2010 and November 2012. Patients were excluded if they had preoperative treatment. Fifty remaining patients with 56 nodules (24 benign, 32 malignant) were examined. CEUS findings were evaluated retrospectively using videos of the first minute after Sonazoid injection. The following findings were evaluated: (1) homogenous enhancement of the entire lesion, (2) heterogeneous enhancement of the lesion with clear defect(s), (3) enhancement extending outward beyond the expected borders of the lesion, and (4) pulsation in the lesion. Item (1) was evaluated on a 5-point scale: not enhanced, similarly enhanced as surrounding breast tissue, slightly more enhanced than surrounding breast tissue, clearly more enhanced than surrounding breast tissue, and difficult to evaluate. Items (2)–(3) were evaluated on a 3-point scale: present, absent, and difficult to evaluate.
Results and Discussion: The numbers of nodules and the aforementioned ratings of CEUS findings were (1) benign 5/9/3/6/1 and malignant 0/1/10/20/1; (2) benign 11/3/10 and malignant 12/13/7; (3) benign 23/1/0 and malignant 15/17/0; and (4) benign 17/0/7 and malignant 16/15/1. In many malignant lesions, the lesion was more enhanced heterogeneously than the surrounding breast tissue, and there were pulsatile enhancement, enhancement extending outward beyond the expected borders of the lesion, and heterogeneous enhancement of the lesion with clear defect(s). In many benign lesions, the entire lesion was enhanced homogenously as much as the surrounding breast tissue, and there was no pulsatile enhancement, enhancement extending outward beyond the expected borders of the lesion, or heterogeneous enhancement of the lesion with clear defect(s). These findings were used to create a flowchart for CEUS-based differential diagnosis between benignancy and malignancy. Its sensitivity, specificity, and accuracy were 87.5%, 91.7%, and 89.3%, respectively, showing good diagnostic ability.
Conclusion: The results of our study suggest that CEUS is useful for diagnosis of benignancy and malignancy of breast mass lesions.

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Purpose: The purpose of this study was to make a comparison of evaluating disease activity between transabdominal ultrasound (US) and colonoscopy (CS) in patients with ulcerative colitis (UC).
Subjects and Methods: From January, 2012 to September, 2013, 28 patients (16 men, 12 woman, age 20–73 years old) suffered with UC were examined by US and CS within two days. Disease activity was evaluated by US and CS in each segment as follows, the cecum, the ascending colon, the right sided transverse colon, the left sided transverse colon, the descending colon, the sigmoid colon, and the rectum. Diagnosis based on CS and US were made according to Matts grade and original US grade, respectively. Disease activity was evaluated as follows; 1. Depicted rate in each colonic segment by US. 2. Rate of concordance of US and CS evaluation in each segment. 3. Coefficient of correlation between US and CS evaluation.
Results and Discussion: 1. Depicted rate of each segment was 100% except the rectum (96.4%). 2. Rate of concordance of US and CS evaluation (ICC) was 0.67. 3. Coefficient of correlation between US and CS evaluation was 0.67. US evaluation was tended to be lower than CS.
Conclusion: Depicted rate of US in each segment was good. The rate of concordance, and coefficient of correlation between US and CS evaluation were substantial.

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Purpose: Impairment of endothelial function and increased thickness of carotid arterial wall are known to be surrogate markers for cardiovascular accidents. The measurement of brachial artery flow-mediated dilation (FMD) is a representative of the noninvasive evaluation of endothelial function. Chronic kidney disease and diabetes mellitus (DM) are important risk factors for atherosclerotic diseases. The aim of this study is to define the differences in these noninvasive vascular indices between patients of preserved renal function with and without DM.
Subjects and Methods: We measured estimated glomerular filtration rate (eGFR), brachial artery FMD and mean carotid intima-media thickness (mean IMT) in 64 patients (M/F 41/23, mean 60 years). The differences in these vascular indices in relation to renal function were examined between the patients with and without DM.
Results and Discussion: eGFR was positively correlated with FMD, and negatively correlated with age, systolic blood pressure (SBP) and mean IMT. In patients with impaired renal function (eGFR<60 mL/min/1.73 m²), age, SBP and mean IMT were significantly higher, and FMD was significantly lower than those in patients with preserved renal function (eGFR>60 mL/min/1.73 m²). There were no differences in FMD and mean IMT between patients of impaired renal function with and without DM. However, FMD was significantly lower, and mean IMT was significantly higher in diabetic patients with preserved renal function as compared to those in non-diabetic patients with preserved renal function.
Conclusions: Diabetic patients with preserved renal function exhibited impairment of endothelial function and increase in carotid IMT as compared to non-diabetic patients with preserved renal function. Early detection of alteration in these noninvasive vascular indices could be essentially important to prevent atherosclerotic vascular disorders in diabetic patients with preserved renal function.

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[in Japanese]

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[in Japanese]

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[in Japanese]

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