Background: To evaluate the value of shear wave elastic imaging (SWE) in the classification of esophageal varices (EV) and detection of rupture hemorrhage.Methods: A total of 120 patients with clinically diagnosed cirrhosis were selected from October 2017 to October 2018 and underwent ultrasonography, endoscopy, and laboratory examinations. Several factors, including gender, age, body mass index (BMI), aspartate aminotransferase (AST), AST to platelet count ratio index (APRI), portal vein diameter, platelet count, spleen thickness, liver stiffness (LS), and spleen stiffness (SS), were evaluated for their diagnostic value for EV classification and detection of rupture hemorrhage.Correlation analyses were also conducted. Results:The APRI, portal vein diameter, platelet count, spleen thickness, LS, and SS had areas under the curve (AUCs) of 0.76, 0.81, 0.82, 0.89, 0.84, and 0.91, respectively, indicating their potential use as indices for the diagnosis of EV (all P<0.05). The platelet count and APRI could not distinguish low-risk EV from high-risk EV (P=0.301, P=0.564), but EV with or without rupture hemorrhage was identified by SS (P<0.001).Therefore, SS is a valuable factor for the identification of low-risk EV and high-risk EV, as well as for the identification of EV with or without rupture hemorrhage. Spearman's correlation analysis indicated that the occurrence of EV is moderately correlated with APRI, portal vein diameter, platelet count, and LS (r=0.41, 0.49, 0.51, 0.54, P<0.05) and highly correlated with spleen thickness and SS (r=0.63, 0.65, P<0.05).Conclusions: SWE demonstrated a high diagnostic value, supporting its application as a non-invasive method for predicting EV classification and rupture hemorrhage.

Aggressive angiomyxoma (AAM) is rare. AAM is characterized by invasion and recurrence.Improving the detection rate of AAM through ultrasonic inspection technology. There is very little literature reported on AAM. And the literature on the ultrasonic performance of AAM is rare. Therefore, this article describes the ultrasound manifestation of a 54-year-old woman whose pathology is confirmed to be AAM, and summarizes the common ultrasound manifestations of AAM. The unique feature is that the ultrasound performance does not explore the typical "vortex". So we need to diagnose this case through other ultrasound findings. The patient initially had no obvious cause of pain in the right hip. Transvaginal ultrasound examination of the pelvic was performed on the patient, and pathological sections were examined. The result suggested mesenchymal tumor. After surgical resection of the tumor, the pathology was again confirmed as AAM. The tumor is composed of well-differentiated spindle-shaped stellate cells with interstitial mucus degeneration, and vascular proliferation can be seen, which is consistent with deep AAM. Through this case we found that pathology is the gold standard for AAM, but early screening of AAM by ultrasound is feasible.

Chinese women have dense and small breasts. Therefore, in China, contrast ultrasound and ultrasound elastography are commonly used for detection of the breast lumps. Purpose of the study was to compare the sensitivity and accuracy of ultrasound elastography with contrast ultrasound for the diagnosis of the breast lumps. A total of 1000 women with a damp in breast mass, breast pain, nipple discharge, and/or breast skin discharge were subjected to contrast ultrasound and ultrasound elastography. Women were subjected to stereotactic vacuum-assisted biopsy under B-mode ultrasonography (n = 750). The ultrasound examinations were graded on a 5-points scale method. Data were subjected to the Chi-square Independence test at 99% of confidence level. Ultrasound elastography was detected the same numbers of benign lesions (648 vs 651, P = .88), malignant lesions (90 vs 99, P = .53), and false positive lesions (5 vs 0, P = .07) as those detected by biopsies. However, diagnostic parameters for contrast ultrasound had a significant difference with those detected by biopsies ( P < .0001 for all). For contrast ultrasound and ultrasound elastography, the working area to detect deformation in the image of the breast lesions at least 1 time were 0% to 45% and 5% to 100%. Ultrasound elastography is the most reliable diagnostic method for detection of the breast lumps.

Gallbladder adenomyomatosis (GAM) is an acquired, reactive, tumor-like condition. Malignant transformation is extremely rare, and imaging features during contrast-enhanced ultrasound (CEUS) have not been described before. Herein, we describe a 73-year-old Asian man who had been diagnosed with gallbladder carcinoma by conventional ultrasonography (US). Based on additional radiological findings, we believed that it was a localized adenomyomatosis. However, the histopathological diagnosis was adenocarcinoma originate from adenomyomatosis with serosal invasion. We believe this is the first case of adenocarcinoma derived from GAM with characteristics of CEUS findings. This case is presented to indicate a clinical awareness of malignant transformation of GAM and discuss the radiology significance with an emphasis on CEUS.