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Background and Aim: The purpose of this study was to assess the clinical value and potential impact of contrast-enhanced ultrasound (CEUS) in the characterization of undetermined focal liver lesions (FLLs) in patients with fatty liver. Methods: Fifty-two patients (34 men, 18 women) with fatty liver with 67 FLLs (size range, 1–8.6 cm; mean, 4.1 ± 3.1 cm) undetermined at baseline ultrasound (US) underwent contrast-enhanced US. CEUS examinations were analyzed by two experienced sonologists blinded to the final diagnosis. Readers evaluated by consensus the baseline echogenicity, the dynamic enhancement pattern in comparison with peripheral liver parenchyma. The final diagnosis was based on consensus interpreting of all examinations by another two expert observers with access to histological data. The characterization accuracy, sensitivity, and specificity of CEUS in characterizing the lesion as benign or malignant, and as the correct pathologic type, were analyzed. Results: After CEUS, two hemangiomas, three inflammatory pseudotumors, and one hepatocellular carcinoma were misdiagnosed. The overall characterization accuracy, sensitivity and specificity of CEUS were 91% (61/67), 91.7% (11/12), and 90.9% (50/55), respectively. Forty-three benign lesions were diagnosed as the correct pathologic type. The portal venous phase and late phase were important in the characterization of the lesions. The characterization accuracy had no relationship with the size of FLLs. Conclusion: CEUS can improve the characterization of undetermined FLLs arising from fatty liver.

OBJECTIVE To compare the histological characteristics, cell proliferation, apoptosis and biological features in benign prostatic hyperplasia (BPH) in the peripheral (PZ) and transition zone (TZ) of the prostate. PATIENTS AND METHODS Tissue from BPH in TZ and PZ was obtained from 68 patients undergoing transrectal ultrasonography-guided biopsy and used for both morphometric analysis and immunohistochemical studies. The epithelial, stromal and luminal composition of the tissue was determined using a computer-assisted method for quantitative morphometric analysis. Apoptosis was detected as the apoptotic index (AI) using the TdT dUTP nick-end labelling assay. Cell proliferation was determined as the proliferation index (PI) using Ki-67 immunostaining. The expression of epidermal growth factor receptor (EGFR), transforming growth factor β1 (TGFβ1), androgen receptor (AR) and bcl-2 were assessed immunohistochemically. RESULTS There was no difference in the stroma/epithelium ratio between PZ and TZ hyperplastic nodules (P > 0.05). The mean AI in epithelium was almost identical to the corresponding PI. In stroma, no apoptotic cells were detectable. There was a significantly higher PI and AI in the glandular epithelial cells in PZ hyperplastic than in TZ hyperplastic nodules, but no difference in PI of the stromal cells between PZ and TZ hyperplastic nodules. There was significantly higher expression of TGFβ1 and lower expression of EGFR and bcl-2 in PZ than TZ hyperplastic nodules (P 0.05). CONCLUSIONS These results indicate that some hyperplastic nodules in PZ might originate from the PZ, and the formation of these nodules might be modulated in a different way from that in the TZ.

Purpose We examined the relationship between the amount of prostate cancer–associated vascularity as seen on color Doppler imaging and the tumor grade. Methods Transrectal color Doppler imaging of the prostate was performed in 54 patients with prostate cancer. Color flow signal/total pixel ratios (SPRs) of selected images were calculated using the ratio of the number of pixels showing color Doppler signals to the total number of pixels within the lesion. All the patients underwent prostate biopsy guided by transrectal sonography. Gleason scores were determined from the biopsy specimens. Results Color Doppler signals were demonstrated in the lesions of 91% (49/54) of the patients. The mean SPRs of prostate cancers 3 cm or smaller and larger than 3 cm were 0.15 ± 0.07 and 0.11 ± 0.04 (± standard deviation), respectively (p < 0.05). The mean SPRs of well- (Gleason score of 2–4), moderately (Gleason 5–7), and poorly (Gleason 8–10) differentiated prostate cancers were 0.08 ± 0.03, 0.12 ± 0.06, and 0.17 ± 0.11, respectively (r = 0.45; p < 0.01). Conclusions The refinement of color Doppler equipment has improved the detection of color Doppler signals associated with prostate cancer. Our study shows a correlation between prostate cancer–associated vascularity as shown on color Doppler imaging and the tumor grade. © 2003 Wiley Periodicals, Inc. J Clin Ultrasound 31:61–68, 2003