Conclusions: Smaller SD values are thought to represent normal or FL,and larger SD values reflect the possibility of CLD that shows coarse echo.Therefore, it is concluded that the SD can be used as a useful quantitativevalue that can determine the coarseness of chronic liver disease.

3618

Analysis of contrast intensity in the liver specific late phase ofenhanced sonography with LevovistTamai H, Oka M, Shingaki N, Shiraki T, Enomoto S, Inoue I,Magari H, Iguchi M, Yanaoka K, Kenji Arii K, Shimizu Y, IchinoseM, Second Department of Internal Medicine, Wakayama MedicalUniversity, Japan

Objectives: Levovist is a galactose-based contrast medium that accu-mulates in the liver parenchyma in the late phase and is thought to bephagocytized by Kupffer cells. The purpose of this study was to assessthe correlation between various liver conditions and the contrast inten-sity seen in the late phase of Levovist-enhanced sonography.Methods: Ultrasound equipment used for the analysis was SONOLINEElegra (Simens). Contrast intensity of microbubbles subtracted fromtissue intensity in the liver parenchyma is measured by NIH imagesoftware in 59 patients with liver tumor. The transmission frequency is2.8 MHz, and phase inversion contrast harmonic gray scale B modewas used. Ultrasound images in late phase were obtained in 5 min afterthe intravenous infusion of 2.5 g Levovist. Focus was always adjusted4 to 6 cm in depth from the body surface as the maximal mechanicalindex was 1.9, and the region of interest was set on the left lobe in thelongitudinal section of upper abdomen.Results: Platelet count, type IV collagen 7S, prothrombin time, albu-min, bilirubin, Child-Pugh score and ICG value (%) were significantlycorrelated with contrast intensity of the microbubbles.Conclusions: The contrast intensity of Levovist in the liver-specificlate phase reflects liver function and the severity of liver fibrosis.

3619

Ultrasound of shoulder instability: Correlation withultrasonography and MR and US arthrographyJeong WK, Armed Forces Capital Hospital, Korea

The ultrasonography to diagnose rotator cuff injuries is well known, butthat for the abnormalities of glenoid labrum is performed relatively alittle. It may be the reason that (1) adjacent bony structures (coracoidprocess, acromion and humeral head) interfere with the sonic window,(2) the joint is located relatively deeply to use high-frequency trans-ducer and (3) because of variable ultrasound artifacts it is difficult thatsmall labral abnormality is revealed. However, ultrasonography is aninexpensive, dynamic, fast and easily accessible method. We performconventional US and tissue harmonic imaging to the patients of shoul-der instability, and perform direct MR arthrography after diluted gad-olinium injection, and then examine the shoulder by ultrasonographyagain to compare between nondilated and dilated joint. This subject ispurposed to know that ultrasound can depict the presence of Hill-Sachsand Bankart lesion and the extent of lesion and substitute MR forpreoperative evaluation.

3620

Imaging spectrum of high risk lesions diagnosed on US-guidedbiopsy and management planYang HR, Kim HH, Shin HJ, Kim SM, Sohn J-H, University ofUlsan, College of Medicine, Asan Medical Center, Korea; SeoulNational University Bundang Hospital, Korea

The purpose of this exhibit is to illustrate the imaging spectrum of thehigh risk lesions diagnosed on sonography-guided biopsy and to sug-

gest the further management plan of these lesions. High risk breastlesions are ductal and lobular proliferations that have either a statisticalassociation with increased risk of subsequent breast cancer, or geneticalterations or mutations similar to those present in ductal carcinoma insitu or infiltrating carcinoma of the breast. Papillary lesions, radialscars, lobular neoplasia and proliferative lesion with atypia are infre-quent histologic entities found at sonography-guided biopsy. The man-agement of these lesions after a sonography-guided biopsy has not beenwell established. This exhibit could help us to learn about whetherimaging findings of high risk lesions found at US-guided biopsy areradiologic-pathologic concordance or discordance and to learn aboutmanagement plan of these lesions.

3621

Ultrasound of groin masses in women: Inguinal anatomy andpathologic conditionJung SE, Oh SN, Lee YJ, St. Mary’s Hospital, The CatholicUniversity of Korea, Korea; Kangnam St. Mary’s Hospital, TheCatholic University of Korea, Korea

Because female groin masses are rare and complex of the anatomy andembryology, these do not arouse radiologist’s interest. However, ultra-sound is best modality of choice in patient presenting palpable groinmass. Various types of hernia and reactive or metastatic lymphadenop-athy are common and various unusual diseases can be affected in thisarea, such as round ligament cyst and varices, wall mass (desmoidtumor and endometriosis), hematoma, pseudoaneurysm, infection andasymmetric prominent fat tissue. Color Doppler ultrasound is useful indiagnosing the vascular mass. The quality of the ultrasound depends onexperience and knowledge of the operator. It is mandatory to have aworking knowledge of the anatomy and embryology of the groin areafor localization and characterization of the masses in this complex area.We will describe the anatomy and embryology of groin area in womenand discuss the differential point of uncommon diseases from commonlesions.

3622

The relationship between cervical length and ultrasoundelastogram of the uterine cervix in pregnant womenYamaguchi S, Kamei Y, Kozuma S, Hanada N, Sakamaki K,Horikoshi T, Komatsu A, Iriyama T, Enari T, Miyachi K, Taketani Y,The University of Tokyo, Japan

Sonographic measurement of cervical length is considered to be themost reliable method to identify high risk patients for preterm delivery.It is, however, desirable to improve its diagnostic accuracy and de-crease the incidence of treatment for preventing preterm delivery. Weperformed cervical transvaginal ultrasound examinations in 25 preg-nant women to obtain cervical length and tissue elasticity images. Wedivided an elastography image of the anterior lip of uterine cervix intofive zones: upper, middle (outer, inner and their border) and lowerzones, and compared their colors with the color of the middle outerzone to evaluate tissue stiffness of the uterine cervix. The stiffness inthe upper and lower zones had significant relationship with cervicallength, but there was no relationship in the border area of the middlezones. A cervical ultrasound examination with elastography might giveadditional information for identifying high risk patients for pretermdelivery.

3623

Low-intensity ultrasound (LIUS) preconditioned mesenchymalstem cells (MSCs) improves healing of articular cartilage defectCui JH, Park SR, Min B-H, Ajou University School of Medicine,Korea; Inha University, College of Medicine, Korea

Abstracts P297

Objectives: In this study LIUS-preconditioned MSCs were implantedinto rabbit cartilage defects and the ensuing outcomes was evaluated inthe context of chondrogenic differentiation of MSCs in vivo and re-sultant defect healing.Methods: Rabbit MSCs were isolated and seeded into polyglycolicacid (PGA) scaffold. The PGA-MSCs constructs were divided into twogroups (US group and non-US group) and cultured in chondrogenicdefined media for a week. The US group received the stimulation at theintensity of 200 mW/cm2 for 10 min twice a day for 1 week. Theconstructs were then implanted into the cartilage defects that werecreated in rabbit femoral trochlea. The gross, histological and immu-nohistological analysis were made at 4, 8 and 12 week post-implanta-tion, respectively.Results: The gross finding showed that the articular cartilage defectswere filled with the repair tissue for all the groups. Histology andimmunohistochemistry however confirmed more intense and widerdistribution of cartilage specific ECM, in the US group than those innon-US-treated group.Conclusions: This study indicated that in vitro preconditioning ofrabbit MSCs can improve healing of cartilage defects that may bethrough due mostly to LIUS induced chondrogenesis of MSCs.

3624

Ultrasonographic features of various cystic lesions in theabdomen: Radiologic and pathologic correlationJun SR, Lee JY, Choi BI, Han JK, Seoul National UniversityHospital, Korea

Cystic lesions occur in almost all abdominal organs and structures, andtheir diagnosis can be challenging. Common lesions include pseudo-cyst (pancreatic or nonpancreatic), choledochal cyst, Meckel’s diver-ticulum, epithelial cysts of various organs, cystadenoma of variousorgans (biliary, pancreas), cystic lymphangioma, mucocele, intraductalpapillary mucinous tumor and so on. Rare diseases include epithelialcyst in intrapancreatic accessory spleen, cystic tumor degeneration,gastrointestinal stromal tumor, renal cell carcinoma, pancreatic cancer,neurogenic tumor, islet cell tumor), dermoid cyst, epidermoid cyst ofthe spleen, Brunner gland hamartoma, intraperitoneal bronchogeniccyst, adrenal cyst, cystic metastasis, etc. We will discuss and illustratethe ultrasonography and MDCT imaging features of these diseases. Wealso correlate radiologic findings with pathologic ones in all cases. Theunderstanding of ultrasonographic features and the radio-pathologiccorrelation of these cystic lesions facilitate us to make accurate diagnosis.

3625

Sonoporating cells for drug delivery: Effect of pulse bandwidthand duty-cycleKarshafian R, Bevan PD, Samac S, Banerjee M, Burns PN,University of Toronto, Sunnybrook Hospital, Canada; SunnybrookHospital, Canada

The combination of ultrasound and microbubbles is currently beingexploited to enhance local drug delivery and uptake. This work inves-tigates the effect of ultrasound parameters on sonoporation, the revers-ible increase in permeability of biological membranes. Suspensions ofKHT-C cells were exposed to ultrasound of varying pressures, pulselengths and duty cycles, in the presence of contrast agent microbubbles(Definity). Fluorescently labeled dextran (70 kDa) was used as apermeability marker. Flow cytometry and microscopy were used toquantify permeability and viability. The bandwidth had a significanteffect, with narrowband tone-bursts more effective at permeabilisingcell membranes. However, longer pulses also killed more cells, de-pending on the pulse repetition frequency (PRF). Our results suggestthat with a bubble concentration of 3.5% (volume-concentration), 16

cycles at 3 KHz PRF may be optimum for such permeabilization,achieving a maximum of 70 � 5% permeabilised, viable cells. Currentwork applies this finding to an in vivo model.

3626

Predictability of transvaginal ultrasonography in terms of serumestradiol level per mature follicle in controlled ovarianhyperstimulation cycles using GnRH antagonistsLee JR, Ku YH, Ku S-Y, Jee BC, Suh CS, Choi YM, Kim JG, MoonSY, Kim SH, Department of Obstetrics and Gynecology, College ofMedicine, Seoul National University, Korea; Institute ofReproductive Medicine and Population, Medical Research Center,Seoul National University, Korea

Objectives: Serum estradiol level on ovulation-triggering day duringcontrolled ovarian hyperstimulation cycles using GnRH agonists (Gn-RHa) correlates well with number of mature ovarian follicles, and isapproximately 150 to 250 pg/ml per follicle � 14 mm in diameter.However, to date, few such reference data are available for GnRHantagonist (GnRHant) cycles. We attempted to evaluate a relationshipbetween number of mature follicles and serum estradiol levels duringGnRHant cycles.Methods: On ovulation-triggering day of GnRHant (n � 97) andGnRHa (n � 102) cycles, number of follicles � 14 mm was countedusing transvaginal ultrasonography, and serum estradiol level wasmeasured using radioimmunoassay. Statistical correlation was ana-lyzed between serum estradiol levels and number of mature follicles.Results: Clinical characteristics of study subjects did not differ be-tween the two groups. Serum estradiol levels per follicle � 14 mmwere 201.9 pg/ml (r � 0.544, p � 0.001) in GnRHant cycles and 161.9pg/ml (r � 0.357, p � 0.001) in GnRHa cycles, respectively.Conclusions: Estimated serum estradiol level per mature follicle ofGnRHant cycles may be higher than that of GnRHa cycles, whenmeasured by transvaginal ultrasound on ovulation-triggering day. Weshould interpret the relationship between number of mature folliclesand serum estradiol level differently during GnRHant cycles.

3627

Myocardial tissue tracking is influenced by acute preload changein patients with end-stage renal diseaseShin M-S, Shim E-O, Chung W-J, Kang WC, Han SH, Koh KK, AhnTH, Chol I-S, Shin EK, Gachon Medical School, Gil Medical Center,Korea

Objectives: We investigated the influence of acute preload reductionon tissue Doppler imaging (TDI) data.Methods: Twenty-nine patients with end-stage renal disease werestudied by TDI and standard Doppler before and after hemodialysis.From the apical window, TDI sample volume was placed at the mitralannulus and the mid segment of anterior and posterior wall of leftventricle (LV). Tissue velocity, tissue tracking, strain and strain ratewere measured. Peak early (E) and late diastolic velocities of transmi-tral flow were measured.Results: Mean body weight change was 2.6 � 0.8 kg. LV ejectionfraction was not significantly changed after hemodialysis. Myocardialtissue tracking was decreased from 7.9 � 2.4 mm to 6.4 � 1.9 mm afterhemodialysis (p � 0.05). Peak systolic tissue velocity, strain and strainrate were not significantly different. E-velocity, early to late diastolicflow velocity ratio and peak velocity of pulmonary venous diastolicflow were significantly decreased (p � 0.05). Deceleration time ofE-wave showed increasing trend after hemodialysis.Conclusions: Tissue tracking measuring myocardial displacement areinfluenced by acute preload change. Therefore, preload should beconsidered in the interpretation of tissue velocity and tissue tracking.

P298 Ultrasound in Medicine and Biology Volume 32, Number 5S, 2006