performance of anti-adhesion and durability of the antennas. The com-plications and local recurrence were compared in clinical study.Results: The coagulation necrosis of the new type of microwaveelectrode had less carbonization. With its longer short-axis diameter (p� 0.01) and a shorter long-axis diameter (p � 0.01), the coagulationnecrosis took a more round shape. The antenna did not burn the skin.There were less complications and low rate of local recurrence inclinical.Conclusions: The new type of microwave antenna has a better perfor-mance and suits percutaneous microwave coagulation therapy for livercancer.

3324

Study on optimal dosage of slow-released carboplatinmicrospheres for intratumoral injection on rabbit VX2 livertumorZhuo ZX, Zhuo Q, Xinqiao Hospital of the Third Military MedicalUniversity, China

Objectives: To investigate the effect and the side effect of variousdoses treatment groups of slow-released carboplatin microspheres byintratumoral injection on the rabbit VX2 liver tumor.Methods: Rabbits with VX2 liver tumor were divided into five treat-ment groups and control group. Changes of the tumors’ volume andblood routine were observed during the 14 days therapy. Comparisonwas made between the five treatment groups and control group andwithin the five groups.Results: It was shown that slow-released carboplatin microspherespossessed obviously antitumoral effects, manifested as dose-depen-dence. The side effects between groups were insignificant (p � 0.05).Conclusions: Group E was evidenced to have the most effective tumorinhibition and no obvious side effect. It may be considered as theoptimal dosage for the treatment of rabbit liver VX2 tumor.

3325

Intraoperative sonography during liver resection forhepatocellular carcinomaHu J-T, Yang S-S, Lai Y-C, Huang C-S, Hung S-H, Lin G-L, CathayGeneral Hospital, Taiwan; Liver Unit, Cathay General Hospital,Taiwan; Dept of Surgery, Cathay General Hospital, Taiwan; Dept ofPathology, Cathay General Hospital, Taiwan

Objectives: We retrospectively studied the role of intraoperativesonography (IOS) in the resection of hepatocellular carcinoma (HCC).Methods: Ninety-five cirrhotics underwent surgical resection for livertumors were studied. All patients had only one single liver tumor. Eightpatients were excluded for non-HCC. Sixty-four patients having tradi-tional hepatectomy without IOS were classified as Group A. Theremaining 23 patients under IOS were classified as group B. Allpatients had been followed-up for 5 years.Results: The gender (M/F, 45/19 versus 11/12), age (54 � 11 yearsversus 54 � 9 years) and Child-Pugh grading (A/B, 30/34 versus 15/8)were not different between groups A and B. The size of liver tumor(144 � 209 cm3 versus 114 � 274 cm3, p � 0.66) was not differentbetween two groups. Group B had smaller resected liver tissue volume(687 � 685 cm3 versus 369 � 449 cm3, p � 0.02). Group B also hadless hospitalization days (13.8 � 7.5 days versus 9.0 � 3.0 days, p �0.039) and complication rate (44% versus 22%, p � 0.046). The 1-yearsurvival rate (84.4% versus 91.3%, p � 0.409) was not differentbetween two groups.Conclusions: IOS may reduce resected liver tissue volume, complica-tion rate and hospitalization days. Traditional wider resection of livertumor does not improve survival rate.

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US-guided omental core biopsy for differentiation of omentalinfiltration on CTLee JK, Baek SY, Ewha Womans University Mokdong Hospital,Korea

We try to show the clinical utility of core biopsy technique in omentalinfiltration on CT and potential applications beyond the patients havingstrong possibility of malignancy. Although sampling error remains aproblem for core biopsy, US-guided core biopsy of omental mass is asafe and accurate option for achieving a firm diagnosis without re-course to laparoscopy or laparotomy. However, when the pathologypresents as omental infiltration only without mass on CT, it is difficultto decide safety, possibility of adequate sampling, and efficient site ofcore biopsy. We compared contrast-enhanced CT and targeted US ofomental pathology from benign to malignant causes, and demonstratedthe site of core biopsy on contrast-enhanced CT and US. We believethat US-guided core biopsy may be a safe and accurate method toobtain omental tissue, which provides the firm diagnosis of omentalpathology presenting as omental infiltration without omental cakeformation or nodularity on CT.

3327

Value of high-end duplex-sonography for compensation ofneuronavigation pitfallsResch KMD, Schroeder HWS, University of Greifswald, Germany

Objectives: Meanwhile neuronavigation is well established, the weakpoints are now more clear than at introduction. Therefore, intraopera-tive imaging gained an increasing role to overcome these problems.Due to its excellent properties high-end sonography is becoming aninteresting tool in neurosurgery.Methods: In a series of 225 cases of intraoperative high-end sonogra-phy imaging we had 120 cases in which neuronavigation problems hadto be compensated. There were 11 females and 9 males, mean age was33.5 years (0.1 to 57 years). Neuronavigation was done with the Zeissand Brain Lab Navigation System and sonography with the Pro Sound5000 ALOKA machine.Results: In two cases the navigation system could not be used becauseof technical problems of hardware. In 16 cases the operative accuracywas too low to target the lesion, and in four cases navigation wasdisplaced by sonography. There were four small cavernomas, onemelanoma, two cysts, two slit ventricles and 11 tumors. The advantagesof the sonography were the real-time use, the online imaging and theeasy handling. The disadvantage was the unusual appearance of thesono images compared to CT or MRT.Conclusions: In conclusion, high-end sonography can compensateneuronavigation pitfalls easily regarding targeting and orientation.

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Endo-neuro-sonography (ENS): First clinical seriesResch KMD, Univ. of Greifswald, Germany

Objectives: The goal to further development had therefore been tomake neuro-endoscopy safer. After laboratory work, in a first series of70 patients with a broad variety of lesions, a sono-catheter for trans-endoscopic imaging was applied for the first time in neurosurgery.Methods: A trans-endoscopic sono-catheter (Aloka DeutschlandGmbH, Dusseldorf/Germany) with a diameter of 1.9 mm (6F) and 2.5mm (8F) was used, and introduced into the working canal of anendoscope. The image produced by the probe is a 360° scan (“brainradar”) displayed on a monitor on which some parameters can be variedto get best view of different anatomical structures.

P246 Ultrasound in Medicine and Biology Volume 32, Number 5S, 2006

Results: In 51 cases intraoperative imaging was the main reason forinvestigation and in 15 cases neuronavigation was in the focus ofinterest. In 20 cases of tumor resection control, targeting a visualizedremnant was necessary. ENS proved in this small series to makeneuroendoscopy safer and easier by online and real-time imaging withhigh resolution. There are limitations and artifacts, which should revealthemselves in laboratory and clinical experience.Conclusions: Endo-neuro-sonography, as it stands now, is a techniquethat can contribute to the concept of minimally invasive techniques inneurosurgery, as this presentation does describe.

3329

Sonographically guided fine-needle aspiration biopsy of multiplethyroid nodulesKim J, Bae IH, Chungbuk National University Hospital, Korea

Objectives: The purpose of this study is the evaluation of pathologicresult in a patient who had multiple nodules, and to decrease unneces-sary procedure or operation.Methods: We conducted a prospective study in 545 nodules of 205patients (mean age 48 years; range 20 to 78) who had two or morenodules between February 2002 and March 2004. All nodules werepathologically proven by USG-guided percutaneous fine-needle aspi-ration biopsy or surgery were included in this study. Compare thepathologic result of each nodule in a patient according to the internalcontent, margin, echogenicity, shape and calcification. We classified astwo groups, all nodules’ feature was same group and at least onenodule’s feature was different group.Results: In 205 patients, 78 were equal featured group and 127 werenot. Equal featured group’s pathologic result is same in all patients(100%). Different featured group’s pathologic results were different in23(18%) patients and same in 104 (82%).Conclusions: If the feature of multiple nodules is equal, then thepathologic result is same in a patient. So, when doing FNAB samefeatured multiple nodules, only one representative nodule can be aspi-rated.

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The role of ultrasonography in the diagnosis of blunt andpenetrating thoracic traumaTrofimova EY, Abakumov MM, Kartavenko VI, Gusev VV,N.V.Sklifosovsky Research Institute of Emergency Medical Aid,Russian Federation

Objectives: To study the potential of ultrasonography (US) for lungmonitoring in patients with thoracic trauma.Methods: We reviewed the results of serial thoracic US examinationsperformed in 320 patients admitted with lung injury after severe bluntthoracic trauma (BTT) (225) and penetrating wounds (PW) (95).Results: In 37 patients (11.6%), US performed within the first 24 h waslow informative because of subcutaneous emphysema. The US sensi-tivity in identifying hemothorax within the first several hours aftertrauma was 92%. Further US examinations revealed hemothorax innine more patients, aggravation of hemothorax in three, clotted hemo-thorax in 12, pleural empyema in 10 patients. Lung abnormalities wererevealed in 76 patients (80%) after PW. In eight patients with thewound in the lung edge, no abnormalities were visualized. Within thefirst 48 hours after BTT, lung trauma was revealed in 42 patients(18.7%). Later on, US showed intrapulmonary hematoma in six pa-tients and intrapulmonary abscess in one patient. The treatment of 35patients with BTT and US-revealed lung contusion included mechan-ical lung ventilation (PEEP). US monitoring demonstrated markedimprovement over time.

Conclusions: US may be used as a monitoring technique to evaluatepleural cavity and lung helping to reduce X-ray exposure.

3331

The usefulness of ultrasound guided core needle biopsy inperipheral pulmonary diseasesQi Q, Zhang H, Ji Z, Huang B, Mao F, Wang W, ZhongshanHospital, Fudan University, Shanghai, China

Objectives: To evaluate the efficacy of ultrasound-guided core needlebiopsy (US-CNB) with 16-gauge cutting needle in the diagnosis ofperipheral pulmonary diseases.Methods: One hundred twenty-four patients with peripheral pulmo-nary diseases underwent US-CNB. Among them, 112 patients hadundergone thoracoscope examination and failed to get a histologicdiagnosis. Biopsy was performed with US guidance by a free handtechnique using 3.5 MHz transducer and an automatic spring loadedbiopsy gun with a 16-gauge cutting needle for lesions larger than 20mm or a 16-gauge semiautomatic biopsy needle for lesions smaller than20 mm.Results: The histologic diagnoses were conclusive in 119 cases(96.8%) and inconclusive in five cases (3.2%).The histologic diagnosesincluded 64 cases of benign diseases and 55 cases of malignancy. Therewere nine cases of complications: hemoptysis (n � 5), pneumothorax(n � 2) and pain (n � 2). None was severe.Conclusions: US-CNB with 16-gauge cutting needle in the diagnosisof peripheral pulmonary disease is safe and has high accuracy. It is aneffective complementary method of thoracoscope.

3332

Ultrasound-guided interventional procedures in pleural diseases:State of the artKang E-Y, Woo OH, Yong H-S, Oh Y-W, Park C-M, Cha I-H,College of Medicine, Korea University, Korea

This exhibit is to illustrate the usefulness of ultrasound-guided inter-ventional procedures in patients with pleural diseases. In clinical prac-tice, pleural diseases are very common and thoracic radiologists play acrucial role in the imaging and management of pleural diseases. Tho-racic radiologists use US frequently for diagnostic and therapeuticthoracentesis, drain catheter insertions, and pleural biopsies. A 3.5–10MHz sector or linear transducer is used according to requirement ofspatial resolution and penetration depth, and US window for pleura isintercostal spaces. US assess the presence of pleural disease and eval-uate pleural effusion with septa and loculations. Diagnostic and ther-apeutic thoracentesis is required for pleural effusions and US-guidedthoracentesis improves the success and decreases complications. Im-age-guided pleural biopsy shows a high diagnostic yield. US-guideddrainage catheter insertion is very convenient for patients with com-plicated pleural effusion. US is the modality of choice for the inter-ventional procedures in patients with pleural diseases.

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Classification of pleural effusions proposed by sonographyNeto M, Cirino LM, Funari M, Daniel M, Francisco L, Cerri G,Chammas MC, Hospital das Clinicas da Faculdade Medicina-USP,Brazil

This study discusses the utility of the ultrasound in the classification ofthe pleural effusion and proposes a classification for them. Fifty-fivepatients from our institution, with pleural effusion proved by thoracen-tesis, were prospectively studied. The authors propose a classificationdivided in seven types of pleural effusion, based on echogenicity of thefluid, pleural and pulmonary parenchyma alterations. It is concluded

Abstracts P247