Abstracts S227

The methods used in augmented mammoplasty have included tissuetransplantation, injection, and the use of implantable prostheses. Thedirect injection of various materials into breast has been performed forbreast augmentation since the early 1900s because this method ischeap, quick, simple to perform, and has an immediate cosmetic result.The methods and materials used in injection mammoplasty are varioussuch as paraffin, silicone, collagen, autologous fat, polyacrylamide gel,or hyaluronic acid. Thus, the imaging findings of augmented breast aredifferent in accordance with injected materials, injection method, orsecondary changes associated with injection. Sometimes, those findingscan mimic a pathologic condition and a true lesion can be missed ormisinterpreted. Familiarity with various imaging findings of injectedbreast could be helpful for the proper evaluation and management. Inthis presentation, we will introduce various injection mammoplastiesand illustrate the various sonographic features of augmented breast inaccordance with injected materials.

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Application of Time–Intensity Curve of Contrast-EnhancedUltrasonography in the Diagnosis of Breast MassesYuan Zhang, Department of Ultrasound, Pudong New DistrictHospital, ChinaQuan Jiang, Pudong New District Hospital, ChinaJian Chen, Department of Ultrasound, Pudong New DistrictHospital, China

Objective: To discuss the diagnostic value of time-intensity curveanalysis contrast–enhanced ultrasonography (CEUS) in the diagnosisof breast masses.Methods: Totally, 49 patients with breast masses (22 benign, 27malignant) were examined with CEUS. SonoVue was used as a contrastmedia. The dynamic CEUS images were analyzed with the time-intensity curve software.Results: After contrast agent injection, high enhancement cases inmalignant group were more than those in benign group. The correlationbetween benign and malignant lesions was stastically significant (P�0.05). There was statistical difference between breast benign andmalignant tumors in configuration and parameters on time-intensitycurve. The arrival time and the time to peak enhancement were shorterin malignant group than those in benign group (P �0.05). The slope ofthe rising part and peak intensity was greater in malignant than that inbenign group (P �0.05).Conclusion: Time-intensity curve analysis of contrast-enhanced ultra-sonography is helpful in differentiating diagnosis of breast masses.

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Focal Pyelonephritis- More Frecvent that we Think? Importanceof Ultrasound Examination in Early DiagnosisMirela Gliga, University of Medicine and Pharmacy Targu Mures,RomaniaDaniela Podeanu, University of Medicine and Pharmacy TarguMures, RomaniaClaudia F Cozma, Private Medical Practice, RomaniaLehel G Mathe, University of Medicine and Pharmacy Targu Mures,RomaniaRares C Georgescu, University of Medicine and Pharmacy TarguMures, RomaniaMihai Gliga, University of Medicine and Pharmacy Targu Mures,RomaniaGrigore G Dogaru, University of Medicine and Pharmacy TarguMures, Romania

Aim: The incidence of renal abscess ranges from 1-10 cases per 10,000

hospital admissions. Spread of infection can affect the vital structures.

Once infection spreads to the perinephric spaces, percutaneous or opensurgical drainage is required. In our nephrology department, we had in3 months 5 cases with clinical suspicion of kidney abscess diagnosed asfocal pyelonephritis(FP), ultrasound (US) being the most important forthe early diagnosis.Method: Five cases were admitted with the diagnosis of acute pyelo-nephritis. They were characterized by lombar pain, fever, low urinarysymptoms. In this cases we always perform US in order to excludeother kidney pathology. We performed US at the presentation and after5 days of unchanged clinical status: persistence of fever and lombalpain. CT scan was also performed.Results: All cases had positive urinary culture with E Coli and Kleb-siella. Initial US revealed unilaterally moderately enlarged kidney withhypoechoic areas in four patients. One patient had focal hipovasculari-sation. The second sonogram revealed an hypoechoic area, with pourvascularisation in the middle of the parenchyma, ranging from 2 to 5cm in length. CT scan described same changes. In order to avoidevolution to kidney abscess, combined i.v. antibiothic therapy wasimmediately applied and clinical status of the patient improved rapidly.Conclusion: Ultrasound had an important role in early detection of FPand in prevention of an kidney abscess. Repeted sonograms in patientwith uncertain clinical evolution of an FP are necessary, being non-invasive, cost-effective and easy to perform.

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Renal Venous Doppler Sonography in Normal Population:Pattern Analysis of Waveform and Venous Impedance IndexMeasurementsDae Chul Jung, National Cancer Center, KoreaSeung Hyup Kim, Seoul National University College of Medicine,KoreaJeong Yeon Cho, Seoul National University College of Medicine,KoreaHak Jong Lee, Seoul National University College of Medicine,KoreaSun Ho Kim, Dongkook University School of Medicine, Korea

Objective: To determine the usefulness of intrarenal venous imped-ance index and pattern analysis of Doppler waveform in renal vein forevaluating functional status of kidney or cardiovascular system innormal population.Materials and Methods: Between May 2007 and December 2008,Doppler sonography of both kidneys was performed in 98 volunteerswho visited for health screening. Doppler waveform and impedanceindex of renal veins were obtained on the peripheral (interlobar) andcentral (segmental) renal veins. Doppler waveforms were divided into3 class by shape (Type I: continuous with minimal fluctuation; Type II:monophasic: Type III: biphasic pattern). Waveforms and impedanceindexes of patients were compared between right vs. left kidney andperipheral vs. central vein using the paired t test. Pattern analysis wasperformed between these variables.Results: Mean venous impedance indexes of peripheral vein (0.36 �0.22) were significantly lower than central vein (0.47 � 0.17) (p �0.01). No significant difference was observed in mean venous imped-ance index between the right and left kidneys. Venous waveforms ofkidneys showed 3 major pattern (type1 � type 3 � type 2, in freq.). Nosignificant association was noted also in normal ranged blood pressureand renal function. However, the cases with hypertension or decreasedrenal function showed decreased phascity on Doppler wave form,resulting in decreased renal venous impedance.Conclusion: Renal venous impedance indexes and pattern analysismay be helpful for detecting decreased renal function or hypertension.Our results could be reference value of normal venous impedance

indexes.