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Objective:To evaluate the effects of different blood pressure control levels on left ventricular myocardial mechanics in patients with primary elderly hypertension by using two-dimensional speckle tracking imaging (2D-STI).Methods:A total of 315 elderly patients with essential hypertension diagnosed in Bethune Hospital Affiliated to Shanxi Medical University from January to June 2017 were collected and randomly divided into standard antihypertensive group and intensive antihypertensive group. The patients who were receiving antihypertensive drugs were treated with antihypertensive drugs more or less, and the patients who had not yet been treated started antihypertensive drugs therapy. The blood pressure was adjusted to the target value within 3 months (blood pressure in standard antihypertensive group was controlled at 130-150/<90 mmHg, intensive antihypertensive group was controlled at 110-130/<80 mmHg). All patients were followed up for 24 months. After 24 months of antihypertensive drugs treatment, 26 cases of lost follow-up, substandard blood pressure or poor image quality were excluded, and 289 patients were included, standard antihypertensive group ( n=148), intensive antihypertensive group ( n=141) . During the same period, 71 age-matched people without essential hypertension were selected as control group. Comprehensive echocardiography were performed in all subjects at baseline and 24 months. The longitudinal strain of the inner, middle and outer layers (GLS-endo, GLS-mid, GLS-epi) of the whole left ventricle were obtained by two-dimensional speckle tracking technique. The routine echocardiographic and left ventricular strain parameters were compared at baseline and 24 months. Results:①At baseline, the end-diastolic thickness of interventricular septum (IVSD), the end-diastolic thickness of left ventricular posterior wall (LVPWD), the end-diastolic diameter of left ventricle (LVEDD), the left ventricular mass index (LVMI), the relative wall thickness (RWT) and the ratio of early diastolic mitral flow velocity to early diastolic mitral annulus velocity(E/e′) in two antihypertensive groups were higher than those in the control group, and the levels of GLS-endo, GLS-mid and GLS-epi were lower than those in the control group(all P<0.05). There were no significant differences in routine echocardiographic parameters and strain parameters between standard antihypertensive group and intensive antihypertensive group (all P>0.05). ②After 24 months of antihypertensive drugs treatment, LVEDD and E/e′ in standard antihypertensive group and IVSD, LVPWD, LVEDD, LVMI, RWT, E/e′in intensive antihypertensive group were lower than those at baseline, and IVSD, LVMI and RWT in intensive antihypertensive group were lower than those in standard antihypertensive group (all P<0.05). ③After 24 months of antihypertensive drugs treatment, GLS-endo, GLS-mid and GLS-epi in two antihypertensive groups were higher than those at baseline, and GLS-endo, GLS-mid, GLS-epi in intensive antihypertensive group were higher than those in standard antihypertensive group(all P<0.05). Conclusions:①The left ventricular myocardial mechanics is damaged and the systolic function is decreased in elderly patients with essential hypertension; ②The myocardial mechanics is significantly improved after antihypertensive treatment, with more improvement in intensive antihypertensive treatment patients.
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Objective@#To analyze the image features of shear wave elastrography (SWE) in breast masses, and to evaluate their values in the differentiation of benign and malignant breast lesions.@*Methods@#A total of 361 patients with 403 breast lesions who simultaneously underwent conventional ultrasound and SWE examination from February 2015 to January 2018 were selected. Diagnosis in all patients was confirmed by aspiration biopsy or operative pathology. The SWE images were collected and the elastic images were divided into 5 types. The SWE image features of different breast pathological types were summarized, and their values in benign and malignant breast lesion diagnoses were evaluated.@*Results@#The main features of benign breast lesion were type Ⅰ and Ⅱ, the main features of the malignant lesion were type Ⅳ and Ⅴ, and the proportion of which were 43.6% (71/163), 37.4% (61/163), 22.1% (53/240) and 57.9% (139/240), respectively. Type Ⅲ accounted for a certain proportion in both benign and malignant lesions. The SWE image features of benign and malignant lesions were compared and a significant difference was observed (P<0.001). The type Ⅴ features were mainly observed in invasive ductal carcinoma, invasive lobular carcinoma and other types of invasive carcinoma, while the type Ⅳ features were mostly presented in ductal carcinoma in situ and mucinous carcinoma. Fibroadenoma, fibroadenosis accompanied with fibroadenoma, and fibroadenosis were featured with type Ⅰ. Both intraductal papilloma and benign phyllodes tumor were mostly type Ⅱ, while type Ⅲ and Ⅴ were more common in chronic granulomatous mastitis. When type Ⅰ and typeⅡof breast lesions were classified as benign features while type Ⅳ and Ⅴ were malignant features, the sensitivity and specificity of breast malignant lesion diagnosis were 91.2% and 84.7% by application of SWE combined with breast imaging reporting and data system (BI-RADS). The sensitivity of combined diagnosis was slightly lower than that of conventional ultrasound (P>0.05), but the specificity was significantly higher than conventional ultrasound (P<0.01).@*Conclusion@#The SWE is a simple and effective method. Combination of SWE with conventional ultrasound may improve the diagnostic differentiation of benign and malignant breast lesions.
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Objective@#To investigate the value of shear wave elastography (SWE) in the early diagnosis of hepatic cirrhosis nephropathy.@*Methods@#Seventy-three hepatic cirrhosis patients with normal conventional renal function were enrolled in the study, and were subdivided into Child-Pugh A group, Child-Pugh B group and Child-Pugh C group. Forty healthy volunteers were served as the control group. All the subjects underwent SWE to obtain the Young′s modulus value of left renal cortex, medulla and parenchyma which included Emax, Emin, Emean. The Young′s modulus value were compared among different groups.@*Results@#Compared to the control group, the Emax, Emean of left renal cortex, modulus and parenchyma in hepatic cirrhosis group were higher(P<0.05). Compared to the control group, there was no significant difference in Emax, Emin and Emean of left renal cortex, medulla and parenchyma in group A(P>0.05). The Emax and Emean of left renal cortex, medulla and parenchyma were higher both in group B and group C than those in control group(P<0.05). Comparison of liver cirrhosis among groups, the Emax and Emean of left renal cortex, medulla and parenchyma in group B and group C were higher than those of group A(P<0.05), there was no significant difference between group B and group C(P>0.05).@*Conclusions@#SWE can quantitatively determine the elastic parameters of renal tissue in patients with different degrees of cirrhosis, the change of renal tissue elasticity is earlier than that of routine laboratory examination, SWE can early detect renal tissue damage in patients with liver cirrhosis.
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Objective@#To investigate the correlation between the maximum elastic modulus(Emax) of breast cancer obtained by shear-wave elastography (SWE) and immunohistochemical profiles.@*Methods@#One hundred and sixty patients with 171 pathologically proven breast lesions were included in this study. All of them underwent conventional ultrasound and SWE examination before surgery. The Emax and maximum diameter were obtained. Histologic grade, immunohistochemical profiles ER, PR, HER-2, Ki-67 and molecular subtypes were recorded according to pathological results after surgery. The correlation between Emax and tumor size, histological grade, ER, PR, HER-2, Ki-67 and molecular subtypes were analyzed.@*Results@#①There was a positive correlation between the tumor size with Emax(r=0.510, P<0.05); ②The Emax of tumors with HER-2 positive expression were higher than that with HER-2 negative expression(P<0.05), the Emax of tumors with Ki67 high expression were higher than that with Ki67 low expression (P<0.05); ③There were significant differences in Emax between different molecular subtypes(P<0.05), the Emax of HER-2 positive tumor was the highest, followed by those of Luminal B tumor, triple-negative and Luminal A tumor; ④Multiple linear regression indicated that tumor size was the strongest pathologic determinate of Emax value(P<0.05), its standardized partial regression coefficient was 0.500, and HER-2 also had significant influence on Emax value of tumor(P<0.05), the standardized partial regression coefficient was 0.237.@*Conclusions@#Some prognosis immunohistochemical feature of breast cancer showed association with the Emax. Breast cancers with higher Emax at shear-wave elastography had poor prognostic features. To some extend, the value of Emax can reflect the biological characteristics of breast cancer, SWE may provide a certain imaging basis for the prognosis of breast cancer and the choice of treatment plan.
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Objective To investigate the structural and functional changes of mitral valve in patients with functional mitral regurgitation (FMR) by real-time three-dimensional transthoracic echocardiography (RT-3D-TTE).Methods RT-3D-TTE were performed on 70 patients with at least moderate mitral regurgitation (FMR group;including 35 cases of ischemic cardiomyopathy [ICM] subgroup and 35 cases of dilated cardiomyopathy [DCM] subgroup) and 30 normal controls (control group).The mitral valve parameters were analyzed by TomTec assessment software to detect dynamic changing pattern of mitral valve size and shape during cardiac systole.The differences of parameters between control group and FMR group were compared.The parameters included mitral annulus structural parameters:Anterior-posterior (AP),anterolateral-posteromedial (AL-PM),sphericity (SPI;SPI=AP/AL-PM),annular circumference (AC),commissural diameter (CD),nonplanarity angle (NPA),annular height (AH),tenting height (TH),tenting volume (TV),three-dimensional annular area (AA3D);dynamic parameters..Maximum annular displacement (ADmax),maximum annular displacement velocity (ADVmax).Results The mitral valve parameters present phasic variation law in FMR group.Compared with control group,AH,ADmax and ADVmaxwere smaller and the other parameters were larger than those in FMR group (all P＜0.05).Compared with control group,AH,ADmax and ADVmax were smaller and the other parameters were larger than those in both ICM subgroup and DCM subgroup (all P＜0.05).Compared with ICM subgroup,AH was smaller in DCM subgroup (P＜0.05),there was no statistical difference in ADmax and ADVmax between ICM subgroup and DCM subgroup (P＞0.05),the rest parameters were greater in DCM group (all P＜0.05).Conclusion RT-3D-TTE can be used to quantitatively assess the structural and functional changes of mitral valve in patients with FMR and provide a reference for the clinical treatment of FMR.
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Objective To investigate the value of shear wave elastography(SWE)to early predict clinical efficacy of breast cancer neoadjuvant chemotherapy(NAC).Methods Fifty-three patients(55 lesions)with breast cancer who underwent NAC were enrolled in this study.SWE was performed at baseline and after the end of 2,4,6 cycles of NAC.According to the postoperative pathological results,the lesions were divided into major pathologic response group and minor pathologic response group.The maximum diameter of the lesions between the baseline and the end of the last cycle of the two groups were measured and the maximum diameter changes(ΔDmax)of the two groups were compared.The maximum elastic modulus(Emax)and the maximum elastic modulus changes(ΔEmax)of the two groups were measured and compared at baseline and after the end of 2,4,6 cycles of NAC.The ROC curves of ΔEmax at the end of 2 and 4 cycles were used to evaluate the predictive value of NAC response.Results The ΔDmax of the major pathologic response group[(64.82±21.06)%]was higher than that of the minor pathologic response group[(26.49±26.1 1)%,P <0.001].With the prolongation of NAC,the values of Emax were significantly decreased in the two groups,but the decreasing degrees were different.The Emax was significantly decreased at the end of 2 cycles in the major pathologic response group(P <0.05),however, at the end of 4 cycles in minor pathologic response group(P <0.05).The value of ΔEmax in the major pathologic response group was higher than that in the minor pathologic response group in every cycle significantly(all P <0.05).The ΔEmax threshold of the 2 cycles for predicting the NAC response was 26.1%(81.8% of sensitivity,75% of specificity),while the threshold of the 4 cycles was 35.5%(87.9%of sensitivity,83.3% of specificity),there was no significant difference between the areas under the two curves(P =0.264).Conclusions The value of ΔEmax in breast cancer lesions can predict the efficacy of NAC early.SWE can provide a valuable complement for two-dimensional ultrasound in the evaluation of NAC efficacy in breast cancer.
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Objective To assess the correlation and agreement of the mitral valve geometry parameters obtained by real-time three-dimensional transthoracic echocardiography ( RT-3D-TTE) and real-time three-dimensional transesophageal echocardiography ( RT-3D-TEE) . Methods RT-3D-TTE and RT-3D-TEE were performed on 29 healthy volunteers under conscious state and general anesthesia respectively . The mid-systole mitral valve parameters were analyzed by TomTec Imaging Systems . The repeatability test of the mitral valve parameters obtained by RT-3D-TTE was performed . The correlation and agreement of the mitral valve parameters obtained by RT-3D-TTE and RT-3D-TEE were assessed , and then the differences of mitral valve parameters between the two methods were compared . The study was approved by the Shanxi Dayi Hospital Ethics Committee ( Approval no .YXLL-2015-040) . Results ① The mitral valve parameters obtained by RT-3D-TTE showed excellent intra- and interobserver reproducibility ,in intra-observer and inter-observer with ICC > 0 .8 for all the parameters ,and the Bland-Altman plots displayed the average differences of anterior-posterior ( AP) ,anterolateral-posteromedial ( ALPM ) ,annular circumference ( AC) ,three-dimensional annular area ( AA3D ) for intra- and interobserver were 0 .009 ± 0 .11 , - 0 .008 ± 0 .10 , - 0 .036 ± 0 .32 ,0 .030 ± 0 .36 in intra-observer and - 0 .018 ± 0 .09 ,0 .087 ± 0 .20 , - 0 .037 ± 0 .44 ,- 0 .016 ± 0 .62 in inter-observers ,respectively . ② There were close correlations ( r = 0 .566 - 0 .870 , P 0 .05) . The rest of parameters including ALPM ,sphericity ( SPI) ,commissural diameter (CD) ,AC ,AA 3D ,nonplanarity angle ( NPA) ,tenting height ( T H) ,maximum annular displacement ( ADmax) and maximum annular displacement velocity ( ADVmax) had significant differences ( P < 0 .05) . Conclusions The mitral valve parameters obtained by RT-3D-TTE are highly reproducible and similar to those obtained by RT-3D-TEE ,and the two methods have close correlations and good agreement . Therefore ,RT-3D-TTE has higher potential clinical application value in the evaluation of mitral valve geometry .
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Objective To evaluate the left ventricular transmural mechanics changes of breast cancer patients between before and after anthracycline chemotherapy by two-dimensional speckle tracking imaging (2D-STI),and to predict early cardiotoxicity caused by anthracycline.Methods Forty-six breast cancer patients with postoperative anthracycline-based chemotherapy were recruited.Echocardiography were performed on all subjects before and at 1 ,3 and 6 anthracycline-based chemotherapeutic cycle.Global longitudinal strain(GLS),endocardial longitudinal strain(LS-endo),epicardial longitudinal strain(LS-epi), global radial strain (GRS),endocardial radial strain (RS-endo ),epicardial radial strain (RS-epi ),global circumferential strain (GCS),endocardial circumferential strain (CS-endo)and epicardial circumferential strain(CS-epi) were assessed by 2D-STI and transmural myocardial strain gradient-longitudinal strain (TMSG-LS),transmural myocardial strain gradient-radial strain(TMSG-RS),transmural myocardial strain gradient-circumferential strain(TMSG-CS)were calculated.Conventional echocardiographic parameters and strain-related parameters before and after chemotherapy were compared. The receiver operating characteristics(ROC)curve was performed to determine sensitivity and specifity of strain parameters for prediction value of cardiotoxicity induced by anthracycline chemotherapy.Results ①After the sixth cycle of anthracycline chemotherapy,9 patients (16.4%)had developed anthracycline-induced cardiotoxicity,and 37 patients (80.4%)did not meet the criteria for cardiotoxicity.② There were no significant differences in conventional echocardiography parameters between before and after chemotherapy (P > 0.05 ).Left ventricular ejection fraction (LVEF),fractional shortening (FS)and E/A significantly decreased,but E/e significantly increased after six cycles of chemotherapy (P LS-endo> GLS> LS-epi.Conclusions After three cycles of chemotherapy,the decreases of TMSG-LS,LS-endo,GLS and LS-epi preceded the change of LVEF and other strain parameters,TMSG-LS and LS-endo can accurately and early detect anthracycline chemotherapy-induced cardiotoxicity.
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Objective To evaluate the value of MicroPure imaging system of ultrasonography in display of breast calcification,and explore its clinical application value.Methods One hundred and forty-one patients underwent by mammography,conventional ultrasound imaging and MicroPure imaging,the mammography results were reference standard,observing the display rate of MicroPure imaging for calcification,and the value of MicroPure imaging in the display of calcification with different shapes on mammography.As the pathologic diagnosis was golden standard,the accuracy of diagnosis of conventional ultrasound,conventional ultrasound combined with MicroPure imaging,conventional ultrasound combined with mammography were evaluated with receiver operating characteristic(ROC) curve.Results The display case of calcifications within breast masses:the specificity of MieroPure imaging was lower than conventional ultrasound(88.14％ vs 100％,P ＜ 0.05),the sensitivity and accuracy were higher than conventional ultrasound(100％ vs 62.79％,93.14％ vs 84.31 ％,P ＜0.05).The display case of microcalcifications within normal breast tissue:the specificity and accuracy of MicroPure software system were lower than conventional ultrasound(9.26％ vs 100％,43.87％ vs 65.96％,P ＜0.05),the sensitivity was higher than conventional ultrasound (100％ vs 20.00％,P ＜0.05).The punctate calcification,amorphous calcification,rough uneven,pleomorphic calcifications on mammography were all hyperechoic spots on MicroPure software system.The area under the ROC curve of the conventional ultrasound,conventional ultrasound combined with MicroPure imaging,conventional ultrasound combined with MicroPure imaging was 0.881,0.858,0.932,respectively.Conclusions MicroPure imaging has some clinical value on microcalcifications within breast masses,which can improve its sensitivity and accuracy.The specificity of MicroPure imaging diagnostic ultrasound imaging of microcalcifications were lower,and it can not distinguish between different shapes of calcifications.Compared with conventional ultrasound,MicroPure imaging system can not improve the accuracy of diagnosis of benign and malignant breast lesions.
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Objective To investigate the value of color Doppler flow imaging(CDFI) in diagnosing lower limb artery in-stent restenosis (ISR), and to provide the evidences for clinical application. Methods Patients with lower limb artery percutaneous transluminal stent insertion in 12 months were enrolled in this study and divided into two groups, CT angiography (CTA) or digital subtraction angiography (DSA) was applied to diagnose ISR, 31 patients with 47 stenting which were diagnosed ISR was named as restenosis group, 63 patients with 89 stenting which were diagnosed no ISR was named as no stenosis group, and 30 normal person was enrolled and named as normal control group. Ultrasonic characteristics and peak systolic blood flow velocity (PSV), systolic blood flow acceleration time (AT) of proximal part, inner stents, distal part were recorded in restenosis group and no stenosis group, then compared with data in normal control group. Regression and receiver operator (ROC) curve were applied to analyse the correlation between PSV and AT. Results PSV of no stenosis group in common femoral artery, femoral artery, superifcial, popliteal artery stent respectively were (146.71±35.59) cm/s, (120.11±25.67) cm/s, (96.44±32.87) cm/s. PSV of normal control group in common femoral artery, femoral artery, superifcial, popliteal artery respective were (119.67±15.34) cm/s, (91.17±15.09) cm/s, (71.13±21.23) cm/s. There was statistically signiifcant difference between the two groups (t=2.457, 2.459, 2.321, all P0.05). PSV of restenosis group in proximal part, restenosis part, distal part respectively were (87.67±23.34) cm/s, (218.17±72.09) cm/s, (54.13±21.23) cm/s. PSV of no stenosis group in proximal part, inner stents, distal part respectively were (91.71±25.59) cm/s, (131.11±45.67) cm/s, (96.44±32.87) cm/s. There was statistically significant difference between restenosis part/inner stents, distal part (t=3.412, 3.511, both P0.05). AT of restenosis group in proximal part, restenosis part, distal part respectively were (98.31±14.09) ms, (109.54±21.03) ms, (158.23±45.21) ms. AT of no stenosis group in proximal part, inner stents, distal part respectively were (84.98±13.77) ms, (86.34±19.36) ms, (83.77±17.05) ms. There was statistically signiifcant difference between restenosis part/inner stents, distal part (t=2.319, 3.610, both P0.05). ROC curve showed that in ISR lower limb artery, PSV>168 cm/s had a sensitivity of 89.4%, speciifcity of 92.1%, the area under the ROC curve was 0.949;AT>127 ms, had a sensitivity of 86.8%, speciifcity of 98.0%, the area under the ROC curve was 0.867. Conclusions CDFI can detect the changes of PSV and AT, ISR can be detected and diagnosed earlier in lower limb artery. By combining PSV>168 cm/s with AT>127 ms, the value of ISR diagnosis can be increased.
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Objective To explore the clinical value of high-frequency color Doppler ultrasound in the diagnosis of isolated calf muscle vein thrombosis (ICMVT). Methods Sonographic features of 175 patients with isolated calf muscular venous thrombosis were analyzed retrospectively and outcome of anticoagulant therapy in 1, 3, and 6 months was followed up. Diagnosis was established with high-frequency color Doppler ultrasound examination. Results One hundred and seventy-ifve patients presenting with 190 calf muscle vein thrombosis were included. One hundred and iffty-eight cases with 173 calf muscle vein thrombosis were diagnosed by high-frequency color Doppler ultrasound, 7 cases of misdiagnosis, missed diagnosis in 10 cases. The accuracy rate was 91.1%(173/190). Seven cases were misdiagnosed with 1 euroifbromatosis, 1 mixed hemangioma, 5 gastrocnemius hematoma. After diagnosis of ICMVT, all patients prescribed thrombolysis and anticoagulation therapy. High-frequency color Doppler ultrasound for 1, 3, 6 months after treatments revealed partial or complete recanalization without calf deep vein thrombosis. Typical sonographic features included:calf muscle venous lumen dilation, tortuous anechoic lumen or hypoechoic iflling, with tubular or branched shape in the longitudinal view and oval or round shape in the transversal view. Conclusion High-frequency color Doppler ultrasound is an accurate and reliable method in the diagnosis of the isolated calf muscular venous thrombosis.
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Objective To investigate the function of the left ventricular (LV) myocardial regional contractility in hyperthyroid by measuring the LV rotation and torsion using speckle tracking imaging (STI).Methods 58 patients with hyperthyroidism had accepted 131 I treatment the first time and cured and improved after treatment for 6 months were enrolled.According to the course of disease,they were divided into two groups:Group A,duration less than 6 months,28 cases;Group B,duration more than 6 months,30 cases.30 normal cases age and gender matched were enrolled as control group.LV peak rotation and torsion of endocardium and epicardium at basal and apical of levels were measured using STI in groups A and B before and after treatment,and correlation with cardiac function and structure parameters,heart rate,blood pressure,and the thyroid hormone were analyzed.Results ①Comparing group A and group B before and after treatment with control group,there was no statistically significant in the LV structure and function parameters (LVDd,LVDs,IVSd,PWd,LVEF) (P ＞0.05).②As for LV peak rotation of endocardium and epicardium at apical levels (EN PAR,EP-PAR) before treatment,group A was higher than the control group (P ＜0.05),group B was lower than the control group (P ＜0.01);After treatment,group A has improved (P ＜0.01),group B has improved only in EP-PAR (P ＜0.05),and there was no statistically significant compared with the control group (P ＞0.05).③ LV peak torsion of endocardium and epicardium (EN-Ptor,EP-Ptor) in group A was higher than the control group before treatment (P ＜0.05),group B was lower than the control group (P ＜0.01) ;After treatment,group A has improved (P ＜0.05),group B has only improved in EP-Ptor(P ＜0.05),and comparing with the control group,there was no statistically significant (P ＞0.05).④LV peak apical rotation and LV torsion were positively correlated with systolic blood pressure,heart rate,E-peak,A-peak,LVOT-V in different degree (P ＜0.01 or P ＜0.05),but no correlation with FT3,FT4,TSH (P ＞0.05).Conclusions Myocardial contractile function strengthens in early patients with hyperthyroidism and lessens with the extension of the course.Have not yet appeared heart diseases in patients with hyperthyroidism whose myocardial regional systolic function had changed,short duration can recover after treatment,but the long duration can not restore completely.Change of myocardial motion of patients with hyperthyroidism is associated with blood flow dynamics.
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Objective To assess the renal perfusion of different severity of hepatic cirrhosis by contrast-enhanced ultrasound with time-intensity curve.Methods Forty hepatic cirrhosis patients with normal conventional renal function enrolled the study and were subdivided into Child-Pugh A group ( n =14),Child-Pugh B group ( n =14) and Child-Pugh C group ( n =12).Thirty healthy subjects were selected as the control group.The parameters of perfusion were compared among the groups.The correlations between parameters and score of Child-Pugh were analyzed using Pearson correlation.Results The cirrhosis groups showed a decrease of peak intensity,increase of time to peak,and reduce of area under the curve in the renal cortex( P ＜0.05).Compared with Child-Pugh A group,the peak intensity decreased in both ChildPugh B and C groups,time to peak increased in Child-Pugh C group( P ＜0.05 or P ＜0.01 ).The peak intensity had negative correlation with Child-Pugh score( r =- 0.506,P ＜0.01 ).Conclusions Contrastenhanced ultrasound combined with time-intensity curve can assess renal perfusion of hepatic cirrhosis quantitatively.The peak intensity was correlated to the severity of cirrhosis.
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Objective To assess the effects of captopril on renal perfusion of diabetic mellitus(DM)rabbits at early stage by contrast-enhanced ultrasound (CEUS).Methods Of 58 rabbits,6 were control group,37 were made as DM model successfully by alloxan and were randomly divided into 4 groups:untreatment group (n =16) and treatment group A,B and C (n =7 averagely).The treatment groups were given captopril(25 mg/kg weight) everyday by intragastric administration after the DM model established and renal pathology appeared Mogensen DN Ⅰ,Ⅱ or / and Ⅲ respectively.The treatment lasted 12 week.Then CEUS was performed on bilateral kidney to observe the renal perfusion,the parameters included:curve ascending slope(K1),time to peak intensity(PIT),peak signal intensity(PSI),area under the curve(AUC) and time to half of peak intensity(HPT).Results At the end of 12 weeks,compared with control group,PIT and HPT delayed,PSI and K1 decreased in untreatment group and group C,AUC of untreatment group increased.Compared with untreatment group,PIT,HPT and AUC decreased,PSI and K1 increased in group A,B and C.Compared with group C,HPT of treatment group A,B decreased.Compared with control group,renal's size increased and the cortex was thickened in untreatment group and group A,B,C.The pathological examination showed:renal were damaged more seriously in untreatment group than that in group A and B.There was no significant difference in Scr and BUN between all groups.Conclusions Assessment of CEUS for renal perfusion of diabetic mellitus rabbits at early stage is feasible and captopril can improve renal perfusion of DM rabbits.
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Objective To study the ventricular-arterial coupling in the patients with type 2 diabetes mellitus (DM) by ultrasound.Methods Eighty patients with DM were divided into 2 groups:normal left ventricular ejection fraction (EF) group (DMN,EF≥50 ％,n =40) and abnormal EF group (DMA,EF＜50％,n =40).At the same time,42 healthy volunteers were selected as a control group.The left ventricular (LV) relative wall thickness (RWT),mass index (LVMI),stroke volume (SV),stroke works (SW),ratepressure product (RPP),systemic vascular resistance index (SVRI),LV end-systolic elastance (Ees),arterial elastance index (Ea) and ventricular vascular index (VVI) were measured and calculated.Longitudinal strain (LS) of myocardial segment including base(LSBA),papillary muscle (LSPM) and apex (LSAP) were analyzed by two-dimensional speckle tracking imaging.Results (1) Compared with the control,the RWT and LVMI were all increased (P ＜0.01),but the LSBA,LSPM and LSAP were decreased (P ＜ 0.01) in the DMN and DMA groups (P ＜0.01).In DMA group,the RWT,LSBA,LSPM and LSAP were decreased (P ＜0.01).Compared with the DMN group,the LSBA,LSPM and LSAP were decreased in DMN group (P ＜0.01).(2) Compared with the control,the Ea,VVI,RPP and SVRI were increased,but the Ees was decreased (P ＜0.05)in DMA group (P ＜0.01).In the DMN,RPP was increased compared with the control group (P ＜0.01).Compared with the DMN group,the Ea,VVI,RPP and SVRI were increased,but Ees was decreased in the DMA (P ＜0.05).(3)The LSBA,LSPM and LSAP were all positively correlated with VVI(P ＜0.01).Multiple regression analysis showed that the LSAP,RWT,LVMI and SW were independent predictor of VVI (b' =-0.613,-0.290,0.290 and-0.205,P ＜ 0.05).Conclusions The ventricular-arterial coupling is normal in the DMN group,but is abnormal in DNA group.LSAP is independent predictors for ventricular-arterial coupling.
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Objective To probe into the value of the evaluation of left ventricular myocardial function by two dimensional strain(2DS) for coronary artery disease(CAD) patients with different degrees of left anterior descending(LAD) branch stenosis. Methods Fifty-five eases without myocardial infarction among a total of 72 patients with CAD were divided in to 3 groups based on the extent of LAD stenosis,that was group A(stenosis<50%, n = 24) ,group B(stenosis50% to 75%, n = 19) ,and group C(stenosis>75%, n = 12). Another 17 eases of CAD with myocardial infarction were selected as group D. Strain and strain rate of the whole 11 segments that blood supplied by LAD of all cases were measured with 2DS. Results The 2DS ultrasound showed that the peak strain(S), the peak systolic strain rate(SRs) and the peak early diastolic strain rate (SRE) in all the 11 segments of group A were high and sharp. The above mentioned parameters of group B decreased compared with that of group A, however, there was no statistical significant difference (P >0.05). The S, SRs and SRE of group C cases decreased in some segments compared with that of group A and group B (P< 0.05 or P<0.01). As for group D, the S, SRS and SRE decreased significantly in all segments. In terms of the peak late diastolic strain rate (SRA), there were no statistical significant differences among group A,B and C (P>0.05). While in group D cases, the SRA decreased markedly. The SRE/SRA was more than 1 in group A. However, in group B, C and D cases, the SRE/SRA were all less than 1. Conclusions 2DS can sensitively reflect the decrease of regional myocardial systolic and diastolic function caused by the reduction of perfusion,and it may be beneficial to find myocardial ischemia for patients as early as possible.
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Objective To assess renal perfusion of chronic renal failure(CRF) at different stages in rabbits by contrast-enhanced ultrasound. Methods Fifteen rabbits were injected cationic bovine serum albumin(C-BSA) intravenously for 8 weeks to establish CRF models. Serum creatinine(Scr) and blood urea nitrogen(BUN) were determined before injection and 2,4,6,8 weeks after C-BSA injection respectively. The size of kidney was measured by two-dimensional ultrasound and contrast-enhanced ultrasound was performed on bilateral kidneys at the same time points. Renal perfusion was analyzed quantitatively with the time intensity curve. Results Renal cortical perfusion reduced started at 4weeks after injection,manifested as the peak signal intensity(PSI) of the time-intensity curve parameters decreased(P<0.05 or P <0.01). The speeds of perfusion and clearance of kidney were slower,showed as the time to peak intensity(PIT) and the time to half of peak intensity(HPT) delayed (P <0.05 or P <0.01). Compared with pre-injection, there were no differences in terms of the area under the curve(AUC) at 2,4 and 6 weeks after injection (all P> 0.05). And compared with pre-injection,2,4,6 weeks after injection, the AUC decreased at 8 weeks (P < 0.05 or P <0.01 ). The level of Scr and BUN of rabbits had increased since 6 weeks after injection (P< 0.05 or P <0.01). Two-dimensional ultrasound showed the renal volume was enlarged and the cortex was thickened from 2 weeks to 6 weeks after injection (P<0.05 or P <0.01). At 8 weeks after injection, the renal size had decreased as well (P < 0.05). These ultrasound changes were in accordance with its pathological changes. Conclusions Contrast-enhanced ultrasound in combination with time-intensity curve can quantitatively analyze the renal perfusion of CRF at different stages. The reduction of renal perfusion was earlier than the changes of routine laboratory indexes in rabbits with CRF. The haemodynamic changes of CRF rabbit were closely related with its pathological changes.
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Objective To probe into the characteristics of strain and strain rate in different time points of coronary artery disease (CAD) patients before and after the improvement of myocardial ischemia, to evaluate the value of two-dimensional strain (2DS) imaging in assessing curative effect of CAD patients. Methods The changes of strain and strain rate in local lesion segments before revascularization,and one week,one month and three months after revascularization of 24 CAD patients accepting revascularization therapy were detected by 2DS. Results Before revascularization treatment,the outlines of strain-time curves and strain-rate-time curves of lesion segments of CAD patients in whole cardiac circle were cluttered. The peak strain (S),the peak systolic strain rate (SRS) and the peak early diastolic strain rate (SRE) were low and calm. The peaks of strain-time curves in some segments of CAD patients were inverted. One week after treatment,the S, SRS,SRE and the peak late diastolic strain rate (SRA) of lesion segments of CAD cases elevated to certain extent. However, there were no statistical significant differences between them (P0.05). One month after treatment,the S and SRE of lesion segments of CAD patients elevated significantly compared to that of before the treatment (P<0.01). Three months after treatment,the outlines of strain-time curves and strain-rate-time curves of lesion segments of CAD patients trended to be regular,and the S, SRS, SRE and SRA elevated markedly compared to that of before treatment (P<0.01). There were statistical significant differences in terms of the S, SRS and SRA compared to that of one week and one month after treatment (P<0.01). Conclusions 2DS can evaluate the strain and strain rate non-invasively and quantitatively at different time points after revascularization of CAD patients. And it can evaluate regional myocardial systolic and diastolic function for CAD patients.