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Objective To evaluate the value of dual Doppler ultrasonography in the diagnosis of fetal atrial extrasystoles.Methods Seven thousands and thirteen fetuses were examined by fetal echocardiography.If fetal arrhythmias were found,information of pulsed wave Doppler signals in hepatic vein (HV) and descending aorta (DAo) using dual Doppler were colleted simultaneously.The detected times were compared between using general Doppler and dual Doppler in 20 cases.Results On dual Doppler examination,28 of the fetuses showed signals of atrial extrasystoles,14 fetuses atrial extrasystoles conducted to ventricle,8 fetuses atrial extrasystoles non-conducted to ventricle,6 fetuses with part of the extrasystoles conducted to ventricle and part of the extrasystoles non-conducted to ventricle.No case had congenital heart disease.Twenty-six fetuses with atrial extrasystole were converted to normal rhythm within the third trimester of pregnancy,and the others' were converted to normal rhythm during the first 3 days postnatally.The detected time of dual Doppler was shorter than that of general Doppler(P ＜0.05).Conclusions Dual Doppler ultrasonography of simultaneous recordings in HV and DAo is an easy,rapid method of assessing fetal atrial extrasystoles,which should allow precise diagnosis of atrial extrasystole.
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ObjectiveTo evaluate the clinical value of the rate of fetal urine production rate (UPR) in fetus with twin-to-twin transfusion syndrome(TTTS).Methods 22 continuative normal monochorionic diamniotic(MCDA) twin fetuses were selected as controll group.Eight fetuses with TTTS were selected as disease group,and UPR was measured by three-dimensional ultrasound virtual organ computer-aided analysis (VOCAL) and the rate of UPR in twin was calculated.Results1)The rate of UPR of twin fetuses in MCDA did not vary significantly throughout pregnancy (0.97 ± 0.28).The correlation coefficient between the rate of UPR and gestational age was 0.13,without obvious correlation.2)The rate of UPR-recipient/UPR-donor in TTTS fetuses increased significantly compared with MCDA twin fetus (7.83 ± 2.61,t =6.19,P ＜0.05).ConclusionsThe rate of UPR may be an important index in the assessment of TTTS.
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ObjectiveTo investigate the application value of ultrasound in the diagnosis of shoulder abnormality among patients with rheumatoid arthritis(RA).MethodsShoulders of 41 RA patients and 20 healthy volunteers were examined by high frequency ultrasound and physicians.Abnormal ultrasonography and clinical appearance were recorded.Results Abnormalities,such as tendonitis of long head of biceps tendon(14 shoulders),synovitis ( 15 shoulders),rotate cuff degeneration (6 shoulders),bone erosion (25 shoulders) and joint effusion(10 shoulders),were found in RA patients and only 16 shoulders were found abnormal by clinical examination.The positive rate of ultrasound (43.9％) was significantly higher than that of clinical examination (19.5％,P =0.001 ).Only a small amount of effusion was found in tendon sheathes of 2 biceps in the control group.ConclusionsMost of shoulder abnormalities can be detected by ultrasound and the sensitivity of ultrasound is higher than that of clinical examination.Ultrasonography is valuable in the diagnosis of shoulder RA.
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Objective To establish normative data for the fetal cisterna magna septa (CMS) at various gestational age,and to evaluate its clinical significance.Methods A total of consecutive fetal between 14 and 40 gestational week(GW) were included in this prospective study.The length and width of CMS were measured by two-dimensional ultrasonography.Regression analysis was used to study the relationship between the width and length of the fetal cisterna magna septa and gestational age.Twenty-five case of fetuses with the absence of CMS and 12 case of fetuses with the enlargement of CMS were retrospectively analyzed in the past six years in our hospital.Results ①The fetal CMS length and width increased gradually between 14 and 22 GW,then plateaued between 23 GW and 36 GW,and decreased after 37 GW.This ultrasonographic pattern was in agreement with normal development of rhombencephalon.②The absence of CMS in the fetuses were common in Dandy-Walker syndrome,holoprosencephaly,severe hydrocephalus,neural tube defects,rhombencephalon synapsis and Arnold-Chiari malformation.The enlargement of CMS in the fetuses may be shown in physiologic enlargement of posterior fossa.ConclusionsCMS is a potential new marker for normal development of rhombencephalon.The enlargement and absence of CMS are related to various malformations of central neural system,especially in the abnormalities of posterior fossa.
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Objective To establish normal reference indexes of aorta during gestation and cut-points for detection of fetuses with coarctation of aorta.Methods From long-axis views of the aortic arch,the internal diameter of the aortic root,ascending aorta,transverse aortic arch,aortic isthmus,descending aorta,anonyma,left common carotid artery,left subclavian artery were measured in 234 normal fetuses at different time ranging from 14 to 41 weeks during gestation.Reference values of each aortic segment were constructed by linear regression analysis.The ratio of each aortic segment to the ascending aorta were calculated.ResultsThe internal diameter in each aortic segments increased as pregnancy progressed (P<0.01).In the prenatal diagnosis of fetus with coarctation of the aorta,the ratio of the aortic isthmus to the ascending aorta and descending aorta to the ascending aorta were significantly lower than the normal fetuses(all P<0.01).Conclusions The ratio of the aortic isthmus to the ascending aorta and ratio of descending aorta to the ascending aorta detected by echocardiography may be helpful in the prenatal diagnosis of coarctation of aorta.
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Objective To investigate the the effects of chronic intrauterine hypoxia on intimal-media thickening(IMT) and strain rate(SR) in abdominal aorta of male offspring rabbits during adult age.Methods Sixten New-Zealand rabbits were assigned randomly to 2 groups: chronic intrauterine hypoxia group (CIH, 12% O_2, n = 8) and normal oxygen group (NO,21%O_2, n = 8).After delivery,2 male offspring rabbits per litter were selected and breast-fed for 3 months, randomly divided into high-fat diet and normal diet groups.Finally, there were 4 groups in this experiment:chronic intrauterine hypoxia with high fat diet (CIH + HFD, n = 8) ,non-chronic intrauterine hypoxia with high fat diet (NCIH + HFD, n = 8),chronic intrauterine hypoxia with normal diet (CIH + ND, n = 8) and normal control (NC, n = 8).At sixth months of age, Serum levels of total cholesterol(TC) and triglyceride(TG) were assayed.SR in the abdominal aorta of male offspring rabbits was evaluated by ultrasonography.Then, abdominal aorta was taken out and observed by electron microscope and IMT was measured.Results CIH increased the levels of TC and TG (P < 0.01), thickened the IMT (P<0.05) and decreased the SR(P<0.05) of abdominal aorta of male offspring rabbits during adult age.There were relevant pathological changes in different groups.All these above-mentioned profiles were aggravated significantly after feeding high fat diet (P<0.05 or P<0.01).Conclusions CIH increased the IMT and decreased the SR of abdominal aorta of male offspring rabbits during adult age.
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Objective To detect the normal values of fetal cerebellar vermis using transabdominal ultrasonography and assess its clinical significance in the diagnosis of vermal hypoplasia(agenesis). Methods A total of 111 fetuses were evaluated by transabdominal sonography between 20 and 40 weeks of gestation.The mid-sagittal antero-posterior(AP) and cranio-caudal(CC) vermian diameters were measured. A second group of 15 fetuses with cisterns magna were assessed and compared with the value of normal fetuses.0.05) and correlated linearly with gestational age ( AP = - 5.406 + 0. 761 GA, r = 0.97 ; CC = - 5.795 +fissure, second fissure and fastigium may help identify developmental anomalies. Conclusions Transabdominal ultrasonography is a valuable tool in the study of fetal vermis during the second half of pregnancy.
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Objective To investigate the application value of three-dimensional power Doppler ultrasonography(3D-PDU) for synovial disease in patients with rheumatoid arthritis(RA). Methods Forty four patients with RA were divided into active (23 cases) and non-active (21 cases) groups. 3D-PDU was used in the wrists to measure the volume of synovium(V) ,vascular index(VI) in synovium.and Doppler spectrum was used to measure synovial artery peak systolic blood flow velocity(PSV) , end diastolic velocity (EDV) and resistance index(RI). Results There were significant differences of the V [(1. 73 0. 73) cm3] and VI (9. 53 6. 11) in the group of active patients compared to the V [(1. 09 0. 76) cm3 , P = 0. 008] and VI [(3.86 4.99), P = 0.000] in the ones of inactive patients. No differences were found for PSV [(16. 8 6. 29) cm/s vs (13. 5 8. 54) cm/s, P = 0. 282] ,EDV [(5. 51 1.77) cm/s vs (5. 03 2. 76) cm/s, P = 0. 539] and RI (0. 66 0. 07 vs 0. 62 0. 08, P = 0. 095)in the comparison of two groups. Conclusions 3D-PDU in determining RA disease activity in patients with synovial medium has a higher application value, VI can be used as an effective indicator to determine the disease activity.
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Objective To detect the normal values of the fetal coronary sinus(CS) in length(L) .diameter (D) and diameter-to-length ratio(D/L) using fetal echocardiography and assess the clinical significance of dilated CS. Methods Fetal echocardiography were performed in 218 normal fetuses from the 20th to the 40th week of gestation. The L,D and D/L of CS were measured and the standard values of the normal fetal CS were established. A second group of 8 fetuses with dilated CS were assessed compared to the values of normal fetuses. Results The L and D of normal fetal CS correlated well with the gestational weeks (Linear regression equation is L= - 0. 94 + 0. 4 weeks, r = 0. 661, P<0. 0001 ;D= - 0. 07 + 0. 08 weeks, r = 0. 433, P <0. 0001). And the D/L did not vary significantly throughout pregnancy(D/L = 0. 21 0.04, r = 0. 115, P = 0.08). Therefore, the D value of normal fetal CS is less than 3.9 mm and D/L is less than 0.3 throughout pregnancy (20-40 gestational weeks). Conclusions The values of D and D/L of fetal CS in prenatal echocardiography might be useful and important parameters for fetal cardiac or extracardiac anomaly.
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Objective To evaluate the pattern of development of fetal cerebral sulei by prenatal ultrasound and its clinical significance. Methods Sixty hundred and ninety-two fetuses at age from 17 to 40 weeks were observed for the development and depth of cerebral sulci (parietal-occipital sulcus, calcarine suleus, central sulcus, eingulate sulcus, cingulate gyrus, and sylvian fissure) by transabdominal ultrasonography. Results Parietal-occipital sulcus,calcarine sulcus,and sylvian fissure were visible at about 19 weeks of gestation, central sulcus was at about 25 weeks, cingulate sulcus and cingulate gyrus were at about 26 weeks. One case of them was considered as cerebral sulei growth retardation due to the signs of invisible parietal-occipital sulcus and sylvian fissure at 24 weeks of gestation. Two cases were considered as cerebral sulci growth retardation due to the signs of invisible parietal occipital sulcus and central sulcus and the shallow blunt shape of sylvian fissure at 29 weeks of gestation. There were positive correlations between the depths of fetal cerebral sulci and gestational weeks, and negative correlations between their relative depths and gestational weeks(all P <0.05), Conclusions Transabdominal ultrasonography can be use to observe the development of fetal cerebral sulci (parietal-occipital sulcus, calcarine sulcus, central sulcus, eingulate sulcus,cingulate gyrus,and sylvian fissure). The depth of cerebral sulci is relative to gestational weeks,and would be considered for prenatal assessment of cerebral sulci maldevelopment, such as cerebral sulci growth retardation and lissencephalia.
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Objective To study the hemodynamic characteristics of ductus venosus,and its relationship to inflammatory cytokines in ovine fetus with systemic inflammatory response syndrome.Methods Ten near-term fetal sheep radomly divided into two groups.Five of them were in experimental group,and five of them were in control group.All of the animals underwent abdominal cordocentesis guided by ultrasound at the term of 120-130 days,with a LPS injection at a dosage of 10 μg/kg of fetal weight in experimental group,and the same quantity of 0.9% NaCl solution in control.Doppler echocardiography were performed to determine hemodynamics changes of ductus venosus at 0.5 hour before the LPS injection,and at 1 hour,3 hours,6 hours after LPS injection.Meanwhile,fetal umbilical vein blood was sampled for ELISA essay of serum TNF-α and IL-6 at each of the above time points.Results In experimental group,the ductus venosus waveform PI values(DVPI),maximum velocity during cardiac ventricle systole(S)and during cardiac ventricle diastole(D),ductus venosus index(DVI),ductus venosus blood flow(DVQ),the ratio of S and ductus venous maximum velocity during atrial contracton(S/A),(S-A)/D increased with the time after LPS injection,and still significantly increased as compared with the control animals(all P＜0.05).A decreased with the time after LPS injection,and still significantly changed as compared with the controls(P＜0.05).And the ductus venosus diameter(DVD)had not obvious change(P＞0.05).There were significantly positive correlations between DVPI and TNF-α,IL-6(all P＜0.05),negative corelations between A and TNF-α,IL-6(all P＜0.05),and positive correlations between S wave,DVI,DVQ,D wave,S/A,(S-A)/D and IL-6(all P＜0.05),but not obvious relationships between S wave,DVI,DVQ,D wave,S/A,(S-A)/D and TNF-a(all P＞0.05).Condusions DVPI and A might be easy and useful quantitative parameters in the evaluation of fetal systemic inflammatory respome syndrome with LPS injection.
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0 05).The size of PEI group was larger than that of PAI group 2 months after treatment (P