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Objective To investigate the clinical value of contrast-enhanced ultrasound(CEUS) in the diagnosis of postnatal placenta increta. Methods Twenty-six patients with postnatal placenta increta were examined by gray-scale and color Doppler ultrasound and CEUS. Then microvascular perfusion and enhanced features of lesions, myometrium and serous layer were observed. Arriving time (AT), time to peak intensity (TTP) and the lasting time of enhancement (LTE) were recorded. AT,TTP and LTE of enhanced lesions were compared with those of normal myometrium. Results Serous layer, lesions and adjcent myometrium,normal myometrium enhanced in turn. There was no obvious boundary between the lesions enhanced and adjcent myometrium. AT and TTP of the lesions enhanced were both less than those of normal myometrium ( P ＜0. 05). LTE of the part of lesions enhanced was more than that of normal myometrium ( P ＜0.05).Part of lesions never enhanced during the whole process. The serous layer of uterine was smooth and uninterrupted in 24 patients. These 24 patients all recovered after conservative treatment. The local serous layer adjcent lesions was not smooth, but no contrast agent leakage occurred in another 2 patients, and uterine lobectomy were performed in emergency because of massive hemorrhage during conservative treatment. Conclusions Microvascular perfusion and enhanced features of lesions,myometrium and serous layer could be showed clearly through CEUS.
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Objective To investigate outcome and prognosis of isolated mild fetal ventriculomegaly (IMV) of fetus in uterus. Methods From Jan. 2006 to Dec. 2009, 18 200 singleton pregnancy women from 20 weeks gestation underwent prenatal ultrasonography examination in Department of Obstetrics and Gynecology, Second Affiliated Hospital of Wenzhou Medical College. One hundred and forty-eight women with IMV (transverse diameter of the atrium of the lateral ventricle measuring between 10 and 15 mm with no other abnormalities) were studied prospectively, which were divided into two groups: 99 women with transverse diameter of the lateral ventricle of 10 - 11 mm in group A and 49 women with transverse diameter lateral ventricle of 12 - 15 mm in group B. The changes of ventriculomegaly and the associated intracranial and extracranial anomalies were observed regularly every 2 or 4 weeks until delivery. The development of neurological system was also followed up. Results ( 1 ) The overall incidence of IMV was 0. 08% (148/18 200). The rate of bilateral ventriculomegaly were 20% (20/99) in group A and 51% (25/49) in group B, which reached statistical difference (P＜ 0. 05). (2) Prognosis of fetus: 139 cases with 2 or more ultrasonographic examinations, IMV resolved throughout pregnancy in 41. 7% (58/139) ,regressed in 7. 9% (11/139) ,remained stable in 36. 7% (51/139)and progressed in 13. 7% ( 19/139). Five cases in group A and 11 cases in group B present progress, which reached significantly difference (P ＜ 0. 05). (3) One hundred and eleven cases infant were followed up for 5-12 months,the rate of psycho-motor developmental delay was 5. 4% (6/111). The rate of neuro-developmental delay in progressed group (3/15) was higher than 2. 5% ( 1/40) in resolved group, 0 (0/8) in regressed group and 4. 2% (2/48) in remained stable group, which reached significantly difference (P＜0. 05). Conclusions About 85% of cases of IMV resolved, regressed or remained stable in utero would exhibited good prognosis. IMV with a transverse atrial size ≥ 12 mm or progression in utero was usually associated with a poor prognosis, which should be observed carefully.
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Objective To investigate the clinical value and the feasibility of strain-blood pressure index(SBPI) in assessing the elasticity of brachial artery and anterior tibial artery in patients with type 2 diabetes mellitus. Methods Forty-six type 2 diabetic patients and 50 healthy volunteers were involved. Maxmum of circumferential strain (CSmax) of brachial artery and anterior tibial artery were acquired through strain and strain rate imaging(Xstrain). Local systolic blood pressure(LSBP) and local diastolic blood pressure(LDBP) of brachial artery and anterior tibial artery were measured at the same time. SBPI,tibial-brachial index (TBI), and ankle-brachial index(ABI) were calculated, SBPI = CSmax/[(LSBP-LDBP) /LDBP]×100%,TBI = SBPI of anterior tibial artery/SBPI of brachial artery, ABI = LSBP of anterior tibial artery/LSBP of brachial artery. Parameters were compared between the case group and the control group. Results SBPI of anterior tibial artery and TBI had significant difference between the case group and the control group( P < 0.05), while SBPI of brachial and ABI had no significant difference( P >0. 05).Conclusions SBPI might be a new index for evaluating the elasticity of medium-sized arteries in patients with type 2 diabetes, and different changes caused by type 2 diabetes between brachial artery and anterior tibial artery could be reflected by TBI.
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Objective To investigate the clinical value of contrast-enhanced three-dimensional ultrasound in assessing neovascularization within carotid soft plaques. Methods Thirty-six cases with 42 soft plaques were examined with contrast-enhanced two dimensional ultrasound and contrast-enhanced three dimensional ultrasound. Soft plaques were divided into four grades according to distribution and shape of contrast media:grade Ⅰ (there was no enhancement in plaque) , grade Ⅱ (plaque was enhanced with sparse spots pattern or enhanced in small range locally), grade Ⅲ (plaque was enhanced with sparse spots and short-line pattern ),grade Ⅳ (plaque was enhanced with line and grid pattern). Results The results of contrast-enhanced two-dimensional ultrasound were as followed: 4.8% grade Ⅰ , 35.7% grade Ⅱ , 52.4% grade Ⅲ and 7.1% grade Ⅳ. The results of contrast-enhanced three-dimensional ultrasound were as followed:9.5% grade Ⅱ , 47.6% grade Ⅲ and 42.9% grade Ⅳ. Conclusions Spatial distribution of neovascularization within carotid soft plaques could be reflected comprehensively by contrast-enhanced three dimensional ultrasound, and it might be a new mothod to investigate spatial structure and microvascular perfusion of soft plaques furtherly.
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Objective To investigate the correlation between intima-media thickness(IMT)and elasticity of carotid in patients with type 2 diabetes accompanied hyperlipidemia by quantitative intima-media thickness(QIMT)and quantitative arterial stiffness(QAS)technique.Methods Fifty-six patients with type 2 diabetes accompanied hyperlipidemia were involved into the study as case group.Forty-eight healthy volunteers were supplied as normal control group in the same period.IMT,compliance coefficient(CC),distensibility coefficient(DC)and stiffness index(β)of carotid were acquired through QIMT and QAS.Case group was divided into case group 1(IMT＜0.9mm)and case group 2(IMT≥0.9 mm),and analysis was performed furtherly.Results β,triglyceride(TG),lowdensity lipoprotein(LDL),cholesterol(Ch),glycosylated hemoglobin(GHb)and IMT had significant differences in case group 1,case group 2 and control group(P＜0.05),control group＜case group 1＜case group 2.DC and CC had significant differences in case group 1,case group 2 and control group(P＜0.05),control group＞case group 1＞case group 2.There was significant positive correlation between β and age,GHb,LDL and IMT of carotid respectively(r=0.811,r:0.764,r=0.732,r:0.729,respectively,P=0.000).Conchmions IMT of carotid could be measured accurately by QIMT.Structure imaging and functional imaging of carotid might be combined organically through QIMT and QAS.Depth study about early change of carotid in structure and function could be performed with these two techniques.
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Objective To explore the clinical value of Doppler tissue imaging (DTI) in evaluating abdominal aortic wall motion to predict pregnancy-induced hypertension (PIH).Methods The velocities of anterior abdominal aortic wall motion in 112 pregnant women with normal 20-40 weeks' pregnancy were detected by DTI and combined with simultaneous electrocardiography.Electromechanical time (EMT), left ventricular pre-ejection period (PEP), patients' height and weight were measured and recorded respectively.Pulsed wave time (PWT, PWT = EMT-PEP) and relative pulse wave velocity (RPWV) were calculated and analyzed.Medium and late stage PIH eases and time were recorded in clinical follow-up.Results PIH group were 11 cases, non-PIH group were 101 cases.E, S_1, S_2, D peak value in PIH group were significantly lower than those in non-PIH group [(2.02 ± 0.39 ) cm/s vs (2.32 ± 0.45 ) cm/s, (6.08 ± 0.87 ) cm/s vs(7.12 ±1.11 ) cm/s, (2.22 ± 0.65 ) cm/s vs( 2.83 ± 0.81 ) cm/s, (3.26 ± 0.54) cm/s vs( 3.86 ± 0.72 ) cm/s, P < 0.01]; EMT shortening[(120.87 ± 11.34) ms vs (134.32 ± 10.62) ms,P<0.05];PEP longer[(92.36±9.04) ms vs(83.11±8.95) ms,P< 0.05];PWT shortening[(31 ± 11) ms vs(45 ± 13) ms,P<0.01]; RPWV faster [( 1 02.28 ± 20.69) m/s vs (75.37 ± 18.74) m/s, P < 0.01].Conclusions Abdominal aortic wall motion has already changed in early stage of PIH.DTI is a valuable method to evaluate the abdominal aorta wall motion for early detection of PIH with high sensitivity, high accuracy and access to promote.
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Objective To assess the elasticity change of common carotid artery in early stage of atherosclerosis in patients with type 2 diabetes by velocity vector imaging(VVI).Methods Sixty patients with type 2 diabetes were divided into group A(32 cases)and group B(28case)according the vascular complications(including Macroangiopathy and Microangiopathy).Patients without vascular complications belong to group A,others belong to group B.Fifty-eight healthy volunteers were supplied as normal control group.Time to the peak of velocity(VTTP),maximum of velocity(Vmax),maximum of strain(Smax),and maximum of strain rate(SRmax)of six segment(anterolateral wall,anterior wall,anteromedial wall,posteromedial wall,posterior wall,posterolateral wall)were measured,which were supplied by VVI automatic analysis software.Results VTTP,Smax and SRmax had no significant differences in any segments intra-group A,B and control group(P＞0.05).Vmax had significant differences in some segments in control group,group A and group B,Vmax of anterior wall,anterolateral wall and posterolateral wall were higher than those of posterior wall,posteromedial wall and anteromedial wall(P＜0.05).VTTP,Vmax,Smax and SRmax of corresponding segments had significant differences among group A,group B and control group(P＜0.05),control group＞group A＞group B(P＜0.05).Conclusions The change of common carotid elasticity can be detected in early stage of atherosclerosis in patients with type 2 diabetes by VVI.