Analysis of imaging characteristics of papulopustular rosacea by high-frequency ultrasound combined with color Doppler flow imaging / 中华皮肤科杂志

Objective:To investigate imaging characteristics of papulopustular rosacea (PPR) by high-frequency ultrasound combined with color Doppler flow imaging.Methods:From August 2021 to August 2022, 30 patients with PPR were enrolled from the Department of Dermatology, the First Affiliated Hospital of Baotou Medical College in the Inner Mongolia Autonomous Region, and 30 healthy volunteers served as controls. The 22-MHz high-frequency ultrasound combined with color Doppler blood flow imaging was performed to measure the skin thickness, echo and blood flow parameters at the cheek, and the ultrasound results were compared between the two groups. Comparisons between groups were conducted by using t test or chi-square test. The diagnostic value was analyzed using the area under the curve (AUC) in the receiver operating characteristic (ROC) curve. Results:In the case group, there were 12 males and 18 females, and their ages ranged from 22 to 65 years (42.3 ± 12.8 years) ; in the control group, there were 10 males and 20 females, and their ages ranged from 24 to 62 years (41.0 ± 8.4 years) . The epidermal and dermal thicknesses at the cheek were significantly higher in the case group (132.64 ± 12.29 μm, 1 812.29 ± 85.52 μm, respectively) than in the control group (104.34 ± 14.45 μm, 1 671.77 ± 146.55 μm, respectively, both P < 0.05) . High-frequency ultrasound images showed that the case group was mainly characterized by irregular hypoechoic areas in the cheek dermis (80%) , while banded moderately echoic areas were common in the cheek dermis in the control group (90%) ; subepidermal low-echogenic bands and dermal irregular hypoechoic areas were more likely to appear in the case group than in the control group (93.33% vs. 43.33%, 80% vs. 10%, respectively, both P < 0.001) . Compared with the control group, the case group showed a significantly increased proportion of patients with abundant blood flow signals (93.3% vs. 10%, P < 0.05) , and significantly increased blood vessel diameters (1.60 ± 0.42 mm vs. 0.95 ± 0.32 mm, P < 0.05) ; there was no significant difference in peak systolic blood flow velocity and vascular resistance index between the two groups (both P > 0.05) . The AUC of high-frequency ultrasound combined with color Doppler flow imaging quantitative parameters (including epidermal thicknesses, dermal thicknesses, and blood vessel diameters) was 0.989 (95% CI: 0.970 - 1.000) for the diagnosis of PPR, and the sensitivity and specificity were both 96.7%, which were higher than those of single parameter-based diagnostic model. Conclusion:High-frequency ultrasound combined with color Doppler flow imaging can help improve the accuracy of the diagnosis of PPR, by accurately and non-invasively measuring skin thickness and blood flow parameters.

Value of multiparametric ultrasonography in the differential diagnosis of benign and malignant testicular lesions / 中华超声影像学杂志

Objective:To explore the value of multiparametric ultrasonography consisting of gray-scale ultrasound(US), color Doppler flow imaging (CDFI), real-time strain elastography(RTE), and contrast-enhanced ultrasound(CEUS) in the differential diagnosis of testicular lesions.Methods:Forty patients (40 lesions) detected by ultrasonography examination at the Ultrasound Medical Center of Lanzhou University Second Hospital from June 2020 to June 2022 were retrospectively analyzed, and further the CDFI, CEUS and RTE were performed. The presence of vascularization in the lesion was determined by CDFI and CEUS, avascular lesions were defined as benign, vascularization lesions were defined as malignant. The lesion tissue elasticity was assessed by real-time strain elastography, tissue stiffness was encoded as red(soft), green(intermediate), and blue(hard), and the hard lesions were defined as malignant, soft lesions were defined as benign. All lesions were subjected to pathological histologic examination after surgical resection or puncture biopsy as a reference standard. The correct classification rate, sensitivity, specificity and likelihood ratio of the multiparametric ultrasonography imaging for the diagnosis of benign and malignant testicular lesions were analyzed by ROC.Results:Of 40 testicular lesions, 24 (60.0%) were benign and 16 (40.0%) were malignant. The sensitivity of CDFI, CEUS and RTE in the diagnosis of testicular lesions was 0.875, 1.000 and 1.000, and the specificity was 0.833, 0.750 and 0.708, respectively. The correct classification rate was 85.0%, 85.0% and 82.5%, and the positive likelihood ratio was 5.24, 4.00 and 4.42, respectively. AUC was 0.781, 0.802, 0.771, respectively. By combining RTE and CDFI, a sensitivity of 1.000 and specificity of 0.875 and correct classification rate of 92.8% and positive likelihood ratio of 8.00 and AUC of 0.915 ( P<0.001) were achieved in differentiating testicular lesions. And combining RTE and CEUS, achieved sensitivity of 1.000 and specificity of 0.917 and correct classification rate of 95.0% and positive likelihood ratio of 12.0 and AUC of 0.958( P<0.001). Conclusions:Multiparametric US is of great value in the differential diagnosis of benign and malignant testicular lesions.

Therapeutic Effect of Canagliflozin on Nephrotic Syndrome and Its Ultrasonic Evaluation / 中山大学学报(医学科学版)

ObjectiveTo investigate the therapeutic effect of antidiabetic drug canagliflozin （CGLZ） on adriamycin-induced nephrotic syndrome （NS） in rats， and the evaluation of contrast-enhanced ultrasound （CEUS） combined with color Doppler flow imaging （CDFI） during the treatment. MethodsA total of 56 male SD rats were randomly divided into normal group （NG）， model group （MG）， prednisone （PAT） group （PG）， low-dose single CGLZ group （LSCG）， high-dose single CGLZ group （HSCG）， low-dose CGLZ + PAT group （LUCG） and high-dose CGLZ + PAT group （HUCG）， with 8 rats in each group. The NS model in rats was induced by injecting adriamycin twice into the tail vein， and then the NS rats were treated by intragastric administration daily for 6 weeks with reference of PAT. Twenty-four hour urine total protein （24 h-UTP） was assessed one day before the start of oral administration and at the end of 2， 4 and 6 weeks after oral administration， respectively. CDFI and CEUS were performed on the right renal artery at the end of 6 weeks after oral administration， and the blood of abdominal aorta was taken for serological test the next day. ResultsCompared with those detection index of NG rats， the 24-hour UTP of MG rats increased （P＜0.01）， the serum ALB decreased and TG， TC， LDL increased （P＜0.01）， and CDFI shows that RRCT was thinner （P＜0.01） and the renal artery blood flow indicators RA-PI， RA-RI， RA-S/D all increased （P＜0.05）， and CEUS image shows that the TIC curve parameters TTP， AT， AUC all increased and DPI decrease in MG rats （P＜0.01）. After drug treatment， compared with those detection index of MG rats， 24 h-UTP decrease in LSCG after 2 weeks （P＜0.01）， and decrease significantly in all drug groups after 6 weeks （P＜0.01）； the serological test results show that the serum ALB in all CGLZ groups increased （P＜0.05）， TG decrease in LSCG （P＜0.01）， TC and LDL also decrease in LUCG after 6 weeks （P＜0.05）； CDFI shows that the RRCT thinning degree in all CGLZ is reduced （P＜0.01）， and the RA-PI in LSCG， RA-RI in PG， and RA-S/D in PG， LSCG， HSCG and LUCG rats all decreased （P＜0.05）； CEUS shows that the TTP， AT and AUC of renal TIC curve in drug treatment groups all decreased （P＜0.01）， and the DPI in PG， HSCG， LUCG and HUCG rats increased （P＜0.01）. ConclusionsCGLZ has the effect of treating NS， and the small dose is the best. CEUS combined with CDFI can be used to evaluate the renal morphology and hemodynamic changes of NS model rats before and after drug treatment， which is helpful to guide clinical application.

Application of constrast-enhanced ultrasound-micro flow imaging technique in differential diagnosis of benign and malignant renal tumors / 中华超声影像学杂志

Objective:To explore the value of constrast-enhanced ultrasound-micro flow imaging (CEUS-MFI) in the differential diagnosis of benign and malignant renal tumors.Methods:Totally 96 patients with renal space occupying found in two-dimensional gray-scale ultrasound examination in the First Affiliated Hospital, College of Medicine, Zhejiang University from November 2020 to August 2021 were collected, and 97 lesions were examined by CEUS-MFI and constrast-enhanced ultrasound(CEUS), respectively. The microvascular morphology and contrast-enhanced characteristics of renal tumors were recorded, ROC curves were constructed, and the diagnostic efficacies of the two methods were compared.Results:In the CEUS examination, the enhancement modes of malignant tumors were mainly fast wash-in(52/66, 78.8%) and fast wash-out (49/66, 74.2%) and high perfusion (56/66, 84.8%), and ring enhancement can be seen in 48.5%(32/66) of the lesions. The enhancement patterns of benign tumors were mainly slow wash-in (17/31, 54.8%) and slow wash-out (20/31, 64.5%) and low perfusion (18/31, 58.1%), and no circular blood flow was found in 31 lesions.In the CEUS-MFI examination, the vascular morphology of malignant tumors was mainly irregular (46/66, 69.7%), 93.9%(62/66) of malignant tumors had circular blood flow. Most of benign tumors were of linear vascular structure(12/31, 38.7%) and dendritic vascular structures (14/31, 45.2%), 93.5% (29/31) of benign tumors showed no circular blood flow. The detection rate of the annular blood flow in malignant tumors by CEUS-MFI was higher than that by CEUS, and the difference was statistically significant (93.9% vs 48.5%, P<0.001). The accuracy, sensitivity, and specificity of diagnosing renal tumors for using CEUS-MFI were 90.7%, 93.9% and 83.8%, respectively; and 84.5%, 92.4% and 67.7%, respectively, for using CEUS. The areas under the ROC curve were 0.898 and 0.814 for using CEUS-MFI and CEUS, respectively, the difference between the two techniques was not significant ( P=0.151). Conclusions:CEUS-MFI can sensitively and clearly display the microvascular morphology inside the tumor, and greatly improve the detection rate of annular blood flow in renal malignant tumors, which provides a new method for clinicians to identify benign and malignant renal tumors.

Differential diagnosis of gallbladder polypoid lesions by micro-flow imaging / 南方医科大学学报

OBJECTIVE@#To explore the value of micro-flow imaging (MFI) in evaluating blood flow characteristics and differential diagnosis of gallbladder polypoid lesions.@*METHODS@#We retrospectively analyzed the clinical data and ultrasound images of 73 patients with gallbladder polypoid lesions, including 24 patients with pathologically confirmed neoplastic polyps (n=24) and 49 with non-neoplastic polyps (n=49). All the patients underwent conventional ultrasound, MFI and contrast enhanced ultrasound (CEUS) before cholecystectomy. The blood flow characteristics of the lesions in color Doppler flow imaging (CDFI) and MFI were compared, and the consistency of the findings by these two modalities with those of CEUS were evaluated by weighted Kappa consistency test. The diagnostic performance of MFI for gallbladder polypoid lesions was assessed.@*RESULTS@#There were significant differences between MFI and CDFI in the evaluation of blood flow characteristics of gallbladder polypoid lesions (χ2=37.684, P < 0.001). MFI showed better performance than CDFI in displaying the blood flow characteristics of the polyps. The consistency in the findings was 0.118 between CDFI and CEUS and 0.816 between MFI and CEUS. The sensitivity, specificity and accuracy of MFI in distinguishing neoplastic polyps from non-neoplastic polyps were 75.00%, 93.88% and 87.67%, respectively.@*CONCLUSION@#MFI has a good consistency with CEUS in displaying the blood flow characteristics of gallbladder polypoid lesions and can accurately distinguish neoplastic polyps from non-neoplastic polyps, thus providing new ultrasound diagnostic evidence to support clinical decisions on optimal treatments of gallbladder polypoid lesions.

Research Progress on Vector Flow Imaging of Cardiac Ultrasound / 中国医疗器械杂志

Echocardiogram is vital for the diagnosis of cardiac disease. The heart has complex hemodynamics requiring an advanced ultrasound imaging mode. Cardiac ultrasound vector flow imaging is capable of measuring the actual magnitude and direction of the blood flow velocity, obtaining the quantitative parameters of hemodynamics, and then providing more information for clinical research and diagnosis. This study mainly reviewed several different vector flow imaging techniques for cardiac flow and presented the implementation difficulties, and proposed a diverging wave based high frame rate cardiac ultrasound vector flow imaging. The study discussed the limitation of current ultrasound technology used in the cardiac flow measurement, analyzed and demonstrated the specific reasons for these implementation difficulties and the potential future development.

Application of Micro-flow Imaging in the Differentiation of Benign and Malignant Thyroid Nodules / 中国医学科学院学报

Objective To evaluate the performance of micro-flow imaging(MFI)in the differential diagnosis of benign and malignant thyroid nodules. Methods Totally 50 patients with thyroid nodules examined by conventional ultrasound,MFI,and contrast-enhanced ultrasound and confirmed by histological or cytological pathology in the First Medical Center of Chinese PLA General Hospital from May to December in 2020 were enrolled in the study.The clinical data and ultrasound images were retrospectively analyzed.A binary logistic regression model was established to evaluate the performance of the model in predicting benign and malignant thyroid nodules. Results Logistic regression showed that composition and "S-W-C" sign were independent risk factors for predicting malignant thyroid nodule.The sensitivity,specificity,and Youden index of the logistic regression model were 73.33%,80.00%,and 0.53,respectively,and the area under receiver operating characteristic curve was 0.799(95%CI=0.662-0.899). Conclusion MFI facilitates the differential diagnosis of benign and malignant thyroid nodules and has the potential to be applied in the future.

Evaluation of microvascular flow imaging combined with high-frequency ultrasonography in children with haemophilic arthropathy A / 中华实用儿科临床杂志

Objective:To explore the application of microvascular flow imaging (MVFI) combined with high-frequency ultrasonography in children with haemophilic arthropathy A (HAA).Methods:Retrospective study.A total of 82 children diagnosed with HAA in the First Affiliated Hospital of Zhengzhou University from October 2018 to October 2020 were recruited.The elbow, knee and ankle joints of each child were examined by high-frequency ultrasonography.The numbers of thickened synovial joints were recorded.Blood flow signals of the thickening of synovial joints was checked by the MVFI and power Doppler ultrasound (PDUS), respectively.Color flow signals were graded by the semi-quantitative scoring systems.The chi- square test and independent multi-group ordinal multi-category rank-sum test were used to compare the differences of MVFI and PDUS in the display of thickened synovial blood flow. Results:A total of 254 joints were involved in 82 children with HAA, including synovial hypertrophy in 188 joints, hydrops articuli in 146 joints, fibrotic septa in 66 joints, cartilage damage in 63 joints, haemosider indeposition in 45 joints, bone erosion in 25 joints, osteophytes in 15 joints and bone remodeling in 8 joints.Grade Ⅱ synovial thickened joints were the most common.The proportion of blood flow signals detected by PDUS in thickened synovial membranes was significantly higher than that detected MVFI (52.66% vs.70.21%, χ2=12.225, P<0.05). Numbers of grade 0 and Ⅰ joints with thickened synovial membranes detected by MVFI were less than those of PDUS, while the opposite result was obtained in detecting grade Ⅱ and Ⅲ joints ( H=21.158, P<0.05). Compared with PDUS, MVFI more sensitively visualized the blood flow of the thickened synovial membrane. Conclusions:MVFI can more prominently detect the thickened synovial blood flow in children with HAA.A combined application of MVFI and high-frequency ultrasonography contributes to the evaluation of children with HAA.

Analysis of ultrasonic features of melanocytoma of optic disc / 中华超声影像学杂志

Objective:To investigate the ultrasonic features, contrast-enhanced ultrasound findings and long-term follow-up results of melanocytoma of the optic disc(MCOD).Methods:The data of 35 patients (35 eyes, 35 lesions) diagnosed with MCOD in Beijing Tongren Ophthalmic Center, Beijing Tongren Hospital from September 2012 to October 2020 were retrospectively analyzed. The B-mode ultrasonography and color Doppler flow imaging (CDFI) were performed on them. The size, morphology, internal echo and secondary changes of the lesions were analyzed. Contrast-enhanced ultrasound was performed on 13 patients. At the same time, 9 patients were followed up for long-term observation.Results:Six lesions (17.1%) showed hemispherical high echo, and 29 lesions (82.9%) showed limited uplift high echo. The largest base diameter of the lesions was (4.0±0.8)mm, average height was(1.9±0.4)mm. Internal echo characteristics: 8 lesions (22.9%) showed uniform echo and 27 lesions (77.1%) showed uneven echo.Lesion boundary: 35 lesions (100%) showed clear lesion boundary. Fifheen lesions (42.9%) showed secondary vitreous opacity. CDFI: blood flow signals could be detected inside the lesions in 19 lesions(54.3%), and not in 16 lesions(45.7%). Contrast-enhanced ultrasound showed 11 of the 13 lesions (84.6%) were completely filled with contrast agent.Conclusions:MCOD has certain ultrasonographic characteristics, which can provide a reliable basis for clinical diagnosis and differential diagnosis. There is no significant change in tumor size after long-term follow-up.

Evaluation of Bilateral Ureteral Urinary Jet Flows for Patency of Uretero- Vesical Junctions by Color Flow Imaging

Background: Ureters are meant to transport urine from the pelvis to the urinary bladder in the form of urinary jet. This is continuous process with intermittent release of urine at uretero-vesical junction. This is regulated by autonomous nervous system. The urine coming to urinary bladder can be seen by color flow imaging (CFI) .This also reflects the patency of the ureter without any obstruction in the pathway. Methods: The size of the population was 30 patients (20 males and 10 females). In this study, the Color Doppler ultrasound was used to evaluate the ureteral jets flow in 10 healthy patients and 20 patients with obstructive uropathy. A probability sampling method was employed while collecting samples. Results: In the right ureteral-vesical junction there was complete absence of detectable jets in 5 patients, 6 patients had weak flow of jet and 19 patients had normal flow of jet. Similarly, in the left ureteral-vesical junction there was complete absence of detectable jet in 3 patients, 12 patients had weak flow and 15 patients had normal flow. Conclusions: The color Doppler evaluation of the ureteral jets is a valid method of evaluating ureteral and renal calculi obstruction and could be a first line of investigation to detect ureteric obstruction in patients with obstructive uropathy.

The value of combination of micro-flow imaging and color Doppler flow imaging in the detection of vascular in hepatic tumors / 中华超声影像学杂志

Objective To evaluate the value in the diagnosis of focal nodular hyperplasia( FNH) by combining micro-flow imaging ( MFI) and color Doppler flow imaging ( CDFI) . Methods A total of 32 patients with 32 FNH lesions were enrolled in this study . Each patient underwent CDFI ,MFI ,and contrast-enhanced ultrasonography ( CEUS ) examinations . The differences in the grade and characteristic distribution of blood flow in FNH were compared between CDFI and MFI . The results were further compared with CEUS . Results There was a significant difference between MFI and CDFI in detecting the blood flow in FNH . Twenty-six cases (81 .3％ ) were detected with blood flow of grade Ⅱ and Ⅲ by MFI , however , 18 cases ( 56 .3％ ) were detected of grade Ⅱ and Ⅲ by CDFI ( P = 0 .000) . A total of 12 (37 .5％ ) lesions were correctly showed spoke-wheel arterial flow peculiar by CDFI ,whereas the number increased to 23(71 .9％ ) in combination with MFI( P = 0 .013) . Conclusions In combination with MFI , CDFI can reveal more blood flow and detect more sensitively in FNH ,which helps to diagnose FNH . To a certain degree ,it can be applied to reduce the use of CEUS .

Vascular ultrasound assessment of internal carotid artery dissection and vertebral artery dissection and the difference analysis of lumen recanalization / 中国脑血管病杂志

Objectives To diagnose and test cervical artery dissection (CAD) during the follow-up by color Doppler flow imaging (CDFI) and to analyze and compare the differences of internal carotid artery dissection ( ICAD) and stenosis degree of vertebral artery dissection ( VAD) , and lumen recanalization. Methods From January 2016 to December 2018 , a total of 136 consecutive patients (160 dissecting vessels) with CAD of intramural hematoma type diagnosed by CDFI and confirmed by high-resolution MRI and/or CT angiography in Xuanwu Hospital .Capital Medical University were enrolled retrospectively. They were divided into ICAD group (n =66, with 75 ICADs) and VAD group (n =70,with 85 VADs).The gender, age,risk factors,cerebral ischemic symptoms, and CDFI manifestations were compared in the patients between the two groups. They were followed up at 3,6, and 12 months after onset. The patients with CAD were reexamined, and the difference of recanalization rate between the two groups was compared. Results There was a statistically significant difference in the mean age and proportion of hypertension between the ICAD group and the VAD group (both P 0. 05); there was significant difference in the degree of vascular stenosis (P 0. 05) between the VAG group and the ICAD group. Conclusions ICAD was different from VAD in the degree of lumen stenosis and the rate of lumen recanalization at different follow-up time. CDFI had good test and follow-up re-examination values for CAD.

Hemodynamic study on the relationship between the internal carotid artery subtotal occlusion and cerebral ischemia / 中国脑血管病杂志

Objective To investigate the differences of intra- and extracranial hemodynamics between internal carotid artery subtotal occlusion (ICASO) and internal carotid artery servere stenosis (1CASS) through ultrasonography assessment,and to explore the hemodynamic mechanism of ICASO with ischemic stroke. Methods From July 2013 to January 2019,a total of 483 consecutive patients with ICASO (60 cases, the subtotal occlusion group) and ICASS(423 cases, the servere stenosis group) were retrospectively recruited. Recorded data of the two groups included the clinical symptoms, vascular internal diameter of the distal internal carotid artery (DICA) in the extracranial segment, and both DICA and middle cerebral artery (MCA) parameters containing average blood flow velocity, vascular resistance index and vascular pulse index. The types of intracranial collateral circulation opening and the characteristics of plaques after carotid endarterectomy were also recorded and compared between the two groups. Results The internal diameter of DICA in subtotal occlusion group was significantly thinner than that servere stenosis group (2. 5 ±0. 8 mm vs. 3. 9 ± 0. 9 mm, t = 10. 849, P 0. 05). Compared with the servere stenosis group, the subtotal occlusion group had higher opening rate of intracranial collateral circulation (all P <0. 01), but lower mean blood flow velocity and the pulse index of affected MCA(48 ± 16 cm/s vs. 61 ± 19 cm/s,P < 0. 01;0. 66 ± 0. 09 vs. 0. 73 ±0. 14,P <0. 01; respectively). Conclusions Vulnerable plaques and low perfusion from intra- and extracranial artery in ICASO patients may be the main pathogenesis of increased risk of ischemic stroke. Comprehensive evaluation of ICASO by ultrasonography could provide an objective basis for the individualized treatment selection in clinic.

Application of vector flow mapping technique in the assessment of left intraventricular pressure gradients in heart failure patients / 中华超声影像学杂志

Objective To evaluate the changes of intraventricular pressure differences(IVPDs)and intraventricular pressure gradients(IVPGs)in different phases of cardiac cycle in patients with heart failure (HF)patients by relative pressure imaging based on vector flow imaging(VFM).Methods Forty-nine HF patients with left ventricular ejection fraction (LVEF) lower than 0.50 hospitalized in Qilu Hospital of Shandong University from November 2018 to January 2019,including thirty-three patients with HF with reduced ejection fraction (HFrEF group) and fifteen patients with midrange ejection fraction (HFmrEF group),and forty-three controls were enrolled in this study.Clinical data and echocardiographic images were collected and the conventional left ventricular diameter,mass,volume,and systolic and diastolic function parameters were measured. IVPDs and IVPGs during isovolemic systole (IC),rapid ej ection (RE), isovolemic diastole (IR),rapid filling (RF) and atrial systole (AC) phases were obtained by the VFM technique.The changes of IVPDs and IVPGs in different phases between the HF and control groups,and their correlations with conventional ultrasound parameters were analyzed.Results IVPDs and IVPGs in heart failure group were significantly reduced compared with the control group especially in isovolumic relaxation phase(all P <0.001).IVPDs and IVPGs showed a decreasing trend in the control group, HFmrEF group and the HFrEF group(P<0.001).IVPDs and IVPGs were correlated with LVID,LVMI,ESV,LVEF,GLS and E/e'(all P <0.01),among which IVPD-IR and IVPG-IR were best correlated. IVPD-IR and IVPG-IR had excellent diagnostic efficacy for HF patients with LVEF<0.5,with cut-off values of<0.73 mmHg(AUC=0.915,P<0.001)and <0.103 mmHg/cm(AUC=0.932,P<0.001), respectively.Conclusions Early diastolic hemodynamics are severely impaired when systolic function declines.IVPG-IR,as a marker of left ventricular diastolic function,significantly correlates with left ventricular systolic function,and can be used as a potential indicator for assessing left ventricular systolic and diastolic function in patients with heart failure and identifying patients with heart failure.

Application of vector flow mapping technique in the assessment of left intraventricular pressure gradients in heart failure patients / 中华超声影像学杂志

Objective@#To evaluate the changes of intraventricular pressure differences (IVPDs) and intraventricular pressure gradients (IVPGs) in different phases of cardiac cycle in patients with heart failure(HF) patients by relative pressure imaging based on vector flow imaging(VFM).@*Methods@#Forty-nine HF patients with left ventricular ejection fraction (LVEF) lower than 0.50 hospitalized in Qilu Hospital of Shandong University from November 2018 to January 2019, including thirty-three patients with HF with reduced ejection fraction (HFrEF group) and fifteen patients with midrange ejection fraction (HFmrEF group), and forty-three controls were enrolled in this study. Clinical data and echocardiographic images were collected and the conventional left ventricular diameter, mass, volume, and systolic and diastolic function parameters were measured. IVPDs and IVPGs during isovolemic systole (IC), rapid ejection (RE), isovolemic diastole (IR), rapid filling (RF) and atrial systole (AC) phases were obtained by the VFM technique. The changes of IVPDs and IVPGs in different phases between the HF and control groups, and their correlations with conventional ultrasound parameters were analyzed.@*Results@#IVPDs and IVPGs in heart failure group were significantly reduced compared with the control group especially in isovolumic relaxation phase(all P<0.001). IVPDs and IVPGs showed a decreasing trend in the control group, HFmrEF group and the HFrEF group(P<0.001). IVPDs and IVPGs were correlated with LVID, LVMI, ESV, LVEF, GLS and E/e′ (all P<0.01), among which IVPD-IR and IVPG-IR were best correlated. IVPD-IR and IVPG-IR had excellent diagnostic efficacy for HF patients with LVEF<0.5, with cut-off values of <0.73 mmHg (AUC=0.915, P<0.001) and <0.103 mmHg/cm (AUC=0.932, P<0.001), respectively.@*Conclusions@#Early diastolic hemodynamics are severely impaired when systolic function declines.IVPG-IR, as a marker of left ventricular diastolic function, significantly correlates with left ventricular systolic function, and can be used as a potential indicator for assessing left ventricular systolic and diastolic function in patients with heart failure and identifying patients with heart failure.

Study on the diagnostic value of superb microvascular imaging, advanced dynamic flow and color Doppler flow imaging in breast microcarcinoma and their correlation with pathological microvessel density / 中华超声影像学杂志

Objective@#To investigate the diagnostic value of superb microvascular imaging(SMI), advanced dynamic flow(ADF) and color Doppler flow imaging(CDFI) in breast microcarcinoma, and to compare the correlation coefficients between these three indicators and postoperative pathological tumor microvascular density(MVD).@*Methods@#A total of 85 patients(87 lesions) with BI-RADS 4 and the maximum diameter≤1 cm were selected, of which, 46 lesions were benign(benign group) and 41 lesions were malignant(malignant group). All the patients and the corresponding lesions were examined by SMI, ADF and CDFI. Blood flow grading was performed on the images using Adler grade of blood flow, and the difference of blood flow among the 3 methods was compared. The expression level of MVD in pathological tumor tissues was detected and analyzed for its correlation with Adler classification by three detection techniques.@*Results@#The areas under the ROC curve(AUR) of CDFI, ADF and SMI were 0.694, 0.705 and 0.776 respectively based on the gold standard with pathological diagnosis. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of CDFI were 78.0%, 54.3%, 60.4%, 73.5%, and 65.5%, respectively; those of ADF were 75.6%, 60.9%, 63.3%, 73.7% and 67.8%, respectively; and those of SMI were 78.0%, 69.6%, 69.6%, 78.0% and 73.6%, respectively. The Adler grades of CDFI, ADF and SMI were positively correlated with MVD(P<0.05), which the highest correlation coefficient between SMI and MVD (r=0.430, P<0.001).@*Conclusions@#SMI is superior to ADF and CDFI in detecting the abundance of breast microcarcinoma, and has the highest correlation coefficient among those 3 detection techniques with tumor pathological MVD, which indicates that SMI may be used for differential diagnosis of breast microcarcinoma and indirectly evaluate the prognosis of patients.

Study on the diagnostic value of superb microvascular imaging ,advanced dynamic flow and color Doppler flow imaging in breast microcarcinoma and their correlation with pathological microvessel density / 中华超声影像学杂志

Objective To investigate the diagnostic value of superb microvascular imaging ( SM I ) , advanced dynamic flow ( ADF ) and color Doppler flow imaging ( CDFI) in breast microcarcinoma ,and to compare the correlation coefficients between these three indicators and postoperative pathological tumor microvascular density ( M VD ) . Methods A total of 85 patients ( 87 lesions ) with BI‐RADS 4 and the maximum diameter≤1 cm were selected ,of which ,46 lesions were benign ( benign group) and 41 lesions were malignant( malignant group) . All the patients and the corresponding lesions were examined by SM I , ADF and CDFI . Blood flow grading was performed on the images using Adler grade of blood flow ,and the difference of blood flow among the 3 methods was compared . T he expression level of M VD in pathological tumor tissues was detected and analyzed for its correlation with Adler classification by three detection techniques . Results T he areas under the ROC curve( AUR) of CDFI ,ADF and SM I were 0 .694 ,0 .705 and 0 .776 respectively based on the gold standard with pathological diagnosis . T he sensitivity ,specificity , positive predictive value ,negative predictive value ,and accuracy of CDFI were 78 .0% ,54 .3% ,60 .4% , 73 .5% ,and 65 .5% , respectively ; those of ADF were 75 .6% , 60 .9% , 63 .3% , 73 .7% and 67 .8% , respectively ; and those of SM I were 78 .0% ,69 .6% ,69 .6% ,78 .0% and 73 .6% ,respectively . T he Adler grades of CDFI , ADF and SM I were positively correlated with M VD ( P ＜ 0 .05 ) , w hich the highest correlation coefficient between SM I and M VD ( r ＝0 .430 , P ＜0 .001 ) . Conclusions SM I is superior to ADF and CDFI in detecting the abundance of breast microcarcinoma , and has the highest correlation coefficient among those 3 detection techniques with tumor pathological M VD ,which indicates that SM I may be used for differential diagnosis of breast microcarcinoma and indirectly evaluate the prognosis of patients .

Microvascular Flow Imaging of Residual or Recurrent Hepatocellular Carcinoma after Transarterial Chemoembolization: Comparison with Color/Power Doppler Imaging

OBJECTIVE: To determine the feasibility of microvascular flow imaging (MVFI) in comparison with color/power Doppler imaging (CDI/PDI) for detection of intratumoral vascularity in suspected post-transarterial chemoembolization (TACE) residual or recurrent hepatocellular carcinomas (HCCs) by using contrast-enhanced ultrasonography (CEUS) or hepatic angiography (HA) findings as the reference standard. MATERIALS AND METHODS: One hundred HCCs (mean size, 2.2 cm) in 100 patients treated with TACE were included in this prospective study. CDI, PDI, and MVFI were performed in tandem for evaluating intratumoral vascularity of the lesions by using an RS85 ultrasound scanner (Samsung Medison Co., Ltd.). Intratumoral vascularity in each technique was assessed by two radiologists in consensus by using a 5-point scale. Then, one of the two radiologists and another radiologist performed additional image review in the reverse order (MVFI-PDI-CDI) for evaluation of intra- and interobserver agreements. Results were then compared with those of either HA or CEUS as the reference. The McNemar test, logistic regression analysis, and intraclass correlation coefficient (ICC) were used. RESULTS: CEUS or HA revealed intratumoral vascularity in 87% (87/100) of the tumors. Sensitivity (79.3%, 69/87) and accuracy (80.0%, 80/100) of MVFI were significantly higher than those of CDI (sensitivity, 27.6% [24/87]; accuracy, 37.0% [37/100]) or PDI (sensitivity, 36.8% [32/87]; accuracy, 44.0% [44/100]) (all p 0.9) and good interobserver agreements (ICCs > 0.6). CONCLUSION: MVFI demonstrated significantly higher sensitivity and accuracy than did CDI and PDI for the detection of intratumoral vascularity in suspected residual or recurrent HCCs after TACE.

The anomalies of choroidal and retinal blood flow in cone-rod dystrophy / 眼科新进展

Objective To study the alteration of blood flow indexes of ophthalmic artery (OA),central retinal artery (CRA) and posterior ciliary artery (PCA) of the patients with cone-rod dystrophy (CRD).Methods The color doppler flow imaging was used in 50 CRD patients (100 eyes,CRD group) and 90 controls (180 eyes,control group) to measure the peak systolic velocity (PSV),end diastolic velocity (EDV),timeaveraged maximum velocity (TAMV),pulsatility index (PI) and resistance index (RI)in OA,CRA and PCA,respectively,and the data was obtained and analyzed statistically by one-sample t test to compare the alteration of these parameters between the CRD group and control group.Results The TAMV of OA was (14.29 ±3.88)cm · s-1 in CRD group and (12.44 ± 3.64) cm · s-1 in the control group,and the difference was statistically significant (P ＜0.05);meanwhile,the PI was 1.75 ±0.42 in CRD group and 2.02 ±0.71 in the control group,and the difference was statistically significant (P ＜0.05).Moreover,the PSV,EDV,TAMV and PI,RI of CRA was (4.60 ± 1.29) cm · s-1,(1.61 ±0.41)cm · s-1,(2.59 ±0.67)cm · s-1 and 1.11 ±0.31,0.63 ±0.10 in CRD group,respectively,and (10.82 ± 2.97) cm · s-1,(3.28 ± 1.11) cm · s-1,(5.50 ± 2.06)cm · s-1 and 1.48 ±0.49,0.71 ±0.08,in the control group,accordingly,and the differences were statistically significant (all P ＜ 0.05).Furthermore,the PSV,EDV,TAMV and PI,RI of PCA was (7.36 ± 2.18) cm · s-1,(2.28 ± 0.82) cm · s-1,(3.99 ± 1.22)cm · s-1 and 1.28 ± 0.37,0.68 ± 0.09 in CRD group,respectively,and (11.61 ± 3.41)cm · s-1,(3.34±1.25)cm · s-1,(5.83 ±1.91)cm · s-1 and 1.49 ±0.43,0.70 ±0.09 in the control group,accordingly,and the differences were statistically significant (all P ＜0.05).Conclusion Hemodynamic unusual alterations of OA,CRA and PCA in CRD patients suggest there is the correlation between the ocular blood supply and the pathological process of CRD,which remains to be observed further.

Clinical value of measurement of cerebral blood flow volume by color Doppler flow imaging in patients with cerebral infarction / 新乡医学院学报

Objective To explore the clinical value of measurement of cerebral blood flow volume by color Doppler flow imaging in patients with cerebral infarction.Methods One hundred and thirty six patients with cerebral infarction in Central Hospital of Zhumadian City from February 2015 to February 2017 were selected as CI group,and 40 non-CI patients in the corresponding time period were chosen as control group.The end diastolic flow velocity,systolic peak systolic velocity,resistance index,and mean flow velocity of the vertebral artery and internal carotid arteries of all the patients were detected by color Doppler flow imaging,and anterior and posterior circulation and total cerebral blood flow were calculated.At the same time,through the color Doppler flow imaging results of the CI group,the patients were divided into anterior circulation blood-supply infarction (anterior circulation group,101 cases) and posterior circulation blood-supply infarction(posterior circulation group,35 cases) according to the blood-supply scope.The patients in the anterior circulation group were divided into cortical branches group (32 cases),perforating branche group (55 cases) and watershed group (14 cases) according to the feeding artery,while the patients in the posterior circulation group were divided into distal infarction group (15 cases),mid-range infarction group (12 cases) and proximal infarction group (8 cases).The cerebral blood flow volume were compared among the groups.Results The end diastolic flow velocity of vertebral artery in the CI group was significantly lower than that in the control group,and the resistance index was significantly higher than that in the control group (P ＜ 0.05).The carotid intravascular diameter and the end diastolic flow velocity in the CI group was significantly lower than those in the control group,and the resistance index was significantly higher than that in the control group (P ＜ 0.05).There was no significant difference in the vertebral artery diameter,the peak velocity of internal carotid artery and vertebral artery between the CI group and the control group(P ＞0.05).The right vertebral artery blood flow,the left and right internal carotid artery blood flow,cerebral blood flow of the anterior circulation and the total cerebral blood flow in the CI group were significantly lower than those in the control group,and cerebral blood flow of the posterior circulation was significantly higher than that in the control group (P ＜ 0.05).The cerebral blood flow of the anterior circulation in the anterior circulation group was lower than that in the posterior circulation group(P ＜0.05),while the cerebral blood flow of the posterior circulation was significantly higher than that in the posterior circulation group(P ＜0.05).There was no significant difference in the total cerebral blood flow between the anterior circulation group and the posterior circulation group(P ＞ 0.05).There was no significant difference in the cerebral blood flow of anterior circulation and posterior circulation,the total cerebral blood flow among the cortical branches group,the perforating branche group and the watershed group(P ＞ 0.05).Also there was no significant difference in the cerebral blood flow of anterior circulation and posterior circulation,the total cerebral blood flow among the distal infarction group,the mid-range infarction group and the proximal infarction group(P ＞0.05).Conclusion The hemodynamics indexes and cerebral blood flow of vertebral artery and internal carotid are well analyzed and evaluated by color Doppler flow imaging,and the color Doppler has a certain clinical values on the diagnosis for CI.