Clinical assessment of pelvic external fixation in hemodynamically unstable patients with pelvic fracture / 中国医师进修杂志

Objective To evaluate the clinical effect of emergency pelvic external fixation in hemodynamically unstable patients with pelvic fracture.Methods The clinical data of 56 hemodynamically unstable patients with pelvic fracture from January 2008 to December 2013 were selected.The changes of hemoglobin,mean arterial pressure,heart rate,serum lactate,urine volume,norepinephrine dosage before and after surgery for 24 h were compared and analyzed.Results Compared with those before surgery,the levels of hemoglobin,mean arterial pressure,serum lactate,urine volume,heart rate after surgery for 24 h were significantly improved:(109 ± 12) g/L vs.(69 ±22) g/L,(87.8 ±6.5) mmHg (1 mmHg =0.133 kPa) vs.(55.8 ± 7.7) mmHg,(6.3 ± 5.1) mmol/L vs.(10.8 ± 6.6) mmol/L,(35.9 ± 9.9) ml/h vs.(17.6 ± 8.4) ml/h,(84.2 ± 15.4) times/min vs.(146.4 ± 12.1) times/min,and the norepinephrine dosage was significantly reduced:(0.8 ± 0.2) μ g/ (kg· min) vs.(2.2 ± 0.8) μ g/ (kg· min).The differences had statistical significance (P ＜ 0.05 or ＜ 0.01).Conclusion Bedside pelvic external fixation can rapidly improve shock symptom in hemodynamically unstable patients with pelvic fracture,which is safe and efficient.

Clinical significance of hemodynamic monitoring using PiCCO / 心血管康复医学杂志

Transpulmonary thermodilution pulse-indicated continuous cardiac output (PiCCO) monitoring only needs a central venous catheter and an artery catheter ,so is a minimally invasive ,simple ,accurate and continuous cardiac output monitor technique used at home and abroad now .It combines transpulmonary thermodilution and analysis technique of arterial pulse wave area under curve (AUC) .It helps to better evaluate ,guide and improve treatment in critically ill patients .

Research of cardiovascular function in patients with type 2 diabetes by wave intensity and tissue Doppler imaging / 中华超声影像学杂志

Objective To evaluate the clinical value of cardiovascular function in patients with type 2 diabetes mellitus by wave intensity and tissue Doppler imaging.Methods According to the course of disease,30 patients with type 2 diabetes mellitus were divided in to two groups:T2DM group 1,the course of disease between 1 year to 5 years; T2DM group 2,the course of disease was longer than 5 years.30healthy volunteers were considered as control group.The parameters of accelerating wave intensity(W1),decelerating wave intensity(W2),negative area(NA),time interval between the R-wave of ECG and the first peak(R-W1),the first and second peaks (W1-W2),elasticity modulus (Ep),stiffness index (β),arterial compliance(AC),pulse wave velocity(PWVβ) and intima media thickness (IMT) were calculated by wave intensity.The left ventricular ejection fraction (LVEF),left ventricular ejection time (LVET),early diastolic peak speed (E),late diastolic peak velocity (A),E / A and isovolumic relaxation time(IVRT) were detected by two dimensional echocardiography.Mitral annular early diastolic peak speeds (Em),late diastolic peak velocity (Am) and Em / Am were detected by tissue Doppler imaging.Then three groups data were recorded and compared.Results Compared with the control group,β,PWVβ,Ep in T2DM group increased significantly(P ＜0.01 or P ＜0.05),while AC decreased(P ＜0.05).IMT in T2DM group 2 was thicker significantly than the control group(P ＜0.01).PWVβ,Ep,IMT in T2DM group 2 were significantly higher than those of T2DM group 1 (P ＜0.05).W2 in T2DM group 2 was significantly higher than those of T2DM group 1 and the control group(P ＜0.01 or P ＜0.05).E/A,Em and Em/Am in T2DM group were significantly lower than those of the control group (P ＜0.05 or P ＜0.01).Compared with T2DM group 1,Em in T2DM group 2 decreased significantly(P ＜0.05).In T2DM group,there were positive correlation between IMT and Ep,β,PWVβ (r =0.48,r =0.385,r =0.478,P ＜0.05 or P ＜0.01),positive correlation between Em and E (r =0.404,P ＜0.05) ;positive correlation between Em/Am and E/Em,E/A (r =0.602,r =0.559,P ＜0.01) ; negative correlation between Em and IVRT (r =-0.653,P ＜0.01);positive correlation between W1 and LVEF (r =0.627,P ＜0.01); positive correlation between W1-W2 and lVET (r =0.847,P ＜ 0.01) ; no correlation between W2 and E/A,E/Em,Em/Am,IVRT(P ＞0.05).Conclusions The elasticity of carotid artery and the diastolic function of left ventricular decreased in T2DM patients,while the systolic function of left ventricular was normal.

Evaluation of portal hypertension esophageal varices (moderate to severe) via liver ultrasound hemodynamic parameters / 中华超声影像学杂志

Objective To evaluate the application of liver ultrasound hemodynamic parameters in diagnosing moderate to severe esophageal varices(EV) among patients suffering from portal hypertension.Methods The control group consisted of twenty nine patients without EV.Sixty patients with EV diagnosed by endoscopy were divided into two groups equal in number according to grade of EV.One being mild,the other was moderate to severe.All patients underwent color Doppler flow imaging and contrastenhanced ultrasound,and the dynamic angiography data were collected.Time intensity curves were drawn by software to acquire the arrive time of hepatic artery (HAAT),hepatic vein (HVAT) and portal vein (PVAT).Then HV-HA interval time,PV HA interval time and PV-HV interval time were calculated.The quantitative parameters including HV-HA,PV-HA,PV-HV,damping index (DI) of hepatic vein and portal vein velocity(PVV) were compared.ROC curve was used to assess the value of the parameters above in predicting moderate to severe esophageal varices.Results The difference of PV-HV,PV HA,HV-HA,PVV,DI between the control and the moderate to severe group were statistically significant (P =0.000).PV-HV,PV-HA,HV-HA,DI in moderate to severe group showed statistically significant compared with mild group (P =0.000,P =0.002,P =0.000,P =0.002),however,PVV had no significant (P ＞0.05) difference between the two groups.Mild group contrasted to the control group,the differences of PV-HA and HV-HA were statistically significant (P =0.000),whereas PV-HV,DI,PVV displayed no significant (P ＞0.05) difference.The areas under ROC curve of PV-HV,PV-HA,HV-HA,PVV,DI were 0.952,0.775,0.847,0.699,0.808 respectively.The best cutoff value of PV-HV for diagnosing moderate to severe EV was 0.5 second,with sensitivity and specificity of 86.2％ and 94.8％ respectively.Conclusions The liver ultrasound hemodynamic parameters is helpful in the diagnosis and evaluation of moderate to severe esophageal varices,which is expected to become a new noninvasive method.

Analysis of the hemodynamic changes of transplanted liver with acute rejection using color Doppler flow imaging: a preliminary study / 中华超声影像学杂志

Objective To investigate the viability of analysis of hemodynamic changes with color Doppler flow imaging in the prediction of acute rejection in transplanted liver.Methods Sixty-eight patients enrolled in the study were categorized into three groups:transplanted liver without acute rejection [rejection activity index(RAI) 0-3,n =24],transplanted liver with mild acute rejection (RAI 4-5,n =23),transplanted liver with moderate and severe acute rejection (RAI 6-9,n =21).All the patients were confirmed by pathology.The color Doppler flow imaging were performed in all the patients within 24 hours and 1 week after biopsy.Results In transplanted liver with moderate and severe acute rejection,the peak systolic velocity of portal vein (PV-PSV) was (31.4 ± 14.1)cm/s,significantly lower than that in transplanted liver without acute rejection,which was (45.1 ± 17.7)cm/s (P ＜0.05).A week later after steroid therapy,the PV-PSV in transplanted liver with moderate and severe rejection was increased to (46.7 ± 21.8)cm/s(P ＜0.05).Patients with acute rejection were associated with the decrease of the PVPSV (P ＜0.05).Conclusions The decrease of PV-PSV may have some clinical value in evaluation the acute rejection in transplanted liver.

Relevance study of renal hemodynamic change and endothelia dysfunction in patients with hypertensive disorder complication pregnancy / 中华超声影像学杂志

Objective To investigate if the endothelin-1 (ET-1),nitric oxide(NO) can affect renal artery blood flow and explore the clinical value of ultrasonography in hypertensive disorder complication pregnancy.Methods 18 patients of gestational hypertension,18 patients of gently preeclampsia,20 patients of severe preeclampsia and 20 normal pregnancy women were chosen in random.Color Doppler ultrasonography was used to detect the peak systolic velocity (PSV),end diastolic velocity (EDV),resistive index (RI),pulsatility index (PI) of renal interlobar artery.The levels of serum ET-1 and NO were measured by enzyme-linked immunosorbent assay (ELISA) and nitric acid recovery respectively.Results The level of EDV in preeclampsia patients were significant lower than the control group (P ＜0.05).The levels of RI,PI,S/D in preeclampsia patients were significant higher than the control group (P ＜0.05).The level of ET-1 in study group was higher than control group (P ＜0.01).The level of NO in study group was lower than control group (P ＜0.01).There was positive correlation between the RI,PI,S/D of renal interlobar artery and the level of serum ET-1.There was inverse correlation between the RI,PI,S/D of renal interlobar artery and the level of serum NO.Conclusions Endothelial dysfunction can cause unbalance of renal vessel systolic-diastolic function.The level of renal artery blood flow parameters can reflect the state of vessel function and have clinical value in hypertensive disorder complication pregnancy.

Influence of dexmedetomidine on the intraoperative fentanyl requirements and cerebral hemodynamics in patients undergoing intracranial tumor surgery / 中国基层医药

Objective To study the effect and safety of dexmedetomidine on the intraoperative fentanyl requirements and cerebral hemodynamics in patients undergoing intracranial tumor surgery.Methods 62 patients scheduled for intracranial tumor surgery were selected and divided into observe group (31 cases) and control group(31 cases).Dexmedetomidine (0.5 μg/kg) was loaded in observe group,and followed by a continuous infusion of a rate of 1.0pμg · kg-1 · h-1 half an hour later.Saline was infused in the same time and the same way in control group.Dose of anesthetic and change of cerebral hemodynamics were recorded and compared.Results The mean heart rate and mean arterial blood pressure were lower in observe group than the underlying value when inducing anesthesia and during the operation (all P ＜ 0.05),while that happened after operation starting 60 minutes later in control group(all P ＜0.05).The mean heart rate and mean arterial blood pressure were lower in observe group those that in control group (all P ＜ 0.05).Dose of fentanyl and end-tidal sevoflurane concentration were lower in observe group(all P ＜ 0.05).Conclusion Dexmedetomidine used for cerebral hemodynamics stabiliby in intracranial tumor surgery has obvious curative effect and good safety.And it could decrease the dose of anesthetics and anesthesia adjuvant.

Effects of low ambient temperature on hemodynamics and oxygen dynamics in a porcine hemorrhagic shock model / 解放军医学杂志

Objective To investigate the effects of low ambient temperature on hemodynamics and oxygen dynamics in a porcine hemorrhagic shock model. Methods Thirty-two healthy adult Bama miniature pigs were randomly divided into four groups (8 each): control (group C), shock under room temperature (22°C, group R), shock under low ambient temperature (-10°C, group L) and shock under normal body temperature (keep pulmonary arterial temperature ranged from 38.5 to 39.5°C, group N). The hemorrhagic shock model was reproduced by venous bleeding (40% of total blood volume), and the core temperature (pulmonary arterial temperature and rectal temperature), heart rate (HR), mean arterial pressure (MAP), pulmonary arterial pressure (PAP), pulmonary arterial wedge pressure (PAWP), central venous pressure (CVP), cardiac output (CO), hemoglobin (Hb), saturation of mixed venous blood (SvO2) and blood gas analysis were recorded before reproduction of shock and at different time points after hemorrhagic shock. The whole body oxygen delivery index (DO2I), oxygen uptake index (VO2I), and oxygen extraction ratio (O2ER) were calculated. Results Four pigs died in group N during the experiment, meanwhile, no pig died in other groups. The core temperature in group C, R and L decreased significantly compared with group N (P<0.05), and the core temperature in group L was significantly lower than that in groups C and R from 120 minutes after shock. No difference was found in hemodynamics, oxygen dynamics and prognosis between group R and group L. The HR and VO2I in group N were significantly higher than those in group L and group R, while there was no difference in other indices between the 3 groups. Conclusion The hemodynamics and oxygen dynamics indices don't worsen in hemorrhagic shock pigs under low ambient temperature, possibly resulting from induced hypothermia caused by anesthesia.

Comparative study on hemodynamics features of recurrent hepatocellular carcinoma between contrast-enhanced ultrasonography and contrast-enhanced MRI / 中华超声影像学杂志

Objective To compare the hemodynamics features of recurrent hepatocellular carcinoma between contrast-enhanced ultrasonography (CEUS) and contrast-enhanced MRI (CEMRI).Methods Forty three recurrent hepatocellular carcinoma lesions in 39 patients were evaluated by CEUS and CEMRI.All lesions were proved by operation or needle biopsy.The dynamic enhancement and washout process on CEUS and CEMRI were analyzed.Results On both two methods,all lesions showed hyperenhancement.Among which,30.2％ (13/43) lesions showed hyperenhancement during arterial phase and no washout was found during portal venous phase,37.2 ％ (16/43) lesions hyperenhanced during arterial phase and washout during portal venous phase.During late phase,the enhancement of 60.5％ (26/43) lesions decreased and 7.0％ (3/43) lesions showed no washout on CEUS or CEMRI.The overall concordance ratio between two methods was 67.4％ (29/43).Difference of hemodynamics features between CEUS and CEMRI was not statistically significant.Conclusions CEUS can accurately display the hemodynamic features of recurrent hepatocellular carcinoma,and enjoy high consistence with CEMRI.

Experimental study in the effect of various intracranial hypertension upon the cerebral blood flow by transcranial Doppler / 中华超声影像学杂志

Objective To investigate the changes of transcranial Doppler (TCD) patterns and parameters in various intracranial hypertension.Methods Sixty rabbits were randomized into 3 groups:control group,the group of mild-to-moderate intracranial hypertension,the group of serious intracranial hypertension.Acute intracranial hypertension was induced by inflating the balloon inserted into the epidural space.Blood flow velocity was measured with TCD and intracranial pressure (ICP) as well as cerebral perfusion pressure(CPP) was measured.Mannitol was injected to the animals of intracranial hypertension,blood flow velocity and ICP was measured.ResultsTwo characteristic flow patterns vere observed in the group of mild-to-moderate intracranial hypertension:high resistance pattern,systolic flow.At the last stage of extreme intracranial hypertension in the group of serious intracranial hypertension Doppler sonograms showed three characteristic flow patterns in the following sequence:retrograde diastolic flow,very small systolic flow and zero flow.Multiform retrograde diastolic flows were related to the phases of brain death.Very small systolic flow showed three shapes:systolic-spike,small systolic triangular and small double peak.AftermedicinaltreatmentICPdecreasedinthethegroupofmild-to-moderateintracranial hypertension,blood flow velocity also increased.After the same treatment IC,P and blood flow velocity did not change in the group of serious intracranial hypertension.ConclusionsAnalysing patterns and parameters of TCD may be helpful for evaluating ICP indirectly as well as clinical experience.

Study on fetal pulmonary venous Doppler spectrum in cardiorespiratory function / 中华超声影像学杂志

ObjectiveTo explore the characteristics of the fetal pulmonary venous Doppler spectrum in medium-term and terminal pregnancy and to evaluate its application in the cardiac function assessment and lung maturation.Methods The study group consisted of 86 normal fetuses aged from 23rd to 41st week's gestation.The Doppler echocardiography was used to record the pulmonary venous spectra.The peak diastolic velocity (D),deceleration time of D wave,deceleration of D wave (Ddec),the peak systolic velocity (S),acceleration time of S wave,and acceleration of S wave of the right superior pulmonary vein (Sac.c) were measured.Sacc/Ddec was calculated.The Tei index of the left ventricle was calculated.ResultsThe D and deceleration time of D wave and Ddec increased with gestational age (P ＜ 0.05).S,the acceleration time of S wave and Sacc showed no significant correlation with gestational age.Sacc/Ddec ratio was more likely smaller than 1 with the gestational age less than 28 weeks and larger than 1 with the gestational age longer than 28 weeks ( P ＜0.05).ConclusionsD wave flow velocity,deceleration time of D wave and the Ddec of the right superior pulmonary vein had a good correlation with the global left ventricular function.The Sac/Ddec ratio might be new index for assessing cardiac function and lung maturation.

Experimental study on effects of captopril on renal perfusion in diabetes mellitus rabbits by contrast-enhanced ultrasound / 中华超声影像学杂志

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.

Contrast-enhanced ultrasound in the assessment of renal cortical perfusion in rabbits in low temperature conditions / 中华超声影像学杂志

Objective To explore the value of contrast-enhanced ultrasound(CEUS) in the evaluation of the renal cortical perfusion in rabbits in low temperature conditions.Methods 20 New Zealand rabbits were randomly divided into five groups,4 rabbits in each group:1) with the first group as the control group (under the conditions of room temperature) ; 2)The second group was treated under-15℃--23℃ for 8hours; 3)the third group was treated under-15℃--23℃ for 4 hours; 4)the fourth group was treated under-6℃--14℃ for 8 hours; 5) the fifth group was treated under-6℃--14℃ for 4 hours.SonoVue was injected via the ear vein at a dose of 0.1 ml/kg,the renal perfusion imaging was made,observing the dynamic image of 0-3 min after the injection and analyzing the time-intensity curves(TIC)obtained from the following parameters:the slope rate of ascending curve(A),the slope rate of descending curve(α),area under the curve (AUC),time to peak (TTP),and derived peak intensity(DPI).Results Compared with the control group,the A,α of the second and the fourth group were significantly decreased (P ＜ 0.05),while the AUC was significantly increased (P ＜ 0.05) and the TTP was significantly prolonged(P ＜0.05),for the third and the fifth group,only the A was decreased (P ＜0.05),and the DPI in each group showed no significant difference.Compared with the third and the fourth group,the AUC of the second group was increased and the TTP was prolonged (P ＜0.05).Conclusions Contrast-enhanced ultrasound can reflect the earlier renal cortical hemodynamic changes in rabbits in the low-temperature conditions,and is of great value for the early diagnosis of renal damage caused by low temperature.

The analysis of influencing factors of perioperative blood pressure fluctuation of pheochromocytoma / 中国医师进修杂志

ObjectiveTo analyze the influencing factors of the blood pressure fluctuation during the perioperative period of pheochromocytoma,and discuss the ways to improve the hemodynamics.Methods The clinical data of patients with pheochromocytoma who had received operation from 2000 to 2010 werestudied retrospectively.The influencing factors of perioperative blood pressure fluctuation were analyzed by statistical methods including Pearson correlation analysis and Logistic regression.ResultsAccording to Pearson correlation analysis,the influencing factors of the highest fluctuation value of the systolic blood pressure ( △ SBP) during the operation included the preoperative highest systolic blood pressure (r =0.196,P =0.013 ),the content of preoperative 24-hour urine epinephrine ( r =0.207,P =0.008 ) and the lost blood volume during the operation (r =0.253,P=0.003).Logistic regression analysis showed that the postoperative persisting hypotension was influenced by the content of preoperative 24-hour urine norepinephrine(OR =1.273,P =0.002) and preoperative preparation duration(OR =0.921,P =0.034);the risk factors of postoperative hypertension were residual tumor (OR =16.920,P =0.001 ) and the preoperative hematocritchange(OR =1.467,P =0.018).ConclusionsIn spite of the adequate preoperative preparation,great changes of blood pressure would still occur during the perioperative period of pheochromocytoma,and it is influenced by many factors.Corresponding measures aiming to these factors should be taken to decrease the perioperative blood pressure fluctuation and surgical risks.

Value of transoral carotid ultrasonography in detecting the change of distal extracranial internal carotid artery with stenosis and occlusion in its initial segment / 中华超声影像学杂志

Objective To investigate the value of transoral carotid ultrasonography (TOCU) in detecting the change of distal extracranial internal carotid artery(ICA) with stenosis and occlusion in its initial segmen.Methods One hundred and ten patients with stenosis at least 50％ or occlusion in the initial segment of ICA diagnosed by high-frequency linear probe were enrolled as case group,while thirty two with healthy carotid arteries as control group.Both of the case and control groups were undergone high-frequency linear probe to examine CCA and the initial segment of ICA,and TOCU to observe their lumen transparency,color Doppler flow display and change of Doppler flow spectrum,even measuring the internal diameter,peak systolic velocity (PSV),end-diastolic velocity(EDV) and PSVICA/PSVCCA ratio,respectively.Digital subtraction angiography (DSA)were performed within two weeks,then compared with ultrasonography.Results 92.7％ patients were performed TOCU examination in case group and 93.8％ in control group.The internal diameter and PSV of the distal extracranial ICA became gradually smaller from control group to near occlusion group,and there were statistical significance between groups ( P ＜0.05),however,near occlusion group had no statistical significance compared with occlusion group( P ＞0.05).There were 80％ arteries having thrombus echo in occlusion group,and the others in this group having no thrombus had gloomy colour flow,even got low-velocity artery spectrum.Doppler flow spectrum of distal extracranial ICA showed characteristics of slow wave or single peak in near occlusion group,and spike shape or slow wave in 76.7 ％ arteries of 70％ ～near-occlusion stenosis group,but spike shape in 30.8％ arteries of 50％～69％ stenosis group,and the others were normal.Conclusions TOCU is useful for detecting the changing regularity of distal extracranial ICA with stenosis or occlusion in its initial segment and has the value of clinical application in association with high-frequency linear probe.

Evaluation of color Doppler ultrasound of renal blood flow combined with the detection of bone morphogenetic protein-7 in early diagnosis of type 2 diabetic nephropathy / 中华超声影像学杂志

Objective To evaluate the significance of color Doppler ultrasound examination of renal blood flow combined with the detection of bone morphogenetic protein-7(BMP-7)in early diagnosis of type 2 diabetic nephropathy.Methods Blood BMP-7 level was tested in 90 patients with type 2 diabetic nephropathy and 30 controls,and parameters of renal blood flow were measured by color Doppler ultrasound examination.Blood BMP-7 level as well as resistant index(RI)of segmental renal artery(SRA)and interlobar renal artery(IRA),were compared between these two groups.Results Compared with controls,blood BMP-7 level gradually decreased with the aggravation of diabetic kidney damage(P＜0.01).The peak systolic velocity(Vmax)and the end diastolic velocity(Vmin)of SRA and TRA were slowed gradually,while RI increased(P＜0.01).Blood BMP-7 level was negatively correlated with IRA's and SRA's RI of IRA and SRA(r =-0.603,P＜0.01;r =-0.652,P＜0.01).Conclusions Color Doppler ultrasound examination of renal blood flow combined with detection of BMP-7 might play an important role in early diagnosis of type 2 diabetic nephropathy.

Early diagnosis of undiscovered nodosity metastasis by hepatic artery Doppler flow imaging perfusion index and contrast-enhanced ultrasound / 中华超声影像学杂志

ObjectiveTo investigate the diagnostic value of early undiscovered nodosity metastasis by hepatic artery Doppler flow imaging perfusion index(DPI) and contrast-enhanced ultrasound (CEUS).MethodsSix hundred and fifty-five patients were collected who suffered with malignant tumor which is not from liver and without liver metastasis.DPI were detected in all patients first,and then patients of higher DPI were taken CEUS and contrast-enhanced CT(CECT).All the diagnosis were confirmed by operation,biopsy under ultrasound or follow-up.ResultsAfter 6 months' follow-up,there were 19 patients found liver metastasis in 562 patients without increase of DPI,and 75 patients found liver metastasis in 93 patients with increase of DPI(DPI＞30％).The negative and the positive predictive value were respectively 96.6％and 80.6％.Seventy-five patients were found 132 liver metastasis who were given CEUS,and 60 patients were found 94 liver metastasis who were given CECT,there was significance difference between them( P ＜0.01).ConclusionsThe combination of DPI and CEUS can get higher detection rate of liver metastasis.

Study of intracardiac flow patterns of left ventricle in patients with premature ventricular complexes from the right ventricular outflow tract / 中华超声影像学杂志

Objective To evaluate the patterns of intracardiac flow of left ventricle (LV) in patients with premature ventricular complexes (PVCs) from the right ventricular outflow tract (RVOT) by analyzing the vortex during isovolumetric contraction phase and the distribution rules of flow-time curves in each layer of LV.Methods Twenty-seven patients with frequent isolated PVCs from RVOT were involved and 25 healthy subjects as control.The color Doppler image of LV at apical four-chamber view was acquired.Vector flow mapping (VFM) was performed to assess the parameters of vortex during isovolumic contraction phase, including diameter (transverse and vertical diameter), velocity (maximal positive and negative velocity) and the number of vortex rings.Positive flow during systole and negative flow during diastole of LV in each layer were measured by flow-time curve.All values of patients with PVCs were recorded during sinus beats (PVC-S) and PVC (PVC-V) respectively.Results Significant differences were demonstrated in all parameters of vortex between the PVC-V and control subjects.And the flow-time curves disarrayed in PVC-V.The velocity of vortex in PVC-S was lower than that in control subjects.And the distribution pattern of flow-time curves in LV of PVC-S differed from that of control subjects.Conclusions Alternation of intracardiac fluid pattern in LV was demonstrated in patients with PVCs from RVOT during both sinus beats and PVC.VFM can be used to analyze the intracardiac flow field in normal and pathological electrical activation.

Comparative study on quantitative parameters of blood perfusion and microvessel density in placenta of rat model of preeclampsia evaluted with contrast-enhanced ultrasound / 中华超声影像学杂志

Objective To investigate the correlation between quantitative parameters with contrastenhanced ultrasound (CEUS) and microvessel density (MVD).Methods Thirty-four placenta of rat model of preeclampsia underwent CEUS examination.The peak intensity time curves on the enhanced images were analyzed quantitatively with computer to get quantitative parameters[the time to peak(TTP), maximal peak intensity(Imax), the area under curve(AUC) and the mean perfusion volume(V)].These parameters were compared with MVD counted with immunohistochemistry and the correlation was statistically studied.Results The TTP in the enhanced images was (14.55 ± 3.45)s, Imax was (20.83 ± 6.15) dB, AUC was (1868.61 ± 25.76)dB, V was (58.01 ± 23.56)dB, and the MVD of placenta of rat model of preeclampsia was (88.98 ± 24.78) in 34 rats.The Imax was correlated positively to MVD (r = 0.885, P = 0.000) ,AUC was correlated positively to MVD (r = 0.677, P = 0.001), V was correlated positively to MVD (r =0.877, P = 0.000).There was no correlation between TTP and MVD in lesions.Conclusions The Imax,AUC and V calculated with CEUS were correlated to MVD, these parameters were valuable index for quantitative evaluation of placental blood perfusion.

Assessment of the hemodynamics of left ventricle in ventricular aneurysm during the contraction phase by vector flow mapping / 中华超声影像学杂志

Objective To evaluate the systolic function of left ventricle in myocardial infarction(MI)patients with ventricular aneurysm and the changing law of blood flow in ventricle with regional abnormality of wall movement by vector flow mapping (VFM).Methods Tirty-one MI patients with ventricular aneurysm and 35 healthy participants were enrolled in this study.The characteristic of vector and streamline,and the changing of the velocity gradient in left ventricular outflow tract (LVOT), and the average flow quantity through aneurysm neck were detected in the isovolumic contraction period, the rapid ejection period and the slow ejection period by VFM.Results The distinction between aneurysm and control group was mainly the persistance of vortex in aneurysm.The size of vortex in aneurysm was highly correlated with that measured by 2-D ultrasound(P ＜0.01).The percentage of vortex duration to cardiac cycle in patients group was significantly greater than that in control group(P ＜0.01).In the early systolic contraction the velocity gradient in LVOT in patients with ventricular aneurysm was smaller than that of control group(P ＜0.05).The average flow through aneurysm neck was notablely decreased compared with control group(P ＜0.01).Conclusions VFM can reveal the hemodynamics of left ventricle with aneurysm directly as well as quantitively measure the regional velocity and flow quantity.VFM can evaluate the systolic function of left ventricle exactly.