2D shear-wave ultrasound elastography (SWE) evaluation of ablation zone following radiofrequency ablation of liver lesions: is it more accurate?

OBJECTIVE: To evaluate the usefulness of two-dimensional quantitative ultrasound shear-wave elastography (2D-SWE) [i.e. virtual touch imaging quantification (VTIQ)] in assessing the ablation zone after radiofrequency ablation (RFA) for ex vivo swine livers. METHODS: RFA was performed in 10 pieces of fresh ex vivo swine livers with a T20 electrode needle and 20-W output power. Conventional ultrasound, conventional strain elastography (SE) and VTIQ were performed to depict the ablation zone 0 min, 10 min, 30 min and 60 min after ablation. On VTIQ, the ablation zones were evaluated qualitatively by evaluating the shear-wave velocity (SWV) map and quantitatively by measuring the SWV. The ultrasound, SE and VTIQ results were compared against gross pathological and histopathological specimens. RESULTS: VTIQ SWV maps gave more details about the ablation zone, the central necrotic zone appeared as red, lateral necrotic zone as green and transitional zone as light green, from inner to exterior, while the peripheral unablated liver appeared as blue. Conventional ultrasound and SE, however, only marginally depicted the whole ablation zone. The volumes of the whole ablation zone (central necrotic zone + lateral necrotic zone + transitional zone) and necrotic zone (central necrotic zone + lateral necrotic zone) measured by VTIQ showed excellent correlation (r = 0.915, p < 0.001, and 0.856, p = 0.002, respectively) with those by gross pathological specimen, whereas both conventional ultrasound and SE underestimated the volume of the whole ablation zone. The SWV values of the central necrotic zone, lateral necrotic zone, transitional zone and unablated liver parenchyma were 7.54-8.03 m s(-1), 5.13-5.28 m s(-1), 3.31-3.53 m s(-1) and 2.11-2.21 m s(-1), respectively (p < 0.001 for all the comparisons). The SWV value for each ablation zone did not change significantly at different observation times within an hour after RFA (all p > 0.05). CONCLUSION: The quantitative 2D-SWE of VTIQ is useful for the depiction of the ablation zone after RFA and it facilitates discrimination of different areas in the ablation zone qualitatively and quantitatively. This elastography technique might be useful for the therapeutic response evaluation instantly after RFA. ADVANCES IN KNOWLEDGE: A new quantitative 2D-SWE (i.e. VTIQ) for evaluation treatment response after RFA is demonstrated. It facilitates discrimination of the different areas in the ablation zone qualitatively and quantitatively and may be useful for the therapeutic response evaluation instantly after RFA in the future.

VEGF attenuates development from cardiac hypertrophy to heart failure after aortic stenosis through mitochondrial mediated apoptosis and cardiomyocyte proliferation.

BACKGROUND: Aortic stenosis (AS) affects 3 percent of persons older than 65 years and leads to greater morbidity and mortality than other cardiac valve diseases. Surgery with aortic valve replacement (AVR) for severe symptomatic AS is currently the only treatment option. Unfortunately, in patients with poor ventricular function, the mortality and long-term outcome is unsatisfied, and only a minority of these patients could bear surgery. Our previous studies demonstrated that vascular endothelial growth factor (VEGF) protects cardiac function in myocardial infarction model through classic VEGF-PI3k-Akt and unclear mitochondrial anti-apoptosis pathways; promoting cardiomyocyte (CM) proliferation as well. The present study was designed to test whether pre-operative treatment with VEGF improves AS-induced cardiac dysfunction, to be better suitable for AVR, and its potential mechanism. METHODS: Adult male mice were subjected to AS or sham operation. Two weeks later, adenoviral VEGF (Ad-VEGF), enhanced green fluorescence protein (Ad-EGFP, as a parallel control) or saline was injected into left ventricle free wall. Two weeks after delivery, all mice were measured by echocardiography and harvested for further detection. RESULTS: AS for four weeks caused cardiac hypertrophy and left ventricular dysfunction. VEGF treatment increased capillary density, protected mitochondrial function, reduced CMs apoptosis, promoted CMs proliferation and eventually preserved cardiac function. CONCLUSIONS: Our findings indicate that VEGF could repair AS-induced transition from compensatory cardiac hypertrophy to heart failure.

Puparial case hydrocarbons of Chrysomya megacephala as an indicator of the postmortem interval.

The puparial case is one of the most common 'stages' of necrophagous flies encountered in crime investigations of highly decomposed corpses. If methods for determining the weathering time of these puparial cases are developed, it is possible that the postmortem interval (PMI) could be estimated accordingly. Gas chromatography coupled with mass spectrometry (GC-MS) was used to determine the changes with the weathering time in cuticular hydrocarbons of the puparial cases of Chrysomya megacephala in the laboratory. The results have shown that cuticular hydrocarbons of the puparial cases were a mixture of n-alkanes, methyl-branched alkanes, and dimethyl-branched alkanes. The carbon chain length ranged from C21 to C35, and the hydrocarbon composition showed significant regular changes with the weathering time. For the even numbered n-alkanes with low molecular weight, namely n-C22, n-C24 and n-C26, the abundance increased significantly with the weathering time. For n-C26, in particular, a linear increase in abundance with the weathering time was observed. In addition, for most of the other low molecular weight hydrocarbons (n-C26 or below), the abundance decreased significantly with the weathering time. It is concluded that, cuticular hydrocarbon is a potential indicator of the weathering time in C. megacephala, and possibly in other necrophagous flies, and might further be used to determine the PMI.