Pub Date : 2020-03-25DOI: 10.3760/CMA.J.CN131148-20190802-00452
Jingzhi Huang, Ming Xu, Jie Chen, Xiao′er Zhang, Xiaoyan Xie, Xiaohua Xie
Objective To compare the characteristics of ultrasonic imaging between pancreatic neuroendocrine tumor (pNET) and pancreatic ductal adenocarcinoma (pDAC), and to identify the ultrasonic characteristics in different pathological grades of pNETs. Methods The ultrasonic imaging data of 67 patients with pathologically confirmed pNETs and 82 patients with pathologically confirmed pDACs from the First Affiliated Hospital of Sun Yat-sen University from January 2010 to March 2019 were retrospectively analyzed. Differences in conventional ultrasonic characteristics and CEUS manifestations between the two groups were compared. Fifty pNET lesions were confirmed with pathological grades G1, G2 and G3.Ultrasonic characteristics of the 3 pathological grades were also compared. Results ①Comparison of ultrasonic imaging characteristics between pNET and pDAC showed that: there were statistically significant differences between the two groups in lesion distribution, lesion size, echo, boundary, signal of blood flow, calcification, dilatation of main pancreatic duct, liver metastasis, vascular involvement, CEUS enhancement in the three phases and non-enhancement area of necrosis (all P<0.05). The binary logistic regression model was built including the signal of blood flow, dilation of main pancreatic duct, liver metastasis and enhancementin arterial and venous phases. The diagnostic model for pNET had 0.988 in sensitivity, 0.791 in specificity, and the area under the ROC curve at 0.951, 95%CI being (0.920, 0.983). ②Comparison of the characteristics of ultrasonic imaging between the pNETs derived from the three pathological grades: there were statistically significant differences among the three groups with the liver metastasis and the enhancement in venous phase (both P<0.05). Only 10.5% (2/19) of G1 pNETs had liver metastasis, while 47.8% (11/23) of G2 and 62.5% (5/8) of G3 pNETs had liver metastasis. In venous phase, 78.9% (15/19) of G1 pNETs showed hyper- or iso- enhancement, while 100% (8/8) of G3 lesions showed hypo-enhancement. Conclusions The combination of features from multiple ultrasonic imaging may help to differentiate pNET from pDAC. There are certain differences in ultrasonic imaging features in pNETs at different pathological grades. Key words: Ultrasonography; Contrast-enhanced ultrasound; Pancreatic neuroendocrine tumor; Pancreatic ductal denocarcinoma
{"title":"Comparative analysis of ultrasonographic characteristics between pancreatic neuroendocrine tumor and pancreatic ductal denocarcinoma","authors":"Jingzhi Huang, Ming Xu, Jie Chen, Xiao′er Zhang, Xiaoyan Xie, Xiaohua Xie","doi":"10.3760/CMA.J.CN131148-20190802-00452","DOIUrl":"https://doi.org/10.3760/CMA.J.CN131148-20190802-00452","url":null,"abstract":"Objective \u0000To compare the characteristics of ultrasonic imaging between pancreatic neuroendocrine tumor (pNET) and pancreatic ductal adenocarcinoma (pDAC), and to identify the ultrasonic characteristics in different pathological grades of pNETs. \u0000 \u0000 \u0000Methods \u0000The ultrasonic imaging data of 67 patients with pathologically confirmed pNETs and 82 patients with pathologically confirmed pDACs from the First Affiliated Hospital of Sun Yat-sen University from January 2010 to March 2019 were retrospectively analyzed. Differences in conventional ultrasonic characteristics and CEUS manifestations between the two groups were compared. Fifty pNET lesions were confirmed with pathological grades G1, G2 and G3.Ultrasonic characteristics of the 3 pathological grades were also compared. \u0000 \u0000 \u0000Results \u0000①Comparison of ultrasonic imaging characteristics between pNET and pDAC showed that: there were statistically significant differences between the two groups in lesion distribution, lesion size, echo, boundary, signal of blood flow, calcification, dilatation of main pancreatic duct, liver metastasis, vascular involvement, CEUS enhancement in the three phases and non-enhancement area of necrosis (all P<0.05). The binary logistic regression model was built including the signal of blood flow, dilation of main pancreatic duct, liver metastasis and enhancementin arterial and venous phases. The diagnostic model for pNET had 0.988 in sensitivity, 0.791 in specificity, and the area under the ROC curve at 0.951, 95%CI being (0.920, 0.983). ②Comparison of the characteristics of ultrasonic imaging between the pNETs derived from the three pathological grades: there were statistically significant differences among the three groups with the liver metastasis and the enhancement in venous phase (both P<0.05). Only 10.5% (2/19) of G1 pNETs had liver metastasis, while 47.8% (11/23) of G2 and 62.5% (5/8) of G3 pNETs had liver metastasis. In venous phase, 78.9% (15/19) of G1 pNETs showed hyper- or iso- enhancement, while 100% (8/8) of G3 lesions showed hypo-enhancement. \u0000 \u0000 \u0000Conclusions \u0000The combination of features from multiple ultrasonic imaging may help to differentiate pNET from pDAC. There are certain differences in ultrasonic imaging features in pNETs at different pathological grades. \u0000 \u0000 \u0000Key words: \u0000Ultrasonography; Contrast-enhanced ultrasound; Pancreatic neuroendocrine tumor; Pancreatic ductal denocarcinoma","PeriodicalId":10224,"journal":{"name":"Chinese Journal of Ultrasonography","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45484023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective To investigate the effect of endometrial thickness(EMT) on the clinical outcome of blastocyst hormone replacement freeze-thawed embryo transfer (HRT-FET) on the first progesterone day, and to analyze the threshold and optimal thickness interval corresponding to ideal clinical pregnancy rate by statistical method. Methods The endometrial preparation protocols of 2 825 blastocyst HRT-FET cycles from January 2013 to December 2016 in Henan Provincial People′s Hospital and the Second Hospital of Hebei Medical University were studied retrospectively. According to EMT on the first progesterone day, they were divided into 5 subgroups: group Q1(EMT: 3.5-7.9 mm), group Q2(EMT: 8.0-8.9 mm), group Q3(EMT: 9.0-9.5 mm), group Q4(EMT: 9.6-10.7 mm), group Q5(EMT: 10.8-21.0 mm). Univariate analysis, classification multivariate Logistic regression analysis, curve fitting and threshold effect analysis were used to investigate the effect of endometrial thickness on clinical outcome of blastocyst HRT-FET. Results Group Q1 was set as the control group in classification multivariate Logistic regression analysis, after adjusting for confounding factors, the clinical pregnancy rate and live birth rate in other groups were higher than the control group. The clinical pregnancy rate and live birth rate in group Q3 and Q4 were significantly increased and the differences were statistically significant(all P<0.05). The cut-off value of the endometrial thickness was 9.6 mm. When endometrial thickness was less than 9.6 mm, with 1 mm increase of endometrial thickness, the clinical pregnancy rate increased by 23%(OR=1.23, 95%CI=1.11-1.36) and the live birth rate increased by 21%(OR=1.21, 95%CI=1.10-1.33). When the endometrial thickness was thicker than the threshold, the clinical pregnancy rate did not increase significantly(OR=0.92, 95%CI=0.84-1.02), and the live birth rate showed a downward trend(OR=0.88, 95%CI=0.81-0.96). Conclusions In the blastocyst HRT-FET cycle, endometrial thickness showes a curvilinear relationship with clinical outcome. The optimal endometrial thickness range for ideal clinical outcome is 9.0-11.0 mm. Key words: Ultrasonography, transvaginal; Freeze-thawed embryo transfer; Endometrial thickness; Clinical pregnancy rate; Live birth rate
{"title":"Analysis of endometrial thickness threshold and optimal thickness interval measured by transvaginal ultrasound in blastocyst hormone replacement freeze-thawed embryo transfer","authors":"Shao-di Zhang, Zhi-gang Zhao, Qiuyuan Li, Yisha Yin, Shuna Wang, Cuilian Zhang","doi":"10.3760/CMA.J.CN131148-20190725-00435","DOIUrl":"https://doi.org/10.3760/CMA.J.CN131148-20190725-00435","url":null,"abstract":"Objective \u0000To investigate the effect of endometrial thickness(EMT) on the clinical outcome of blastocyst hormone replacement freeze-thawed embryo transfer (HRT-FET) on the first progesterone day, and to analyze the threshold and optimal thickness interval corresponding to ideal clinical pregnancy rate by statistical method. \u0000 \u0000 \u0000Methods \u0000The endometrial preparation protocols of 2 825 blastocyst HRT-FET cycles from January 2013 to December 2016 in Henan Provincial People′s Hospital and the Second Hospital of Hebei Medical University were studied retrospectively. According to EMT on the first progesterone day, they were divided into 5 subgroups: group Q1(EMT: 3.5-7.9 mm), group Q2(EMT: 8.0-8.9 mm), group Q3(EMT: 9.0-9.5 mm), group Q4(EMT: 9.6-10.7 mm), group Q5(EMT: 10.8-21.0 mm). Univariate analysis, classification multivariate Logistic regression analysis, curve fitting and threshold effect analysis were used to investigate the effect of endometrial thickness on clinical outcome of blastocyst HRT-FET. \u0000 \u0000 \u0000Results \u0000Group Q1 was set as the control group in classification multivariate Logistic regression analysis, after adjusting for confounding factors, the clinical pregnancy rate and live birth rate in other groups were higher than the control group. The clinical pregnancy rate and live birth rate in group Q3 and Q4 were significantly increased and the differences were statistically significant(all P<0.05). The cut-off value of the endometrial thickness was 9.6 mm. When endometrial thickness was less than 9.6 mm, with 1 mm increase of endometrial thickness, the clinical pregnancy rate increased by 23%(OR=1.23, 95%CI=1.11-1.36) and the live birth rate increased by 21%(OR=1.21, 95%CI=1.10-1.33). When the endometrial thickness was thicker than the threshold, the clinical pregnancy rate did not increase significantly(OR=0.92, 95%CI=0.84-1.02), and the live birth rate showed a downward trend(OR=0.88, 95%CI=0.81-0.96). \u0000 \u0000 \u0000Conclusions \u0000In the blastocyst HRT-FET cycle, endometrial thickness showes a curvilinear relationship with clinical outcome. The optimal endometrial thickness range for ideal clinical outcome is 9.0-11.0 mm. \u0000 \u0000 \u0000Key words: \u0000Ultrasonography, transvaginal; Freeze-thawed embryo transfer; Endometrial thickness; Clinical pregnancy rate; Live birth rate","PeriodicalId":10224,"journal":{"name":"Chinese Journal of Ultrasonography","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48376068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-03-25DOI: 10.3760/CMA.J.CN131148-20190813-00484
Xiao-duo Wen, Haiyan Tian, Xiaojing Yan, Cuiqin Sun, Yi Yang
Objective To assess the validity of ultrasonic surveillance of percentage change in the levator ani hiatal antro posterior diameter (LHap) in the diagnosis of pelvic floor muscle dysfunction. Methods Two hundred and forty seven women suspected to have pelvic floor disorder related symptoms from January to December 2017 were enrolled. Digital palpation of the puborectalis muscle using modified Oxford score grading system (MOS) was performed.Women with MOS point of 0, 1, 2, or 3 were defined as having low pubic floor muscle contraction (LPFMC), and those with MOS point of 4 or 5 were defined as having normal pubic floor muscle contraction (NPFMC). Then ultrasound measurement of LHap diameter at rest, at maximum contraction, and at the maximum Valsalva were performed in all women to calculate the percentage decrease on contraction (PDC%) and percentage increase on Valsalva (PIV%). Statistical analysis was performed to test the significance of differences in PDC% and PIV% between the LPFMC group and NPFMC group, and the ROC curve analysis was performed to evaluate the validity of using PDC% and PIV% for predicting LPFMC. Results Compared with the NPFMC group, the PIV% of LPFMC group was significantly larger [(6.07±4.20)% vs (11.29±10.49)%, P 5.19% predicted LPFMC with sensitivity 71.43%, specificity 57.89%, and the area under the ROC curve was 0.69. A cut-off of PDC% 5.19% and PDC%<25.37%, the sensitivity was 84.55%, the specificity was 55.00%, and area under ROC was 0.70. Conclusions Ultrasonic measurement of percentage change in the LHap diameter is valuable for the diagnosis of pelvic floor muscle dysfunction. Key words: Ultrasonography; Pelvic floor muscle dysfunction; Levator ani hiatal antro posterior diameter
{"title":"Validity of trans-perineum ultrasonic surveillance of percentage change in the levator ani hiatal antro posterior diameter for the diagnosis of pelvic floor muscle dysfunction","authors":"Xiao-duo Wen, Haiyan Tian, Xiaojing Yan, Cuiqin Sun, Yi Yang","doi":"10.3760/CMA.J.CN131148-20190813-00484","DOIUrl":"https://doi.org/10.3760/CMA.J.CN131148-20190813-00484","url":null,"abstract":"Objective \u0000To assess the validity of ultrasonic surveillance of percentage change in the levator ani hiatal antro posterior diameter (LHap) in the diagnosis of pelvic floor muscle dysfunction. \u0000 \u0000 \u0000Methods \u0000Two hundred and forty seven women suspected to have pelvic floor disorder related symptoms from January to December 2017 were enrolled. Digital palpation of the puborectalis muscle using modified Oxford score grading system (MOS) was performed.Women with MOS point of 0, 1, 2, or 3 were defined as having low pubic floor muscle contraction (LPFMC), and those with MOS point of 4 or 5 were defined as having normal pubic floor muscle contraction (NPFMC). Then ultrasound measurement of LHap diameter at rest, at maximum contraction, and at the maximum Valsalva were performed in all women to calculate the percentage decrease on contraction (PDC%) and percentage increase on Valsalva (PIV%). Statistical analysis was performed to test the significance of differences in PDC% and PIV% between the LPFMC group and NPFMC group, and the ROC curve analysis was performed to evaluate the validity of using PDC% and PIV% for predicting LPFMC. \u0000 \u0000 \u0000Results \u0000Compared with the NPFMC group, the PIV% of LPFMC group was significantly larger [(6.07±4.20)% vs (11.29±10.49)%, P 5.19% predicted LPFMC with sensitivity 71.43%, specificity 57.89%, and the area under the ROC curve was 0.69. A cut-off of PDC% 5.19% and PDC%<25.37%, the sensitivity was 84.55%, the specificity was 55.00%, and area under ROC was 0.70. \u0000 \u0000 \u0000Conclusions \u0000Ultrasonic measurement of percentage change in the LHap diameter is valuable for the diagnosis of pelvic floor muscle dysfunction. \u0000 \u0000 \u0000Key words: \u0000Ultrasonography; Pelvic floor muscle dysfunction; Levator ani hiatal antro posterior diameter","PeriodicalId":10224,"journal":{"name":"Chinese Journal of Ultrasonography","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48546841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-03-25DOI: 10.3760/CMA.J.CN131148-20190812-00477
Chunling Li, Hezhou Li, Juan Wu, Yun Liu, Yan Wei
Objective To explore prenatal ultrasound diagnostic clues of congenital dislocation of the knee(CDK). Methods The prenatal ultrasonographic features of 13 CDK fetuses diagnosed from January 2013 to December 2018 in the Third Affiliated Hospital of Zhengzhou University were retrospectively analyzed, combined with the results of gene detections and pathological findings. Results Thirteen fetuses were diagnosed by prenatal ultrasound during the second trimester. Two-dimensional and three-dimensional ultrasound showed dislocation of the knee(unilateral in 3 cases and bilateral in 10 cases). All cases were accompanied with multiple abnormalities, including talipes(5 cases), overlapping fingers(2 cases), short nasal bone(1 case), thicken nuchal fold(1 case), narrow thorax(1 case), abnormal vertebral development(1 case), etc. Ultrasound diagnosis included Larsen syndrome in 2 cases, arthrogryosis multiplex congenital in 3 cases, asphyxiating thoracic dysplasia in 1 case, and congenital dislocation of the knee in 7 cases. CDK was confirmed in all fetuses after termination of pregnancy. Three of them were known to undergo chromosome examinations with normal chromosomal microarray analysis (CMA). One case was confirmed to be Larsen syndrome by further second-generation sequencing combined with first-generation sequencing screening, suggesting there was FLNB gene mutation. Conclusions CDK can exist isolated, and it can also be a common manifestation of various diseases. Therefore, attention should be paid to other associated abnormalities in the prenatal detection of knee flexion, and further detection of related genes can provide valuable information for genetic counseling. Key words: Prenatal ultrasonography; Fetal; Congenital dislocation of the knee; Gene
{"title":"Prenatal ultrasound diagnostic clues of congenital dislocation of the knee","authors":"Chunling Li, Hezhou Li, Juan Wu, Yun Liu, Yan Wei","doi":"10.3760/CMA.J.CN131148-20190812-00477","DOIUrl":"https://doi.org/10.3760/CMA.J.CN131148-20190812-00477","url":null,"abstract":"Objective \u0000To explore prenatal ultrasound diagnostic clues of congenital dislocation of the knee(CDK). \u0000 \u0000 \u0000Methods \u0000The prenatal ultrasonographic features of 13 CDK fetuses diagnosed from January 2013 to December 2018 in the Third Affiliated Hospital of Zhengzhou University were retrospectively analyzed, combined with the results of gene detections and pathological findings. \u0000 \u0000 \u0000Results \u0000Thirteen fetuses were diagnosed by prenatal ultrasound during the second trimester. Two-dimensional and three-dimensional ultrasound showed dislocation of the knee(unilateral in 3 cases and bilateral in 10 cases). All cases were accompanied with multiple abnormalities, including talipes(5 cases), overlapping fingers(2 cases), short nasal bone(1 case), thicken nuchal fold(1 case), narrow thorax(1 case), abnormal vertebral development(1 case), etc. Ultrasound diagnosis included Larsen syndrome in 2 cases, arthrogryosis multiplex congenital in 3 cases, asphyxiating thoracic dysplasia in 1 case, and congenital dislocation of the knee in 7 cases. CDK was confirmed in all fetuses after termination of pregnancy. Three of them were known to undergo chromosome examinations with normal chromosomal microarray analysis (CMA). One case was confirmed to be Larsen syndrome by further second-generation sequencing combined with first-generation sequencing screening, suggesting there was FLNB gene mutation. \u0000 \u0000 \u0000Conclusions \u0000CDK can exist isolated, and it can also be a common manifestation of various diseases. Therefore, attention should be paid to other associated abnormalities in the prenatal detection of knee flexion, and further detection of related genes can provide valuable information for genetic counseling. \u0000 \u0000 \u0000Key words: \u0000Prenatal ultrasonography; Fetal; Congenital dislocation of the knee; Gene","PeriodicalId":10224,"journal":{"name":"Chinese Journal of Ultrasonography","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41730597","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-03-25DOI: 10.3760/CMA.J.CN131148-20190813-00483
C. Lei, L. Zuo, Yan Wang, Xiaoli Zhu, M. Zhou, Qian Yang, Hanxi Xu, Liwen Liu
Objective To explore the value of three-dimensional speckle tracking imaging (3D-STI) in the diagnosis of immunoglobulin light-chain cardiac amyloidosis(AL-CA) patients with normal left ventricular ejection fraction (LVEF). Methods A total of 92 consecutive patients diagnosed with systemic immunoglobulin light chain amyloidosis(sAL) and with normal LVEF from October 2014 to January 2018 in Xijing Hospital were enrolled.Based on the diagnostic criteria of cardiac involvement, the patients were divided into AL-CA group (52 cases) and immunoglobulin light chain amyloidosis (AL) group (40 cases). The clinical data and serological markers of the patients were collected, the conventional echocardiography and full-volume three dimensional dynamic images were acquired, left ventricular global longitudinal strain (GLS), global radial strain (GRS), global circumferential strain (GCS), and global area strain (GAS) were analyzed using off-line TomTec software. The differences between the two groups were compared. Results Compared with the AL group, the NT-proBNP of AL-CA group was significantly higher (P 0.05). Compared with the AL group, the maximal left ventricular wall thickness, left ventricular mass index, left atrial volume index, and E/e′ in the AL-CA group were significantly increased (all P 0.05). Compared with the AL group, GLS, GAS, and GRS were significantly lower in AL-CA group (all P 0.05). The ROC curve analysis showed that the cut-off values discriminating cardiac involvement were 16.09% for GLS, 36.54% for GAS and 31.90% for GRS. Conclusions 3D-STI measurements of left ventricular myocardial mechanics could detect cardiac involvement in patients with sAL amyloidosis, and provides a new method for diagnosis of AL-CA. Key words: Echocardiography; Three-dimensional speckle tracking imaging; Immunoglobulin light-chain cardiac amyloidosis; Strain
{"title":"The role of three-dimensional speckle tracking imaging in the diagnosis of immunoglobulin light-chain cardiac amyloidosis with normal left ventricular ejection fraction","authors":"C. Lei, L. Zuo, Yan Wang, Xiaoli Zhu, M. Zhou, Qian Yang, Hanxi Xu, Liwen Liu","doi":"10.3760/CMA.J.CN131148-20190813-00483","DOIUrl":"https://doi.org/10.3760/CMA.J.CN131148-20190813-00483","url":null,"abstract":"Objective \u0000To explore the value of three-dimensional speckle tracking imaging (3D-STI) in the diagnosis of immunoglobulin light-chain cardiac amyloidosis(AL-CA) patients with normal left ventricular ejection fraction (LVEF). \u0000 \u0000 \u0000Methods \u0000A total of 92 consecutive patients diagnosed with systemic immunoglobulin light chain amyloidosis(sAL) and with normal LVEF from October 2014 to January 2018 in Xijing Hospital were enrolled.Based on the diagnostic criteria of cardiac involvement, the patients were divided into AL-CA group (52 cases) and immunoglobulin light chain amyloidosis (AL) group (40 cases). The clinical data and serological markers of the patients were collected, the conventional echocardiography and full-volume three dimensional dynamic images were acquired, left ventricular global longitudinal strain (GLS), global radial strain (GRS), global circumferential strain (GCS), and global area strain (GAS) were analyzed using off-line TomTec software. The differences between the two groups were compared. \u0000 \u0000 \u0000Results \u0000Compared with the AL group, the NT-proBNP of AL-CA group was significantly higher (P 0.05). Compared with the AL group, the maximal left ventricular wall thickness, left ventricular mass index, left atrial volume index, and E/e′ in the AL-CA group were significantly increased (all P 0.05). Compared with the AL group, GLS, GAS, and GRS were significantly lower in AL-CA group (all P 0.05). The ROC curve analysis showed that the cut-off values discriminating cardiac involvement were 16.09% for GLS, 36.54% for GAS and 31.90% for GRS. \u0000 \u0000 \u0000Conclusions \u00003D-STI measurements of left ventricular myocardial mechanics could detect cardiac involvement in patients with sAL amyloidosis, and provides a new method for diagnosis of AL-CA. \u0000 \u0000 \u0000Key words: \u0000Echocardiography; Three-dimensional speckle tracking imaging; Immunoglobulin light-chain cardiac amyloidosis; Strain","PeriodicalId":10224,"journal":{"name":"Chinese Journal of Ultrasonography","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47592643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-03-25DOI: 10.3760/CMA.J.CN131148-20190728-00439
Lu Tang, Nianwei Zhou, Yingying Jiang, Xuejie Li, Minmin Sun, C. Pan, X. Shu
Objective To explore the relationship between genotypes and phenotypes in hypertrophic cardiomyopathy(HCM) patients using whole exome sequencing(WES) and three-dimensional speckle-tracking echocardiography(3D-STE). Methods Twenty patients with apical HCM(ApHCM) and 25 patients with non-apical HCM(non-ApHCM) from June 2018 to January 2019 in Zhongshan Hospital of Fudan University were enrolled. All subjects underwent venous blood sampling and WES. Regular two-dimensional echocardiography was performed to acquire the following parameters: interventricular septum thickness, left ventricular posterior wall thickness, left ventricular end diastolic diameter, left ventricular end systolic diameter, the maximum thickness of left ventricular walls and left ventricular ejection fraction(LVEF). Full volume images were collected and then off-time analyzed with 3D-STE to acquire global longitudinal strain(GLS), global circumferential strain(GCS), twist and torsion. The relationships between above parameters, genotypes and phenotypes of left ventricle were analyzed. Results Mutations were found in 73% of HCM patients.The two most common genes MYBPC3 and MYH7 accounted for 18% and 15% of mutations respectively. KCNEc.79C>T(p.Arg27Cys) and PRKAG2c.905G>A (p.Arg302Gln) were detected in both ApHCM group and non-ApHCM group. In ApHCM group, 60% of patients carried genetic mutations, which was significantly lower than non-ApHCM group(84%)(P=0.041). Compared with non-ApHCM group, GLS in ApHCM group was significantly higher (P=0.008). There was no statistical difference of GLS between patients with mutations and without mutations(P=0.068). GLS demonstrated a moderate correlation with morphologic types of HCM(ApHCM and non-ApHCM)(r=0.364, P=0.012). However, there was no correlation between GLS and the condition of mutations(r=0.269, P=0.062). Conclusions The relationship between genetics and phenotypic expression of HCM appears to be complex and heterogeneous. There are marked differences in gene mutations and systolic functions between ApHCM and non-ApHCM. The value of GLS correlates with the shape of left ventricle but not with genotypes. Key words: Echocardiography, three-dimensional; Speckle tracking imaging; Hypertrophic cardiomyopathy; Mutations; Strain
{"title":"A research on the relationship of genotypes and phenotypes in hypertrophic cardiomyopathy","authors":"Lu Tang, Nianwei Zhou, Yingying Jiang, Xuejie Li, Minmin Sun, C. Pan, X. Shu","doi":"10.3760/CMA.J.CN131148-20190728-00439","DOIUrl":"https://doi.org/10.3760/CMA.J.CN131148-20190728-00439","url":null,"abstract":"Objective \u0000To explore the relationship between genotypes and phenotypes in hypertrophic cardiomyopathy(HCM) patients using whole exome sequencing(WES) and three-dimensional speckle-tracking echocardiography(3D-STE). \u0000 \u0000 \u0000Methods \u0000Twenty patients with apical HCM(ApHCM) and 25 patients with non-apical HCM(non-ApHCM) from June 2018 to January 2019 in Zhongshan Hospital of Fudan University were enrolled. All subjects underwent venous blood sampling and WES. Regular two-dimensional echocardiography was performed to acquire the following parameters: interventricular septum thickness, left ventricular posterior wall thickness, left ventricular end diastolic diameter, left ventricular end systolic diameter, the maximum thickness of left ventricular walls and left ventricular ejection fraction(LVEF). Full volume images were collected and then off-time analyzed with 3D-STE to acquire global longitudinal strain(GLS), global circumferential strain(GCS), twist and torsion. The relationships between above parameters, genotypes and phenotypes of left ventricle were analyzed. \u0000 \u0000 \u0000Results \u0000Mutations were found in 73% of HCM patients.The two most common genes MYBPC3 and MYH7 accounted for 18% and 15% of mutations respectively. KCNEc.79C>T(p.Arg27Cys) and PRKAG2c.905G>A (p.Arg302Gln) were detected in both ApHCM group and non-ApHCM group. In ApHCM group, 60% of patients carried genetic mutations, which was significantly lower than non-ApHCM group(84%)(P=0.041). Compared with non-ApHCM group, GLS in ApHCM group was significantly higher (P=0.008). There was no statistical difference of GLS between patients with mutations and without mutations(P=0.068). GLS demonstrated a moderate correlation with morphologic types of HCM(ApHCM and non-ApHCM)(r=0.364, P=0.012). However, there was no correlation between GLS and the condition of mutations(r=0.269, P=0.062). \u0000 \u0000 \u0000Conclusions \u0000The relationship between genetics and phenotypic expression of HCM appears to be complex and heterogeneous. There are marked differences in gene mutations and systolic functions between ApHCM and non-ApHCM. The value of GLS correlates with the shape of left ventricle but not with genotypes. \u0000 \u0000 \u0000Key words: \u0000Echocardiography, three-dimensional; Speckle tracking imaging; Hypertrophic cardiomyopathy; Mutations; Strain","PeriodicalId":10224,"journal":{"name":"Chinese Journal of Ultrasonography","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48626061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-03-25DOI: 10.3760/CMA.J.CN131148-20190918-00577
B. Qi, Zi-yao Li, J. Tian
Objective To explore the value of three-dimensional ultrasound in differential diagnosis of different molecular subtypes of breast cancer. Methods One hundred and twenty patients from August 2017 to December 2018 in the Second Affiliated Hospital of Harbin Medical University with breast masses were selected, and a total of 120 breast lesions were confirmed to be malignant by postoperative pathology. All patients underwent routine ultrasound and three-dimensional ultrasound before surgery. According to the St.Gallen criteria, the selected cases were divided into tubes according to the expression of immunohistochemical markers estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER-2). The Luminal epithelial subtype (Luminal subtype), HER-2 overexpression subtype and the triple negative subtype(TN subtype) were used to analyze whether there were differences in the three-dimensional ultrasound characteristics among different molecular subtypes of breast cancer. Results ①Three-dimensional gray-scale ultrasound: Luminal subtype breast cancer often showed as an irregular shape of the mass, with burrs on the edges, differential leaves, high echo echoes around and coronal surface convergence. The HER-2 overexpression subtype masses were blurred, with angles, uneven internal echo, and often accompanied by microcalcification. The TN subtype were more clearly mass with more regular edge, slightly enhanced posterior echo. And the differences between the 3 groups were statistically significant (P 0.05). Conclusions Three-dimensional ultrasound imaging combined with two-dimensional ultrasound can better reflect the morphological, blood supply and characteristics of different molecular subtypes of breast cancer, and provide more evidence for the diagnosis and identification of breast cancer before surgery. Key words: Ultrasonography, three-dimensional; Breast cancer; Molecular subtype
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