Pub Date : 2019-11-25DOI: 10.3760/CMA.J.ISSN.1004-4477.2019.11.009
Jin Zhou, Shichong Zhou, Jia-wei Li, Yu Wang, Ya-ling Chen, Fen Wang, Wen-xiang Zhi, Min Chen
Objective To evaluate the risk factors in terms of clinical characteristics and sonographic features regarding solitairy thyroid papillary carcinoma (PTC) for the lateral cervical lymph node metastasis(LLNM) and then to establish nomogram model. Methods All patients were confirmed to be solitary PTC in paraffin wax pathology after thyroidectomy in Fudan University Shanghai Cancer Center from January to September 2016. Meanwhile, the status of lateral cervical lymph node metastasis was determined referring to postoperative pathology. Clinical characteristics including gender, age, preoperative thyroid stimulating hormone (TSH), thyroglobulin (Tg), thyroglobulin antibody (TGAb), thyroid peroxidase antibody (TPOAb), central lymph node metastasis (CLNM) and sonographic features of the PTC lesion including maximum tumor diameter, location, aspect ratio, relation with thyroid capsule, echo, margin, acoustic halo, microcalcification were evaluated for the association with lateral cervical lymph node metastasis using univariate and multivariate logistic regression analyses. Then the nomogram model was established and its application value was evaluated using ROC. Results Out of 1 174 patients, 125 patients (10.6%) presented lateral neck lymph node metastasis and 10 patients presented skipping metastasis.Univariate analysis showed gender, preoperative Tg and TGAb, CLNM, maximum tumor diameter, location, close to the thyroid tumor capsule, echo, aspect ratio, acoustic halo, microcalcification were associated with LLNM(P<0.05). Binomial logistic regression analysis indicated CLNM, maximum tumor diameter of larger than 10 mm, superior or multiple location, microcalcification were independent risk factors of LLNM. The AUC of the nomogram model was 0.865, the sensitivity was 88.0%, the specificity was 75.2%, and the accuracy was 76.6%. Conclusions As for patients with single focal PTC, CLNM, larger lesions, microcalcification, superior location are associated with lateral neck lymph node metastasis. The nomogram model can be tried for clinical application. Key words: Ultrasonography; Papillary thyroid carcinoma; Lymph node metastasis; Risk factors; Nomogram
{"title":"Risk factors of predicting lateral neck lymph node metastasis following solitary papillary thyroid carcinoma","authors":"Jin Zhou, Shichong Zhou, Jia-wei Li, Yu Wang, Ya-ling Chen, Fen Wang, Wen-xiang Zhi, Min Chen","doi":"10.3760/CMA.J.ISSN.1004-4477.2019.11.009","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1004-4477.2019.11.009","url":null,"abstract":"Objective \u0000To evaluate the risk factors in terms of clinical characteristics and sonographic features regarding solitairy thyroid papillary carcinoma (PTC) for the lateral cervical lymph node metastasis(LLNM) and then to establish nomogram model. \u0000 \u0000 \u0000Methods \u0000All patients were confirmed to be solitary PTC in paraffin wax pathology after thyroidectomy in Fudan University Shanghai Cancer Center from January to September 2016. Meanwhile, the status of lateral cervical lymph node metastasis was determined referring to postoperative pathology. Clinical characteristics including gender, age, preoperative thyroid stimulating hormone (TSH), thyroglobulin (Tg), thyroglobulin antibody (TGAb), thyroid peroxidase antibody (TPOAb), central lymph node metastasis (CLNM) and sonographic features of the PTC lesion including maximum tumor diameter, location, aspect ratio, relation with thyroid capsule, echo, margin, acoustic halo, microcalcification were evaluated for the association with lateral cervical lymph node metastasis using univariate and multivariate logistic regression analyses. Then the nomogram model was established and its application value was evaluated using ROC. \u0000 \u0000 \u0000Results \u0000Out of 1 174 patients, 125 patients (10.6%) presented lateral neck lymph node metastasis and 10 patients presented skipping metastasis.Univariate analysis showed gender, preoperative Tg and TGAb, CLNM, maximum tumor diameter, location, close to the thyroid tumor capsule, echo, aspect ratio, acoustic halo, microcalcification were associated with LLNM(P<0.05). Binomial logistic regression analysis indicated CLNM, maximum tumor diameter of larger than 10 mm, superior or multiple location, microcalcification were independent risk factors of LLNM. The AUC of the nomogram model was 0.865, the sensitivity was 88.0%, the specificity was 75.2%, and the accuracy was 76.6%. \u0000 \u0000 \u0000Conclusions \u0000As for patients with single focal PTC, CLNM, larger lesions, microcalcification, superior location are associated with lateral neck lymph node metastasis. The nomogram model can be tried for clinical application. \u0000 \u0000 \u0000Key words: \u0000Ultrasonography; Papillary thyroid carcinoma; Lymph node metastasis; Risk factors; Nomogram","PeriodicalId":10224,"journal":{"name":"Chinese Journal of Ultrasonography","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43632226","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 : 2019-11-25DOI: 10.3760/CMA.J.ISSN.1004-4477.2019.11.001
Yuan-yuan Liu, Cunying Cui, Yanan Li, Ying Wang, Yanbin Hu, Juan Zhang, Danqing Huang, Guanghui Li, Zhao Li, Lin Liu
Objective To investigate the value of layer-specific strain in evaluating the changes of left ventricular three layers and segmental myocardial function in patients with different degree of aortic stenosis (AS). Methods Ninety-eight AS patients were selected as AS group from December 2017 to June 2019 in Henan Provincial People′s Hospital, they were divided into mild AS group(30 cases), moderate AS group(33 cases), severe AS group(35 cases); 30 healthy subjects were enrolled as control group.Longitudinal strain (LS), circumferential strain (CS) of endocardium, mid-myocardium, epicardium, global full thickness and each segment of left ventricular myocardium were measured by layer-specific strain and then compared. Results Compared with the control group, Vmax, PPG, interventricular septal thickness in diastole(IVSD), left ventricular posterior wall thickness in diastole(LVPWD), left ventricular mass index(LVMI), and E/e increased in all three AS groups(all P 0.05). There were no significant difference in CS of endocardial, mid-myocardial, epicardial and global full-thickness myocardium layers in basal, middle and apical LV segments between mild AS group and control group(all P>0.05). CS of endocardial, mid-myocardial, epicardial and global full-thickness myocardium layers were decreased in moderate AS and severe AS groups compared with control group(all P<0.05). CS of endocardial, mid-myocardial myocardium layers in basal and middle LV segments were decreased in moderate AS group compared with control group(all P<0.05). CS of three myocardium layers in basal, middle and apical LV segments were decreased in severe AS group compared with control group(all P<0.05). Conclusions Layer-specific strain can quantitatively evaluate left ventricular three layers and segmental myocardial function in patients with aortic stenosis, and has certain clinical application value. Key words: Echocardiography; Layer-specific strain; Aortic stenosis; Ventricular function, left
{"title":"Evaluation of left ventricular myocardial function in patients with aortic stenosis by layer-specific strain","authors":"Yuan-yuan Liu, Cunying Cui, Yanan Li, Ying Wang, Yanbin Hu, Juan Zhang, Danqing Huang, Guanghui Li, Zhao Li, Lin Liu","doi":"10.3760/CMA.J.ISSN.1004-4477.2019.11.001","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1004-4477.2019.11.001","url":null,"abstract":"Objective \u0000To investigate the value of layer-specific strain in evaluating the changes of left ventricular three layers and segmental myocardial function in patients with different degree of aortic stenosis (AS). \u0000 \u0000 \u0000Methods \u0000Ninety-eight AS patients were selected as AS group from December 2017 to June 2019 in Henan Provincial People′s Hospital, they were divided into mild AS group(30 cases), moderate AS group(33 cases), severe AS group(35 cases); 30 healthy subjects were enrolled as control group.Longitudinal strain (LS), circumferential strain (CS) of endocardium, mid-myocardium, epicardium, global full thickness and each segment of left ventricular myocardium were measured by layer-specific strain and then compared. \u0000 \u0000 \u0000Results \u0000Compared with the control group, Vmax, PPG, interventricular septal thickness in diastole(IVSD), left ventricular posterior wall thickness in diastole(LVPWD), left ventricular mass index(LVMI), and E/e increased in all three AS groups(all P 0.05). There were no significant difference in CS of endocardial, mid-myocardial, epicardial and global full-thickness myocardium layers in basal, middle and apical LV segments between mild AS group and control group(all P>0.05). CS of endocardial, mid-myocardial, epicardial and global full-thickness myocardium layers were decreased in moderate AS and severe AS groups compared with control group(all P<0.05). CS of endocardial, mid-myocardial myocardium layers in basal and middle LV segments were decreased in moderate AS group compared with control group(all P<0.05). CS of three myocardium layers in basal, middle and apical LV segments were decreased in severe AS group compared with control group(all P<0.05). \u0000 \u0000 \u0000Conclusions \u0000Layer-specific strain can quantitatively evaluate left ventricular three layers and segmental myocardial function in patients with aortic stenosis, and has certain clinical application value. \u0000 \u0000 \u0000Key words: \u0000Echocardiography; Layer-specific strain; Aortic stenosis; Ventricular function, left","PeriodicalId":10224,"journal":{"name":"Chinese Journal of Ultrasonography","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47772938","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}
The risk of congenital heart disease (CHD) in the offspring of pregnant women with diabetes is increased, and the pathogenesis is complex. Early diagnosis of fetal heart abnormalities helps pregnant women to undergo genetic testing and terminate pregnancy early. Echocardiography in the third and third trimesters of early pregnancy can early diagnose cardiac structural abnormalities and evaluate cardiac function of the offspring, and then give pregnant mothers appropriate perinatal management, in order to reduce the incidence rate of CHD in the offspring of pregnant diabetes mothers.
{"title":"Progress of congenital heart disease in the offspring of maternal diabetes","authors":"M. Xiangli, W. Qingqing","doi":"10.3760/CMA.J.ISSN.1004-4477.2019.11.017","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1004-4477.2019.11.017","url":null,"abstract":"妊娠糖尿病母亲子代罹患先天性心脏病(congenital cardiac disease，CHD)的危险性增加，且发病机制复杂。早期诊断胎儿心脏异常有助于孕妇尽早进行基因学检测及早期终止妊娠。早孕晚期及中孕早期超声心动图检查可以较早诊断子代心脏结构异常及评价心脏功能，进而给予妊娠母亲恰当的围产期管理，以期降低妊娠糖尿病母亲子代罹患CHD的发病率。","PeriodicalId":10224,"journal":{"name":"Chinese Journal of Ultrasonography","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43569451","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 : 2019-11-25DOI: 10.3760/CMA.J.ISSN.1004-4477.2019.11.012
Lifang Jin, Lingling Zhuang, Zhengrong Xia, Chao Jia, Jun Liu, Yubiao Jin, Qiusheng Shi, L. Du
Objective To evaluate the diagnostic efficiency in differential diagnosis for breast sentinel lymph nodes, and to analyze the imaging characteristics of involved breast sentinel lymph node in lymphatic contrast enhanced ultrasound. Methods Sixty-one patients suspected with breast cancer from May 2017 to March 2019 in Shanghai General Hospital, Shanghai Jiao Tong University were included in the study. Ultrasound contrast agent was injected subcutaneously, and axillary lymph nodes were displayed under contrast enhanced ultrasound mode. The longitudinal diameter (anteroposterior diameter), transverse diameter, longitudinal/transverse ratio and the distance from skin surface were measured. Five types were concluded according to the imaging characteristics in lymphatic contrast enhanced ultrasound: typeⅠ, uniform enhancement; type Ⅱ, ring-shape enhancement; type Ⅲ, ununiform enhancement; type Ⅳ, regional filling defect; type Ⅴ, total filling defect. Sentinel lymph nodes were guided by wire guides and verified in pathology after excision in the operation. Results The detection rate of sentinel lymph nodes was 95.08% (58/61). Seventy-seven lymph nodes, including 21 involved nodes and 56 uninvolved nodes were detected by lymphatic contrast enhanced ultrasound in 58 patients. The longitudinal diameters and transverse diameters of involved lymph nodes were larger than those of uninvolved ones (P=0.001, 0.003). When type Ⅳ(regional filling defect) and type Ⅴ(total filling defect) were classified as involved, the sensitivity, specificity, positive-predictive value, negative-predictive value, accuracy and the area under ROC curve of predicting sentinel lymph node metastases were 85.71%, 96.43%, 90.00%, 94.70%, 93.51% and 0.911, respectively. Conclusions Lymphatic contrast enhanced ultrasound reaches a high diagnostic efficiency in qualitative analysis of breast sentinel lymph nodes. Regional filling defect and total filling defect are the imaging characteristics of involved sentinel lymph nodes in lymphatic contrast enhanced ultrasound. Key words: Contrast-enhanced ultrasound; Breast cancer; Sentinel lymph node; Differential diagnose; Diagnostic efficiency
{"title":"The clinical study of character types of sentinel lymph nodes in patients with breast cancer in lymphatic contrast enhanced ultrasound","authors":"Lifang Jin, Lingling Zhuang, Zhengrong Xia, Chao Jia, Jun Liu, Yubiao Jin, Qiusheng Shi, L. Du","doi":"10.3760/CMA.J.ISSN.1004-4477.2019.11.012","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1004-4477.2019.11.012","url":null,"abstract":"Objective \u0000To evaluate the diagnostic efficiency in differential diagnosis for breast sentinel lymph nodes, and to analyze the imaging characteristics of involved breast sentinel lymph node in lymphatic contrast enhanced ultrasound. \u0000 \u0000 \u0000Methods \u0000Sixty-one patients suspected with breast cancer from May 2017 to March 2019 in Shanghai General Hospital, Shanghai Jiao Tong University were included in the study. Ultrasound contrast agent was injected subcutaneously, and axillary lymph nodes were displayed under contrast enhanced ultrasound mode. The longitudinal diameter (anteroposterior diameter), transverse diameter, longitudinal/transverse ratio and the distance from skin surface were measured. Five types were concluded according to the imaging characteristics in lymphatic contrast enhanced ultrasound: typeⅠ, uniform enhancement; type Ⅱ, ring-shape enhancement; type Ⅲ, ununiform enhancement; type Ⅳ, regional filling defect; type Ⅴ, total filling defect. Sentinel lymph nodes were guided by wire guides and verified in pathology after excision in the operation. \u0000 \u0000 \u0000Results \u0000The detection rate of sentinel lymph nodes was 95.08% (58/61). Seventy-seven lymph nodes, including 21 involved nodes and 56 uninvolved nodes were detected by lymphatic contrast enhanced ultrasound in 58 patients. The longitudinal diameters and transverse diameters of involved lymph nodes were larger than those of uninvolved ones (P=0.001, 0.003). When type Ⅳ(regional filling defect) and type Ⅴ(total filling defect) were classified as involved, the sensitivity, specificity, positive-predictive value, negative-predictive value, accuracy and the area under ROC curve of predicting sentinel lymph node metastases were 85.71%, 96.43%, 90.00%, 94.70%, 93.51% and 0.911, respectively. \u0000 \u0000 \u0000Conclusions \u0000Lymphatic contrast enhanced ultrasound reaches a high diagnostic efficiency in qualitative analysis of breast sentinel lymph nodes. Regional filling defect and total filling defect are the imaging characteristics of involved sentinel lymph nodes in lymphatic contrast enhanced ultrasound. \u0000 \u0000 \u0000Key words: \u0000Contrast-enhanced ultrasound; Breast cancer; Sentinel lymph node; Differential diagnose; Diagnostic efficiency","PeriodicalId":10224,"journal":{"name":"Chinese Journal of Ultrasonography","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43448083","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 : 2019-11-25DOI: 10.3760/CMA.J.ISSN.1004-4477.2019.11.011
Qiaolu Shen, Yihong Sun, Hongbo Feng, Saiguang Xu, T. Jiang
Objective To explore the value of full-angle ultrasonic shear wave elastography in differentiating benign and malignant breast diseases. Methods After constructing a new ultrasonic shear wave elastography system, the clinical and ultrasonographic data of 74 patients with mass breast diseases were retrospectively analyzed. The patients were divided into benign group and malignant group according to the pathologic results. Meanwhile, the significant indicators of difference were screened out for ROC analysis, and the curve characteristics were compared. Results Eratio-45°, Eratio-225°, Emax-90°, Emax-270°, Emean-0° and Emean-180° were significantly different between the benign and malignant groups. The AUC of ROC were 0.71, 0.81, 0.83, 0.80, 0.86 and 0.83, respectively. The results of model evaluation showed that the specificity of model-Eratio-45° was relatively low (0.42), while the other 5 indicators showed high specificity (0.73-0.78). Conclusions The full-angle ultrasonic shear wave elastography can provide more information for differentiating benign from malignant breast diseases. Key words: Ultrasonography; Breast neoplasms; Shear wave elastography; Differential diagnosis
{"title":"The differential diagnosis of benign and malignant in mass type breast diseases based on the real-time monitoring of full-angle ultrasonic shear wave elastography","authors":"Qiaolu Shen, Yihong Sun, Hongbo Feng, Saiguang Xu, T. Jiang","doi":"10.3760/CMA.J.ISSN.1004-4477.2019.11.011","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1004-4477.2019.11.011","url":null,"abstract":"Objective \u0000To explore the value of full-angle ultrasonic shear wave elastography in differentiating benign and malignant breast diseases. \u0000 \u0000 \u0000Methods \u0000After constructing a new ultrasonic shear wave elastography system, the clinical and ultrasonographic data of 74 patients with mass breast diseases were retrospectively analyzed. The patients were divided into benign group and malignant group according to the pathologic results. Meanwhile, the significant indicators of difference were screened out for ROC analysis, and the curve characteristics were compared. \u0000 \u0000 \u0000Results \u0000Eratio-45°, Eratio-225°, Emax-90°, Emax-270°, Emean-0° and Emean-180° were significantly different between the benign and malignant groups. The AUC of ROC were 0.71, 0.81, 0.83, 0.80, 0.86 and 0.83, respectively. The results of model evaluation showed that the specificity of model-Eratio-45° was relatively low (0.42), while the other 5 indicators showed high specificity (0.73-0.78). \u0000 \u0000 \u0000Conclusions \u0000The full-angle ultrasonic shear wave elastography can provide more information for differentiating benign from malignant breast diseases. \u0000 \u0000 \u0000Key words: \u0000Ultrasonography; Breast neoplasms; Shear wave elastography; Differential diagnosis","PeriodicalId":10224,"journal":{"name":"Chinese Journal of Ultrasonography","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42252678","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 : 2019-11-25DOI: 10.3760/CMA.J.ISSN.1004-4477.2019.11.004
Qiuping Li, Y. Hua, Jie Yang, Mingjie Gao, Lili Wang
Objective To analyze the effects of the degree and location of intracranial vertebral artery(VA) lesions on the hemodynamic parameters of extracranial VA. Methods A total of 275 consecutive patients who were diagnosed as posterior circulation ischemic stroke or transient ischemic attack (TIA) with unilateral intracranial VA stenosis or occlusion in the Department of Neurology and Neurosurgery of Capital Medical University Xuanwu Hospital from January 2015 to December 2017 were enrolled. All patients were examined by head and neck vascular ultrasound, CT angiography (CTA) and/or digital subtraction angiography (DSA) within one week. According to the results of DSA or CTA, the patients were divided into mild stenosis group(53 patients), moderate stenosis group(62 patients), severe stenosis group(58 patients) and occlusion group(102 patients). The inner diameter (D), peak systolic velocity (PSV), end diastolic velocity (EDV), and resistance index (RI) of the extracranial segment (V2 segment) of the VA were recorded and analyzed. Results The PSV and EDV in the severe stenosis group and the occlusion group were significantly lower than those in the mild stenosis group and the moderate stenosis group (P=0.000), and the PSV and EDV in the occlusion group were significantly lower than those in the severe stenosis group[ (31±10) cm/s vs (46±12)cm/s, (5±4)cm/s vs (15±7)cm/s; all P=0.000], RI was significantly higher than the other three groups (0.85±0.12, 0.70±0.10, 0.66±0.07, 0.64±0.06, respectively; all P=0.000); RI in the severe stenosis group were not significantly different from those in the mild to moderate stenosis groups (P=0.044, 0.223). There were no significant differences in the inner diameter, PSV, EDV and RI between the subgroups in the severe stenosis group before or after the PICA (posterior inferior cerebellar artery)(P=0.130, 0.322, 0.865, 0.227). However, the EDV decreased and RI increased in the occlusive subgroup before the PICA when compared the subgroup after the PICA (all P=0.000). Conclusions The location and degree of intracranial VA lesions directly affect the changes of blood flow velocity and vascular resistance of extracranial VA, and the changes of low-speed and high-resistance hemodynamics of extracranial VA may indicate the existence of occlusive lesions in intracranial VA. Key words: Ultrasonography; Vertebral artery stenosis; Occlusive diseases; Hemodynamics; Extracranial segment; Intracranial segment
{"title":"Correlation between the hemodynamic parameters of extracranial vertebral artery and the severity and location of intracranial vertebral artery stenosis","authors":"Qiuping Li, Y. Hua, Jie Yang, Mingjie Gao, Lili Wang","doi":"10.3760/CMA.J.ISSN.1004-4477.2019.11.004","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1004-4477.2019.11.004","url":null,"abstract":"Objective \u0000To analyze the effects of the degree and location of intracranial vertebral artery(VA) lesions on the hemodynamic parameters of extracranial VA. \u0000 \u0000 \u0000Methods \u0000A total of 275 consecutive patients who were diagnosed as posterior circulation ischemic stroke or transient ischemic attack (TIA) with unilateral intracranial VA stenosis or occlusion in the Department of Neurology and Neurosurgery of Capital Medical University Xuanwu Hospital from January 2015 to December 2017 were enrolled. All patients were examined by head and neck vascular ultrasound, CT angiography (CTA) and/or digital subtraction angiography (DSA) within one week. According to the results of DSA or CTA, the patients were divided into mild stenosis group(53 patients), moderate stenosis group(62 patients), severe stenosis group(58 patients) and occlusion group(102 patients). The inner diameter (D), peak systolic velocity (PSV), end diastolic velocity (EDV), and resistance index (RI) of the extracranial segment (V2 segment) of the VA were recorded and analyzed. \u0000 \u0000 \u0000Results \u0000The PSV and EDV in the severe stenosis group and the occlusion group were significantly lower than those in the mild stenosis group and the moderate stenosis group (P=0.000), and the PSV and EDV in the occlusion group were significantly lower than those in the severe stenosis group[ (31±10) cm/s vs (46±12)cm/s, (5±4)cm/s vs (15±7)cm/s; all P=0.000], RI was significantly higher than the other three groups (0.85±0.12, 0.70±0.10, 0.66±0.07, 0.64±0.06, respectively; all P=0.000); RI in the severe stenosis group were not significantly different from those in the mild to moderate stenosis groups (P=0.044, 0.223). There were no significant differences in the inner diameter, PSV, EDV and RI between the subgroups in the severe stenosis group before or after the PICA (posterior inferior cerebellar artery)(P=0.130, 0.322, 0.865, 0.227). However, the EDV decreased and RI increased in the occlusive subgroup before the PICA when compared the subgroup after the PICA (all P=0.000). \u0000 \u0000 \u0000Conclusions \u0000The location and degree of intracranial VA lesions directly affect the changes of blood flow velocity and vascular resistance of extracranial VA, and the changes of low-speed and high-resistance hemodynamics of extracranial VA may indicate the existence of occlusive lesions in intracranial VA. \u0000 \u0000 \u0000Key words: \u0000Ultrasonography; Vertebral artery stenosis; Occlusive diseases; Hemodynamics; Extracranial segment; Intracranial segment","PeriodicalId":10224,"journal":{"name":"Chinese Journal of Ultrasonography","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45875276","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 : 2019-11-25DOI: 10.3760/CMA.J.ISSN.1004-4477.2019.11.003
Zhao Na, Hua Shaohua, Wang Honggu, Qi Qinghua, Yang Yu, Zhang Ruifang
Objective To study the local morphology of post-infarction ventricular septal rupture (PI-VSR) and the left ventricular function before and after operation and to evaluate the relevant risk factors of death in patients with PI-VSR by using left ventricular opacification (LVO) combined with real-time three-dimensional echocardiography (RT-3DE). Methods Twenty-eight patients with PI-VSR and 19 patients undergoing surgical treatment were selected. The consistency of two-dimensional ultrasound, RT-3DE and the detection of LVO on the maximum diameter, location, number and shape of ventricular septal rupture (VSR) with the surgical results were compared. Through LVO combined with RT-3DE, the changes of left ventricular function indexes before and after surgery were compared. According to the general data and clinical data of patients, independent risk factors affecting survival and prognosis were explored. Results ①There was no significant difference between LVO and RT-3DE in detecting VSR maximum diameter and surgical results (all P>0.05). The location, number and shape of VSR detected by LVO were consistent with the surgical results (all P<0.05). RT-3DE had good consistency in detecting VSR location, shape and surgical results (all P<0.05). Among them, of LVO′s detection of VSR location and shape and the Kappa values of consistence of the intraoperative results were 0.650 and 0.883 respectively. LVO had a sensitivity of 0.923, specificity of 1.000, accuracy of 0.947, positive predictive value of 1.000 and negative predictive value of 0.857 in observing VSR shape. ②LVO combined with RT-3DE was used to evaluate the left ventricular function of postoperative patients. The parameters of left ventricular function improved significantly(all P<0.05). ③The independent risk factors affecting the 30 d survival rate included: gender, Killips pump function classification, and whether or not surgery was performed. Conclusions LVO and RT-3DE can provide more accurate anatomical information such as VSR maximum diameter, location, number and shape, which provides the basis for the selection of treatment strategy. LVO combined with RT-3DE can evaluate the changes of left ventricular function before and after surgery, which can provide reference for clinical evaluation of prognosis. Key words: Echocardiography, real-time three-dimensional; Ventricular septal rupture; Left ventricular opacification; Risk factor
{"title":"The evaluation of post-infarction ventricular septal rupture and the risk factors of death by left ventricular opacification and real-time three-dimensional echocardiography","authors":"Zhao Na, Hua Shaohua, Wang Honggu, Qi Qinghua, Yang Yu, Zhang Ruifang","doi":"10.3760/CMA.J.ISSN.1004-4477.2019.11.003","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1004-4477.2019.11.003","url":null,"abstract":"Objective \u0000To study the local morphology of post-infarction ventricular septal rupture (PI-VSR) and the left ventricular function before and after operation and to evaluate the relevant risk factors of death in patients with PI-VSR by using left ventricular opacification (LVO) combined with real-time three-dimensional echocardiography (RT-3DE). \u0000 \u0000 \u0000Methods \u0000Twenty-eight patients with PI-VSR and 19 patients undergoing surgical treatment were selected. The consistency of two-dimensional ultrasound, RT-3DE and the detection of LVO on the maximum diameter, location, number and shape of ventricular septal rupture (VSR) with the surgical results were compared. Through LVO combined with RT-3DE, the changes of left ventricular function indexes before and after surgery were compared. According to the general data and clinical data of patients, independent risk factors affecting survival and prognosis were explored. \u0000 \u0000 \u0000Results \u0000①There was no significant difference between LVO and RT-3DE in detecting VSR maximum diameter and surgical results (all P>0.05). The location, number and shape of VSR detected by LVO were consistent with the surgical results (all P<0.05). RT-3DE had good consistency in detecting VSR location, shape and surgical results (all P<0.05). Among them, of LVO′s detection of VSR location and shape and the Kappa values of consistence of the intraoperative results were 0.650 and 0.883 respectively. LVO had a sensitivity of 0.923, specificity of 1.000, accuracy of 0.947, positive predictive value of 1.000 and negative predictive value of 0.857 in observing VSR shape. ②LVO combined with RT-3DE was used to evaluate the left ventricular function of postoperative patients. The parameters of left ventricular function improved significantly(all P<0.05). ③The independent risk factors affecting the 30 d survival rate included: gender, Killips pump function classification, and whether or not surgery was performed. \u0000 \u0000 \u0000Conclusions \u0000LVO and RT-3DE can provide more accurate anatomical information such as VSR maximum diameter, location, number and shape, which provides the basis for the selection of treatment strategy. LVO combined with RT-3DE can evaluate the changes of left ventricular function before and after surgery, which can provide reference for clinical evaluation of prognosis. \u0000 \u0000 \u0000Key words: \u0000Echocardiography, real-time three-dimensional; Ventricular septal rupture; Left ventricular opacification; Risk factor","PeriodicalId":10224,"journal":{"name":"Chinese Journal of Ultrasonography","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42589384","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 : 2019-11-25DOI: 10.3760/CMA.J.ISSN.1004-4477.2019.11.005
Xin Feng, Gang Yu, Bo Xia, N. Shang, Limin Wang, C. Hong, Jing Tang
Objective To analyze the characteristics of lung ultrasound (LUS) in congenital pulmonary airway malformation (CPAM), and to compare the difference of image characteristics between LUS and chest X-ray(CXR) and evaluate the value of neonate LUS in CPAM. Methods From June 2017 to October 2018, the characteristics of LUS and CXR of 32 neonates who were diagnosed with CPAM by prenatal ultrasound and postnatal chest CT were analyzed retrospectively, and the difference of their direct signs and indirect signs were compared. Results Among 32 CPAM cases, 10 cases (31.25%) showed a single large cystic lesions and 3 cases with consolidation, 4 cases (12.5%) characterized by multiple hypoechoic lesions and 3 cases with consolidation, 16 cases (50%) showed consolidation with or without intensiveaerated bronchus sign or dendritic air-filled bronchi, 2 cases (6.25%) only characterized by dense B-line. The non-characteristic sonographic findings including pleural line was not smooth and not clear; A-line decreased or disappeared, dense B-lines were observed. The ability of LUS in measuring the size of CPAM was limited.Among 32 CPAM cases, 10 cases (31.25%) showed large cystic hypoechoic lesions and 22 cases (68.75%) showed small cystic hypoechoic lesions by CT scan. In this group, there were 11 cases(34.4%) with normal CXR. There was no significant differences of the direct signs (including single large cystic lesions and multiple hypoechoic lesions) between LUS and CXR (P=0.80), however the indirect signs of LUS were more obvious than CXR, with significant difference(P=0.001). Conclusions The neonatal LUS findings of CPAM is multiple, it can be used as a preliminary qualitative screening method.The diagnosis value of indirect sign of LUS is superior to CXR. Key words: Ultrasonography; Lungs; Congenital pulmonary airway malformation; Computed tomography; Chest X-ray
{"title":"The application of neonate lung ultrasound in congenital pulmonary airway malformation","authors":"Xin Feng, Gang Yu, Bo Xia, N. Shang, Limin Wang, C. Hong, Jing Tang","doi":"10.3760/CMA.J.ISSN.1004-4477.2019.11.005","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1004-4477.2019.11.005","url":null,"abstract":"Objective \u0000To analyze the characteristics of lung ultrasound (LUS) in congenital pulmonary airway malformation (CPAM), and to compare the difference of image characteristics between LUS and chest X-ray(CXR) and evaluate the value of neonate LUS in CPAM. \u0000 \u0000 \u0000Methods \u0000From June 2017 to October 2018, the characteristics of LUS and CXR of 32 neonates who were diagnosed with CPAM by prenatal ultrasound and postnatal chest CT were analyzed retrospectively, and the difference of their direct signs and indirect signs were compared. \u0000 \u0000 \u0000Results \u0000Among 32 CPAM cases, 10 cases (31.25%) showed a single large cystic lesions and 3 cases with consolidation, 4 cases (12.5%) characterized by multiple hypoechoic lesions and 3 cases with consolidation, 16 cases (50%) showed consolidation with or without intensiveaerated bronchus sign or dendritic air-filled bronchi, 2 cases (6.25%) only characterized by dense B-line. The non-characteristic sonographic findings including pleural line was not smooth and not clear; A-line decreased or disappeared, dense B-lines were observed. The ability of LUS in measuring the size of CPAM was limited.Among 32 CPAM cases, 10 cases (31.25%) showed large cystic hypoechoic lesions and 22 cases (68.75%) showed small cystic hypoechoic lesions by CT scan. In this group, there were 11 cases(34.4%) with normal CXR. There was no significant differences of the direct signs (including single large cystic lesions and multiple hypoechoic lesions) between LUS and CXR (P=0.80), however the indirect signs of LUS were more obvious than CXR, with significant difference(P=0.001). \u0000 \u0000 \u0000Conclusions \u0000The neonatal LUS findings of CPAM is multiple, it can be used as a preliminary qualitative screening method.The diagnosis value of indirect sign of LUS is superior to CXR. \u0000 \u0000 \u0000Key words: \u0000Ultrasonography; Lungs; Congenital pulmonary airway malformation; Computed tomography; Chest X-ray","PeriodicalId":10224,"journal":{"name":"Chinese Journal of Ultrasonography","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48772708","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 : 2019-11-25DOI: 10.3760/CMA.J.ISSN.1004-4477.2019.11.015
J. Fu, Fang Liu, Chao Sun, G. He, Jun Zhang, Liwen Liu, R. Hu, H. Shao, Wenxia Li
Objective To investigate the safety and long-term efficacy of a new treatment, echocardiography-guided transthoracic laser ablation of the animal interventricular septum (IVS), for obstructive hypertrophic cardiomyopathy (HOCM). Methods Ten healthy sheep were randomly divided into two groups: experimental group: sheath puncture with laser ablation (energy: 3 W, 1000 J), sham control group: sheath puncture only without laser ablation. Echocardiography and electrocardiogram (ECG) were recorded before operation, immediately after operation, and 1, 3 and 6-month after the operation. Left ventricular systolic and diastolic function, longitudinal strain, difference of time to peak between the ablation segment and the surrounding segments were analyzed. Blood samples were collected before and one hour after the operation to examine the serological results. Results Immediately and 6 months after the operation, all animals survived with normal cardiac function. No severe complications such as cardiac tamponade or bundle branch block occurred. The Troponin I level was significantly elevated immediately after the operation(P<0.05). The thickness of the ablated IVS was significantly reduced 6 months after the operation compared with before the operation[(3.23±1.21)mm vs (8.53±0.44)mm, P<0.05]. M-mode echocardiography showed that the amplitude of movement of the ablated region of the experimental group 6 months after the operation was significantly decreased compared with the control group(P<0.05). Three dimensional strain analysis showed that for the experimental group, the longitudinal strain of the ablation segment was significantly reduced and the difference of time to peak was significantly delayed, compared with the control group(P<0.05). Conclusions Echocardiography-guided transthoracic laser ablation of IVS is a safe, effective, and minimally invasive method. It is capable to reduce the volume of IVS without influencing the cardiac function, which makes it a potential alternative for HOCM treatment. Key words: Echocardiography, transthoracic; Hypertrophic cardiomyopathy; Septal ablation; Laser ablation
{"title":"The animal study of echocardiography-guided transthoracic laser ablation of the interventricular septum","authors":"J. Fu, Fang Liu, Chao Sun, G. He, Jun Zhang, Liwen Liu, R. Hu, H. Shao, Wenxia Li","doi":"10.3760/CMA.J.ISSN.1004-4477.2019.11.015","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1004-4477.2019.11.015","url":null,"abstract":"Objective \u0000To investigate the safety and long-term efficacy of a new treatment, echocardiography-guided transthoracic laser ablation of the animal interventricular septum (IVS), for obstructive hypertrophic cardiomyopathy (HOCM). \u0000 \u0000 \u0000Methods \u0000Ten healthy sheep were randomly divided into two groups: experimental group: sheath puncture with laser ablation (energy: 3 W, 1000 J), sham control group: sheath puncture only without laser ablation. Echocardiography and electrocardiogram (ECG) were recorded before operation, immediately after operation, and 1, 3 and 6-month after the operation. Left ventricular systolic and diastolic function, longitudinal strain, difference of time to peak between the ablation segment and the surrounding segments were analyzed. Blood samples were collected before and one hour after the operation to examine the serological results. \u0000 \u0000 \u0000Results \u0000Immediately and 6 months after the operation, all animals survived with normal cardiac function. No severe complications such as cardiac tamponade or bundle branch block occurred. The Troponin I level was significantly elevated immediately after the operation(P<0.05). The thickness of the ablated IVS was significantly reduced 6 months after the operation compared with before the operation[(3.23±1.21)mm vs (8.53±0.44)mm, P<0.05]. M-mode echocardiography showed that the amplitude of movement of the ablated region of the experimental group 6 months after the operation was significantly decreased compared with the control group(P<0.05). Three dimensional strain analysis showed that for the experimental group, the longitudinal strain of the ablation segment was significantly reduced and the difference of time to peak was significantly delayed, compared with the control group(P<0.05). \u0000 \u0000 \u0000Conclusions \u0000Echocardiography-guided transthoracic laser ablation of IVS is a safe, effective, and minimally invasive method. It is capable to reduce the volume of IVS without influencing the cardiac function, which makes it a potential alternative for HOCM treatment. \u0000 \u0000 \u0000Key words: \u0000Echocardiography, transthoracic; Hypertrophic cardiomyopathy; Septal ablation; Laser ablation","PeriodicalId":10224,"journal":{"name":"Chinese Journal of Ultrasonography","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45298236","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}
Pathological scars are a fibroproliferative disease of dermal tissue after skin injury, and their formation mechanism is a research hotspot in the field of skin. Currently, clinical diagnosis and efficacy evaluation mainly rely on scar scoring scales and personal experience of doctors, with strong subjectivity. In recent years, ultrasound has been recognized by more and more dermatologists as an objective evaluation technique for skin diseases. For pathological scars, ultrasound is also expected to become an important evaluation tool for quantifying and supplementing scar scoring scales. This article reviews the recent research progress of ultrasound technology in the application of pathological scars.
{"title":"Progress of ultrasonography in diagnosing and evaluating efficacy of pathological scars","authors":"Jiezhai Chen, Jing Hang, Zongkai Wei, Qingqing Zong, Di Xu","doi":"10.3760/CMA.J.ISSN.1004-4477.2019.11.018","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1004-4477.2019.11.018","url":null,"abstract":"病理性瘢痕是一种皮肤损伤后真皮组织的纤维增生性疾病，其形成机制是皮肤领域的研究热点，目前临床诊断及疗效评估主要依据瘢痕评分量表及医生的个人经验，主观性均较强。近几年超声作为一种客观评估皮肤疾病的技术被越来越多的皮肤科医生认可，对于病理性瘢痕，超声也有望成为量化及补充瘢痕评分量表的重要评估手段。本文对近期超声技术在病理性瘢痕应用中的相关研究进展进行综述。","PeriodicalId":10224,"journal":{"name":"Chinese Journal of Ultrasonography","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48975737","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}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：