Clinical hemorheology and microcirculation最新文献

AimAim of the study was to differentiate solid liver lesions according to their microvascularization. Therefore, we analyzed perfusion using time intensity curves (TIC) measured during contrast-enhanced intraoperative ultrasound (CE-IOUS).Material and MethodsData of 40 patients who underwent hepatic surgery with the diagnosis of hepatocellular carcinoma (HCC), intrahepatic cholangiocarcinoma (CCC), or liver metastases (LM) were retrospectively collected. CE-IOUS was performed using a linear multifrequency T-probe connected to a high-resolution device. Digital Imaging and Communications in Medicine (DICOM) loops were recorded, and TIC were analyzed for time to peak (TTP) and area under the curve (AUC) in tumor center, margin and reference tissue.ResultsAnalyses of the tumor center revealed significant higher AUC in HCC lesions than in CCC (p = 0.0310). HCC patients also showed longer TTP in reference tissue compared to CCC (p = 0.0251). Within the HCC cohort, TTP was shorter at tumor margins compared to reference tissue (p = 0.0420). For LM, AUC measured at tumor margins was higher than in center and reference tissue (p_{center-margin} = 0.0266, p_{margin-reference} = 0.0064).ConclusionTIC analysis of solid liver lesions during CE-IOUS revealed significant differences in their microvascularization, improving, intraoperative differentiation. Artificial intelligence tools may enhance IOUS in the future by standardization and motion compensation.

The rheological properties of blood are influenced by red blood cell (RBC) mechanics and cell-cell aggregates, which yield important clinical information; however, measurement of rheological parameters is often not possible at phlebotomy-sites. We investigated the effect of short-term storage on the stability of RBC aggregation and deformability. Blood was obtained from apparently healthy volunteers and anticoagulated with lithium heparin or ethylenediaminetetraacetic acid (EDTA). Samples were stored either at ambient (22 °C) or cold (4 °C) temperature for up to 48 h. Aggregation and deformability were measured utilising light transmission and laser backscatter methods, and laser diffractometry, respectively. EDTA significantly lowered aggregation when compared with heparin-anticoagulated blood. During ambient temperature storage, EDTA preserved baseline RBC aggregation for up to 4 h, while lithium heparin-anticoagulated blood showed significant changes within 1 h. Deformability was altered after 8 h of storage, irrespective of anticoagulant. Cold storage extended stability most effectively in EDTA. It remains that EDTA should be the anticoagulant of choice to preserve blood physical properties. Even short-term storage of blood has a remarkable impact on physical properties; when unavoidable, however, EDTA blood should be stored at 4 °C for same day testing without negative effect.

ObjectiveTo explore the preoperative predictive efficacy of multimodal ultrasound based on microflow imaging(MFI) in Glypican-3(GPC-3) in hepatocellular carcinoma(HCC).MethodsThe general data and ultrasonographic data of patients with HCC confirmed by histopathology and hepatectomy from January 2019 to June 2023 were analyzed retrospectively. According to the gold standard of postoperative pathology, the patients were divided into GPC-3 positive group and GPC-3 negative group. Through analyze the correlation between multimodal ultrasound features and GPC-3, to determine the independent predictors of GPC-3, and to further analyze the preoperative predictive efficiency of Two-dimensional ultrasound(2D-US), contrast-enhanced ultrasound(CEUS) and microflow imaging(MFI) for GPC-3 of HCC.ResultsA total of 102 patients were enrolled in this study, including 60 GPC-3 positive patients(58.8%) and 42 GPC-3 negative patients(41.2%). Through univariate and multivariate analysis, it was found that there were significant differences in diameter(95%CI: 1.080-7.741, P = 0.034), start washout time(95%CI: 0.105-0.694, P = 0.007) and CEUS-MFI(95%CI: 1.180-4.553, P = 0.015) between the two groups, which were independent predictors of GPC-3 positive occurrence. The prediction efficiency of multimodal ultrasound combined with GPC-3 for HCC is better than that of single mode(P<0.05).ConclusionThe feasibility of multimodal ultrasound in predicting GPC-3 of HCC before operation is confirmed.

BackgroundSteatosis hepatis is of outstanding clinical importance. The aim of this study was to apply the new parametric method "Ultrasound Derived Fat Fraction" (UDFF) to monitor changes of liver fat in obese patients undergoing weight loss measures.MethodsIn 53 obese patients BMI, absolute body fat, waist circumference and UDFF were measured before and after a three-month weight loss intervention. UDFF measurements were performed using a Siemens ultrasound system (DAX, 1.0-3.5 Mz). We analysed the correlation of change in BMI (≥-1 vs < -1), body fat (≥-2 kg vs < -2 kg) and waist circumference (≥-10 cm vs < -10 cm) with the change in UDFF (≥-30% vs < -30%) (significance level: p < 0.0167).ResultsAt baseline, mean BMI was 39.2 (range: 29.8-63.6), body fat 51.3 kg (range: 29.9-111.7), waist circumference 120.2 cm (range: 95-164) and UDFF 26% (range: 7-41%). 54.7% of patients lost at least 2 kg of body fat. These patients were significantly more likely to have a reduction in UDFF of at least 30% (≥2 kg fat: 58.6% vs. < 2 kg fat: 20.8%; p = 0.011). For BMI and waist circumference changes no significant correlation with UDFF was observed.ConclusionThis study underlines that UDFF could be a promising, non-invasive tool to monitor changes in liver fat.

ObjectivesThis study investigated haemorheological alterations in patients with rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE).MethodsA total of 136 individuals were enrolled, comprising 52 healthy controls, 51 RA patients, and 33 SLE patients. Blood samples were collected at the University of Health Sciences Sultan Abdulhamid Han Training and Research Hospital in Istanbul, Türkiye. Whole blood and plasma viscosity, along with red blood cell (RBC) deformability and aggregation, were analysed using a Brookfield viscometer and a laser-assisted optical rotational cell analyser (LORRCA).ResultsRBC deformability was reduced in both patient groups compared to controls (EImax: RA 0.645, SLE 0.642, control 0.648), while RBC aggregation was markedly increased (AI: RA 75.66, SLE 74.73, control 65.5) (p < 0.05). Plasma and whole blood viscosity were also elevated in RA and SLE groups, with the highest values observed in SLE patients (PV: RA 1.43, SLE 1.48, control 1.31).ConclusionsRA and SLE patients show notable impairments in haemorheological parameters. Evaluating RBC deformability, aggregation, and plasma viscosity may help clarify disease mechanisms and guide therapeutic strategies to mitigate vascular complications and tissue damage in autoimmune disorders.

ObjectiveCervical tuberculous lymphadenitis (CTBL) and cervical lymph node metastasis (CLNM) share similar imaging characteristics, making differentiation challenging. This study aims to evaluate the clinical utility of a multimodal radiomics model combining grayscale ultrasound (GUS), elastography ultrasound (EUS), and contrast-enhanced ultrasound (CEUS) for distinguishing CTBL from CLNM.MethodsA high-quality dataset comprising 203 cases of CTBL was used to train and test the radiomics models. The performance of single-modal (GUS, EUS, CEUS) and combined models was compared using AUC, sensitivity, specificity, and accuracy metrics. An independent test set of 45 cases was included for validation.ResultsThe combined GUS + EUS + CEUS model outperformed single-modal models, achieving AUCs of 0.894, 0.832, and 0.919 in the training, validation, and test sets, respectively. Its diagnostic performance was comparable to a clinical model in validation and test sets, demonstrating superior generalizability and robustness. Wavelet features accounted for all selected features, enhancing the model's discrimination ability.ConclusionsThe integration of three ultrasound modalities captures multidimensional imaging features, reducing reliance on subjective interpretation. This multimodal radiomics approach provides a standardized diagnostic tool with significant clinical potential, particularly for less experienced physicians. Further validation with diverse datasets is needed to confirm its utility.

BackgroundBorderline ovarian tumors (BOTs) represent a rare group of neoplasms exhibiting abnormal epithelial proliferation with cellular atypia while lacking stromal invasion or infiltrative destructive growth. And postoperative recurrence may be associated with histological features and lymph node status. Therefore, preoperative prediction of BOTs' histological characteristics and lymph node status is of paramount importance for formulating surgical plans and follow-up treatments.ObjectiveTo investigate the value of conventional ultrasound (US) and contrast-enhanced ultrasound (CEUS) characteristics for preoperative identification of histological features and lymph node status in BOTs.MethodsPatients with pathologically confirmed primary BOTs were enrolled, which classified into high-risk and low-risk groups based on whether the presence of at least one of microinvasion, micropapillary pattern, extraovarian implantation, or lymph node invasion. CEUS was performed at the maximal solid tumor component identified on gray-scale imaging, with bolus injection of contrast agent and dynamic recording of the wash-in to wash-out phases for quantitative contrast kinetics analysis. A comparative analysis of US and CEUS characteristics was conducted between the groups, with subsequent longitudinal assessment of recurrence-free survival (RFS) curves employing Kaplan-Meier methodology.ResultsThe study comprised 58 patients with BOTs, stratified into low-risk (n = 37) and high-risk (n = 21) groups, with mean patient ages of 42.8 ± 11.8 years. No statistically significant differences were observed in tumor size (maximum diameter, p = 0.840) or location (unilateral versus bilateral, p = 0.077) between the two groups on US. The type of tumor, proportion of solid components, and color score were observed to statistically significantly differ between the two groups (all p < 0.05). Iso- or hyper-enhancement, early or synchronously wash-in, and early wash-out were more likely to occur in the high-risk group (16/21, 76.2%; 11/21, 52.4%; 11/21, 52.4%) than in the low-risk group (15/37, 40.5%; 5/37, 13.5%; 9/37, 24.3%). In quantitative parameters, there were significant differences in MeanLin, PE, RT, TTP, WiR, WiPI, WoAUC, WiWoAUC, FT, and WoR between the two groups (all p < 0.05). During the follow-up, there were 3 cases recurrence in the high-risk group, while no recurrence was observed in the low-risk group.ConclusionThe combination of US and CEUS is capable of facilitating preoperative prediction of the histological features and lymph node status of BOTs, and holds potential value for identifying the recurrence risk.

ObjectiveThis study aims to explore the effects of obstructive sleep apnea (OSA) on hemorheological parameters.MethodsBetween February 2023 and March 2024, 882 patients were screened, and 787 were included in the study. The participants were divided into a non-OSA group (72 individuals) and an OSA group (715 individuals). Propensity score overlap weighting was used to balance the clinical variables, red blood cell count, and blood biochemistry results between the two groups, and regression analysis was conducted to assess the relationship between OSA and hemorheological parameters. Sensitivity analysis was conducted using propensity score covariate adjustment to ensure the robustness of the results.ResultsCompared to non-OSA patients, OSA patients exhibited a significant increase in whole blood viscosity at high shear rates by 0.18 mPa.s (95% CI: [0.03, 0.32]) and in plasma viscosity by 0.05 mPa.s (95% CI: [0.01, 0.10]). However, there was no significant difference in whole blood viscosity at low shear rates between the two groups (95%CI: [-0.01, 0.56]).ConclusionAfter adjusting the effects of comorbidities such as hypertension, diabetes, and cardiovascular diseases, OSA still had a significant impact on high-shear whole blood viscosity and plasma viscosity.