四维时空关联成像技术在孕期检测胎儿室间隔缺损中的研究效果分析

目的 应用STIC对孕期胎儿室间隔缺损情况进行检测，提高孕期胎儿先心病的检测率，以便及时进行干预。 方法 选取孕周在17～30周的疑似VDS胎儿进行STIC检测，分别选有经验和无经验的医生各1名进行操作，并使用双盲法将检测结果交由2名医生通过不同的方法进行观察，了解胎儿室间隔缺损的心脏结构表现及缺损状态。结果2名检测医生应用STIC进行检测的结果不存在差异性（P〉0.05），证明四维STIC的检测不存在人员的依赖性。其中2名医生使用了三正交模式、透明成像模式、反转成像模式、室间隔平面表面成像模式等进行处理后。有2名医生同时检测出的病例有40例。2名医生单独检测出的病例各有2例．在检测观察中，有1例病例在确定为室间隔缺损时可以应用反转成像技术发现穿隔血流以便进行诊断。结论 四维STIC技术的应用不存在人为操作的差异。同时其检测效果比三维超声检测更加明显，在提高检测率中更具有技术优势。【关键词】四维时空关联成像技术；孕期检测；室间隔缺损中图分类号 R445．1     

四维自动化定量超声联合心电图HRV预测AMI患者预后的价值

目的 分析四维自动化定量超声联合心电图心率变异性（HRV）预测急性心肌梗死（AMI）患者预后的价值。方法 选取2020年3月至2022年3月该院收治的AMI患者83例，均行四维自动化定量超声、心电图检查，依据预后情况分为发生主要不良心血管事件（MACE）组、未发生MACE组，分析两组的超声参数、HRV参数差异及与MACE发生率的相关性，评估两种影像学方法联合对预后的预测价值。结果 发生MACE组的左房排空容积（LAEV）、左房被动射血分数（LAPEF）、左房主动射血分数（LAAEF）及左室射血分数（LVEF）、径向应变（GRPS）等低于未发生MACE组，而左房最大容积指数（LAVImax）高于未发生MACE组（P＜0.05）；发生MACE组的全部窦性心搏RR间期的标准差（SDNN）、RR间期平均值的标准差（SDANN）、相邻RR间期差值的均方根（RMSSD）、低频（LF）/高频（HF）、相邻RR间期相差＞50 ms的个数占总窦性心搏个数的百分比（PNN50）低于未发生MACE组（P＜0.05）；LAEV、LAPEF、LVEF、GAPS、SDNN与MACE事件发生率呈负相关，LAVImax与MACE事件发生率呈正相关（P＜0.05）；LAEV、LAPEF、LVEF、LAVImax、GAPS、SDNN联合预测AMI患者预后的曲线下面积为0.841，敏感度、特异度分别为0.81、0.76，高于各项参数单独预测。结论 四维自动化定量超声联合心电图HRV对AMI患者预后有较高预测价值，值得在临床推广实践。     

Myocardial strain analysis by 4D-speckle tracking echocardiography for prediction of coronary artery disease severity in patients with stable angina pectoris

ObjectiveWe sought to evaluate the myocardial strain by four-dimensional speckle-tracking echocardiography (4D-STE) in patients with stable angina pectoris (SAP) to determine the severity of coronary artery disease (CAD) based on the Gensini score.MethodsThe present study comprised of 150 patients with SAP. Patients with history of SAP, normal left ventricular ejection fraction, and without regional wall motion abnormalities (RWMA) were scheduled for elective coronary angiography. Based on Gensini score, there were two groups: non-critical stenosis group [Gensini score (0–19), n = 117] and critical stenosis group [Gensini score ≥20, n = 33]. Correlation between Gensini score and 4D-STE strain parameters were investigated.ResultsOut of 150 patients, critical stenosis group had significantly depressed values of all 4D-STE strain parameters than non-critical stenosis group (p < 0.001), except global radial strain (GRS) parameter. Significant positive correlation was found between Gensini score and 4D global longitudinal strain (GLS), global circumferential strain (GCS), global area strain (GAS) with Spearman's correlation coefficient (ρ) as 0.626, 0.548, and 0.631, respectively (p < 0.001), whereas significant negative correlation was found between Gensini score and GRS (ρ = −0.433, p < 0.001). A 4D GLS value of ≥ −17 had 84.9% sensitivity and 97.4% specificity, GAS ≥ −31 (90.9% sensitivity, 78.6% specificity), GCS ≥ −17 (69.7% sensitivity, 92.3% specificity), and GRS <47 (sensitivity 72.7%, specificity 76.1%) to detect critical CAD described by Gensini score ≥20.ConclusionThe 4D-STE can aid in the assessment of severe CAD stenosis with good sensitivity and specificity in the patients with SAP without RWMA on traditional echocardiography.     

Computed tomography imaging for subclinical leaflet thrombosis following surgical and transcatheter aortic valve replacement

Subclinical leaflet thrombosis (LT) may occur following surgical and transcatheter aortic valve replacement. Computed tomography (CT) has become an established imaging modality to diagnose subclinical LT following bioprosthetic aortic valve replacement. Even so, there is a limited (but growing) experience in utilizing CT imaging for this indication. This review emphasizes a systematic approach to acquiring and analysing CT imaging for subclinical LT, highlighting evidence surrounding clinical sequelae of subclinical LT and anti-thrombotic implications following diagnosis.     

Prospects for the use of olfactory mucosa cells in bioprinting for the treatment of spinal cord injuries

The review focuses on the most important areas of cell therapy for spinal cord injuries. Olfactory mucosa cells are promising for transplantation. Obtaining these cells is safe for patients. The use of olfactory mucosa cells is effective in restoring motor function due to the remyelination and regeneration of axons after spinal cord injuries. These cells express neurotrophic factors that play an important role in the functional recovery of nerve tissue after spinal cord injuries. In addition, it is possible to increase the content of neurotrophic factors, at the site of injury, exogenously by the direct injection of neurotrophic factors or their delivery using gene therapy. The advantages of olfactory mucosa cells, in combination with neurotrophic factors, open up wide possibilities for their application in three-dimensional and four-dimensional bioprinting technology treating spinal cord injuries.