Alterations in Carotid Parameters in ApoE–/– Mice Treated with a High-Fat Diet: A Micro-ultrasound Analysis

Information on the common carotid artery and cerebral microcirculation can be obtained by micro-ultrasound (µUS). The aim of the study described here was to investigate high-fat diet-induced alterations in vascular parameters in ApoE–/– mice. Twenty-two ApoE–/– male mice were examined by µUS and divided into the standard diet (ApoE–/–_SD) and high-fat diet (ApoE–/–_HF) groups. The µUS examination was repeated after 4 mo (T₁). Carotid stiffness, reflection magnitude and reflection index were measured; the amplitudes of the first (W₁) and second (W₂) local maxima, the local minimum (W_b) and the reflection index (RI_WIA?=?W_b/W₁) were assessed with wave intensity analysis. At T₁, ApoE–/–_HF mice had increased carotid stiffness (1.48 [0.36] vs. 1.88 [0.51]) and reflection magnitude (0.89 [0.07] vs. 0.94 [0.07]) values. Longitudinal comparisons highlighted increases in carotid stiffness for ApoE–/–_HF mice (from 1.37 [0.25] to 1.88 [0.51] m/s) but not for ApoE–/–_SD mice (from 1.40 [0.62] to 1.48 [0.36] m/s). ApoE–/–_HF mice exhibited carotid artery stiffening and increased wave reflections.     

Primary Application of Micro-Flow Imaging Technology in the Diagnosis of Hepatic Tumors

The purpose of the study was to evaluate the vascular architecture of focal liver lesions with the newly released non-contrast micro-flow imaging (MFI) technique. Eighty patients with 80 hepatic tumors were enrolled in this study. The richness of displayed blood flow was first compared with color Doppler flow imaging using grades according to Adler's method. The results indicated that MFI outperformed color Doppler flow imaging with a statistically significant difference (p <0.0001). With the enhanced position in arterial phase of contrast-enhanced ultrasound imaging as the ground truth, the displayed blood flow distribution within tumors in MFI was further evaluated. The coincidence rate between MFI and contrast-enhanced ultrasound was 73.75% (59/80), which was higher than that of color Doppler flow imaging (52.5%, 42/80) (p < 0.0001). Moreover, for the five cases of focal nodular hyperplasia, MFI clearly revealed the spoke-wheel or radiating intra-tumoral vasculature, a finding specific to the diagnosis of focal nodular hyperplasia.     

Ultrasound with Microbubble Contrast Agent and Urokinase for Thrombosis

This study was aimed at assessing the effects of urokinase (UK) in combination with ultrasound and microbubbles in in vitro and in vivo thrombolytic therapy for the treatment of deep vein thrombosis (DVT). Thrombi with formation times of 1, 3, 7, 14 and 21 d were used for thrombolysis. Forty-five adult mongrel dogs were used to evaluate thrombosis in vivo. Both in vitro and in vivo analyses revealed that UK?+?microbubbles had the best effect among the combinations. Thrombolysis <7 d was more effective at a thrombolysis rate of about 50%, but the thrombolytic effect of thrombi >7 d was poor at thrombolysis rates <30%. Ultrasound?+?UK significantly increased the thrombolysis rate of thrombi <7 d. These results suggest that the combination of ultrasound with microbubble contrast agents and UK may have a synergistic effect on thrombolysis.     

超声多探头检查在新生儿颅脑疾病诊断中的应用

目的研究超声低频探头和低频探头联合高频探头检查在新生儿颅脑疾病诊断中的准确率和敏感性。 方法选取河源市妇幼保健院自2017年1月至2018年12月收治的有颅脑疾病高危因素(早产、低体质量、多胎妊娠、出生过程有缺氧窒息及产时感染)的新生儿90例作为研究对象。采用随机数字表法将所有新生儿平均分为2组，研究组（45例）给予低频探头联合高频探头进行探查，对照组（45例）仅给予低频探头进行探查。结合CT检查结果和临床治疗，比较2种检测方法的准确率和敏感性。 结果研究组检测新生儿缺氧缺血性脑病、脑室内出血和室管膜下出血诊断准确率分别为87.5%、100%、100%，高于相应对照组（15.38%、12.5%、0%），差异有统计学意义（P<0.05）；研究组和对照组检测脑实质内出血和脑积水的诊断准确率分别为87.5%、100%以及42.85%、66.67%，差异无统计学意义（P>0.05）。研究组检测新生儿颅脑疾病的效率为82.22%，高于对照组（22.22%），差异具有统计学意义（P<0.05）。 结论使用超声低频探头联合高频探头的方法提高了缺氧缺血性脑病、脑室内出血、室管膜下出血等新生儿颅脑疾病诊断的准确率，在诊断新生儿脑实质内出血和脑积水的准确率没有差异，且对颅脑疾病诊断的敏感性较高，因此具有较为重要的临床意义。     

颈内静脉内径呼吸变异度和血流速度在椎管内麻醉后容量预测中的价值

目的探究超声测量颈内静脉内径呼吸变异度和血流速度在椎管内麻醉后血容量判断中的价值。方法选择我院2017年2月至2019年2月择期手术的椎管内麻醉患者120例,男64例,女56例,年龄为34～66岁,ASAⅠ或Ⅱ级。记录麻醉前、麻醉后5、15、25 min左侧颈内静脉最大直径(Dmax)、最小直径(Dmin)、内径呼吸变异度(RVI)、中心静脉压(CVP)、血流速度最大值(BVmax)、血流速度最小值(BVmin)和血流速度变异度(BVI),取CVP=6 mmHg作为预测值,并通过绘制ROC曲线来评估Dmax、Dmin、RVI、BVmax、BVmin和BVI的预测效能。结果与麻醉前比较,麻醉后5 min时Dmax、Dmin和BVI明显降低(P0.05),RVI明显升高(P0.05);与麻醉后5和15 min比较,麻醉后25 min,Dmax、Dmin和BVI明显升高(P0.05),RVI明显降低(P0.05)。麻醉前BVmin的AUC值最大为0.958,临界值6.86,敏感性82.6%,特异性95.2%;麻醉后5 min,Dmin的AUC值最大为0.944,临界值0.74,敏感性98.4%,特异性84.3%;麻醉后15 min,Dmin和BVmax的AUC值最大分别为0.949和0.945,临界值分别为0.72和7.99,敏感性分别为96.5%和89.8%,特异性分别为82.4%和82.1%;麻醉后25 min,BVmax的AUC值最大为0.981,临界值8.98,敏感性92.0%,特异性90.5%。结论超声测量患者颈内静脉的内径变异度和血流速度可作为预测椎管内麻醉后血容量的方式。     

Imaging update on soft tissue sarcoma

Soft tissue sarcomas (STS) are rare tumours presenting as soft tissue lumps. Ultrasound is often the primary modality for the initial assessment, with MRI the mainstay for lesion characterisation. PET/CT along with other emerging MRI sequences are used in certain situations as an adjunct and problem solving tool in STS staging and assessment of disease recurrence. Recent advances include the promise of whole body MRI, hybrid PET/MRI, diffusion weighted imaging, dynamic contrast enhanced MRI and advances in artificial intelligence. This article discusses current concepts in extremity STS imaging and highlights recent advances.     

Current update on imaging for pancreatic neuroendocrine neoplasms

Pancreatic neuroendocrine neoplasms (panNEN) are a heterogeneous group of tumors with differing pathological, genetic, and clinical features. Based on clinical findings, they may be categorized into functioning and nonfunctioning tumors. Adoption of the 2017 World Health Organization classification system, particularly its differentiation between grade 3, well-differentiated pancreatic neuroendocrine tumors (panNET) and grade 3, poorly-differentiated pancreatic neuroendocrine carcinomas (panNEC) has emphasized the role imaging plays in characterizing these lesions. Endoscopic ultrasound can help obtain biopsy specimen and assess tumor margins and local spread. Enhancement patterns on computed tomography (CT) and magnetic resonance imaging (MRI) may be used to classify panNEN. Contrast enhanced MRI and diffusion-weighted imaging have been reported to be useful for characterization of panNEN and quantifying metastatic burden. Current and emerging radiotracers have broadened the utility of functional imaging in evaluating panNEN. Fluorine-18 fluorodeoxyglucose positron emission tomography (PET)/CT and somatostatin receptor imaging such as Gallium-68 1,4,7,10-tetraazacyclododecane-1,4,7,10-tetraacetic acid–octreotate PET/CT may be useful for improved identification of panNEN in comparison to anatomic modalities. These new techniques can also play a direct role in optimizing the selection of treatment for individuals and predicting tumor response based on somatostatin receptor expression. In addition, emerging methods of radiomics such as texture analysis may be a potential tool for staging and outcome prediction in panNEN, however further investigation is required before clinical implementation.     

经皮肾镜气压弹道超声碎石在肾结石中的效果

目的 B超引导经皮肾镜气压弹道超声联合碎石治疗肾结石的临床效果。方法选择2017年9月-2018年9月医院收治的肾结石患者82例,按照抽签法的要求将其平均分成对照组(41例:B超引导经皮肾镜气压弹道超声治疗)与试验组(41例:输尿管软镜治疗),分析手术时间、住院时间、出血量、结石清除率、结石的残留率。结果试验组的手术时间、住院时间、出血量。优于对照组,数据比较有差异性,P<0.05。对照组的结石清除率高于试验组、结石的残留率低于试验组,相互比较有差异性,P<0.05。结论在肾结石实际治疗期,使用输尿管软镜钬激光碎石治疗方式。