To evaluate the possibility and accuracy of Doppler tissue image (DTI) on assessment of normal and abnormal ventricular activation and contraction sequence, 9 open chest canine hearts were analyzed by acceleration mod...To evaluate the possibility and accuracy of Doppler tissue image (DTI) on assessment of normal and abnormal ventricular activation and contraction sequence, 9 open chest canine hearts were analyzed by acceleration mode, M mode, and spectrum mode DTI. Our results showed that: (1) Acceleration mode DTI could show the origin of activation and conduction sequence on line; (2) M mode DTI revealed that the activation in mid interventricular septum was earlier than that in mid left ventricular posterior wall at sinus activation; (3) Spectrum DTI showed the ventricular endocardium was activated earlier than the ventricular epicardium in all segments at sinus rhythm. The earliest site of activation of the normal ventricular wall was at middle interventricular septum; the latest site was at basal posterior wall; the contraction sequence was different at the different walls; (4) During abnormal ventricular activation, mid left ventricular posterior wall was activated earliest in accordance with the pacing sites. Abnormal ventricular activation was slower than sinus activation, and the contraction sequence varied at different sites of ventricular wall. It is concluded that DTI can be used to localize the origin of normal or abnormal myocardial activation and to assess the contraction sequence conveniently, accurately and non invasively.展开更多
Background: Coronary artery disease (CAD) is often silent in diabetic patients, and it is typically in ad-vanced stages of development by the time it manifests. Various forms of stress testing have been investigated t...Background: Coronary artery disease (CAD) is often silent in diabetic patients, and it is typically in ad-vanced stages of development by the time it manifests. Various forms of stress testing have been investigated to detect obstructive CAD in diabetes mellitus. Ob-jectives: To assess the diagnostic value of dobutamine stress pulsed-wave Doppler tissue imaging (DTI) compared with standard wall motion analysis in de-tection of myocardial ischemia in diabetic patients with suspected CAD. Methods: The study comprised 46 diabetic patients with suspected CAD underwent dobutamine stress echocardiography (DSE) with DTI within 4 weeks before coronary angiography(CA). Dobutamine infusion started at 5 μ/kg/min and in-creased up to 40 μ/kg/min with additional atropine during submaximal heart rate responses. In addition to wall-motion score index (WMSI) analysis, pulsed- wave DTI examination of basal and mid segments of posteroseptal, lateral, anterior, inferior and antero- septal walls was performed. Myocardial velocities were measured at rest in the apical 4, 3 and 2-cham- ber views. The measurements were repeated at low dose (10 - 15 μ/kg/min) and at peak stress (40 μ/kg/min). DTI measurements included peak systolic velocity (S), peak early diastolic velocity (E) and peak late diastolic velocity (A) and the results were com-pared to WMSI analysis. Patients were classified into two groups according to CA results;group (I) di-abetics with positive CA (n = 27) and group (II) di-abetics with negative CA (n = 19). Results: There was no significant difference between the two groups in duration of diabetes, global WMSI at rest or the ? changes (stress-rest/rest) of WMSI (P > 0.05). Global S and global E were significantly lower in group I compared to group II at peak stress (11.3 ± 3.7 cm/sec vs. 14.5 ± 2.2 cm/sec, p < 0.01) and (11.3 ± 1.6 cm/sec vs. 13.1 ± 2.1 cm/sec, p < 0.01) respectively. The cutoff points for global S and global E to detect obstructive CAD in diabetics were 11.3 cm/s and 11.2 cm/s re-spectively with 75.7%, 73.4% sensitivity and 94.7%, 89.47% specificity respectively. An increment (? changes) less than 0.56 in S or 0.26 in E from rest to peak stress identified CAD with 78.8 %, 89.3% sensi-tivity and 94.7%, 90.7% specificity respectively. The accuracy of DTI parameters during peak stress was higher than WMSI analysis (sensitivity 74.1% vs. 59.3% and specificity 90% vs. 79%, P < 0.01 for each). In multivariate regression analysis, only ?S and ?E were independent predictors of obstructive CAD in diabetics (odd ratio: 36.16, 95% CI, 1.34- 532.01 and 63.77, 95% CI, 3.19-721.47) respectively. Conclusion: Quantitative analysis, using DTI during DSE, adds new dimension in diagnosis of myocardial ischemia. It is more sensitive, specific, accurate and reproducible compared with standard wall motion analysis for recognition of significant CAD in diabetic patients.展开更多
Background: Coronary artery disease (CAD) is a paramount cause of death. Global and regional left ventricular (LV) systolic function is an important non-invasive marker of CAD. We can use tissue Doppler imaging (TDI) ...Background: Coronary artery disease (CAD) is a paramount cause of death. Global and regional left ventricular (LV) systolic function is an important non-invasive marker of CAD. We can use tissue Doppler imaging (TDI) to measure the low velocities generated by myocardium which are: S'-wave, E'-wave, and A'-wave. We aimed to examine the value of the S'-wave dispersion of TDI across mitral valve annular velocities to predict angiographically significant coronary artery obstruction. Patients and Methods: We included 100 patients with symptoms suggesting CAD. All patients had undergone full history taken and clinical examination;ECG, echocardiographic with assessment of LV function, and Doppler derived mitral valve velocities;TDI with measuring of S'-wave and coronary angiography. Lesions with ≥70% or more stenosis in major epicardial artery or ≥50% stenosis in the left main coronary artery were considered significant. Patients were classified into two groups according to the presence or absence of significant coronary stenosis. Results: Clinical and conventional echocardiographic and Tissue Doppler measures were comparable between the two groups;there was statisticallysignificant difference between Group I and Group II (P value;patients with significant coronary arteries lesions have higher S' wave dispersion as compared with patients with normal or mild significant coronary lesions. Conclusion: S'-wave dispersion may consider a good predictor of angiographically significant coronary artery disease.展开更多
Objective To examine the clinical application of pulsed Doppler tissue imaging(DTI)for regional left ventricular function assessment in normal subjects. Methods We examined 50 healthy subjects(range 12-42 years,mean a...Objective To examine the clinical application of pulsed Doppler tissue imaging(DTI)for regional left ventricular function assessment in normal subjects. Methods We examined 50 healthy subjects(range 12-42 years,mean age 28.3 ± 6.9 years)using pulsed Doppler tissue imaging to characterize the diastolic and systolic velocity profiles of mitral annulus. Recordings were made along the long axis in the apical 4-chamber, 2-chamber, and long apical views of 6 sites(posterior-septum, lateral, anterior, inferior, anterior-septum, posterior)at the mitral annulus. Myocardial velocities were determined with use of variance F statistical analysis. Correlation analysis was employed to test the relationship between age and mitral annular velocities. Results Both early diastolic and systolic velocities at the septum were lower than other sites. There were no differences in mitral annulus late diastolic velocities. Mean early diastolic and systolic velocities was negatively correlated with age. Conclusions Doppler tissue imaging can directly reflect regional left ventricular function.展开更多
To explore the feasibility of using tissue Doppler imaging technique for the evaluation of fetus’s left ventricular diastolic function, and to confirm its reliability by comparing it with traditional methods, this st...To explore the feasibility of using tissue Doppler imaging technique for the evaluation of fetus’s left ventricular diastolic function, and to confirm its reliability by comparing it with traditional methods, this study examined 61 pregnant women in whom satisfactory images were obtained of fetal echocardiography. The peak velocity of blood stream were measured, including E, A and E/A at mitral valve orifice on the four chamber view with pulse wave. And then tissue Doppler imaging mode was employed to measure the velocity of mitral valve annulus including Ea, Aa, Sa and Ea /Aa. Correlation analysis was conducted between the velocity of orifice and that of annulus in terms of gestation age. And then correlation analysis was performed between above data and gestation ages. A positive correlation was found between the velocity of orifice and that of annulus, and the velocity increased with the gestation age. The change was the most significant between the 28th and the 34th week of gestation age. Our study showed that it is feasible to evaluate the fetus’s left ventricular diastole function by tissue Doppler imaging. Its stability can avoid the influence of fetal heart rates and preload.展开更多
To determine the clinical application of pulsed Doppler tissue imaging in assessing the left ventricular diasto-lic function and in discriminating between normal subjects and patients with hypertrophic cardiomyopathy ...To determine the clinical application of pulsed Doppler tissue imaging in assessing the left ventricular diasto-lic function and in discriminating between normal subjects and patients with hypertrophic cardiomyopathy with various stages of diastolic dysfunction. Methods We measured the peak diastolic velocities of mitral annulus in 81 patients with hypertrophic cardiomyopathy with various stages of diastolic dysfunction and 50 normal volunteers by Doppler tissue imaging using the apical window at 2-ch-amber and long apical views, respectively. The myocardial velocities were determined with use of variance F statistical analysis. Results Early diastolic myocardial velocities of mitral annulus were higher in normal subjects than in patients with hy-pertrophic cardiomyopathy with either delayed relaxation, pseudonormal filling, or restrictive filling. However, peak myocar-dial velocities of mitral annulus during atrial contraction were similar in normal subjects and patients with hypertrophic cardiomyopathy. Conclusion Doppler tissue imaging can directly reflect upon left diastolic ventricular function. Early phase of diastole was the best discriminator between control subjects and patients with hypertrophic cardiomyopathy.展开更多
Ectopic adiposity has gained considerable attention because of its tight association with metabolic and cardiovascular health in persons with spinal cord injury(SCI). Ectopic adiposity is characterized by the storage ...Ectopic adiposity has gained considerable attention because of its tight association with metabolic and cardiovascular health in persons with spinal cord injury(SCI). Ectopic adiposity is characterized by the storage of adipose tissue in non-subcutaneous sites. Magnetic resonance imaging(MRI) has proven to be an effective tool in quantifying ectopic adiposity and provides the opportunity to measure different adipose depots including intermuscular adipose tissue(IMAT) and intramuscular adipose tissue(Intra MAT) or intramuscular fat(IMF). It is highly important to distinguish and clearly define these compartments, because controversy still exists on how to accurately quantify these adipose depots. Investigators have relied on separating muscle from fat pixels based on their characteristic signal intensities. A common technique is plotting a threshold histogram that clearly separates between muscle and fat peaks. The cut-offs to separate between muscle and fat peaks are still not clearly defined and different cut-offs have been identified. This review will outline and compare the Midpoint and Otsu techniques, two methods used to determine the threshold between muscle and fat pixels on T1 weighted MRI. The process of water/fat segmentation using the Dixon method will also be outlined. We are hopeful that this review will trigger more research towards accurately quantifying ectopic adiposity due to its high relevance to cardiometabolic health after SCI.展开更多
Objective: To construct an animal model of chronic ischemic myocardium, and evaluate it by ultrasonic integrated backscatter (IBS) and Doppler tissue imaging (DTI). Methods: An Ameroid constrictor was placed around th...Objective: To construct an animal model of chronic ischemic myocardium, and evaluate it by ultrasonic integrated backscatter (IBS) and Doppler tissue imaging (DTI). Methods: An Ameroid constrictor was placed around the porcine left circumflex coronary artery (LCX). The calibrated average image intensity (%AII), cyclic variation of IBS (CVIB), transmural gradient index (TGI) of CVIB in lateral-posterior wall (LPW), and DTI spectrum of LPW in left ventricular papillary muscle level short axis view (LVPM-SAM) and apical four chamber view (AP-4CV) at normal state, 2, 4, 6 and 8 weeks postoperatively were measured. Results: Normal %AII, CVIB and TGI were 2.29±0.32, 9.69±2.22dB and 0.22±0.08, respectively. The %AII increased gradually postoperatively. The CVIB decreased also gradually, and the decrease was higher in subepicardium than in subendocardium. Most of TGI decrease occurred from 2 to 4 weeks postoperatively and became zero at 8 weeks (P<0.01); Normal V S (peak systolic velocity) of AP-4CV was higher than that of LVPM-SAM (P<0.01). V E (peak early diastolic velocity) of AP-4CV was lower than that of LVPM-SAM (P<0.05). V S and V E were all decreased after operation (P<0.01). The decrease of V S in AP-4CV was greater than that in LVPM-SAM. Conclusion: The pathological changes of the myocardium in human ischemic heart disease (IHD) are similar to that of Ameriod model. IBS and DTI can detect echo changes and ventricular wall motion in chronic ischemic myocardium, and provide more information for clinical investigation and treatment of IHD.展开更多
Objectives To quantitatively analyze the longitudinal myocardial systolic and diastolic velocities and time intervals of the left ventricle in normal subjects, and to explore the value of pulsed Doppler tissue imaging...Objectives To quantitatively analyze the longitudinal myocardial systolic and diastolic velocities and time intervals of the left ventricle in normal subjects, and to explore the value of pulsed Doppler tissue imaging (DTI) for the assessment of left ventricular systolic and diastolic synchronicity. Methods Twenty and six healthy subjects were studied by pulsed DTI. The septal and lateral, anterior and inferior walls of the left ventricle were displayed respectively, and basal and middle segments of each wall were selected for myocardial motion spectrum sampling. DTI parameters were; peak systolic myocardial velocity (s) , regional pre-ejection period (PEP), time to the peak of s wave (Ts), regional ejection time (ET); peak early diastolic velocity (e), peak late diastolic velocity (a), e/a ratio, time to the beginning of e wave (QE), time to the peak of e wave (Te) and regional isovolumic relaxation time (IVRT). Results The e and e/a were significantly different among basal segments, and s and e/a were significantly different among middle segments, with the highest value in lateral segments and the lowest value in septal segments. The s, e and a were all significandy higher in basal segments than middle segments. None of the systolic time intervals (PEP, Ts and ET) and diastolic time intervals (QE, Te and IVRT) were significantly different among basal segments and middle segments, neither were they when basal segment was compared with middle segment. Conclusions In normal subjects, the longitudinal myocardial systolic and diastolic velocities of the left ventricle are not homogeneous, but the contraction and relaxation are highly synchronized. Pulsed DTI can be used to quantitatively analyze the systolic and diastolic synchronicity of the heart.展开更多
Objectives To assess the prevalence of systolic dyssynchrony of the left ventricular (LV) walls in patients of heart failure(HF) with a normal QRS duration by Doppler tissue imaging (DTI). Methods 20 patients of HF wi...Objectives To assess the prevalence of systolic dyssynchrony of the left ventricular (LV) walls in patients of heart failure(HF) with a normal QRS duration by Doppler tissue imaging (DTI). Methods 20 patients of HF with a normal QRS duration and 20 healthy individuals were investigated with DTI to quantitatively analyze their pulsed-wave Doppler spectrum of basal and middle segments in six walls of left ventricle. The time between the onset of the QRS complex of the surface ECG and the onset of the systolic wave of pulsed-wave Doppler spectrum was measured (TS). LV systolic synchronization was assessed by the maximal difference (MD) in time of TS, the standard deviation (SD) and the coefficient of variation (CV) of TS in the all 12 LV segments. Results When a TS-MD of TS> 53.08 ms, a TS-SD of TS >18.08 ms and a TS-CV of TS > 0.91 (+1.65 SD of normal controls) was used to define significant systolic dyssynchrony, the prevalence of systolic dyssynchrony was 55.0 %, 55.0 % and 55.0 %, respectively, in the HF patients group, significantly higher than those in the normal control and the locations of delayed contraction of these patients were different. Conclusions LV systolic dyssynchrony could be commonly demonstrated by DTI in HF patients with a normal QRS duration. This finding will support the view about the possibility that more HF patients could benefit from cardiac resynchronization therapy.展开更多
To investigate the validity and accuracy of tissue Doppler imaging (TDI) using a novel balloon phantom, validation of TDI myocardial velocity measurements has been carried out indirectly from conventional M mode image...To investigate the validity and accuracy of tissue Doppler imaging (TDI) using a novel balloon phantom, validation of TDI myocardial velocity measurements has been carried out indirectly from conventional M mode images. However it is not a true and independent gold standard. We described a new TDI validation method by using a specially developed left ventricular balloon model mounted in a water bath and constructed using two pear shaped balloons. It was connected to a pulsatile flow pump at 8 stroke volumes (50-85 ml/beat). The displacement and velocity of the balloon walls were recorded simultaneously by video imaging and TDI on a GE Vingmed System Five with a 5 MHz phased array probe at the highest frame rates available. Conventional M mode and 2 D imaging verified that our balloon model mimicked the shape and wall motion of left ventricle. There was a good correlation and agreement between the maximum video excursion of the anterior and posterior walls of the phantom and the results of the temporal integration of digital distance data by TDI (Anterior wall: r =0.97, SEE=0.24 mm, ±s =0.04±0.24 mm; Posterior wall: r =0.95, SEE=0.22 mm, ±s =0.03±0.24 mm). Analysis of the velocity profile by the TDI method showed that the velocity at each measured point was correlated well with the velocity obtained from the video images (Anterior wall: r =0.97, SEE=0.30 mm, ±s =-0.04±0.28 mm; Posterior wall: r =0.97, SEE=0.30 mm, ±s =0.04±0.28 mm). Our balloon model provided a new independent method for the validation of TDI data. This study demonstrated that the present TDI system is reliable for measuring wall motion distance and velocity.展开更多
Conventional fabrication methods lack the ability to control both macro-and micro-structures of generated scaffolds. Three-dimensional printing is a solid free-form fabrication method that provides novel ways to creat...Conventional fabrication methods lack the ability to control both macro-and micro-structures of generated scaffolds. Three-dimensional printing is a solid free-form fabrication method that provides novel ways to create customized scaffolds with high precision and accuracy. In this study, an electrically controlled cortical impactor was used to induce randomized brain tissue defects. The overall shape of scaffolds was designed using rat-specific anatomical data obtained from magnetic resonance imaging, and the internal structure was created by computer-aided design. As the result of limitations arising from insufficient resolution of the manufacturing process, we magnified the size of the cavity model prototype five-fold to successfully fabricate customized collagen-chitosan scaffolds using three-dimensional printing. Results demonstrated that scaffolds have three-dimensional porous structures, high porosity, highly specific surface areas, pore connectivity and good internal characteristics. Neural stem cells co-cultured with scaffolds showed good viability, indicating good biocompatibility and biodegradability. This technique may be a promising new strategy for regenerating complex damaged brain tissues, and helps pave the way toward personalized medicine.展开更多
Background: Heart failure (HF) is a common clinical syndrome mostly due to the impaired ability of the Left Ventricle (LV) to eject blood with reduced cardiac output. Heart failure is called systolic (SHF) if left ven...Background: Heart failure (HF) is a common clinical syndrome mostly due to the impaired ability of the Left Ventricle (LV) to eject blood with reduced cardiac output. Heart failure is called systolic (SHF) if left ventricle ejection fraction on echo-cardiogram is low (LVEF of ≤50%). Aim: To assess the echocardiographic characteristics of patients with SHF with Atrial Fibrillation (AF) and compare with those with Sinus Rhythm (SR) on 12 leads ECG. Furthermore, to evaluate the clinical and biochemical markers for the prediction of AF in SHF. Method: Over two years duration, each patient diagnosed with SHF was enrolled in the study (n = 354) based on admission code. AF or sinus rhythm on 12 leads ECG was documented on each patient. Multiple logistic regression analysis was applied to assess the risk ratio of different clinical and Doppler derived variables for the development of AF in SHF. Results: Out of the total hospital medical admissions of 14,674 patients, there were 354 patients with diagnosis of SHF, a prevalence of 2.4%. The incidence of AF on ECG was 109 (31%) patients in the whole study population and 245 (69%) in SR. M Mode echocardiogram in patients with SHF and AF compared with those in SR showed significant dilation of LV cavity in systole with LVESD of 5.72 ± 0.63 vs. 5.23 ± 0.76 cm, P < 0.001 and in Diastole LVEDD of 6.83 ± 0.51 vs. 6.58 ± 0.63 cm, P < 0.001. Pulsed Doppler echocardiogram showed a severe restrictive-pattern with shorter Decellration Time (DT) of 163.73 ± 7.42 vs. 214.9 ± 31.81msec, P < 0.001 and higher Pulse to Tissue Doppler ratio of E/Em of 14.26 ± 1.34 vs. 9.99 ± 1.27, P , and the serum level of Brain Natriuretic Peptide (BNP) hormone of 723.72 ± 13.45 vs. 686.98 ± 72.57 pg/ml, P < 0.001. The predictive risks (odd ratio) of different clinical variables for the development of AF in SHF were positive for high BNP > 500 pg/ml of 2.8, history of hypertension of 1.8, history of DM of 1.7, BMI > 28 of 1.4, LV hypertrophy on ECG of 1.3. Conclusions: The prevalence of Systolic Heart Failure in the study population was 2.4%. The prevalence of AF in the study population was 31%. The best predictors of AF in SHF were high BNP > 500 pg/ml, history of hypertension, Diabete Mellitus and LV Hypertrophy on ECG.展开更多
Diagnosis of extremity soft-tissue tumors can be challenging.Characteristics of tumor margins can help precisely identify locally aggressive or non-aggressive behavior for surgical planning,but cannot differentiate be...Diagnosis of extremity soft-tissue tumors can be challenging.Characteristics of tumor margins can help precisely identify locally aggressive or non-aggressive behavior for surgical planning,but cannot differentiate benign from malignant lesions.Most malignant tumors can have inhomogeneous signals on T2-weighted images.Although a uniform signal on T2-weighted images can be a reliable indication of a benign lesion,a well-defined mass with homogeneous internal signal intensity does not definitively identify a benign lesion.Some common and distinctive soft-tissue lesions can have specific clinical and imaging features allowing a diagnosis without biopsy.These are known as determinate lesions.This illustrative report presents a diagnostic guide for extremity soft-tissue tumors based on tissue signal and morphological characteristics on magnetic resonance images.It is important for clinicians to be familiar with the imaging characteristics of common determinate lesions.展开更多
Background: Symptoms of heart failure (HF) are identical in both systolic (SHF) and diastolic hear failure (DHF). The prevalence of atrial fibrillation (AF) in heart failure varies in different studies depending on th...Background: Symptoms of heart failure (HF) are identical in both systolic (SHF) and diastolic hear failure (DHF). The prevalence of atrial fibrillation (AF) in heart failure varies in different studies depending on the criteria of enrollment and the use of echocardiographic parameters in the definition of HF. Aim: To assess the clinical characteristic of pa- tients with DHF complicated by AF and compare with those with SHF in regard of echocardiographic abnormalities and causative agents. Furthermore, evaluate the clinical and biochemical markers for the prediction of AF in HF. Method: Over the duration of 12 months, each patient diagnosed as HF based on admission code was enrolled in the study. Patients were classified into two groups: group 1: DHF, with preserved LVPEF% > 50%, n = 204 (60%), and group 2, with SHF, with LVREF% ≤ 50%, n = 140 (40%). The presence or absence of AF on ECG was recorded. The predictive value of different clinical and biochemical variables for the development of AF was evaluated using logistic multiple regression analysis. Results: Three hundred and forty four eligible patients were admitted to hospital with heart failure out of 7650 who had other medical problems. The prevalence of HF in this population was 4.5%, those with DHF were 2.7% and SHF of 1.8%. The incidence of AF on ECG was 35% in the whole study population and 65% were in sinus rhythm (SR). The occurrence of AF was twice higher in DHF patients of 22% compared with 11% in SHF. Echo pulsed Doppler in DHF and AF compared with those in SR showed a severe restrictive pattern with significantly thick septum wall, higher LV mass index, shorter DT and higher E/e? ratio of 12.4 vs. 9.73, P 0.05. The predictive risk (odd ratio) of different clinical variables for development of AF in HF was positive for LV hypertrophy on ECG of 2.4, history of hypertension of 1.6, history of DM of 1.4, BMI > 28 of 1.7. Conclusions: The prevalence of HF was 4.5% in the study population, with SHF of 1.8% and DHF of 2.7%. Patients with DHF and AF were older with a higher female ratio with severe restrictive pattern compared with those of SHF. The incidence of AF in the whole study was 35%. The best predictor of AF in HF was left ventricle hypertrophy followed by history of hypertension and DM.展开更多
<span style="white-space:nowrap;font-family:Verdana;"><strong>Background: </strong></span>This study aimed to determine the impact of the percutaneous coronary intervention (PCI)...<span style="white-space:nowrap;font-family:Verdana;"><strong>Background: </strong></span>This study aimed to determine the impact of the percutaneous coronary intervention (PCI) on myocardial function assessed by tissue Doppler echocardiography.<span style="font-family:;" "=""> </span><b><span style="font-family:Verdana;">Methods:</span></b><i><span style="font-family:;" "=""> </span></i><span style="font-family:;" "=""><span style="font-family:Verdana;">Conventional two-dimensional echocardiography</span><b> </b><span style="font-family:Verdana;">and</span><i> </i><span style="font-family:Verdana;">Myocardial tissue peak velocities were recorded at the lateral, ant.septal, post.septal, posterior, ant. and inferior angles of the mitral annulus as well as at the lateral tricuspid annulus by pulsed-wave tissue Doppler echocardiography before PCI, as well as 1 day and 6 weeks after intervention.</span></span><span style="font-family:;" "=""> </span><b><span style="font-family:Verdana;">Results:</span></b><i><span style="font-family:;" "=""> </span></i><span style="font-family:;" "=""><span style="font-family:Verdana;">Fifty consecutive patients with chronic stable angina and </span><span style="font-family:Verdana;">preserved systolic left ventricular function (mean age, 58.3 ± 6.594 years;32 men) undergoing PCI were studied. Conventional echocardiographic revealed no statistically significant difference between pre- and post-PCI (1 day after PCI and 6</span><span style="font-family:Verdana;"> weeks after PCI) as regarding trans-mitral and trans-tricuspid flow velocities except as regarding LVEDD, LVESD and LVEF which showed a significant improvement post-PCI. Compared with pre-interventional values, systolic peak velocity and early diastolic velocities improved at all sites (P ≤ </span></span><span style="font-family:Verdana;">0</span><span style="font-family:Verdana;">.05 for each). The most pronounced improvement occurred in the septal area. Similarly, late diastolic velocities improved at all sites (P ≤ </span><span style="font-family:Verdana;">0</span><span style="font-family:Verdana;">.05 for each) except at post</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">Wall A’. Also, there was a significant improvement of E’DT & E’/A’ ratio after PCI (P value is significant <0.05 for each) but there was insignificant difference between pre & post PCI for E/E’ (P-value = 0.154). There was a significant improvement in tissue Doppler measures of early, late diastolic function and E’/A’ at the lateral tricuspid annulus after PCI compared with baseline values (P value is significant <0.05) but there was an insignificant change in tissue Doppler measures at the lateral tricuspid annulus of E’DT & E/E’ after PCI (repeated measures ANOVA P-value is >0.05 for each). There were significant reductions in IVRT, IVCT & MPI after PCI (P value is significant <0.05 for each) but there was insignificant change in ET after PCI (P-value = 0.09) at the septal angle of the mitral annulus and the lateral angle of the tricuspid annulus.</span><span style="font-family:;" "=""> </span><b><span style="font-family:Verdana;">Conclusions:</span></b><span style="font-family:Verdana;"> Tissue Doppler parameters of diastolic and systolic function improve early after successful PCI, and this effect persists to 6 weeks after the intervention that emphasizes its value in the improvement of regional and global LV functions and myocardial contractility.</span>展开更多
Fluorescence imaging is a noninvasive and dynamic real-time imaging technique;however,it exhibits poor spatial resolution in centimeter-deep tissues because biological tissues are highly scattering media for optical r...Fluorescence imaging is a noninvasive and dynamic real-time imaging technique;however,it exhibits poor spatial resolution in centimeter-deep tissues because biological tissues are highly scattering media for optical radiation.The recently developed ultrasound-controlled fluorescence(UCF)imaging is a novel imaging technique that can overcome this bottleneck.Previous studies suggest that the effective contrast agent and sensitive imaging system are the two pivotal factors for generating high-resolution UCF images ex vivo and/or in vivo.Here,this review highlights the recent advances(2015e2020)in the design and synthesis of contrast agents and the improvement of imaging systems to realize high-resolution UCF imaging of deep tissues.The imaging performances of various UCF systems,including the signal-to-noise ratio,imaging resolution,and imaging depth,are specifically discussed.In addition,the challenges and prospects are highlighted.With continuously increasing research interest in this field and emerging multidisciplinary applications,UCF imaging with higher spatial resolution and larger imaging depth may be developed shortly,which is expected to have a far-reaching impact on disease surveillance and/or therapy.展开更多
BACKGROUND Primary soft tissue giant cell tumor(GCT-ST)is rare and has relatively low malignant potential.Most reports are pathological and clinical studies,while imaging studies have only been reported in cases of ad...BACKGROUND Primary soft tissue giant cell tumor(GCT-ST)is rare and has relatively low malignant potential.Most reports are pathological and clinical studies,while imaging studies have only been reported in cases of adjacent bone or with atypical cystic degeneration.With regard to the findings on magnetic resonance imaging(MRI)or ultrasonography,superficial masses can be further identified based on facial edema,skin thickening,skin contact,internal hemorrhage or necrosis and lobulation of the mass.Unlike deep-seated masses,MRI features do not always provide an accurate diagnosis for benign and malignant patients with superficial soft-tissue lesions.Thus,the application of diffusion-weighted imaging(DWI)to evaluate superficial soft tissue tumors is necessary.CASE SUMMARY A 36-year-old woman who had a suspected malignant tumor in the upper limb on ultrasound and computed tomography is reported.The signal intensity of the suspected tumor was heterogeneous on plain MRI;nodular and heterogeneous enhancement was observed in the tumor with irregular shapes and blurred margins on dynamic contrast-enhanced MRI.The lesion on DWI was hyperintense with a higher mean apparent diffusion coefficient(ADC)value.Finally,a GCT-ST was confirmed by pathology.This case suggests that GCT-ST should be distinguished as a benign soft tissue mass from giant cell-rich soft tissue neoplasms or malignant tumors.CONCLUSION The MRI features of the superficial GCT-ST in the upper limb included heterogeneous signal intensity within the lesion on T2-weighted image(T2WI)and T1-weighted fat-saturation spoiled gradient recalled echo(T1 FSPGR),nodular enhancement with blurred margins,irregular shapes,and a slow-increased enhancement.DWI could be used to differentiate a benign soft tissue mass from a malignant mass by the mean ADC value and provide more radiologic-pathologic information for the diagnosis of GCT-ST.Comprehensive imaging of primary GCT-ST could help complete tumor resection,and in turn likely prolong survival after surgery.展开更多
文摘To evaluate the possibility and accuracy of Doppler tissue image (DTI) on assessment of normal and abnormal ventricular activation and contraction sequence, 9 open chest canine hearts were analyzed by acceleration mode, M mode, and spectrum mode DTI. Our results showed that: (1) Acceleration mode DTI could show the origin of activation and conduction sequence on line; (2) M mode DTI revealed that the activation in mid interventricular septum was earlier than that in mid left ventricular posterior wall at sinus activation; (3) Spectrum DTI showed the ventricular endocardium was activated earlier than the ventricular epicardium in all segments at sinus rhythm. The earliest site of activation of the normal ventricular wall was at middle interventricular septum; the latest site was at basal posterior wall; the contraction sequence was different at the different walls; (4) During abnormal ventricular activation, mid left ventricular posterior wall was activated earliest in accordance with the pacing sites. Abnormal ventricular activation was slower than sinus activation, and the contraction sequence varied at different sites of ventricular wall. It is concluded that DTI can be used to localize the origin of normal or abnormal myocardial activation and to assess the contraction sequence conveniently, accurately and non invasively.
文摘Background: Coronary artery disease (CAD) is often silent in diabetic patients, and it is typically in ad-vanced stages of development by the time it manifests. Various forms of stress testing have been investigated to detect obstructive CAD in diabetes mellitus. Ob-jectives: To assess the diagnostic value of dobutamine stress pulsed-wave Doppler tissue imaging (DTI) compared with standard wall motion analysis in de-tection of myocardial ischemia in diabetic patients with suspected CAD. Methods: The study comprised 46 diabetic patients with suspected CAD underwent dobutamine stress echocardiography (DSE) with DTI within 4 weeks before coronary angiography(CA). Dobutamine infusion started at 5 μ/kg/min and in-creased up to 40 μ/kg/min with additional atropine during submaximal heart rate responses. In addition to wall-motion score index (WMSI) analysis, pulsed- wave DTI examination of basal and mid segments of posteroseptal, lateral, anterior, inferior and antero- septal walls was performed. Myocardial velocities were measured at rest in the apical 4, 3 and 2-cham- ber views. The measurements were repeated at low dose (10 - 15 μ/kg/min) and at peak stress (40 μ/kg/min). DTI measurements included peak systolic velocity (S), peak early diastolic velocity (E) and peak late diastolic velocity (A) and the results were com-pared to WMSI analysis. Patients were classified into two groups according to CA results;group (I) di-abetics with positive CA (n = 27) and group (II) di-abetics with negative CA (n = 19). Results: There was no significant difference between the two groups in duration of diabetes, global WMSI at rest or the ? changes (stress-rest/rest) of WMSI (P > 0.05). Global S and global E were significantly lower in group I compared to group II at peak stress (11.3 ± 3.7 cm/sec vs. 14.5 ± 2.2 cm/sec, p < 0.01) and (11.3 ± 1.6 cm/sec vs. 13.1 ± 2.1 cm/sec, p < 0.01) respectively. The cutoff points for global S and global E to detect obstructive CAD in diabetics were 11.3 cm/s and 11.2 cm/s re-spectively with 75.7%, 73.4% sensitivity and 94.7%, 89.47% specificity respectively. An increment (? changes) less than 0.56 in S or 0.26 in E from rest to peak stress identified CAD with 78.8 %, 89.3% sensi-tivity and 94.7%, 90.7% specificity respectively. The accuracy of DTI parameters during peak stress was higher than WMSI analysis (sensitivity 74.1% vs. 59.3% and specificity 90% vs. 79%, P < 0.01 for each). In multivariate regression analysis, only ?S and ?E were independent predictors of obstructive CAD in diabetics (odd ratio: 36.16, 95% CI, 1.34- 532.01 and 63.77, 95% CI, 3.19-721.47) respectively. Conclusion: Quantitative analysis, using DTI during DSE, adds new dimension in diagnosis of myocardial ischemia. It is more sensitive, specific, accurate and reproducible compared with standard wall motion analysis for recognition of significant CAD in diabetic patients.
文摘Background: Coronary artery disease (CAD) is a paramount cause of death. Global and regional left ventricular (LV) systolic function is an important non-invasive marker of CAD. We can use tissue Doppler imaging (TDI) to measure the low velocities generated by myocardium which are: S'-wave, E'-wave, and A'-wave. We aimed to examine the value of the S'-wave dispersion of TDI across mitral valve annular velocities to predict angiographically significant coronary artery obstruction. Patients and Methods: We included 100 patients with symptoms suggesting CAD. All patients had undergone full history taken and clinical examination;ECG, echocardiographic with assessment of LV function, and Doppler derived mitral valve velocities;TDI with measuring of S'-wave and coronary angiography. Lesions with ≥70% or more stenosis in major epicardial artery or ≥50% stenosis in the left main coronary artery were considered significant. Patients were classified into two groups according to the presence or absence of significant coronary stenosis. Results: Clinical and conventional echocardiographic and Tissue Doppler measures were comparable between the two groups;there was statisticallysignificant difference between Group I and Group II (P value;patients with significant coronary arteries lesions have higher S' wave dispersion as compared with patients with normal or mild significant coronary lesions. Conclusion: S'-wave dispersion may consider a good predictor of angiographically significant coronary artery disease.
文摘Objective To examine the clinical application of pulsed Doppler tissue imaging(DTI)for regional left ventricular function assessment in normal subjects. Methods We examined 50 healthy subjects(range 12-42 years,mean age 28.3 ± 6.9 years)using pulsed Doppler tissue imaging to characterize the diastolic and systolic velocity profiles of mitral annulus. Recordings were made along the long axis in the apical 4-chamber, 2-chamber, and long apical views of 6 sites(posterior-septum, lateral, anterior, inferior, anterior-septum, posterior)at the mitral annulus. Myocardial velocities were determined with use of variance F statistical analysis. Correlation analysis was employed to test the relationship between age and mitral annular velocities. Results Both early diastolic and systolic velocities at the septum were lower than other sites. There were no differences in mitral annulus late diastolic velocities. Mean early diastolic and systolic velocities was negatively correlated with age. Conclusions Doppler tissue imaging can directly reflect regional left ventricular function.
文摘To explore the feasibility of using tissue Doppler imaging technique for the evaluation of fetus’s left ventricular diastolic function, and to confirm its reliability by comparing it with traditional methods, this study examined 61 pregnant women in whom satisfactory images were obtained of fetal echocardiography. The peak velocity of blood stream were measured, including E, A and E/A at mitral valve orifice on the four chamber view with pulse wave. And then tissue Doppler imaging mode was employed to measure the velocity of mitral valve annulus including Ea, Aa, Sa and Ea /Aa. Correlation analysis was conducted between the velocity of orifice and that of annulus in terms of gestation age. And then correlation analysis was performed between above data and gestation ages. A positive correlation was found between the velocity of orifice and that of annulus, and the velocity increased with the gestation age. The change was the most significant between the 28th and the 34th week of gestation age. Our study showed that it is feasible to evaluate the fetus’s left ventricular diastole function by tissue Doppler imaging. Its stability can avoid the influence of fetal heart rates and preload.
文摘To determine the clinical application of pulsed Doppler tissue imaging in assessing the left ventricular diasto-lic function and in discriminating between normal subjects and patients with hypertrophic cardiomyopathy with various stages of diastolic dysfunction. Methods We measured the peak diastolic velocities of mitral annulus in 81 patients with hypertrophic cardiomyopathy with various stages of diastolic dysfunction and 50 normal volunteers by Doppler tissue imaging using the apical window at 2-ch-amber and long apical views, respectively. The myocardial velocities were determined with use of variance F statistical analysis. Results Early diastolic myocardial velocities of mitral annulus were higher in normal subjects than in patients with hy-pertrophic cardiomyopathy with either delayed relaxation, pseudonormal filling, or restrictive filling. However, peak myocar-dial velocities of mitral annulus during atrial contraction were similar in normal subjects and patients with hypertrophic cardiomyopathy. Conclusion Doppler tissue imaging can directly reflect upon left diastolic ventricular function. Early phase of diastole was the best discriminator between control subjects and patients with hypertrophic cardiomyopathy.
基金supported in part by Grant-in-Aid for JSPS Research Fellow
文摘Ectopic adiposity has gained considerable attention because of its tight association with metabolic and cardiovascular health in persons with spinal cord injury(SCI). Ectopic adiposity is characterized by the storage of adipose tissue in non-subcutaneous sites. Magnetic resonance imaging(MRI) has proven to be an effective tool in quantifying ectopic adiposity and provides the opportunity to measure different adipose depots including intermuscular adipose tissue(IMAT) and intramuscular adipose tissue(Intra MAT) or intramuscular fat(IMF). It is highly important to distinguish and clearly define these compartments, because controversy still exists on how to accurately quantify these adipose depots. Investigators have relied on separating muscle from fat pixels based on their characteristic signal intensities. A common technique is plotting a threshold histogram that clearly separates between muscle and fat peaks. The cut-offs to separate between muscle and fat peaks are still not clearly defined and different cut-offs have been identified. This review will outline and compare the Midpoint and Otsu techniques, two methods used to determine the threshold between muscle and fat pixels on T1 weighted MRI. The process of water/fat segmentation using the Dixon method will also be outlined. We are hopeful that this review will trigger more research towards accurately quantifying ectopic adiposity due to its high relevance to cardiometabolic health after SCI.
文摘Objective: To construct an animal model of chronic ischemic myocardium, and evaluate it by ultrasonic integrated backscatter (IBS) and Doppler tissue imaging (DTI). Methods: An Ameroid constrictor was placed around the porcine left circumflex coronary artery (LCX). The calibrated average image intensity (%AII), cyclic variation of IBS (CVIB), transmural gradient index (TGI) of CVIB in lateral-posterior wall (LPW), and DTI spectrum of LPW in left ventricular papillary muscle level short axis view (LVPM-SAM) and apical four chamber view (AP-4CV) at normal state, 2, 4, 6 and 8 weeks postoperatively were measured. Results: Normal %AII, CVIB and TGI were 2.29±0.32, 9.69±2.22dB and 0.22±0.08, respectively. The %AII increased gradually postoperatively. The CVIB decreased also gradually, and the decrease was higher in subepicardium than in subendocardium. Most of TGI decrease occurred from 2 to 4 weeks postoperatively and became zero at 8 weeks (P<0.01); Normal V S (peak systolic velocity) of AP-4CV was higher than that of LVPM-SAM (P<0.01). V E (peak early diastolic velocity) of AP-4CV was lower than that of LVPM-SAM (P<0.05). V S and V E were all decreased after operation (P<0.01). The decrease of V S in AP-4CV was greater than that in LVPM-SAM. Conclusion: The pathological changes of the myocardium in human ischemic heart disease (IHD) are similar to that of Ameriod model. IBS and DTI can detect echo changes and ventricular wall motion in chronic ischemic myocardium, and provide more information for clinical investigation and treatment of IHD.
文摘Objectives To quantitatively analyze the longitudinal myocardial systolic and diastolic velocities and time intervals of the left ventricle in normal subjects, and to explore the value of pulsed Doppler tissue imaging (DTI) for the assessment of left ventricular systolic and diastolic synchronicity. Methods Twenty and six healthy subjects were studied by pulsed DTI. The septal and lateral, anterior and inferior walls of the left ventricle were displayed respectively, and basal and middle segments of each wall were selected for myocardial motion spectrum sampling. DTI parameters were; peak systolic myocardial velocity (s) , regional pre-ejection period (PEP), time to the peak of s wave (Ts), regional ejection time (ET); peak early diastolic velocity (e), peak late diastolic velocity (a), e/a ratio, time to the beginning of e wave (QE), time to the peak of e wave (Te) and regional isovolumic relaxation time (IVRT). Results The e and e/a were significantly different among basal segments, and s and e/a were significantly different among middle segments, with the highest value in lateral segments and the lowest value in septal segments. The s, e and a were all significandy higher in basal segments than middle segments. None of the systolic time intervals (PEP, Ts and ET) and diastolic time intervals (QE, Te and IVRT) were significantly different among basal segments and middle segments, neither were they when basal segment was compared with middle segment. Conclusions In normal subjects, the longitudinal myocardial systolic and diastolic velocities of the left ventricle are not homogeneous, but the contraction and relaxation are highly synchronized. Pulsed DTI can be used to quantitatively analyze the systolic and diastolic synchronicity of the heart.
文摘Objectives To assess the prevalence of systolic dyssynchrony of the left ventricular (LV) walls in patients of heart failure(HF) with a normal QRS duration by Doppler tissue imaging (DTI). Methods 20 patients of HF with a normal QRS duration and 20 healthy individuals were investigated with DTI to quantitatively analyze their pulsed-wave Doppler spectrum of basal and middle segments in six walls of left ventricle. The time between the onset of the QRS complex of the surface ECG and the onset of the systolic wave of pulsed-wave Doppler spectrum was measured (TS). LV systolic synchronization was assessed by the maximal difference (MD) in time of TS, the standard deviation (SD) and the coefficient of variation (CV) of TS in the all 12 LV segments. Results When a TS-MD of TS> 53.08 ms, a TS-SD of TS >18.08 ms and a TS-CV of TS > 0.91 (+1.65 SD of normal controls) was used to define significant systolic dyssynchrony, the prevalence of systolic dyssynchrony was 55.0 %, 55.0 % and 55.0 %, respectively, in the HF patients group, significantly higher than those in the normal control and the locations of delayed contraction of these patients were different. Conclusions LV systolic dyssynchrony could be commonly demonstrated by DTI in HF patients with a normal QRS duration. This finding will support the view about the possibility that more HF patients could benefit from cardiac resynchronization therapy.
文摘To investigate the validity and accuracy of tissue Doppler imaging (TDI) using a novel balloon phantom, validation of TDI myocardial velocity measurements has been carried out indirectly from conventional M mode images. However it is not a true and independent gold standard. We described a new TDI validation method by using a specially developed left ventricular balloon model mounted in a water bath and constructed using two pear shaped balloons. It was connected to a pulsatile flow pump at 8 stroke volumes (50-85 ml/beat). The displacement and velocity of the balloon walls were recorded simultaneously by video imaging and TDI on a GE Vingmed System Five with a 5 MHz phased array probe at the highest frame rates available. Conventional M mode and 2 D imaging verified that our balloon model mimicked the shape and wall motion of left ventricle. There was a good correlation and agreement between the maximum video excursion of the anterior and posterior walls of the phantom and the results of the temporal integration of digital distance data by TDI (Anterior wall: r =0.97, SEE=0.24 mm, ±s =0.04±0.24 mm; Posterior wall: r =0.95, SEE=0.22 mm, ±s =0.03±0.24 mm). Analysis of the velocity profile by the TDI method showed that the velocity at each measured point was correlated well with the velocity obtained from the video images (Anterior wall: r =0.97, SEE=0.30 mm, ±s =-0.04±0.28 mm; Posterior wall: r =0.97, SEE=0.30 mm, ±s =0.04±0.28 mm). Our balloon model provided a new independent method for the validation of TDI data. This study demonstrated that the present TDI system is reliable for measuring wall motion distance and velocity.
基金supported by the National Natural Science Foundation of China,No.81301050,81401067,81271392,81471275,81541034the Natural Science Foundation of Tianjin City of China,No.14JCQNJC10200,15JCQNJC11100,16JCYBJC27600
文摘Conventional fabrication methods lack the ability to control both macro-and micro-structures of generated scaffolds. Three-dimensional printing is a solid free-form fabrication method that provides novel ways to create customized scaffolds with high precision and accuracy. In this study, an electrically controlled cortical impactor was used to induce randomized brain tissue defects. The overall shape of scaffolds was designed using rat-specific anatomical data obtained from magnetic resonance imaging, and the internal structure was created by computer-aided design. As the result of limitations arising from insufficient resolution of the manufacturing process, we magnified the size of the cavity model prototype five-fold to successfully fabricate customized collagen-chitosan scaffolds using three-dimensional printing. Results demonstrated that scaffolds have three-dimensional porous structures, high porosity, highly specific surface areas, pore connectivity and good internal characteristics. Neural stem cells co-cultured with scaffolds showed good viability, indicating good biocompatibility and biodegradability. This technique may be a promising new strategy for regenerating complex damaged brain tissues, and helps pave the way toward personalized medicine.
文摘Background: Heart failure (HF) is a common clinical syndrome mostly due to the impaired ability of the Left Ventricle (LV) to eject blood with reduced cardiac output. Heart failure is called systolic (SHF) if left ventricle ejection fraction on echo-cardiogram is low (LVEF of ≤50%). Aim: To assess the echocardiographic characteristics of patients with SHF with Atrial Fibrillation (AF) and compare with those with Sinus Rhythm (SR) on 12 leads ECG. Furthermore, to evaluate the clinical and biochemical markers for the prediction of AF in SHF. Method: Over two years duration, each patient diagnosed with SHF was enrolled in the study (n = 354) based on admission code. AF or sinus rhythm on 12 leads ECG was documented on each patient. Multiple logistic regression analysis was applied to assess the risk ratio of different clinical and Doppler derived variables for the development of AF in SHF. Results: Out of the total hospital medical admissions of 14,674 patients, there were 354 patients with diagnosis of SHF, a prevalence of 2.4%. The incidence of AF on ECG was 109 (31%) patients in the whole study population and 245 (69%) in SR. M Mode echocardiogram in patients with SHF and AF compared with those in SR showed significant dilation of LV cavity in systole with LVESD of 5.72 ± 0.63 vs. 5.23 ± 0.76 cm, P < 0.001 and in Diastole LVEDD of 6.83 ± 0.51 vs. 6.58 ± 0.63 cm, P < 0.001. Pulsed Doppler echocardiogram showed a severe restrictive-pattern with shorter Decellration Time (DT) of 163.73 ± 7.42 vs. 214.9 ± 31.81msec, P < 0.001 and higher Pulse to Tissue Doppler ratio of E/Em of 14.26 ± 1.34 vs. 9.99 ± 1.27, P , and the serum level of Brain Natriuretic Peptide (BNP) hormone of 723.72 ± 13.45 vs. 686.98 ± 72.57 pg/ml, P < 0.001. The predictive risks (odd ratio) of different clinical variables for the development of AF in SHF were positive for high BNP > 500 pg/ml of 2.8, history of hypertension of 1.8, history of DM of 1.7, BMI > 28 of 1.4, LV hypertrophy on ECG of 1.3. Conclusions: The prevalence of Systolic Heart Failure in the study population was 2.4%. The prevalence of AF in the study population was 31%. The best predictors of AF in SHF were high BNP > 500 pg/ml, history of hypertension, Diabete Mellitus and LV Hypertrophy on ECG.
文摘Diagnosis of extremity soft-tissue tumors can be challenging.Characteristics of tumor margins can help precisely identify locally aggressive or non-aggressive behavior for surgical planning,but cannot differentiate benign from malignant lesions.Most malignant tumors can have inhomogeneous signals on T2-weighted images.Although a uniform signal on T2-weighted images can be a reliable indication of a benign lesion,a well-defined mass with homogeneous internal signal intensity does not definitively identify a benign lesion.Some common and distinctive soft-tissue lesions can have specific clinical and imaging features allowing a diagnosis without biopsy.These are known as determinate lesions.This illustrative report presents a diagnostic guide for extremity soft-tissue tumors based on tissue signal and morphological characteristics on magnetic resonance images.It is important for clinicians to be familiar with the imaging characteristics of common determinate lesions.
文摘Background: Symptoms of heart failure (HF) are identical in both systolic (SHF) and diastolic hear failure (DHF). The prevalence of atrial fibrillation (AF) in heart failure varies in different studies depending on the criteria of enrollment and the use of echocardiographic parameters in the definition of HF. Aim: To assess the clinical characteristic of pa- tients with DHF complicated by AF and compare with those with SHF in regard of echocardiographic abnormalities and causative agents. Furthermore, evaluate the clinical and biochemical markers for the prediction of AF in HF. Method: Over the duration of 12 months, each patient diagnosed as HF based on admission code was enrolled in the study. Patients were classified into two groups: group 1: DHF, with preserved LVPEF% > 50%, n = 204 (60%), and group 2, with SHF, with LVREF% ≤ 50%, n = 140 (40%). The presence or absence of AF on ECG was recorded. The predictive value of different clinical and biochemical variables for the development of AF was evaluated using logistic multiple regression analysis. Results: Three hundred and forty four eligible patients were admitted to hospital with heart failure out of 7650 who had other medical problems. The prevalence of HF in this population was 4.5%, those with DHF were 2.7% and SHF of 1.8%. The incidence of AF on ECG was 35% in the whole study population and 65% were in sinus rhythm (SR). The occurrence of AF was twice higher in DHF patients of 22% compared with 11% in SHF. Echo pulsed Doppler in DHF and AF compared with those in SR showed a severe restrictive pattern with significantly thick septum wall, higher LV mass index, shorter DT and higher E/e? ratio of 12.4 vs. 9.73, P 0.05. The predictive risk (odd ratio) of different clinical variables for development of AF in HF was positive for LV hypertrophy on ECG of 2.4, history of hypertension of 1.6, history of DM of 1.4, BMI > 28 of 1.7. Conclusions: The prevalence of HF was 4.5% in the study population, with SHF of 1.8% and DHF of 2.7%. Patients with DHF and AF were older with a higher female ratio with severe restrictive pattern compared with those of SHF. The incidence of AF in the whole study was 35%. The best predictor of AF in HF was left ventricle hypertrophy followed by history of hypertension and DM.
文摘<span style="white-space:nowrap;font-family:Verdana;"><strong>Background: </strong></span>This study aimed to determine the impact of the percutaneous coronary intervention (PCI) on myocardial function assessed by tissue Doppler echocardiography.<span style="font-family:;" "=""> </span><b><span style="font-family:Verdana;">Methods:</span></b><i><span style="font-family:;" "=""> </span></i><span style="font-family:;" "=""><span style="font-family:Verdana;">Conventional two-dimensional echocardiography</span><b> </b><span style="font-family:Verdana;">and</span><i> </i><span style="font-family:Verdana;">Myocardial tissue peak velocities were recorded at the lateral, ant.septal, post.septal, posterior, ant. and inferior angles of the mitral annulus as well as at the lateral tricuspid annulus by pulsed-wave tissue Doppler echocardiography before PCI, as well as 1 day and 6 weeks after intervention.</span></span><span style="font-family:;" "=""> </span><b><span style="font-family:Verdana;">Results:</span></b><i><span style="font-family:;" "=""> </span></i><span style="font-family:;" "=""><span style="font-family:Verdana;">Fifty consecutive patients with chronic stable angina and </span><span style="font-family:Verdana;">preserved systolic left ventricular function (mean age, 58.3 ± 6.594 years;32 men) undergoing PCI were studied. Conventional echocardiographic revealed no statistically significant difference between pre- and post-PCI (1 day after PCI and 6</span><span style="font-family:Verdana;"> weeks after PCI) as regarding trans-mitral and trans-tricuspid flow velocities except as regarding LVEDD, LVESD and LVEF which showed a significant improvement post-PCI. Compared with pre-interventional values, systolic peak velocity and early diastolic velocities improved at all sites (P ≤ </span></span><span style="font-family:Verdana;">0</span><span style="font-family:Verdana;">.05 for each). The most pronounced improvement occurred in the septal area. Similarly, late diastolic velocities improved at all sites (P ≤ </span><span style="font-family:Verdana;">0</span><span style="font-family:Verdana;">.05 for each) except at post</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">Wall A’. Also, there was a significant improvement of E’DT & E’/A’ ratio after PCI (P value is significant <0.05 for each) but there was insignificant difference between pre & post PCI for E/E’ (P-value = 0.154). There was a significant improvement in tissue Doppler measures of early, late diastolic function and E’/A’ at the lateral tricuspid annulus after PCI compared with baseline values (P value is significant <0.05) but there was an insignificant change in tissue Doppler measures at the lateral tricuspid annulus of E’DT & E/E’ after PCI (repeated measures ANOVA P-value is >0.05 for each). There were significant reductions in IVRT, IVCT & MPI after PCI (P value is significant <0.05 for each) but there was insignificant change in ET after PCI (P-value = 0.09) at the septal angle of the mitral annulus and the lateral angle of the tricuspid annulus.</span><span style="font-family:;" "=""> </span><b><span style="font-family:Verdana;">Conclusions:</span></b><span style="font-family:Verdana;"> Tissue Doppler parameters of diastolic and systolic function improve early after successful PCI, and this effect persists to 6 weeks after the intervention that emphasizes its value in the improvement of regional and global LV functions and myocardial contractility.</span>
基金supported by the National Natural Science Foundation of China(Grant No.:81703466)the Outstanding Talents Research Start-up Fund of Xuzhou Medical University,China(Grant No.:RC20552107)Xuzhou Science and Technology Bureau,China(Grant No.:KC21292).
文摘Fluorescence imaging is a noninvasive and dynamic real-time imaging technique;however,it exhibits poor spatial resolution in centimeter-deep tissues because biological tissues are highly scattering media for optical radiation.The recently developed ultrasound-controlled fluorescence(UCF)imaging is a novel imaging technique that can overcome this bottleneck.Previous studies suggest that the effective contrast agent and sensitive imaging system are the two pivotal factors for generating high-resolution UCF images ex vivo and/or in vivo.Here,this review highlights the recent advances(2015e2020)in the design and synthesis of contrast agents and the improvement of imaging systems to realize high-resolution UCF imaging of deep tissues.The imaging performances of various UCF systems,including the signal-to-noise ratio,imaging resolution,and imaging depth,are specifically discussed.In addition,the challenges and prospects are highlighted.With continuously increasing research interest in this field and emerging multidisciplinary applications,UCF imaging with higher spatial resolution and larger imaging depth may be developed shortly,which is expected to have a far-reaching impact on disease surveillance and/or therapy.
基金Supported by National Natural Science Foundation of China,No.81502274National Natural Science Foundation of China(General Program),No.81771804Guiding Plan of Natural Science Foundation in Liaoning,China,No.2019-ZD-0907。
文摘BACKGROUND Primary soft tissue giant cell tumor(GCT-ST)is rare and has relatively low malignant potential.Most reports are pathological and clinical studies,while imaging studies have only been reported in cases of adjacent bone or with atypical cystic degeneration.With regard to the findings on magnetic resonance imaging(MRI)or ultrasonography,superficial masses can be further identified based on facial edema,skin thickening,skin contact,internal hemorrhage or necrosis and lobulation of the mass.Unlike deep-seated masses,MRI features do not always provide an accurate diagnosis for benign and malignant patients with superficial soft-tissue lesions.Thus,the application of diffusion-weighted imaging(DWI)to evaluate superficial soft tissue tumors is necessary.CASE SUMMARY A 36-year-old woman who had a suspected malignant tumor in the upper limb on ultrasound and computed tomography is reported.The signal intensity of the suspected tumor was heterogeneous on plain MRI;nodular and heterogeneous enhancement was observed in the tumor with irregular shapes and blurred margins on dynamic contrast-enhanced MRI.The lesion on DWI was hyperintense with a higher mean apparent diffusion coefficient(ADC)value.Finally,a GCT-ST was confirmed by pathology.This case suggests that GCT-ST should be distinguished as a benign soft tissue mass from giant cell-rich soft tissue neoplasms or malignant tumors.CONCLUSION The MRI features of the superficial GCT-ST in the upper limb included heterogeneous signal intensity within the lesion on T2-weighted image(T2WI)and T1-weighted fat-saturation spoiled gradient recalled echo(T1 FSPGR),nodular enhancement with blurred margins,irregular shapes,and a slow-increased enhancement.DWI could be used to differentiate a benign soft tissue mass from a malignant mass by the mean ADC value and provide more radiologic-pathologic information for the diagnosis of GCT-ST.Comprehensive imaging of primary GCT-ST could help complete tumor resection,and in turn likely prolong survival after surgery.
