ObjectiveBy comparing the difference between different stenosed degree of aortic valve in flow field uniformity and turbulent shear stress (TSS), to explore the relation between flow field uniformity and different stenosed degree of aortic valve, and probe the clinical value for deciding the operation timing, and analyze the possible role of TSS in the progress of the disease.MethodsThe flow field uniformity values and TSS in parasternal long axis plane and apical five cavity plane on each point were measured and calculated by pulse wave Doppler echocardiography technique for 33 patients with different stenosed degree of aortic valve.ResultsThere were significant difference between the different stenosed degree of aortic valve in maximal velocity difference(ΔV max )and TSS( P lt;0.05, 0.01). The more severe the aortic stenosis was, the worse the flow field uniformity was, the lower the TSS was.ConclusionsThere are significant difference between the patients of different stenosed degree of aortic valve in flow field uniformity. Flow field uniformity has important value in classifying the degree of aortic stenosis and deciding the timing of operation. The more severe the aortic stenosis is ,the lower TSS is. It can be thought that low TSS distribution has important role in pathological process of constriction in cardiovascular system diseases.
ObjectiveTo observe the diagnostic sensitivity and specificity of color Doppler flow imaging (CDFI) for persistent hyperplastic primary vitreous (PHPV).
MethodsThe clinical data of 71 children (93 eyes) with congenital cataract which suspected of concurrent PHPV were retrospectively analyzed. The children included 45 males (54 eyes) and 26 females (39 eyes), aged from 1 to 24 months, with an average age of (7.6±4.3) months. All eyes were examined by CDFI, and observe whether there was a pathological strip in the vitreous, the site of the connection between the strip echo and the wall of the eye and the signal of blood flow on the strip echo. Within 1 week after a CDFI examination under general anesthesia, 64 children (79 eyes) underwent lens excision combined with vitrectomy and the other 14 eyes of 7 children underwent mydriatic fundus examination by two experienced eye specialists. Combined with clinical features of PHPV, the diagnosis and differential diagnosis were made according to the clouding of the lens, posterior capsule proliferation, vitreous proliferation and retinal detachment position which were found during operation and fundus examination. Compare and analyze the CDFI examination results and the above diagnosis results, calculate the sensitivity and specificity of CDFI for PHPV.
ResultsIn surgery and mydriatic fundus examination results of 93 eyes, vitreous abnormal in 85 eyes, no significant changes were found in vitreous of the other 8 eyes. In 85 eyes of abnormal vitreous, 68 eyes were diagnosed as PHPV, 16 eyes were diagnosed as familial exudative vitreoretinopathy (FEVR), and 1 eye was diagnosed as treactional retinal detachment. In 85 eyes of abnormal vitreous which were found by surgery and fundus examination, CDFI confirmed 81 eyes and its diagnostic sensitivity was 95.3%; the other 4 eyes were not found vitreous abnormality, and the missed diagnosis rate was 4.7%. Surgery and mydriatic fundus examination found no vitreous abnormal in 8 eyes, but CDFI explored strip low echo connected with the optic disc or posterior lens capsule in vitreous. In the 68 eyes of PHPV which were diagnosed by surgery or fundus examination, 59 eyes had the same diagnosis of CDFI, the sensitivity of CDFI was 86.8%; PHPV was not diagnosed in 25 eyes by surgery or fundus examination, but only 8 eyes were also not diagnosed by CDFI, and the specificity of CDFI was 32.0%. The remaining 17 eyes were diagnosed as FEVR in 16 eyes and traction retinal detachment in 1 eye after surgery or mydriatic fundus examination, but they were all diagnosed as PHPV in CDFI. The misdiagnosis rate of CDFI was 68.0%.
ConclusionFor PHPV, the diagnostic sensitivity and specificity of CDFI are 86.8% and 32.0%, respectively.
【Abstract】 Objective To compare the accuracy of color-doppler ultrasonography, mammography and near-infrared light scanning for diagnosing breast diseases. Methods The diagnostic accuracy of the above three imaging methods were analyzed and compared with each other on the basis of the postoperative pathological results. ResultsFive hundreds and sixty-five cases (breast cancer: 274 cases, benign diseases: 291 cases) were examined. The sensitivity of color-doppler ultrasonography, mammography and near-infrared light scanning for diagnosing breast cancer were 83.7%(200/239), 84.2%(64/76) and 76.9%(100/130), respectively. The specificity were 88.6%(226/255), 93.2%(69/74) and 82.6%(114/138), and the accuracy were 86.2%(426/494), 88.7%(133/150) and 79.9%(214/268), respectively. Color-doppler ultrasonography and mammography were superior to near-infrared light in the item of accuracy (P＜0.05), especially for lesions of breast cancers that were less than 2 cm. The false negative rate of near-infrared light was higher (48.8%, 21/43）than those of the other methods in detecting breast cancer at early stage. The sensitivity for detecting intraductal papilloma and inflammation of breast using color-doppler ultrasonography were 58.8%(10/17) and 69.2%(18/26), respectively, which were higher than that of near-infrared light scanning 〔0 and 23.5%(4/17)， P＜0.05 and P＜0.01〕. The sensitivity and the accuracy of near-infrared light without physical examination reduced significantly, in which the sensitivity reduced from 76.9%(100/130) to 56.9%(74/130), P＜0.01, and the accuracy reduced from 79.9%(214/298) to 61.9%(166/268), P＜0.01. Conclusion Color-doppler ultrasonography and mammography are accurate imaging methods for diagnosing breast diseases.
ObjectiveTo evaluate liver perfusion in pregnant women with hepatitis between 13 and 41 weeks of gestation by three-dimensional color power Doppler angiography (3D-CPA) vascular indexes.
MethodsThis study involved 73 pregnant women with hepatitis and 44 healthy pregnant women who had the pregnancy examination between February 2012 and June 2013. We sampled in the area which was near the right lobe of the pregnant women liver's portal vein branch, and obtained the vascularization index (VI), flow index (FI) and vascularization flow index (VFI) via the virtual organ computer-aided analysis (VOCAL) method. Then, we compared the liver perfusion differences between the pregnant women with hepatitis and healthy pregnant women.
ResultsThe hepatic flow indexes obtained by 3D-CPA were significantly different between the HBV-DNA viral load and the control groups. The cutoff values of the three vascular indexes of patients with hepatitis with HBV-DNA viral load and the healthy pregnant women were respectively VI=8.760 (P<3×10-4); FI=22.180 (P<6×10-7); and VFI=1.575 (P<3×10-5).
ConclusionApplication of the 3D-CPA on liver perfusion may differentiate pregnant women with hepatitis B from normal ones, thus offer a support for clinical prevention and treatment for pregnant women with hepatitis B.
【摘要】 目的 探討2型糖尿病（T2DM）胰島素抵抗導致糖尿病性心功能不全的臨床表現特點及相關激素的改變。 方法 2008年1-4月對T2DM患者35例（胰島素抵抗指數HOMA-IRlt;2.69者19例為A1組，HOMA-IR≥2.69者16例為A2組）及健康體檢者20人B組測體重指數（BMI）、空腹血糖（FPG）、胰島素、心鈉素（ANP）、腦鈉素（BNP）水平；心臟彩色多普勒超聲分別測E/A、e/a、S/D、LVEF、DT期。 結果 A2組BMI較A1、B組均明顯增加（Plt;0.05），A1、B組間差異無統計學意義（Pgt;0.05）。ANP、BNP及DT值在A1、A2組均較B組增高（Plt;0.05），BNP在A2組高于A1組（Plt;0.05），ANP、DT值在A1、A2組間差異均無統計學意義（Pgt;0.05）。E/A、e/a和S/D在A1、A2組均較B組降低（Plt;0.05），A1、A2組間差異均無統計學意義（Pgt;0.05）。A2組患者LVEF較A1、B組均明顯降低（Plt;0.05），A1、B組間差異無統計學意義（Pgt;0.05）。 結論 隨著胰島素抵抗加重，心肌舒張順應性較差和收縮力下降，伴隨相關激素（心臟利鈉肽）分泌增加，最終產生心功能不全的臨床表現、體征及多普勒超聲心動圖表現。【Abstract】 Objective To investigate the clinical features and related hormone changes of diabetic cardiac insufficiency leaded by insulin resistance in type 2 diabetes mellitus (T2DM). Methods From January to April 2008, 35 patients with T2DM (group A1: HOMA-IRlt;2.69, n=19; group A2: HOMA-IR≥ 2.69, n=16) and 20 subjects without T2DM (group B) were enrolled. The body mass index (BMI), fasting plasma glucose (FPG), insulin (FINS), atrial natriuretic peptide (ANP), brain natriuretic peptide (BNP), and E/A, e/a, S/D, LVEF and DT stage of all subjects were detected. Results The BMI in group A2 was higher than those in group A1 and group B (Plt;0.05), while the difference between the later two groups was not statistically significant (Pgt;0.05). The ANP, BNP and DT stage were all higher than those in group B (Plt;0.05), the BNP was higher in group A2 than in group A1 (Plt;0.05), while the difference of neither ANP nor DT stage between the later two groups was statistically significant (Pgt;0.05). The values of E/A, e/a and S/D in group A1 and A2 were all lower than those in group B (Plt;0.05), while there were no statistically significant diferences between group A1 and A2 (Pgt;0.05). The values of LVEF of group A1 and A2 were both significantly reduced than that in group B (Plt;0.05), and the values in group A2 were the lowest (Plt;0.05). Conclusion With the aggravating of insulin resistance, myocardial contractility and diastolic function will decline, meanwhile the ANP and BNP secretion will increase, and then the clinical and echocardiographic manifestation will appear.
