Evaluation of right heart function changes in patients with pulmonary hypertension via two-dimensional speckle tracking imaging: a retrospective study.

Objective: To realize the changes in pulmonary hypertension (PH) patients' right ventricular function.Methods: A total number of 74 patients with PH were included, and the parameters of standard echocardiographic were measured as well as the strain of peak longitudinal of each segment during the systole of the right ventricle to calculate the global longitudinal strain (LS) during systole of the right ventricular free wall.Results: ① As pulmonary arterial pressure increased, the right ventricular area gradually increased, and the case group showed the decreased right ventricular fractional area change (RVFAC), tricuspid annular plane systolic excursion (TAPSE), and tricuspid annular peak systolic velocity (S') (p < 0.05). They, RVFAC, and TAPSE depicted significant differences that were statistical (p < 0.05) from the other groups. ② With increasing pulmonary arterial pressure, the right ventricular free wall's LS gradually reduced (p < 0.05).Conclusion: ① LS right ventricular free wall is useful in detecting changes in right ventricular systolic function early on with greater sensitivity than RVFAC, TAPSE, and S'. In addition, increased right ventricular pressure loading can result in a subsequent impairment of right ventricular myocardial mechanics. ② As right ventricular pressure loading increases, right ventricular strain decreases. ③ In mild PH, the right ventricular free wall's. LS is more sensitive than standard measures in spotting early alterations in myocardial mechanics.

Analysis of the Influence of Thyroid Nodule Characteristics on the Results of Shear Wave Elastography.

Objective: To analyze the ultrasonic characteristics of false-negative and false-positive results of shear wave elastography (SWE) in the diagnosis of thyroid nodules to clarify the influence of nodular characteristics on SWE and to guide the clinical application of SWE. Methods: A total of 435 thyroid nodules from 343 patients with the diagnosis confirmed by surgical pathology were analyzed. Preoperative ultrasonography and SWE were conducted. The conventional ultrasound characteristics of thyroid nodules and the maximum Young's modulus were recorded. The false negativity and false positivity of SWE for the diagnosis of thyroid nodules were calculated. The ultrasonic characteristics of thyroid nodules with SWE false results were analyzed, and logistic regression analysis was adopted to determine the ultrasonic characteristics associated with SWE false results of thyroid nodules. Results: Among 323 malignant nodules, the SWE false negativity was 27.2% (88/323). The false positivity of SWE in 112 benign nodules was 19.6% (22/112). Regression analysis showed that an increase in the nodule volume increased the risk of SWE false-positive results (odds ratio [OR] 3.286; 95% confidence interval [CI]: 1.572-6.871; P = 0.002) and decreased the risk of false-negative results (OR 0.238; 95% CI: 0.115-0.493; P < 0.001). Nodules with coarse calcification had an increased risk of SWE false-positive results compared with those without calcification (OR 5.303; 95% CI: 1.098-25.619; P = 0.038). However, nodules with scattered hyperechoic foci had a reduced risk of SWE false-negative results (OR 0.515; 95% CI: 0.280-0.951; P = 0.034). Conclusion: Nodular size and calcification were correlated with SWE false results, and the clinical application of SWE should be combined with conventional ultrasound features. Fine needle aspiration or a puncture biopsy should be conducted if necessary.

Clinical Value of Shear Wave Elastography Color Scores in Classifying Thyroid Nodules.

OBJECTIVE: To evaluate the clinical value of qualitative shear wave elastography (SWE) color in the differential diagnosis of benign and malignant thyroid nodules. METHODS: From January 2017 to July 2018, 241 patients with 261 thyroid nodules, who underwent conventional ultrasonography and SWE examination before surgical resection, were enrolled. The nodules were also evaluated by histopathologic analyses. The SWE color characteristics that could differentiate malignant and benign thyroid nodules were selected and scored based on the malignancy rate. The diagnostic performances were evaluated by receiver operating characteristic (ROC) curves analysis. RESULTS: Among the 261 thyroid nodules, 58 were benign, and 203 were malignant. Malignancy was associated with orange or red as the color of maximum hardness inside a nodule, green as the primary color, with a "stiff rim," inhomogeneous internal color, and inhomogeneous color between the nodules and its surrounding areas. The SWE color scores for benign thyroid nodules were mainly 0 and 1, while 4 and 5 were for malignant thyroid nodules. The area under the ROC curve (AUC) of the SWE color score ≥3 for the diagnosis of malignant thyroid nodules was 0.828 (95% CI: 0.764, 0.891) with a sensitivity of 82.8%, a specificity of 82.8%, and an accuracy of 83.1%. Additionally, conventional ultrasound combined with SWE color scores had a higher diagnostic performance than conventional ultrasound (AUC 0.820 vs AUC 0.796, P = 0.04). CONCLUSION: The SWE color scores might be a convenient and effective method to assist in differentiating thyroid nodules.

Corrigendum to "Intraoperative Contrast Enhanced Ultrasound Evaluates the Grade of Glioma".

[This corrects the article DOI: 10.1155/2016/2643862.].

Intraoperative Contrast Enhanced Ultrasound Evaluates the Grade of Glioma.

OBJECTIVE: The aim of our study was to investigate the value of intraoperative contrast enhanced ultrasound (CEUS) for evaluating the grade of glioma and the correlation between microvessel density (MVD) and vascular endothelial growth factor (VEGF). METHODS: We performed intraoperative conventional ultrasound (CUS) and CEUS on 88 patients with gliomas. All of the patients have undergone surgery and obtained the results of pathology. All patients have undergone intraoperative CUS and CEUS to compare the characteristics of different grade gliomas and the results of CUS and CEUS were compared with pathological results. RESULTS: The time to start (TTS) and time to peak (TTP) of low grade glioma (LGG) were similar to those of edema and normal brain surrounding glioma. The enhanced extent of LGG was higher than that of the normal brain and edema. The TTS and TTP of high grade glioma were earlier than those of the edema and normal brain surrounding glioma. The enhancement of HGG was higher than that of LGG. The absolute peak intensity (API) was correlated with MVD and VEGF. CONCLUSION: Intraoperative CEUS could help in determining boundary of peritumoral brain edema of glioma. Intraoperative CEUS parameters in cerebral gliomas could indirectly reflect the information of MVD and VEGF.

Intraoperative contrast-enhanced ultrasound in traumatic brain surgery.

OBJECTIVE: The objective was to assess intraoperative contrast-enhanced ultrasound (CEUS) in traumatic brain surgery. METHODS: We prospectively performed intraoperative conventional ultrasound (IOUS) and CEUS in 32 patients who underwent emergency surgery for the treatment of traumatic brain injury (TBI). Sonographic appearance including echogenicity, border, and size of the traumatic lesion and adjacent brain tissue on CEUS were compared with those on IOUS using surgical results as the gold standard. The differences in the size and contrast enhancement parameters of the lesions between IOUS and CEUS were analyzed with a paired t test. RESULTS: The accuracy of CEUS in assessing TBI was 100%, whereas IOUS was 51%. The absolute peak intensity (API) varied depending on the severity of brain injury. Lower API was observed in severely damaged brain tissue, whereas high API was seen in normal brain tissue or the brain tissue with mild injury. The border of the trauma lesion was more clearly defined on CEUS when compared to IOUS. The size of the lesions measured on CEUS was significantly larger than that on IOUS (P<.01). Importantly, small vessels supplying blood to the tissue in traumatic lesions, as an indication of possible brain vitality, were optimized on CEUS during the surgery. Based on the parameter of time intensity curve and appearances of the lesions on CEUS, the severity of lesions was reclassified and surgical intervention was redesigned in 21 (21/32, 66%) cases. CONCLUSION: Intraoperative CEUS improves accuracy in classification of traumatic brain injury, which helps neurosurgeons to effectively remove hematoma, preserve normal brain tissue, and prevent damaging the vessels during surgical intervention.

[Application of intraoperative contrast-enhanced ultrasound in different pathological grades of glioma].

OBJECTIVE: To explore the feasibility and value of intra-operative contrast-enhanced ultrasound in different pathological grades of glioma. METHODS: A total of 46 patients with glioma were selected to undergo the contrast-enhanced ultrasound. They were divided into 3 groups according to their pathological grades. RESULTS: All 46 tumors were hyperechoic after examinations and the borders became much more distinct. Different level of tumors had their representative ultrasonic findings. CONCLUSIONS: Intraoperative contrast-enhanced ultrasound is quite useful for determining the position and border of tumors. And it is also excellent in detecting the residual tumor tissues post-operatively. And it can improve the resection accuracy and operative precision, especially for Grade IV glioma with internal necrosis, cyst and surrounding brain edema.