The reseclability of 45 cases with pancreato-ampullar diseases was evaluated preoperatively with color Doppler flow imaging(CDFI).In 43,the situation was confirmed by surgery and pathology with obvious involvement of the peripancreatic vessels and/or liver metastases as the criteria for nonresectability. 22 patients considered to be not resectable on the basis of CDFl were proved at surgerY.While in 21 patients without sign of obvious involvement of peripancreatic vessels on CDFI,the resectability rate was 85.7%.The overall correlation rate of CDFl was 93%.It is concluded that CDFI plays a definite role in evaluating the resectability of panereato-ampullar disease.The positive signs of vessel involvement are discussed.

Objective To investigate the changes of mi crovascular endothelial dilatation in stunned myocardium. Methods Thirteen healthy and adult mongrel dogs were randomly organized into two groups, group A (n=6) and group B (n=7). Each dog in group A and B underwent 15 min and 30 min acute ligation at left anterior descending coronary artery (LAD), respectively. Myocardial contrast echocardiography was implemented via intra-femoral vein bolus injection of C 3F 8-exposed sonicated dextrose albumin at different examining time.Peak-intensity (PI) and area under curve (AUC) were derived from time-intensity curve (TIC) after aortic root injection of acetylcholine (ACH) or nitroglycerin (NG),and then PI ratio (PIR) and AUC ratio (AUCR) of pre- to post-ACH or pre- to post- NG were calculated at each of the corresponding examining times. Myocardial endothelium-dependent relaxation (EDR) and non-EDR were analyzed at different examining times. Results ①At baseline (before LAD ligation), PI and AUC in group A and B increased considerably via aortic root injection of ACH and NG. ② After ACH injection,PIR in group A decreased sharply at 5,30 and 60 min, whose P values were less than 0.05 compared with baseline. And all these recovered completely at 120 min reperfusion. However,PIR in group B recovered slowly and reached finally to baseline at 150 min reperfusion. Meanwhile, the variation trends of AUCR in both group A and B were the same as those of PIR. Overall, the dynamic tendencies of PIR and AUCR in these two groups for post-NG at different examining times were much similar to those of post-ACH. ③ The decreased magnitudes of PIR and AUCR in group A and B after ACH injection were bigger than those of NG injection at 5,30 and 60 min reperfusion(P

Objective To understand the sonographic feature of skin and skin nerves in the patients of herpes zoster. Methods High frequency sonography was used to examine 37 cases of herpes zoster patients with 77 pathological changes, 7 cases of sequence of neuralgia with 17 pathological changes. Compared with the healthy side of the same patient, thickness and echo feature of the skin and subcutaneous tissue, the width and echo feature of the skin nerves were recorded. Results The skin and subcutaneous tissue of the herpes zoster patients thickened (P 0.05),but the involved skin nerves widened significantly(P

(0.05)) during dobutamine 5 ?g?kg~(-1)?min~(-1) stage. Blood pressure had significant increase both in dobutamine 10 ?g?kg~(-1)?min~(-1) stage and post-coronary revascularization. The sensitivity,specificity,accuracy of dobutamine 5 and 10 ?g?kg~(-1)?min~(-1) were (73.0)% and (89.6)%, (81.7)% and (82.8)%,(76.9)% and (86.5)%, respectively. Conclusions LDDSE is a simple,safe and no injury means to identify survival myocardium in myocardial infarction.

Objective To analyze the accuracy,repeatability and feasibility of Ultrafast Doppler for renal artery ultrasonography.Methods One hundred and one cases were selected that were suspected to have renal artery disease and were successful of conventional and Ultrafast Doppler for renal artery ultrasonography,and 101 cases were grouped by age (≤40 years old,41-60 years old,≥61 years old),body mass index (BMI) (normal 18.5-23.9 kg/m2,overweight 24.0-27.9 kg/m2,obesity ≥28.0kg/m2) and whether there were the presence of renal artery stenosis (no significant renal artery stenosis and renal artery stenosis ＞60％).Each case was respectively examined by conventional and Ultrafast Doppler for renal artery ultrasonography in a random order.The consistency of Doppler parameters was tested.The duration of each Doppler study was compared and the feasibility of Ultrafast Doppler for renal artery ultrasonography was explored.The Doppler parameters included:renal artery peak systolic velocity (PSV),resistance index (RI),renal segmental artery acceleration time (T) and time consuming (△T).The concordence and △T of two Doppler method were compared.Results ① Ultrafast Doppler had good reproducibility,intraclass correlation coefficient (ICC) values were ＞ 0.6.② For renal artery ultrasonography,the successful number of cases examined by Ultrafast Doppler were more than those examined by conventional Doppler,but the difference was not statistically significant (P ＞0.05).③The Doppler parameters from all subjects and different groups showed a strong positive correlation between the two Doppler studies (P ＜0.05).④ UltraFast Doppler required a shorter time than conventional Doppler (P ＜0.05).⑤The △T of cases with different ages and with or without renal artery stenosis showed no statistically significant (P ＞0.05),however,their △T were increased with body mass index increasing (P＜0.05).Conclusions Ultrafast Doppler for renal artery ultrasonography has a high success rate,a good repeatability and consistency,and a shorter time consuming and simple operation than conventional Doppler.

Objective To probe into the characteristics of strain and strain rate in different time points of coronary artery disease (CAD) patients before and after the improvement of myocardial ischemia, to evaluate the value of two-dimensional strain (2DS) imaging in assessing curative effect of CAD patients. Methods The changes of strain and strain rate in local lesion segments before revascularization,and one week,one month and three months after revascularization of 24 CAD patients accepting revascularization therapy were detected by 2DS. Results Before revascularization treatment,the outlines of strain-time curves and strain-rate-time curves of lesion segments of CAD patients in whole cardiac circle were cluttered. The peak strain (S),the peak systolic strain rate (SRS) and the peak early diastolic strain rate (SRE) were low and calm. The peaks of strain-time curves in some segments of CAD patients were inverted. One week after treatment,the S, SRS,SRE and the peak late diastolic strain rate (SRA) of lesion segments of CAD cases elevated to certain extent. However, there were no statistical significant differences between them (P0.05). One month after treatment,the S and SRE of lesion segments of CAD patients elevated significantly compared to that of before the treatment (P<0.01). Three months after treatment,the outlines of strain-time curves and strain-rate-time curves of lesion segments of CAD patients trended to be regular,and the S, SRS, SRE and SRA elevated markedly compared to that of before treatment (P<0.01). There were statistical significant differences in terms of the S, SRS and SRA compared to that of one week and one month after treatment (P<0.01). Conclusions 2DS can evaluate the strain and strain rate non-invasively and quantitatively at different time points after revascularization of CAD patients. And it can evaluate regional myocardial systolic and diastolic function for CAD patients.

The reliability and reliable indexes of quantitative assessment of coronary flow reserve (CFR) by using time-intensity curve (TIC) via myocardial contrast echocardiography were investigated. The TIC variables were obtained by employing acoustic densitometry (AD) technique before and after acetylcholine (Ach) injection in 12 dogs. Meanwhile, the correlation between these variables and CFR was analyzed. Among the variables derived from TIC, peak intensity (PI), area under the curve (AUC) and descending slope (DS) were increased significantly (P < 0.05) with the increase of coronary blood flow after Ach injection. Conversely, time-to-peak (TP), half-time of descent (HT), and mean-transit-time (MTT) were decreased remarkably (P < 0.0001). The PI and AUC ratios from post- to pre-Ach injection were strongly associated with CFR with the correlation coefficient (r) being 0.8366 and 0.8824, respectively. It is reliable by using the variables derived from TIC with myocardial contrast echocardiography to quantitatively evaluate regional myocardial CFR. The PI and AUC ratios from post- to pre-Ach injection are the reliable indexes for quantitative assessment of CFR.
Blood Flow Velocity/physiology ; Contrast Media ; Coronary Circulation/*physiology ; Coronary Vessels/physiology ; Coronary Vessels/ultrasonography ; *Echocardiography/methods ; *Image Processing, Computer-Assisted ; Observer Variation ; Regional Blood Flow/drug effects ; Regional Blood Flow/physiology ; Reproducibility of Results ; Ultrasonography, Interventional

Objective To assess renal perfusion of chronic renal failure(CRF) at different stages in rabbits by contrast-enhanced ultrasound. Methods Fifteen rabbits were injected cationic bovine serum albumin(C-BSA) intravenously for 8 weeks to establish CRF models. Serum creatinine(Scr) and blood urea nitrogen(BUN) were determined before injection and 2,4,6,8 weeks after C-BSA injection respectively. The size of kidney was measured by two-dimensional ultrasound and contrast-enhanced ultrasound was performed on bilateral kidneys at the same time points. Renal perfusion was analyzed quantitatively with the time intensity curve. Results Renal cortical perfusion reduced started at 4weeks after injection,manifested as the peak signal intensity(PSI) of the time-intensity curve parameters decreased(P<0.05 or P <0.01). The speeds of perfusion and clearance of kidney were slower,showed as the time to peak intensity(PIT) and the time to half of peak intensity(HPT) delayed (P <0.05 or P <0.01). Compared with pre-injection, there were no differences in terms of the area under the curve(AUC) at 2,4 and 6 weeks after injection (all P> 0.05). And compared with pre-injection,2,4,6 weeks after injection, the AUC decreased at 8 weeks (P < 0.05 or P <0.01 ). The level of Scr and BUN of rabbits had increased since 6 weeks after injection (P< 0.05 or P <0.01). Two-dimensional ultrasound showed the renal volume was enlarged and the cortex was thickened from 2 weeks to 6 weeks after injection (P<0.05 or P <0.01). At 8 weeks after injection, the renal size had decreased as well (P < 0.05). These ultrasound changes were in accordance with its pathological changes. Conclusions Contrast-enhanced ultrasound in combination with time-intensity curve can quantitatively analyze the renal perfusion of CRF at different stages. The reduction of renal perfusion was earlier than the changes of routine laboratory indexes in rabbits with CRF. The haemodynamic changes of CRF rabbit were closely related with its pathological changes.

Objective To probe into the value of the evaluation of left ventricular myocardial function by two dimensional strain(2DS) for coronary artery disease(CAD) patients with different degrees of left anterior descending(LAD) branch stenosis. Methods Fifty-five eases without myocardial infarction among a total of 72 patients with CAD were divided in to 3 groups based on the extent of LAD stenosis,that was group A(stenosis<50%, n = 24) ,group B(stenosis50% to 75%, n = 19) ,and group C(stenosis>75%, n = 12). Another 17 eases of CAD with myocardial infarction were selected as group D. Strain and strain rate of the whole 11 segments that blood supplied by LAD of all cases were measured with 2DS. Results The 2DS ultrasound showed that the peak strain(S), the peak systolic strain rate(SRs) and the peak early diastolic strain rate (SRE) in all the 11 segments of group A were high and sharp. The above mentioned parameters of group B decreased compared with that of group A, however, there was no statistical significant difference (P >0.05). The S, SRs and SRE of group C cases decreased in some segments compared with that of group A and group B (P< 0.05 or P<0.01). As for group D, the S, SRS and SRE decreased significantly in all segments. In terms of the peak late diastolic strain rate (SRA), there were no statistical significant differences among group A,B and C (P>0.05). While in group D cases, the SRA decreased markedly. The SRE/SRA was more than 1 in group A. However, in group B, C and D cases, the SRE/SRA were all less than 1. Conclusions 2DS can sensitively reflect the decrease of regional myocardial systolic and diastolic function caused by the reduction of perfusion,and it may be beneficial to find myocardial ischemia for patients as early as possible.

Objective To study the ventricular-arterial coupling in the patients with type 2 diabetes mellitus (DM) by ultrasound.Methods Eighty patients with DM were divided into 2 groups:normal left ventricular ejection fraction (EF) group (DMN,EF≥50 ％,n =40) and abnormal EF group (DMA,EF＜50％,n =40).At the same time,42 healthy volunteers were selected as a control group.The left ventricular (LV) relative wall thickness (RWT),mass index (LVMI),stroke volume (SV),stroke works (SW),ratepressure product (RPP),systemic vascular resistance index (SVRI),LV end-systolic elastance (Ees),arterial elastance index (Ea) and ventricular vascular index (VVI) were measured and calculated.Longitudinal strain (LS) of myocardial segment including base(LSBA),papillary muscle (LSPM) and apex (LSAP) were analyzed by two-dimensional speckle tracking imaging.Results (1) Compared with the control,the RWT and LVMI were all increased (P ＜0.01),but the LSBA,LSPM and LSAP were decreased (P ＜ 0.01) in the DMN and DMA groups (P ＜0.01).In DMA group,the RWT,LSBA,LSPM and LSAP were decreased (P ＜0.01).Compared with the DMN group,the LSBA,LSPM and LSAP were decreased in DMN group (P ＜0.01).(2) Compared with the control,the Ea,VVI,RPP and SVRI were increased,but the Ees was decreased (P ＜0.05)in DMA group (P ＜0.01).In the DMN,RPP was increased compared with the control group (P ＜0.01).Compared with the DMN group,the Ea,VVI,RPP and SVRI were increased,but Ees was decreased in the DMA (P ＜0.05).(3)The LSBA,LSPM and LSAP were all positively correlated with VVI(P ＜0.01).Multiple regression analysis showed that the LSAP,RWT,LVMI and SW were independent predictor of VVI (b' =-0.613,-0.290,0.290 and-0.205,P ＜ 0.05).Conclusions The ventricular-arterial coupling is normal in the DMN group,but is abnormal in DNA group.LSAP is independent predictors for ventricular-arterial coupling.