Ultrasound imaging is widely used in clinical daily diagnosis and treatment, and is considered to be a preferred examination in a variety of diseases. With the rapid development and continuous integration of computer technologies and related cross-field technologies, the novel ultrasound technologies have emerged, which greatly expand the application fields of ultrasound. From the clinical viewpoint, this article reviews several new ultrasound technologies and their application progress in recent years.

Objective To assess the velocity patterns of right ventricular long axis myocardial motion during isovolumic contraction phase in the patients with dilated cardiomyopathy(DCM) by Doppler tissue imaging(DTI).Methods Right ventricular systolic free wall myocardial(the place close to the tricuspid annular) motion velocities were examined by DTI on apical four-chamber view in 28 patients with DCM and 30 healthy volunteers.Peak positive and negative velocities(V_(IVC1),V_(IVC2)),velocity time integrals(VTI_(IVC1),VTI_(IVC2)),times(T_(IVC1),T_(IVC2)) of right ventricular free wall myocardial motion during isovolumic contraction,and the peak velocity(V_S),time(T_S),velocity time integral(VTI_S) of ejection wave(S) were measured.Right ventricular percent changes in area(RVPCA) on three different views were calculated.Results V_(IVC1),V_S,VTI_S and differential IVC(the difference between V_(IVC1) and V_(IVC2)) in the patients with DCM were significantly decreased than those in control group(P(0.05)).Conclusions The changes of DTI indices of right ventricular long axis myocardial motion during isovolumic contraction in the patients with DCM are characteristic,which could be a new method to evaluate right ventricular systolic function.

To evaluate the morphology of atrial septum by the live three-dimensional echocardiography (L3DE) and its value of clinical application, L3DE was performed in 62 subjects to observe the morphological characteristics and dynamic change of the overall anatomic structure of atrial septum. The study examined 49 patients with atrial septal defect (ASD), including 3 patients with atrial septal aneurysm, and 10 healthy subjects. ASD in the 35 patients was surgically confirmed. The maximal diameters of ASD were measured and the percentages of area change were calculated. The parameters derived from L3DE were compared with intraoperative measurements. The results showed that L3DE could directly and clearly display the morphological features of overall anatomic structure of normal atrial septum, repaired and artificially-occluded atrial septum, atrial septal aneurysm. The defect area in ASD patients changed significantly during cardiac cycle, which reached a maximum at end-systole and a minimum at end-diastole, with a mean change percentage of 46.6%, ranging from 14.8% to 73.4%. The sizes obtained from L3DE bore an excellent correlation with intraoperative findings (r=0.90). It is concluded that L3DE can clearly display the overall morphological features and dynamic change of atrial septum and measure the size of ASD area accurately, which is important in the decision to choose therapeutic protocols.
Atrial Septum/*ultrasonography ; Echocardiography, Three-Dimensional/*methods ; Heart Septal Defects, Atrial/*pathology ; Heart Septal Defects, Atrial/*ultrasonography ; Young Adult

To assess the normal value of left ventricular twist (LVtw) and examine the changes with normal aging by 2-dimensional ultrasound speckle-tracking imaging (STI), 121 healthy volunteers were divided into three age groups: a youth group (19-45 y old), a middle-age group (46-64 y old) and an old-age group (> or = 65 y old). Basal and apical short-axis images of left ventricular were acquired to analyse LV rotation (LVrot) and LVrot velocity. LVtw and LVtw velocity was defined as apical LVrot and LVrot velocity relative to the base. Peak twist (Ptw), twist at aortic valve closure (AVCtw), twist at mitral valve opening (MVOtw), untwisting rate (UntwR), half time of untwisting (HTU), peak twist velocity (PTV), time to peak twist velocity (TPTV), peak untwisting velocity (PUV), time to peak untwisting velocity (TPUV) were separately measured. The results showed that the normal LV performs a wringing motion with a clockwise rotation at the base and a counterclock-wise rotation at the apex (as seen from the apex). The LVtw velocity showed a systolic counterclock-wise twist followed by a diastolic clockwise twist. Peak twist develops near the end of systole (96%+/-4.2% of systole). With aging, Ptw, AVCtw, MVOtw, HTU and PUV increased significantly (P<0.05) and UntwR decreased significantly (P<0.05). However, no significant differences in TPUV, PTV and TPTV were noted among the 3 groups (P>0.05). It is concluded that LV twist can be measured non-invasively by 2-dimensional ultrasound STI imaging. The age-related changes of LVtw should be fully taken into consideration in the assessment of LV function.
Aging ; Echocardiography ; Heart Ventricles/anatomy & histology ; Heart Ventricles/*ultrasonography ; Ventricular Function, Left/*physiology ; Young Adult

The effects of cardiomyocyte grafting on left ventricular (LV) remodeling and function in rats with chronic myocardial infarction were evaluated using high-frequency ultrasound. Chronic myocardial infarction was induced in 50 Wister rats by ligating the left anterior descending artery. They were randomized into two groups: a trial group that received neonatal rat cardiomyocyte transplantation (n=25) and a control group which were given intramyocardial injection of culture medium (n=25). The left ventricular (LV) geometry and function were evaluated by high-frequency ultrasound before and 4 weeks after the cell transplantation. After the final evaluation, all rats were sacrificed for histological study. The results showed that 4 weeks after the cell transplantation, as compared with the control group, the LV end-systolic dimension, end-diastolic dimension, end-systolic volume and end-diastolic volume were significantly decreased and the LV anterior wall end-diastolic thickness, LV ejection fraction and fractional shortening were significantly increased in the trial group (P<0.01). Histological study showed that transplanted neonatal rat cardiomyocytes were found in all host hearts and identified by Brdu staining. It was suggested that transplantation of neonatal rat cardiomyocytes can reverse cardiac remodeling and improve heart function in chronic myocardial infarction rats. High-frequency ultrasound can be used as a reliable technique for the non-invasive evaluation of the effect of cardiomyocyte transplantation.
Animals, Newborn ; Echocardiography/*methods ; Myocardial Infarction/physiopathology ; Myocardial Infarction/*therapy ; Myocardial Infarction/ultrasonography ; Myocytes, Cardiac/*transplantation ; Random Allocation ; Rats, Wistar ; Ventricular Function, Left/*physiology ; Ventricular Remodeling

Objective To investigate the gene silencing,apoptosis induction and the suppression of proliferation in vivo transfected by UTMD techniques associated with shRNA techniques. Methods The survivin-shRNA expression vector was constructed. Nude mice were randomly arranged into 3 groups:control group, plasmid injection and ultrasound (P + US), P + UTMD group. Histological examination were evaluated. Protein expressions of Survivin and proliferating cell nuclear antigen (PCNA), Bcl-2, Bax,Caspase-3, Ki-67, nucleostemin (NS), p53 were investigated by immunohistochemistry. Results In transplanted tumors experiment, comparing with those in C and P + US groups, protein expressions of PCNA,Ki-67,Bcl-2, Survivin, NS were down-regulated markedly, while those of Bax, Caspase-3 and P53 were up-regulated significantly ( P ＜ 0.05). Conclusions UTMD combined with shRNA technique can induce apoptosis and inhibit proliferation significantly, without causing any apparently adverse effect,representing a new,promising technology that can be used in the tumor gene therapy and research.

Purpose To investigate renal cortical blood perfusion in patients with nephrotic syndrome (NS) by region of interest (ROI) quantification.Materials and Methods Twenty-one patients with NS treated at Wuhan Union Hospital from September 2014 to January 2015 (NS group) and twenty-nine matched healthy subjects (control group) were enrolled in our study.High frequency blood flow dynamic images of the left kidney for all the subjects were acquired by color Doppler (Philips iU22).Resistance index (RI) of interlobar artery,arcuate artery and interlobular artery were measured.Vascularization index (VI),flow index (FI),vascularization flow index (VFI) were further analyzed by ROI quantification at Q-LAB work station.Results ① The signals of renal cortical blood flow in NS patients were sparse and slim;while the signals in the control group were continuous,most of which reached the edge of renal cortical.② No statistical differences of RI values of interlobar artery and interlobular artery were found between the two groups (P＞0.05);③ The renal cortical blood perfusion in the NS patients decreased significantly compared with that in control group,and the renal cortical VI,FI and VFI values in NS group were significantly lower (P＜0.01).④ Bland-Altman analysis showed that there was good repeatability in the measurement of renal cortical VI,FI and VFI.Conclusion Color Doppler flow imaging combined with RO1 quantitative technique can assess renal cortical blood perfusion accurately,which provides diagnostic information for early detection of renal damage.

Objective To quantitatively describe the texture features of myocardial image in the acute myocardiac infarction (AMI) using image texture analysis. Methods Anterior descending branch of left coronary artery was ligated to set up AMI model in 11 dogs. Image texture was analyzed using grey tone co-occurrence matrix method, and 4 kinds of texture parameters including angular second moment(ASM), contrast(CON), entropy(ENT), and inverse difference moment(IDM) in normal myocardium and infarct myocardium were observed. Results A significant difference in 4 kinds of texture parameters was found between pre- and post-infarct myocardium (P

Objective To assess right ventricular(RV) regional and global function in patients with repaired tetralogy of Fallot (TOF) by speckle tracking imaging (STI).Methods 36 asymptomatic patients with repaired TOF whose postoperative period is more than one year and 35 healthy controls were studied.RV longitudinal peak systolic strain (ε),strain rate (SRs) were measured in RV free wall and interventricular septum(IVS) for basal,mid and apical segments by STI from the apical 4-chamber view,RV global longitudinal peak systolic strain (GLS),strain rate (GLSRs),early diastolic strain rate (GLSRe) and late diastolic strain rate (GLSRa) were measured from the above view.The correlations between RV systolic functional parameters and the postoperative period,degree of pulmonary regurgitation (PR) and QRS duration were explored.Results ①Compared with controls,εand SRs of RV free wall and IVS for most segments,GLS,GLSRs,GLSRe,and GLSRa were significantly impaired in patients with repaired TOF (P ＜ 0.05 for all).Both GLS and GLSRs were lower in postoperative patients with transannular patch than in those with RV out tract patch.②In comparison with controls,GLS,GLSRs,GLSRe and GLSRa were decreased in postoperative patients with mild,mid and severe PR,Whereas,there was no difference in RV global function among the patients with varying degree of PR.③GLSRs of RV was correlated inversely with postoperative period and QRS duration(r1--0.431,P1 =0.009 ; r2 ==-0.469,P2-0.004),RV GLS and GLSRs had no correlation with PR.Conclusions RV regional and global function in patients with late repaired TOF are decreased,STI can early detect right ventricular dysfunction in asymptomatic patients with repaired TOF.The type of operation impacts on late prognosis,RV abnormal deformations are associated with electrical depolarization abnormalities.

Objective To study the early and mid-term outcome in terms of left ventricular(LV)geometry and function in patients with transposition of great arteries with intact ventricular septum (TGA/IVS) undergoing arterial switch operation.Methods Twenty patients were followed up and divided into 2 groups according to age:the earlier group and the later group.Age and sexual matched controls were also designed as control group 1 and control group 2.LV posterior wall thickness(PWTd),dimension(LVIDd)and length(L) at end diastolic phase,LV end-diastolic volume (EDV),end-systolic volume (ESV),ejection fraction (EF),mitral valve early (E) and late (A) inflow velocities and E/A,isovolumic relaxation time (IVRT) were obtained by two-dimensional echocardiography,normalized isovolumic relaxation time (IVRTn),wall thickness index (PWTd/LVIDd) and LV geometry index(LVIDd/L) were calculated,and these indexes between groups were compared.Results ①Compared with control group 1,PWTd in earlier group was higher [(0.41 + 0.06)cm vs (0.36 + 0.05)cm,P =0.022],but LVIDd had no significant statistical difference [(2.08 + 0.21)cm vs (2.21 + 0.23)cm,P =0.117],indicating PWTd/ LVIDd differed between groups(0.20 + 0.04 vs 0.16 + 0.01 P =0.001).②No abnormalities were observed in later group.③Compared with different age groups in TGA,EDV,ESV,L,LVIDd,PWTd were significantly higher in later group(P =0.000).There were obvious correlations between EDV,ESV,L,LVIDd and examined age (r =0.90,0.83,0.73,0.90,P =0.000,R2 =0.809,0.694,0.528,0.808) while there were no significant correlation between PWTd and examined age(r =0.56,P =0.000,R2 =0.309).Conclusions Early after operation,LV is undergoing hypertrophy or hyperplasia in TGA/IVS,but will recover in the mid-term period,and the function is normal all the time indicating that the LV myocardium may avoided irreversible pathological changes if operated in time.All in all,LV develops well in mid-term period.