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Effect of microbubble destruction with ultrasound on wound healing in rats

Chinese Journal of Ultrasonography.2011;20(2):164-167. doi:10.3760/cma.j.issn.1004-4477.2011.02.023

Objective To investigate the effect of microbubble(Sono Vue) destruction with ultrasound on wound healing in rats. Methods Total 96 SD rats were accepted one rounded whole-layer skin incision on back each other and randomly divided into four groups:microbubble destruction with ultrasound(US + MB),microbubble(MB), ultrasound(US) and control group. Rats in US + MB group were injected with 0.5 ml microbubble contrast agent via tail vein,and then ultrasound irradiated for 3 minutes immediately. MB group were injected with 0.5 ml microbubble contrast agent. US group were injected with 0.5 ml physiological saline,and then ultrasound irradiated for 3 minutes immediately under the same condition. Control group were injected with 0.5 ml physiological saline. Feed each rat in single cage. On day 1,3,5,7,14 and 21 after wound creation,the excised wound tissues were analyzed by histology and VEGF expression in wounds by immunohistochemistry. Results HE staining: On day 7, wounds of US + MB group displayed the most accumulation of granulation tissue and all new capillaries were perpendicular to the wound surface, but the new capillaries of other 3 groups were disordered. Immunohistochemical examination of VEGF expression:the peak expression appeared on day 3 in US + MB group, other 3 groups were on day 5 to day 7.Conclusions US + MB treatment could improve the quality of wound healing and granulation tissues were maturated earlier than MB, US treatment and control group, which could accelerate wound healing. High temperature,high pressure and some kind of chemistry effecs induced by microbubble destruction with ultrasound can stimulate the secretion of endogenous VEGF, which may be the mechanism of promoting angiogenesis and wound healing.

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Predictive value for coronary heart disease by epicardial adipose tissue and carotid intima-media thickness

Hongbo XIA ; Youbin DENG ; Haoyi YANG ; Meihua ZHU ; Chuanlin LI

Chinese Journal of Ultrasonography.2011;20(2):104-107. doi:10.3760/cma.j.issn.1004-4477.2011.02.004

Objective To explore the predictive value for coronary heart disease by epicardial adipose tissue(EAT) thickness and carotid intima-media thickness(IMT) measured with high-frequency ultrasound.Methods According to the results of coronary angiography, the cases were divided into the normal control group (29 patients),coronary artery disease group with single-vessel lesion (43 patients),coronary artery disease group with multi-vessels lesion (28 patients), respectively. EAT and IMT were measured by high-frequency ultrasound. Results The EAT in the three groups were (4.8 ± 1.3) mm, (7.6 ± 1.8) mm,(10.1±2.6) mm respectively, and the IMT were (0.8±0.1)mm,(1.0±0.2)mm,(1.1 ± 0.2)mmrespectively. In either coronary artery disease group with single-vessel lesion or multi-vessels lesion, the EAT and IMT were significantly higher than those in the normal control group ( P＜ 0.01 ). And the difference between groups of single-vessel lesion and multi-vessels lesion was also statistically significant (P＜ 0.01). The areas under receive operating characteristic(ROC) curve to predict coronary heart disease by EAT and IMT was 0.947 and 0.917, respectively, there was no significant difference between the two areas. For patient with coronary artery stenosis＞50%, the sensitivity and specificity of EAT＞6 mm were 90.1% and 86.2% ,respectively,the sensitivity and specificity of IMT＞0.85 mm were 87.3% and 82.8%,respectively. Conclusions EAT and IMT measured by high-frequency ultrasound can precisely predictcoronary heart disease. EAT can be a new predictor to diagnose coronary heart disease.

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Assessment of left ventricular systolic synchrony by real-time three-dimensional echocardiography and speckle tracking imaging in patients with myocardial infarction

Yan JIA ; Ruiqiang GUO ; Jinling CHEN ; Qing ZHOU

Chinese Journal of Ultrasonography.2011;20(2):97-100. doi:10.3760/cma.j.issn.1004-4477.2011.02.002

Objective To assess the left ventricular (LV) systolic synchrony in patients with myocardial infarction using real-time three dimensional echocardiography(RT-3DE) and speckle tracking imaging(STI). Methods Twenty-five healthy subjects and thirty patients with myocardial infarction underwent two-dimensional echocardiography and RT-3DE examination. The systolic synchrony parameters derived from RT-3DE were the dispersion of time and the maximum difference of time to minimum regional volume for 16 LV segments (Tmsv-16-SD and Tmsv-16-Dif). When the Tmsv-16-SD was above the percent 99 of the control group distribution in patients with myocardial infarction were considered statistically different from those in the control group and were accordingly classified as LV systolic asynchrony. The time from the onset of QRS complexes to systole peak strain from the radial vectors was recorded using STI. The standard deviation and the maximal temporal difference of the radial (TRS-SD and TRS-Dif) of 18 segments were calculated as indicator of LV systolic synchrony. LV systolic asynchrony was defined as an interval≥130 ms for the absolute difference in time to peak radial strain for the anteroseptal wall versus the posterior wall (TAS-POST). Results All the systolic synchrony parameters derived from RT-3DE and STI were significantly larger in the myocardial infarction group than those of the control group (all P＜0.01 ).For Tmsv-16-SD and Tmsv-16-Dif,a moderate correlation with TRS-SD and TRS-Dif( r = 0.675 and 0.620,all P＜0.01) was found. No significant difference and general consistency were found between the systolic asynchrony parameters by RT-3DE and STI ( P = 0.125, Kappa = 0.60). Conclusions RT-3DE and STI provide effective tools to assess the LV systolic synchrony. There is no obvious correlation between these methods, thus it is essential of using different methods and parameters to evaluate the LV systolic synchrony.

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Preparation of asialoglycoprotein receptor-mediated hepatic targeting nano- lipid ultrasound contrast agent and its ultrasound imaging in vitro

Jinhong YU ; Zhigang WANG ; Yuanyi ZHENG ; Yingxia XIANG ; Ao LI ; Qiao LI

Chinese Journal of Ultrasonography.2011;20(2):172-175. doi:10.3760/cma.j.issn.1004-4477.2011.02.025

Objective To prepare the liver targeting nano-liquid perfluorocarbon ultrasound contrast agent and observe its general characteristics;to observe the targeting combined effects of the human liver cells L02 and the targeted ultrasound contrast agent ;to evaluate the gathering imaging effects of the targeted ultrasound contrast agent. Methods Amine method was used to prepared asialoglycoprotein Gal specific ligand polylysine (Gal-PLL), rotary evaporator and sonicated liquid fluorocarbon were used to prepare nano lipid ultrasound contrast agent. Human liver cell L02 were cultured, the combined effects were observed according to the reacting time of the cells and the targeted nano-lipid ultrasound contrast agent. The nanolipid ultrasound contrast agent and the degassed_ water_ were loaded into cysts and their ultrasound imaging effects were observed by ultrasound diagnostic apparatus Philips iU22. Results The particle size of the liquid fluorocarbon nano-targeted lipid ultrasound contrast agent was extremely small, uniform, cylindrical and spherical. The cysts in vitro showed that the side of the targeted liquid perfluorocarbon nano-lipid ultrasound contrast agent showed high echo. Conclusions The targeted liquid perfluorocarbon nano-lipid ultrasound contrast agent can be effectively targeted to the human liver cells L02 due to carrying home-made Gal-PLL. The targeted ultrasound contrast agents can be imaging by ultrasound and be confirmed in vitro.The size of the contrast agent was small, therefore, it can be considered an ideal ultrasonic molecular probe and achieve the ultrasound molecular imaging in cell level.

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Adhesive behavior of dual-targeted microbubbles carrying both Sialyl Lewisx and anti-ICAM-1 monoclonal antibody in vitro

Meiyu LI ; Li YANG ; Juefei WU ; Yunbin XIAO ; Jianguo BIN ; Ying LIU ; Jianping BIN

Chinese Journal of Ultrasonography.2011;20(2):168-171. doi:10.3760/cma.j.issn.1004-4477.2011.02.024

Objective To assess the adhesive behavior of dual-targeted microbubbles carrying both Sialyl Lewisx and anti-ICAM-1 monoclonal antibodies in vitro. Methods Selectin-targeted (with Sialyl Lewisx) microbubbles (MB-S),ICAM-1-targeted (with anti-ICAM-1 monoclonal antibodies) microbubbles (MB-Ⅰ),and dual-targeted (with both ligands) microbubbles(MB-D) were prepared by attaching the ligands to the biotinylated lipid-microbubbles via multi-step avidin biotin bridging chemistry. A parallel plate flow chamber combined with a novel automated tracking algorithm,were used to analyze the transient velocities,rolling and firmly adherent numbers of microbubbles at various shear stress (0. 6,2.0 and 4.0 dyn/cm2)over 6 min. Microbubbles detachments were tested by ramping up the shear stress at 30 s intervals. Results At 0.6 dyn/cm2 shear stress, the rolling numbers of MB-S and MB-D were remarkably more than that of MB-I( P＜0.05), while at 2.0 and 4.0 dyn/cm2 MB-S performed higher rolling efficiency as compared with either MB-I and MB-D ( P＜ 0.05). In all flow conditions, the adhesive numbers of MB-D to the targets were obviously greater than those of MB-S and MB-I ( P＜ 0.05). Half-maximal detachment decreased gradually in MB-I, MB-D and MB-S by turns ( P＜ 0.05). Conclusions MB-I, MB-S and MB-D have different adhesive behaviors. MB-I exhibites primarily firm adhesion with low rolling efficiency, while MB-S reveales unstable or transient adhesion with high rolling efficiency,and MB-D exhibites firm adhesion with high rolling efficiency. MB-D may be suitable for molecular imaging in high-flow vessels.

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Application of located needles guided by intraoperative ultrasound in resection of brain cavernous malformations

Yan HE ; Wen HE ; Huiqin ZHANG ; Lishu WANG ; Jizong ZHAO ; Rong WANG ; Zhixiang GUO

Chinese Journal of Ultrasonography.2011;20(2):142-144. doi:10.3760/cma.j.issn.1004-4477.2011.02.015

Objective To explore the value of the located needles guided by intraoperative ultrasound in resection of brain cavernous malformations. Methods Fourteen patients diagnosed as brain cavernous malformations confirmed by preoperative CT and MRI. Detected by the located needles under intraoperative ultrasound guidance, 14 lesions were excised. Results Intraoperative ultrasound-guided needles accurately located 14 cases of patients with brain cavernous malformations. Fourteen lesions were removed successfully. The distances between lesions and the dura mater were 1.5-2.9 cm,the sizes of lesions were 0.8-2.8 cm. Fourteen lesions by color Doppler flow imaging showed point-like blood flow. Conclusions Brain cavernous malformations can be accurately detected by the located needles under intraoperative ultrasound guidance.

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Development of a new method to measure pleural effusion volume by ultrasound in critically ill patients

Mao ZHANG ; Jianxin YANG ; Shanxiang XU ; Li BA ; Zhihai LIU ; Yucai HONG ; Jianxin GAN ; Shaowen XU

Chinese Journal of Ultrasonography.2011;20(2):129-133. doi:10.3760/cma.j.issn.1004-4477.2011.02.012

Objective To develop a new method to measure pleural effusion volume by ultrasound in critically ill patients. Methods Forty-six critically ill patients admitted to emergency ICU were involved.The height of effusion (H),area of effusion at the middle section (S), thickness of effusion at middle-back line (T1) and posterior axillary line (T2) were measured by ultrasound in supine position at the end of expiration. The measured volume of pleural effusion (Vc) was calculated by H×S,and the actual volume of drainage (V) within 2 hours was also recorded. The correlation of actual volume of pleural effusion (V)with effusion height (H) ,thickness (T1, T2), area (S) and the calculated volume (Vc) were analyzed to decide the most accurate index and method. Results There was much better correlation between actual volume of effusion and S, (H & S), Vc, than these between V and T1 ,T2, H in all patients and subgroup, Vc had good correlation with V and very close to V(the average difference was 56 ml) when the actual volume was less than 500 ml,there was no difference[(417 ± 94)ml vs (402±95)ml, t = 1.095, P = 0. 285]. Both Logistic regression analysis and receiver operating characteristic (ROC) curve showed S was the most reliable index to predict the actual volume to exceed 500 ml,400 ml,and 300 ml when compared with H,S,T1 and T2. The corresponding threshold was 30.3 cm2 , 28.3 cm2 and 23. 1 cm2 , with the sensitivity and specificity of 0. 77 and 0. 88,0.72 and 1.0,0.95 and 1.0, respectively. Conclusions This new method based on measuring the area of effusion by ultrasound is more efficient and reliable than those traditional ones to measure the volume of pleural effusion. It's clinically valuable and easy to perform, and deserves broad application.

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Prenatal ultrasound diagnosis of absent pulmonary valves syndrome

Sheng ZHAO ; Xinlin CHEN ; Xiaohong YANG

Chinese Journal of Ultrasonography.2011;20(2):126-128. doi:10.3760/cma.j.issn.1004-4477.2011.02.011

Objective To assess the value of prenatal ultrasonography in diagnosing fetal absent pulmonary valve syndrome(APVS). Methods This was a retrospective study of 8 fetuses with absent pulmonary valve syndrome. Fetal echocardiography and segmental analysis were used to determine the atrial situs,atrioventricular connections and ventriculoarterial relationships. Cardiac chamber dimensions,Doppler studies of the atrioventricular valve and semilunar value were recorded, and cardiothoracic ratio were calculated. Results Levocardia,normal situs and atrioventricular connections were present in all cases. All cases showed typical signs:severe dilatation of the pulmonary trunk and it's branches, and concurrent occurrence of pulmonary valve stenosis and regurgitation. In 6/8 there was an associated ventricular septal defect,overriding aorta and absent arterial duct(Fallot-like APVS),while in 2/8 there was an assoiciated intact ventricular septal and patent arterial duct. Extracardiac malformations were detected in 5 cases.Conclusions APVS can be accurately diagnosed by prenatal ultrasonography but we should pay more attention to the ventricular septal and arterial duct,due to the existence of two variants.

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Assessment of transcatheter closure of coronary artery fistula by transthoracic echocardiography

Xing ZHAO ; Xiuzhang Lü ; Jianpeng WANG ; Zhenhui ZHU ; Shiliang JIANG ; Zhongying XU ; Liang XU ; Yanling LIU

Chinese Journal of Ultrasonography.2011;20(2):101-103. doi:10.3760/cma.j.issn.1004-4477.2011.02.003

Objective To investigate the efficacy of transcatheter closure of coronary artery fistula (CAF) by transthoracic echocardiography(TTE) and the role of TTE in this therapy. Methods CAF were occluded with transcatheter closure techniques in 17 patients. TTE was performed before and after the treatments. The key points were retrospectively analyzed including: the sites of CAF, the position and diameter of CAF,the shape and position of the devices after the intervention,the residual shunt,and cardiac chamber size. Results Before the therapy,TTE made definite diagnosis of CAF. All patients had lesions in single coronary artery, and the diameter of CAF was 2-14 (6.4 ± 3.5)mm. All patients underwent transcatheter closure successfully. TTE revealed the shunts disappear 1-4 days after the occlusion. During a follow-up period of 1- 29 (11.7± 7.9)months,no residual shunts, no complications, and normal size of thecardiac chambers were recognized by TTE. Conclusions The transcatheter closure of CAF has emerged as a less invasive, safe and effective strategy. Echocardiography has important role in primary screening of patients and the follow-up after the treatments.

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Evaluation of dynamic morphology of atrial septal defect by real-time three-dimensional transesophageal echocardiography

Huihong JIN ; Bowen ZHAO ; Chan YU ; Bei WANG ; Peng LI ; Mei PAN ; Lilong XU

Chinese Journal of Ultrasonography.2011;20(2):93-96. doi:10.3760/cma.j.issn.1004-4477.2011.02.001

Objective To determine whether real-time three-dimensional transesophageal echocardiography(RT-3D TEE) is an accurate non-invasive technique for defining the morphology of atrial septal defects(ASD). Methods In 20 patients with secundum ASD, mean age 42.2 years (7 male, 13 female) ,live three dimensional surgical views of ASD were acquired,qualitative morphology of ASD such as the shape, presence of fenestrations and the defect margins were noted during the cardiac cycle. The measurements obtained from 2-dimensional transesophageal echocardiography(2D-TEE) and RT-3D TEE were compared to those obtained from stretched balloon diameter(SBD) or surgery. Measurements of the size and area change of ASD were validated during the cardiac cycle by RT-3D TEE,stepwise multiple linear regression analysis was performed to test the correlation between the maximum change ratios of area and diameter of ASD and age, atrial septal length, ASD shunting velocity, the maximum diameter of ASD and right ventricular systolic pressure. Results ① The morphology of ASD was circle-like or elliptical in systole,irregular or elliptical in diastole. ②The area and diameter of ASD measured by RT-3D TEE was minimal in isovolumetric contraction phase, maximal in isovolumetric diastole phase. The correlation coefficient of maximum diameter measured by 3D with SBD was 0.962 , greater than that by 2D and SBD (0.820). ③The change ratio of area and maximum diameter of ASD acquired by RT-3D-TEE was 11.48%-71.12% and 2.80%-43.87% respectively,and the correlation coefficient of them was 0.921. Conclusions RT-3D TEE using live 3D-Zoom mode accurately displayed the varying morphology,dimensions and spatial relations of ASD. RT-3D TEE can offer visualization morphological changing of ASD in different periods of cardiac cycle,providing more information for percutanous catheter intervention and open heart surgery.

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