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Quantitative evaluation of carotid plaque vulnerability by using GSM based on three dimensional ultrasound

Xiuling WANG ; Minyu ZHANG ; Guichun DING ; Hongbin WANG ; Jianhua WANG

Chinese Journal of Medical Ultrasound (Electronic Edition).2017;14(1):23-28. doi:10.3877/cma.j.issn.1672-6448.2017.01.008

Objective To quantitatively evaluate the vulnerability of carotid plaques in patients with acute ischemic cerebral infarction by using Gray-scale median (GSM) based on Three-dimensional ultrasound (3D-US).Methods Totally 207 patients were examined with carotid plaques in the PLA Army General Hospital from December 2015 to August 2016,including 102 patients with acute cerebralischemic stroke (cerebral infarction group) and 105 patients without cerebral infarction (control group).The Vascular plaque quantification (VPQ) software was applied to acquire GSM value of carotid plaques automatically.Results The GSM value of carotid plaques in cerebral infarction group was significantly lower than that in control group (44.78± 11.58 vs 54.36± 11.99,t=7.70,P ＜ 0.01),and the low density lipoprotein in the cerebral infarction group was significantly higher than that in the control group [(3.51 ± 1.20) mmol/L vs (3.10± 1.07) mmol/L,t=1.58,P ＜ 0.05].There was no significant difference between the two groups in age,gender,body mass index,smoking,drinking,history of diabetes,history of hypertension,systolic blood pressure,diastolic blood pressure,triglyceride,total cholesterol,high density lipoprotein,plaque thickness,plaque area stenosis rate and plaque volume (all P ＞ 0.05).Conclusion The GSM value of carotid plaques based on 3D-US-VPQ technology can effectively reflect the vulnerability of carotid plaques,and may be valuable in the risk assessment of carotid plaques.

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Assessment of left atrial function in patients with hypertrophic obstructive cardiomyopathy before and one year after alcohol septal ablation by two dimensional speckle tracking echocardiography

Hailin TANG ; Peng LI ; Gongpai HU ; Li LI ; Hui FANG ; Guosheng FU ; Bowen ZHAO

Chinese Journal of Medical Ultrasound (Electronic Edition).2017;14(1):29-34. doi:10.3877/cma.j.issn.1672-6448.2017.01.009

Objective To assess left atrial (LA) function by two dimensional speckle tracking echocardiography (2DSTE) in patients with hypertrophic obstructive cardiomyopathy (HOCM) before and one year after percutaneous transluminal septal myocardial ablation (PTSMA).Methods The study included 31 patients with HOCM who underwent PTSMA performed between November 2012 and December 2014 in Sir Run Run Shaw Hospital.Mean age was 51 ± 13 years,and 13 patients were men,18 patients were women.New York Heart Association class was 2.6± 0.7 at baseline.If the target region was correctly marked by the injection of the echo contrast agent,ethanol was slowly (0.5 ml/min) injected to a maximum of 3 ml.Ten minutes after the injection of ethanol,the balloon was deflated.A successful procedure was defined as a ≥ 50％ reduction in the LV outflow tract peak systolic gradient compared to baseline level.Each patient with HOCM had a complete two-dimensional transthoracic echocardiography assessment before and one year after the PTSMA.The measurements included basal septal thickness,left ventricular outflow tract (LVOT) gradient,mitral regurgitation (MR) grade,left atrial dimensions,left ventricular (LV) ejection fraction and tissue Doppler parameters of lateral mitral annular e'and septal mitral annular e'.The LA wall was tracked on a frame-by-frame basis using 2D-STE,and LA volume waveforms were generated.The maximum LA volume (LAVmax),minimal LA volume (LAVmin),and the LA volume before atrial contraction (LAVpre-a) were measured.The LA reservoir function was calculated as left atrial expansion index (LAEI) and left atrial diastolic emptying index (LADEI).The LA conduit function was calculated as the passive emptying percentage of total emptying (PE) and the passive emptying index (PEI).The LA booster function was calculated as the active emptying percentage of total emptying (AE) and the active emptying index (AEI).The comparisons between patient New York Heart Association class,echocardiography and LA function parameter before and after PTSMA were conducted by paired t test.Results Compared with pre-operative values,LVOTG,MR grade,LA end-diastolic size,E/lateral e'ratio,septal mitral annular e'decreased in patients one year after the PTSMA [(35±26) mmHg vs (74135) mmHg,0.9310.35 vs 2.27±0.73,(40±6) mm vs (45±6) mm,12.6±3.8 vs 14.6±4.6,(4.3± 1.1) cm/s vs (5.0± 1.3) cm/s],whereas New York Heart Association class,Lateral mitral annular e',E/septal e'ratio [1.4±0.5 vs 2.6±0.7,(6.9±2.3) cm/s vs (5.8± 1.7) cm/s,20.2±7.1 vs 17.0±5.2] increased (t=6.55,4.78,2.60,2.84,2.59,-3.32,-2.67,-2.93,all P ＜ 0.05).Compared with pre-operative values,LAVImax,LAVImin,LAVIpre-a,AE,AEI(％) decreased in patients one year after the PTSMA [(32.7±7.1) ml/m2 vs (38.9±9.3) ml/m2,(16.3±4.4) ml/m2 vs (20.7±5.5) ml/m2,(23.1±5.7) ml/m2 vs (30.5±7.0) ml/m2,(41.5±8.7)％ vs (53.8± 10.4)％,(29.4±3.9)％ vs (32.1±4.6)％],(t=3.65,3.11,3.38,3.92,2.17,all P ＜ 0.05);whereas the LAEI(％),LADEI(％),PE(％),PEI(％) [(100.1 ± 19.3)％ vs (87.9± 14.7)％,(50.2±9.8)％ vs (46.7±9.1) ％,(58.5± 11.8) ％ vs (46.1 ±9.1) ％,(26.9±5.2)％ vs (21.6±4.8)％] increased (t=-2.82,-2.33,-3.89,-2.74,all P ＜ 0.05).Conclusions The study showed the improvement in LA reservoir and conduit function,while the reduction in LA booster pump function in patients one year after PTSMA.

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Evaluation of left ventricular systolic synchrony in patients with dilated cardiomyopathy by tissuemotion mitral annular displacement

Yanting WANG ; Haiyan FENG ; Dongmei GAO ; Bingbing XIAO

Chinese Journal of Medical Ultrasound (Electronic Edition).2017;14(1):35-39. doi:10.3877/cma.j.issn.1672-6448.2017.01.010

Objective To investigate the value of tissue motion mitral annular displacement (TMAD) in assessment of left ventricular systolic synchrony in patients with dilated cardiomyopathy (DCM).Methods Thirty-eight DCM patients and 30 healthy subjects were enrolled in this study.The left ventricular end diastolic volume (LVEDV),left ventricular end systolic volume (LVESV),and left ventricular ejection fraction (LVEF) in two groups were investigated using conventional echocardiographyexamination.The time of systolic mitral annular peak displacement (TP) in two groups were measured by the technique of TMAD at six sites (anteroseptal,posteroseptal,anterior,lateral,posterior and inferior).The standard deviation of TP (TP-SD) and the maximal difference of TP (TP-DIF) were calculated.And the correlation between TP-SD and LVEF as well as TP-DIF and LVEF in the DCM group were analyzed.The standard deviation and maximal difference of the time to point with minimal systolic volume of 16 segments (Tmsv16-SD,Tmsv16-DIF) of the DCM group were measured by the technique of real-time three-dimensional echocardiography (RT-3D).And the correlation between Tmsv-16SD and TP-SD as well as Tmsv16-DIF and TP-DIF were analyzed.Results Compared with the healthy subjects,LVESV and LVEDV increased (t=14.023,16.643,P ＜ 0.01) and the LVEF decreased significantly (t=26.112,P ＜ 0.01) in the DCM group.TP,TP-SD and TP-DIF in the DCM group obviously increased (t=7.628,6.869,7.507,6.616,5.631,4.738,7.368,5.777,6.781,P ＜ 0.01).TP-SD and TP-DIF were negatively correlated with LVEF (r=-0.645,-0.513,P ＜ 0.05),while TP-SD and Tmsv1 6-SD,TP-Dif and Tmsv1 6-Dif were positively correlated(r=0.643,P ＜ 0.01;r=0.563,P ＜ 0.05).Conclusions In this study,the TMAD technique was used to measure the time of peak displacement of mitral annulus to evaluate the synchrony of left ventricle movement.It is expected to be a new method in evaluation of the synchrony of left ventricle,which is simple,feasible approach without angle dependence.

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Ultrasounographic assessment of facet joint in the lumbar spine: a feasibility study

Ying HUANG ; Dan TIAN ; Da LIU ; Jing YIN ; Qiushuang YU

Chinese Journal of Medical Ultrasound (Electronic Edition).2017;14(1):40-44. doi:10.3877/cma.j.issn.1672-6448.2017.01.011

Objective To assess the feasibility and accuracy of ultrasound evaluation of facet joint in the lumbar spine by comparison of ultrasonography and CT measurements in normal and degenerative lumbar vertebra small joint.Methods Fifteen patients with chronic low back pain in Shengjing hospital of China Medical University were taken as the study group,and 20 healthy volunteers as the healthy controls from physical examination center of our hospital between January 2014 and December 2014.The ultrasonic and CT values were measured in L 1-S 1 small joints between normal and abnormal lumbar joints (height and width).The length and width of the left and right side small joints of healthy controls,ultrasonic measurement of healthy controls and patients with chronic low back pain,and value of ultrasonography and CT measurements were compared by using t test.Results The abnormal facet joint can be clearly showed by sonography,characterized by bone hyperplasia of edge joints,bone destruction,wear or thinning/thickening of articular cartilage.For the length and width of the lumber joints,the difference of ultrasonic measurement values between normal and abnormal lumbar joints were statistically significant [(1.26±0.03) cm vs (1.43±0.05) cm,t=2.626,P ＜ 0.05;(0.18±0.01) cm vs (0.15±0.02) cm,t=2.264,P ＜ 0.05].In patient group,the difference of length and width values in a total of 150 small joints between ultrasonography and CT were not statistically significant [(1.43 ± 0.17) cm vs (1.42 ± 0.16) cm],t=1.655,P ＞ 0.05;(0.15 ± 0.03) cm vs (0.14±0.03) cm,t=1.656,P ＞ 0.05].Conclusions The facet joint of the lumbar can be clearly shown by sonography and it is valuable in the diagnosis of small joint degeneration for lumbar vertebra.

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Real-time tissue elastography in the evaluation of uterine fibroids with different echo intensity following radio-frequency ablation

Siming WANG ; Xiaoqiu DONG ; Xiaohui SHAO ; Lulu WANG ; Liwei ZHANG ; Yunfeng QI ; Jingyu DUAN

Chinese Journal of Medical Ultrasound (Electronic Edition).2017;14(1):45-50. doi:10.3877/cma.j.issn.1672-6448.2017.01.012

Objective To investigate the value of real-time elastography (RTE) in evaluating the characteristics and elasticity index (E-index) changes at different echo level of uterine fibroids before and after radiofrequency ablation (RFA).Methods A total of 43 patients (with 55 lesions) accepted RFA under ultrasound guidance in the Fourth Affiliated Hospital of Harbin Medical University from September 2013 to January 2015.All lesions were confirmed to have no perfusion through ultrasonography 1 h after RFA.The diameter of lesions ranging from 1.0 cm to 3.0 cm (with an average of 1.9± 1.2 cm).Preoperative lesions were classified into 3 groups for comparison based on ultrasonic echo type,group A:hypo echo (n=30);group B:hyper echo (n=12);and group C:mixed echo (n=12).Measured elasticity index E-index and internal uniformity (△ E) were analyzed.Comparisons of E value and△ E value were performed with repeated measures.RTE images features using x2 test of Fisher inspection comparison at the same time differences between groups.Results (1) Before RFA,RTE images showed blue alternating with green with green being dominated accounting for 70％ (21/30).50％ of RTE images in group B were completely covered in blue (6/12),while group C exhibited 53.9％ blue alternating with green with blue being dominated (7/13).There were statistically significant characteristics of RTE images among 3 groups (P ＜ 0.01).1 h after RFA,74.5％ lesions exhibited with blue being dominated (41/55).However,83.6％ (41/55) exhibited with blue 3 months after RFA.The difference in characteristics of RTE among 3 groups displayed no statistical significance (P ＞ 0.05).(2) The comparison of E-index revealed that before RFA,the E value was the lowest in the group A and the highest in the group B,while the group C was between them.There was significant difference between group A and B (F=19.25,P ＜ 0.01).E-index elevated in all the three groups and significant differences were found 1 h,3 month after RFA in comparison with that before RFA in the group A (F=386.75,294.68,both P ＜ 0.01).In addition,significant differences were also found 1 h,3 month after RFA in comparison with the treatment in the group B (F=29.98,45.88,both P ＜ 0.01).As for the group C,there were significant differences in E-index 1 h,3 month after RFA compared with before RFA (F=120.29,139.64,both P ＜ 0.01).3 months after RFA,E-index further elevated in the three groups and no significant inter-group difference was found at the same time points (P ＞ 0.05).(3)Before RFA,the△ E value was lower in group A and group B,while higher in the group C,group C presenting significant difference from group A and B (F=484.68,344.15,both P ＜ 0.01).At 1 h after RFA,△ E value was higher in group A and group C,while lower in group B,with group B showing significant difference from the low and mixed echo groups (F=53.58,94.79,both P ＜ 0.01).Significant difference was observed 1 h after surgery compared to before RFA in group A (F=154.35,P ＜ 0.01).Significant difference was also found 1 h after RFA compared to 3 month after RFA in group A (F=266.85,P ＜ 0.01).As for group C,there were also significant differences in△ E-index before treatment and 1 h after RFA compared with 3 month after RFA (F=103.24,76.53,both P ＜ 0.01).At 3 months after RFA,△ E-index decreased in all three groups.No significant inter-group difference was found at the same time points (all P ＞ 0.05).Conclusions RTE characteristics and the elasticity index are distinctly different among uterine fibroid at various echo intensities.RTE contributes to judging changes in hardness before and after RFA.The application of RTE for quantitative comparison of lesion hardness and uniformity can be served as the foundation for evaluating therapeutic effects of RFA.

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Diagnosis and differential diagnosis of bladder leiomyoma on sonography

Na SU ; Qing DAI ; Meng YANG ; Chenyang ZHAO ; Wen XU ; Ming WANG ; Bing ZHANG ; Lili WANG

Chinese Journal of Medical Ultrasound (Electronic Edition).2017;14(1):51-56. doi:10.3877/cma.j.issn.1672-6448.2017.01.013

Objective Bladder leiomyoma is a rare type of benign bladder tumors.Because of the lack of knowledge about the ultrasonic pattems of this kind of disease,misdiagnosis frequently happens.Through reviewing the cases and relevant researches,we are able to understand the disease and figure it out in ultrasonic images.Methods Seventeen cases of patients with bladder leiomyoma were reviewed which were hospitalized in Peking Union Medical College Hospital during 2000 to 2016.All of the patients underwent ultrasound examinations before surgery.Transvaginal ultrasound was performed in 2 cases.And the diagnosis of each patient was confirmed by pathologic findings.Results In 14 Submucous leiomyomacases,hypoechoic mass with broad base was found in the bladder,circumscribed by a hyperechoic line,merging with mucous layer of the bladder.Circular shape was found in 6 cases,elliptical shape was in 9 cases,and 2 were lobulated.Blood signals were detected in 9 cases,while 8 cases showed no signals.Abundant regular blood flow was visualized in the 2 cases of transvaginal examinations.Conclusions There are some specific characteristics of bladder leiomyoma in ultrasound images,such as elliptical shape,hypoechoic mass with broad base,circumscribed by a hyperechoic line,merging with mucous layer of the bladder,thus it can be diagnosed before surgery by ultrasonography.Moreover,transvaginal ultrasound can provide more information for diagnosis and treatment planning of bladder leiomyoma,playing an important role in the diagnosis of bladder neoplasms.

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Conventional and Contrast-enhanced Ultrasound Features of Adenoid Cystic Carcinoma in Major Salivary Gland

Lingyan ZHOU ; Minghua GE ; Liyu CHEN ; Qi SHAO ; Dong XU

Chinese Journal of Medical Ultrasound (Electronic Edition).2017;14(1):57-60. doi:10.3877/cma.j.issn.1672-6448.2017.01.014

Objective To investigate the characterization of adenoid cystic carcinoma (ACC) in major salivary glandby conventional and contrast-enhanced ultrasound (CEUS).Methods The conventional and contrast-enhanced ultrasound images of 17 ACC in major salivary gland with pathological confirmation were retrospectively reviewed.Results 12 (70.6％) cases in 17 were found in submandibular,while 5 cases (29.4％) were in parotid.All the patients complained a mass,52.9％ had cheek pain,and 17.6％ had hadfacial nerve or lingual nerve paralysis;these symptoms had been present from 3 to 240 months (mean duration was 42.9± 62.1 months).14 cases (82.4％) were primary focuses,and 3 cases (17.6％) were recurrences with recurrence time from 36 to 132 months (mean recurrence time was 70.7±43.2 months).All lesions were hypoechoic with irregular shape,and only 17.6％ had a homogeneous echotexture,64.7％ heterogeneous.64.7％ of all tumors were well-defined.On CDFI,blood flow signal hadn't detected in 23.5％ patients,and 64.7％ hadintermediate (+ and + +) grades of vascularity.Only 11.8％ had the highest grade of vascularity (+ + +).The CEUS images of ACC in major salivary showed slow fill-in,centripetal,higher enhancement,inhomogeneous enhancement,poorly defined margins and after enhancing the size unchanged.No enhancement orlow enhancement area were common in the AC.Facial nerve invasion can be seen in all cases,including 3 cases (17.6％) of lingual nerve invasion,4 cases (23.5％) of blood vessel invasion;4 cases (23.5％) of striated muscle infiltration;1 case with mandibular involvement;1 case (5.9％) with cervical lymph node metastasis.94.1％ of ACC in major salivary gland were cribriform patterns,and 5.9％ were solid pattems.Conclusions ACC in major salivary gland are more likely to happen in the submandibular gland,which has especially high tendency of facial nerve invasion and cheek pain.Conventional Ultrasound and CEUS imaging characteristics can be used to differentiate ACC firom other tumors in major salivary gland,which would help clinicians to diagnose.The clinical course is characterized by very late recurrences;consequently,longer following-up with ultrasound is proposed.

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The effect of heterogeneity in different parts of deep venous thrombus on the ultrasound shear wave elasticity in rabbit

Xiaona LIU ; Na LI ; Haining ZHENG ; Yixiao HAN ; Qinggui YE ; Yisha TONG ; Chaoyang WEN

Chinese Journal of Medical Ultrasound (Electronic Edition).2017;14(1):61-66. doi:10.3877/cma.j.issn.1672-6448.2017.01.015

Objective To study the effect of heterogeneity in different parts of acute and chronic deep venous thrombus on the ultrasound shear wave elasticity value.Methods Fifteen Japanese rabbits were used to create an inferior vena cava (IVC) thrombus model via IVC ligation.Young's modulus of the thrombus head,body and tail were measured using ultrasonic shear wave elasticity technique on the fifth day (acute phase) and 14th day (chronic phase) of thrombus formation.Pathological sections were obtained from the IVC thrombus in five rabbits at the two points of time mentioned above.Pair t-test and one-way analysis of variance (ANOVA) were used to compare the data between groups.Results On the fifth day,Young's modulus values of the thrombus head,body and tail were (5.73 ±0.47)kPa,(7.82±0.63)kPa and (4.76±0.45)kPa respectively.ANOVA showed significant difference among three parts (F=134.468,P ＜ 0.01).The value of the thrombus body was significantly higher than that of the head and tail (both P ＜ 0.01),and the value of the head was significantly higher than that of the tail (P ＜ 0.01).On the 14th day,Young's modulus values of the thrombus head,body and tail were (12.46 ± 2.59)kPa,(15.08 ±2.71)kPa and (10.03 ± 2.02)kPa,respectively.ANOVA analysis also showed significant difference among three parts (F=10.539,P ＜ 0.01).The value of the thrombus body was significantly higher than that of the tail (P ＜ 0.01),and also higher than that of the head,although the difference was not significant (P ＞ 0.05).There was no significant difference between the head and tail (P ＞ 0.05).Young's modulus values of the thrombus head,body and tail in the chronic phase were significantly higher than those in the acute phase (t=-7.456,-7.989 and-8.159,respectively,all P ＜ 0.01).Pathological results showed that there was significant difference in thrombus structure and composition among different parts of the thrombus and among the thrombi in different individuals at corresponding points of time following thrombus formation.Conclusion There is significant heterogeneity among different parts of the same thrombus and among different thrombi at corresponding points of time after thrombus formation.Continual monitoring of the thrombus with ultrasound elasticity imaging may help to improve the accuracy of thrombosis staging.

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Calculation of left ventricular relaxation time constant (Tau) in dogs with mitral regurgitation by continuous-wave Doppler

Jing SUN ; Chunzhi FAN ; Jianping DOU ; Chaoyang WEN

Chinese Journal of Medical Ultrasound (Electronic Edition).2017;14(1):67-71. doi:10.3877/cma.j.issn.1672-6448.2017.01.016

Objective To explore the new method for noninvasively measuring the time constant of left ventricular relaxation (Tau) in animals with mitral regurgitation by continuous-wave Doppler.Methods The acute ischaemic left diastolic heart failure with mitral regurgitation was produced in 9 dogs.Dobutamine hydrochloride or esmolol hydrochloride had been applied to change the hemodynamic states.In different hemodynamic states,left ventricular pressures,left atrial pressures,curves of dP/dt and continuous-wave mitral regurgitant spectra were synchronously recorded.Doppler spectra were laterly processed through Matlab workstation.Paired t-test was used to compare the difference between Tau-catheter (Tau-c) and Tau-doppler ultrasound (Tau-d),and the correlation between Tau-c and Tau-d was analyzed by Pearson correlation analysis.Results Thirty-nine hemodynamic status had been obtained in 9 dogs.Tau-c was 21.03-78.45 ms and the average was (48.76± 17.60) ms.Tau-d was 21.24-94.60 ms and the average was (49.33 ± 18.79) ms.There was no significant difference (t=0.353,P=0.726) between Tau-d and Tau-c.The correlation analysis between Tau-d and Tau-c suggested a strong positive relationship with the correlation coefficient (r=0.85,P ＜ 0.001).Conclusions The dog aortic regurgitation model under ultrasound guidance is less traumatic.The method of inducing left ventricular diastolic dysfunction by repeatedly injecting microspheres into the left coronary sinus is safe and reliable.Choosing three points (t1,1 m/s;t2,2 m/s;t3,3 m/s) in aortic regurgitant velocity spectrum and putting them into the corresponding formula,we can obtain Tau,which had a good correlation with the catheter-derived Tau.

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An animal experimental study on the multiple comet tail sign and early abdominal visceral injury

Yiwen DING ; Dan ZHANG ; Yandong LI ; Lin ZHAI ; Yan MENG ; Dandan YAN ; Lan ZHANG

Chinese Journal of Medical Ultrasound (Electronic Edition).2017;14(1):72-77. doi:10.3877/cma.j.issn.1672-6448.2017.01.017

Objective To study the correlation between multiple comet tail sign and the early abdominal visceral injury and explore the clinical application of the multiple comet tail sign in prompting the early abdominal visceral injury in an oleic acid animal model.Methods The experimental animals were divided into an experimental group and a control group.The sonograms of the lungs,livers and kidneys of control group were collected,and then the rabbits were executed.The animals of experimental group were made into multiple comet tail sign models.The thorax sonogram of successful model showed at least one lung area with varying degrees of multiple comet tail sign.Collect the sonograms of lungs,livers and kidneys were collected,and then the rabbits were executed.The two groups of rabbits were dissected,and the lungs,livers,kidneys,and spleens were removed to make the tissue sections.The gross pathologic findings and microscopic histological changes of the two groups were observed and noted.The ultrasound scores of chest sonograms were recorded:short comet tail sign for 1 point,isolated comet tail sign for 2 points,mild multiple comet tail sign for 3 points,moderate multiple comet tail sign for 4 points,and falls sign (severe multiple comet tail sign) for 5 points.The degree of organ injury was assessed by the percentage of pathologic injury area under microscope,and the correlation between the multiple comet tail sign and abdominal organ injary was analyzed.Results The successful rate of multiple comet tail sign model in experimental group was 100％.The sonograms of liver and kidney have no significant change after the experiment.The incidence of positive pathologic changes in experimental group was 100％ (11/11).The gross pathologic findings of lung were complete shape with dark red hemorrhagic area at surface;the microscopic pathologic findings were pulmonary edema (11/11,100％) and pulmonary hemorrhage (9/11,81.8％).The incidence of positive pathologic changes in the liver of experimental group was 45.5％ (5/11).The gross pathologic findings of liver were complete shape with reddish brown surface and flexible texture;the microscopic pathologic findings were cellular swelling of hepatocytes (5/11,45.5％).The incidence of positive pathologic changes in the kidneys of experimental group was 18.2％ (2/11).The gross pathology had no obvious changes,and the microscopic pathologic findings were cellular swelling of renal tubular epithelial cells (2/11,18.2％).Results showed that the lung ultrasound scores of rabbits with liver injury were obviously higher than those of rabbits with no liver injury,and there was significant differences (Z=-2.529,P=0.011).There was a statistically significant positive correlation between the lung ultrasound scores of rabbits with liver injury and the microscopic pathologic area of liver lesion (r=0.893,P=0.041),and the higher the lung ultrasound score,the more severity of the liver injury.Conclusions The appearance of multiple comet tail sign is earlier than the sonogram changes of liver and kidney.The most sensitive pathologic changes of abdominal organ appear in liver,followed by kidney.The scope and extent of the multiple comet tail sign can prompt the early injury in liver and kidney.

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