Objective To explore the clinical characteristics and short-term prognosis of postoperative acute myocardial infarction (PAMI) after cardiac surgery. Methods A retrospective study was conducted on 45 PAMI patients who underwent coronary angiography after cardiac surgery at Zhongshan Hospital, Fudan University, from February 2015 to February 2025. General information, type of surgery, onset time and causes of PAMI, and in-hospital recovery condition were collected. Univariate logistic regression was used to analyze factors related to in-hospital survival. Results The patients’ age was (62.40±11.72) years, 31 cases (68.89%) were male, 21 cases (46.67%) had hypertension. Twenty-six patients (57.78%) underwent cardiac valve surgery, and 16 patients (35.56%) received coronary artery bypass grafting. The onset time of PAMI was 24 (0, 48) hours, with 38 cases (84.44%) developing within 48 hours after surgery. Twenty-eight patients (62.22%) presented with new lesions in coronary arteries/bypass grafts, and 20 patients (44.44%) were considered to have thrombus-induced PAMI. Nine patients died in hospital, 13 patients failed to recover and were discharged automatically, and 23 patients were discharged after recovery. Univariate logistic regression analysis showed that new lesion in coronary arteries/bypass grafts was risk factor for in-hospital survival (OR=0.235, P=0.036). Conclusions PAMI frequently occurs within 48 hours post-cardiac surgery, and thrombosis is the most common cause of PAMI. New lesions in coronary arteries/bypass grafts are closely correlated with poor short-term prognosis.

Objective:To investigate the contrast-enhanced ultrasound (CEUS) features of inflammatory hepatocellular adenoma (I-HCA).Methods:The contrast-enhanced ultrasound features I-HCA of 28 cases from April 2009 to November 2019 in Zhongshan Hospital, Fudan University were retrospectively analyzed, including arterial phase enhancement pattern, the homogeneity of enhancement, subcapsular enhancement, and the internal perfusion defect. All I-HCA lesions were divided into >5 cm group( n=9) and ≤5 cm group( n=19), the CEUS features between the two groups were compared. Results:All I-HCA lesions were hyper-enhanced in the arterial phase, among which 39.3% (11/28) showed diffuse filling, 39.3%(11/28) showed centripetal filling, and 21.4%(6/28) showed centrifugal filling pattern. Twenty-five percent (7/28) of I-HCAs showed heterogeneous enhancement, 10.7% (3/28) revealed unenhanced areas within the lesions. Subcapsular vessels were observed in 67.7 (21/31) of I-HCA lesions. Heterogeneous enhancement and unenhanced areas were more frequently detected in lesions >5 cm ( P=0.020, 0.026, respectively), while there was no difference in the enhancement pattern and subcapsular vessels between the two groups ( P>0.05). Inportal venous phase, 42.9%(12/28) of I-HCAs showed hypo-enhancement, and 57.1%(16/28) of lesions showed washout in late phase. According to "hyper-enhancement in arterial phase, sustained hyper- or iso-enhancement in portal venous and late phase" by CEUS, the diagnostic accuracy of benign lesion was 42.9%(12/28). According to any of hyper-enhancement pattern in arterial phase, subcapsular vascular enhancement, and sustained hyper- or iso-enhancement in portal venous and late phase, the diagnostic accuracy of I-HCA was 71.4% (20/28). Conclusions:CEUS is valuable in the diagnosis of inflammatory hepatocellular adenoma.

Objective To analyze the typical contrast-enhanced ultrasound ( CEUS ) enhancement characteristics of hepatic focal nodular hyperplasia ( FNH) within 3 cm ,and to discuss the diagnostic value of CEUS in small FNH lesions . Methods Forty-eight cases of FNH were retrospectively studied . All lesions were confirmed histopathologically after surgical resection . CEUS examinations with SonoVue were performed to characterize the enhancement patterns of lesions in 5 minutes . The whole wash in and wash out enhancement procedure of lesions were recorded and analyzed . Results All FNH lesions displayed a rapid hyper-enhancement in arterial phase by CEUS ,39 lesions of which showed spring-like enhancement ;8 lesions showed spoke-like enhancement ;1 lesion showed dendritic enhancement . 6 .3% (3/48) of the lesions showed central scar ,and feeding arteries was found in 52 .1% (25/48) lesions . According to echogenicity shift of the lesions in various phases ,20 .8% (10/48) FNH showed fast-in and slow-out" ,64 .6% (31/48) showed fast-in and synchronous-out" ,and 14 .6% (7/48) showed fast-in and fast-out" . According to fast-in and synchronous-out" or fast-in and slow-out" by CEUS ,the accuracy rate of benignity reached 85 .4% (41/48) . According to any of the spring-like enhancement ,spoke-like enhancement ,central scars or feeding arteries ,the accuracy rate of diagnosis of FNH within 3 cm reached 97 .9% (47/48) ,and 81 .3%(39/48) of which were diagnosed through spring-like enhancement . Conclusions CEUS is helpful in diagnosis of FNH within 3 cm by showing various characteristic enhancement patterns ,and spring-like enhancement is the most important sign in diagnosis of FNH less than 3 cm . CEUS has high diagnostic value for FN H less than 3 cm .

Objective To observe the morphological changes of carotid artery wall by ultrasonography in patients with Takayasu arteritis,and to evaluate the diagnostic value of contrast-enhanced ultrasonography for active Takayasu arteritis.Methods High-frequency ultrasound technique was used to analyze the morphological changes of the carotid artery in 40 patients.NIH score was used as the gold standard and the complete clinical data and acute phase reactors were recorded.T test,Chi-square test,sensitivity and specificity were calculated for statistical analysis.Results The thickness of carotid artery wall in active group was much more thickened than the non-active group [(2.2±0.6) mm vs (1.8±0.5) mm,t=-2.142,P＜0.05].The CDD [(0.89±0.06) in active group vs (0.95±0.03) in non-active group,t=3.683,P＜0.01] and RDD [(0.17±0.06 in active group vs (0.09±0.05) in non-active group,t=-4.020,P＜0.01] were significantly different between the two groups.The distribution of neovascularization in the carotid artery wall of the active group was more diffuse in the central part of the wall.The sensitivity and specificity of contrast-enhanced ultrasonography to diagnose the active of Takayasu arteritis were 72.7％ and 87.5％ respectively,and the positive predictive value and the negative predictive value were 80.0％ and 82.4％ respectively.Conclusion Contrast-enhanced ultrasonography can be used as an effective way to assess the disease activity of TA patients.

Objective To study the risk factor and prognosis of concurrent depression in elderly patients with acute myocardial infarction (AMI) treated with percutaneous coronary intervention (PCI). Methods Two hundred and ninety-five AMI patients who received PCI and whose clinical data were complete were selected. Depression was determined by a self-rating scale (SDS), and was confirmed when SDS standard score≥53 scores. The patients were divided into 2 groups according to the ages:senium (age ≥ 60 years, 144 cases) group and younger group (age<60 years, 151 cases). Multiple Logistic regression analysis was used to analyze the related factors of depression. The patients were followed up for 1 year, and the rehospitalization rate, incidence of major adverse cardiovascular events (MACE) and left ventricular ejection fraction (LVEF) at 12 months were compared. Results The incidence of depression in senium group was significantly higher than that in younger group: 41.7%(60/144) vs. 21.2%(32/151), and there was statistical difference (P<0.05). Female gender, hypertension and type 2 diabetes mellitus were the independent risk factor for depression in patients with AMI after PCI (P<0.05). In senium group, the rehospitalization rate and incidence of MACE in patients with depression were significantly higher than those in patients without depression: 18.3% (11/60) vs. 6.0% (5/84) and 15.0% (9/60) vs. 4.8%(4/84), the LVEF was significantly lower than that in patients without depression:(41.50 ± 2.25)%vs. (49.76 ± 2.93)%, and there were statistical differences (P<0.05). The LVEF in patients with depression of senium group was significantly lower than that in patients with depression of younger group:(41.50 ± 2.25)%vs. (51.50 ± 2.32)%, and there was statistical difference (P<0.05). Conclusions The elderly AMI patients treated with PCI have higher rates of depression. Female gender, hypertension and type 2 diabetes mellitus are the important risk factor for depression after PCI. Depression has a significant effect on the prognosis of AMI patients, especially on LVEF in elderly patients.

Objective:To compare blood perfusion visibility of contrast‐enhanced ultrasound (CEUS) in colorectal carcinoma (CRC) liver metastasis with contrast‐enhanced computed tomography (CECT ) .Methods :Sixty cases of CRC liver metastasis in Zhongshan Hospital ,Fudan University were enrolled in this study and were analyzed with both CEUS and CECT .Results:At arterial phase ,53 .3% (32/60) lesions showed rim‐like enhancement and 46 .7% (28/60) lesions showed total enhancement on CEUS ,while on CECT , rim‐like enhancement , total enhancement and no enhancement were detected in 78 .3% (47/60 ) lesions ,16 .7% (10/60) lesions and 5% (3/60) lesions lesions ,respectively (P< 0 .01) .At peak enhancement ,93 .3%(56/60) lesions showed higher enhancement and 6 .7% (4/60) lesions showed lower enhancement on CEUS ,which were detected in 91 .2% (52/57) lesions and 8 .8% (5/57) lesions at arterial phase of CECT ,respectively (P>0 .05) .At portal venous phase ,all lesions showed lower enhancement on both CEUS and CECT (P>0 .05) .Conclusions :The blood perfusion appearance of CRC liver metastasis with CEUS is not identical as that of CECT .Among some cases ,CEUS is superior to CECT on arterial perfusion visualization of liver metastasis .

Objective To investigate the diagnostic value of ultrasound in primary hepatic lymphoma (PHL).Methods The ultrasonic and clinical features in 40 cases of PHL were analyzed retrospectively.All cases were pathologically confirmed by surgical operation or ultrasound-guided biopsy.Results The most common presentation of PHL was a solitary lesion which occurred in 57.5％ (23/40) of patients,followed by multiple lesions in 30.0％ (12/40),and diffuse infiltration patterns in 12.5 ％ (5/40).The first two types were usually shown on ultrasound as hypoechoic lesions with surrounding normal liver parenchyma in 88.6％ (31/35) of cases.The diffuse pattern presented as diffuse hepatomegaly without nodules in the liver parenchyma.There were 52.5％ (21/40) of the lesions which could not be diagnosed either as benign or malignant by ultrasound.Conclusions The clinical presentations and imaging features of PHL are non-specific.PHL should be considered as a differential diagnosis in cases of liver metastases when no primary tumour is apparent,or when sonographic findings show atypical features of primary liver carcinoma or hemangioma.When patients with unexplained fever and diffuse hepatomegaly,PHL should be considered and precaution should be taken to prevent to misdiagnose these patients as having fatty liver or chronic liver disease.

Objective To investigate the relationship between ultrasound features and pathological types of primary hepatic lymphoma (PHL).Methods Ultrasound and pathological features in 26 cases of PHL were analyzed retrospectively.Results The most common presentation of PHL was a solitary lesion,which occurred in about 57.7％ (15/26) of cases,followed by multiple lesions in about 26.9％ (7/26) of patients,and least commonly as diffuse infiltration patterns in about 15.4％ (4/26) cases.The first two types were similar and usually demonstrated as hypoechoic lesions to the surrounding normal liver parenchyma in 86.4％ (19/22) of cases on ultrasound.All the cases were B-cell non-Hodgkin lymphoma proven by histological and immunohistochemical examinations.The diffuse pattern demonstrated diffuse hepatomegaly without nodular,which were T-cell non-Hodgkin lymphoma proven by histological and immunohistochemical examinations.Conclusions PHL could be divided into single,multiple and diffuse types on ultrasound.The single and multiple types mainly present as hypoechoic lesions and the diffuse type shows hepatomegaly on ultrasound,which are closely related to histology and T or B-cell phenotype on immunohistochemical examination.

Objective To investigate the enhancement patterns of hypervascularized breast tumors with real time contrast-enhanced ultrasound (CEUS) and to evaluate the accuracy of CEUS in comparison with power Doppler in the discrimination purpose. Methods CEUS was preoperatively performed in 35 patients with 37 hypervascular breast lesions detected on power Doppler. The patterns of enhancement were analyzed and compared with morphological characteristics of the vessels displayed by power Doppler. Results Considering initial lump enhancement and peripheral flake enhancement as a criterion suggesting malignancy, CEUS showed a sensitivity of 90.9% ,a specificity of 73.3% and an accuracy of 75.70/00. While the morphological characteristics of the vessels demonstrated by power Doppler showed no significant difference between benign and malignant lesions, Conclusions CEUS is more accurate than power Doppler ultrasound in the assessment of blood flow of hypervascular breast tumors and more helpful in the differentiation role.

Objective To evaluate the value of contrast-enhanced ultrasonography(CEUS)in the diagnosis of hepatic artery complications after liver transplantation.Methods Thirty-seven patients suspected of hepatic artery complications were examined by CEUS.Contrast agent was SonoVue and low mechanical index harmonic CEUS was performed.Results CEUS helped significantly improve flow visualization in hepatic artery(100%).After contrast agent injection,mean contrast material arrival time was(16.1±5.5)s in hepatic artery and(19.3±4.6)s in portal vein.The diagnostic accuracy of hepatic artery thrombosis(HAT)was improved from 86%(30/35)to 100%(35/35)with CEUS.In the HAT group,contrast material arrival time in portal vein was(13.6±4.6)s,shorter to that in group without HAT(P＜0.05).Hepatic artery pseudo-aneurysm was also showed in 2 patients with CEUS after liver transplantation.Conclusions CEUS is a useful technique in improving hepatic artery visualization,which contribute to diagnose hepatic artery complications after liver transplantation.