With the great improvement in the prognosis and survival of breast cancer patients, coupled with the widespread use of cardiotoxic drugs, the cardiotoxicity caused by radiation-induced heart disease (RIHD) partially offsets the overall survival benefits of breast cancer patients. Heart damage occurs in many structures, such as left and right coronary arteries, the cardiac conduction system, the pericardium, and heart valves. RIHD has a long incubation period, most of which occur more than 10 years after radiotherapy, and the clinical manifestations become prominent with the extension of time. Advanced modern radiotherapy concepts such as respiratory gating, image-guided radiotherapy, conformal intensity-modulated radiotherapy, and intensity-modulated proton therapy can effectively reduce the radiation dose of breast cancer radiotherapy-related heart and left anterior descending coronary artery. The study of precise radiotherapy protection technology for the heart and large vessels is expected to reduce non-tumor-related death and achieve long-term survival in patients with breast cancer. The important direction in the future is to study the mechanism of RIHD, to find the best cardiac dose reference point, and to define the ideal dose-response relations. Combined with hematological markers, auxiliary examination parameters and cardiovascular risk factors, a predictive model will be established to estimate the probability of radiation-related cardiotoxicity in patients with breast cancer. As the radiation-related cardiotoxicity of breast cancer has become increasingly prominent, the purpose of this article is to summarize the related studies of RIHD in order to improve the long-term survival rate and quality of life of these sufferers.

With the great improvement in the prognosis and survival of breast cancer patients, coupled with the widespread use of cardiotoxic drugs, the cardiotoxicity caused by radiation-induced heart disease (RIHD) partially offsets the overall survival benefits of breast cancer patients. Heart damage occurs in many structures, such as left and right coronary arteries, the cardiac conduction system, the pericardium, and heart valves. RIHD has a long incubation period, most of which occur more than 10 years after radiotherapy, and the clinical manifestations become prominent with the extension of time. Advanced modern radiotherapy concepts such as respiratory gating, image-guided radiotherapy, conformal intensity-modulated radiotherapy, and intensity-modulated proton therapy can effectively reduce the radiation dose of breast cancer radiotherapy-related heart and left anterior descending coronary artery. The study of precise radiotherapy protection technology for the heart and large vessels is expected to reduce non-tumor-related death and achieve long-term survival in patients with breast cancer. The important direction in the future is to study the mechanism of RIHD, to find the best cardiac dose reference point, and to define the ideal dose-response relations. Combined with hematological markers, auxiliary examination parameters and cardiovascular risk factors, a predictive model will be established to estimate the probability of radiation-related cardiotoxicity in patients with breast cancer. As the radiation-related cardiotoxicity of breast cancer has become increasingly prominent, the purpose of this article is to summarize the related studies of RIHD in order to improve the long-term survival rate and quality of life of these sufferers.

Objective To observe the feasibility of Fourier ring correlation(FRC)for measuring the overall resolution of ultrasonic microvascular images.Methods Liver contrast-enhanced ultrasound(CEUS)images of 1 patient with suspected hepatic hemangioma(dataset 1)were processed with singular value decomposition(SVD)filter(dataset 2)and Frangi filter(dataset 3),respectively.Three ROI were selected on CEUS image in each dataset,and the signal-intensity curves were drawn,and local resolution of CEUS image in each dataset was measured using full width at half maxima(FWHM)method.Then the above datasets were divided into odd frame subset and even frame subset,respectively,which were converted into frequency domain using fast Fourier transform.FRC curves were generated to calculate the overall resolution of each kind images.Results The signal-to-noise ratio(SNR)of CEUS images in dataset 1,2,3 was(19.94±2.33),(30.36±0.78)and(69.52±16.38)dB,respectively,the local resolution was(4.07±9.82),(1.53±0.04)and(1.27±0.06)mm,both successively increased(all P＜0.05).The overall resolution of CEUS images in dataset 1,2,3 was 2.07,0.91 and 0.51 mm,respectively.Conclusion FRC was feasible for measuring the overall resolution of ultrasonic microvascular images.

Objective To observe the effect of extracting different speed contrast-enhanced ultrasound(CEUS)signals using singular value decomposition filtering and implementing fused imaging for improving visualization of microvascular structures.Methods Singular value decomposition and filtering were performed on 200 frames of mouse subcutaneous tumor and 250 frames of human liver CEUS image datasets.The singular value inflection point was used as the threshold for separating low-speed and high-speed contrast signals by exponential projection of singular values on the singular value sequence.The low-speed and high-speed signals in dataset were extracted,and dual-modal fusion imaging was performed on the processed images.The image resolution differences of ultrasound microvascular imaging regions with different flow velocities were evaluated.Results The high-speed blood flow images processed by the high singular value sequence range retained the fast-moving contrast signals which mainly showed the thicker blood vessel structures,while the low-speed blood flow images processed by the low singular value sequence range retained the low-speed moving contrast signals which reflected the microvascular structures on high singular value images.The fusion imaging displayed microvascular network more completely.Conclusion Appropriate selection of singular value range was crucial to optimization of CEUS images using singular value decomposition filtering.Fusion imaging was beneficial to improving visualization of microvascular structures.

Objective To observe the value of ultrasound vector flow imaging(VFI)combined with singular value decomposition(SVD)filtering for depicting deep microvasculature flow velocity of liver.Methods Grayscale ultrasound,CDFI and contrast-enhanced ultrasound(CEUS)were prospectively performed in a patient with suspected liver hemangioma.Images of CEUS were dealt with SVD filtering.Cross-correlation algorithm was used to obtain images of VFI based on grayscale ultrasound,original CEUS and SVD filtered CEUS,respectively,and the ability of the above images for depicting liver microvascular flow direction and velocity were compared.Results The signal-to-noise ratio(SNR)of liver grayscale ultrasound,original CEUS and SVD filtered CEUS images was 7.56,17.65 and 22.43 dB,respectively,while their contrast-to-issue ratio(CTR)was 1.12,7.56 and 16.34 dB,respectively.Compared with VFI based on grayscale ultrasound and original CEUS,VFI based on SVD filtered CEUS could display faster velocity and more uniform direction of blood flow.Before and after SVD filtering,liver microvascular flow velocity measured with VFI was 1.91(0.81,4.11)and 6.83(4.25,9.41)mm/s,respectively,which were significantly different(Z=-10.671,P＜0.001).Conclusion Combined with SVD filtering could significantly improve the efficiency of VFI for depicting liver deep microvasculature flow velocity.

Objective To look for more serum biomarkers supporting the diagnosis of multiple system atrophy ( MSA) and providing more evidence for early treatment.Methods All patients and healthy controls were enrolled from January 2011 to March 2015 in the First Affiliated Hospital of Zhengzhou University.Demographic features and biochemical examination results were collected.The t test was used to compare the lipid levels between MSA patients and controls.LSD-t test was used to compare the lipid levels among subtypes of MSA patients.Multivariate Logistic regression analysis was conducted to analyze the influencing factors.The relevance between lipid levels and onset age, disease duration and Hoehn & Yahr stage was calculated by Spearman correlation coefficients.Results Participants included 195 MSA patients and 195 age-and gender-matched controls with no neurological diseases.The levels of total cholesterol ((4.33 ±0.90) mmol/L), triglyceride ((1.27 ±0.71) mmol/L), low-density lipoprotein (LDL;(2.70 ±0.76) mmol/L) were significantly lower in patients than in controls ((4.52 ±0.85), (1.47 ± 0.86), (2.85 ±0.71) mmol/L ,t=2.056,2.528 and 2.149 respectively, all P<0.05).The levels of total cholesterol ((4.28 ±0.96) mmol/L) and triglyceride ((1.20 ±0.64) mmol/L) were significantly lower in MSA-P patients than in control group ((4.52 ±0.85), (1.47 ±0.86) mmol/L;LSD-t=1.983, 2.566, both P<0.05).After adjusting for age, gender and histories, the odds ratio ( OR) was 0.31 (95%CI 0.15-0.65, P =0.002 ) for MSA patients in the highest quartile of triglyceride and 0.38 (95%CI 0.17 -0.83,P=0.016) for those in the highest quartile of high-density lipoprotein (HDL), compared with the lowest quartiles.And HDL level was in a significantly positive correlation with onset age (r=0.15, P=0.039).Conclusion Our data suggest that triglyceride and HDL may be associated with the prevalence of MSA, and the lower levels of HDL, the earlier onset of MSA.