OBJECTIVE To analyze the value of elastic modulus of shear wave elastography in the diagnosis of cervical lymph node metastasis of thyroid cancer and its correlation with VEGF-C and VEGF-D.METHODS A total of 120 patients with thyroid cancer admitted to our hospital were divided into metastatic group(n=37)and non-metastatic group(n=83)according to whether the cervical lymph node metastasis.The clinical data and SWE elastic modulus values of the two groups were compared,and the effects of clinical characteristics on SWE elastic modulus values were analyzed by hierarchical regression.Logistic regression analysis was conducted to analyze the independent correlation between SWE elastic modulus and the risk of lymph node metastasis of thyroid cancer.The dose-response relationship between the elastic modulus of SWE and the risk of lymph node metastasis in thyroid cancer was analyzed with restricted cubic strips.The correlation between SWE elastic modulus and VEGF-C and D levels was analyzed after adjusting factors by Logistic regression.RESULTS The results of general data analysis showed that male proportion,BMI,clinical stage,lesion diameter,TSH,FT4,TgAb positive rate,TPOAb positive rate,VEGF-C and VEGF-D in metastatic group were higher than those in non-metastatic group.Under different clinical characteristics,SWE parameters Emax,Emean and Eratio in metastatic group were higher than those in non-metastatic group.In hierarchical regression analysis,gender,clinical stage,lesion diameter,biochemical indices(TSH,FT4,TgAb,TPOAb)had significant positive effects on SWE parameters.SWE parameters were independently associated with the risk of lymph node metastasis of thyroid cancer.Subgroup analysis showed that the association between SWE parameters and the risk of lymph node metastasis of thyroid cancer in all subgroups was statistically significant(P<0.05).There was no nonlinear dose-response relationship between SWE parameters and thyroid cancer risk(P>0.05).After adjusting for confounding factors,there was a significant linear correlation between Emax,Emean,Eratio and VEGF-C and VEGF-D(P<0.05).CONCLUSION The elastic modulus of SWE has a certain diagnostic value for lymph node metastasis of thyroid cancer,and SWE parameters have a certain correlation with VEGF-C and VEGF-D.

Objective To investigate the value of three-dimensional speckle tracking imaging (3D-STI) in quantitative evaluation of left ventricular global strain in patients with atrial septal defect (ASD) before and after transcatheter closure.Methods Totally 35 patients with secondary ASD who received successful transcatheter occlusion were selected.Routine echocardiography and 3D-STI examination were performed before the operation,2 days,1 month,3 months and 6 months after the operation.Routine echocardiography was used to obtain the parameters of left ventricular end diastolic diameter (LVEDD),left ventricular end systolic diameter (LVEDS),left ventricular end diastolic volume (LVEDV),left ventricular end systolic volume (LVESV),stroke volume (SV) and other parameters.The left ventricular global peak longitudinal strain (GPLS),left ventricular global peak circumferential strain (GPCS),left ventricular global peak radial strain (GPRS) and left ventricular global peak area strain (GPAS) were examined with 3D-STI.The preoperative and postoperative parameters at each time point were analyzed statistically.Results Routine echocardiography showed that LVEDD,LVEDS,LVEDV,LVESV and SV increased significantly after operation,but no significant difference was found to compare each other 2 days,1 month,3 months and 6 months after operation (all P＞0.05).3D-STI examination showed that left ventricular GPLS,GPCS,GPRS and GPAS increased after operation,and the most increase was noticed at the second day after transcatheter occlusion.GPLS,GPCS and GPAS 6 months after operation were larger than those 3 months after operation (all P＞0.05).Conclusion 3D-STI technique can evaluate the left ventricular global strain in patients with ASD before and after occlusion.Compared with conventional echocardiography,3D-STI technique can objectively and effectively evaluate the changes of left ventricular systolic function.

Objective To investigate the change features of the 3-dimensional speckle tracking imaging (3D-STI) for quantitative evaluation of whole strain of left ventricular before and after left atrial appendage closure in the patients with non valvular atrial fibrillation and to evaluate its clinical application value.Methods Thirty patients who received left atrial appendage (LAA) closure from June, 2016 to A-pril, 2017 in Changhai Hospital were enrolled as research subjects .The patients received routine ultrasonic cardiography and 3D-STI, and left ventricular fractional shortening (LVFS), left ventricular ejection fractions (LVEF), global peak longitudinal strain (GPLS), global peak circumferential strain (GPCS), global peak radial strain (GPRS)as well as global peak area strain (GPAS) were respectively detected before surgery, 2 days, 1 and 3 months after surgery.Results In the 30 patients who received LAA closure, LVFS and LVEF were evaluated by u-sing routine ultrasonic cardiography and the data detected before surgery , 2 days, 1 and 3 months after surgery were compared between the two, and results showed that there was no statistical significance, when comparisons were made between them (P>0.05).In the 30 patients who were implemented with LAA closure, GPLS, GPCS, GPRS and GPAS values were detected using 3D-STI.The detected data 2 days after surgery were significantly higher as compared with those before surgery and 1 and 3 months after surgery(e.g.GPAS:39.90 ±10.22/27.80 ± 5.00, 26.20 ±6.05, 27.60 ±7.58), and there was statistical significance, when comparisons were made between them (P<0.05).However, there was no statistical significance in the data of GPLS, GPRS, GPCS and GPAS detected before surgery and 1 and 3 months after surgery, when comparisons were made between the two (P>0.05).Conclusion 3D-STI could be used for quantitative evaluation of the changes in left ventricular systolic function before and after LAA closure.The whole strain of the left ventricle of the patient was considerably increased 2 days after surgery, and the whole strain of the left ventricle recovered to pre-surgical level one month after surgery.