For diagnosis of significant coronary artery stenosis, the most accurate parameter among the conventional echocardiographic parameters remains unknown.To assess the diagnostic efficacy of conventional echocardiographic parameters in the diagnosis of significant coronary artery stenosis and their correlation with the percentage of stenosis considering conventional coronary angiography as gold standard.Seventy eight individuals were included in the study. The three echocardiographic parameters including the coronary sinus flow [flow (mL/minute)], the global left ventricular perfusion by dividing the coronary sinus flow by left ventricular mass [flow/LVM (mL/minute)] and the difference between the left ventricular mass at end diastole and peak systole using area-length calculation methods [LV (d-s) mass A-L] were assessed using receiver operating characteristic (ROC) analysis for their accuracy to distinguish between normal subjects and patients with significant (> 50%) coronary artery disease (CAD).Flow (mL/minute), flow/LVM (mL/minuteg) and LV (d-s) mass A-L all correlated significantly with the percentage of stenosis (r = -0.64, P < 0.001; r = -0.47, P < 0.001; r = -0.56, P < 0.001, respectively). With the use of the percentage of stenosis > 50% as the criteria to distinguish patients with or without CAD, the areas under the ROC curve for flow (mL/minute) were 0.75, while they were 0.57 for flow/LVM (mL/minuteg) and 0.59 for LV (d-s) mass A-L. The percentage of stenosis > 70% was best detected by coronary sinus flow < 198 mL/minute (sensitivity, 81.35%; specificity, 70.37%; positive predictive value, 63.63%; negative predictive value, 86.36% and accuracy, 75%; P < 0.001).The coronary sinus flow per minute is the most accurate parameter among the three echocardiographic parameters mentioned above for the assessment of significant stenosis of the coronary artery.
Objectives This study was conducted to evaluate the value of sonographic B‐lines (previously called “comet tail artifacts”) in assessment of pulmonary hypertension in patients with interstitial lung diseases. Methods One hundred thirty‐four patients with clinically diagnosed interstitial lung diseases complicated by pulmonary hypertension underwent transthoracic lung sonography and Doppler echocardiography for assessment of the presence of B‐lines, the distance between them, and the pulmonary artery (PA) systolic pressure. A correlation analysis and a receiver operating characteristic curve analysis were performed. Results All patients had diffuse bilateral B‐lines. The maximum number of B‐lines seen in any positive zone (not a summation) was significantly correlated with the severity of PA systolic pressure ( r = 0.812; P < .0001), and a linear regression equation could be demonstrated: that is, y = 6.06 x + 17.57, where x and y represent the number of B‐lines and PA systolic pressure, respectively. A cutoff of more than 4 B‐lines seen in any positive zone had 89.5% sensitivity, 85.0% specificity, and 87.2% accuracy in predicting elevated PA pressure (>30 mm Hg). Conclusions The number of B‐lines is useful in assessment of pulmonary hypertension, especially when tricuspid regurgitation and pulmonary valve regurgitation do not exist or cannot be satisfactorily measured by Doppler echocardiography.
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Coronavirus disease (COVID-19) is highly infectious, has spread worldwide, and has a relatively high mortality rate. Early diagnosis and timely isolation are essential to control the spread of COVID-19. Computed tomography (CT) is considered to be an effective tool for the rapid diagnosis of COVID-19 and plays a key role in diagnosis, clinical course monitoring, and the evaluation of treatment outcomes. Artificial intelligence (AI) has emerged as a useful technology for early diagnosis, lesion quantification, and prognosis evaluation in patients with COVID-19. In this review, we discuss the role of CT in the diagnosis of COVID-19, typical CT manifestations of COVID-19 throughout the disease course, differential diagnoses, and the application of AI as a diagnostic and therapeutic tool in this patient population.
Objective: To explore the value of micro surface coil combined with three-dimensional reversed fast imaging with steady-state precession and diffusion-weighted imaging (3D-PSIF-DWI) in displaying intraparotid facial nerves and parotid ducts. Methods: In total 24 healthy volunteers with no parotid disease underwent scanning of head and neck coil and 4-cm micro surface coil combined with 3D-PSIF-DWI prospectively. The obtained original images were processed through maximum intensity projection, multiplanar reconstruction, and curved planar reconstruction. The magnetic resonance imaging (MRI) signal characteristics of intraparotid structure, the subjective score of image quality, the signal intensity ratio (SIR) of facial nerve/parotid tissues (SIR N ), and SIR of parotid duct/parotid tissues (SIR D ) were calculated, and the displaying rates of the facial nerves and parotid ducts were observed. The Wilcoxon matched-sample signed rank sum test was used to compare the scores of head and neck coil and micro surface coil 3D-PSIF-DWI sequence images; paired- t test was used to compare SIR N and SIR D of the 2 groups; χ 2 test was used to compare the displaying rate of the facial nerves and parotid ducts in the 2 groups. Results: In total 24 volunteers successfully underwent MRI scan of parotid glands. On 3D-PSIF-DWI images, the parotid gland showed slightly low signal intensity, muscle tissues showed intermediate intensity, while the vessels showed slightly high or equal intensity; the parotid segment of facial nerves was displayed as a tortuous line-like high intensity, and the parotid duct showed curved high intensity, lymph nodes showed kidney-shaped, oval, or spindle-shaped high intensity. The subjective scores for head and neck coil and small coil images were (2.2 ± 0.7) and (1.5 ± 0.3) respectively, with significant difference (Z = −2.714, P = 0.007), and image quality of micro surface coils was better than that of head and neck coil. The SIR N s of head and neck coil and micro surface coil images were 1.6 ± 0.5 and 2.2 ± 1.1 respectively; the SIR D s were 2.0 ± 0.6 and 2.8 ± 1.4 respectively, which showed significant differences ( t = 3.440, 3.639 respectively, P value was 0.001, 0.001 respectively). All facial nerve trunks could be displayed by head and neck coils and micro surface coils. On head and neck coil images, 46 sides of temporofacial division, 47 sides of cervicofacial division, 21 sides of temporal branches, 22 sides of zygomatic branches, 29 sides of buccal branches, 30 sides of marginal mandibular branches, 32 sides of cervical branches, and 28 sides of the parotid duct could be displayed. On micro coil images, 48 sides of temporofacial division, 48 sides of cervicofacial division, 37 sides of temporal branches, 39 sides of zygomatic branches, 42 sides of buccal branches, 35 sides of marginal mandibular branches, 46 sides of cervical branches, and 28 sides of the parotid duct could be displayed. The display number of first branches of the intraparotid facial nerve by these 2 methods had no significant difference, the number of the secondary branches and parotid duct had significant differences. Conclusion: Micro surface coil surpassed parotid MRI with 3D-PSIF-DWI sequence than neck coil, which can simultaneously clearly display the trunk and branches of the intraparotid facial nerves and parotid ducts.
The timely diagnosis of presence or absence of reperfusion injury after cardiac operation is critical for the patient's outcome. Whether transesophageal echocardiography (TEE) acquisition of regional grayscale intensity (TI), velocity, and displacement (D) after cardiac operation can discriminate between patients with ST-segment elevation ischemic reperfusion injury (STEIRI) and normal reperfusion state remains unknown.In this study, we investigated whether these parameters can effectively reflect the situation of ST-segment elevation ischemic reperfusion injury (STEIRI) in patients after cardiac operation and which has a higher performance of discrimination between patients with and without STEIRI.The maximal and minimal grayscale intensity in the cardiac cycle [TI (max), TI (min)], the difference of TI (max) and TI (min) [TI (max-min)], the cyclic variation index of TI [TI (CVI)], the systolic velocity (Vs), the early diastolic velocity (Ve), the late diastolic velocity (Va) and the peak displacement in the cardiac cycle (D) at the lateral side of the mitral annulus were measured and compared between patients with and without STEIRI. The performance of these parameters in discriminating between patients with and without STEIRI was analyzed.Compared with the patients without STEIRI, the patients with STEIRI had significantly smaller TI (max-min), TI (CVI), Vs, Ve, Va and D (P<0.05). With the use of these parameters as the criteria to distinguish patients with STEIRI from patients without STEIRI, the areas under the receiver operating characteristic curve were 0.86 for TI (max-min), 0.99 for TI (CVI), 0.89 for Vs, 0.71 for Ve, 0.85 for Va and 0.82 for D. For the best cut-off value of TI (CVI) of less than 34.45%, the sensitivity, specificity and accuracy for the prediction of patients with STEIRI were 94.74%, 97.05%, and 96.22%, respectively.The myocardial grayscale intensity, velocity and displacement can effectively reflect the situation of STEIRI in patients after cardiac operation, and TI (CVI) has a higher performance in discriminating between patients with and without STEIRI.
Objective Doppler arterial, peak velocity and intimal media thickness(IMT)from the abnormal femoral artery were utilized to assess the degree of stenosis. Methods IMT in the superficial femoral artery (SFA), peak velocity in systole, acceleratiln time and velocity waveform were recorded as assess the atherosclerosis of the SFA. Results The SFA or distal segment artery were affected by atherosclerosis stenosis or obstruction disease when IMT is more than 1mm, peak velocity in systole became less than 0.55m/s and normal multiphasic waveform in SFA was dismissed. The severity of the stenosis or the obstructive lesions was further evaluated by measurement of the three procedures. Conclusion The severity of the stenosis or the obstructive lesions in SFA or distal segment is evaluated by sonographical measurement and the elimination of normal multiphasic waveform.
Objective To investigate the source of the blood flow through ventricular septum in normal subject caused by slice-thickness artifact in echocardiography. Methods Echocardiography was performed in 50 normal subjects without ventricular septum defect by two models of echocardiography unit equipped with two models of transducer, observing the conditions and sections in which the blood flow through ventricular septum could be detected. Results The blood flow through ventricular septum was detected in 8 normal subjects using the certain model of echocardiography unit,especially in parasternal four chambers section and parasternal irregular sections, while the blood flow through ventricular septum wasn't detected in the other 42 subjects by any echocardiography unit. The blood flow through ventricular septum was caused by coronary vessel in atrioventrieular groove proved by combining dynamic observation with anatomy analysis. Conclusions The blood flow through ventricular septum in normal subjects, a kind of slice-thickness artifact in echocardiography,is caused by coronary vessel in atrioventricular groove mapped into intact ventricular septum.
Key words:
Echocardiography; Ventricular septum; Artifact
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