Clinical Hemorheology and Microcirculation - Volume 81, issue 2

Authors: Zhang, Yi | Sun, Xiaofeng | Li, Jingjing | Gao, Qian | Guo, Xiaofei | Liu, Jian-xin | Gan, Wenyuan | Yang, Shunshi

Article Type: Research Article

Abstract: OBJECTIVE: To investigate the added value of contrast-enhanced ultrasound (CEUS) and superb microvascular imaging (SMI) to the conventional ultrasound (US) in the diagnosis of breast lesions. METHODS: PubMed, EMBASE, Web of Science, Chinese national knowledge infrastructure databases, Chinese biomedical literature databases, and Wanfang were searched for relevant studies from November 2015 to November 2021. The quality of the included studies was evaluated using the Quality Assessment of Diagnostic Studies (QUADAS) tool. Meta-Disc version 1.4 was used to calculate sensitivity (SEN), specificity (SPE), positive likelihood ratio (LR+ ), negative likelihood ratio (LR– ), area under curve (AUC), and diagnostic …odds ratio (DOR). Meta-regression analysis was performed using STATA 16.0 software to compare the diagnostic accuracy of the two techniques. RESULTS: In the five studies included, 530 patients were eligible for this meta-analysis. For SMI, the pooled SEN and SPE were 0.75 (95% confidence interval [CI]: 0.69–0.91) and 0.88 (95% CI: 0.83–0.91), respectively, LR+ was 5.75 (95% CI: 4.26–7.78), LR– was 0.29 (95% CI: 0.23–0.36), DOR was 21.42 (95% CI, 13.61–33.73), and AUC was 0.8871. For CEUS, the pooled SEN and SPE were 0.87 (95% CI: 0.82–0.91) and 0.86 (95% CI: 0.82–0.89), respectively, LR+ was 5.92 (95% CI: 4.21–8.33), LR– was 0.16 (95% CI: 0.11–0.25), DOR was 38.27 (95% CI: 18.73–78.17), and AUC was 0.9210. CONCLUSIONS: Adding CEUS and (or) SMI to conventional US could improve its diagnostic performance in differentiating benign from malignant solid breast lesions. Show more

Keywords: Contrast-enhanced ultrasound, superb microvascular imaging, breast lesions, BI-RADS

DOI: 10.3233/CH-211367

Citation: Clinical Hemorheology and Microcirculation, vol. 81, no. 2, pp. 109-121, 2022

Authors: Zhang, Fan | Li, Gang | Jin, Lifang | Jia, Chao | Shi, Qiusheng | Wu, Rong

Article Type: Research Article

Abstract: OBJECTIVE: To evaluate and optimize the additional diagnostic value of Doppler imaging for malignant NMLs detected by US. MATERIALS AND METHODS: The characteristics of 233 NMLs in Doppler imaging were analyzed, and different Adler grades of intralesional vessels were selected as the diagnostic cutoffs on Doppler imaging: grade 1 in the full cohort and in women < 40 years, and grade 0 in women ≥40 years. The diagnostic performance of US and US + Doppler imaging were calculated and compared with that of mammography. RESULTS: The AUC of US + Doppler was larger than that of US alone in each group (P … < 0.001). In the full cohort, addition of Doppler imaging increased specificity of US, but decreased sensitivity. However, by use of different diagnostic cutoffs in the two subgroups, it was possible to achieve high sensitivity and specificity simultaneously, which were 100% and 75.8% in women < 40 years, 94.7% and 69.5% in women ≥40 years, respectively. The AUC + Doppler was comparable to that of mammography in the full cohort and in women ≥40 years. In women < 40 years, the AUC of the combination was larger than that of mammography (P  < 0.001). CONCLUSION: Doppler imaging, with different Adler grades used as cutoffs in older versus younger women, can improve the specificity of US for the diagnosis of malignant NMLs without losing sensitivity. In younger women, US + Doppler imaging may be better than mammography. Show more

Keywords: Breast, ultrasound, doppler, mammography, diagnosis

DOI: 10.3233/CH-211371

Citation: Clinical Hemorheology and Microcirculation, vol. 81, no. 2, pp. 123-134, 2022

Authors: Mao, Xiang | Wang, Lingqing | Chen, Changgong | Tao, Luyuan | Ren, Shijia | Zhang, Li

Article Type: Research Article

Abstract: BACKGROUND: Circular RNA circ_0124644 has crucial regulation in the progression of coronary artery diseases, including atherosclerosis (AS). The aim of this study was to explore the regulatory mechanism of circ_0124644 in oxidized low-density lipoprotein (ox-LDL)-induced endothelial injury in human umbilical vein endothelial cells (HUVECs). METHODS: Cell viability and proliferation were assessed using cell counting kit-8 (CCK-8) assay and EdU assay. The apoptosis detection was performed by flow cytometry. Angiogenesis was evaluated through tube formation assay. The protein analysis was conducted via western blot. Inflammatory cytokines were examined by enzyme-linked immunosorbent assay (ELISA). The expression determination of circ_0124644, microRNA-370-3p …(miR-370-3p) and forkhead box protein O4 (FOXO4) was performed through reverse transcription-quantitative polymerase chain reaction (RT-qPCR). Dual-luciferase reporter assay and RNA immunoprecipitation (RIP) assay were used to analyze the interaction between targets. RESULTS: Treatment of ox-LDL resulted in the inhibition of cell viability, proliferation and angiogenesis but the promotion of apoptosis and inflammation in HUVECs. These ox-LDL-induced cell damages were alleviated after the downregulation of circ_0124644. Circ_0124644 interacted with miR-370-3p, and the regulatory role of circ_0124644 was associated with the sponge function of miR-370-3p. Additionally, miR-370-3p targeted FOXO4 and circ_0124644 increased the expression of FOXO4 through acting as a sponge of miR-370-3p. Overexpression of miR-370-3p protected from ox-LDL-induced injury via the downregulation of FOXO4. CONCLUSION: All results revealed that circ_0124644 accelerated endothelial injury in ox-LDL-treated HUVECs by mediating miR-370-3p-related FOXO4 expression. Show more

Keywords: Circ_0124644, miR-370-3p, FOXO4, atherosclerosis, ox-LDL

DOI: 10.3233/CH-211375

Citation: Clinical Hemorheology and Microcirculation, vol. 81, no. 2, pp. 135-147, 2022

Authors: Qiu, Yi-Jie | Zhao, Guo-Chao | Shi, Shuai-Nan | Zuo, Dan | Zhang, Qi | Dong, Yi | Lou, Wen-Hui | Wang, Wen-Ping

Article Type: Research Article

Abstract: OBJECTIVE: To explore the value of dynamic contrast enhanced ultrasound (DCE-US) in preoperative differential diagnosis of focal-type autoimmune pancreatitis (AIP) and pancreatic ductal adenocarcinoma (PDAC). PATIENTS AND METHODS: From May 2016 to March 2020, patients with biopsy and histopathologically confirmed focal-type AIP (n  = 9) were retrospectively included. All patients received contrast enhanced ultrasound (CEUS) examinations one week before surgery/biopsy. Dynamic analysis was performed by VueBox® software (Bracco, Italy). Eighteen cases of resection and histopathologically proved PDAC lesions were also included as control group. B mode ultrasound (BMUS) features, CEUS enhancement patterns, time intensity curves (TICs) and CEUS quantitative …parameters were obtained and compared between AIP and PDAC lesions. RESULTS: After injection of ultrasound contrast agents, most focal-type AIP lesions displayed hyper-enhancement (2/9, 22.2%) or iso-enhancement (6/9, 66.7%) during arterial phase of CEUS, while most of PDAC lesions showed hypo-enhancement (88.9%) (P  < 0.01). During late phase, most of AIP lesions showed iso-enhancement (8/9, 88.9%), while most of PDAC lesions showed hypo-enhancement (94.4%) (P  < 0.001). Compared with PDAC lesions, TICs of AIP lesions showed delayed and higher enhancement. Among all CEUS perfusion parameters, ratio of PE (peak enhancement), WiAUC (wash-in area under the curve), WiR (wash-in rate), WiPI (wash-in perfusion index, WiPI = WiAUC/ rise time), WoAUC (wash-out area under the curve), WiWoAUC (wash-in and wash-out area under the curve) and WoR (wash-out rate) between pancreatic lesion and surrounding normal pancreatic tissue were significantly higher in AIP lesions than PDAC lesions (P  < 0.05). CONCLUSION: DCE-US with quantitative analysis has the potential to make preoperative differential diagnosis between focal-type AIP and PDAC non-invasively. Show more

Keywords: Dynamic contrast enhanced ultrasound (DCE-US), autoimmune pancreatitis (AIP), time intensity curves (TICs), quantitative parameters, preoperative

DOI: 10.3233/CH-221390

Citation: Clinical Hemorheology and Microcirculation, vol. 81, no. 2, pp. 149-161, 2022

Authors: Wang, Lan | Nie, Fang | Dong, Tiantian | Yin, Ci | Li, Ming | Li, Yuanyuan

Article Type: Research Article

Abstract: OBJECTIVES: To observe and assess the diagnostic value of contrast-enhanced ultrasound (CEUS) in patients with iso-/hypervascular solid pancreatic lesions. METHODS: 70 pancreatic lesions (all confirmed by surgery or biopsy pathology) that manifested iso-/hyperenhancement on CEUS were retrospectively studied from January 2018 to January 2022, including 24 pancreatic ductal adenocarcinomas (PDAC), 15 mass-forming pancreatitis (MFP), 24 pancreatic neuroendocrine tumors (PNET) (14 hyper-PNETs, 10 iso-PNETs), and 7 solid pseudopapillary tumors of pancreas (SPTP). 65 pancreatic ductal adenocarcinomas (PDAC) that manifested hypoenhancement on CEUS were retrospectively studied from January 2020 to January 2022. CEUS patterns and the clinical and pathologic features …were analyzed, and the diagnostic ability of CEUS for iso/hyperenhanced solid pancreatic lesions was assessed. RESULTS: Centripetal enhancement, heterogeneous enhancement, early washout, and hypoenhancement in the late phase mostly appeared in iso-/hyper-PDACs (p  < 0.05). Heterogeneous enhancement in small lesions (< 3 cm) as the diagnostic criterion for iso-/hyper-PDACs had an accuracy of 74.3% and a specificity of 91.3%. Iso-PNETs more commonly had larger tumor sizes and more often showed heterogeneous enhancement than hyper-PNETs (p  = 0.007, p  = 0.035, respectively). The characteristics of the combination of isoenhancement, homogeneous enhancement, and synchronous wash-in/out for MFP had a high accuracy of 90%. Capsular enhancement with heterogeneous enhancement inside for SPTP had an accuracy of 97.1%. CONCLUSION: CEUS enhancement patterns have potentially great value in the differentiation of iso-/hyperenhanced pancreatic lesions. Show more

Keywords: Ultrasonography, contrast agent, pancreatic neoplasms, pancreatitis

DOI: 10.3233/CH-221397

Citation: Clinical Hemorheology and Microcirculation, vol. 81, no. 2, pp. 163-176, 2022

Authors: Tews, H.C. | Kandulski, A. | Schmid, S. | Peschel, G. | Gülow, K. | Schlosser, S. | Schirner, S. | Stroszczynski, C. | Müller, M. | Jung, E.M.

Article Type: Research Article

Abstract: Ten patients with confirmed COVID-19 disease were studied. Nine patients required intensive care treatment, among them four needed extracorporeal membrane oxygenation (ECMO). Contrast enhanced ultrasonography (CEUS) was performed by one experienced investigator as a bolus injection of up to 2.4 ml of sulphur hexafluoride microbubbles via a central venous catheter. B-Mode evaluation and strain elastography showed mural edema of the small bowel with a thickness of up to 10 mm in all patients. We applied color coded Doppler sonography (CCDS) and power mode with flow-adapted parameters and early, dynamic capillary arterial contrast enhancement of bowel wall structures <10 s to assess perfusion of …the small bowel. In all patients, reactive hyperemia was seen in the entire small bowel. In a subgroup of seven patients microbubbles translocated into the intestinal lumen. Thus, high-grade intestinal barrier disruption secondary to SARSCoV-2 infection can be postulated in these patients. This is the first description of perfusion changes and a disruption of the small bowel epithelial barrier in COVID-19 Patients using contrast ultrasonography and elastography. Show more

DOI: 10.3233/CH-221407

Citation: Clinical Hemorheology and Microcirculation, vol. 81, no. 2, pp. 177-190, 2022