High-Resolution Ultrasound in Research of Mouse Orthotopic Glioma and Ultrasound-Guided Cell Implant

The purpose is to evaluate the feasibility of imaging mouse brain with high resolution ultrasound (HiRes US), and generation of mouse brain tumor (glioma) model under HiRes US guided implantation of glioma cells. Normal mouse brain was imaged with 30 MHz HiRes US in six pups and ten adult nude mice. Glioma model was developed by injecting human glioma cells (5 × 105), U-87MG-luc, under HiRes US guidance, in three pups and five adult mice. Bioluminescence imaging, magnetic resonance imaging, and HiRes US were used for in vivo tumor imaging. In addition, brain imaging ex vivo with HiRes US were also performed in three tumor bearing and five normal brains. The brain parenchyma was seen as a homogeneous low echo on HiRes US without locoregional echo differences. An inverted U shaped linear echo structure (fissure) differentiated the telencephalon from the diencephalon. Bilaterally budding structure at the base of the skull represented the trigeminal nerve. The inserted needle, used to implant the glioma cells, was seen as a high linear echogenic reflection. Brain tumor on ex vivo HiRes US was well demarcated, homogeneous and hyperechoic compared to the surrounding healthy brain. In conclusion, imaging the brain with HiRes US in small animal model like mouse is possible and convenient. Real-time guiding is possible to perform any intervention from tumor implantation to percutaneous therapeutic procedures. Ex vivo, HiRes US is extremely useful to study the detailed anatomical features.

Comparison of high-resolution ultrasound and MR-enterography in patients with inflammatory bowel disease

AIM:To compare the results of high-resolution ultrasound(HR-US) and magnetic resonance enterography(MRE) examinations in patients with inflammatory bowel disease(IBD).METHODS:The reports of 250 consecutive cases with known IBD,who had an MRE and HR-US examination,were retrospectively analyzed.Using a patient-based approach we evaluated morphological disease features such as affected bowel wall,stenosis,abscess and fistula.The comparison between the two modalities was based on the hypothesis,that any pathological change described in any imaging modality was a true finding,as no further standard of reference was available for complete assessment.RESULTS:Two hundred and fifty examinations representing 207 different patients were evaluated.Both modalities assessed similar bowel wall changes in 65% of the examinations,with more US findings in 11% and more MRE findings in 15%.When the reports were analyzed with regard to "bowel wall inflammation",US reported more findings in 2%,while MRE reported more findings in 53%.Stenoses were assessed to be identical in 8%,while US found more in 3% and MRE in 29%(P < 0.01).For abscess detection,US showed more findings in 2%(n = 4) while MRE detected more in 6%(n = 16).US detected more fistulas in 1%(n = 2),while MRE detected more in 13%(n = 32)(P < 0.001).The most common reason for no detected pathology by US was a difficult to assess anatomical region(lesser pelvis,n = 72).CONCLUSION:US can miss clinically relevant pathological changes in patients with IBD mostly due to difficulty in assessing certain anatomical regions.

Use of High-Resolution Ultrasound (HRU) in the Assessment of Deep Injections of CHAP-Hyaluronic Acid (CHAP-HA) Fillers for Midface Lift

High-resolution ultrasound (HRU) imaging is a useful tool to study hyaluronic acid (HA) filler injection in the face. It is noninvasive, quick, well-tolerated, and can provide in vivo and dynamic information. The formations of pools or pearls in HA fillers could be observed real time during injection. The plane of injection could be determined accurately, and there were no specimen manipulation artifacts. It was observed that HA gel fillers with differing production technologies showed distinct spread and distribution patterns in the periocular tissues on HRU examination. The authors used HRU to assess deep injections of CHAP-Hyaluronic Acid (CHAP-HA) fillers for midface lift. 10 patients who underwent bilateral midface deep injections using CHAP-HA filler were examined with HRU before and immediately after treatment, and in 2 weeks and one month later. The CHAP-HA appeared as hypoechoic densities within the preperiosteal plane in HRU. CHAP-HA adopted variable morphology within the tissue depending on individual tissue densities and the compliance of the tissues in the plane of injection. CHAP-HA was unidentifiable with surrounding tissue after one month in 13 of the 20 injection sites. HRU allows in vivo study of CHAP-HA injection behavior and could be a tool for further studies of HA-tissue reactions.

Verification and Validation of High-Resolution Inviscid and Viscous Conical Nozzle Flows

Capturing elaborated flow structures and phenomena is required for well-solved numerical flows.The finite difference methods allow simple discretization of mesh and model equations.However,they need simpler meshes,e.g.,rectangular.The inverse Lax-Wendroff(ILW)procedure can handle complex geometries for rectangular meshes.High-resolution and high-order methods can capture elaborated flow structures and phenomena.They also have strong mathematical and physical backgrounds,such as positivity-preserving,jump conditions,and wave propagation concepts.We perceive an effort toward direct numerical simulation,for instance,regarding weighted essentially non-oscillatory(WENO)schemes.Thus,we propose to solve a challenging engineering application without turbulence models.We aim to verify and validate recent high-resolution and high-order methods.To check the solver accuracy,we solved vortex and Couette flows.Then,we solved inviscid and viscous nozzle flows for a conical profile.We employed the finite difference method,positivity-preserving Lax-Friedrichs splitting,high-resolution viscous terms discretization,fifth-order multi-resolution WENO,ILW,and third-order strong stability preserving Runge-Kutta.We showed the solver is high-order and captured elaborated flow structures and phenomena.One can see oblique shocks in both nozzle flows.In the viscous flow,we also captured a free-shock separation,recirculation,entrainment region,Mach disk,and the diamond-shaped pattern of nozzle flows.

A High-Resolution Measurement Method for Inner and Outer 3D Surface Profiles of Laser Fusion Targets Using a Laser Differential Confocal–Atomic Force Probe Technique

The high-resolution and nondestructive co-reference measurement of the inner and outer threedimensional(3D)surface profiles of laser fusion targets is difficult to achieve.In this study,we propose a laser differential confocal(LDC)–atomic force probe(AFP)method to measure the inner and outer 3D surface profiles of laser fusion targets at a high resolution.This method utilizes the LDC method to detect the deflection of the AFP and exploits the high spatial resolution of the AFP to enhance the spatial resolution of the outer profile measurement.Nondestructive and co-reference measurements of the inner profile of a target were achieved using the tomographic characteristics of the LDC method.Furthermore,by combining multiple repositionings of the target using a horizontal slewing shaft,the inner and outer 3D surface profiles of the target were obtained,along with a power spectrum assessment of the entire surface.The experimental results revealed that the respective axial and lateral resolutions of the outer profile measurement were 0.5 and 1.3 nm,while the respective axial and lateral resolutions of the inner profile measurement were 2.0 nm and approximately 400.0 nm.The repeatabilities of the rootmean-square deviation measurements for the outer and inner profiles of the target were 2.6 and 2.4 nm,respectively.We believe our study provides a promising method for the high-resolution and nondestructive co-reference measurement of the inner and outer 3D profiles of laser fusion targets.

Accurate Source-Receiver Positioning Method for a High-Resolution Deep-Towed Multichannel Seismic Exploration System

The near-seabed multichannel seismic exploration systems have yielded remarkable successes in marine geological disaster assessment,marine gas hydrate investigation,and deep-sea mineral exploration owing to their high vertical and horizontal resolution.However,the quality of deep-towed seismic imaging hinges on accurate source-receiver positioning information.In light of existing technical problems,we propose a novel array geometry inversion method tailored for high-resolution deep-towed multichannel seismic exploration systems.This method is independent of the attitude and depth sensors along a deep-towed seismic streamer,accounting for variations in seawater velocity and seabed slope angle.Our approach decomposes the towed line array into multiline segments and characterizes its geometric shape using the line segment distance and pitch angle.Introducing optimization parameters for seawater velocity and seabed slope angle,we establish an objective function based on the model,yielding results that align with objective reality.Employing the particle swarm optimization algorithm enables synchronous acquisition of optimized inversion results for array geometry and seawater velocity.Experimental validation using theoretical models and practical data verifies that our approach effectively enhances source and receiver positioning inversion accuracy.The algorithm exhibits robust stability and reliability,addressing uncertainties in seismic traveltime picking and complex seabed topography conditions.

Investigating the relationship between intracranial atherosclerotic plaque remodelling and diabetes using high-resolution vessel wall imaging

BACKGROUND Intracranial atherosclerosis,a leading cause of stroke,involves arterial plaque formation.This study explores the link between plaque remodelling patterns and diabetes using high-resolution vessel wall imaging(HR-VWI).AIM To investigate the factors of intracranial atherosclerotic remodelling patterns and the relationship between intracranial atherosclerotic remodelling and diabetes mellitus using HR-VWI.METHODS Ninety-four patients diagnosed with middle cerebral artery or basilar artery INTRODUCTION Intracranial atherosclerotic disease is one of the main causes of ischaemic stroke in the world,accounting for approx-imately 10%of transient ischaemic attacks and 30%-50%of ischaemic strokes[1].It is the most common factor among Asian people[2].The adaptive changes in the structure and function of blood vessels that can adapt to changes in the internal and external environment are called vascular remodelling,which is a common and important pathological mechanism in atherosclerotic diseases,and the remodelling mode of atherosclerotic plaques is closely related to the occurrence of stroke.Positive remodelling(PR)is an outwards compensatory remodelling where the arterial wall grows outwards in an attempt to maintain a constant lumen diameter.For a long time,it was believed that the degree of stenosis can accurately reflect the risk of ischaemic stroke[3-5].Previous studies have revealed that lesions without significant luminal stenosis can also lead to acute events[6,7],as summarized in a recent meta-analysis study in which approximately 50%of acute/subacute ischaemic events were due to this type of lesion[6].Research[8,9]has pointed out that the PR of plaques is more dangerous and more likely to cause acute ischaemic stroke.Previous studies[10-13]have found that there are specific vascular remodelling phenomena in the coronary and carotid arteries of diabetic patients.However,due to the deep location and small lumen of intracranial arteries and limitations of imaging techniques,the relationship between intracranial arterial remodelling and diabetes is still unclear.In recent years,with the development of magnetic resonance technology and the emergence of high-resolution(HR)vascular wall imaging,a clear and multidimensional display of the intracranial vascular wall has been achieved.Therefore,in this study,HR wall imaging(HR-VWI)was used to display the remodelling characteristics of bilateral middle cerebral arteries and basilar arteries and to explore the factors of intracranial vascular remodelling and its relationship with diabetes.

In vivo pilot study into superficial microcirculatory characteristics of colorectal adenomas using novel high-resolution magnifying endoscopy with blue laser imaging

BACKGROUND No studies have yet been conducted on changes in microcirculatory hemody-namics of colorectal adenomas in vivo under endoscopy.The microcirculation of the colorectal adenoma could be observed in vivo by a novel high-resolution magnification endoscopy with blue laser imaging(BLI),thus providing a new insight into the microcirculation of early colon tumors.AIM To observe the superficial microcirculation of colorectal adenomas using the novel magnifying colonoscope with BLI and quantitatively analyzed the changes in hemodynamic parameters.METHODS From October 2019 to January 2020,11 patients were screened for colon adenomas with the novel high-resolution magnification endoscope with BLI.Video images were recorded and processed with Adobe Premiere,Adobe Photoshop and Image-pro Plus software.Four microcirculation parameters:Microcirculation vessel density(MVD),mean vessel width(MVW)with width standard deviation(WSD),and blood flow velocity(BFV),were calculated for adenomas and the surrounding normal mucosa.RESULTS A total of 16 adenomas were identified.Compared with the normal surrounding mucosa,the superficial vessel density in the adenomas was decreased(MVD:0.95±0.18 vs 1.17±0.28μm/μm2,P<0.05).MVW(5.11±1.19 vs 4.16±0.76μm,P<0.05)and WSD(11.94±3.44 vs 9.04±3.74,P<0.05)were both increased.BFV slowed in the adenomas(709.74±213.28 vs 1256.51±383.31μm/s,P<0.05).CONCLUSION The novel high-resolution magnification endoscope with BLI can be used for in vivo study of adenoma superficial microcirculation.Superficial vessel density was decreased,more irregular,with slower blood flow.

Evaluation of Tianji and ECMWF high-resolution precipitation forecasts for extreme rainfall event in Henan in July 2021

The extreme rainfall event of July 17 to 22, 2021 in Henan Province, China, led to severe urban waterlogging and flood disasters. This study investigated the performance of high-resolution weather forecasts in predicting this extreme event and the feasibility of weather forecast-based hydrological forecasts. To achieve this goal, high-resolution precipitation forecasts from the Tianji weather system and the forecast system of the European Centre for Medium-Range Weather Forecasts (ECMWF) were evaluated with the spatial verification metrics of structure, amplitude, and location. The results showed that Tianji weather forecasts accurately predicted the amplitude of 12-h accumulated precipitation with a lead time of 12 h. The location and structure of the rainfall areas in Tianji forecasts were closer to the observations than ECMWF forecasts. Tianji hourly precipitation forecasts were also more accurate than ECMWF hourly forecasts, especially at lead times shorter than 8 h. The precipitation forecasts were used as the inputs to a hydrological model to evaluate their hydrological applications. The results showed that the runoff forecasts driven by Tianji weather forecasts could effectively predict the extreme flood event. The runoff forecasts driven by Tianji forecasts were more accurate than those driven by ECMWF forecasts in terms of amplitude and location. This study demonstrates that high-resolution weather forecasts and corresponding hydrological forecasts can provide valuable information in advance for disaster warnings and leave time for people to act on the event. The results encourage further hydrological applications of high-resolution weather forecasts, such as Tianji weather forecasts, in the future.

Few-Shot Object Detection Based on the Transformer and High-Resolution Network

Now object detection based on deep learning tries different strategies.It uses fewer data training networks to achieve the effect of large dataset training.However,the existing methods usually do not achieve the balance between network parameters and training data.It makes the information provided by a small amount of picture data insufficient to optimize model parameters,resulting in unsatisfactory detection results.To improve the accuracy of few shot object detection,this paper proposes a network based on the transformer and high-resolution feature extraction(THR).High-resolution feature extractionmaintains the resolution representation of the image.Channels and spatial attention are used to make the network focus on features that are more useful to the object.In addition,the recently popular transformer is used to fuse the features of the existing object.This compensates for the previous network failure by making full use of existing object features.Experiments on the Pascal VOC and MS-COCO datasets prove that the THR network has achieved better results than previous mainstream few shot object detection.

Assessment of early radial injury after transradial coronary intervention by high-resolution ultrasound biomicroscopy： innovative technology application

Background Transradial coronary intervention （TRI） introduces injury to the radial artery （RA） which will affect repeat transradial coronary procedure and the quality as a bypass conduit. We sought to compare the early radial injury after TRI between first-TRI and repeat-TRI by ultrasound biomicroscopy （UBM）. Methods A total of 1116 patients who underwent the transradial coronary procedures were enrolled. The patients depending on whether for the first time to accept transradial coronary procedure were divided into first-TRI group and repeat-TRI group. The RA was examined by UBM before and one day after the procedure. Results Compared with first-TRI group, the mean RA diameter of repeat-TRI one day after the procedure decreased significantly （P 〈0.05）. In first-TRI group, the mean RA diameter was （2.32±0.53） and （1.93±0.57） mm before procedure and one day after the procedure respectively （P 〈0.05）. In repeat-TRI group, the mean RA diameter was （2.37±0.51） and （1.79±0.54） mm before procedure and one day after the procedure, respectively （P 〈0.01）. Compared with first-TRI group, the mean RA diameter was reduced significantly in repeat-TRI group one day after the procedure （P〈0.05）. The early radial injuries and intimal thickening were compared between first-TRI and repeat-TRl. The mean intima-media thickness of RA was （,0.24±0.13） mm and （0.59±0.28） mm before procedure and one day after the procedure in first-TRI group. The mean intima-media thickness of RA was （0.29±0.16） mm and （0.68±0.32） mm before procedure and one day after the procedure in repeat-TRI group. Compared with first-TRI group, the mean intimal thickening was increased significantly in repeat-TRI group one day after the procedure （P〈0.05）. Intimal dissection, stenosis and occlusion were all significantly greater in repeat-TRI RAs （P 〈0.05）. Linear regression analysis revealed that diameter, repeated TRI procedure and PCI procedure were the independent predictors of intimal thickening. Conclusions RA early injuries were greater in repeat-TRI patients than in first-TRI patients. We first use high-resolution UBM imaging to demonstrate the rate of radial injury and revealed that diameter, repeated TRI procedure and PCI procedure were the independent predictors of intimal thickening.

Seeing beneath the surface:Harnessing point-of-care ultrasound for internal jugular vein evaluation

Point-of-care ultrasound(POCUS)of the internal jugular vein(IJV)offers a noninvasive means of estimating right atrial pressure(RAP),especially in cases where the inferior vena cava is inaccessible or unreliable due to conditions such as liver disease or abdominal surgery.While many clinicians are familiar with visually assessing jugular venous pressure through the internal jugular vein,this method lacks sensitivity.The utilization of POCUS significantly enhances the visualization of the vein,leading to a more accurate identification.It has been demonstrated that combining IJV POCUS with physical examination enhances the specificity of RAP estimation.This review aims to provide a comprehensive summary of the various sonographic techniques available for estimating RAP from the internal jugular vein,drawing upon existing data.

Diagnostic and therapeutic role of endoscopic ultrasound in liver diseases:A systematic review and meta-analysis

BACKGROUND In hepatology,the clinical use of endoscopic ultrasound(EUS)has experienced a notable increase in recent times.These applications range from the diagnosis to the treatment of various liver diseases.Therefore,this systematic review summarizes the evidence for the diagnostic and therapeutic roles of EUS in liver diseases.AIM To examine and summarize the current available evidence of the possible roles of the EUS in making a suitable diagnosis in liver diseases as well as the therapeutic accuracy and efficacy.METHODS PubMed,Medline,Cochrane Library,Web of Science,and Google Scholar databases were extensively searched until October 2023.The methodological quality of the eligible articles was assessed using the Newcastle-Ottawa scale or Cochrane Risk of Bias tool.In addition,statistical analyses were performed using the Comprehensive Meta-Analysis software.RESULTS Overall,45 articles on EUS were included(28 on diagnostic role and 17 on therapeutic role).Pooled analysis demonstrated that EUS diagnostic tests had an accuracy of 92.4%for focal liver lesions(FLL)and 96.6%for parenchymal liver diseases.EUS-guided liver biopsies with either fine needle aspiration or fine needle biopsy had low complication rates when sampling FLL and parenchymal liver diseases(3.1%and 8.7%,respectively).Analysis of data from four studies showed that EUS-guided liver abscess had high clinical(90.7%)and technical success(90.7%)without significant complications.Similarly,EUS-guided interventions for the treatment of gastric varices(GV)have high technical success(98%)and GV obliteration rate(84%)with few complications(15%)and rebleeding events(17%).CONCLUSION EUS in liver diseases is a promising technique with the potential to be considered a first-line therapeutic and diagnostic option in selected cases.

Endoscopic-ultrasound-guided biliary drainage with placement of electrocautery-enhanced lumen-apposing metal stent for palliation of malignant biliary obstruction:Updated meta-analysis

BACKGROUND Endoscopic ultrasound-guided biliary drainage using electrocautery-enhanced(ECE)delivery of lumen-apposing metal stent(LAMS)is gradually being re-cognized as a viable palliative technique for malignant biliary obstruction after endoscopic retrograde cholangiopancreatography(ERCP)failure.However,most of the studies that have assessed its efficacy and safety were small and hetero-geneous.Prior meta-analyses of six or fewer studies that were published 2 years ago were therefore underpowered to yield convincing evidence.AIM To update the efficacy and safety of ECE-LAMS for treatment of biliary ob-struction after ERCP failure.METHODS We searched PubMed,EMBASE,and Scopus databases from the inception of the ECE technique to May 13,2022.Primary outcome measure was pooled technical success rate,and secondary outcomes were pooled rates of clinical success,re-intervention,and adverse events.Meta-analysis was performed using a random-effects model following Freeman-Tukey double-arcsine transformation in R soft-ware(version 4.1.3).RESULTS Fourteen eligible studies involving 620 participants were ultimately included.The pooled rate of technical success was 96.7%,and clinical success was 91.0%.Adverse events were reported in 17.5%of patients.Overall reinter-vention rate was 7.3%.Subgroup analyses showed results were generally consistent.CONCLUSION ECE-LAMS has favorable success with acceptable adverse events in relieving biliary obstruction when ERCP is impossible.The consistency of results across most subgroups suggested that this is a generalizable approach.

Quick and easy assessment of sarcopenia in cirrhosis: Can ultrasound be the solution?

Cirrhosis is frequently associated with sarcopenia,with reported rates of over 80%in patients with decompensated alcohol-related liver disease.Sarcopenia nega-tively impacts the prognosis of cirrhotic patients and affects the response to treatment of patients with hepatocellular carcinoma(HCC).For these reasons,identifying an easy-to-perform method to assess sarcopenia in is a key element in the optimization of care in this patient population.Assessment of muscle mass by computed tomography is considered the standard of care for the diagnosis of sarcopenia,but exposure to radiation and high costs limit its application in this setting,especially for repeated assessments.We believe that ultrasound,a cheap and harmless technique also used for HCC screening in cirrhotic patients,could have an expanding role in the diagnosis and follow-up of sarcopenia in these patients.

Full Scale-Aware Balanced High-Resolution Network for Multi-Person Pose Estimation

Scale variation is amajor challenge inmulti-person pose estimation.In scenes where persons are present at various distances,models tend to perform better on larger-scale persons,while the performance for smaller-scale persons often falls short of expectations.Therefore,effectively balancing the persons of different scales poses a significant challenge.So this paper proposes a newmulti-person pose estimation model called FSANet to improve themodel’s performance in complex scenes.Our model utilizes High-Resolution Network(HRNet)as the backbone and feeds the outputs of the last stage’s four branches into the DCB module.The dilated convolution-based(DCB)module employs a parallel structure that incorporates dilated convolutions with different rates to expand the receptive field of each branch.Subsequently,the attention operation-based(AOB)module performs attention operations at both branch and channel levels to enhance high-frequency features and reduce the influence of noise.Finally,predictions are made using the heatmap representation.The model can recognize images with diverse scales and more complex semantic information.Experimental results demonstrate that FSA Net achieves competitive results on the MSCOCO and MPII datasets,validating the effectiveness of our proposed approach.

High-Resolution Mass Spectroscopy for Revealing the Charge Storage Mechanism in Batteries: Oxamide Materials as an Example

The pursuit of high-performance electrode materials is highly desired to meet the demand of batteries with high energy and power density.However,a deep understanding of the charge storage mechanism is always challenging,which limits the development of advanced electrode materials.Herein,high-resolution mass spectroscopy(HR-MS)is employed to detect the evolution of organic electrode materials during the redox process and reveal the charge storage mechanism,by using small molecular oxamides as an example,which have ortho-carbonyls and are therefore potential electrochemical active materials for batteries.The HR-MS results adequately proved that the oxamides could reversibly store lithium ions in the voltage window of 1.5–3.8 V.Upon deeper reduction,the oxamides would decompose due to the cleavage of the C–N bonds in oxamide structures,which could be proved by the fragments detected by HR-MS,^(1)H NMR,and the generation of NH_(3)after the reduction of oxamide by Li.This work provides a strategy to deeply understand the charge storage mechanism of organic electrode materials and will stimulate the further development of characterization techniques to reveal the charge storage mechanism for developing high-performance electrode materials.

Prognostic value of ultrasound in early arterial complications post liver transplant

Liver transplantation is the primary therapeutic intervention for end-stage liver disease.However,vascular complications,particularly those involving the hepatic artery,pose significant risks to patients.The clinical manifestations associated with early arterial complications following liver transplantation are often non-specific.Without timely intervention,these complications can result in graft fai-lure or patient mortality.Therefore,early diagnosis and the formulation of an op-timal treatment plan are imperative.Ultrasound examination remains the pre-dominant imaging modality for detecting complications post liver transplan-tation.This article comprehensively reviews common causes and clinical present-ations of early hepatic artery complications in the post-transplantation period and delineates abnormal sonographic findings for accurate diagnosis of these con-ditions.Overall,ultrasound offers the advantages of convenience,safety,effect-iveness,and non-invasiveness.It enables real-time,dynamic,and precise evalua-tion,making it the preferred diagnostic method for post-liver transplantation assessments.INTRODUCTION Liver transplantation stands as the primary therapeutic approach for end-stage liver disease.Continuous advancements in surgical techniques and the application of novel immunosuppressive agents contribute to ongoing improvements in the success rate and overall survival in patients undergoing liver transplantation procedures.Despite these advan-cements,vascular complications,particularly those involving the hepatic artery,pose significant risks to patients.During the early stages following liver transplantation(within the first 30 d),proper hepatic artery function is crucial for hepatic arterial blood flow.During later stages,collateral circulation,including arteries such as the phrenic artery,right gastric artery,and gastroduodenal artery,becomes important for maintaining hepatic blood supply.It is now understood that the establishment of effective collateral circulation is pivotal for determining the prognosis of hepatic artery complic-ations.The clinical manifestations of these complications are closely linked to factors such as timing,severity,and the specific type of onset.Insufficient hepatic arterial blood flow can lead to abnormal liver function,hepatic infarction,and the formation of hepatic abscesses.Additionally,since the hepatic artery is the sole blood supply to the biliary tract,hepatic artery-related ischemia may result in biliary stricture,obstruction,and the formation of bile ducts.Ultrasound examination remains the primary imaging modality for diagnosing complications post liver transplantation.This article comprehensively reviews common causes and clinical presentations of early hepatic artery complications in the post-transplantation period and outlines abnormal sonographic findings for accurately diagnosing these conditions.NORMAL HEPATIC ARTERY During the intraoperative phase,an ultrasound examination is typically conducted to evaluate the hepatic artery anas-tomosis.The normal internal diameter of the hepatic artery typically ranges from 2 to 5 mm.Two strong echo points are typically identified near the anastomosis.To assess blood flow dynamics,peak systolic velocity,end-diastolic velocity,and resistance index are measured at the donor and recipient sides of the anastomosis following angle correction.Anastomotic stenosis presence and severity can be evaluated by comparing the velocity at the anastomotic site with that at the recipient side.Postoperatively,direct visualization of the anastomosis site through gray ultrasound scans is often challenging.The surgical approach has a significant impact on the proper hepatic artery’s position,resulting in a lower overall success rate of continuous visualization.Color Doppler ultrasound is primarily employed to trace the artery’s path,and spectral measurements are taken at the brightest position of the Color Doppler blood flow signal,primarily used to identify the presence of high-speed turbulence.Hepatic artery spectrum examination plays a crucial role,as a favorable arterial spectral waveform and appropriate hepatic artery flow velocity typically indicate a successful anastomosis,even in cases where the hepatic artery anastomosis cannot be directly visualized by ultrasound.The hepatic artery runs alongside the portal vein,often selected as a reference due to its larger inner diameter.A normal hepatic artery spectrum displays a regular pulsation pattern with a rapid rise in systole and a slow decline in diastole.Parameters for assessing hepatic artery resistance include a resistance index between 0.5 to 0.8 and an artery systolic acceleration of less than 80 ms.Instantaneous increases in the resistance index(RI>0.8)often occur within 2 d after surgery,followed by a subsequent return to normal hepatic arterial parameters.It has been established that the maximum blood flow velocity during systole in the hepatic artery should not exceed 200 cm/s[1].

Novel approach of ultrasound-guided lateral recess block for a patient with lateral recess stenosis: A case report

BACKGROUND Ultrasound guide technology,which can provide real-time visualization of the needle tip and tissues and avoid many adverse events,is widely used in mini-mally invasive therapy.However,the studies on ultrasound-guided Lateral recess block(LRB)are limited,this is probably because there is no recognized standard method for ultrasound scanning.This study aimed to evaluate the effect of ultrasound-guided LRB in patients with lateral recess stenosis(LRS).CASE SUMMARY A 65-year-old patient complained of low back pain accompanied occasionally by pain and numbness in the left lower limb.Physical examination showed ten-derness on the spinous process and paraspinal muscles from L1 to S1,extensor hallucis longus and tibialis anterior weakness(muscle strength:4-),and a positive straight leg raising test in the left lower limb(60°).Magnetic resonance imaging showed L4–L5 disc degeneration with left LRS and nerve root entrapment.Subsequently,the patient was diagnosed with LRS.This patient was treated with a novel ultrasound-guided LRB approach.The patient’s symptoms significantly improved without any complications at 1 wk postoperatively and at the 3-month follow-up.CONCLUSION This is the first report on the LRS treatment with ultrasound-guided LRB from the contralateral spinous process along the inner side of the articular process by out-plane technique.Further studies are expected to investigate the efficacy and safety of ultrasound-guided LRB for patients with LRS.

Use of endoscopic ultrasound-guided gallbladder drainage as a rescue approach in cases of unsuccessful biliary drainage

This narrative review provides an overview of the utilization of endoscopic ultrasound-guided gallbladder drainage(EUS-GBD)as a salvage approach in cases of unsuccessful conventional management.EUS-GBD is a minimally invasive and effective technique for drainage in patients with acute cholecystitis with high risk of surgery.The procedure has demonstrated impressive technical and clinical success rates with low rates of adverse events,making it a safe and effective option for appropriate candidates.Furthermore,EUS-GBD can also serve as a rescue option for patients who have failed endoscopic retrograde cholangiopancreatography or EUS biliary drainage for relief of jaundice in malignant biliary stricture.However,patient selection is critical for the success of EUS-GBD,and proper patient selection and risk assessment are important to ensure the safety and efficacy of the procedure.As the field continues to evolve and mature,ongoing research will further refine our understanding of the benefits and limitations of EUS-GBD,ultimately leading to improved outcomes for patients.