Expedited extraction of xylan from corncob by power ultrasound

Some lignocellulosic biomass like corncob contains a large amount of xylan,a valuable material for applications in food,chemical and pharmaceutical industries.Conventional extraction of xylan is a time consuming process,requiring 12 to 24 hours to complete.In this study,the efficacy of power ultrasound for reducing the extraction time and increasing the xylan yield was investigated.Two acoustic energy densities(0.18 W/mL and 0.45 W/mL)of the power ultrasound were applied to corncob for 10,20,30,and 60 min.The treated samples were steamed at 110,118 and 121℃for 30 min.At 0.45 W/mL acoustic energy density and 121℃steaming temperature,ultrasonic treatment was able to extract 39%of xylan in 43 min.In contrast,the conventional treatment was able to extract only 34%of xylan in 24 h.Power ultrasound assisted extraction reduced the processing time by 97%in addition to yield increase by 14.7%.Power ultrasound can be a potential technology for enhanced xylan extraction from corncob to result in significant processing time savings.

Power ultrasound for the preservation of postharvest fruits and vegetables

Increasing public demands for improved safety and quality of fruits and vegetables in the fresh market,awaken a growing interest for novel technologies for the preservation of postharvest fruits and vegetables before storage.Ultrasound technology provides one of the methods that with better treating time,enhanced products quality,reduced chemical hazards,low consumption of energy,and is environmentally friendly.This review provides an up-to-date summary of published findings on the application of ultrasound in the preservation of fresh fruits and vegetables.The ultrasound devices commonly utilized,effects of power ultrasound treatment as a factor that affects decay incidence,safety and quality of fresh fruits and vegetables are included.Application challenges and research trends in the future are also analyzed.It is concluded that much progress has been achieved in this field during recent years.These achievements paved the way for the industrial-scale application of ultrasound in the preservation of postharvest fruits and vegetables.

Correlation between Perifollicular Vascularity and Outcome in Stimulated Intrauterine Insemination Treatment Cycles: A Study Using Two-Dimensional Transvaginal Power Doppler Ultrasound

Objective:?The aim of this study is to assess any potential relationship between perifollicular vascularity and occurrence of pregnancy in cases of stimulated IUI cycles using the subjective grading system by 2D transvaginal power Doppler ultrasonography.?Design: A prospective cross sectional cohort study. Method: This is a prospective cross-sectional cohort study of 90 stimulated IUI treatment cycles. Selected women were prescribed clomiphene citrate combined with highly purified urinary follicle stimulating hormone. All patients underwent serial transvaginal ultrasound scans starting from day 6 to 7 of the cycle. Perifollicular Doppler blood flows were assessed in dominant follicles ≥18 mm. The patients then were categorized into 3 groups (high vascularity group {G3 & G4}, low vascularity group {G1 & G2} and mixed grades group). Other parameters measured included number of follicles ≥ 18 mm in both ovaries, endometrial thickness and estradiol (E2) level . Human chorionic gonadotropin (hCG) injection 10,000 IU IM was given to the patient when the dominant follicle reached 18 mm in diameter. At that time, the endometrium was evaluated as regards endometrial thickness. IUI was carried out using prepared/“washed” semen (husband). All patients received luteal support in the form of progesterone from day of IUI for 14 days. Serum Β-hCG was estimated 2 weeks after insemination. Results: In this study, from all 90 cases only 8 cases got pregnant with pregnancy rate of 8.88% (6 cases got pregnant in high grade vascularity group;2 cases in mixed grades group and no cases got pregnant?in low grade group). There was statistically significant difference among the 3 groups as regarding?the pregnancy rate (P value = 0.02). There is statistically significant difference in perifollicular resistance index (RI) and pulsatility index (PI) between pregnant and non pregnant cases (P value = 0.016 and 0.047 respectively). In this study, there is no statistically significant difference between pregnant and non pregnant cases as regarding endometrial thickness and E2 level at the day of hCG administration (P value = 0.39 and 0.76 respectively). Conclusion: Perifollicular blood-flow assessment by 2D transvaginal power Doppler is a good predictive for the outcome of stimulated IUI cycles.

Effect of focused ultrasound stimulation at different ultrasonic power levels on the local field potential power spectrum

Local field potential(LFP) signals of the rat hippocampus were recorded under noninvasive focused ultrasound stimulation(FUS) with different ultrasonic powers. The LFP mean absolute power was calculated with the Welch algorithm at the delta, theta, alpha, beta, and gamma frequency bands. The experimental results demonstrate that the LFP mean absolute power at different frequency bands increases as the ultrasound power increases.

Comparative Study of Radiological Changes in Hands and Feet in Patients Suffering from Early Rheumatoid Arthritis by Power Doppler Ultrasound and Direct Digital Radiography

Rheumatoid arthritis is a chronic multisystem disease of unknown cause. The characteristic feature of RA is persistent inflammatory synovitis. The natural history of disease is such that the early months of the disease are critical period during which reversible joint damage occurs. So early diagnosis of RA and appropriate drug application is the only way to save a patient from this crippling disease. In India, the cost of investigations is a significant factor for most of the patients. Ultrasonography or Power Doppler Ultra Sound (PDUS) has the advantage of being economic in spite of its sensitivity in assessing both inflammatory and destructive changes. The aim of the present study was to evaluate the diagnostic efficiency of PDUS in early rheumatoid arthritis. The study was performed with the patients attending Rheumatology Clinic. A total number of 106 patients of clinically suspected rheumatoid arthritis were studied as per selection criteria. Radiological examinations of hands were done by digital radiography and PDUS in a group of 53 patients, assessment of foot changes by PDUS and Digital Radiography were done in another similar group of 53 patients. Final diagnosis by ACR EULAR-2010 criteria is done for all the patients. The comparative study reveals that synovial vascularity as demonstrated by PDUS is much more effective in diagnosing early rheumatoid arthritis, both in hand and in feet than digital radiograph. PDUS of feet may yield earlier and better findings than hands, which is conventionally used in patients suffering from early rheumatoid arthritis.

三维能量多普勒定量技术对乳腺癌组织学分级的预测价值探讨

目的探讨三维能量多普勒超声(3D-PDUS)中血管定量参数对乳腺癌组织学分级的预测价值。方法回顾性选择2018年1月至2023年6月在杭州市中医院行手术治疗的乳腺癌患者77例(恶性肿块86个),所有肿块均经病理组织学检查证实,根据组织学分级分为Ⅰ级组、Ⅱ级组、Ⅲ级组。比较3组患者年龄、常规超声检查所见、3D-PDUS指标。常规超声检查所见包括淋巴结转移、肿块内部钙化、肿块Adler血流分级;3D-PDUS指标包括肿块体积、血管参数[血管形成指数(VI)、血流指数(FI)、血管形成-血流指数(VFI)]。应用logistic回归分析乳腺癌组织学分级的危险因素。采用ROC曲线分析VI、FI、VFI对乳腺癌组织学分级的预测准确度。结果Ⅲ级组VI、FI、VFI高于Ⅱ级组,Ⅱ级组高于Ⅰ级组,差异均有统计学意义(均P<0.05)。其中FI为乳腺癌不同组织学分级的独立危险因素(P<0.001)。ROC曲线分析显示VI、FI、VFI对乳腺癌组织学分级的预测准确度均较高(AUC=0.888、0.891、0.894,均P<0.001)。结论3D-PDUS显示的VI、FI、VFI是瘤内血管化重要定量指标,可为乳腺癌患者组织学分级提供可靠的影像学预测信息。

超微血流成像及能量多普勒超声技术在监测类风湿关节炎活跃性的应用价值

目的探讨超微血流成像(SMI)及能量多普勒超声(PDUS)技术在监测类风湿关节炎(RA)滑膜炎活跃性的应用价值。方法本研究入选60例RA患者,超声检测其双侧腕关节、掌指关节、近端指间关节,对受累关节的增厚滑膜,分别启用SMI及PDUS两种血流模式,分别记录两种技术的滑膜血流显示率和血流分级,并探讨SMI及PDUS血流分级指数与临床上常用于评估RA活跃性的实验室指标ESR、CRP及DSA28评分之间是否具有正相关性。结果(1)在60例RA患者中,共有450个关节滑膜增厚,PDUS血流模式与SMI血流模式对受累关节增厚滑膜的血流显示率分别为71.8%、81.1%,PDUS对于滑膜内低速血流的敏感性明显低于SMI,差异具有统计学意义(P=0.001)。(2)在RA临床缓解期,PDUS对亚临床滑膜炎显示率为42.9%,明显低于SMI的66.7%,差异具有统计学意义(P=0.028)。(3)PDUS与SMI对滑膜血流分级结果的一致性较好(kappa=0.721,P<0.05),但SMI较PDUS能够更敏感的显示滑膜微血管内的低速血流,提高滑膜血流分级。(4)SMI及PDUS的滑膜血流分级指数与临床上常用于评估RA活跃性的实验室指标ESR、CRP、DAS28呈正相关(P<0.05)。结论SMI技术是一种先进的超声成像技术,它可以较PDUS可以更敏感的显示微小血管内的低速血流信号,帮助临床医生判断滑膜炎的活跃性,尤其在评估RA临床缓解期的患者是否存在亚临床滑膜炎,达到真正缓解中有着一定的优势。

高功率聚焦超声与射频消融治疗子宫肌瘤的临床效果对比

目的对比高功率聚焦超声与射频消融治疗子宫肌瘤的临床效果。方法60例子宫肌瘤患者随机分为两组,聚焦超声组采用高功率聚焦超声治疗,射频消融组采用射频消融治疗,比较两组的治疗效果及不良反应。结果治疗后,射频消融组的总有效率高于聚焦超声组,痛经评分低于聚焦超声组,月经量少于聚焦超声组,子宫肌瘤体积小于聚焦超声组(P<0.05)。两组的不良反应总发生率比较,差异无统计学意义(P>0.05)。结论相较于高功率聚焦超声,射频消融治疗子宫肌瘤的效果更好,可明显改善患者的痛经程度,减少月经量,缩小子宫肌瘤体积,且未显著增加不良反应的发生。

三维能量多普勒超声在早期不明位置妊娠诊断中的应用价值

目的:分析三维能量多普勒超声在诊断早期不明位置妊娠(PUL)中的应用价值。方法:选取2022年1—12月广东医科大学顺德妇女儿童医院收治的60例PUL患者,随访至孕12周,根据手术结果或妊娠结局分组,将宫内早孕26例作为宫内组,将异位妊娠22例作为宫外组,将绒毛膜促性腺激素(HCG)下降至阴性且无法确定妊娠位置者12例作为流产组。所有患者均行超声检查,对比三组声像图回声类型、血流分级、黄体血流参数及三维能量多普勒超声血管参数,绘制受试者工作特征曲线(ROC)曲线,分析三维能量多普勒超声对PUL的诊断价值。结果:宫内组黄体厚壁双环型占比较宫外组高(42.31%vs9.09%,P<0.05);宫内组黄体血流分级Ⅲ级率较流产组更高(57.69%vs16.67%,P<0.05);宫外组及流产组RI水平较宫内组更高(P<0.05);流产组RI水平较宫外组更高(P<0.05);宫外组VI、VFI水平较宫内组更低(P<0.05);流产组FI、VFI水平较宫内组更低(P<0.05);RI预测非宫内妊娠结局的AUC为0.841(P<0.05);VI预测的AUC为0.682(P<0.05);FI预测的AUC为0.665(P<0.05);VFI预测的AUC为0.674(P<0.05),RI联合VI预测非宫内妊娠结局的AUC为0.917(P<0.05);RI联合FI预测的AUC为0.870(P>0.05);RI联合VFI预测的AUC为0.912(P>0.05);三组黄体低回声型、混合回声型、薄壁囊肿型比较,差异无统计学意义(P>0.05);三组血流分级Ⅰ级、Ⅱ级比较,差异无统计学意义(P>0.05)。结论:单一三维能量多普勒超声血管参数对PUL中非宫内妊娠结局的诊断价值不高,VI联合RI预测非宫内妊娠结局的诊断效能较高。

HIFU治疗中换能器驱动电功率变化机制及规律

高强度聚焦超声(HIFU)治疗中的驱动电功率对治疗效率起着非常关键的作用,驱动电功率控制的精准性势必会影响治疗的效率和安全性。前期研究表明:HIFU治疗过程中焦域瞬态物理特性的变化会导致换能器的负载阻抗发生变化,进而影响HIFU驱动电功率,但驱动电功率与焦域瞬态物理特性之间的影响关系及规律尚不明确。该文基于电压、电流传感器、空化检测探头和温度传感器等器件,构建了一种HIFU治疗中驱动电功率实时监测及焦域声空化、温度检测系统。基于该实验研究系统,以离体牛心组织作为HIFU辐照对象,分别研究了HIFU焦域温度变化、声空化及组织损伤与驱动电功率之间的变化关系及规律。研究结果表明:当焦域温度升高时,驱动电功率缓慢上升,驱动电功率与温度变化有良好的相关性;当空化产生时,驱动电功率出现明显的波动;当组织出现损伤时,驱动电功率呈陡然下降的变化。三种情景下,驱动电功率变化有明显区别,这有望为区分HIFU治疗过程中焦域处发生损伤和空化以及实时监测靶组织损伤程度提供一种新的解决方案。

Power Doppler ultrasonographic assessment of the ankle in patients with inflammatory rheumatic diseases

Ankle involvement is frequent in patients with inflammatory rheumatic diseases, but accurate evaluation by physical examination is often difficult because of the complex anatomical structures of the ankle. Over the last decade, ultrasound(US) has become a practical imaging tool for the assessment of articular and periarticular pathologies, including joint synovitis, tenosynovitis, and enthesitis in rheumatic diseases. Progress in power Doppler(PD) technology has enabled evaluation of the strength of ongoing inflammation. PDUS is very useful for identifying the location and kind of pathologies in rheumatic ankles as well as for distinguishing between inflammatory processes and degenerative changes or between active inflammation and residual damage. The aim of this paper is to illustrate the US assessment of ankle lesions in patients with inflammatory rheumatic diseases, including rheumatoid arthritis, spondyloarthritis, and systemic lupus erythematosus, focusing on the utility of PDUS.

三维能量多普勒超声在观察孕早期胎盘血流预测胎儿生长受限中的应用

目的探讨三维能量多普勒超声对胎儿生长受限的预测价值研究。方法选取2021年1—12月在医院建卡的正常孕妇400例作为研究对象,全部孕妇于孕早期11~13^(+6)周应用三维能量多普勒超声检查胎盘,获得血管化-血流指数(VFI)、血管化指数(VI)、血流指数(FI)、胎盘体积(PV)、胎盘商(PQ)的水平。绘制受试者工作特征(ROC)曲线分析VFI、VI、FI、PV、PQ对胎儿生长受限的诊断效能。结果正常孕妇400例出现胎儿生长受限35例,发生率为8.75%;将400例孕妇分为研究组35例(胎儿生长受限)和对照组365例(未发生胎儿生长受限)。两组的年龄、孕周、孕次、体质指数、初产妇的资料对比,差异无统计学意义(P>0.05)。研究组的PV、PQ均显著低于对照组,差异有统计学意义(P<0.05)。研究组的VFI、VI、FI均低于对照组,差异有统计学意义(P<0.05)。经ROC曲线分析,PV、VFI、VI的曲线下面积均高于0.7,且高于PQ、FI。PV、PQ、VFI、VI、FI的最大截断值分别为45.83、0.83、7.32、22.70、28.41,特异度为77.89%、67.74%、58.32%、57.99%、74.80%,敏感度为53.72%、73.10%、96.88%、97.60%、58.42%。结论三维能量多普勒超声对胎儿生长受限具有重要的预测价值,能为改变的诊断提供可量化指标。

Effect of ultrasound exposure on sonicated microbubbles stability

Objectives and Methods: Both the concentration and the size of contrast microbubbles are the important factors that affect the quality of intravenous myocardial contrast echocardiography (IVMCE) image, but the interactions between microbubbles and ultrasound are poorly understood. In order to select optimal ultrasound exposure condition for IVMCE, the influences of ultrasound power, frequency and exposure time on sonicated microbubbles stability were evaluated by a 2 x 2 x 4 factorial analysis in the study. Results: It was found that the concentration of microbubbles was decreased when the ultrasound power increased or the exposure time of ultrasound prolonged (P < 0. 001). The frequency of ultrasound did not influence the concentration of the bubbles (P = 0. 061 ). The higher the power or the frequency and the longer the exposuretime, the smaller the mean size of the contrast bubbles (power, P = 0.004; frequency, P < 0.001); exposure time, P < 0. 00l ). The controlling factors of the condition did not interactively affect the concentration or the mean size of contrast mi- crobubbles. Conclusion: These findings could allow us to select ultrasound at lower frequency, lower ultrasound power and to reduce the exposure time bine of microbubbles to ultrasound for the improvement in the contrast effect in IVMCE.

Doppler Ultrasound in Post-Molar Gestational Trophoblastic Neoplasia

Objectives: To evaluate the role of Doppler ultrasound in prediction and follow up during management of gestational trophoblastic neoplasia (GTN). Methods: The study was performed at Oncology Unit, Maternity Hospital, Ain Shams University in the period from November 2015 to December 2018. Forty cases of complete mole, after evacuation and follow up of serum human chorionic gonodotrophin (β-hCG) titre until it reached zero level (group I) and forty post molar GTN cases (group II) were included in the study. Doppler ultrasound of the subendometrial and intramural blood flow was done for all cases of group I and II. Doppler included two dimensional and three dimensional power Doppler indices. Group II received Methotrexate (MTX) and folinic acid in a dose of 8-day MTX-FA regimen. Doppler follow up for six months of group II concurrently with the chemotherapy regimen was done. Results: A statistically significant difference was found between group I and II regarding initial readings of all Doppler parameters. Follow up for 6 months of GTN cases revealed progressive statistically significant decrease of intramural and subendometrial three dimensional power Doppler (3DPD) indices, while there was a significant increase in two dimensional (2D) Doppler parameters. Four cases were resistant to Methotrexate chemotherapy. Cut off values were determined for prediction of GTN. Multivariate analysis revealed that the most predictive parameter was the subendometrial pulsatility index (PI), odds ratio = 10.63 (95% CI: 1.30 - 86.89). The cut-off point for sub-endometrial PI was: 2.05 (AUC, 90%;sensitivity, 88%;specificity, 76%, PPV 78%, and NPV 86%) with a diagnostic accuracy of 87%. To and Fro sign may be considered a pathognomonic intramural ultrasound sign for prediction of GTN chemo-resistance or choriocarcinoma. Conclusion: Cut off values for Doppler parameters can be used for early predication of GTN. Doppler ultrasound indices can be used during follow up of GTN cases concurrently with serum β-hCG to monitor the response to treatment.

2D-TVS、3D-TVS容积成像和3D-PDUS联合检查在宫腔粘连诊断中的效能

目的:分析阴道二维超声(2D-TVS)、三维超声(3D-TVS)容积成像、三维能量多普勒超声(3D-PDUS)联合检查在宫腔粘连诊断中的效能。方法:选取2018年1月至2021年8月该院收治的85例疑似宫腔粘连患者进行前瞻性研究。所有患者均行2D-TVS、3D-TVS容积成像及3D-PDUS检查,并以宫腔镜检查诊断结果作为金标准,比较2D-TVS、3D-TVS容积成像、3D-PDUS单项及联合检查在宫腔粘连诊断中的效能。结果:宫腔镜检查诊断结果显示,85例疑似宫腔粘连患者中,阳性72例,阴性13例,其中轻度粘连35例,中度粘连24例,重度粘连13例;2D-TVS检查诊断结果显示,阳性60例,阴性25例;3D-TVS容积成像检查诊断结果显示,阳性68例,阴性17例;3D-PDUS检查诊断结果显示,阳性69例,阴性16例;联合检查诊断结果显示,阳性71例,阴性14例;联合检查诊断灵敏度、特异度、准确度、阳性预测值、阴性预测值均高于2D-TVS、3D-TVS容积成像、3D-PDUS单项检查,差异有统计学意义(P<0.05);宫腔粘连组子宫内膜厚度(ED)、子宫内膜体积(EV)、内膜区血管指数(VI)、血管血流指数(VFI)均低于宫腔正常组,差异有统计学意义(P<0.05);重度粘连组ED、EV、VI、FI、VFI水平均低于中度粘连、轻度粘连组,中度粘连组ED、EV、VI、VFI水平低于轻度粘连组,差异有统计学意义(P<0.05);中度粘连组FI水平与轻度粘连组比较,差异无统计学意义(P>0.05)。结论:2D-TVS、3D-TVS容积成像、3D-PDUS联合检查诊断宫腔粘连的灵敏度、特异度、准确度、阳性预测值、阴性预测值均高于单项检查。

三维能量多普勒超声技术产前定量评估对胎儿宫内生长受限的诊断价值研究

目的:探讨三维能量多普勒超声技术产前定量评估对胎儿宫内生长受限(IUGR)的诊断价值。方法:选择2020年4月—2021年3月郑州市妇幼保健院就诊的100例孕中晚期IUGR孕妇作为研究组,另选取同期于医院产检的100例正常妊娠孕妇为对照组。应用三维能量多普勒超声技术(3D-PDU)定量检测两组胎儿的胎盘血管化指数(VI)、血流指数(FI)、血管化—血流指数(VFI),记录两组胎儿的静脉导管血流波形,包括二尖瓣口与三尖瓣口的舒张晚期A峰、舒张早期E峰、E/A比值及肺静脉左心房开口与下腔静脉的心室收缩期S峰、舒张期D峰、心肺收缩期A峰。结果:研究组的VI值、FI值、VFI值均显著低于对照组,差异有统计学意义(t=16.990、7.799、13.069,P<0.05)。研究组的二尖瓣口E/A比值、三尖瓣口E/A比值均显著高于对照组,二尖瓣口A峰、三尖瓣口A峰显著低于对照组,差异有统计学意义(t=5.548、5.633、7.342、9.382,P<0.05);两组胎儿的二尖瓣口及三尖瓣口E峰比较,差异无统计学意义(t=0.915、0.147,P>0.05)。研究组的肺静脉左心房开口A峰、下腔静脉A峰均显著低于对照组,差异有统计学意义(t=7.342、9.382,P<0.05);两组胎儿的肺静脉左心房开及下腔静脉S峰、D峰比较,差异无统计学意义(t=0.859、0.192,P>0.05)。结论:三维能量多普勒超声技术产前定量检测胎儿的血流参数,有利于产前良好评估胎儿的宫内情况,可作为胎儿宫内生长受限的辅助诊断手段,有利于改善临床症状及妊娠结局,减少不良妊娠的发生。

不同超声方法对类风湿关节炎滑膜炎的诊断价值

目的探讨不同超声方法对类风湿关节炎滑膜炎患者的诊断价值。方法选取2020年7月至2021年6月湖州市第三人民医院收治的疑似类风湿关节炎滑膜炎患者50例,均给予能量多普勒超声(power Doppler ultrasound,PDUS)和超声造影(contrast enhanced ultrasound,CEUS)检查,以28个关节疾病活动度评分(disease activity score in 28 joints,DAS28)结果作为“金标准”,评价两种超声方法的诊断效能。对确诊患者给予药物治疗,1个月后评价患者预后。结果50例疑似类风湿关节炎滑膜炎患者经DAS28确诊32例,确诊率为64.00%。PDUS、CEUS及二者联合诊断类风湿关节炎滑膜炎与DAS28诊断的符合率分别为60.00%、60.00%和78.00%。CEUS联合PDUS诊断类风湿关节炎滑膜炎的敏感度和特异性均高于单一CEUS和PDUS检查(P<0.05)。治疗1个月后,患者的C反应蛋白、红细胞沉降率、DAS28及视觉模拟评分法评分均显著低于治疗前(P<0.05)。结论CEUS联合PDUS用于类风湿关节炎滑膜炎患者的检出率较高,且诊断效能提升,可用于指导临床诊疗。

3D-PDU胎盘及子宫动脉血流动力学参数与胎盘植入的相关性分析

目的探讨三维能量多普勒超声(3D-PDU)胎盘及子宫动脉血流动力学参数与胎盘植入的相关性。方法回顾性分析2021年3月—2022年3月贵州省人民医院收治的70例胎盘植入孕妇的临床资料,将其作为胎盘植入组,另选取同期该院无胎盘植入的70例孕妇作为无胎盘植入组。比较两组孕妇的一般资料,测量胎盘血管参数指标[血管化指数(VI)、流量指数(FI)、血管流量指数(VFI)]及子宫动脉血流动力学参数[搏动指数(PI)、阻力指数(RI)、收缩期峰值/舒张末期流速(S/D)]。多因素Logistic逐步回归性分析明确胎盘植入发生的危险因素;绘制受试者工作特征(ROC)曲线分析胎盘植入预测模型预测胎盘植入发生的价值。结果胎盘植入组与无胎盘植入组孕妇的年龄、流产史、前置胎盘、剖宫产史、VI、FI、VFI、PI、RI、S/D比较,差异均有统计学意义(P<0.05);胎盘植入组中年龄≥35岁、有流产史、前置胎盘、剖宫产史的孕妇占比高于无胎盘植入组,VI、FI、VFI、S/D高于无胎盘植入组,PI、RI低于无胎盘植入组。ROC曲线分析结果显示:VI、FI、VFI、PI、RI、S/D预测胎盘植入发生的曲线下面积分别为0.853(95%CI:0.789,0.917)、0.756(95%CI:0.674,0.837)、0.771(95%CI:0.690,0.852)、0.850(95%CI:0.786,0.914)、0.765(95%CI:0.686,0.844)、0.747(95%CI:0.666,0.827)(P<0.05),敏感性分别为70.0%(95%CI:0.643,0.858)、75.7%(95%CI:0.691,0.866)、65.7%(95%CI:0.582,0.771)、81.4%(95%CI:0.745,0.861)、64.3%(95%CI:0.573,0.716)、61.4%(95%CI:0.532,0.698),特异性分别为90.0%(95%CI:0.832,0.957)、68.6%(95%CI:0.603,0.757)、84.3%(95%CI:0.779,0.904)、75.7%(95%CI:0.689,0.812)、84.3%(95%CI:0.767,0.915)、78.6%(95%CI:0.703,0.849)。多因素Logistic逐步回归分析结果显示,年龄≥35岁[O^R=3.459(95%CI:1.721,6.952)]、流产史[O^R=3.023(95%CI:1.511,6.048)]、前置胎盘[O^R=4.878(95%CI:2.215,10.743)]、剖宫产史[O^R=3.436(95%CI:1.517,7.783)]、VI≥21.315[O^R=3.244(95%CI:1.624,6.480)]、FI≥35.575[O^R=3.105(95%CI:1.347,7.157)]、VFI≥11.475[O^R=2.994(95%CI:1.471,6.094)]、PI≤0.735[O^R=3.843(95%CI:1.678,8.801)]、RI≤0.605[O^R=3.111(95%CI:1.319,7.338)]、S/D≥3.405[O^R=3.486(95%CI:1.677,7.246)]是胎盘植入发生的危险因素(P<0.05)。根据多因素Logistic回归分析建立胎盘植入预测模型,Logit(P)=-35.687+1.177XVI+1.133XFI+1.097XVFI+1.346XPI+1.135XRI+1.249XS/D,ROC曲线分析结果显示,胎盘植入预测模型预测胎盘植入发生的曲线下面积为94.9%(95%CI:0.913,0.984),敏感性为90.0%(95%CI:0.829,0.962),特异为88.6%(95%CI:0.819,0.923)(P<0.05)。结论3D-PDU胎盘血管化指数及子宫动脉血流动力学参数与胎盘植入具有相关性,可辅助用于胎盘植入的诊断。

三维能量多普勒超声评估不孕症患者子宫内膜容受性及与VEGF表达关系

目的:探讨三维能量多普勒超声(3DPD-US)参数与不孕症患者子宫内膜容受性及血管内皮生长因子(VEGF)的相关性。方法:收集本院2020年1月-2021年10月期间收治且初次行体外受精-胚胎移植的96例不孕症患者临床资料,根据妊娠结果分为妊娠组48例和未妊娠组48例。免疫组织化学法检测两组子宫内膜组织VEGF,超声诊断仪检查3DPD-US参数血管指数(VI)、血流指数(FI)、血管血流指数(VFI)及子宫内膜容受性常规参数:内膜厚度、内膜容积、螺旋动脉阻力指数(RI)、螺旋动脉搏动指数(PI)、子宫内膜及内膜下血流分型、子宫内膜形态;3DPD-US参数与子宫内膜容受性常规参数及VEGF表达水平的相关性采用Pearson法及Spearman法分析;3DPD-US参数对不孕症患者妊娠结局的预测效能采用受试者工作特征曲线分析。结果:未妊娠组内膜厚度、螺旋动脉RI、螺旋动脉PI高于妊娠组,VI、FI、VFI、VEGF蛋白阳性率、内膜容积低于妊娠组(均P<0.05)。未妊娠组3DPD-US参数VI、FI、VFI与内膜厚度、螺旋动脉RI、螺旋动脉PI均呈负相关,与内膜容积、VEGF表达水平均呈正相关(均P<0.05),与子宫内膜及内膜下血流分型、子宫内膜形态均无明显相关性(P>0.05)。VI、FI、VFI及联合预测妊娠结局的曲线下面积分别为0.842、0.825、0.854、0.961。结论:VI、FI、VFI可一定程度反映不孕症患者子宫内膜容受性,且对妊娠结局有预测作用。

早孕期三维能量多普勒超声联合彩色多普勒预测胎儿生长受限

目的:探讨早孕期三维能量多普勒超声联合彩色多普勒对胎儿生长受限(FGR)的预测效能。方法:回顾性收集2020年10月-2021年5月本院行早期妊娠行胎儿颈后透明层厚度(NT)检查的孕妇317例临床资料,根据分娩后随访结果分为非FGR组298例和FGR组19例。比较两组临床资料,胎儿头臀长(CRL)、胎盘容积(PV)、胎盘血流指数(FI)、血管化指数(VI)以及血管化-血流指数(VFI),分析各指标对FGR的预测效能。结果:非FGR组和FGR组FI、新生儿出生1min及5min Apgar评分无差异(P>0.05),新生儿体重、CRL、PV、VI及VFI均有差异(均P<0.05)。多因素logistics回归分析表明,CRL、PV、VI和VFI降低是导致FGR的独立危险因素(P<0.05)。绘制受试者工作特征曲线(ROC)分析,CRL、PV、VI和VFI单独及联合检测诊断FGR均有价值,但联合预测的曲线下面积(AUC)最高为0.762,敏感度84.2%。结论:早期妊娠孕妇采用三维能量多普勒超声联合彩色多普勒预测FGR的效能较高,有助于早期诊断并及时采取干预措施。