Nowadays,force sensors play an important role in industrial production,electronic information,medical health,and many other fields.Two-dimensional material-based filed effect transistor(2D-FET)sensors are competitive ...Nowadays,force sensors play an important role in industrial production,electronic information,medical health,and many other fields.Two-dimensional material-based filed effect transistor(2D-FET)sensors are competitive with nano-level size,lower power consumption,and accurate response.However,few of them has the capability of impulse detection which is a path function,expressing the cumulative effect of the force on the particle over a period of time.Herein we fabricated the flexible polymethyl methacrylate(PMMA)gate dielectric MoS_(2)-FET for force and impulse sensor application.We systematically investigated the responses of the sensor to constant force and varying forces,and achieved the conversion factors of the drain current signals(I_(ds))to the detected impulse(I).The applied force was detected and recorded by I_(ds)with a low power consumption of~30 nW.The sensitivity of the device can reach~8000%and the 4×1 sensor array is able to detect and locate the normal force applied on it.Moreover,there was almost no performance loss for the device as left in the air for two months.展开更多
Space objects such as spacecraft or missiles may be exposed to intense X-rays in outer space,leading to severe damage.The reinforcement of these objects to reduce the damage caused by X-ray irradiation is a significan...Space objects such as spacecraft or missiles may be exposed to intense X-rays in outer space,leading to severe damage.The reinforcement of these objects to reduce the damage caused by X-ray irradiation is a significant concern.The blow-off impulse(BOI)is a crucial physical quantity for investigating material damage induced by X-ray irradiation.However,the accurate calculation of BOI is challenging,particularly for large deformations of materials with complex configurations.In this study,we develop a novel two-dimensional particle-in-cell code,Xablation2D,to calculate BOIs under far-field X-ray irradiation.This significantly reduces the dependence of the numerical simulation on the grid shape.The reliability of this code is verified by simulation results from open-source codes,and the calculated BOIs are consistent with the experimental and analytical results.展开更多
Streamers represent an important stage in the initiation of gap discharge. In this work, we used an eight-frame intensified charge-coupled device camera to capture the streamer development process when a lightning imp...Streamers represent an important stage in the initiation of gap discharge. In this work, we used an eight-frame intensified charge-coupled device camera to capture the streamer development process when a lightning impulse voltage of 95%–100% U50% was applied in a 3 m rod–plate gap and the streamer velocity was analyzed. Analysis of the observations shows that streamer velocity can be defined by three stages: rapid velocity decline(stage 1), rapid velocity rise(stage 2)and slow velocity decline(stage 3). The effects of electrode shape, applied voltage and gap breakdown or withstanding on streamer velocity were analyzed. The electrode with a larger radius of curvature will result in a higher initial velocity, and a higher voltage amplitude will cause the streamer to propagate faster at stage 3. Gap withstanding or breakdown has no obvious effect on streamer velocity. In addition, the experimental results are compared with previous results and the statistical characteristics of the primary streamer discharge are discussed.展开更多
Motivated by recent advances made in the study of dividend control and risk management problems involving the U.S.bankruptcy code,in this paper we follow[44]to revisit the De Finetti dividend control problem under the...Motivated by recent advances made in the study of dividend control and risk management problems involving the U.S.bankruptcy code,in this paper we follow[44]to revisit the De Finetti dividend control problem under the reorganization process and the regulator's intervention documented in U.S.Chapter 11 bankruptcy.We do this by further accommodating the fixed transaction costs on dividends to imitate the real-world procedure of dividend payments.Incorporating the fixed transaction costs transforms the targeting optimal dividend problem into an impulse control problem rather than a singular control problem,and hence computations and proofs that are distinct from[44]are needed.To account for the financial stress that is due to the more subtle concept of Chapter 11 bankruptcy,the surplus process after dividends is driven by a piece-wise spectrally negative Lévy process with endogenous regime switching.Some explicit expressions of the expected net present values under a double barrier dividend strategy,new to the literature,are established in terms of scale functions.With the help of these expressions,we are able to characterize the optimal strategy among the set of admissible double barrier dividend strategies.When the tail of the Lévy measure is log-convex,this optimal double barrier dividend strategy is then verified as the optimal dividend strategy,solving our optimal impulse control problem.展开更多
The merits of compressed air energy storage(CAES)include large power generation capacity,long service life,and environmental safety.When a CAES plant is switched to the grid-connected mode and participates in grid reg...The merits of compressed air energy storage(CAES)include large power generation capacity,long service life,and environmental safety.When a CAES plant is switched to the grid-connected mode and participates in grid regulation,using the traditional control mode with low accuracy can result in excess grid-connected impulse current and junction voltage.This occurs because the CAES output voltage does not match the frequency,amplitude,and phase of the power grid voltage.Therefore,an adaptive linear active disturbance-rejection control(A-LADRC)strategy was proposed.Based on the LADRC strategy,which is more accurate than the traditional proportional integral controller,the proposed controller is enhanced to allow adaptive adjustment of bandwidth parameters,resulting in improved accuracy and response speed.The problem of large impulse current when CAES is switched to the grid-connected mode is addressed,and the frequency fluctuation is reduced.Finally,the effectiveness of the proposed strategy in reducing the impact of CAES on the grid connection was verified using a hardware-in-the-loop simulation platform.The influence of the k value in the adaptive-adjustment formula on the A-LADRC was analyzed through simulation.The anti-interference performance of the control was verified by increasing and decreasing the load during the presynchronization process.展开更多
For bistatic multiple-input multiple-output(MIMO)radar,this paper presents a robust and direction finding method in strong impulse noise environment.By means of a new lower order covariance,the method is effective in ...For bistatic multiple-input multiple-output(MIMO)radar,this paper presents a robust and direction finding method in strong impulse noise environment.By means of a new lower order covariance,the method is effective in suppressing impulse noise and achieving superior direction finding performance using the maximum likelihood(ML)estimation method.A quantum equilibrium optimizer algorithm(QEOA)is devised to resolve the corresponding objective function for efficient and accurate direc-tion finding.The results of simulation reveal the capability of the presented method in success rate and root mean square error over existing direction-finding methods in different application situations,e.g.,locating coherent signal sources with very few snapshots in strong impulse noise.Other than that,the Cramér-Rao bound(CRB)under impulse noise environment has been drawn to test the capability of the presented method.展开更多
Because muzzle impulse noise could cause damage to or have an intluence on the operator, tiae ettecnve protecnve measures should be taken. Therefore, correct analysis of impulse noise characteristics is very significa...Because muzzle impulse noise could cause damage to or have an intluence on the operator, tiae ettecnve protecnve measures should be taken. Therefore, correct analysis of impulse noise characteristics is very significant. Considering the shortcomings of fast Fourier transform method (FFT) in analysis of muzzle impulse noise frequency characteristics, wavelet energy spectrum method is put forward. Based on specific experiment data, the frequency characteristics and spectral energy dis tribution can be obtained. The experiment results show that wavelet energy spectrum method is applicable in muzzle impulse noise characteristic analysis.展开更多
Isolationism and expansionism are two themes of American diplomacy. From the beginning of the state’s history, isolationism and expansionism have manifested themselves as two policy imperatives in American diplomacy....Isolationism and expansionism are two themes of American diplomacy. From the beginning of the state’s history, isolationism and expansionism have manifested themselves as two policy imperatives in American diplomacy. On the surface, isolationism and expansionism represent contradictory attitudes and assumptions about America’s proper relationship with the outside world: isolationism advocates diplomatic and military non-entanglement in world affairs; expansionism urges active involvement in external affairs. But in a deeper sense, both isolationism and expansionism are manifestations of American sense of mission, the belief that the US has a special role to perform for all nations in the world. Isolationism is a passive approach to accomplish that mission: it emphasizes the exemplary nature of their country. Expansionism stresses the need for active involvement to achieve that mission; thus, is an active approach to American mission.展开更多
Several boundedness criteria for the impulsive integro-differential systems with fixed moments of impulse effects are established, employing the method of Lyapunov functions and Razumikhin technique.
The aerodynamic aspects of indirect thrust measurement by the impulse method have been studied both experimentally and numerically. The underlying basic aerodynamic principle is outlined, the phenomena in subsonic, su...The aerodynamic aspects of indirect thrust measurement by the impulse method have been studied both experimentally and numerically. The underlying basic aerodynamic principle is outlined, the phenomena in subsonic, supersonic and arc-heated jets are explored, and factors affecting the accuracy of the method are studied and discussed. Results show that the impulse method is reliable for indirect thrust measurement if certain basic requirements are met, and a simple guideline for its proper application is given.展开更多
AIM:To investigate the diagnostic performance of acoustic radiation force impulse(ARFI) elastography for characterizing focal liver mass by quantifying their stiffness.METHODS:This prospective study included 62 patien...AIM:To investigate the diagnostic performance of acoustic radiation force impulse(ARFI) elastography for characterizing focal liver mass by quantifying their stiffness.METHODS:This prospective study included 62 patients with a focal liver mass that was well visualized on conventional ultrasonography performed in our institution from February 2011 to November 2011.Among them,12 patients were excluded for ARFI measurement failure due to a lesion that was smaller than the region of the interest and at an inaccessible location(deeper than 8 cm)(n = 7) or poor compliance to hold their breath as required(n = 5).Finally,50 patients with valid ARFI measurements were enrolled.If a patient had multiple liver masses,only one mass of interest was chosen.The masses were diagnosed by histological examination or clinical diagnostic criteria.During ultrasonographic evaluation,stiffness,expressed as velocity,was checked 10 times per focal liver mass and the surrounding liver parenchyma.RESULTS:After further excluding three masses that were non-diagnostic on biopsy,a total of 47 focal mass lesions were tested,including 39(83.0%) malignant masses [24 hepatocellular carcinomas(HCC),seven cholangiocellular carcinomas(CCC),and eight liver metastases] and eight(17.0%) benign masses(five hemangiomas and three focal nodular hyperplasias,FNH).Thirty-seven(74.0%) masses were confirmed by histological examination.The mean velocity was 2.48 m/s in HCCs,1.65 m/s in CCCs,2.35 m/s in metastases,1.83 m/s in hemangiomas,and 0.97 m/s in FNHs.Although considerable overlap was still noted between malignant and benign masses,significant differences in ARFI values were observed between malignant and benign masses(mean 2.31 m/s vs 1.51 m/s,P = 0.047),as well as between HCCs and benign masses(mean 2.48 m/s vs 1.51 m/s,P = 0.006).The areas under the receiver operating characteristics curves(AUROC) for discriminating the malignant masses from benign masses was 0.724(95%CI,0.566-0.883,P = 0.048),and the AUROC for discriminating HCCs from benign masses was 0.813(95%CI,0.649-0.976,P = 0.008).To maximize the sum of sensitivity and specificity,an ARFI value of 1.82 m/s was selected as the cutoff value to differentiate malignant from benign liver masses.Furthermore,the cutoff value for distinguishing HCCs from benign masses was also determined to be 1.82 m/s.The diagnostic performance of the sum of the ARFI values for focal liver masses and the surrounding liver parenchyma to differentiate liver masses improved(AUROC = 0.853;95%CI,0.745-0.960;P = 0.002 in malignant liver masses vs benign ones and AUROC = 0.948;95%CI,0.896-0.992,P < 0.001 in HCCs vs benign masses).CONCLUSION:ARFI elastography provides additional information for the differential diagnosis of liver masses.However,our results should be interpreted in clinical context,because considerable overlap in ARFI values existed among liver masses.展开更多
Acoustic radiation force impulse(ARFI)imaging is a new and promising ultrasound-based diagnostic technique that,evaluating the wave propagation speed,allows the assessment of the tissue stiffness.ARFI is implemented i...Acoustic radiation force impulse(ARFI)imaging is a new and promising ultrasound-based diagnostic technique that,evaluating the wave propagation speed,allows the assessment of the tissue stiffness.ARFI is implemented in the ultrasound scanner.By short-duration acoustic radiation forces(less than 1 ms),localized displacements are generated in a selected region of interest not requiring any external compression so reducing the operator dependency.The generated wave scan provides qualitative or quantitative(wave velocity values)responses.Several non-invasive methods for assessing the staging of fibrosis are used,in order to avoid liver biopsy.Liver function tests and transient elastography are non-invasive,sensitive and accurate tools for the assessment of liver fibrosis and for the discrimination between cirrhotic and non-cirrhotic liver.Many published studies analyse ARFI performance and feasibility in studying diffuse liver diseases and compare them to other diagnostic imaging modalities such as conventional ultrasonography and transient elastography.Solid focal liver lesions,both benign and malignant,are common findings during abdominal examinations.The accurate characterization and differential diagnosis are important aims of all the imaging modalities available today.Only few papers describe the application of ARFI technology in the study of solid focal liver lesions,with different results.In the present study,the existing literature,to the best of our knowledge,about ARFI application on diffuse and focal liver pathology has been evaluated and results and statistical analyses have been compared,bringing to the conclusion that ARFI can be used in the study of the liver with similar accuracy as transient elastography in diagnosing significant fibrosis or cirrhosis and has got some advantages in respect to transient elastography since it does not require separate equipment,better displays anatomical structures and measurements can be successfully carried out almost in every patient.展开更多
AIM: To evaluate the performance of elastography by ultrasound with acoustic radiation force impulse(ARFI) in determining fibrosis stage in patients with alcoholic liver disease(ALD) undergoing alcoholic detoxificatio...AIM: To evaluate the performance of elastography by ultrasound with acoustic radiation force impulse(ARFI) in determining fibrosis stage in patients with alcoholic liver disease(ALD) undergoing alcoholic detoxification in relation to biopsy.METHODS: Eighty-three patients with ALD undergoing detoxification were prospectively enrolled. Each patient underwent ARFI imaging and a liver biopsy onthe same day. Fibrosis was staged according to the METAVIR scoring system. The median of 10 valid ARFI measurements was calculated for each patient.RESULTS: Sixty-nine males and thirteen females(one patient excluded due to insufficient biopsy size) were assessed with a mean alcohol consumption of 132.4 ± 128.8 standard drinks per week and mean cumulative year duration of 17.6 ± 9.5 years. Sensitivity and specificity were respectively 82.4%(0.70-0.95) and 83.3%(0.73-0.94)(AUROC = 0.87) for F ≥ 2 with a cut-off value of 1.63m/s; 82.4%(0.64-1.00) and 78.5%(0.69-0.89)(AUROC = 0.86) for F ≥ 3 with a cut-off value of 1.84m/s; and 92.3%(0.78-1.00] and 81.6%(0.72-0.90)(AUROC = 0.89) for F = 4 with a cut-off value of 1.94 m/s.CONCLUSION: ARFI is an accurate, non-invasive and easy method for assessing liver fibrosis in patients with ALD undergoing alcoholic detoxification.展开更多
基金financially supported by the National Natural Science Foundation of China(Nos.52272160,U2330112,and 52002254)Sichuan Science and Technology Foundation(Nos.2020YJ0262,2021YFH0127,2022YFH0083,2022YFSY0045,and 2023YFSY0002)+1 种基金the Chunhui Plan of Ministry of Education,Fundamental Research Funds for the Central Universities,China(No.YJ201893)the Foundation of Key Laboratory of Lidar and Device,Sichuan Province,China(No.LLD2023-006)。
文摘Nowadays,force sensors play an important role in industrial production,electronic information,medical health,and many other fields.Two-dimensional material-based filed effect transistor(2D-FET)sensors are competitive with nano-level size,lower power consumption,and accurate response.However,few of them has the capability of impulse detection which is a path function,expressing the cumulative effect of the force on the particle over a period of time.Herein we fabricated the flexible polymethyl methacrylate(PMMA)gate dielectric MoS_(2)-FET for force and impulse sensor application.We systematically investigated the responses of the sensor to constant force and varying forces,and achieved the conversion factors of the drain current signals(I_(ds))to the detected impulse(I).The applied force was detected and recorded by I_(ds)with a low power consumption of~30 nW.The sensitivity of the device can reach~8000%and the 4×1 sensor array is able to detect and locate the normal force applied on it.Moreover,there was almost no performance loss for the device as left in the air for two months.
基金supported by the National Science Foundation of China(No.12347103)the Fundamental Research Funds for the Central Universities(No.226-2022-00216)。
文摘Space objects such as spacecraft or missiles may be exposed to intense X-rays in outer space,leading to severe damage.The reinforcement of these objects to reduce the damage caused by X-ray irradiation is a significant concern.The blow-off impulse(BOI)is a crucial physical quantity for investigating material damage induced by X-ray irradiation.However,the accurate calculation of BOI is challenging,particularly for large deformations of materials with complex configurations.In this study,we develop a novel two-dimensional particle-in-cell code,Xablation2D,to calculate BOIs under far-field X-ray irradiation.This significantly reduces the dependence of the numerical simulation on the grid shape.The reliability of this code is verified by simulation results from open-source codes,and the calculated BOIs are consistent with the experimental and analytical results.
基金supported by the Beijing Science Fund for Distinguished Young Scholars(No.JQ22009)National Natural Science Foundation of China(No.51977198)。
文摘Streamers represent an important stage in the initiation of gap discharge. In this work, we used an eight-frame intensified charge-coupled device camera to capture the streamer development process when a lightning impulse voltage of 95%–100% U50% was applied in a 3 m rod–plate gap and the streamer velocity was analyzed. Analysis of the observations shows that streamer velocity can be defined by three stages: rapid velocity decline(stage 1), rapid velocity rise(stage 2)and slow velocity decline(stage 3). The effects of electrode shape, applied voltage and gap breakdown or withstanding on streamer velocity were analyzed. The electrode with a larger radius of curvature will result in a higher initial velocity, and a higher voltage amplitude will cause the streamer to propagate faster at stage 3. Gap withstanding or breakdown has no obvious effect on streamer velocity. In addition, the experimental results are compared with previous results and the statistical characteristics of the primary streamer discharge are discussed.
基金the financial support from the National Natural Science Foundation of China(12171405 and 11661074)the Program for New Century Excellent Talents in Fujian Province University+2 种基金the financial support from the Characteristic&Preponderant Discipline of Key Construction Universities in Zhejiang Province(Zhejiang Gongshang University-Statistics)Collaborative Innovation Center of Statistical Data Engineering Technology&ApplicationDigital+Discipline Construction Project(SZJ2022B004)。
文摘Motivated by recent advances made in the study of dividend control and risk management problems involving the U.S.bankruptcy code,in this paper we follow[44]to revisit the De Finetti dividend control problem under the reorganization process and the regulator's intervention documented in U.S.Chapter 11 bankruptcy.We do this by further accommodating the fixed transaction costs on dividends to imitate the real-world procedure of dividend payments.Incorporating the fixed transaction costs transforms the targeting optimal dividend problem into an impulse control problem rather than a singular control problem,and hence computations and proofs that are distinct from[44]are needed.To account for the financial stress that is due to the more subtle concept of Chapter 11 bankruptcy,the surplus process after dividends is driven by a piece-wise spectrally negative Lévy process with endogenous regime switching.Some explicit expressions of the expected net present values under a double barrier dividend strategy,new to the literature,are established in terms of scale functions.With the help of these expressions,we are able to characterize the optimal strategy among the set of admissible double barrier dividend strategies.When the tail of the Lévy measure is log-convex,this optimal double barrier dividend strategy is then verified as the optimal dividend strategy,solving our optimal impulse control problem.
基金supported by National Natural Science Foundation of China(Project No.52077079).
文摘The merits of compressed air energy storage(CAES)include large power generation capacity,long service life,and environmental safety.When a CAES plant is switched to the grid-connected mode and participates in grid regulation,using the traditional control mode with low accuracy can result in excess grid-connected impulse current and junction voltage.This occurs because the CAES output voltage does not match the frequency,amplitude,and phase of the power grid voltage.Therefore,an adaptive linear active disturbance-rejection control(A-LADRC)strategy was proposed.Based on the LADRC strategy,which is more accurate than the traditional proportional integral controller,the proposed controller is enhanced to allow adaptive adjustment of bandwidth parameters,resulting in improved accuracy and response speed.The problem of large impulse current when CAES is switched to the grid-connected mode is addressed,and the frequency fluctuation is reduced.Finally,the effectiveness of the proposed strategy in reducing the impact of CAES on the grid connection was verified using a hardware-in-the-loop simulation platform.The influence of the k value in the adaptive-adjustment formula on the A-LADRC was analyzed through simulation.The anti-interference performance of the control was verified by increasing and decreasing the load during the presynchronization process.
基金This work was supported by the National Natural Science Foundation of China(62073093)the Postdoctoral Scientific Research Developmental Fund of Heilongjiang Province(LBH-Q19098)+1 种基金the Heilongjiang Provincial Natural Science Foundation of China(LH2020F017)the Key Laboratory of Advanced Marine Communication and Information Technology,Ministry of Industry and Information Technology.
文摘For bistatic multiple-input multiple-output(MIMO)radar,this paper presents a robust and direction finding method in strong impulse noise environment.By means of a new lower order covariance,the method is effective in suppressing impulse noise and achieving superior direction finding performance using the maximum likelihood(ML)estimation method.A quantum equilibrium optimizer algorithm(QEOA)is devised to resolve the corresponding objective function for efficient and accurate direc-tion finding.The results of simulation reveal the capability of the presented method in success rate and root mean square error over existing direction-finding methods in different application situations,e.g.,locating coherent signal sources with very few snapshots in strong impulse noise.Other than that,the Cramér-Rao bound(CRB)under impulse noise environment has been drawn to test the capability of the presented method.
文摘Because muzzle impulse noise could cause damage to or have an intluence on the operator, tiae ettecnve protecnve measures should be taken. Therefore, correct analysis of impulse noise characteristics is very significant. Considering the shortcomings of fast Fourier transform method (FFT) in analysis of muzzle impulse noise frequency characteristics, wavelet energy spectrum method is put forward. Based on specific experiment data, the frequency characteristics and spectral energy dis tribution can be obtained. The experiment results show that wavelet energy spectrum method is applicable in muzzle impulse noise characteristic analysis.
文摘Isolationism and expansionism are two themes of American diplomacy. From the beginning of the state’s history, isolationism and expansionism have manifested themselves as two policy imperatives in American diplomacy. On the surface, isolationism and expansionism represent contradictory attitudes and assumptions about America’s proper relationship with the outside world: isolationism advocates diplomatic and military non-entanglement in world affairs; expansionism urges active involvement in external affairs. But in a deeper sense, both isolationism and expansionism are manifestations of American sense of mission, the belief that the US has a special role to perform for all nations in the world. Isolationism is a passive approach to accomplish that mission: it emphasizes the exemplary nature of their country. Expansionism stresses the need for active involvement to achieve that mission; thus, is an active approach to American mission.
基金国家自然科学基金面上项目(60970058)江苏省现代企业信息化应用支撑软件工程技术研发中心开放基金项目(SX200906)+1 种基金The National Natural Science Foundation of China(No.60970058)The Opening Project of Jiangsu Province Support Software Engineering R&D Center for Modern Information Technology Application in Enterprise(No.SX200906)
文摘Several boundedness criteria for the impulsive integro-differential systems with fixed moments of impulse effects are established, employing the method of Lyapunov functions and Razumikhin technique.
基金supported by the National Natural Science Foundation of China (50836007, 10921062, 10772016)
文摘The aerodynamic aspects of indirect thrust measurement by the impulse method have been studied both experimentally and numerically. The underlying basic aerodynamic principle is outlined, the phenomena in subsonic, supersonic and arc-heated jets are explored, and factors affecting the accuracy of the method are studied and discussed. Results show that the impulse method is reliable for indirect thrust measurement if certain basic requirements are met, and a simple guideline for its proper application is given.
基金Supported by A Grant of the Korea Healthcare Technology R and D Project,Ministry of Health and Welfare,South Korea, A102065
文摘AIM:To investigate the diagnostic performance of acoustic radiation force impulse(ARFI) elastography for characterizing focal liver mass by quantifying their stiffness.METHODS:This prospective study included 62 patients with a focal liver mass that was well visualized on conventional ultrasonography performed in our institution from February 2011 to November 2011.Among them,12 patients were excluded for ARFI measurement failure due to a lesion that was smaller than the region of the interest and at an inaccessible location(deeper than 8 cm)(n = 7) or poor compliance to hold their breath as required(n = 5).Finally,50 patients with valid ARFI measurements were enrolled.If a patient had multiple liver masses,only one mass of interest was chosen.The masses were diagnosed by histological examination or clinical diagnostic criteria.During ultrasonographic evaluation,stiffness,expressed as velocity,was checked 10 times per focal liver mass and the surrounding liver parenchyma.RESULTS:After further excluding three masses that were non-diagnostic on biopsy,a total of 47 focal mass lesions were tested,including 39(83.0%) malignant masses [24 hepatocellular carcinomas(HCC),seven cholangiocellular carcinomas(CCC),and eight liver metastases] and eight(17.0%) benign masses(five hemangiomas and three focal nodular hyperplasias,FNH).Thirty-seven(74.0%) masses were confirmed by histological examination.The mean velocity was 2.48 m/s in HCCs,1.65 m/s in CCCs,2.35 m/s in metastases,1.83 m/s in hemangiomas,and 0.97 m/s in FNHs.Although considerable overlap was still noted between malignant and benign masses,significant differences in ARFI values were observed between malignant and benign masses(mean 2.31 m/s vs 1.51 m/s,P = 0.047),as well as between HCCs and benign masses(mean 2.48 m/s vs 1.51 m/s,P = 0.006).The areas under the receiver operating characteristics curves(AUROC) for discriminating the malignant masses from benign masses was 0.724(95%CI,0.566-0.883,P = 0.048),and the AUROC for discriminating HCCs from benign masses was 0.813(95%CI,0.649-0.976,P = 0.008).To maximize the sum of sensitivity and specificity,an ARFI value of 1.82 m/s was selected as the cutoff value to differentiate malignant from benign liver masses.Furthermore,the cutoff value for distinguishing HCCs from benign masses was also determined to be 1.82 m/s.The diagnostic performance of the sum of the ARFI values for focal liver masses and the surrounding liver parenchyma to differentiate liver masses improved(AUROC = 0.853;95%CI,0.745-0.960;P = 0.002 in malignant liver masses vs benign ones and AUROC = 0.948;95%CI,0.896-0.992,P < 0.001 in HCCs vs benign masses).CONCLUSION:ARFI elastography provides additional information for the differential diagnosis of liver masses.However,our results should be interpreted in clinical context,because considerable overlap in ARFI values existed among liver masses.
文摘Acoustic radiation force impulse(ARFI)imaging is a new and promising ultrasound-based diagnostic technique that,evaluating the wave propagation speed,allows the assessment of the tissue stiffness.ARFI is implemented in the ultrasound scanner.By short-duration acoustic radiation forces(less than 1 ms),localized displacements are generated in a selected region of interest not requiring any external compression so reducing the operator dependency.The generated wave scan provides qualitative or quantitative(wave velocity values)responses.Several non-invasive methods for assessing the staging of fibrosis are used,in order to avoid liver biopsy.Liver function tests and transient elastography are non-invasive,sensitive and accurate tools for the assessment of liver fibrosis and for the discrimination between cirrhotic and non-cirrhotic liver.Many published studies analyse ARFI performance and feasibility in studying diffuse liver diseases and compare them to other diagnostic imaging modalities such as conventional ultrasonography and transient elastography.Solid focal liver lesions,both benign and malignant,are common findings during abdominal examinations.The accurate characterization and differential diagnosis are important aims of all the imaging modalities available today.Only few papers describe the application of ARFI technology in the study of solid focal liver lesions,with different results.In the present study,the existing literature,to the best of our knowledge,about ARFI application on diffuse and focal liver pathology has been evaluated and results and statistical analyses have been compared,bringing to the conclusion that ARFI can be used in the study of the liver with similar accuracy as transient elastography in diagnosing significant fibrosis or cirrhosis and has got some advantages in respect to transient elastography since it does not require separate equipment,better displays anatomical structures and measurements can be successfully carried out almost in every patient.
基金support from the national clinical research program for public hospitals of France
文摘AIM: To evaluate the performance of elastography by ultrasound with acoustic radiation force impulse(ARFI) in determining fibrosis stage in patients with alcoholic liver disease(ALD) undergoing alcoholic detoxification in relation to biopsy.METHODS: Eighty-three patients with ALD undergoing detoxification were prospectively enrolled. Each patient underwent ARFI imaging and a liver biopsy onthe same day. Fibrosis was staged according to the METAVIR scoring system. The median of 10 valid ARFI measurements was calculated for each patient.RESULTS: Sixty-nine males and thirteen females(one patient excluded due to insufficient biopsy size) were assessed with a mean alcohol consumption of 132.4 ± 128.8 standard drinks per week and mean cumulative year duration of 17.6 ± 9.5 years. Sensitivity and specificity were respectively 82.4%(0.70-0.95) and 83.3%(0.73-0.94)(AUROC = 0.87) for F ≥ 2 with a cut-off value of 1.63m/s; 82.4%(0.64-1.00) and 78.5%(0.69-0.89)(AUROC = 0.86) for F ≥ 3 with a cut-off value of 1.84m/s; and 92.3%(0.78-1.00] and 81.6%(0.72-0.90)(AUROC = 0.89) for F = 4 with a cut-off value of 1.94 m/s.CONCLUSION: ARFI is an accurate, non-invasive and easy method for assessing liver fibrosis in patients with ALD undergoing alcoholic detoxification.