Assessment of Uterine Receptivity by Endometrial and Subendometrial Blood Flows Measured by Vaginal Color Doppler Ultrasound in Women Undergoing IVF Treatment

Objective To evaluate endometrial and subendometrial blood flows measured by vaginal color Doppler ultrasound as a predicator of endometrial receptivity in women undergoing IVF treatment. Methods A total of 119 infertile patients undergoing the first IVF/ICSI-ET cycle were recruited. Three groups were divided according to a color Doppler ultrasound examination performed on the day of hCG injection. Group A, endometrial and subendometrial blood flows were 2 branches and below; group B, endometrial and subendometrial blood flows were between 3 and 4 branches; group C, endometrial and subendometrial blood flows were 5 branches and above. Patients were transferred 1-3 embryos each. Demographic data, ovarian responses, endometrial thickness, PI, RI, development of embryo and IVF result among groups were compared. Results Demographic data, ovarian responses, endometrial thickness, PI, RI and development of embryo among groups have no significant difference. The pregnancy rate of group A was significantly lower than that of group B （P〈0.05） and group C （P〈0.01）. The implantation rate of group A was significantly lower than than of group C （P〈0.01）. There was no significant difference of the rate of pregnancy and implantation between group B and group C （P〉0.05）. Conclusion Endometrial and subendometrial blood flows measured by vaginal color Doppler ultrasound is a good predicator of pregnancy during IVF treatment. A good endometrial and subendometrial blood flows is benefit for the result of IVF.

Assessment of voluntary rhythmic muscle contraction-induced exercising blood flow variability measured by Doppler ultrasound

Given recent technological developments, ultrasound Doppler can provide valuable measurements of blood velocity/flow in the conduit artery with high temporal resolution. In human-applied science such as exercise physiology, hemodynamic measurements in the conduit artery is commonly performed by blood flow feeding the exercising muscle, as the increase in oxygen uptake (calculated as a product of arterial blood flow to the exercising limb and the arterio-venous oxygen difference) is directly proportional to the work performed. The increased oxygen demand with physical activity is met through a central mechanism, an increase in cardiac output and blood pressure, as well as a peripheral mechanism, an increase in vascular conductance and oxygen extraction (a major part of the whole exercising muscles) from the blood. The increase in exercising muscle blood flow in relation to the target workload (quantitative response) may be one indicator in circulatory adjustment for the ac- tivity of muscle metabolism. Therefore, the determination of local blood flow dynamics (potential oxygen supply) feeding repeated (rhythmic) muscle contractions can contribute to the understanding of the factors limiting work capacity including, for instance, muscle metabolism, substance utilization and magnitude of vasodilatation in the exercising muscle. Using non-invasive measures of pulsed Doppler ultrasound, the validity of blood velocity/flow in the forearm or lower limb conduit artery feeding to the muscle has been previously demonstrated during rhythmic muscle exercise. For the evaluation of exercising blood flow, not only muscle contraction induced internal physiological variability, or fluctuations in the magnitude of blood velocity due to spontaneous muscle contraction and relaxation induced changes in force curve intensity, superimposed in cardiac beat-by-beat, but also the alterations in the blood velocity (external variability) due to a temporary sudden change in the achieved workload, compared to the target workload, should be considered. Furthermore, a small amount of inconsistency in the voluntary muscle contraction force at each kick seems to be unavoidable, and may influence exercising muscle blood flow, although subjects attempt to perform precisely similar repeated voluntary muscle contractions at target workload (muscle contraction force). This review presents the methodological considerations for the variability of exercising blood velocity/flow in the limb conduit artery during dynamic leg exercise assessed by pulsed Doppler ultrasound in relation to data previously reported in original research.

Measurement of Liver Size and Intrahepatic Blood Flow of Red-eared Turtles by Color Doppler Ultrasound

In the study, a total of 20 red-eared turtles （ half male and half female） were selected to conduct the measurement of liver size and intrahepatic blood flow of red-eared turtles by color Doppler ultrasound. The results showed that the fight hepatic lobe could be scanned through the right carotid anterior acoustic win- dow, and the left hepatic lobe could be scanned through the left carotid anterior acoustic window, but the vision would be obstructed by the air in trachea. The liver could also be scanned through the left femoral anterior acoustic window and the fight femoral anterior acoustic window when filling of bladder was good. The correla- tion regression analysis suggested that estimated values of liver showed no linear relationship with weight, the longest back curve and the widest back curve. Through the study, the normal indicators for ultrasound examination of red-eared turtle liver were established, in order to provide a reference for examination of turtle liver.

Measurement of the exercising blood flow during rhythmical muscle contractions assessed by Doppler ultrasound:Methodological considerations

Given the recent technological developments, ultra-sound Doppler can provide valuable measurements of arterial blood flow with high temporal resolution. In a clinical setting, measurements of hemodynamics is used to monitor, diagnose and manage changes in blood velocity profile for cardiac valve disease, relatively large vessel stenosis and other cardiovascular diseases. In health science and preventive medicine for cardiovascular disease with exercise therapy, evaluation of cardiac and vascular function is a useful indicator not only at rest but also during exercise, leading to improved exercise tolerance as well as physical activity. During exercise, the increase in oxygen uptake (calculated as product of arterial blood flow to the exercising limb and the arteriovenous oxygen difference) is directly proportional to the work performed. The increased oxygen demand is met through a central mechanism, an increase in cardiac output and blood pressure, as well as a peripheral mechanism, an increase in vascular conductance and oxygen extraction (major part in the whole exercising muscles) from the blood. Therefore, the determination of the local blood flow dynamics (potential oxygen supply) feeding to rhythmic muscle contractions can contribute to the understanding of the factors limiting the work capacity including, for instance the muscle metabolism, substance utilization and vasodilatation in the exercising muscle. Using non-invasive measures of pulsed Doppler ultrasound the validity of evaluating blood velocity/flow in the fore- arm or lower limb conduit artery feeding to the mus- cle is demonstrated during rhythmic muscle exercise;however the exercising blood velocity profile (fast Fourier transformation) due to muscle contractions is always seen as a physiological variability or fluctuations in the magnitude in blood velocity due to the spontaneous muscle contraction and relaxation induced changes in force curve intensity. Considering the above mentioned variation in blood velocity in relation to muscle contractions may provide valuable information for evaluating the blood flow dynamics during exercise. This review presents the methodological concept that underlines the methodological considerations for determining the exercising blood velocity/flow in the limb conduit artery in relation the exercise model of dynamic leg exercise assessed by pulsed Doppler ultrasonography.

Measurements Of Cerebral Blood Flow in Postasphyxiated Newborns by Color Doppler Imaging（CDI）

Cerebral blood flow of 10 asphyxiated term newborns was continuously measured during the first 7 days of life and compared with that of 10 normal term infants by CDI. Frequency spectrum and blood flow variables in the anterior, middle and posterior cerebral arteries were studied. The results showed evidently lower systolic amplitude in patients than that in normal subjects. End diastolic amplitude was zero in part of vessels, and values of bloed flow variables were all lower in day 1 of the life as compared with the control groups. Frequency spectrum recovered to normal patterns in 9 survived infants in day 2. but blood flow variables recovered to normal by day 7. Values of resistance index (RI) rose to 1 in some vessels of moderate hypoxic ischemic encephalopathy (HIE) infants and stayed at 1 in the severe HIE infants. It is concluded that low CBF plays a key role in brain damage of post-asphyxiated newborns and RI may be an important parameter in the evaluation prognosis.

Antidiastole Value of Three-dimensional Ultrasonography and Power Doppler between Uterine Parenchyma Lumps and Endometrial Cancer:A Retrospective Study

Sometimes endometrial polyps,submucosal myomas,and endometrial cancer show similar findings under ultrasonography.The aim of this study was to assess the antidiastole value of blood flow parameters using three-dimensional(3D)power Doppler ultrasonography angiography(PDA)between endometrial cancer and uterine parenchyma lumps.The data of the blood flow indices in 3D-PDA including the vascularization index(VI),flow index(FI),and vascularization flow index(VFI)in 40 patients with endometrial cancer and 41 patients with uterine parenchyma lumps(endometrial polyps and submucosal myomas)were retrospectively analysed and compared utilizing Virtual Organ Computer-aided AnaLysis(VOCAL)software.The results showed that all the blood flow parameters(VI,FI,VFI)were significantly higher in women with endometrial cancer than in those with uterine parenchyma lumps(P<0.001).The area under the curve of ROC of VI,FI,and VFI was 0.98,0.84,and 0.97,respectively.Thus,the best predictor of endometrial carcinoma was VI with a sensitivity of 97.0% and a specificity of 91.0%.The optimal cutoff value of VI was 4.06%.Our data demonstrated that all of the blood flow signal parameters(including VI,FI,and VFI)in 3D power Doppler ultrasonography had significant antidiastole values between endometrial cancer and uterine parenchyma lumps to assist clinicians in properly diagnosing patients.

Voluntary Thigh Muscle Strength with Resection Stump-Dependent Blood Flow and Vasodilation in an Amputated Lower Leg with Total Surface Bearing Prosthesis during Dynamic Knee Extensor: A Case Trial

Background: The magnitude of the hyperemic response due to repeated thigh stump exercise on incremental contraction intensity might be useful information in localized exercise tolerance for devising cardiovascular physical therapy for amputees. The effect of exercise on amputated leg blood flow (LBF) may potentially be altered due to voluntary muscle contractions after loss of the lower leg compared with the healthy leg. Case Presentation: A 57-year-old male patient with Burger disease attempted 3 min unilateral repeat/dynamic knee extensor exercise at a target muscle contraction frequency (1 s thigh muscle contraction and 1 s relaxation, 90 repetitions) with each leg <right transtibial amputated leg (AL) using a total surface-bearing prosthesis (TSB) and left non-AL> at six different contraction intensities (rubber resistance belt). Simultaneous measurement of blood velocity/flow (Doppler ultrasound) in the femoral artery, blood pressure, leg vascular conductance (LVC), and peak muscle strength (PMS) were performed during the 3 min exercise period. The maximum voluntary contraction by one-legged isometric knee muscle contraction was 14.7 kg in non-AL and 7.9 kg in the AL with prosthesis. The relative PMS was defined as “PMS/maximum voluntary contraction × 100 (%)”. Pre-exercise LBF was lower in the AL (200 ± 25 ml/min) than the non-AL (275 ± 74 ml/min). Both the non-AL and AL showed good positive linear relationships between absolute-/relative-PMS and LBF or LVC during 30 s at steady-state before the end of the exercise period. Furthermore, there was also similarity seen in the increase rate in LBF and/or LVC for the incremental relative PMS compared with the absolute PMS. Conclusion: In this case, the muscle strength depended on blood flow increase/vasodilation was seen in this “AL” using a TSB prosthesis for repeated dynamic knee extensor exercise. The present amputee’s limb muscle strengthening with the resection stump closely related to the degree of hyperemia in the amputated limb.

子宫动脉多普勒超声血流成像相关参数与妊娠期高血压产妇妊娠结局的关系

目的 探讨子宫动脉多普勒超声血流成像相关参数与妊娠期高血压产妇妊娠结局的关系。方法 选取80例妊娠期高血压产妇纳入病例组,80例健康产妇纳入健康组,比较两组的子宫动脉多普勒超声血流成像相关参数。比较病例组不同妊娠结局产妇的相关参数,分析不良妊娠结局的危险因素。结果 病例组的子宫动脉RI、 PI、 S/D均高于健康组(P <0.05)。病例组发生不良妊娠结局产妇的子宫动脉RI、 PI、 S/D均高于未发生产妇(P <0.05)。Logistic回归分析显示,子宫动脉RI、 PI、 S/D均为不良妊娠结局发生的独立危险因素(OR>1,P <0.05)。结论 妊娠期高血压产妇的子宫动脉RI、 PI、 S/D显著高于正常产妇,且子宫动脉RI、 PI、 S/D与不良妊娠结局有关,临床中可将多普勒超声检查用于病情诊断及不良妊娠结局风险预测。

二维斑点追踪技术在评估冠心病患者左心室收缩与舒张功能中的应用价值

目的探讨二维斑点追踪技术在评估老年冠心病患者左心室收缩与舒张功能中的应用价值。方法对60例老年冠心病患者(研究组)和60名健康老年人(对照组),应用彩色多普勒超声诊断仪进行左心室功能检查。比较两组血压、生化指标(三酰甘油、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、总胆固醇、糖化血红蛋白)及常规超声参数、二维斑点超声应变参数、血流频谱测量超声参数。结果研究组受试者收缩压、舒张压及三酰甘油、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、总胆固醇、糖化血红蛋白水平均高于对照组(P<0.01)。两组受试者收缩末期和舒张末期的左室内径、室间隔壁厚度、左室前/后/下壁厚度比较,差异无统计学意义(P>0.05)。研究组受试者左室舒张充盈末流速峰值/左室收缩末流速峰值低于对照组(P<0.05);两组受试者左室射血分数、左室舒张充盈末流速峰值、左室收缩末流速峰值比较,差异无统计学意义(P>0.05)。研究组受试者舒张期和收缩期的左心室前壁、后壁、下壁、室间隔的纵向、径向、周向峰值绝对值均低于对照组(P<0.01)。结论二维斑点追踪技术的抗干扰能力较强,二维斑点超声应变参数能有效反映冠心病患者左室收缩、舒张情况,具有较高的应用价值。

基于多频脉冲采样的血流速度估计方法

传统双模超声技术相较于新兴技术更具实现可穿戴化的潜力。在进行脉冲多普勒血流速度估计时,双模超声需同时发射B模式脉冲进行成像定位,这要求B模式脉冲和多普勒脉冲共享采样时间。采用基于单频多普勒脉冲的稀疏间隔发射方式可以解决这一问题,但常见的稀疏发射排布方式(如嵌套发射、互质发射等)存在采样时间窗较长的缺点,特别是在血流速度变化明显的情况下存在时间分辨率不足的问题。此外,长时间窗包含了较多的血流速度分量,容易由于稀疏采样引起伪影,从而影响血流速度估计的准确性。因此,文中提出了一种基于多频脉冲采样的新型血流速度估计方法。首先,构建了多频脉冲采样的回波模型,并对该模型进行推导,证明了在频率衰减平稳假设下,该数学模型等价于单频多普勒脉冲稀疏发射方式,即多频脉冲采样可以通过较短的时间窗实现类似于基于单频脉冲采样模式的长时间窗的性能,从而提高血流速度谱的时间分辨率和估计精度;然后,提出了两种可用于多频脉冲采样模式的血流速度谱的构建方法,分别为复杂度较低的BMUSIC算法和伪影抑制效果较佳的VMUSIC算法。基于FieldⅡ仿真数据和人体实测数据的实验结果表明:相较于单频多普勒脉冲稀疏发射方式,文中方法不仅可以采用较短的时间窗提升血流速度谱的时间分辨率,还可以获得连续、清晰、精度较高且伪影抑制效果较佳的血流速度估计结果;在人体实测数据实验中,由于实验条件所限,文中方法无法实现非整数倍频,未能充分展现VMUSIC算法的性能优势。

子宫动脉血流多普勒超声联合血清PIGF、Vaspin、ESM-1诊断HDP价值

目的:探讨妊娠高血压疾病(HDP)患者子宫动脉血流多普勒超声、血清促血管生成因子(PIGF)、丝氨酸蛋白酶抑制剂(Vaspin)、内皮细胞特异分子-1(ESM-1)水平及其诊断价值。方法:回顾性收集2020年6月-2021年12月本院接诊的HDPL患者86例为病例组,产前检查健康孕妇75例为对照组,检测两组血清PIGF、Vaspin、ESM-1水平及子宫动脉血流参数,分析在诊断HDP价值。结果:病例组血清PIGF(271.56±45.56 pg/ml)低于对照组(330.15±50.35 pg/ml),Vaspin(0.46±0.04 ng/ml)、ESM-1(1.38±0.51μg/L)高于对照组(0.39±0.08 ng/ml、1.01±0.07μg/L),多普勒超声子宫动脉血流阻力指数(RI)(0.79±0.14)、搏动指数(PI)(0.83±0.21)、收缩期峰值流速与舒张末期血流速度比值(S/D)(2.26±0.74)均高于对照组(0.51±0.20、0.44±0.19、1.41±0.35),且病例组妊娠期高血压、轻度子痫前期、重度子痫前期患者上述各指标均有差异(均P<0.05)。受试者工作特征曲线分析,血清PIGF、Vaspin、ESM-1、RI、PI、S/D及各项联合,诊断HDP的曲线下面积分别为0.811、0.780、0.691、0.944、0.860、0.813、0.999,截断值分别为291.56 pg/ml、0.43 ng/ml、1.12μg/L、0.58、0.53、1.87,联合检测的特异度(96.5%)、准确度(93.4%)最高(均P<0.05)。结论:HDP患者血清PIGF、Vaspin、ESM-1、子宫动脉血流参数异常改变,且对HDP有较好诊断价值,本次研究也为靶向药物治疗HDP提供了新思路。

二维超声联合微血管血流成像对睾丸结核的诊断价值

目的:探讨二维超声联合微血管血流成像(MV-flow)对睾丸结核的诊断价值。方法:选择2023年1月至12月在郑州大学第一附属医院因阴囊疼痛、坠胀,或伴有阴囊肿块就诊,疑似睾丸结核的91例患者为研究对象。均行二维超声检查、彩色多普勒血流显像(CDFI)和MV-flow。以病理结果为金标准,比较二维超声联合MV-flow及二维超声联合CDFI诊断睾丸结核的效能,同时计算血流像素占比。另外选取20例疑似睾丸结核患者,通过MV-flow获取血管指数(VI),采用同类相关系数(ICC)评估MV-flow检测结果的一致性。结果:91例患者中共有80例病理确诊为睾丸结核。二维超声联合MV-flow诊断睾丸结核的敏感度、特异度、准确度分别为96.3%、54.6%和91.2%,高于二维超声联合CDFI(87.5%、18.2%、79.1%)。MV-flow睾丸内血流像素占比高于CDFI[(2.13±0.81)%vs(1.86±0.70)%,P=0.360]。VI在观察者内和观察者间的一致性良好[ICC(95%CI)分别为0.874(0.683~0.950)、0.945(0.860~0.978)]。结论:相比二维超声联合CDFI,二维超声联合MV-flow对睾丸结核的诊断效能更高。

经阴道彩色多普勒超声在子宫内膜病变患者中的应用价值

目的分析经阴道彩色多普勒超声在子宫内膜病变患者中的应用价值。方法选取2021年2月至2022年4月南昌大学第四附属医院收治的88例子宫内膜病变患者作为研究对象,所有患者均接受经阴道彩色多普勒超声及病理学检查,按照病理学检查结果将患者分为息肉组与癌变组,每组44例。比较两组二维超声子宫内膜情况、病灶血流动力学情况、经阴道彩色多普勒超声血流相关参数;以病理学检查结果为金标准,分析经阴道彩色多普勒超声对子宫内膜癌变的诊断效能。结果癌变组子宫内膜厚度厚于息肉组,内膜-肌层分界清晰、病灶回声均匀占比均低于息肉组,差异有统计学意义(P<0.05);癌变组血流丰富占比高于息肉组,差异有统计学意义(P<0.05);癌变组血流阻力指数(RI)、搏动指数(PI)均低于息肉组,时间平均峰值流速(TAP)慢于息肉组,差异有统计学意义(P<0.05);经阴道彩色多普勒超声对子宫内膜癌变的诊断灵敏度为86.36%,特异度为84.09%,准确度为85.23%;诊断息肉的灵敏度为84.09%,特异度为86.36%,准确度为85.23%。结论经阴道彩色多普勒超声对子宫内膜病变的诊断准确率较高,能通过血流动力学、RI、PI、TAP及影像学表现鉴别息肉或癌变。

基于彩色多普勒超声分析胎儿脐血流对FGR的诊断价值

目的:探讨彩色多普勒超声胎儿脐血流参数对FGR的诊断价值。方法:回顾性选取2019年12月~2021年12月收治的100例FGR孕妇(研究组)及100例正常孕妇(对照组),均接受超声检测。分析胎儿超声脐血流参数与FGR的关系,Logistic回归分析FGR发生的影响因素。ROC曲线分析胎儿脐血流参数对FGR的诊断价值。结果:Logistic分析显示年龄、羊水过少、低蛋白血症、RI,PI,S/D均是FGR发病的影响因素。ROC分析显示S/D、RI、PI对FGR诊断价值高。结论:FGR胎儿彩色多普勒RI,PI,S/D异常升高,具有良好诊断价值。

床旁经颅多普勒超声在神经重症脑血管疾病患者中的监测价值

目的分析神经重症脑血管疾病患者监测中床旁经颅多普勒超声应用效果。方法筛选郑州人民医院2021年5月至2023年5月86例重症脑血管疾病患者作为研究对象(高血压脑出血,术后35例,未手术者7例,脑动脉瘤破裂出血,术后32例,未手术者5例,其他脑血管疾病术后4例,未手术者3例),均采用经颅多普勒超声(TCD)监测,包含经枕窗探测基底动脉(BA)、经颞窗探测双侧大脑中动脉(MCA),另监测收缩期峰值血流动力学改变、舒张末期峰值血流速度、平均峰值血流速度、血管阻力指数、血管搏动指数、血流频谱形态等了解血流动力学改变,了解血流动力学改变,依照监测结果分三组,脑血管痉挛组(n=26)、供血不足组(n=37)、血流增快组(n=29),对各组监测结果予以分析。结果患者均完成TCD监测,在不同病因中,脑动脉瘤破裂出血与高血压脑出血患者供血不足发生率最高,其次是血流增快、血管痉挛,三组发生率对比差异有统计学意义(P<0.05)。结论在神经重症脑血管疾病患者中,床旁TCD监测能为临床治疗及预后评价提供有效支持。

多普勒超声子宫动脉血流参数联合凝血相关指标对易栓症所致复发性流产妊娠结局的预测价值

目的:探讨多普勒超声子宫动脉血流参数联合凝血相关指标对易栓症所致复发性流产妊娠结局的预测价值。方法:选取2020年1月至2023年1月北京市海淀医院妇科门诊就诊的82例复发性流产患者,所有患者均进行相关治疗,并统计随访结果。所有患者于入院次日治疗前均进行子宫动脉搏动指数(PI)、阻力指数(RI)、收缩压最大血流速度(S)与舒张末期最大血流速度(D)比值(S/D),以及活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)、纤维蛋白原(FIB)、凝血酶时间(TT)及D二聚体(D-D)检测。采用Pearson相关性分析PI、RI与S/D与APTT、PT、FIB、TT、D-D的相关性;采用受试者工作特征(ROC)曲线下面积(AUC)分析PI、RI、S/D、APTT、PT、FIB、TT及D-D单独检测及联合检测预测易栓症所致复发性流产妊娠结局的价值。结果:随访结果显示,82例复发性流产患者妊娠成功49例,妊娠丢失33例,妊娠成功孕妇的PI、RI与S/D均明显低于妊娠丢失孕妇,差异有统计学意义(t=10.598、6.693、3.059,P<0.05);APTT、PT、FIB、TT、D-D水平均明显低于妊娠丢失孕妇,差异有统计学意义(t=9.552、96.462、22.767、5.100、95.805,P<0.05);PI与APTT、PT、FIB、TT及D-D均存在正相关性(r=3.178,P<0.05),RI与APTT、PT、FIB、D-D均存在正相关性(r=3.246,P<0.05),S/D与PT、FIB、TT、D-D均存在正相关性(r=3.246,P<0.05);PI、RI、S/D、APTT、PT、FIB、TT及D-D单独检测及联合检测预测易栓症所致复发性流产妊娠结局灵敏度分别为42.40%、48.50%、39.40%、48.50%、63.60%、72.70%、42.40%、39.40%、84.80%,特异性分别为98.00%、71.40%、55.10%、75.50%、59.20%、71.40%、77.60%、85.70%、98.80%,AUC分别为0.674、0.685、0.409、0.646、0.784、0.788、0.566、0.563和0.941。结论:PI、RI及S/D子宫动脉血流参数与APTT、PT、FIB、TT和D-D凝血相关指标单独及联合检测预测易栓症所致复发性流产妊娠结局均具有一定的价值,且联合检测的预测价值更高。

基于超声血流参数的胎儿生长受限辅助诊断预测模型构建及机器学习算法的筛选

目的应用机器学习算法基于超声血流参数构建胎儿生长受限(FGR)辅助诊断预测模型,比较不同预测模型的预测效能。方法本研究纳入2021年1月至2023年12月河南省人民医院收治的88例单胎且出生后确诊为FGR的孕妇资料(FGR组),并以河南省人民医分娩的88例非FGR孕妇作为对照(非FGR组)。本研究应用单因素和多因素logistic回归分析法筛选影响FGR的危险因素,并运用R软件构建支持向量机预测模型、随机森林预测模型及logistic回归预测模型。绘制3种预测模型的受试者工作特征曲线,比较不同模型预测FGR的效能,以确定最优的预测工具。结果FGR组、非FGR组分娩孕周、大脑中动脉搏动指数(MCAPI)、脐动脉搏动指数(UAPI)、静脉导管搏动指数(DVPI)、脑胎盘比(CPR)差异有统计学意义(P<0.05),年龄、产妇类型、体重指数、新生儿性别差异无统计学意义(P>0.05)。logistic回归分析结果显示,分娩孕周、DVPI、CPR是影响FGR的危险因素(P<0.05)。基于影响FGR的3个危险因素分别构建logistic回归预测模型、支持向量机预测模型、随机森林预测模型,结果显示,随机森林预测模型的曲线表现最优,其曲线下面积为0.986(95%CI:0.975~0.997)。结论分娩孕周、DVPI、CPR均为影响FGR的危险因素,机器学习算法中随机森林预测模型预测FGR的效能最好。

子宫动脉血流多普勒超声检查联合血清胎盘生长因子、D-二聚体与孕中期子痫前期妊娠结局及新生儿预后的相关研究

目的 探讨子宫动脉血流多普勒超声检查联合血清胎盘生长因子(PIGF)和D-二聚体(D-D)与孕中期子痫前期孕妇妊娠结局及新生儿预后的相关性。方法 将2019年1月至2022年8月江阴市中医院(南京中医药大学江阴附属医院)就诊的89例孕中期先兆子痫孕妇纳入本次回顾性研究,设为先兆子痫组,另选择同时间段226例孕中期正常孕妇纳入对照组。比较各组孕20~26周子宫动脉血流参数[包括收缩期与舒张期流速比(S/D)、搏动指数(PI)和子宫动脉阻力指数(RI)],血清PIGF和D-D水平,Pearson相关性分析分析PIGF、D-D与S/D、PI和RI的相关性,比较不同母体结局及新生儿预后及子宫动脉血流参数、血清PIGF、D-D水平。结果 先兆子痫组S/D、PI和RI为3.35±0.26、2.21±0.12、0.84±0.21,均明显高于对照组(2.89±0.30、0.82±0.09、0.53±0.19),差异均有统计学意义(P<0.05)。先兆子痫组的血清PIGF为(13.41±0.59)μg/L,显著低于对照组[(42.35±2.21)μg/L],血清D-D为(598.05±79.51)μg/L,显著高于对照组[(264.19±45.96)μg/L],差异均有统计学意义(P<0.05)。Pearson相关性分析显示,PIGF与S/D、PI和RI呈负相关(r=-0.481、-0.509、0.489,P<0.05),而D-D与S/D、PI和RI呈正相关(r=0.422、0.447、0.438,P<0.05)。先兆子痫组新生儿出生孕周为(33.53±1.95)周,明显短于对照组[(38.97±2.27)周],出生体重及1 min Apgar评分分别为(2 324.10±413.77)g、(7.51±1.91)分,均明显低于对照组[(3 114.43±541.72)g、(9.50±1.83)分],差异均有统计学意义(P<0.05)。母体并发症发生率和新生儿不良预后发生率为68.54%(61/89)、47.19%(42/89)。母体并发症组的S/D、PI及RI、血清D-D水平均显著高于非母体并发症组,而血清PIGF水平显著低于非母体并发症组,差异均有统计学意义(P<0.05);新生儿预后不良组的的S/D、PI及RI、血清D-D水平显著高于预后良好组,而血清PIGF水平显著低于预后良好组,差异均有统计学意义(P<0.05)。结论 先兆子痫患者孕中期子宫动脉血流参数异常,血清PLGF、D-D表达异常,且先兆子痫患者新生儿预后差,孕中期子宫动脉血流参数、血清PLGF、D-D与先兆子痫患者母婴结局密切相关。

彩色多普勒超声血流信号及血流参数对原发性肝癌与转移性肝癌的诊断作用研究

目的:探讨彩色多普勒超声血流信号及血流参数对原发性肝癌及转移性肝癌的诊断价值。方法:对2021年1月-2023年6月韶关市曲江区人民医院体检中心科室收治的100例肝癌患者临床资料进行回顾性分析,所有患者均经病理组织确诊,其中原发性肝癌48例,转移性肝癌52例,所有患者均行彩色多普勒超声检查,比较两组血流信号、血流参数差异。结果:超声对原发性肝癌检出率为95.83%(46/48),与病理结果一致性较好(Kappa=0.715,P<0.05),超声对转移性肝癌检出率为88.46%(46/52),与病理结果一致性一般(Kappa=0.695,P<0.05);原发性肝癌组瘤周血流信号、瘤内血流信号检出率分别为93.75%(45/48)、91.67%(44/48),明显较转移性肝癌组75.00%(39/52)、67.31%(35/52)高(P<0.05);原发性肝动脉直径、门静脉流速、肝动脉峰值流速、肝动脉最小流速、RI各项超声血流参数与转移性肝癌组相比,有显著差异(P<0.05);原发性肝癌声像图多表现为形态不规则、大小不一,多为单发性病灶,边界清晰,超声显示为等或低回声;转移性肝癌大小、形态不一,多为等回声,边界清晰,呈“靶环征”。结论:彩色多普勒超声对原发性及转移性肝癌具有较高诊断价值,可精准反映两者血供分布情况,通过超声血流动力学参数可有效鉴别诊断两者,值得推广。

基于多普勒超声技术的中医脉象鉴别指标筛选

目的 探索基于多普勒超声技术的中医脉象表达规律,筛选可用于脉象鉴别的多普勒超声血流频谱图指标。方法 利用彩色多普勒超声诊断仪收集临床常见脉象平脉、浮脉、沉脉、弦脉、滑脉、弱脉、涩脉数据信息,比较分析平脉与浮、沉、弦、滑、弱、涩脉之间的差异,筛选可作为脉象鉴别的多普勒超声血流频谱图指标。结果 收缩期峰值血流速度(PS)、舒张末期血流速度(ED)、收缩期峰值血流速度/舒张末期血流速度(S/D)、收缩期峰值血流速度-舒张末期血流速度(PS-ED)、阻力指数(RI)、收缩期主峰加速度(V1)、收缩期主峰减速度(V2)、收缩期升支角度、收缩期降支角度、收缩期降支角度-升支角度、平均血流速度(V3)、搏动指数(PI)、灰度值最大值、灰度值平均值、灰度值中间值、一周期面积、收缩末期血流速度等指标可以作为脉象鉴别指标。结论 利用彩色多普勒超声进行脉象的客观化表达研究具有可行性,共筛选出彩色多普勒超声脉象鉴别指标17个。