Qichang Zhou

Evaluation of regional left ventricular longitudinal function in 151 normal fetuses using velocity vector imaging

The purpose of this study was to investigate the clinical value of velocity vector imaging (VVI) in the assessment of normal fetal regional myocardial performance and to establish a normative data set for normal Chinese fetuses.

Assessment of regional right ventricular longitudinal functions in fetus using velocity vector imaging technology

The velocity vector imaging (VVI) technique is useful to assess regional myocardial mechanics. The aim of this study was to evaluate the usefulness of this technology in assessing regional right ventricular longitudinal functions in the fetus and to establish a nomogram of the right ventricle (RV).

Assessment of regional myocardial function in patients with dilated cardiomyopathy by velocity vector imaging.

Objective: To assess the left ventricular (LV) longitudinal systolic and diastolic function in patients with dilated cardiomyopathy (DCM) by syngo Velocity Vector Imaging (VVI). Methods: Digital dynamic images of 30 DCM patients and 30 healthy subjects were collected; then the longitudinal velocity, strain, and strain rate were measured in systolic early and late diastolic periods, and the time to peak systolic velocity, strain, and strain rate were measured and recorded. The parameters of the two groups were compared. Results: All of the parameters of the DCM were significantly lower than those of the normal group (P < 0.05–0.01), except that the parameter of late diastolic strain was not different between the two groups (P > 0.05). Conclusions: VVI is a novel noninvasive tool to assess quantitatively and objectively LV regional systolic and diastolic function in patients with DCM; it provides another useful modality for evaluating cardiac function.

Four‐dimensional echocardiography with B‐flow imaging and spatiotemporal image correlation in the assessment of congenital heart defects

The objective of the present study was to evaluate the role of four‐dimensional ultrasound with B‐flow imaging and spatiotemporal image correlation (STIC) in the detection of congenital heart defects.

Z-score reference ranges for normal fetal heart sizes throughout pregnancy derived from fetal echocardiography.

To construct Z‐score reference ranges for normal fetal heart sizes throughout pregnancy.

Quantitative Assessment of Left Ventricular Systolic Function in Patients with Coronary Heart Disease by Velocity Vector Imaging

Objective: To assess the left ventricular (LV) longitudinal systolic function and asynchrony in patients with coronary atherosclerotic heart disease (CAD) by syngo velocity vector imaging (VVI). Methods: Twenty‐eight control subjects and 79 patients with CAD were examined, including 28 patients with myocardial infarction, 26 patients with coronary lumen stenosis <50%, and 25 patients with myocardial ischemia. According to the results of coronary arteriography and electrocardiogram (ECG), the myocardial segments of the LV of CAD patients were divided into four groups: ischemic, infarcted, nonischemic, and normal. Dynamic imaging was performed on all subjects. The systolic peak strain (Smax), systolic strain rate (SRmax), time to peak strain (PTs), and time to peak strain rate (PTsr) in every cardiac cycle were measured. Results: A total of 1,253 out of 1,712 (96.5%) segments were successfully analyzed with VVI. Smax and SRmax of the ischemic and infarcted segments were impaired in CAD patients. Optimal sensitivity and specificity were obtained with strain and strain rate cutoffs of −14.08% and −0.83 s−1, respectively, for detecting ischemic segments and −6.65% and −0.38 s−1, respectively, for detecting infarcted segments. The PTs and PTsr were significantly longer in the ischemic and infarcted segments compared to those of the control group. Conclusions: Utilizing VVI, the longitudinal strain, strain rate, and peak time in CAD patients are easy to obtain and reproducible. Strain and strain rate cutoff values of abnormal myocardium are valuable for detecting ischemia and infarction. The PTs and PTsr values possibly estimate myocardium asynchrony in CAD patients. (Echocardiography 2012;29:340‐345)

Impaired Fetal Myocardial Deformation in Intrahepatic Cholestasis of Pregnancy

To investigate changes in fetal myocardial deformation in intrahepatic cholestasis of pregnancy.

Sustained maternal hyperoxygenation improves aortic arch dimensions in fetuses with coarctation

The aim was to investigate the impact of maternal hyperoxygenation (HO) on cardiac dimensions in fetuses with isolated Coarctation (CoA). Fetal echocardiography was performed serially in 48 fetuses with CoA and gestation age matched normal fetues. The Z-scores for the mitral valve (MV), tricuspid valve (TV), aortic valve (AV), ascending aorta (AAo), isthmus, pulmonary valve (PV), main pulmonary artery (MPA), and descending aorta (DAo) were measured and compared among normal fetuses, CoA fetuses with oxygen and CoA fetuses with air. In the group with oxygen, 6 L/min oxygen was administered to the mother using a face mask. Regression analyses were performed to identify potential factors for HO outcome. The left heart dimension Z-scores increased gradually during HO therapy periods, especially at 4 weeks after oxygen therapy (P < 0.05). As for the case group with air, the left heart dimension remained unchanged. The duration of HO was associated with aortic arch Z-scores (adjusted R2 = 0.199, 0.60 for AAO and isthmus, respectively). Sustained maternal middle-flow oxygenation can be safely used to improve left heart dimensions in fetuses with isolated CoA. The duration of HO were associated with treatment outcome. These findings may provide useful information for developing novel treatment strategies.

Sonographic Markers of Fetal α-Thalassemia Major

α‐Thalassemia prevails in Southeast Asia, where α‐thalassemia major is a lethal type. Sonography is a helpful and cost‐effective screening tool for detecting α‐thalassemia major fetuses. The cardiothoracic ratio, placental thickness, and middle cerebral artery peak systolic velocity are most used in clinical practice. These sensitive markers are helpful for evaluation of the hemodynamic status and cardiovascular function of the affected fetuses. They can predict fetal α‐thalassemia major and assess the efficacy of treatment noninvasively; therefore, the medical costs as well as the possibility of fetal loss caused by invasive procedures can be reduced. Other potentially useful sonographic markers need further studies, although previous preliminary research suggests their usefulness. This article will review those sonographic markers.

Indocyanine-green-loaded microbubbles for localization of sentinel lymph node using near-infrared fluorescence/ultrasound imaging: a feasibility study

Current strategies for sentinel lymph node (SLN) biopsy to detect cancer metastasis have some limitations such as the associated radiation exposure and high false-negative rates due to rapid diffusion of the dye particles through the true SLNs to contiguous lymph nodes. In this study, we incorporated the clinically used indocyanine green (ICG) into biocompatible poly (lactic-co-glycolic acid) (PLGA) microbubbles, and filled these with perfluorocarbon gas to form near-infrared (NIR) fluorescent polymer (ICG-PLGA) microbubbles for more efficient sentinel lymph node imaging. With the encapsulation of ICG into PLGA, the photo-stability of aqueous ICG solution was markedly enhanced at both room- and body-temperature, and could be concurrently used as a contrast media to enhance near-infrared fluorescence (NIRF) imaging and ultrasound (US) imaging signals. Upon subcutaneous injection into the front paw of a mouse, ICG-PLGA microbubbles translocated via lymphatic vessels into SLNs within 5 min; the associated NIR fluorescent signal intensity and retention time in lymph node was superior to that achieved with use of ICG alone. Further, ICG-PLGA microbubbles enhanced ultrasonographic contrast of popliteal lymph nodes of rabbits, unlike a simple ICG solution. Use of ICG-PLGA microbubbles improved efficacy of SLN imaging in this study; their use as imaging contrast agents for SLN mapping in humans is expected to be of much clinical relevance.