Echo Type Research Articles

Construction of vulnerable plaque prediction model based on multimodal vascular ultrasound parameters and clinical risk factors

The rupture of vulnerable plaque (VP) are significant pathogenic factors leading to cardiovascular and cerebrovascular diseases. This study aims to construct a vulnerable plaque prediction model (VPPM) by combining multimodal vascular ultrasound parameters and clinical risk factors, and to validate it. A total of 196 atherosclerotic patients who underwent carotid endarterectomy (CEA) from January 2017 to December 2023 were collected and divided into a modeling group (n = 137) and a validation group (n = 59). Clinical information including: hypertension, diabetes, smoking history, and body mass index (BMI) was included in the analysis. All patients underwent carotid ultrasound and contrast-enhanced ultrasound (CEUS) examination after admission, with main ultrasound parameters including thickness, echogenicity types, stenosis degree, and CEUS neovascularization grading of plaques. Independent risk factors for VP in CEA patients were screened through binary Logistic regression analysis, and a prediction model was established along with a nomogram. The calibration curve, receiver-operating characteristic curve (ROC), and decision curve analysis (DCA) were employed to assess the calibration, diagnostic efficacy, and clinical utility of the VPPM model. There were no significant statistical differences in multimodal vascular ultrasound parameters and clinical risk factors between the modeling and validation groups (P > 0.05). Binary Logistic regression analysis identified plaque thickness, echo type, CEUS neovascularization grading, BMI, and smoking history as 5 variables entering the prediction model. The VPPM model showed good diagnostic efficacy, with an area under the ROC curve of 0.959 (95% CI 0.915–0.999). Using the nomogram with a VPPM risk assessment score of 135.42 as the diagnostic cutoff value in the modeling group, the sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and Youden index were 88.1%, 94.1%, 14.98, 0.126, and 82.2%, respectively. In the DCA curve, the VPPM model curve was significantly better than two extreme lines, indicating good clinical utility. The VPPM model constructed by integrating multimodal ultrasound parameters and clinical key risk factors has high diagnostic efficacy and is expected to be an auxiliary tool for clinical diagnosis of vulnerable plaques.

Application of strain elastography ultrasound to the endometrium of normal women

BackgroundWhile there is a scarcity of studies utilizing strain elastography (SE) for the endometrium, commonly used gynecologic ultrasound instruments are equipped with built-in elastography modalities, primarily SE. With the objective of facilitating comprehensive examinations for gynecologic patients on a single ultrasound instrument, we undertook this study. Therefore, our aim was to study the value of SE ultrasonography in the assessment of endometrial elasticity in normal women.MethodsThree hundred and twenty normal women were recruited at our hospitals from November 2021 to December 2022. Each volunteer underwent a transvaginal two-dimensional (2D) and SE ultrasound during either the endometrial proliferative or secretory phase. The 2D ultrasound indices obtained included endometrial thickness, echo type (type A, B, and C), and blood flow grading (grades 0, 1, 2, and 3). SE indices obtained included endometrial strain values, myometrial strain values, and endometrial strain ratios. Differences in endometrial ultrasound indices between different menstrual cycles and different age groups were compared.ResultsComparison of 2D ultrasound parameters revealed that endometrial thickness in the proliferative phase endometrium group was smaller than that in the secretory phase endometrium group, with a statistically significant difference. Additionally, there was a statistically significant difference in endometrial echo types between the two groups, while the disparity in endometrial blood flow grading was not significant. Regarding SE parameters, the median and mean values of endometrial strain ratio in the proliferative phase endometrium group were smaller than those in the secretory phase endometrium group, showing a statistically significant difference. However, there were no significant differences observed between the two groups in endometrial strain and myometrial strain in the fundus. Furthermore, there were no significant differences in any of the endometrial ultrasound indices among the different age groups.ConclusionsSE can reflect changes in endometrial stiffness in different menstrual cycles and is an important tool for assessing endometrial softness.

Segmentation of polarimetric radar imagery using statistical texture

Abstract. Weather radars are increasingly being used to study the interaction between wildfires and the atmosphere, owing to the enhanced spatio-temporal resolution of radar data compared to conventional measurements, such as satellite imagery and in situ sensing. An important requirement for the continued proliferation of radar data for this application is the automatic identification of fire-generated particle returns (pyrometeors) from a scene containing a diverse range of echo sources, including clear air, ground and sea clutter, and precipitation. The classification of such particles is a challenging problem for common image segmentation approaches (e.g. fuzzy logic or unsupervised machine learning) due to the strong overlap in radar variable distributions between each echo type. Here, we propose the following two-step method to address these challenges: (1) the introduction of secondary, texture-based fields, calculated using statistical properties of gray-level co-occurrence matrices (GLCMs), and (2) a Gaussian mixture model (GMM), used to classify echo sources by combining radar variables with texture-based fields from (1). Importantly, we retain all information from the original measurements by performing calculations in the radar's native spherical coordinate system and introduce a range-varying-window methodology for our GLCM calculations to avoid range-dependent biases. We show that our method can accurately classify pyrometeors' plumes, clear air, sea clutter, and precipitation using radar data from recent wildfire events in Australia and find that the contrast of the radar correlation coefficient is the most skilful variable for the classification. The technique we propose enables the automated detection of pyrometeors' plumes from operational weather radar networks, which may be used by fire agencies for emergency management purposes or by scientists for case study analyses or historical-event identification.

Using Polarimetric Radar Observations to Characterize First Echoes of Thunderstorms and Nonthunderstorms: A Comparative Study

AbstractThis work compares the characteristics of the first echoes of thunderstorms and nonthunderstorms retrieved from S‐band polarimetric radar observations. Observations of 57 (39) isolated thunderstorm (nonthunderstorm) cells with roughly equivalent aerosol and water vapor conditions but different convective available potential energy were obtained with a S‐band polarimetric radar and three independent lightning location systems during 2016/2017 in southern China. Storms with the first echoes were divided into three types based on echo top heights, namely, type 1 (below 0°C layer), type 2 (0°C to −10°C), and type 3 (above −10°C layer). Our observations show median values of radar reflectivity (ZH) and differential reflectivity (ZDR) of type 1 and type 2 in warm phase layer (below 0°C layer) are obviously greater in nonthunderstorms than in thunderstorms, but this feature is not significant in type 3 storms. In the mixed 1 phase layer (0°C to −10°C), median ZH in type 2 is greater in nonthunderstorms while median ZDR in type 3 is slightly smaller. In the mixed 2 phase layer (−10°C to −38°C), median ZH is greater in thunderstorms while median ZDR is smaller, and ZDR values in nonthunderstorms are closer to zero. Although results of ZDR comparisons in the mixed phase are likely affected by random errors and/or residual bias errors, these different signatures suggest different characteristics of liquid or ice particles between thunderstorms and nonthunderstorms. This study is expected to advance our understanding of physical processes responsible for the generation of the first flash.

A multi-proxy approach for delineation of ferromanganese mineralization from the West Sewell Ridge, Andaman Sea

Based on the Multibeam backscatter data, Sub-bottom profiling and Remotely Operated Vehicle (ROV) dives, an attempt has been made to understand the spatial distribution of ferromanganese crusts and nodules on the West Sewell Ridge (WSR), Andaman Sea. Slope analysis of the multibeam data and echo type characters from sub-bottom profiles were used to identify favorable areas for crust and nodule occurrence and these areas were selected for detailed seafloor feature analysis using ROV videography. Further, histogram analysis of backscatter intensity revealed five boundary values and integrated these threshold values with ground truth observation from ROV videos identified crust dominated, crust and nodule dominated, the hard substrate with thin sediment cover, the hard substrate with thick sediment cover, and complete sediment covered seabed. The seafloor variation map prepared from the different geological classes identified shows that crust-dominated seabed is distributed in the eastern summit region while crust and nodule-dominated seabed in the western summit region of WSR. Further, the flanks of the WSR are covered with turbidity sediments and sediments derived from the slope failure and possess the least possibility of the occurrence of crusts and nodules on the flanks.

Fast B1 Mapping Based on Double-Angle Method with T1 Correction Using Standard Pulse Sequence.

Radiofrequency (RF) field (B1) mapping by combining the double-angle method (DAM) and T1 correction was investigated. The signal intensities S1 and S2 acquired by flip angle (FA) α and double FA 2α at short repetition time (TR) were converted to a signal intensity at TR=∞ by T1 correction. Then, these were used for DAM calculation. The T1 values are measured from two different images acquired with different TRs based on the saturation recovery (SR) method preliminarily. The effects of imaging parameters for T1 estimation and measured FA were investigated using CuSO4-doped water phantoms. A two-dimensional gradient echo type echo planar imaging pulse sequence was used. T1 values obtained by the 2-SR method were underestimated compared to the multipoint inversion recovery method. FA error was less than 5% when the appropriate imaging parameters were used. The acquisition time could be shortened to under 25 s by the use of T1-corrected DAM.

Multimodal Ultrasound Versus MRI for the Diagnosis and Monitoring of Achilles Tendinopathy: A Prospective Longitudinal Study.

Background:The diagnosis and monitoring of Achilles tendinopathy with imaging are challenging. There is a lack of studies comparing the diagnostic accuracy of magnetic resonance imaging (MRI), brightness mode ultrasound (B-mode), and power Doppler ultrasound with recent technologies such as ultrasound tissue characterization (UTC) and shear wave elastography (SWE).Purpose:To assess whether SWE and UTC, which offer quantitative values, show a superior diagnostic accuracy and capacity to detect structural improvement in Achilles tendinopathy compared with MRI, B-mode, or power Doppler.Study Design:Cohort study (diagnosis); Level of evidence, 2.Methods:Patients with insertional (n = 28) and midportion (n = 38) Achilles tendinopathy were evaluated at baseline and 6-month follow-up using MRI, B-mode, power Doppler, SWE, and UTC. Asymptomatic controls (n = 37) were evaluated at T 0. Diagnostic accuracy was analyzed based on a quantitative receiver operating characteristic (ROC) analysis with quantitative cutoff values (anteroposterior diameter, Öhberg score, UTC echo type, Young modulus) and by semiquantitative Likert scale–based assessment of experienced physicians.Results:For diagnosing insertional Achilles tendinopathy, semiquantitative MRI and power Doppler were most favorable (diagnostic accuracy, 95%), while the cross-sectional area of MRI revealed 89% accuracy in the ROC analyses (area under the curve [AUC], 0.911; P < .001). For diagnosing midportion Achilles tendinopathy, semiquantitative MRI and B-mode were most favorable (diagnostic accuracy, 87%), while UTC echo types 3 and 4 revealed 86% and 87% accuracy, respectively, in the ROC analyses (AUC, 0.911 and 0.941, respectively; P < .001). However, for quantitative and semiquantitative evaluation of diagnostic accuracy in both insertional and midportion Achilles tendinopathy, there was no significant difference in favor of one imaging modality over the others. Compared with baseline, only SWE showed a significant change at the 6-month follow-up (P = .003-.035), but there were only fair to poor monitoring accuracies of 71% (insertion) and 60% (midportion). However, compared with the other modalities, the monitoring accuracy of SWE was significantly higher (P = .002-.039).Conclusion:There was no statistically significant difference in favor of one imaging modality over the others, but MRI revealed the highest overall diagnostic accuracy for the diagnosis of both insertional and midportion Achilles tendinopathy.

Effect of Autologous Expanded Bone Marrow Mesenchymal Stem Cells or Leukocyte-Poor Platelet-Rich Plasma in Chronic Patellar Tendinopathy (With Gap >3 mm): Preliminary Outcomes After 6 Months of a Double-Blind, Randomized, Prospective Study

Background: Patellar tendinopathy is common. The success of traditional management, including isometric or eccentric exercises combined with shockwave therapy and even surgery, is limited. Therefore, it is important to determine whether biological treatments such as ultrasound-guided intratendinous and peritendinous injections of autologous expanded bone marrow mesenchymal stem cells (BM-MSCs) or leukocyte-poor platelet-rich plasma (Lp-PRP) improve clinical outcomes in athletic patients with patellar tendinopathy. Study Design: Randomized controlled trial; Level of evidence, 2. Methods: A prospective, double-blinded, randomized, 2-arm parallel group, active controlled, phase 1/2 single-center clinical study was performed in patients who had proximal patellar tendinopathy with a lesion >3 mm. A total of 20 participants (age 18-48 years) with pain for >4 months (mean, 23.6 months) and unresponsive to nonoperative treatments were randomized into 2 groups. Of these, 10 participants were treated with BM-MSC (20 × 106 cells) and 10 with Lp-PRP. Both groups performed the same postintervention rehabilitation protocol. Outcomes included the Victorian Institute of Sport Assessment for pain (VISA-P), self-reported tendon pain during activity (visual analog scale [VAS]), muscle function by dynamometry, tendon thickness and intratendinous vascularity by ultrasonographic imaging and Doppler signal, ultrasound tissue characterization (UTC) echo type changes, and magnetic resonance imaging (MRI) T2-weighted mapping changes. Participants were followed longitudinally for 6 months. Results: The average VAS scores improved in both groups at all time points, and there was a significant reduction in pain during sporting activities (P < .05). In both groups, the average mean VISA-P scores at 6 months were significantly increased compared with baseline (66 BM-MSC group and 72.90 Lp-PRP group), with no significant differences in VAS or VISA-P scores between the groups. There were statistically significant greater improvements in tendon structure on 2-dimensional ultrasound and UTC in the BM-MSC group compared with the Lp-PRP group at 6 months. Similarly, the BM-MSC group demonstrated significant evidence of restoration of tendon structure on MRI compared with the Lp-PRP group at 6 months. Only the participants in the BM-MSC group showed evidence of normalization of tendon structure, with statistically significant differences between the groups on T2-weighted, fat-saturated sagittal and coronal scans and hypersignal in T2-weighted on spin-echo T2-weighted coronal MRI scan. Both treatments were safe, and no significant adverse events were reported in either group. Conclusion: Treatment with BM-MSC or Lp-PRP in combination with rehabilitation in chronic patellar tendinopathy is effective in reducing pain and improving activity levels in active participants. Participants who received BM-MSC treatment demonstrated greater improvement in tendon structure compared with those who received Lp-PRP. Registration: 2016-001262-28 (EudraCT identifier); NCT03454737 (ClinicalTrials.gov identifier)

The Evaluation of Equine Allogeneic Tenogenic Primed Mesenchymal Stem Cells in a Surgically Induced Superficial Digital Flexor Tendon Lesion Model.

Background: Tendon injuries are very common in horses and jeopardize the athletic performance, and due to the high risk of reinjury may lead to early retirement. The use of mesenchymal stem cells for the treatment of equine tendon disease is widely investigated because of their regenerative potential. The objective of this study is to investigate the safety and efficacy of equine allogeneic tenogenic primed mesenchymal stem cells (tpMSCs) for the management of tendinitis in horses.Methods: A core lesion was surgically induced in the superficial digital flexor tendon of both forelimbs of eight horses. After 7 days, one forelimb was treated with tpMSCs, while the contralateral forelimb served as an intra-individual control and was treated with saline. A prescribed exercise program was started. All horses underwent a daily clinical evaluation throughout the entire study period of 112 days. Blood samples were taken at different time points for hematological and biochemical analysis. Tendon assessment, lameness examination, ultrasound assessment and ultrasound tissue characterization (UTC) were performed at regular time intervals. At the end of the study period, the superficial digital flexor tendons were evaluated macroscopically and histologically.Results: No suspected or serious adverse events occurred during the entire study period. There was no difference in local effects including heat and pain to pressure between a single intralesional injection of allogeneic tpMSCs and a single intralesional injection with saline. A transient moderate local swelling was noted in the tpMSC treated limbs, which dissipated by day 11. Starting at a different time point depending on the parameter, a significant improvement was observed in the tpMSC treated limbs compared to the placebo for echogenicity score, fiber alignment score, anterior-posterior thickness of the tendon and echo type by UTC assessment. Immunohistochemistry 112 days post-injection revealed that the amount of collagen type I and Von Willebrand factor were significantly higher in the tendon tissue of the tpMSC group, while the amount of collagen type III and smooth muscle actin was significantly lower.Conclusion: Equine allogeneic tenogenic primed mesenchymal stem cells were shown to be well-tolerated and may be effective for the management of tendon injuries.

Evaluation of Current Symptoms in Postoperative Achilles Tendons: A Multimodal Ultrasound Study

(1) Background: It is unknown which imaging parameters are associated with clinical persistent symptoms in postoperative Achilles tendons. This study used B-Mode, Power Doppler (PD-US), Ultrasound Tissue Characterization (UTC) and Shear Wave Elastography (SWE) to investigate which imaging parameters are associated with persistent symptoms in postoperative Achilles tendon tissue. (2) Methods: Retrospective, cross-sectional, multimodal imaging study. Based on the VISA-A score, postoperative tendons were assigned to two groups: 1. asymptomatic (VISA-A ≥ 90, n = 18); 2. symptomatic (VISA-A < 90, n = 10). The following imaging parameters were analyzed: UTC (echo type I, II, III, IV), B-Mode (diameter, cross sectional area, calcification, fiber irregularity), PD-US (Öhberg score) and SWE (SWE 3 mm, SWE area) using a t-test and a Mann–Whitney U test. (3) Results: SWE and PD-US showed significantly reduced elasticity and increased neovascularization in symptomatic tendons (SWE 3 mm p = 0.031, SWE area p = 0.046, Öhberg score p < 0.001). The only significant correlation between imaging parameters and the VISA-A score was assessed for SWE 3 mm (r = 0.378; p = 0.047) and the Öhberg score (r = −0.737; p < 0.001). Conclusions: Symptomatic postoperative Achilles tendons showed increased neovascularization and lower SWE values than asymptomatic ones. Future studies should examine the diagnostic accuracy of PD-US and SWE in detecting current symptoms in postoperative Achilles tendons.

Routine or enhanced imaging to differentiate between type 1 and type 2 papillary renal cell carcinoma

To investigate imaging features and differentiating qualities of type 1 and type 2 papillary renal cell carcinoma (pRCC) by different imaging techniques. From 2007 to 2019, 107 patients with type 1 pRCC (T1-pRCC) and 147 with type 2 pRCC (T2-pRCC) were included in this retrospective study. All patients underwent conventional ultrasound (US); some also underwent contrast-enhanced ultrasound (CEUS), contrast-enhanced computed tomography (CECT), or contrast-enhanced magnetic resonance imaging (CE-MRI). Tumour Fuhrman grade or World Health Organization (WHO)/International Society of Urological Pathology (ISUP) grade (after June 2016) and invasive ranges were recorded. The two types of pRCC were analysed and compared for imaging features including tumour position, size, margin, echo type, and colour Doppler flow imaging (CDFI) using US as well as enhanced features from CEUS, CECT, or CE-MRI. T2-pRCC showed a higher Fuhrman grade (p<0.001) and greater propensity to invade extrarenal tissue (p<0.001) than T1-pRCC. On US imaging, T2-pRCC was more likely to be a cystic-solid lesion (p<0.001), and colour flow with a higher resistance index (RI; p=0.014) was more easily detected (p=0.001) in T2-pRCC than in T1-pRCC. Within contrast-enhanced examinations, more T2-pRCC lesions had blurred tumour borders (p=0.003), hypervascular characteristics (p=0.003), and heterogeneous enhancement (p<0.001) than those of T1-pRCC. T2-pRCC manifests more aggressively than T1-pRCC. T2-pRCC has a higher proportion of hypervascular and heterogeneous enhancement than T1-RCC.

Analysis of factors related to recanalization of intramural hematoma-type carotid artery dissection

Objective: To investigate the factors related to recanalization of intramural hematoma-type carotid artery dissection (CAD). Methods: Retrospective analysis was performed on 56 patients (61 CADs) with intramural-hematoma type CAD confirmed by multimodal imaging examination based on cervical vascular ultrasound (CDU) in the Stroke Center of the First Affiliated Hospital of Suzhou University from August 2015 to May 2019. The clinical and imaging data were collected, and the time from onset to visit is bounded by 14 days. CDU follow-up was performed at 3, 6, and 12 months after the onset. According to the results of the 12-month follow-up, patients were divided into complete recanalization group and incomplete recanalization group. The clinical data, ultrasonic manifestations and drug treatment of patients between the two groups were compared. Multivariate logistic regression analysis was used to analyze the related factors affecting vascular recanalization. Results: Vascular recanalization: the rates of complete recanalization at 3, 6 and 12 months were 42.6% (26/61), 55.7% (34/61) and 59.0% (36/61), respectively. While among the 25 vessels in the incomplete recanalization group, 26.2% (16/61) showed residual stenosis and 14.8% (9/61) showed persistent occlusion. Comparison between the complete recanalization group and the incomplete recanalization group: the differences in the proportion of time from onset to visit ≤ 14 days, the echo type of intramural hematoma, and the proportion of vascular occlusion were statistically significant (all P<0.05). Multivariate logistic regression analysis showed that the time from onset to visit ≤14 days (OR=5.625, 95%CI: 1.302-24.293, P=0.021), and the hypoechoic intramural hematoma (OR=4.888, 95%CI: 1.304-18.320, P=0.019) were positively correlated with complete recanalization, while the dissection vascular occlusion (OR=0.234, 95%CI: 0.059-0.932, P=0.039) was negatively correlated with complete recanalization. Conclusions: CDU showed that hypoechoic intramural hematoma-type CAD treated with standard medications in the acute phase had a higher complete recanalization rate, while the recanalization rate of patients with dissecting vessel occlusion decreased. Early evaluation can provide a basis for clinical individualized treatment.

Intra individual comparison of unilateral Achilles tendinopathy using B-mode, power Doppler, ultrasound tissue characterization and shear wave elastography.

The asymptomatic side of unilateral Achilles tendinopathy (AT) is used as a reference in ultrasound. However, this procedure has not been evaluated in a comparative analysis using B-mode (B-US), power Doppler (PD-US), ultrasound tissue characterization (UTC) and shear wave elastography (SWE). Retrospective cross-sectional study. Tendons were assigned to 3 groups: 1) asymptomatic side of unilateral AT N.=55; 2) symptomatic side of unilateral AT N.=55; and 3) young reference group N.=29. The following parameters were analyzed separately for the insertion and midportion: UTC (echo type I, II, III, IV), B-US (diameter, cross sectional area), PD-US (Öhberg Score) and SWE (SWE 3 mm, SWE area) using a Wilcoxon Test (group 1 vs. 2) and a Kruskal-Wallis Test (group 1 vs. 2 vs. 3). The Wilcoxon Test making an isolated comparison between group 1 vs. 2 revealed a significant difference for all parameters of B-US, PD-US, UTC and SWE (P<0.001, P=0.042), except for the insertion in UTC. However, in the overall analysis including the reference group, the Kruskal-Wallis Test could only detect a significant difference between group 1 vs. 2 for PD-US (P<0.001). Thus, group 1 and 2 had significantly more pathological parameters in B-US (P<0.001, P=0.027), SWE (P<0.001, P=0.008) and UTC (type I, III, IV P<0.001) in both, insertion and midportion, compared to the reference group. The asymptomatic side of unilateral AT seems to show subclinical tendons alterations in B-US, SWE and UTC in comparison to a young and healthy control group. The asymptomatic side of unilateral AT especially with detectable neovascularization might be at risk for future symptoms. Further studies must examine whether the asymptomatic side can still serve as a reference for intra individual comparison in clinical evaluation.

Ultrasound Tissue Characterization (UTC) of the Achilles Tendon in Pre- and Post-Pubertal Dancers.

This study examined whether maturation status, body physique, and the impact of training are related to the development of Achilles tendon structure in young dancers. Seventy-one pre- and post-menarche dancers (12 to 15 years of age) were recruited. The Achilles tendon of each dancer was examined via ultrasonography tissue characterization (UTC) imaging. The cross-sectional area (CSA) and the fibrillar structure (echo types I to IV) were measured. The participants were screened for anthropometric parameters (weight, height, and leg length) with body mass index (BMI) and BMI percentile calculated; for hours and impact of training; for Tanner pubertal maturation; and for pain in their Achilles tendon (VAS scale). In addition, age and age at onset of menarche were documented. Tendon structure was found to differ between pre- and post-menarche dancers. Post-menarche dancers had a significantly lower percentage of echo type I fibers and a significantly higher percentage of echo type II, III, and IV fibers, with a greater CSA compared to pre-menarche dancers. The tendon structure was found to be correlated with BMI percentile, but no correlations were found with chronologic age or the impact of dance training. Furthermore, ANCOVA showed that BMI had a statistically significant effect on fiber types II and III (p < 0.005) and that the effect of menarche was significant, meaning that pre-menarche dancers had a lower BMI compared with those who were post-menarche. It is concluded that pre- and post-menarche dancers had developed different patterns of Achilles tendon fiber structure. Body mass index was found to be the most significant factor influencing the different tendon structures in young pubertal dancers.

The influence of a multidisciplinary intervention program on Achilles tendon structure in children with overweight and obesity.

The effects of childhood obesity on tendon structure and its relation to physical activity are barely known. We aimed to investigate the influence of a 6-month multidisciplinary childhood obesity management program (which included dietary intervention and an exercise program) on Achilles tendon structure in overweight/obese children. Twenty-five overweight/obese children (overweight group) who participated in a 6-month multidisciplinary childhood obesity program, and 27 normal-weight controls were examined for anthropometric measurements and for Achilles tendon structure (using ultrasound tissue characterization to capture a three-dimensional structure of four echo type fibers and the cross-sectional area) at baseline, 3, and 6months. The BMI of the overweight group significantly decreased from the pre- to the post-intervention period, (p = .002, η2 = .229), yet among the control group, the BMI significantly increased (p = .002, η2 = .222). Interactions (pre-post × group) showed a significant decrease in the prevalence of echo type I and in echo type III fibers and a significant increase in the prevalence of echo type II fibers and in the cross-sectional area along the intervention. No significant changes in echo type fibers were found in the control group along the 6months.Conclusion: At pre-intervention, the overweight group had significantly "worse" tendon structure, with a lower prevalence of echo type II fiber and a higher prevalence of echo type III fibers compared with the control group. Following the 6-month intervention, the tendon structure of the overweight group was "positively" changed, with reduced echo type III fibers and increased echo type II fibers. What is Known: • Physical activity and weight reduction programs are efficient for obese children. • Obese children tend to suffer orthopedic problems and pain during physical activity. What is New: • Pre-intervention, obese children had 'worse' tendon structure compared to controls. • Following 6-month program, tendon structure of obese children 'positively' changed.

Differences Between Long Distance Road Runners and Trail Runners in Achilles Tendon Structure and Jumping and Balance Performance.

Load and joint kinematics change with differences in running surface. Running regularly on trails compared to roads might influence the load on the Achilles tendon and its adaptations, along with other factors such as balance, strength, and proprioception. To investigate Achilles tendon structure and functional tests in road and trail runners. Cross-sectional study. Laboratory, sport sciences college. The study included 26 road and 17 trail runners who run at least three times per week with a minimum of 20 km per week and who participated in running competitions over the preceding 2 years. Each participant was examined for Achilles tendon structure (via ultrasound tissue characterization [UTC] imaging) and underwent functional tests in addition to completing a demographic questionnaire. The percentages of echo types I, II, III, and IV (degree of structural homogeneity) within the tendon, tendon length and width, tendon cross-sectional area (via UTC imaging); Ankle inversion movement discrimination ability (via Active Movement Extent Discrimination Apparatus device); dynamic postural balance (via Y balance test); jumping performance (by Triple hop distance test); and Hip muscle abduction muscle strength (by hand-held dynamometry). Percentage of echo type I was significantly lower while echo type II was higher in the road group compared with the trail group (67.3% type I and 28.9% type II in the road group compared with 74.1% type I and 22.1% type II in the trail group, P < .001). No differences between genders were found and no significant differences between groups were found for the other tests. Tendon integrity as examined with UTC is different between road and trail runners. This suggests an influence of running surface on Achilles tendon structure. This difference was not reflected in other tests, thus the influence of tendon structure on function needs further examination.

Running a Marathon-Its Influence on Achilles Tendon Structure.

Several studies have been conducted to better understand the effect of load on the Achilles tendon structure. However, the effect of a high cumulative load consisting of repetitive cyclic movements, such as those that occur during the running of a marathon, on Achilles tendon structure is not yet clear. Clinicians, coaches, and athletes will benefit from knowledge about the effects of a marathon on the structure of the Achilles tendon. To investigate the short-term response of the Achilles tendon structure to running a marathon. Case series (prospective). Sports medicine centers. Ten male nonelite runners who ran in a marathon. Tendon structure was assessed before and 2 and 7 days after a marathon using ultrasound tissue characterization (UTC), an imaging tool that quantifies tendon organization in 4 echo types (I-IV). Echo type I represents the most stable echo pattern, and echo type IV, the least stable. At 7 days postmarathon, both the insertional and midportion structure changed significantly. At both sites, the percentage of echo type II increased (insertion P < .01; midportion P = .02) and the percentages of echo types III and IV decreased (type III: insertion P = .01; midportion P = .02; type IV: insertion P = .01; midportion P < .01). Additionally, at the insertion, the percentage of echo type I decreased (P < .01). We observed the effects of running a marathon on the Achilles tendon structure 7 days after the event. Running the marathon combined with the activity performed shortly thereafter might have caused the changes in tendon structure. This result emphasizes the importance of sufficient recovery time after running a marathon to prevent overuse injuries.

The ultrasonic appearances of primary testicular lymphoma

Objective To explore the sonographic features of primary testicular lymphoma(PLT). Methods The sonographic features of 16 PLT patients confirmed by surgery and pathology were retrospectively analyzed. Results Sixteen PLT patients were typed into 3 ultrasonic patterns: ①The diffuse homogeneous echo type: 2 cases, the ultrasonic features were homogeneous sieve-like hypoechoic echo, the blood flow signal was rich and radially distributed, with interstisial fibrosis inapparently under-microscope. ②The diffuse uneven homogeneous echo type: 9 cases, the ultrasonic features lobulated or map-like heterogeneous hypoechoic features, the blood flow signal was rich in linear distribution, and interstisial fibrosis proliferated to form fibrous septa under-microscope. ③The focal nodular pattern echo type: 5 cases, the ultrasonic features were homogeneous hypoechoic nodules, the blood flow signal was few, interstisial fibrosis hyperplasia surrounding the tumor under-microscope. Conclusions Ultrasonic appearances of primary testicular lymphoma are closely related to its pathologic characteristics, the recognization of their relations contributes to improve the diagnostic value of ultrasound. Key words: Ultrasonograghy; Lymphoma, testis, primary

Autocalibrated parallel imaging reconstruction with sampling pattern optimization for GRASE: APIR4GRASE

PurposeTo reduce artifacts and scan time of GRASE imaging by selecting an optimal sampling pattern and jointly reconstructing gradient echo and spin echo images. MethodsWe jointly reconstruct images for the different echo types by considering these as additional virtual coil channels in the novel Autocalibrated Parallel Imaging Reconstruction with Sampling Pattern Optimization for GRASE (APIR4GRASE) method. Besides image reconstruction, we identify optimal sampling patterns for the acquisition. The selected optimal patterns were validated on phantom and in-vivo acquisitions. Comparison to the conventional GRASE without acceleration, and to the GRAPPA reconstruction with a single echo type was also performed. ResultsUsing identified optimal sampling patterns, APIR4GRASE eliminated modulation artifacts in both phantom and in-vivo experiments; mean square error (MSE) was reduced by 78% and 94%, respectively, compared to the conventional GRASE with similar scan time. Both artifacts and g-factor were reduced compared to the GRAPPA reconstruction with a single echo type. ConclusionAPIR4GRASE substantially improves the speed and quality of GRASE imaging over the state-of-the-art, and is able to reconstruct both spin echo and gradient echo images.

Reduced Distortion in Prostate DWI by Using Split Echo Type TSE-DWI (SPLICE) with Multi-VANE Acquisition [Presidential Award Proceedings

Reduced Distortion in Prostate DWI by Using Split Echo Type TSE-DWI (SPLICE) with Multi-VANE Acquisition [Presidential Award Proceedings