Flow Mapping Research Articles

Whole-brain mapping of mouse CSF flow via HEAP-METRIC phase-contrast MRI.

PurposeCSF plays important roles in clearing brain waste and homeostasis. However, mapping whole‐brain CSF flow in the rodents is difficult, primarily due to its assumed very low velocity. Therefore, we aimed to develop a novel phase‐contrast MRI method to map whole‐brain CSF flow in the mouse brain.MethodsA novel generalized Hadamard encoding–based multi‐band scheme (dubbed HEAP‐METRIC, Hadamard Encoding APproach of Multi‐band Excitation for short TR Imaging aCcelerating) using complex Hadamard matrix was developed and incorporated into conventional phase contrast (PC)‐MRI to significantly increase SNR.ResultsSlow flow phantom imaging validated HEAP‐METRIC PC‐MRI’s ability to achieve fast and accurate mapping of slow flow velocities (~102 µm/s). With the SNR gain afforded by HEAP‐METRIC scheme, high‐resolution (0.08 × 0.08 mm in‐plane resolution and 36 0.4 mm slices) PC‐MRI was completed in 21 min for whole‐brain CSF flow mapping in the mouse. Using this novel method, we provide the first report of whole‐brain CSF flow in the awake mouse brain with an average flow velocity of ~200 µm/s. Furthermore, HEAP‐METRIC PC‐MRI revealed CSF flow was reduced by isoflurane anesthesia, accompanied by reduction of glymphatic function as measured by dynamic contrast‐enhanced MRI.ConclusionWe developed and validated a generalized HEAP‐METRIC PC‐MRI for mapping low velocity flow. With this method, we have achieved the first whole‐brain mapping of awake mouse CSF flow and have further revealed that anesthesia reduces CSF flow velocity.

Innovative use of operational tools to improve care delivery for the uninsured ESRD patients and to inform healthcare policy-makers

End-stage renal disease (ESRD) is a direful diagnosis for which regular (i.e., periodically scheduled) dialysis is typically the only immediate and accessible treatment. ESRD patients who are uninsured are in a high-risk category as they do not have access to regular treatment and have to rely on safety-net hospitals, funded by county governments, for access to dialysis. Since no national funding provides scheduled dialysis to this population, their only option is to seek dialysis under “emergency” conditions. These conditions are such that without urgent medical attention in the Emergency Room (ER), the patient’s life is under threat. Hence, ER serves as a screening stage for gaining access to regular dialysis by the uninsured, and the resulting practice is known as “compassionate dialysis,” a type of emergent dialysis treatment frequently offered at county hospitals serving uninsured ESRD patients. For a typical compassionate dialysis practice, existing county policy is such that patients are subject to a screening protocol upon arrival in the ER. The protocol serves to assess the severity of the patients’ condition in the ER, and, hence, a certain fraction of the patients may not be offered treatment, i.e., these patients have to revisit the hospital at a later time, potentially within a few hours due to the nature of the underlying disease. The fraction of patients not offered the treatment is referred to as the screening threshold. As documented in the literature, the practice is costly and leads to significant congestion and treatment delays. Motivated by a real-life compassionate dialysis practice, we employ process flow mapping to gain a better understanding of the patient flow and identify inefficiencies and bottlenecks caused by the screening protocol of the existing county policy. We use simulation modeling to examine and estimate various system and patient-oriented metrics as a function of stochastic arrival rates and service times. Our eventual goal is to explore and analyze two proposals as alternatives to the current practice: one modifies the existing screening threshold based on the available capacity, and the other schedules and consolidates the future revisits of patients. We analyze and compare the effectiveness of both proposals using simulation optimization approaches. Ultimately, our goal is to propose solutions for alleviating congestion and treatment delays, and to inform hospital administrators and policy-makers about such solutions.

Flowmapper.org: a web-based framework for designing origin–destination flow maps

ABSTRACT FlowMapper.org is a web-based framework for automated production and design of origin-destination flow maps. FlowMapper has four major features that contribute to the advancement of existing flow mapping systems. First, users can upload and process their own data to design and share customized flow maps. The ability to save data, cartographic design and map elements in a project file allows users to easily share their data and/or cartographic design with others. Second, users can generate customized flow symbols to support different flow map reading tasks such as comparing flow magnitudes and directions and identifying flow and location clusters that are strongly connected with each other. Third, FlowMapper supports supplementary layers such as node symbols, choropleth, and base maps to contextualize flow patterns with location references and characteristics. Finally, the web-based architecture of FlowMapper supports server-side computational capabilities to process and normalize large flow data and reveal natural patterns of flows.

Вікові особливості структурних та гемодинамічних показників магістральних судин шиї при неалкогольній жировій хворобі печінки та підвищеній масі тіла

Усього було обстежено 290 пацієнтів (85 чоловіків та 205 жінок). Порівнювались показники пацієнтів із неалкогольною жировою хворобою печінки (НАЖХП) (стеатоз), поєднаною з підвищеною масою тіла, та показники пацієнтів контрольних груп з нормальною масою тіла без патології печінки. Обстежені були розподілені на чотири вікові групи (за критерієм ВООЗ): 1-ша вікова група — від 25 до 34 років, 2-га — від 35 до 44 років, 3-тя — від 45 до 59 років, 4-та — від 60 до 75 років. Проаналізовані структурні та гемодинамічні показники магістральних судин шиї, отримані при комплексному дуплексному обстеженні (ультразвукова сонографія в В-режимі, режимі колірного допплерівського картування й допплер-обстеження).Встановлені зміни структурних та гемодинамічних показників магістральних судин шиї (стовщення комплексу інтима-медія, зменшення лінійних швидкостей кровотоку). НАЖХП (стеатоз), поєднана з підвищеною масою тіла, справляє прямий вплив на структурний та гемодинамічний стан магістральних судин шиї. Виявлений кореляційний зв’язок між НАЖХП (стеатоз), поєднаною з підвищеною масою тіла, та швидкісним показником кровотоку — піковою систолічною швидкістю кровотоку (p < 0,05). Порушення структури та гемодинаміки магістральних судин шиї, виявлені при комплексному дуплексному обстеженні, є результатом прямого впливу НАЖХП (стеатоз) та підвищеної маси тіла та призводять до зростання кардіоваскулярного ризику переважно в групах середнього та похилого віку.

Amount of dissipative energy loss when assessing left ventricular dysfunction in female patients with systemic lupus erythematosus.

Systemic lupus erythematosus (SLE) is associated with an increased risk of cardiovascular disease. The purpose of the current study was to explore the amount of energy loss (EL) using vector flow mapping (VFM) in the detection of early stage left ventricular (LV) dysfunction among patients with SLE. Eighty-nine patients with SLE and fifty-six healthy controls were enrolled. SLE patients were further divided into inactive (SLEDAI ≤ 4, n = 43) and active (SLEDAI ≥ 5, n = 46) subgroups. A prosound F75 echocardiography machine was used for echocardiographic examination. Intra-cardiac flow images were analysed by a VFM workstation. Compared with the healthy group, the inactive SLE group had increased diastolic EL values (38.05 mW/m vs. 33.02 mW/m, p = 0.010). However, the systolic EL values were comparable between the inactive SLE group and the control group (26.07mW/m vs 23.15 mW/m, p = 0.105). The active SLE group exhibited significantly higher diastolic (104.13mW/m vs 33.02mW/m, p < 0.001) and systolic (48.83 mW/m vs 23.15mW/m, p < 0.001) EL values than the control group. The most notable correlation was observed between the values of the diastolic EL and SLEDAI in the inactive SLE group (r = 0.633, p < 0.001) and in the active SLE group (r = 0.824, p < 0.001). LV-dissipative EL assessed by using VFM is useful and feasible for estimating lesions of LV systolic and diastolic function in active SLE patients with preserved left ventricular ejection fraction. Increased disease activity may lead to increased risk of LV dysfunction.

Energy efficiency in cold supply chains of the food and beverage sector

Food refrigeration during transport, and storage activities makes energy consumption in the supply chain particularly high, with relevant impacts on its sustainability. The growing push towards sustainability and product quality makes it necessary to have a continuous temperature control that allows to avoid food waste and temperature abuses with unmotivated high energy consumption. An efficient management of the cold chain guarantees product quality, customer satisfaction and, more generally, greater protection of public health, with direct impacts on the quantities of food and drinks wasted. In this perspective, energy efficiency not only encompasses benefits for the environment but also for food quality and for the final consumer. All aspects linked to the sustainable development goals, on which the attention of the UN and FAO is also focusing.Aim of the present study is to propose a quantitative approach to map the energy flows throughout the cold chain, while considering the time-temperature relationship of products from farm-to-fork. This approach can support decision makers inside cold chains in the identification of energy efficient best practices which allow to reduce the environmental impact both reducing the energy consumption and the quality losses. Results of the energy flow mapping also allow companies in the cold chains and cold logistic operators to prioritize these energy efficiency measures (i.e., starting from the stage with the highest energy consumptions or quality losses) and subsequent what-if analyses assess the potential energy savings for the whole cold chain. The holistic perspective can support the overcoming reservations to the uptake of new technologies, maintenance policies and sustainable operation management practices.

Importance of Coronary to Pulmonary Artery Fistulae Incidentally Detected on Echocardiography: Can We Ignore It During Childhood?

Backround:Coronary artery fistula (CAF) is an abnormal precapillary connection between a coronary artery and an adjacent structure. The incidence of CAF in children as estimated from echocardiography is 0.06-0.2%. We aimed to establish the follow up results of clinically silent CAF found incidentally by colour Doppler echocardiography.Methods:The study included patients with abnormal fistulous flow in the pulmonary artery who had been studied between 2008 and 2020. Patient demographics, clinical findings, indication for echocardiography, electrocardiographic findings at presentation, follow-up times and any fistula progress were obtained from the recorded files.Results:Among the 78,000 patients who had had an echocardiographic examination, 118 had been found by colour Doppler flow mapping to have a clinically silent CAF. The exit point of CAF was clearly visualized with colour Doppler in all patients. In most patients the CAF was located around the pulmonary valve and the bifurcation; in 76 patients, it was on the aortic side of the main pulmonary artery, 26 patients had fistulous flow through the anterior wall of the main pulmonary artery, two had the right ventricular outflow tract (RVOT) as the exit site, for 12, it was the right pulmonary artery, and for another two, the left pulmonary artery. The 118 patients had ongoing follow-up to mean 41 months. There was no spontaneous resolution of fistula. The patients were asymptomatic without intervention and with ongoing echocardiographic evidence of small CAF at the last follow-up.Conclusion:We recommend the treatment strategy for paediatric patients should be individualized according to fistula origin, size, chamber enlargement, draining site, age of the patient and cost of imaging during follow up.

Characterization of the Left Ventricular Diastolic Vortex in Healthy Young Adults Using Vector Flow Mapping

Characterization of the Left Ventricular Diastolic Vortex in Healthy Young Adults Using Vector Flow Mapping

Hemodynamic Parameters for Cardiovascular System in 4D Flow MRI: Mathematical Definition and Clinical Applications.

Blood flow imaging becomes an emerging trend in cardiology with the recent progress in computer technology. It not only visualizes colorful flow velocity streamlines but also quantifies the mechanical stress on cardiovascular structures; thus, it can provide the detailed inspections of the pathophysiology of diseases and predict the prognosis of cardiovascular functions. Clinical applications include the comprehensive assessment of hemodynamics and cardiac functions in echocardiography vector flow mapping (VFM), 4D flow MRI, and surgical planning as a simulation medicine in computational fluid dynamics (CFD).For evaluation of the hemodynamics, novel mathematically derived parameters obtained using measured velocity distributions are essential. Among them, the traditional and typical parameters are wall shear stress (WSS) and its related parameters. These parameters indicate the mechanical damages to endothelial cells, resulting in degenerative intimal change in vascular diseases. Apart from WSS, there are abundant parameters that describe the strength of the vortical and/or helical flow patterns. For instance, vorticity, enstrophy, and circulation indicate the rotating flow strength or power of 2D vortical flows. In addition, helicity, which is defined as the cross-linking number of the vortex filaments, indicates the 3D helical flow strength and adequately describes the turbulent flow in the aortic root in cases with complicated anatomies. For the description of turbulence caused by the diseased flow, there exist two types of parameters based on completely different concepts, namely: energy loss (EL) and turbulent kinetic energy (TKE). EL is the dissipated energy with blood viscosity and evaluates the cardiac workload related to the prognosis of heart failure. TKE describes the fluctuation in kinetic energy during turbulence, which describes the severity of the diseases that cause jet flow. These parameters are based on intuitive and clear physiological concepts, and are suitable for in vivo flow measurements using inner velocity profiles.

Dark-blood late gadolinium enhancement CMR improves detection of papillary muscle fibrosis in patients with mitral valve prolapse

PurposePapillary muscle fibrosis may act as an arrhythmogenic substrate in patients with mitral valve prolapse (MVP). Previous studies used conventional bright-blood late gadolinium enhancement cardiovascular magnetic resonance (LGE CMR) imaging to assess papillary muscle fibrosis, although this technique suffers from poor scar-to-blood contrast which may limit its sensitivity, in contrast to dark-blood LGE. This study sought to compare bright-blood and dark-blood LGE for the detection of papillary muscle fibrosis in patients with MVP. Method60 patients with known isolated MVP referred for CMR were prospectively recruited. A routine CMR protocol was used to obtain cine imaging, dark-blood LGE and bright-blood LGE in three long-axis views and a stack of short-axis views. Flow mapping of the proximal aorta was performed to calculate mitral regurgitant volume. Images were analysed for cardiac volumes, ejection fraction, mitral regurgitation severity, MVP characteristics (mitral annular disjunction, prolapse volume) and presence of LGE at the papillary muscles and myocardium. ResultsDark-blood LGE detected significantly more subjects with LGE at the papillary muscles than bright-blood LGE (35% vs 15%, p = 0.002). There was no difference between LGE techniques regarding myocardial (non-papillary muscle) fibrosis (present in 25% each). No statistical differences were observed between patients with or without LGE at the papillary muscles regarding demographics, clinical data (including ventricular arrhythmia) and MVP characteristics. Furthermore, no association was found between LGE at the papillary muscles and at the myocardium. ConclusionsCompared to bright-blood LGE, dark-blood LGE CMR improves the detection of LGE at the papillary muscles in patients with MVP.

Use of the Smart Lean Method to Conduct High-Quality Integrated Perioperative Management Prior to Hospitalization

Background: competition in the healthcare market is becoming increasingly intense. Health technology continues to evolve, so hospitals and clinics need to strengthen hospital management techniques and also adopt a more patient-centered approach in order to provide high-quality healthcare services, including a more simplified process and shorter waiting times for examinations. The Lean and Six Sigma methodologies and smart technology were introduced and implemented into the integrated perioperative management (PERIO) processes for the purpose of decreasing pre-admission management waiting time, as well as increasing the completion rate and quality of pre-admission management for surgical patients in a 1576-bed medical center in central Taiwan. Methods: in order to improve hospital admission procedures for surgical patients by shortening process waiting times, simplifying admission processes, emphasizing a patient-centered approach, and providing the most efficient service process, the present study applied the DMAIC architecture of the Lean Six Sigma. This approach allowed the patients to save time on the hospital admission process. The current workflow used value flow mapping to identify wasted time caused by unnecessary walking and waiting during the hospital admission process. Therefore, we improved the process cycle for each patient by simultaneously selecting and controlling the process for the purpose of saving time. Results: the experimental results show that the percentage of Process Cycle Efficiency (PCE) increased from 35.42% to 42.47%, Value Added was reduced from 34 to 31 min, and Non-Value Added was reduced from 62 to 42 min. The satisfaction score of the 97 pre-implementation patients was 4.29 compared with 4.40 among the 328 post-implementation patients (p < 0.05). The LOS (Length of Stay) of 2660 pre-implementation patients was 2.49~3.31 days and for 304 after-implementation patients it was 1.16~1.57 days. Conclusions: by integrating different units and establishing standard perioperative management (PERIO) procedures, together with the support of the information systems, the time spent by patients on hospital admission procedures was shortened. These changes also improved the comprehensiveness of the preoperative preparations and the surgical safety of patients, thereby facilitating the provisions necessary for high-quality healthcare services. This in turn reduced the average length of hospital stays and increased the turnover of patients, benefiting the overall operations of the hospital.

Physics-constrained intraventricular vector flow mapping by color Doppler

Color Doppler by transthoracic echocardiography creates two-dimensional fan-shaped maps of blood velocities in the cardiac cavities. It is a one-component velocimetric technique since it only returns the velocity components parallel to the ultrasound beams. Intraventricular vector flow mapping (iVFM) is a method to recover the blood velocity vectors from the Doppler scalar fields in an echocardiographic three-chamber view. We improved our iVFM numerical scheme by imposing physical constraints. The iVFM consisted in minimizing regularized Doppler residuals subject to the condition that two fluid-dynamics constraints were satisfied, namely planar mass conservation, and free-slip boundary conditions. The optimization problem was solved by using the Lagrange multiplier method. A finite-difference discretization of the optimization problem, written in the polar coordinate system centered on the cardiac ultrasound probe, led to a sparse linear system. The single regularization parameter was determined automatically for non-supervision considerations. The physics-constrained method was validated using realistic intracardiac flow data from a patient-specific computational fluid dynamics (CFD) model. The numerical evaluations showed that the iVFM-derived velocity vectors were in very good agreement with the CFD-based original velocities, with relative errors ranged between 0.3% and 12%. We calculated two macroscopic measures of flow in the cardiac region of interest, the mean vorticity and mean stream function, and observed an excellent concordance between physics-constrained iVFM and CFD. The capability of physics-constrained iVFM was finally tested with in vivo color Doppler data acquired in patients routinely examined in the echocardiographic laboratory. The vortex that forms during the rapid filling was deciphered. The physics-constrained iVFM algorithm is ready for pilot clinical studies and is expected to have a significant clinical impact on the assessment of diastolic function.

751 Quantitative changes in intracardiac vortices between patients with different ventricular geometry

Abstract Aims Over the past decades growing evidence have demonstrated the promising role of intracardiac fluid-dynamics in evaluating cardiac performance. To investigate quantitative changes in vortices parameters in patients with different ventricular geometry. Methods and results We enrolled 50 consecutive patients with one of the following: LV concentric hypertrophy (CH), eccentric hypertrophy (EH), concentric remodelling, and normal LV geometry (CTRL). They underwent a complete echocardiographic examination with intracardiac fluid-dynamic analysis by Color Vector Flow Mapping (Hyperdoppler). The following parameters were obtained: vortex area (VA); vortex length (VL); and vortex depth (VD). Bland Altman Plot has been used to assess intra and inter-observer variability. Mean VD was higher in CR, CH, and EH compared to CTRL (P = 0.013, P = 0.001, and P = 0.022, respectively). Moreover, CH showed higher VL (P = 0.006) and larger VA (P = 0.012) compared to CTRL. A similar trend was noticed in EH patients, despite did not reach statistical significance (P = 0.21 and P = 0.07 for VA and VL, respectively). No significative differences in vortices parameters have been observed between CH and EH. Conclusions This is the first study providing quantitative echocardiographic parameters of vortex location and morphology in different LV geometries. Quantitative fluid-dynamic assessment was feasible and reliable in the whole population.

Evaluation of intraventricular flow by multimodality imaging: a review and meta-analysis

BackgroundThe aim of this systematic review was to evaluate current inter-modality agreement of noninvasive clinical intraventricular flow (IVF) assessment with 3 emerging imaging modalities: echocardiographic particle image velocimetry (EPIV), vector flow mapping (VFM), and 4-dimensional flow cardiovascular magnetic resonance imaging (4D flow CMR).MethodsWe performed a systematic literature review in the databases EMBASE, Medline OVID and Cochrane Central for identification of studies evaluating left ventricular (LV) flow patterns using one of these flow visualization modalities. Of the 2224 initially retrieved records, 10 EPIV, 23 VFM, and 25 4D flow CMR studies were included in the final analysis.ResultsVortex parameters were more extensively studied with EPIV, while LV energetics and LV transport mechanics were mainly studied with 4D flow CMR, and LV energy loss and vortex circulation were implemented by VFM studies. Pooled normative values are provided for these parameters. The meta- analysis for the values of two vortex morphology parameters, vortex length and vortex depth, failed to reveal a significant change between heart failure patients and healthy controls.ConclusionAgreement between the different modalities studying intraventricular flow is low and different methods of measurement and reporting were used among studies. A multimodality framework with a standardized set of flow parameters is necessary for implementation of noninvasive flow visualization in daily clinical practice. The full potential of noninvasive flow visualization in addition to diagnostics could also include guiding medical or interventional treatment.

Adaptive Identification and Application of Flow Mapping and Inverse Flow Mapping for Electrohydraulic Valves

Good estimation of flow mapping (FM) and inverse flow mapping (IFM) for electrohydraulic valves are important in automation of fluid power system. The purpose of this paper is to propose adaptive identification methods based on LSM, BPNN, RBFNN, GRNN, LSSVM and RLSM to estimate the uncertain structure and parameters in flow mapping and inverse flow mapping for electrohydraulic valves. In order to reduce the complexity and improve the identification performance, model structures derived from new algorithm are introduced. The above identification methods are applied to map the flow characteristic of an electrohydraulic valve. With the help of novel simulation architecture via OPC UA, the accuracy and efficiency of these algorithms could be verified. Some issues like invertibility of flow mapping are discussed. At last, places and suggestions to apply these methods are made.

Anomalous aortic origin of coronary artery: For a challenging diagnosis, a transthoracic echocardiogram is recommended.

Anomalous aortic origin of a coronary artery (AAOCA), especially the interarterial course of the right or left coronary artery, predisposes paediatric patients to myocardial ischaemia. This rare condition is a leading cause of sudden cardiac death. General paediatricians face challenges when diagnosing this anomaly, and they should pay particular attention to the recurrence of exercise‐related syncope without prodromal symptoms, chest pain and dyspnoea. An accurate transthoracic echocardiogram with Doppler colour flow mapping is the best method to use to identify AAOCA.ConclusionIdentifying an AAOCA is challenging, and we provide advice on clinical red flags and diagnostic approaches for general paediatricians.

Reduction of tethering distance by papillary muscle tugging approximation with mitral valve replacement for non-ischemic functional mitral regurgitation induces left ventricular reverse remodeling

BackgroundFunctional mitral regurgitation (FMR) is caused by left ventricular (LV) remodeling and subsequent tethering of the mitral valve (MV). If LV remodeling is irreversibly advanced, it could not be attenuated by the MV procedure alone, although the additional subvalvular procedure could induce LV reverse remodeling by forcibly reducing MV tethering. This study aimed to assess the anti-tethering effect of papillary muscle tugging approximation (PMTA) on LV reverse remodeling after mitral valve replacement (MVR) for non-ischemic FMR. MethodsThe study subjects were 19 patients who underwent MVR with and without PMTA [MVR + PMTA (n = 11) and MVR alone (n = 8), respectively] for non-ischemic FMR. The tethering distance (TD) and LV end-systolic volume (ESV) at the preoperative, postoperative, and follow-up periods were assessed in terms of their correlation and time-dependent changes. The intra-LV energy efficiency was also evaluated through vector flow mapping analysis. ResultsTD and ESV were comparable between both procedures preoperatively and did not change after MVR alone. In MVR + PMTA, however, a significant decrease was identified in TD and ESV at the early postoperative and follow-up periods, respectively [TD = 48, 30, and 31 mm (p < 0.001) and ESV = 159, 133, and 82 mL (p < 0.001) at the preoperative, postoperative, and follow-up periods, respectively]. Finally, at follow-up, the extent of change from the preoperative value in ESV significantly correlated with that in TD (ρ = 0.81, p < 0.001 for overall; ρ = 0.93, p < 0.001 for MVR + PMTA; ρ = 0.86, p = 0.011 for MVR alone). The ratio of TD to ESV was also significantly correlated with systolic energy loss to LV stroke work after MVR + PMTA (ρ = 0.81, p = 0.015). ConclusionsPMTA for non-ischemic FMR could induce LV reverse remodeling depending on the extent of postoperative TD reduction. A smaller TD to ESV was associated with a higher intra-LV energy efficiency after PMTA + MVR.

The Use of Compression Sonoelastography in Multiparametric Ultrasound Examination in Cases of Benign Ovarian Formations

Properly diagnosed benign ovarian formations are a condition for appropriate treatment choice. Qualitative assessment of signs detected by multiparametric ultrasound, including compression elastography, is highly effective in the differential diagnosis of benign ovarian formations. Our study became especially relevant for women in the reproductive period since the correct diagnosis influenced the choice of surgical treatment in order to preserve the ovarian reserve. The detailed sonographic aspect of these formations in B-mode, Doppler mode and compression sonoelastography mode is analyzed in the article. Color Flow Mapping, power Doppler and pulsed wave Doppler were used to study blood vessels. Pulsed wave Doppler characterized blood flow quantitatively. Color Flow Mapping was used to determine vessels localization, and power Doppler was used to provide a detailed qualitative assessment of blood flow loci. Elastotype according to the Ueno scale as a qualitative feature and Strain Ratio (coefficient of deformation) as a quantitative indicator were determined for all types of benign ovarian formations. Serous and mucinous cystadenomas were found to belong to elastotypes 0 and I according to the Ueno scale, the papillary component of serous superficial papillomas was mapped as elastotype I and II, fibroids predominantly belonged to elastotype II and III, mature teratoma appertained to elastotypes IV and V. Quantitative coefficient of deformation for all benign ovarian formations ranged from 0.63 to 24.9. According to our results, ultrasound examination of ovarian formations is an accurate and highly informative method for stratification of risks in accordance with the O-RADS classification.

Early diastolic mitral regurgitation in left ventricular aneurysm.

Diastolic mitral regurgitation is a type of functional mitral regurgitation that develops via a reversal of the left atrioventricular pressure gradient during diastole. This study aimed to explore the mechanism underlying early diastolic mitral regurgitation (EDMR) in patients with left ventricular (LV) aneurysms after anterior myocardial infarction (AMI) by assessing the intraventricular pressure difference using vector flow mapping. We enrolled 23 consecutive patients with LV aneurysms (with and without EDMR) and 15 healthy men as controls. In the control group, LV suction began from the apex during early diastole. In contrast, the blood that pooled in the apical aneurysm during systole generated a relatively higher pressure at the apex than at the basal LV during early diastole; consequently, the pressure reversal phenomenon occurred in the LV. Compared to the EDMR- group, the EDMR + group (n = 7) exhibited a significantly higher diastolic time ratio ([time from the second heart sound to the pressure inversion point]/[total diastolic time]) (P < 0.001). The diastolic time ratio was significantly correlated with log BNP, but not with E/A, E/E', or the left atrial expansion index. In conclusion, EDMR in LV aneurysm may be due to a prolonged diastolic time ratio leading to prolonged pressure inversion in the LV during early diastole.

Hypersonic nozzle for laser-spectroscopy studies at 17 K characterized by resonance-ionization-spectroscopy-based flow mapping

The in-gas-jet laser spectroscopy method relies on the production of uniform and low-temperature gas jets to fully resolve the atomic hyperfine structure and efficiently determine fundamental nuclear properties of short-lived isotopes from, e.g., the hardly accessible actinide and transactinide elements. In this article we present the studies devoted to designing, producing, and characterizing the flow properties of a convergent-divergent (de Laval) hypersonic nozzle with a superior performance for laser spectroscopy applications. A novel flow mapping technique, based on resonance ionization spectroscopy (RIS), has been employed to characterize the local flow properties of an argon gas jet formed by this nozzle, revealing a 61.5-mm long, highly collimated atomic jet at a uniform low temperature of 16.6(5) K [Mach 8.11(12)] that will enable laser spectroscopy experiments on heavy-exotic nuclei with an unprecedented spectral resolution and a high efficiency. These results have been compared with those obtained by planar laser induced fluorescence spectroscopy (PLIFS) studies and show a good agreement between the two techniques and a significant improvement in efficiency of the RIS mapping method with respect to PLIFS. The data are compared to state-of-the-art fluid-dynamics calculations that were carried out to obtain the nozzle contour and simulate its performance, as well as to explain the observation of a possible onset of argon nucleation.