Three-dimensional Ultrasound Imaging Research Articles

Three-dimensional echo decorrelation imaging of percutaneous microwave ablation in liver tumors

In a pilot clinical study, patients underwent standard-of-care percutaneous microwave ablation (MWA) of liver tumors with monitoring by three-dimensional (3D) ultrasound echo decorrelation imaging. An MWA needle (Amica) was inserted into each tumor, guided by x-ray computed tomography (CT) and ultrasound imaging. A matrix ultrasound array (4Z1c array with Acuson SC2000 scanner, Siemens) was positioned on patients’ skin near the MWA needle insertion point. Paired sequential complex in-phase/quadrature (IQ) echo volumes (inter-frame time 5–20 ms) were acquired throughout ablation at 10–20 s intervals, then processed to form 3D echo decorrelation images. Respiratory motion was estimated and compensated using a theoretical model that separates motion- and heat-induced echo decorrelation. Volumetric B-mode images constructed from the same IQ data were rigidly registered to follow-up contrast-enhanced magnetic resonance (MR) image volumes, recorded within 4 days after MWA. Specified registration transformations were then applied to cumulative 3D echo decorrelation maps, which were compared voxel-wise to ablation zones segmented from MR images. Receiver operator characteristic (ROC) curve analysis indicated effective prediction of local ablation by motion-compensated echo decorrelation imaging. Comparison with subsequent follow-up MR images tested the ability of 3D echo decorrelation imaging to predict any incomplete treatment or recurrence of treated tumors.

A Neuroligin Isoform Translated by circNlgn Contributes to Cardiac Remodeling.

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Prenatal Diagnosis of Fetal Cleft Lip and Palate with Three-Dimensional Ultrasound Information Technology

Objective. To evaluate the three-dimensional ultrasound paper cleft lip and palate deformities in applications in prenatal diagnosis. Methods. 25 cases of cleft lip and palate fetus, 20–32 weeks of gestational age, with the maternal age of 22–44 years, were examined by prenatal ultrasound in our hospital; conventional two-dimensional ultrasound examination was performed after a cleft lip, and the application of three-dimensional ultrasound imaging surface and a transparent imaging showed the alveolar process and the palate of the fetus. Also, the results of two-dimensional ultrasound and postnatal (or after induction) results were compared. Results. Of the 25 cases, there were 6 cases of postpartum induction or simply unilateral cleft lip, 17 cases of unilateral cleft palate, and two cases of bilateral cleft lip palate. There was no significant ( P > 0.05 ) difference of two- and three-dimensional ultrasound detection rate of pure cleft lip; two-dimensional ultrasound cleft palate detection rate was 36.8% (7/19), and three-dimensional ultrasound cleft palate detection rate was 89.5% (17/19). The two methods showed a statistically significant ( P < 0.05 ) difference in the detection rate of cleft palate. Conclusion. Three-dimensional ultrasound can significantly improve the diagnostic accuracy of prenatal cleft palate.

Three-dimensional ultrasound assessment of effects of therapies on carotid atherosclerosis using vessel wall thickness maps

We present a new method for assessing the effects of therapies on atherosclerosis, by measuring the weighted average of carotid vessel-wall-plus-plaque thickness change (ΔVWT¯Weighted) in 120 patients randomized to pomegranate juice/extract versus placebo. Three-dimensional ultrasound images were acquired at baseline and one year after. Three-dimensional VWT maps were reconstructed and then projected onto a carotid template to obtain two-dimensional VWT maps. Anatomic correspondence on the two-dimensional VWT maps was optimized to reduce misalignment for the same subject and across subjects. A weight was computed at each point on the two-dimensional VWT map to highlight anatomic locations likely to exhibit plaque progression/regression, resulting in ΔVWT¯Weighted for each subject. The weighted average of VWT-Change measured from the two-dimensional VWT maps with correspondence alignment (ΔVWT¯Weighted,MDL) detected a significant difference between the pomegranate and placebo groups (P = 0.008). This method improves the cost-effectiveness of proof-of-concept studies involving new therapies for atherosclerosis.

A Study on Capacitive Micromachined Ultrasonic Transducer Periodic Sparse Array.

Capacitive micromachined ultrasonic transducer (CMUT) is an ultrasonic transducer based on the microelectromechanical system (MEMS). CMUT elements are easily made into a high-density array, which will increase the hardware complexity. In order to reduce the number of active channels, this paper studies the grating lobes generated by CMUT periodic sparse array (PSA) pairs. Through the design of active element positions in the transmitting and receiving processes, the simulation results of effective aperture and beam patterns show that the common grating lobes (CGLs) generated by the transmit and receive array are eliminated. On the basis of point targets imaging, a CMUT linear array with 256 elements is used to carry out the PSA pairs experiment. Under the same sparse factor (SF), the optimal sparse array configuration can be selected to reduce the imaging artifacts. This conclusion is of great significance for the application of CMUT in three-dimensional ultrasound imaging.

3D ultrasound imaging provides reliable angle measurement with validity comparable to X-ray in patients with adolescent idiopathic scoliosis.

Background & ObjectiveThe application of ultrasound imaging for spine evaluation could minimize radiation exposure for patients with adolescence idiopathic scoliosis (AIS). A customized three-dimensional (3D) ultrasound imaging system has been demonstrated to provide reliable and valid coronal curvature measurements. However, these measurements were using the spinous processes as anatomical reference, leading to a predictable underestimation of the traditionally used Cobb angles. An alternative 3D ultrasound image reconstruction method was applied to create coronal images with more lateral features for angle measurement. The objective of this study was to test the reliability and the validity of this angle, the ultrasound curve angle (UCA), and compare the UCA with the Cobb angles on X-ray images of patients with AIS.Materials and methodsThis study was divided into: 1) Investigation of intra- and inter-reliability between two raters for measuring the UCA and two operators for acquiring ultrasound images; 2) Investigation of the validity between the radiographic Cobb angle and the UCA. Fifty patients and 164 patients with AIS, were included in the two stages, respectively. Patients underwent bi-planar X-ray and 3D ultrasound scanning on the same day. The proposed UCA was used to measure the coronal curvature from the ultrasound coronal images, which were formed using a newly customized volume projection imaging (VPI) method. The intra-rater/operator and inter-rater and operator reliability of the UCA were tested by intra-class correlation coefficient (ICC) (3,1) and (2,1), respectively. The validity of UCA measurements as compared to radiographic Cobb angles was tested by inter-method ICC (2,1), mean absolute difference (MAD), standard error of measurement (SEM), Pearson correlation coefficient and Bland–Altman statistics. The level of significance was set as 0.05.ResultsExcellent intra-rater and intra-operator (ICC (3,1)≥0.973) and excellent inter-rater and inter-operator reliability (ICC (2,1)≥0.925) for UCA measurement, with overall MAD and SEM no more than 3.5° and 1.7° were demonstrated for both main thoracic and (thoraco)lumbar curvatures. Very good correlations were observed between UCA and Cobb angle for main thoracic (=0.893) and (thoraco)lumbar (=0.884) curves. The mean (SD) measurements in terms of radiographic Cobb and UCA were 27.2 ​± ​11.6° and 26.3 ​± ​11.4° for main thoracic curves; and 26.2 ​± ​11.4° and 24.8 ​± ​9.7° for (thoraco)lumbar curve respectively. One hundred sixty-four subjects (33 male and 131 female subjects; 11–18 years of age, mean of 15.1 ​± ​1.9 years) were included for the validity session. Excellent inter-method variations (ICC (2,K) ≥0.933) with overall MAD and SEM no more than 3.0° and 1.5° were demonstrated for both main thoracic and (thoraco)lumbar curvatures. In addition, Bland–Altman plots demonstrated an acceptable agreement between ultrasound and radiographic Cobb measurements.ConclusionIn this study, very good correlations and agreement were demonstrated between the ultrasound and X-ray measurements of the scoliotic curvature. Judging from the promising results of this study, patients with AIS with different severity of curves can be evaluated and monitored by ultrasound imaging, reducing the usage of radiation during follow-ups. This method could also be used for scoliosis screening.The Translational potential of this article: Ultrasound curve angle (UCA) obtained from 3D ultrasound imaging system can provide reliable and valid evaluation on coronal curvature for patients with AIS, without the need of radiation.

The effect of three-dimensional ultrasound and magnetic resonance imaging in the staging diagnosis of endometrial cancer with hepatitis B virus infection and construction of mathematical model

This paper was aimed to explore the effect of three-dimensional ultrasound and MRI (magnetic resonance imaging) in the staging diagnosis of endometrial cancer (EC) with hepatitis B virus infection and construction of mathematical model. The paper selected 31 patients with endometrial carcinoma with hepatitis B virus infection who were admitted to the hospital and who were diagnosed as endometrial carcinoma with hepatitis B virus infection. All patients underwent three-dimensional ultrasound and MRI. The results of the joint examination were compared with the final pathological diagnosis analysis, and the pathological diagnosis was used as the gold standard, and the detection rate and the coincidence rate of each examination result were calculated. The binary logistic regression mathematical model was established to analyze the fitting effect. The results of the study showed that the detection rates of 3D-TVUS (3-dimensional transvaginal ultrasound), MRI, and 3D-TVUS*MRI were 64.5%, 71%, and 96.8%, respectively. 3D-TVUS was statistically significant compared with 3D-TVUS*MRI results. MRI and the 3D-TVUS*MRI results were statistically significant. The difference between the three methods was statistically significant (P < 0.05). The coincidence rate of 3D-TVUS*MRI was higher than that of 3D-TVUS or MRI single examination. For Ia and Ib, the difference was statistically significant (P < 0.05), and in stage Ia. The staging results of MRI were compared with the staging results of 3D-TVUS*MRI, and the difference was statistically significant. Moreover, the fitting prediction effect of mathematical model was excellent. Clinical trials have verified that the diagnosis and staging of endometrial carcinoma with hepatitis B virus infection by 3D-TVUS*MRI is significantly better than 3D-TVUS or MRI single examination, which can better guide clinical treatment.

Automatic ultrasound scanning robotic system with optical waveguide-based force measurement.

The three-dimensional (3D) ultrasound (US) imaging realized by continuous scanning of a region is of great value for medical diagnosis and robot-assisted needle insertion. During scanning, the contact force and posture between the probe and skin of the patient are crucial factors that determine the quality of US imaging. We propose a robotic system for automatic scanning of curved surfaces with a stable contact force and vertical contact posture (the probe is parallel to the normal of the surface at the contact point). A 6-DOF robotic arm is used to hold and drive a two-dimensional (2D) US probe to complete automatic scanning. Further, a path-planning strategy is proposed to generate the scan path covering the selected area automatically. We also developed a novel force-measuring device based on optical waveguides to measure the distributed contact force and contact posture. Based on the measured force and posture, the robotic arm automatically adjusts the position and orientation of the probe and maintains a stable contact force and vertical contact posture at each scan point. The novel force-measuring device is easy to fabricate, integrates with the probe and has the capacity of measuring the force distributed on the contact surface and estimating the contact posture. The experimental results of automatic scanning of a US phantom and parts of the human body demonstrate that the proposed system performs well in automatically scanning curved surfaces, maintaining a stable contact force and vertical contact posture and producing a good quality 3D US volume. An automatic US scanning robotic system with an optical waveguide-based force-measuring device was developed and tested successfully. Experimental results demonstrated the feasibility of the proposed system to scan the human body.

Sirenomelia: two case\xa0reports

BackgroundSirenomelia, also called mermaid syndrome, is a rare lethal multi-system congenital deformity with an incidence of one in 60,000–70,000 pregnancies. Sirenomelia is mainly characterized by the fusion of lower limbs and is widely associated with severe urogenital and gastrointestinal malformations. The presence of a single umbilical artery derived from the vitelline artery is the main anatomical feature distinguishing sirenomelia from caudal regression syndrome. First-trimester diagnosis of this disorder and induced abortion may be the safest medical option. In this report, two cases of sirenomelia that occurred in an white family will be discussed.Case presentationWe report two white cases of sirenomelia occurring in a 31-year-old multigravid pregnant woman. In the first pregnancy (18 weeks of gestation) abortion was performed, but in the third pregnancy (32 weeks) the stillborn baby was delivered by spontaneous vaginal birth. In the second and fourth pregnancies, however, she gave birth to normal babies. Three-dimensional ultrasound imaging showed fusion of the lower limbs. Neither she nor any member of her family had a history of diabetes. In terms of other risk factors, she had no history of exposure to teratogenic agents during her pregnancy. Also, her marriage was non-consanguineous.ConclusionThis report suggests the existence of a genetic background in this mother with a Mendelian inheritance pattern of 50% second-generation incidence in her offspring.

Three-dimensional ultrasound imaging: An effective method to detect the effect of moderate intensity statin treatment in slowing carotid plaque progression.

We aimed to evaluate the feasibility of three-dimensional ultrasound imaging (3DUS) in assessing the therapeutic effect of moderate-intensity statin therapy on carotid atherosclerotic plaques. Patients with carotid plaques were recruited to the study from January 2016 to September 2018, and were divided into two groups based on whether or not they were taking statins. All participants underwent 3DUS of their carotid plaques at baseline, then 3months and 2 years after initial examination. The changes of the carotid plaques were compared between the two groups. Were included 97 patients (57 males and 40 females), 65.26 ± 9.53 year-old with 67 into the statin group and 30 in the control group. The baseline levels of total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) were lower in the statin group than in the control group (3.79 ± 0.78 mmol/L vs 4.50 ± 1.12 mmol/L; 2.01 ± 0.62 mmol/L vs 2.58 ± 0.91 mmol/L, P< .05). There was no significant difference in the change of total plaque volume (TPV) detected by 3D-US between the statin (median [interquartile range]: 0 [-30-20] mm3 ) and the control group (0 [-22.5-25] mm3 ) at 3months. Over 2 years, the TPV increased faster in the control group (+70 [25-150] mm3 ), than in the statin group (15 [-57.5-90) mm3 , P< .05). 3DUS can be an effective tool to observe the development of carotid plaques and the effect of statin treatment.

Validation of Scolioscan Air-Portable Radiation-Free Three-Dimensional Ultrasound Imaging Assessment System for Scoliosis.

To diagnose scoliosis, the standing radiograph with Cobb’s method is the gold standard for clinical practice. Recently, three-dimensional (3D) ultrasound imaging, which is radiation-free and inexpensive, has been demonstrated to be reliable for the assessment of scoliosis and validated by several groups. A portable 3D ultrasound system for scoliosis assessment is very much demanded, as it can further extend its potential applications for scoliosis screening, diagnosis, monitoring, treatment outcome measurement, and progress prediction. The aim of this study was to investigate the reliability of a newly developed portable 3D ultrasound imaging system, Scolioscan Air, for scoliosis assessment using coronal images it generated. The system was comprised of a handheld probe and tablet PC linking with a USB cable, and the probe further included a palm-sized ultrasound module together with a low-profile optical spatial sensor. A plastic phantom with three different angle structures built-in was used to evaluate the accuracy of measurement by positioning in 10 different orientations. Then, 19 volunteers with scoliosis (13F and 6M; Age: 13.6 ± 3.2 years) with different severity of scoliosis were assessed. Each subject underwent scanning by a commercially available 3D ultrasound imaging system, Scolioscan, and the portable 3D ultrasound imaging system, with the same posture on the same date. The spinal process angles (SPA) were measured in the coronal images formed by both systems and compared with each other. The angle phantom measurement showed the measured angles well agreed with the designed values, 59.7 ± 2.9 vs. 60 degrees, 40.8 ± 1.9 vs. 40 degrees, and 20.9 ± 2.1 vs. 20 degrees. For the subject tests, results demonstrated that there was a very good agreement between the angles obtained by the two systems, with a strong correlation (R2 = 0.78) for the 29 curves measured. The absolute difference between the two data sets was 2.9 ± 1.8 degrees. In addition, there was a small mean difference of 1.2 degrees, and the differences were symmetrically distributed around the mean difference according to the Bland–Altman test. Scolioscan Air was sufficiently comparable to Scolioscan in scoliosis assessment, overcoming the space limitation of Scolioscan and thus providing wider applications. Further studies involving a larger number of subjects are worthwhile to demonstrate its potential clinical values for the management of scoliosis.

A two-steps implementation of 3D ultrasound imaging in frequency domain with 1D array transducer

Compared with B-mode imaging, three-dimensional (3D) ultrasound imaging is more helpful in research and clinical application. At present, the 3D ultrasound images can be acquired directly with two-dimensional (2D) array transducer or reconstructed from a series of B-mode images obtained with one-dimensional (1D) array transducer. Imaging with 2D array transducer can achieve a high frame rate, but suffering from the complexity of the imaging system, such as the large amount of channels, and high computational complexity. Reconstructing 3D images from a series of B-mode images can be implemented by recording the position and orientation of the slice images. This is a low-cost and flexible imaging method, but usually suffering from the low imaging quality and low frame rate. In our previous work, a novel 3D ultrasound imaging method in frequency domain with a moved 1D array transducer is presented. This method can reduce the computational complexity with FFT, and get improved imaging quality and frame rate to some extent. Besides, this method can be adopted to construct images with a row–column-addressed 2D array, which can reduce the amount of channels effectively. In this paper, a two-steps implementation of this imaging method is proposed, in which the combined implementation of the 3D imaging is decomposed to two steps of 2D imaging processes in Frequency domain. In the first step, the received echoes of the 1D array transducer at each position are processed with a 2D imaging processes in the lateral- axial planes. In the second step, a 2D imaging processes is preformed in the planes of orthogonal to the transducer. Simulation results show that the two-steps implementation can achieve almost the same imaging quality to the previous work. Compared with the implementation of 3D imaging in our previous work, the proposed two-steps implementation can be carried out with parallel process to improve the computational efficiency, or carried out with loop to reduce the hardware cost. Besides, the first step can be performed with a conventional DAS imaging method when a cylindrical wave is adopted for imaging. The influence of the spread angle of the field is also discussed.

Analysis of Three-Dimensional Ultrasound in Diagnosis of Shoulder and Neck Inflammation and Surrounding Tissue Lesions

Ultrasound imaging technology can not only show neck tear the degree and extent of disease, to help make the correct diagnosis, can also be used to assess shoulder neck inflammation after surgery to repair a shoulder muscle neck tissue integrity and healing. Ultrasound imaging with high-resolution, real-time operation, low cost, etc. gradually become shoulder neck inflammatory disease preferred imaging modality. The sensitivity and specificity for three-dimensional ultrasound imaging of shoulder neck inflammation were 78% and 93% in this study. The full-thickness inflammation sensitivity and specificity were 50% and 95%. The sensitivity and specificity of inflammation were 57% and 87%, respectively. This study shows that the diagnostic accuracy of 3D ultrasound imaging in shoulder and neck inflammation and surrounding tissue lesions is close to that of MRI. Three-dimensional appearance of new technologies such as ultrasound imaging will further improve ultrasound imaging techniques in shoulder neck inflammation application in the diagnosis and treatment assessment.

Abstract PS3-28: Three-dimensional H-scan ultrasound imaging for acute detection of breast cancer response to neoadjuvant treatment - Initial results using a preclinical animal model

Abstract Introduction: The use of noninvasive ultrasound (US) for tumor tissue characterization is an exciting prospect for anticancer treatment response monitoring. To that end, our group has developed a new technology termed H-scan US imaging, which links differences in the raw backscattered US signals to various-sized tissue structures. The purpose of this research project was to develop a 3-dimensional (3D) H-scan US imaging system and method for tissue characterization in volume space and evaluate using a preclinical animal model of breast cancer. Methodology: Preliminary studies were conducted using female nude athymic mice (N = 20, Charles River Laboratories) implanted in the mammary fat pad with 1 million breast cancer cells (MDA-MB-231, ATCC). Once tumors reached about 1 cm in size, animals were sorted into four groups so that mean tumor size in each was comparable (N = 5 per group). Animals were then US imaged at baseline and before receiving intraperitoneal injections, namely: (1) 0.3 mg sterile saline (control), (2) 0.2 mg of agnostic TRA-8 monoclonal antibody to human death receptor 5 (DR5) + 0.1 mg sterile saline, (3) 0.1 mg paclitaxel + 0.2 mg sterile saline, and (4) 0.1 mg TRA-8 + 0.2 mg paclitaxel. Image data was acquired using a programmable US scanner (Vantage 256, Verasonics Inc) equipped with a volumetric imaging transducer (4DL7, Vermon) at baseline and again every 24 hours for 3 days. To generate the H-scan US images, a set of Gaussian-weighted Hermite filters were convolved with the radiofrequency (RF) data to measure the relative strength of the received signals. The signal envelope for each of the filtered signal then was calculated using a Hilbert transformation. Finally, the lower frequency backscattered signals were assigned to a red (R) channel and the higher frequency components to a blue (B) channel. The unfiltered original RF signal was assigned to the green (G) channel to complete the RGB colormap and 3D H-scan US image display. After US imaging on day 3, animals were humanely euthanized and tumors excised for histological processing using the TUNEL HRP-DAB assay and immunofluorescent staining for activated caspase-3, PARP1, Ki-67, and DAPI. Results: The in vivo results show that 3D H-scan US imaging is considerably more sensitive to tumor changes after neoadjuvant treatment as compared to traditional B-scan US. While there was no difference at baseline (p = 0.52), repeat H-scan US results from treated tumors exhibited progressive increases in image intensity (164.9 ± 23.4%, 180.29 ± 11.6%, and 229.2 ± 14.6% for groups 2, 3, and 4 at day 3, respectively; p &amp;lt; 0.05) due to cancer cell nuclear condensation and apoptotic activity. Moreover, 3D H-scan US exhibited less variance than planar measurements due to increased sample size and statistical averaging. Histological findings also confirmed increased apoptosis and decreased proliferation that matched H-scan US data trends. Conclusions: 3D H-scan US imaging is a promising technique that allows visualization of the heterogenous tissue microenvironment and improves the evaluation of treatment at an early stage of therapy as validated by histologic findings. Citation Format: Haowei Tai, Shreya Reddy, Jane Song, Mawia Khairalseed, Kenneeth Hoyt. Three-dimensional H-scan ultrasound imaging for acute detection of breast cancer response to neoadjuvant treatment - Initial results using a preclinical animal model [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr PS3-28.

Robust Resolution-Enhanced Prostate Segmentation in Magnetic Resonance and Ultrasound Images through Convolutional Neural Networks

Prostate segmentations are required for an ever-increasing number of medical applications, such as image-based lesion detection, fusion-guided biopsy and focal therapies. However, obtaining accurate segmentations is laborious, requires expertise and, even then, the inter-observer variability remains high. In this paper, a robust, accurate and generalizable model for Magnetic Resonance (MR) and three-dimensional (3D) Ultrasound (US) prostate image segmentation is proposed. It uses a densenet-resnet-based Convolutional Neural Network (CNN) combined with techniques such as deep supervision, checkpoint ensembling and Neural Resolution Enhancement. The MR prostate segmentation model was trained with five challenging and heterogeneous MR prostate datasets (and two US datasets), with segmentations from many different experts with varying segmentation criteria. The model achieves a consistently strong performance in all datasets independently (mean Dice Similarity Coefficient -DSC- above 0.91 for all datasets except for one), outperforming the inter-expert variability significantly in MR (mean DSC of 0.9099 vs. 0.8794). When evaluated on the publicly available Promise12 challenge dataset, it attains a similar performance to the best entries. In summary, the model has the potential of having a significant impact on current prostate procedures, undercutting, and even eliminating, the need of manual segmentations through improvements in terms of robustness, generalizability and output resolution.

Analysis of the Effect of Three-Dimensional MRI Reconstruction of Human Placenta in Cesarean Section of Placenta Previa

Objective: To explore the characteristics of three-dimensional ultrasound reconstruction and MRI imaging of placenta previa combined with placental implantation, and to compare its diagnostic accuracy. Methods: A retrospective analysis of 26 cases of ultrasound imaging data that were initially confirmed as placenta previa and had a high risk of placenta implantation in pregnant women (maternal age ≥35 years, history of multiple abortions, and history of previous cesarean section) feature. The analysis results were compared with the intraoperative conditions and postoperative medical examination results. Imaging of placenta previa has its characteristic features. The diagnostic accuracy, sensitivity, and specificity of 3D ultrasound reconstruction and MRI in the diagnosis of placenta previa combined with placenta were compared and analyzed. Results: Twenty-one patients were confirmed as placental implants after operation. The placenta previa with placenta accrete was about 1800 m1 during delivery and postpartum, which was significantly more than those without concomitant placenta implantation. Hysterectomy in one case with placental implantation. MRI accuracy was 65% (17/26), sensitivity was 80%, and specificity was 20%. The accuracy of ultrasound 3D reconstruction was 81% (21/26), the sensitivity was 89%, and the specificity was 67%. There was no significant difference between the two P &gt; 0.05. Conclusions: Placenta previa with placenta implantation is associated with a high incidence of placenta and placental implantation in pregnant women at high risk, and it poses a huge threat to the life of the mother and child at the termination of pregnancy. Both 3D ultrasound reconstruction and MRI can accurately diagnose placental implantation. The estimation of the difficulty and prognosis of surgery has great diagnostic value.

Hysteroscopy as An Investigational Operative Procedure in Primary and Secondary Infertility: A Systematic Review.

BackgroundThe aim of this study is to review current indications to diagnostic and/or operative hysteroscopy in primary and secondary infertility, as well as to determine its efficacy in improving fertility.Materials and Methods We gathered available evidence about the role of hysteroscopy in the management of vari- ous infertility conditions. Literature from 2000 to 2020 that pertained to this topic were retrieved and appropriately selected. ResultsHysteroscopy does not appear as a first line diagnostic procedure for every clinical scenario. However, its di- agnostic sensitivity and specificity in assessing intrauterine pathology is superior to all other non-invasive techniques, such as saline infusion/gel instillation sonography (SIS/GIS), transvaginal sonography (TVS) and hysterosalpingog- raphy (HSG). Hysteroscopy allows not only a satisfactory evaluation of the uterine cavity but also, the eventual treat- ment of endocavitary pathologies that may affect fertility both in spontaneous and assisted reproductive technology (ART) cycles.ConclusionHysteroscopy, due to its diagnostic and therapeutic potential, should be regarded as a necessary step in infertility management. However, in case of suspected uterine malformation, hysteroscopy should be integrated with other tests [three-dimensional (3D) ultrasound or magnetic resonance imaging (MRI)] for diagnostic confirmation.

Left heart function evaluation of patients with essential hypertension and paroxysmal atrial fibrillation by two-dimensional speckle tracking imaging combined with real-time three-dimensional ultrasound imaging.

BackgroundThis study aims to assess the value of two-dimensional speckle tracking imaging (2D-STI) combined with real-time 3-dimensional echocardiography (RT-3DE) in evaluating left heart function in patients with combined ETH and PAF.MethodsA prospective study was designed, and the research period was from January 2017 to January 2020. A PAF observation group comprised of patients with ETH and PAF, a PAF control group of patients with ETH but without PAF, and a healthy volunteer group referred to as the healthy group, each comprised of 50 patients was established. All patients underwent routine ultrasound imaging examination using 2D-STI and RT-3DE. The interventricular septum thickness (IVST), left and right atrioventricular diameter (LAD), left ventricular posterior wall thickness (PWT), left ventricular ejection fraction (LVEF), the mean left atrium peak strain (mSs, mSe, mSa), strain rate (mSRs, mSRe, mSRa), the left ventricular mass (LVM), left ventricular mass index (LVMI), and left atrial total emptying volume (LATEV), the left atrial volume index (LAVI), left atrial total emptying fraction (LATEF), left atrium expansion index (LAEI), left atrium passive ejection fraction (LAPEF), and left atrial active ejection fraction (LAAEF) were calculated. Patients in the PAF observation group received telmisartan combined with rosuvastatin after diagnosis and 12- and 24-month-follow up visits were conducted. During these visits, 2D-STI combined with RT-3DE was used to evaluate cardiac function and each patient’s blood pressure was monitored.ResultsPatients in the PAF observation group had a significantly longer course of ETH than patients in the PAF control group (13.5±4.4 vs. 10.32±5.6, P=0.002). The comparison of routine 2D-STI and RT-3DE ultrasound indexes among the three groups also showed significant differences (P<0.01). During the 2-year follow-up period, the IVST, LAD, PWT, and LVEF of remaining patients significantly improved as treatment progressed (P<0.05). The LAVI, LATEF, and LAEI also improved significantly as the treatment progressed (P<0.05). After 12 months of treatment, the recurrence rate of atrial fibrillation was 16.33% (8/45) and after 24 months this was 34.21% (13/38).ConclusionsCardiac function could be evaluated comprehensively by 2D-STI combined with RT-3DE in patients with ETH combined with PAF at initial diagnosis and follow-up.

The effect of vaginal delivery and Caesarean section on the anal Sphincter complex of Primipara based on optimized three-dimensional ultrasound image and nuclear regression Reconstruction Algorithm.

Objective:The study used the optimized nuclear regression reconstruction algorithm to explore the value of three-dimensional perineal ultrasound evaluation of the effect of caesarean delivery and caesarean section on the anal sphincter complex of primipara.Methods:This study performed three-dimensional perineal ultrasound scanning of the anal sphincter complex of 157 primiparas 42 days after delivery. Among them, 77 were in caesarean delivery (spontaneous delivery group) and 80 were in caesarean section (caesarean delivery group) from September 2018 to December 2020 in our hospital. The thickness of the end plane, the middle plane, the distal plane and the distal plane of the external anal sphincter at 3, 6, 9, 12 o’clock direction, and measure the thickness of the central plane of the pubic rectum muscle at 4, 8 o’clock direction. At the same time, the study used tomography and volume contrast imaging to observe the morphology and integrity of the anal sphincter complex.Results:The thickness of the distal anal sphincter at the 12 o’clock direction, the proximal anal sphincter at 6, 12 o’clock, and the central plane at 9 and 12 o’clock in the obstetric group were smaller than those in the caesarean section group (all P < 0.05). There were no significant differences in the thickness of the remaining anal internal and external anal sphincter and puborectalis muscles between the two groups in different directions (all P> 0.05). In the obstetric group, a perineal sphincter defect was found via three-dimensional perineal ultrasound.Conclusion:The delivery method has a certain influence on the shape of the anal sphincter complex. The thickness of the internal and external anal sphincter of the primiparous women in a certain direction is significantly smaller than that of caesarean section. Transperineally three-dimensional ultrasound can clearly show the morphological characteristics and integrity of the anal sphincter complex, and diagnose the defect of the anal sphincter complex.

Maternal birth trauma: how imaging can (and should) change clinical practice.

Maternal birth trauma: how imaging can (and should) change clinical practice.