This study aimed to evaluate the development of atherosclerosis in ApoE-deficient dogs fed with a high-fat diet (HFD) using vascular duplex ultrasonography (VDU).

Thirty beagle dogs were enrolled, including 10 wild-type, 16 heterozygous (ApoE^-/+), and four homozygous (ApoE^-/-) mutant dogs. The dogs were categorized into either the normal diet (ND) or HFD group. Plasma lipids levles were tested at baseline and then after feeding the dog a different diet for 6 months. The carotid arteries, abdominal aorta (AO) and iliac arteries were examined using VDU. Artery sections of the ApoE^-/- dogs were analyzed.

After HFD, lipids especially triglycerides, total cholesterol and low-density lipoprotein (LDL) in the wild type and ApoE^-/+ dogs were significantly increased. Both the intima-media thickness (IMT) of the common carotid artery (CCA) and AO in the wild type and ApoE^-/+ dogs significantly increased. In the ApoE^-/+ dogs, the mean percentages increases in CCA-IMT and AO-IMT after HFD were higher than those in the ND dogs. The mean values of CCA-IMT and AO-IMT in the ApoE^-/- dogs increased to 2-2.5 folds after HFD. Histological analysis confirmed that the carotid and iliac arteries had advanced atherosclerotic lesions in the ApoE^-/- dogs.

HFD may accelerate the development of atherosclerosis in ApoE-deficient dogs, which is an optimal large-animal model of atherosclerosis.

General anesthesia (GA) can decrease cerebral flow velocities and predispose patients to cerebral hyperperfusion syndrome (CHS) and other perioperative adverse events after carotid endarterectomy (CEA). The aim of this study was to investigate whether decreased pre-operative flow velocity is associated with an increased risk of CHS and perioperative cerebral infarct, and to further identify risk factors if there is any.

We retrospectively evaluated 920 consecutive patients who received CEA from 2010 to 2020 at a major academic hospital in China. Middle cerebral artery (MCA) blood flow velocities were measured before and after induction of the GA by transcranial Doppler (TCD). Patients were classified into two groups: the NORMAL group if flow velocity decreased < 30% and the LOW group if flow velocity decreased ≥30%. The ultrasonographic diagnostic criterion of CHS was defined as the 100% increase in flow velocity by TCD from the baseline to post-CEA. The occurrence of CHS, perioperative cerebral infarction was compared between the two groups.

399 (43.4%) were classified as LOW measurement, and 521 (56.6%) patients were classified as NORMAL measurement. In the LOW group, there were more patients with diabetes, fewer patients with ipsilateral ICA severe stenosis and the opening of anterior/posterior communicating artery. Although the occurrence of CHS per ultrasonography criteria was higher in the LOW group (21.3% vs 15.7%, P = 0.03), the occurrence of CHS per clinical criteria (3.2%, vs 2.1%, P = 0.28) or the perioperative cerebral infarct between the two groups (5.8% vs 5.0%, P = 0.60) is equivalent.

Patients with decreased flow velocities post-GA were more likely to meet the ultrasonography criteria for CHS, but they are not at risk of developing clinical CHS or perioperative cerebral infarct.

This study was to investigate the characteristic morphology and hemodynamics in patients with internal jugular vein (IJV) stenosis by color duplex ultrasonography (CDU).

From 2017 October to 2019 October, 111 patients with unilateral IJV regional stenosis at the J3 segment (IJV out of the jugular foramen to the anatomic level of the carotid artery bifurcation) and 126 healthy individuals (control group) were enrolled. Using CDU, the diameter, maximum velocity (Vmax), maximum pressure gradient (PGmax), and mean flow volume (FVm) of bilateral IJVs were measured. With MR venous angiography (MRV) and/or CT venous angiography (CTV) as reference, the optimal cut-off values of Vmax and PGmax were determined by ROC analysis.

Among the 111 patients, 39 (35.1%) were associated with intracranial hypertension (ICH). The diameter at the IJV stenosis was significantly smaller than that of the segment distal to the stenosis (2.04 ± 0.36mm vs. 4.49 ± 0.68mm, t = 19.367, P < 0.001). The Vmax and PGmax at the IJV stenosis segment were obviously higher than those at the segment distal to the stenosis (Vmax: 106.8 ± 29.0 cm/s vs. 32.4 ± 13.1 cm/s, t = 29.259; PGmax: 5.10 ± 2.69 mmHg vs. 0.50 ± 0.53 mmHg, all P < 0.001). With MRV/CTV as reference, the ROC curves of Vmax and PGmax at the stenosis site showed high diagnostic efficacy. The optimal cut-off value of Vmax was 75cm/s, with a sensitivity of 87.4% and a specificity of 95.2%. The optimal cut-off value of PGmax was 2.2 mmHg, with a sensitivity of 92.8% and a specificity of 96.0%.

CDU may be a useful method to evaluate IJV regional stenosis.

The characteristics of Internal jugular vein (IJV) morphology and hemodynamics of IJV hypoplasia have not been well illustrated.

Seventy-three cases with IJV hypoplasia diagnosed by MR and/or CT venous angiography and 126 healthy control were recruited. Ultrasound was performed to examine the J1-J3 segments of IJV. The diameter and mean flow volume (FVm) of bilateral IJV were compared. The linear regression of bilateral diameter ratio and FVm ratio were analyzed. The optimal cut-off values of diameter and flow volume of different segment of IJVs were determined by receiver operating characteristic (ROC) analysis. Furthermore, the correlation between the IJV hypoplasia and cerebral venous sinus stenosis were analyzed.

There were 91.8% (67/73) cases with left IJV hypoplasia. The diameter and FVm of hypoplasia IJV were lower than the contralateral side (P < 0.001). The bilateral J1 diameter ratio was linear correlation with the FVm ratio, with a coefficient 0.720. The optimal cut-off diameter ratio of J1-J3 hypoplasia/dominant side were 0.70, 0.80 and 0.75 respectively and the optimal cut-off FVm ratio of three segments were all 0.50. The side of IJV hypoplasia was highly correlated with the side of transverse sinus and/or sigmoid sinus stenosis with an overall coincidence rate of 68.5%.

The left IJV was vulnerable for hypoplasia. IJV hypoplasia was correlated with ipsilateral cerebral venous sinus stenosis. Ultrasound is a reliable modality for evaluating IJV hypoplasia.

Ultrasonography is widely used for the diagnosis of many diseases including thyroid and breast cancers. Delineation of lesion boundaries from ultrasound images plays an important role in calculation of clinical indices and early diagnosis of diseases. However, accurate automatic segmentation of lesions is challenging because of their heterogeneous appearance and lack of background contrast.

In this study, we employed a pre-trained deep convolutional neural network (PCNN) to automatically segment lesions from ultrasound images. Specifically, our PCNN based method used whole images of normal tissues and lesions as inputs and then generated the segmentation probability maps as outputs. A pre-training strategy was used to improve the performance of the PCNN based model. Additionally, we compared the performance of our approach with that of the common convolutional neural network segmentation methods on the same dataset.

We validated on ultrasound images of thyroid nodules and breast nodules. The experimental results were shown in true positive rate (TP), false positive rate (FP), overlap metric (OM) and dice ratio (DR). Specifically, for thyroid nodule segmentation, our method could achieve an average of OM, DR, TP, FP as 0.8943, 0.9558, 0.9694, 0.0569 on overall folds, respectively. For breast nodule segmentation, our method could achieve an average of OM, DR, TP, FP as 0.8572, 0.9001, 0.9497, 0.8619, respectively.

Our proposed method is fully automatic without any user interaction and may be good enough to replace the time-consuming and tedious manual segmentation approach, demonstrating the potential clinical applications.