Clinical Hemorheology and Microcirculation - Volume 82, issue 3

Authors: Jung, Friedrich | Connes, Philippe | Lehmann, Christian

Article Type: Editorial

DOI: 10.3233/CH-229901

Citation: Clinical Hemorheology and Microcirculation, vol. 82, no. 3, pp. 199-200, 2022

Authors: Sachdeva, Shivani | Saluja, Harish | Mani, Ameet | Phadnaik, M.B. | Mani, Shubhangi

Article Type: Research Article

Abstract: Lipoxins and ATL appear to be the first recognized members of a new class of endogenous mediator that are anti-inflammatory or serve for the “pro-resolution” of inflammation. PGE2 can and may display anti-inflammatory properties in certain settings, but in most cases, it enhances inflammation in vivo . This is likely the result of numerous receptor isoforms and differential coupled mechanisms for PGE2 and its diverse role in human physiology. Since the integrated response of the host is essential to health and disease, it is important to achieve a more complete understanding of the molecular and cellular events governing the …formation and actions of endogenous mediators of resolution that appear to control the magnitude and duration of inflammation. In view of the present body of evidence, it is not surprising that a protective action for inhibition of COX-2 was found in cardiovascular disease. Characterizing useful experimental systems with clinically relevant endpoints will also take a multidisciplinary approach and require a shift in our current thinking about inflammation and the role of lipid mediators. Show more

Keywords: Lipoxins, anti-inflammatory, chemical mediators

DOI: 10.3233/CH-211346

Citation: Clinical Hemorheology and Microcirculation, vol. 82, no. 3, pp. 201-216, 2022

Authors: Wang, Dan | Zhao, Chong-Ke | Wang, Han-Xiang | Lu, Feng | Li, Xiao-Long | Guo, Le-Hang | Sun, Li-Ping | Fu, Hui-Jun | Zhang, Yi-Feng | Xu, Hui-Xiong

Article Type: Research Article

Abstract: PURPOSE: To evaluate a computer-aided diagnosis (CAD) technique in predicting malignancy for cytologically indeterminate thyroid nodules (TNs) as compared with different experienced radiologists. METHOD: 436 patients with 436 cytologically indeterminate TNs on fine-needle aspiration cytology (FNAC) were included and all were confirmed by surgical pathology. They were retrospectively analyzed with respect to ultrasound (US) characteristics using a commercially available CAD system (AmCAD-UT; AmCad BioMed, Taiwan, China) and reviewed by one junior and one senior radiologists.The CAD system and different experienced radiologists stratified the risk of malignancy using ACR TI-RADS category. The diagnostic performance by different experienced radiologists independently …and after consulting the CAD (different experienced radiologists + CAD) and by the CAD alone were compared. RESULTS: The different experienced radiologists showed significantly higher specificities than the CAD system alone. The combination of radiologist and CAD system showed improved diagnostic performance with an AUC (Area under the curve) of 0.740 in the senior radiologist and 0.677 in the junior radiologist, as compared with CAD (AUC: 0.585) alone (all P  < 0.05). The combination of senior radiologist and CAD system had the highest diagnostic performance (AUC: 0.740) and specificity (68.9%) compared to the others (all P  < 0.05). CONCLUSION: The CAD system may play the potential role as a decision-making assistant alongside radiologists for differential diagnosis of TNs with indeterminate cytology. Show more

Keywords: Computer-aided diagnosis, thyroid, ultrasound

DOI: 10.3233/CH-221423

Citation: Clinical Hemorheology and Microcirculation, vol. 82, no. 3, pp. 217-230, 2022

Authors: Jung, Ernst-Michael | Jung, Friedrich | Verloh, Niklas | Haimerl, Michael | Lürken, Lukas | Jage, Simon | Stroszczynski, Christian | Scharf, Gregor

Article Type: Research Article

Abstract: BACKGROUND: Ultrasound follow-up of transjugular intrahepatic portosystemic shunt (TIPS) is challenging due to the bent course of the stent-graft. OBJECTIVE: Aim of this retrospective study was to assess to which extent the combination of HR flow with Glazing Flow improves hemodynamic assessment in the ultrasound follow-up of TIPS. METHODS: Comparative studies with CCDS and High Resolution (HR)-Flow with Glazing Flow were evaluated regarding image quality and artifacts on a 5-point scale (0 = cannot be assessed up to 5 = maximum image quality without artifacts). In all cases, an experienced examiner performed the examinations with a 1–6 MHz probe (Resona 7, …Mindray). RESULTS: 61 ultrasound examinations in 48 patients were performed; the mean patient age was 54±14.2 years. The use of HR-Flow with Glazing Flow resulted in an improved flow display in 55/61 cases (90.2%). Both methods correlated well (r  = 0.71), but HR flow with Glazing flow values were in general higher than CCDS values. The reading resulted in an average value of 2.52±0.54 for CCDS and 3.52±0.57 for HR flow with Glazing flow (p  = 0.013). CONCLUSION: The combination of HR-Flow and Glazing Flow results in improved flow representation and reduction of artifacts in the ultrasound follow-up of TIPS. Show more

Keywords: Transjugular intrahepatic shunt (TIPS), color coded doppler sonography (CCDS), HR-flow, glazing flow, postinterventional control

DOI: 10.3233/CH-221427

Citation: Clinical Hemorheology and Microcirculation, vol. 82, no. 3, pp. 231-238, 2022

Authors: Dong, Yi | Qiu, Yijie | Cao, Jiaying | Fan, Peili | Wang, Wen-Ping | Fleischmann, Johannes | Jung, Ernst Michael

Article Type: Research Article

Abstract: Purpose: Abdominal thromboses are a poorly characterized thrombotic complication of COVID-19. The aim of this paper is to report multimodality ultrasound imaging findings of the abdomen in evaluation of thrombotic lesions in hospitalized patients with COVID-19. Patients & Methods: In this retrospective observational study, patients admitted to a single University Hospital from April 1, 2020 to April 30, 2022, who tested positive for COVID-19 and developed acute abdominal pain over the course of hospitalization were included. Abdominal ultrasound imaging studies performed in these patients were reviewed, including B mode ultrasound (BMUS), color-coded Doppler ultrasound (CCDS) and contrast enhanced …ultrasound (CEUS). Thromboembolic findings on contrast enhanced computed tomography (CTA) were also recorded. Results: Finally, 13 cases of abdominal thrombosis in 226 with COVID 19 infections were included (mean age, 56.69±8.97 years; 10 men, 3 women). Thromboembolic events included: iliac thrombosis (n  = 4), portal venous (PV) thrombosis (n  = 3), superior mesenteric vein (VMS) thrombosis (n  = 2), inferior vena cava (IVC) thrombosis (n  = 5) and inferior mesenteric vein (VMI) thrombosis (n  = 1). In all cases of abdominal thrombosis, during high resolution BMUS scan, intra-luminary hypoechogenic appositional thrombi could be detected. Meanwhile blood flow with reduced speed less than 20 cm/s could be observed by CCDS. High arterial flow speed was a sign of collateral flow changes with diffuse venous dilatation. On CEUS, changes of the microcirculation of the liver, spleen, kidneys or small bowel by infarctions or micro-emboli could be detected. In 3 cases of PV thrombosis and in 2 cases of IVC thrombosis, catheter interventions were successful performed for recanalization without relevant lumen reduction afterwards. In other cases, without interventional procedure, partial recanalization happened with venous flow speed over 15 cm/s and lumen reduction more than 50%. Conclusions: Our study highlights those thromboembolic complications can be seen in hospitalized patients with COVID-19. Multimodality ultrasound examinations is helpful for early and accurate diagnosis of these complications. Show more

Keywords: COVID 19, abdominal thrombosis, ultrasound, diagnosis

DOI: 10.3233/CH-221487

Citation: Clinical Hemorheology and Microcirculation, vol. 82, no. 3, pp. 239-248, 2022

Authors: Rasyid, Al | Timan, Ina Susianti | Riyanto, Dinda Larastika | Harris, Salim | Kurniawan, Mohammad | Mesiano, Taufik | Hidayat, Rakhmad | Wiyarta, Elvan

Article Type: Research Article

Abstract: In 2021 the delta variant was discovered, heralding the start of the second pandemic wave. This case series aims to analyse and compare the coagulation and hemorheology profiles of COVID-19 patients diagnosed with acute stroke during the pandemic’s second wave and ascertain the effect on patient outcomes. This case series reports 4 cases with their respective characteristics. Case 1 reports on COVID-19 patients without comorbidities, Case 2 with comorbidities, Case 3 with strokes in young patients, and Case 4 with strokes in elderly patients. All cases had abnormal coagulation and hemorheology factors with mixed outcomes. Coagulation and hemorheology factors tend …to be higher in COVID-19 patients with acute stroke. The value of coagulation and hemorheology factors can be a prognostic outcome in COVID-19 patients with severe disease, especially in patients associated with acute stroke. Show more

Keywords: Coagulation, hemorheology, stroke, case series, prognostic, COVID-19

DOI: 10.3233/CH-221504

Citation: Clinical Hemorheology and Microcirculation, vol. 82, no. 3, pp. 249-254, 2022

Authors: Jin, Lin | Tong, Lan-Yue | Sha, Lei | Cao, Meng-Meng | Shen, Cui-Qin | Du, Lian-Fang | Li, Zhao-Jun

Article Type: Research Article

Abstract: AIM: Carotid ultrasound is a key tool for the diagnosis and evaluation of cardio disease, and the measurement of carotid intima-media thickness (CIMT) and hemodynamic parameters is of paramount importance for the imaging method. The aim of this study was to evaluate the feasibility and accuracy of handheld ultrasound devices for measuring carotid parameters. METHODS: We performed a carotid ultrasound on 25 participants using a handheld ultrasound device and a conventional ultrasound machine. For each participant, max and mean CIMT of common carotid artery (CCA) and peak systolic velocity (PSV), end diastolic velocity (EDV) and resistive index (RI) …of CCA, bilateral external carotid artery (ECA), internal carotid artery (ICA) and the vertebral artery were measured. Agreement and repeatability were evaluated by linear regression and Bland-Altman analysis. RESULTS: We found a good repeatability and consistent of handheld ultrasound device in measuring mean CIMT (r  = 0.68, P  < 0.01). Furthermore, there was a moderate to good agreement between handheld and conventional ultrasound systems in measuring max IMT, mean IMT, PSV, EDV and RI of CCA (0.73, 0.79, 0.52, 0.58 and 0.84, respectively). CONCLUSION: Handheld ultrasound devices were able to provide carotid IMT and hemodynamic parameters measurements similar to those of conventional ultrasound. Such capabilities of handheld ultrasound devices might be useful for the primary assessment of carotid in clinical work. Show more

Keywords: Handheld ultrasound scanner, carotid artery, carotid intima-media thickness, Ultrasound

DOI: 10.3233/CH-221521

Citation: Clinical Hemorheology and Microcirculation, vol. 82, no. 3, pp. 255-263, 2022

Authors: Liu, Shasha | Li, Weiling | Zhang, Jiefang | Qi, Lin | Dong, Yiming | Fu, Liman | Li, Yuan

Article Type: Research Article

Abstract: Hypertensive disorders complicating pregnancy (HDCP) are common pregnancy-related disorders. In this study, we aimed to study the clinical value of flow-mediated dilation (FMD) in HDCP and its association with endothelial dysfunction and HDCP-related factors. 160 HDCP patients and 120 healthy pregnancies were enrolled in the study. The expressions of endothelial function markers and FMD were determined. In addition, their correlations in HDCP patients were also analyzed using Pearson’s correlation analysis. FMD value decreased gradually from normal pregnancy to severe PE. The levels of plasma nitric oxidase (NO) were significantly lower in the HDCP group than those in the control group, …while the levels of plasma endothelin-1 (ET-1) were increased dramatically in the HDCP group. Moreover, the levels of placental growth factor (PLGF) in HDCP women were significantly lower, while the soluble FMS-like tyrosine kinase 1 (sFLt-1) levels were markedly higher than those in control. In addition, the FMD value was correlated with the levels of plasma NO, ET-1, PLGF and sFlt1. It was also found that lower levels of FMD correspond to endothelial dysfunction and abnormal concentrations of PLGF and sFlt-1. The FMD value was associated with endothelial function indicators and could be a strong and non-invasive measure to predict HDCP. The association between the FMD values and endothelial function indicators in HDCP could be helpful for the prediction of pregnant hypertension more accurately. Show more

Keywords: HDCP, ET-1, NO, PLGF, sFlt-1

DOI: 10.3233/CH-221533

Citation: Clinical Hemorheology and Microcirculation, vol. 82, no. 3, pp. 265-274, 2022

Authors: Stern, M. | Schremmer, J. | Scharm, S. | Baasen, S. | Heinen, Y. | Sansone, R. | Polzin, A. | Jung, C. | Heiss, C. | Kelm, M. | Busch, L.

Article Type: Research Article

Abstract: BACKGROUND: Femoral pseudoaneurysm (PSA) is a severe complication after endovascular procedures. Ultrasound-guided manual compression (MC) and percutaneous thrombin injection (TI) are frequently used treatments. MC is less effective, TI may cause thromboembolic events. OBJECTIVE: Up to date, there is no data regarding impairment of microvascular tissue perfusion after PSA treatment. METHODS: In this single-center, prospective study 22 patients with PSA were included. We compared macro- and microcirculatory perfusion in the treated and untreated leg at baseline before, after and one day after treatment. Leg perfusion was assessed with ultrasound and ankle-brachial index (ABI). Microcirculatory perfusion of …the feet was measured with a near-infrared spectroscopy (NIRS) camera generating StO2 -tissue-maps. RESULTS: Successful PSA thrombosis was achieved in 16 (100%) patients in TI group and in 4 (66.7%) patients in MC group. There was no evidence of arterial thrombi on ultrasound and the ABI did not differ between groups. NIRS StO2 -tissue-maps of the feet showed no significant difference in both groups concerning the treated (p  = 0.121) or the untreated (p  = 0.198) leg during follow up. CONCLUSIONS: In this small exploratory study, there was no evidence of micro- and macrovascular tissue perfusion impairment after treatment of postcatheterization femoral pseudoaneurysm with thrombin injection underscoring the safety of this approach. Show more

Keywords: Microcirculation, tissue perfusion, femoral pseudoaneurysm, ultrasound-guided manual compression, ultrasound-guided percutaneous thrombin injection, near-infrared spectroscopy

DOI: 10.3233/CH-221438

Citation: Clinical Hemorheology and Microcirculation, vol. 82, no. 3, pp. 275-282, 2022

Authors: Chen, Jin | Liu, Dandan | Wang, Jing | Song, Wanji | Ma, Fang

Article Type: Research Article

Abstract: BACKGROUND: Contrast-enhanced ultrasound (CEUS) is a routine technique for detecting intraplaque neovascularization (IPN). However, the invasiveness and complexity of CEUS severely limit its clinical application. This article aims to investigate the application value of AngioPLUS (AP) technique in assessing IPN formation in patients with atheromatous (AS) carotid artery plaque. METHODS: Patients diagnosed with carotid artery atherosclerosis combined plaque formation were recruited and their demographic characteristics including serum fasting blood glucose (FBG), triglyceride (TG), and low-density lipoprotein (LDL) were collected. AP was used to scoring intraplaque microvascular flow (IMVF), measuring the thickness and length of the plaque and determining …the number of IPN of the plaque. RESULTS: IMVF score evaluated by AP was positively correlated with plaque length, thickness, IPN number, serum TG, LDL and FBG levels in patients with carotid atherosclerosis with plaque. The evaluation results of CEUS score and IMVF classification detected by AP of plaques were consistent in patients with carotid atherosclerosis. CONCLUSION: IMVF scoring by AP is a promising approach to assess IPN and plaque status in patients with atheromatous carotid artery plaque. Show more

Keywords: Carotid artery atherosclerosis (AS), vulnerable plaques, intraplaque neovascularization (IPN), contrast-enhanced ultrasound (CEUS), AngioPLUS (AP)

DOI: 10.3233/CH-221510

Citation: Clinical Hemorheology and Microcirculation, vol. 82, no. 3, pp. 283-293, 2022