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Cover, Foreword and Content
2024, 8 (2): 0-0.
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Review Articles

Ultrasound Assessment of Effect of Maternal Thyroid Function During Pregnancy on Fetal and Neonatal Bone Development

Hao Feng, MM, Yaqin Sun, MM, Jingjing Zhang, MM, Jiajia Wang, MM, Shuai Han, MM, Shumin Wang, PhD

2024, 8 (2): 41-48. DOI:10.37015/AUDT.2024.230043

Abstract ( 96 ) HTML ( 7 ) PDF ( 14925KB ) ( 129 ) 　　

Throughout pregnancy, maternal thyroid-related hormones are transported to the fetus via the placenta to allow normal fetal growth and development and are particularly important in the first and second trimesters of pregnancy. During maternal-fetal transport, in addition to thyroid-related hormones, thyroid-stimulating hormone receptor antibodies and antithyroid drugs can enter the fetus and interfere with development of the fetal thyroid gland and endocrine function, potentially leading to hyperthyroidism or hypothyroidism in the fetus or newborn. Several basic studies have been performed to demonstrate the important role of thyroid-related hormones in fetal and neonatal bone development. Ultrasound can assess neonatal skeletal maturity and bone development safely, rapidly, and effectively. This review aims to communicate the latest knowledge about maternal and fetal thyroid function in both normal and pathological pregnancies and summarize the latest advances in the potential effects of abnormal maternal thyroid function on bone development in the fetus and neonate. Finally, it discusses recent advances in research on ultrasound in the assessment of fetal and neonatal bone development.

Original Research

Evaluation of Atherosclerosis Development by Vascular Duplex Ultrasonography in ApoE-deficient Dogs Fed with a High-fat Diet

Lingyun Jia, MD, PhD, Yuan Li, PhD, Yang Hua, MD, Yumei Liu, MD, Nan Zhang, MD, Mingjie Gao, MD, Ke Zhang, MD, Jingzhi Li, MD, Benchi Chen, BS, Jidong Mi, MS, Nan Zhao, PhD

2024, 8 (2): 49-56. DOI:10.37015/AUDT.2024.230037

Abstract ( 77 ) HTML ( 3 ) PDF ( 18417KB ) ( 104 ) 　　

Objective 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).

Methods 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.

Results 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.

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

Accuracy of Prenatal Ultrasound in the Diagnosis of Isolated Fetal Cleft Palate in High-risk Patients

Hongmei Wu, MD, Shuqin Li, MD, Fengfeng Shi, MD, Yuxiu Gao, MD, Jiansheng Li, MD

2024, 8 (2): 57-63. DOI:10.37015/AUDT.2024.230038

Abstract ( 86 ) HTML ( 3 ) PDF ( 15907KB ) ( 78 ) 　　

ObjectiveThe objective of this study was to develop a sonographic technique using two-dimensional (2D) markers for detecting isolated fetal cleft palate (no cleft lip) and to evaluate the ability of 2D and three-dimensional (3D) sonography to image the normal and abnormal palate.

Methods Seventy-three fetuses with a high risk of cleft palate at 12-39 weeks of gestation were referred for specialist ultrasound. A detailed evaluation of the palate was performed through 2D ultrasound, which revealed the appearance of the palatine line in the sagittal plane; the palate and alveolar ridge in the coronal plane of the fetal face; the horizontal plate of the palatine bone in the axial maxillary plane; and the soft palate in the transverse plane of the cavum pharyngis. Subsequently, 3D ultrasound imaging of the palate was performed in all fetuses. Antenatal diagnoses were compared with postnatal findings or autopsy findings.

Results Visualization of 2D markers was accomplished in all fetuses, and 3D assessment was achieved in 97% of fetuses. Cleft palate was suspected in 16 cases (21.9%), among which 14 were suspected on the basis of both 2D and 3D evaluation, and two were suspected only on the basis of 3D evaluation. A normal palate was observed in 57 fetuses (78.1%). The mean gestational age was 27 weeks (range of 12 weeks to 39 weeks). All 16 fetuses with suspected cleft palate were confirmed by postnatal or autopsy findings, no false-positives were observed, and one case with a bifid uvula was missed among 57 fetuses with a presumed normal palate.

Conclusions The fetal palate can be evaluated with 2D markers and 3D sonography. The detection of isolated cleft palate is more sensitive when 2D markers are present in all four planes.

A Study on Left Atrial Function in Patients with Essential Hypertension Using Four-Dimensional Echocardiography

Junrong Hong, MD, Pingyang Zhang, MD, PhD, Mengyao Fei, MD, Lingling Wang, MD

2024, 8 (2): 64-73. DOI:10.37015/AUDT.2024.230042

Abstract ( 57 ) HTML ( 0 ) PDF ( 14928KB ) ( 67 ) 　　

Objective Aimed to evaluate patients with essential hypertension (EH) using four-dimensional automatic left atrial quantification (4DLAQ) To assess the occurrence of EH.

Methods This study selected 80 patients with EH for the EH group and 36 healthy individuals for the control group. Various cardiac parameters, including left atrial diameter (LAD), interventricular septal thickness (IVST), left ventricular end-diastolic diameter (LVDD), left ventricular posterior wall thickness (LVPWT), early E-wave velocity of mitral valve diastole/mitral valve ring myocardial displacement velocity (E/e'), biplanar left ventricular ejection fraction (biplanLVEF), left atrial minimum volume (LAVmin), lateral left atrial maximum volume (LAVmax), left atrial presystolic volume (LAVpreA), left atrial ejection fraction obtained by two-dimensional echocardiography (LAEF), left atrial passive ejection fraction (LAPEF), left atrial active ejection fraction (LAAEF), left atrial reservoir longitudinal strain (LASr), left atrial catheter longitudinal strain (LAScd), left atrial systolic longitudinal strain (LASct), left atrial reservoir circular strain (LASr_c), left atrial catheter circular strain (LAScd_c), and left atrial systolic circular strain (LASct_c) were measured using 4DLAQ. Binary logistic regression was employed to analyze the effect of 4DLAQ strain parameters on EH. Receiver operating characteristic (ROC) curves were used to assess the predictive value of 4DLAQ strain parameters for EH.

Results Systolic blood pressure and diastolic blood pressure in the EH group were higher than those in the control group (P = 0.000 and 0.000, respectively). In the EH group, LAD, IVST, LVDD, LVPWT, E/e', LAVmin, LAVmax, and LAVpreA were significantly increased (P = 0.000, 0.000, 0.072, 0.000, 0.000, 0.001, 0.052, and 0.004, respectively), whereas biplanLVEF, LAEF, LAPEF, LAAEF, LASr, LAScd, LASct, LASr_c, LAScd_c, and LASct_c significantly decreased (P = 0.090, 0.000, 0.009, 0.064, 0.000, 0.000, 0.000, 0.000, 0.000, and 0.689, respectively). Bland-Altman plots were used to illustrate the relationship between variables and audience consensus. LASr and LAScd were identified as independent risk factors for EH. The area under the ROC curve (AUC) for LASr was 0.925, (95% confidence interval [CI] = 0.879-0.971) with a sensitivity of 80.00%, specificity of 94.44%, using a cut-off value of 20%. For LAScd, the AUC-ROC was 0.878 (95% CI = 0.818-0.939 with a sensitivity of 76.25%, specificity 86.11%, and using a critical value of -11%.

Conclusion LASr and LAScd exhibited superior predictive capabilities for EH, with LASr performing the best. This study fills a critical gap in left atrial research and holds significant clinical implications.

Case Reports

Multimodal Sonographic Findings of Embryonal Carcinoma in the Testis: A Case Report and Literature Review

Guiwu Chen, MS, Zhizhong He, BS, Wenqin Liu, MS, Junjun Chen, BS, Xiaomin Liao, MS, Yuhuan Xie, BS

2024, 8 (2): 74-77. DOI:10.37015/AUDT.2024.220046

Abstract ( 59 ) HTML ( 4 ) PDF ( 15280KB ) ( 83 ) 　　

Pure embryonal carcinoma (EC) is a rare malignant tumor that primarily occurs in infants with a sex development disorder and adults aged in their thirties to forties. This tumor behaves more aggressively than other germ cell tumors in the testis, and most of them should undergo surgery or chemotherapy. However, only a few case reports have involved imaging, and most of them are limited. Here, we present a case of pure EC in the testis of a 27-year-old male with multimodal ultrasonography, computed tomography, and magnetic resonance imaging.