BACKGROUND & AIMS: :Subvalvar left ventricular aneurysms are rare and occur predominantly in black Africans. A submitral left ventricular aneurysm was diagnosed on cross sectional echocardiography in a black woman born in the United Kingdom. The left parasternal long axis view showed a highly echogenic mass apparently attached to the wall of a dilated left atrium, but the apical two-chamber view showed that this was thrombus in the apex of a left ventricular aneurysm. The patient subsequently underwent surgical correction.

背景与目标： ：左室下动脉瘤很少见，主要发生在非洲黑人中。通过横断面超声心动图检查，在英国出生的一名黑人妇女被确诊为左心室动脉瘤。左胸骨旁长轴视图显示高度回声的肿块，明显附着在扩张的左心房壁上，但心尖两腔视图显示这是左心室动脉瘤顶点的血栓。患者随后接受了手术矫正。

BACKGROUND & AIMS: BACKGROUND:Cardiac output (CO) monitoring is a valuable tool for the diagnosis and management of critically ill patients. In the critical care setting, few studies have evaluated the level of agreement between CO estimated by transthoracic echocardiography (CO-TTE) and that measured by the reference method, pulmonary artery catheter (CO-PAC). The objective of the present study was to evaluate the precision and accuracy of CO-TTE relative to CO-PAC and the ability of transthoracic echocardiography to track variations in CO, in critically ill mechanically ventilated patients. METHODS:Thirty-eight mechanically ventilated patients fitted with a PAC were included in a prospective observational study performed in a 16-bed university hospital ICU. CO-PAC was measured via intermittent thermodilution. Simultaneously, a second investigator used standard-view TTE to estimate CO-TTE as the product of stroke volume and the heart rate obtained during the measurement of the subaortic velocity time integral. RESULTS:Sixty-four pairs of CO-PAC and CO-TTE measurements were compared. The two measurements were significantly correlated (r = 0.95; p < 0.0001). The median bias was 0.2 L/min, the limits of agreement (LOAs) were -1.3 and 1.8 L/min, and the percentage error was 25%. The precision was 8% for CO-PAC and 9% for CO-TTE. Twenty-six pairs of ΔCO measurements were compared. There was a significant correlation between ΔCO-PAC and ΔCO-TTE (r = 0.92; p < 0.0001). The median bias was -0.1 L/min and the LOAs were -1.3 and +1.2 L/min. With a 15% exclusion zone, the four-quadrant plot had a concordance rate of 94%. With a 0.5 L/min exclusion zone, the polar plot had a mean polar angle of 1.0° and a percentage error LOAs of -26.8 to 28.8°. The concordance rate was 100% between 30 and -30°. When using CO-TTE to detect an increase in ΔCO-PAC of more than 10%, the area under the receiving operating characteristic curve (95% CI) was 0.82 (0.62-0.94) (p < 0.001). A ΔCO-TTE of more than 8% yielded a sensitivity of 88% and specificity of 66% for detecting a ΔCO-PAC of more than 10%. CONCLUSION:In critically ill mechanically ventilated patients, CO-TTE is an accurate and precise method for estimating CO. Furthermore, CO-TTE can accurately track variations in CO.

背景与目标： 背景：心脏输出（CO）监测是诊断和管理重症患者的宝贵工具。在重症监护环境中，很少有研究评估经胸超声心动图（CO-TTE）评估的CO与参考方法肺动脉导管（CO-PAC）评估的CO之间的一致性水平。本研究的目的是评估重症机械通气患者中CO-TTE相对于CO-PAC的准确性和准确性，以及经胸超声心动图追踪CO变化的能力。
方法：38名装有PAC的机械通气患者被纳入在16张病床的大学医院ICU中进行的前瞻性观察研究中。通过间歇热稀释法测量CO-PAC。同时，第二位研究者使用标准视野TTE来估计CO-TTE，作为中风量和在测量主动脉下时间积分时获得的心率的乘积。
结果：比较了64对CO-PAC和CO-TTE测量值。两次测量结果显着相关（r = 0.95； p <0.0001）。中位数偏差为0.2 L / min，一致极限（LOA）为-1.3和1.8 L / min，百分误差为25％。对于CO-PAC，精度为8％，对于CO-TTE，精度为9％。比较了26对ΔCO测量值。 ΔCO-PAC和ΔCO-TTE之间存在显着相关性（r = 0.92; p <0.0001）。平均偏差为-0.1 L / min，LOA为-1.3和1.2 L / min。具有15％的禁区，四象限地块的一致性率为94％。在0.5L / min的禁区下，极坐标图的平均极角为1.0°，LOA的百分比误差为-26.8至28.8°。在30至-30°之间的一致性率为100％。当使用CO-TTE检测到ΔCO-PAC的增加超过10％时，接收工作特性曲线下的面积（95％CI）为0.82（0.62-0.94）（p <0.001）。 ΔCO-TTE大于8％时，检测到ΔCO-PAC大于10％时，灵敏度为88％，特异性为66％。
结论：对于重症机械通气患者，CO-TTE是估算CO的准确方法。此外，CO-TTE可以准确跟踪CO的变化。

BACKGROUND & AIMS: :Objectives: We assessed the natural history of the different types of isolated ventricular septal defects (VSDs) diagnosed by fetal echocardiography and analyzed their postnatal outcomes.Methods: This is a retrospective cohort study of 86 fetuses with isolated VSDs, detected in 7466 sequential echocardiographic examinations. The subtype and size of the VSDs were assessed during fetal life and the following birth. Data on the spontaneous closure of the VSD, need for intervention, additional abnormalities and chromosomal aberrations was analyzed.Results: From the original cohort 75 cases of isolated VSDs with complete data on outcome were further analyzed. Muscular and perimembranous VSDs were found in 85.3 and 14.7%, respectively. Spontaneous closure of the VSDs occurred prenatally in 31/64 and 3/11 of fetuses with muscular VSD and perimembranous VSD, respectively. Spontaneous closure of the VSD by the age of 2 years occurred in 92.2 and 45.5% of cases with muscular and perimembranous VSDs respectively (p = 0.001).Conclusion: Isolated muscular VSDs usually close spontaneously during pregnancy or in the first 2 years of life and probably do not increase the risk for chromosomal aberrations. On the other hand, isolated perimembranous VSDs may need intervention following birth and may be associated with a chromosomal anomaly.

背景与目标： ：目的：我们评估了由胎儿超声心动图诊断出的不同类型的孤立室间隔缺损（VSD）的自然史，并分析了其出生后的结局。方法：这是一项回顾性队列研究，研究对象是7466例连续超声心动图检查的86例具有孤立VSD的胎儿。考试。在胎儿生命期间和以后的出生中评估了VSD的亚型和大小。分析了有关VSD自发闭合，需要干预，其他异常情况和染色体畸变的数据。结果：从最初的队列中分离出的75例VSD患者中，进一步获得了关于结局的完整数据。分别在85.3和14.7％处发现肌肉和膜周VSD。 VSDs的自发性关闭发生在产前分别为肌肉VSD和膜周VSD的胎儿的31/64和3/11。分别在92.2岁和24.5岁时出现肌肉和膜周VSD的患者自发关闭VSD，分别为92.2和45.5％（p = 0.001）。结论：孤立的肌肉VSD通常在怀孕期间或生命的前2年和5年内自发关闭。可能不会增加染色体畸变的风险。另一方面，孤立的膜周性VSD可能在出生后需要干预，并且可能与染色体异常有关。

BACKGROUND & AIMS: :Doppler ultrasound recordings of velocities of flow across the mitral and tricuspid valves and in the hepatic veins, and their variation with respiration, were recorded in seven patients with constrictive pericarditis and in six patients with restrictive cardiomyopathy. Deceleration of mitral and tricuspid flow was also evaluated during apnea. Color flow Doppler was performed in order to evaluate mitral and tricuspid regurgitation. Eight healthy adults served as controls. The patients with constrictive pericarditis showed higher peak diastolic velocities of mitral flow, as well as marked increase of velocity of flow at the onset of expiration and decrease at the onset of inspiration. Reciprocal respiratory variation of the velocities were also observed across the tricuspid valve. The patients with restrictive cardiomyopathy showed moderate or severe mitral and tricuspid regurgitation. They also showed shorter deceleration of flow across the mitral and tricuspid valves during apnea. The pattern of flow in the hepatic veins showed reversal during systole with accentuated reversion during inspiration. These results suggest that patient with constrictive pericarditis and restrictive cardiomyopathy can be differentiated by comparing Doppler echocardiographic data, along with changes induced by respiration.

背景与目标： 多普勒超声记录了二尖瓣和三尖瓣以及肝静脉中的流速及其随呼吸的变化，记录了7例收缩性心包炎患者和6例限制性心肌病患者。在呼吸暂停期间还评估了二尖瓣和三尖瓣血流的减速度。进行彩色多普勒检查以评估二尖瓣和三尖瓣关闭不全。八名健康成年人作为对照。收缩性心包炎患者的二尖瓣血流舒张峰值速度较高，并且在呼气开始时血流速度明显增加，在吸气开始时血流速度明显降低。在三尖瓣上也观察到速度的相互呼吸变化。限制性心肌病患者表现为中度或重度二尖瓣和三尖瓣关闭不全。他们还显示了在呼吸暂停期间，穿过二尖瓣和三尖瓣的血流的减速更短。肝静脉的血流模式在收缩期出现逆转，在吸气时出现明显的逆转。这些结果表明，可以通过比较多普勒超声心动图数据以及呼吸引起的变化来区分患有缩窄性心包炎和缩窄性心肌病的患者。

BACKGROUND & AIMS: OBJECTIVE:Cardiac involvement is the most important cause of mortality in juvenile systemic sclerosis (JSSc). Recent reports in adult patients underline that traditional techniques of imaging are inadequate to assess the subclinical cardiac involvement, while speckle tracking echocardiography (STE) is able to identify ventricular dysfunctions in the early stages. The aim of our study was to assess the role of STE in JSSc. METHODS:Demographic, clinical and laboratory data were collected from patients with JSSc. Cardiac investigations performed at baseline (T0) and 18 (T18) and 36 months (T36) follow-up included electrocardiography, conventional echocardiography with measurement of the ejection fraction (EF) and STE with assessment of left and right ventricular global longitudinal strain (LV-GLS and RV-GLS). Cardiac parameters have been compared with demographic characteristics and disease severity, assessed by the Juvenile Systemic Sclerosis Severity Score (J4S). RESULTS:A total of 18 patients, 12 (67%) females, entered the study. At T0, electrocardiography was abnormal in three patients, EF was reduced in one, LV-GLS was abnormal in three (16.7%) and RV-GLS was abnormal in five (27.8%). At T18, EF remained stable while at T36 the result decreased in seven of nine patients. At the same time, LV-GLS also worsened (from -21.6% to -18.2%, P = 0.01). LV-GLS and RV-GLS at baseline showed a significant correlation with J4S (P = 0.012 and P = 0.02, respectively). CONCLUSION:STE is more sensitive than standard echocardiography to identify cardiac involvement in JSSc. Over time, we observed a gradual worsening of LV-GLS, a sign of left ventricular dysfunction, that anticipated by several months the decrease of EF.

背景与目标： 目的：心脏受累是青少年系统性硬化症（JSSc）死亡的最重要原因。成人患者的最新报道强调，传统的成像技术不足以评估亚临床心脏受累，而散斑跟踪超声心动图（STE）能够在早期识别出心室功能障碍。我们研究的目的是评估STE在JSSc中的作用。
方法：收集JSSc患者的人口统计学，临床和实验室数据。在基线（T0），18（T18）和36个月（T36）随访时进行的心脏检查包括心电图检查，常规超声心动图检查（测量射血分数（EF））和STE（评估左心室和右心室总纵向应变（LV）） -GLS和RV-GLS）。已通过青少年系统性硬化症严重程度评分（J4S）对心脏参数与人口统计学特征和疾病严重程度进行了比较。
结果：总共18位患者，其中12位女性（67％）进入了研究。在T0时，三名患者的心电图异常，一例EF降低，三例（16.7％）的LV-GLS异常，五例（27.8％）的RV-GLS异常。在T18时，EF保持稳定，而在T36时，九名患者中的七名患者的结果下降。同时，LV-GLS也恶化了（从-21.6％降至-18.2％，P = 0.01）。基线时的LV-GLS和RV-GLS与J4S呈显着相关性（分别为P = 0.012和P = 0.02）。
结论：STE比标准超声心动图对识别JSSc的心脏受累更为敏感。随着时间的流逝，我们观察到左室功能不全的迹象LV-GLS逐渐恶化，预计几个月后EF会下降。

BACKGROUND & AIMS: :The aims of this study were to review the prevalence and outcome of all surgically treated upper and lower limb emboli presenting to one vascular unit in the last 3 years and to compare transthoracic with transesophageal echocardiography for defining the source of the embolus. All patients who underwent surgical embolectomy for acute limb ischemia from January 2001 to June 2004 were reviewed. Transthoracic and transesophageal echocardiography were carried out on a subset of consecutive unselected patients. Forty-two patients, with a mean age of 80 years, underwent surgical embolectomy from January 2001 to June 2004 (M/F 1:1.8): 27 for lower limb ischemia and 15 for upper limb ischemia. Two thirds of these patients were found to be in atrial fibrillation at presentation (n = 28), of whom less than a third were receiving anticoagulants or antiplatelet agents (n = 8). The mean hospital stay was 15 days with 36 patients (86%) being fully anticoagulated before discharge from hospital. The 30-day mortality rate was 11% (n = 3/27) with 5 patients requiring fasciotomies (12%) and 3 patients requiring an amputation of the lower limb (11%). Postoperatively, 34 patients (81%) had transthoracic echocardiography (TTE), which demonstrated a source or potential source for thrombus in 19 (56%). Fifteen patients (36%) had transesophageal echocardiography (TEE), which changed the subsequent management in 3 patients. All patients in whom TEE altered clinical management would have required this investigation if standard clinical guidelines were followed. TEE did not identify any additional patients with cardiac embolic sources that were not detected by TTE. Arterial limb emboli are still prevalent, but limb salvage and mortality rates appear to be improving. Despite clear guidelines on anticoagulation for patients in atrial fibrillation, many are not receiving appropriate treatment. Transthoracic echocardiography is a good screening tool for detecting a potential cardiac source for peripheral embolism, with transesophageal echocardiography being reserved for specific indications.

背景与目标： ：这项研究的目的是回顾过去3年中所有接受手术治疗的上肢和下肢栓塞在一个血管内的发生率和结局，并比较经胸和经食道超声心动图检查来确定栓子的来源。回顾性分析了2001年1月至2004年6月所有因急性肢体缺血而行外科手术栓塞切除术的患者。经胸和经食道超声心动图检查是对连续的未选择患者的子集进行的。 2001年1月至2004年6月，平均年龄为80岁的42例患者接受了手术栓塞切除术（M / F 1：1.8）：下肢缺血27例，上肢缺血15例。这些患者中有三分之二被发现存在房颤（n = 28），其中不到三分之一接受抗凝剂或抗血小板药物（n = 8）。平均住院时间为15天，其中36例患者（86％）在出院前已充分抗凝。 30天死亡率为11％（n = 3/27），其中5位需要进行筋膜切开术的患者（12％）和3位需要下肢截肢的患者（11％）。术后34例（81％）患者经胸超声心动图（TTE），其中19例（56％）证明有血栓来源或潜在来源。 15例患者（36％）进行了食管超声心动图检查（TEE），这改变了3例患者的后续治疗方法。如果遵循标准的临床指南，所有TEE改变了临床管理的患者都需要进行此项调查。 TEE并未发现TTE未发现的任何其他具有心脏栓塞源的患者。动脉肢体栓塞仍很普遍，但肢体抢救和死亡率似乎正在提高。尽管对房颤患者的抗凝治疗有明确的指导原则，但许多人并未得到适当的治疗。经胸超声心动图检查是一种很好的筛查工具，可用于检测周围性栓塞的潜在心脏源，保留经食道超声心动图检查以用于特定适应症。

BACKGROUND & AIMS: :Automated visual tracking of cells from video microscopy has many important biomedical applications. In this paper, we track human monocyte cells in a fluorescent microscopic video using matching and linking of bipartite graphs. Tracking of cells over a pair of frames is modeled as a maximum cardinality minimum weight matching problem for a bipartite graph with a novel cost function. The tracking results are further refined using a rank-based filtering mechanism. Linking of cell trajectories over different frames are achieved through composition of bipartite matches. The proposed solution does not require any explicit motion model, is highly scalable, and, can effectively handle the entry and exit of cells. Our tracking accuracy of (97.97±0.94)% is superior than several existing methods [(95.66±2.39)%, (94.42±2.08)%, (81.22±5.75)%, (78.31±4.70)%] and is highly comparable (98.20±1.22)% to a recently published algorithm.

背景与目标： 从视频显微镜对细胞进行自动视觉跟踪具有许多重要的生物医学应用。在本文中，我们使用二分图的匹配和链接在荧光显微视频中跟踪人单核细胞。一对框架上的单元格跟踪被建模为具有新颖成本函数的二部图的最大基数最小权重匹配问题。使用基于等级的过滤机制进一步完善跟踪结果。通过二分匹配的组成，可以实现不同框架上细胞轨迹的链接。提出的解决方案不需要任何显式的运动模型，具有高度可伸缩性，并且可以有效地处理单元的进入和退出。我们的（97.97±0.94）％跟踪精度优于几种现有方法[（95.66±2.39）％，（94.42±2.08）％，（81.22±5.75）％，（78.31±4.70）％]，并且具有很高的可比性（ 98.20±1.22）％至最近发布的算法。

BACKGROUND & AIMS: OBJECTIVE:To evaluate the feasibility of electron beam tomography (EBT) for morphological assessment of congenital heart disease. MATERIALS AND METHODS:Sixteen subjects were examined by EBT, transthoracic echocardiography, cardiac cine angiography and surgery. EBT scan was performed using single slice continuous volume mode to acquire high-resolution static image. Double dose contrast medium was injected by bolus technique after measuring scan delay time and calculation of proper injection rate. The results of EBT and echocardiography were compared based on the results of cardiac cine angiography and surgical findings. All anomalous components were evaluated in all subjects and grouped according to major cardiac structures. Statistical analysis was performed to compare two modalities' ability to evaluate the anomalies of major structures. RESULTS:EBT was more sensitive to evaluate the anomalies of systemic vessels, pulmonary vessels and small systemic arteries such as coronary artery. EBT was less sensitive to identify the abnormality of cardiac valves such as valvular regurgitation. There was no difference of sensitivity in evaluation of cardiac chambers and septa between the two modalities. CONCLUSION:EBT assisted by transthoracic echocardiography is excellent noninvasive modality to diagnose congenital heart disease.

背景与目标： 目的：评价电子束断层扫描（EBT）在先天性心脏病形态学评估中的可行性。
材料与方法：对16名受试者进行了EBT，经胸超声心动图，心脏血管造影和手术检查。使用单切片连续体积模式执行EBT扫描，以获取高分辨率的静态图像。在测量扫描延迟时间并计算适当的注射速率后，通过推注技术注射双剂量造影剂。根据心脏血管造影结果和手术结果比较了EBT和超声心动图检查的结果。在所有受试者中评估所有异常成分，并根据主要心脏结构进行分组。进行统计分析以比较两种方式评估主要结构异常的能力。
结果：EBT对评估系统性血管，肺血管和小系统性动脉（如冠状动脉）异常更为敏感。 EBT对识别心脏瓣膜异常（如瓣膜返流）的敏感性较低。两种方式之间在评估心腔和间隔方面的敏感性没有差异。
结论：经胸超声心动图辅助EBT是诊断先天性心脏病的极佳无创方法。

BACKGROUND & AIMS: OBJECTIVES:This study investigated whether the measurement of mitral annulus displacement by the tissue-tracking method with Doppler-tissue images can provide more accurate information on the severity of heart failure compared to conventional methods, such as left ventricular ejection fraction (LVEF). BACKGROUND:Impaired left ventricular function is an important predictor of poor prognosis. Although LVEF has been used to assess left ventricular function, such indicators do not necessarily correlate well to clinical variables such as New York Heart Association (NYHA) functional class or plasma brain natriuretic peptide (BNP) concentration. METHODS:In 90 subjects with or without various heart diseases, mitral annulus displacement was measured by the tissue-tracking method with Doppler-tissue images and the correlations evaluated with NYHA functional class, plasma BNP concentration, left ventricular mass index and Tei index. RESULTS:Mitral annulus displacement by the tissue-tracking method with Doppler-tissue images was well correlated with NYHA functional class and plasma BNP concentration. LVEF was also correlated with these clinical variables, but significantly more weakly. Furthermore, mitral annulus displacement by the tissue-tracking method with Doppler-tissue images was correlated with left ventricular mass index and Tei index, which indicate left ventricular systolic and diastolic function. CONCLUSIONS:The present study suggests that mitral annulus displacement measured by our technique is a useful and reliable method for assessing the severity of heart failure.

背景与目标： 目的：本研究调查了使用多普勒组织图像的组织追踪方法测量二尖瓣环移位是否可以提供比常规方法（如左心室射血分数（LVEF））更准确的心力衰竭严重程度信息。
背景：左心室功能受损是预后不良的重要预测指标。尽管LVEF已用于评估左心室功能，但此类指标不一定与临床变量（例如纽约心脏协会（NYHA）功能类别或血浆脑钠肽（BNP）浓度）具有良好的相关性。
方法：对90例患有或未患有多种心脏病的受试者，采用多普勒组织图像组织追踪法测量二尖瓣环移位，并通过NYHA功能类别，血浆BNP浓度，左心室质量指数和Tei指数评估相关性。
结果：采用多普勒组织图像的组织追踪法检测二尖瓣环移位与NYHA功能类别和血浆BNP浓度密切相关。 LVEF也与这些临床变量相关，但明显较弱。此外，采用多普勒组织图像的组织追踪法进行的二尖瓣环移位与左心室质量指数和Tei指数相关，表明左心室收缩和舒张功能。
结论：本研究表明，用我们的技术测量的二尖瓣环移位是评估心力衰竭严重程度的一种有用且可靠的方法。

BACKGROUND & AIMS: :From the time of its introduction as a clinical tool in the early 1970s, efforts have been made to use echocardiography to characterize the atrium and its function as these relate to attempted cardioversion and embolic risk. M-mode and 2-D echo studies suggest left atrial size is not a definitive determinant of the potential for successful cardioversion. Doppler studies show that atrial function can take weeks to recover postcardioversion, accounting in part for the delayed embolic risk. TEE is particularly effective at detecting atrial thrombi and shows that slow velocities in the atrium and appendage are an important risk factor for embolism and clot. All are associated with the finding of spontaneous echo contrast and atrial stunning postcardioversion. The ultimate role of TEE in management is not yet fully defined. The insights these and other studies provide to our understanding of atrial physiology and the appropriate management of atrial fibrillation are reviewed.

背景与目标： ：自1970年代初将其引入临床以来，人们就一直在努力使用超声心动图来表征心房及其功能，因为它们与尝试的心脏复律和栓塞风险有关。 M型和二维回声研究表明，左心房大小不是成功复律潜力的决定性因素。多普勒研究表明，心房功能可能需要数周的时间才能恢复原位复律，部分原因是延迟的栓塞风险。 TEE在检测心房血栓方面特别有效，并且显示出心房和附件的速度缓慢是栓塞和血栓形成的重要危险因素。所有这些都与自发的回声对比和心房惊厥性复律的发现有关。 TEE在管理中的最终作用尚未完全定义。这些研究和其他研究为我们对心房生理的理解提供了见识，并对房颤的适当管理进行了综述。

BACKGROUND & AIMS: :Despite significant progress in understanding protein trafficking and compartmentation in plants, the identification and protein compartmentalization for organelles that belong to both the secretory and endocytic pathways have been difficult because protein trafficking has generally been studied separately in these two pathways. However, recent data indicate that the trans-Golgi network serves as an early endosome merging the secretory and endocytic pathways in plant cells. Here, we discuss the proteins identified as markers for post-Golgi compartments in these two pathways and propose that the trans-Golgi network is a pivotal organelle with multiple sorting domains for post-Golgi protein trafficking in plant cells.

背景与目标： ：尽管在理解植物中蛋白质运输和分隔方面取得了重大进展，但同时属于分泌和内吞途径的细胞器的鉴定和蛋白质分隔仍然很困难，因为通常在这两种途径中分别研究了蛋白质运输。但是，最近的数据表明，反式高尔基体网络充当了融合植物细胞分泌途径和内吞途径的早期内体。在这里，我们讨论被鉴定为这两种途径中高尔基体后区标记的蛋白质，并提出反式高尔基体网络是具有多个排序域的关键细胞器，用于植物细胞中高尔基体后蛋白的运输。

BACKGROUND & AIMS: :We propose a new optical coherence tomography (OCT) based method to measure red blood cell (RBC) velocities of single capillaries in the cortex of rodent brain. This OCT capillary velocimetry exploits quantitative laser speckle contrast analysis to estimate speckle decorrelation rate from the measured temporal OCT speckle signals, which is related to microcirculatory flow velocity. We hypothesize that OCT signal due to sub-surface capillary flow can be treated as the speckle signal in the single scattering regime and thus its time scale of speckle fluctuations can be subjected to single scattering laser speckle contrast analysis to derive characteristic decorrelation time. To validate this hypothesis, OCT measurements are conducted on a single capillary flow phantom operating at preset velocities, in which M-mode B-frames are acquired using a high-speed OCT system. Analysis is then performed on the time-varying OCT signals extracted at the capillary flow, exhibiting a typical inverse relationship between the estimated decorrelation time and absolute RBC velocity, which is then used to deduce the capillary velocities. We apply the method to in vivo measurements of mouse brain, demonstrating that the proposed approach provides additional useful information in the quantitative assessment of capillary hemodynamics, complementary to that of OCT angiography.

背景与目标： ：我们提出了一种新的基于光学相干断层扫描（OCT）的方法来测量啮齿动物大脑皮层中单个毛细血管的红细胞（RBC）速度。该OCT毛细管测速仪利用定量激光散斑对比度分析来根据测得的时间OCT散斑信号估计散斑去相关率，这与微循环流速有关。我们假设，由于表面下毛细血管流动而产生的OCT信号在单个散射状态下可被视为散斑信号，因此，其散斑波动的时间尺度可以进行单散射激光散斑对比度分析，以得出特征去相关时间。为了验证该假设，在以预设速度运行的单个毛细管流动体模上进行了OCT测量，其中使用高速OCT系统获取M模式B帧。然后对在毛细管流处提取的随时间变化的OCT信号进行分析，表现出估计的去相关时间与绝对RBC速度之间的典型反比关系，然后将其用于推导毛细管速度。我们将该方法应用于小鼠大脑的体内测量，证明了所提出的方法在定量评估毛细血管血流动力学方面提供了更多有用的信息，与OCT血管造影技术相辅相成。

BACKGROUND & AIMS: OBJECTIVES:To explore whether the use of four dimensional (4D) ultrasound examination with B-flow imaging and spatiotemporal image correlation (STIC) can supply additional information with respect to two-dimensional (2D) gray-scale and color Doppler echocardiography in the prenatal characterization of isolated total anomalous pulmonary venous connection (TAPVC). METHODS:The study population comprised a group of three TAPVC fetuses that had been examined exclusively by conventional echocardiography, and a group of four additional cases initially identified by conventional echocardiography and examined further by 4D ultrasonography; a thorough postnatal work-up was available for all fetuses. RESULTS:At our center, isolated TAPVC was found in seven of 1040 fetuses with cardiac defects (0.67%). Anomalous drainage was supracardiac to the innominate vein in three cases, cardiac to the coronary sinus in two, and infracardiac to the portal vein in the remaining two cases. An evident asymmetry between left heart and right heart structures was observed in 4/7 cases. The confluence of the anomalous pulmonary veins (PVs) was visualized in 4/7 cases and the connecting vertical vein was identified in 3/5 cases at 2D echocardiography. 4D ultrasound imaging with B-flow imaging and STIC clearly visualized the anomalous PV confluence and the draining vertical vein in all four cases examined. CONCLUSION:2D and color Doppler echocardiography appears to diagnose reliably TAPVC, albeit with some limitations in thorough assessment of the pathology, depending on the anatomy of the defect, on the technical adequacy of the equipment used and on the experience of the operator. 4D ultrasound examination with B-flow imaging and STIC is apparently able to facilitate identification of the anatomical features of TAPVC, thus supplying additional information over that provided by 2D fetal sonography.

背景与目标： 目的：探讨将二维（4D）超声检查与B型流成像和时空图像相关性（STIC）结合使用是否可以提供有关产前二维（2D）灰度和彩色多普勒超声心动图的其他信息孤立性总异常肺静脉连接（TAPVC）的特征。
方法：研究人群包括三只经常规超声心动图检查的TAPVC胎儿，以及另外四例最初由常规超声心动图检查确定并进一步由4D超声检查的病例。所有胎儿均可进行全面的产后检查。
结果：在我们中心，在1040例有心脏缺陷的胎儿中，有7例被发现分离出TAPVC（0.67％）。异常引流在无创静脉上流至无名静脉3例，心脏向冠状窦2例，在门下至门静脉的其余2例。在4/7例中，观察到左心脏和右心脏结构之间存在明显的不对称性。在二维超声心动图检查中，在4/7例中可见肺静脉异常（PVs）汇合处，在3/5例中发现了连接垂直静脉。在所有四个检查的病例中，带有B型流成像和STIC的4D超声成像可以清楚地看到异常的PV融合和引流的垂直静脉。
结论：二维和彩色多普勒超声心动图似乎可以可靠地诊断TAPVC，尽管在彻底评估病理学方面存在一定的局限性，这取决于缺陷的解剖结构，所用设备的技术充分性以及操作员的经验。带有B型流成像和STIC的4D超声检查显然能够促进TAPVC解剖特征的识别，从而提供了比2D胎儿超声检查所提供的更多信息。

BACKGROUND & AIMS: :In this study, the left atrial appendage (LAA) structure and morphology were assessed using real-time three-dimensional transesophageal echocardiography (RT3D-TEE) and enhanced cardiac computed tomography (CT) scanning, and the two measurements obtained using these different techniques were compared. Two hundred nonvalvular atrial fibrillation (NVAF) patients who were prepared to undergo radiofrequency ablation were enrolled, and 62 controls were enrolled prospectively. RT3D-TEE and CT were performed, and the following parameters were measured: LAA orifice diameter, area, depth, maximum volume, and emptying velocity. The differences between the NVAF patients and controls were compared, and the differences and correlations in the LAA parameters between the two imaging techniques were assessed. The NVAF patients had significantly bigger orifice sizes, orifice areas, and maximum volumes, and lower emptying rates. The AF cohort had roughly equal proportions of the four morphological types, whereas the controls predominantly had the windsock type. A Bland-Altman analysis demonstrated that the LAA measurements obtained using RT3D-TEE were lower than those obtained with the CT. However, linear regression analysis showed the good correlations between the RT3D-TEE and CT measurements of the LAA orifice area, depth and volume (r = 0.86, 0.63, and 0.75, respectively). The use of RT3D-TEE for the visualization and quantitative analysis of LAA parameters is feasible, and the obtained measurements correlate well with those obtained with cardiac CT. This technique may be an ideal tool for guiding LAA occlusion procedures, and combining these two methods may enhance the accuracy of LAA measurements.

背景与目标： ：在这项研究中，使用实时三维经食道超声心动图（RT3D-TEE）和增强型心脏计算机断层扫描（CT）扫描评估了左心耳（LAA）的结构和形态，并使用这些不同的技术获得了两次测量结果进行比较。入选了准备进行射频消融的200例非瓣膜性心房颤动（NVAF）患者，并前瞻性纳入62例对照。进行了RT3D-TEE和CT，并测量了以下参数：LAA孔直径，面积，深度，最大体积和排空速度。比较了NVAF患者和对照组之间的差异，并评估了两种成像技术之间LAA参数的差异和相关性。 NVAF患者的孔口尺寸，孔口面积和最大容积明显更大，并且排空率较低。 AF队列在四种形态学类型中所占比例大致相等，而对照组则主要是风向袋类型。 Bland-Altman分析表明，使用RT3D-TEE获得的LAA测量值低于使用CT获得的LAA测量值。但是，线性回归分析显示RT3D-TEE与LAA孔口面积，深度和体积的CT测量值之间具有良好的相关性（分别为r = 0.86、0.63和0.75）。使用RT3D-TEE进行LAA参数的可视化和定量分析是可行的，并且所获得的测量结果与心脏CT所获得的测量结果具有良好的相关性。该技术可能是指导LAA闭塞手术的理想工具，并且将这两种方法结合起来可以提高LAA测量的准确性。

BACKGROUND & AIMS: BACKGROUND:The ratio of mitral inflow early diastolic velocity (E) to annulus velocity (E') might be critical for the assessment of an abnormal filling pressure for patients with myocardial ischemia. OBJECTIVES:We sought to determine whether a quantitative estimation of E/E' provides more reliable information for detecting coronary artery disease during dobutamine stress echocardiography. METHODS:A total of 82 patients suggested to have angina pectoris underwent Doppler studies during dobutamine stress echocardiography. The value of E and E' were measured at baseline and peak dose of dobutamine stress. The value of E/E' during stress over that at rest was defined as the E/E' index. RESULTS:Patients who had significant stenosis by coronary angiogram were classified as being in group A (n = 45) and those with no coronary artery disease were classified as being in group B (n = 37). Dobutamine infusion led to a significant increase of E/E' in group A, whereas no changes were found with group B. Likewise, larger E/E' index was also observed for patients with multivessel disease. The value of E/E' index increased proportionally with the number of stenotic vessels, implying a direct correlation of the E/E' value to the extent of myocardial ischemia. CONCLUSIONS:E/E' offers a quantitative estimation of myocardial ischemia during dobutamine stress echocardiography, thereby, providing a reliable and accurate method for the evaluation of coronary artery disease.

背景与目标： 背景：二尖瓣流入舒张早期速度（E）与瓣环速度（E'）之比对于评估心肌缺血患者的异常充盈压可能至关重要。
目的：我们试图确定E / E'的定量估计是否为在多巴酚丁胺应力超声心动图检查中检测冠状动脉疾病提供更可靠的信息。
方法：在多巴酚丁胺负荷超声心动图检查期间，共有82例建议患有心绞痛的患者接受了多普勒检查。在基线和多巴酚丁胺应激的峰值剂量下测量E和E'的值。压力期间的E / E'值大于静止时的E / E'值定义为E / E'指数。
结果：冠状动脉造影显着狭窄的患者被归为A组（n = 45），无冠状动脉疾病的患者被归为B组（n = 37）。多巴酚丁胺输注导致A组E / E'显着增加，而B组未见变化。同样，多支血管疾病患者也观察到较大的E / E'指数。 E / E'指数的值与狭窄血管的数量成比例地增加，这意味着E / E'值与心肌缺血程度直接相关。
结论：E / E'可定量评估多巴酚丁胺负荷超声心动图期间的心肌缺血，从而为评估冠状动脉疾病提供可靠而准确的方法。