[Background] Clinical usefulness of novel 2D speckle tracking echocardiography and derived strain measurement that allows objectively regional myocardial motion independent of cardiac translation and Doppler angle was reported.
[Objective] The aim of this study was to evaluate the 2D strain for the regional myocardial deformation after cardiopulmonary bypass (CPB) operation.
[Method] We studied the radial peak stain value (RPS) at the LV short axis cross-sections (papillary muscle level) in 17 out of 26 patients (mean age: 67+/−13 years) who had valvular disease, congenital heart disease and resection for atrial thrombus. None of the patients had coronary artery disease. Using an iE33 echocardiographic system (Philips Medical System, Andover, MA, USA) equipped with a broad-band phased-array S5-1 transducer, RPS was measured at the area of left anterior descending artery (LAD), left circumflex artery (LCX) and right coronary artery by direct strain method. Cardioplegia infusion was delivered through the anterograde approach (ANT) in 9 patients and by the retrograde approach (RETRO) in 8 patients. The value of ΔRPS was expressed as the RPS percentage of change that occurred after versus before the CPB operation.
[Results] After the CPB operation, RPS decreased significantly from 34.3±9.3% to 19.1±8.6% in the LAD area (p<0.0001), from 38.7±9.9% to 23.5±11.0% in the LCX area (p<0.0001), and from 35.4±12.3% to 24.8±11.3% in the RCA area (p=0.0033). The ΔRPS in the LAD area was significantly higher than that in the RCA area (p=0.03). There was no significant difference in ΔRPS between ANT and RETRO. However, in RETRO, ΔRPS was higher than those in the LCX and the RCA area. In the RCA area, there was a significant correlation between ΔRPS and CK-MB release (r=−0.566, p<0.05). In contrast, there was no correlation between ΔRPS and CK-MB release in either the LAD or the LCX area.
[Conclusion] These data suggest that regional myocardial deformation after CPB operation appeared predominantly in the LAD area. The contraction in the RCA area may be for compensation in the impaired myocardial deformation area.

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Purpose: Thyroid ultrasound (US) with two dimensional (2-D) probe and 3-D volumetric probe was performed in healthy adults to determine appropriate coefficient in evaluating thyroid gland volume using ellipsoid formula. Subjects and Methods: 29 adults with normal thyroid function and negative anti-thyroid antibodies underwent thyroid ultrasound using 2-D probe and 3-D volumetric probe. In 2-D US, Thyroid volume (V) was calculated using ellipsoid formula (V=A×width×length×depth, where A=coefficient) with varied coefficients (0.47, 0.52 and 0.7). In 3-D US, volume was calculated by multi-planar volume approximation and data processing software. Results from 2-D US were compared with those from 3-D US, which was considered as the standard in our study. Results and Discussion: Significant correlation was observed between thyroid volume determined by 2-D US with varied coefficients vs that by 3-D US. The average volume of thyroid gland (cm3) by 2-D US with coefficient of 0.47, 0.52, and 0.7 and that by 3-D volumetric probe were 9.4±3.7, 10.2±4.0, and 13.7±5.4 and 13.4±5.0, respectively. Results from 2-D US using coefficient of 0.47 and 0.52 were smaller than those from 3-D US (p<0.05). With the use of 0.7 as a coefficient, thyroid volume from 2-D US was comparable to that from 3-D US. Conclusion: Our study suggests that coefficient of 0.7 gives appropriate results in evaluating thyroid volume by 2-D US and ellipsoid formula unless thyroid evaluate has substantial deformity or lumpy contour.

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