Purpose: It is known that the perflubutane microbubbles (PFBs) of Sonazoid®, a contrast medium used for the ultrasonic diagnosis of tumor lesions, disintegrate easily when pressure is applied. The purpose of this study was to quantitatively examine the pressure at which PFBs disintegrate and to evaluate the number and size of PFBs and their contrast effect to establish a standard when administering contrast media.
Subjects and Methods: Pressurization was performed by connecting a syringe containing Sonazoid®PFBs to a syringe pump, which was operated with a closed syringe port. A pressure sensor was attached to the syringe port to evaluate the changes in the properties and quantity of PFBs due to the differences in pressure. Furthermore, an original phantom was prepared, and the contrast effect of PFBs was examined after the pressurization.
Results and Discussion: The number of PFBs decreased with pressurization; it decreased by about 60% with pressures ≥900 mmHg. At 900–1,000 mmHg, PFBs that were ≥2–3 µm in size, which play an important role in the contrast effect, collapse, and a hypoechoic ultrasonic image was also displayed in the contrast medium administration part of the original phantom.
Conclusion: This study quantitatively examined the pressure at which PFBs can maintain the contrast effect. PFBs decreased when the pressure was ≥900 mmHg, and a pressure of 1,000 mmHg affected the contrast effect.
Purpose: This study investigated the characteristics of diastolic left ventricular vortex in young healthy subjects using vector flow mapping (VFM).
Subjects and Methods: Twenty-eight young healthy adults (16 males, mean age: 22±1 years) were enrolled. Color Doppler loops were acquired for VFM using the apical long-axis view, after which the incidence of left ventricular vortex during diastole and the correlation between the circulation during diastole and echocardiographic parameters were examined.
Results and Discussion: During the early diastole, vortices were detected in 28/28 (100.0%) and 23/28 patients (82.1%) on the anterior and posterior mitral leaflets, respectively. A vortex was observed in 19/28 patients (67.9%) during the mid-diastole in the left ventricle, 19/28 patients (67.9%) on the anterior side, and 1/28 patients (3.6%) on the posterior side during atrial contraction. Circulation in the early diastole was significantly higher on the anterior leaflet than on the posterior leaflet (p＜0.001). Circulation on both mitral leaflets was significantly correlated with E wave velocity, E/A, and e′; however, echocardiographic values showed no significant correlation with circulation in the mid-diastole and atrial contraction phase. In young healthy adults, the incidence of diastolic left ventricular vortices varied according to time phase, and early diastolic vortex intensity was associated with left ventricular relaxation.
Conclusion: Characteristic findings were found for the diastolic left ventricular vortex observed via VFM in healthy young adults. Vortex analysis may be a novel method for evaluating left ventricular relaxation.
Eosinophilic gastroenteritis is a rare disease. The age of onset varies from children to adults. Mucosa or submucosa thickening is the main cause of eosinophilic gastroenteritis in many cases in Japan; however, its diagnosis is difficult because the site of occurrence is the entire gastrointestinal tract. We herein report the case of an under 6-yerar-old girl who was admitted to our hospital due to abdominal pain, diarrhea, and bloody stools. Ultrasonography revealed thickening of the wall, mainly in the submucosa, from the descending colon to the rectum. Moreover, strong echoes in the wall, suspected as ulcers, could be confirmed during exacerbation. Since an increase in blood eosinophils, appearance of fecal eosinophils, and an increase in IgE were observed, eosinophil gastroenteritis was suspected and prednisolone administration was initiated. Consequently, a definitive diagnosis of eosinophilic gastroenteritis was made from the tissue collected by colonoscopy. Ultrasonography is an important part of the first screening in pediatric abdominal pain patients from the radiation dose viewpoint. Although it never leads to a definitive diagnosis, the main role of ultrasonography is to follow the course while giving attention to the eosinophil level when eosinophilic gastroenteritis is suspected.