Xiaodong Zhou

Objectives: The aim of this study was to investigate the feasibility of contrast-enhanced ultrasound (CEUS)-guided microwave ablation for managing iatrogenic hepatic hemorrhage following percutaneous liver puncture. Materials and methods: This retrospective study analyzed six patients (5 males, 1 female; mean age 56.8 ± 12.3 years) with CEUS-confirmed active hepatic hemorrhage refractory to 10 min compression and Agkistrodon halflorum hemagglutinase administration after percutaneous liver puncture (2023–2024). Etiologies included portal vein cavernous transformation (n = 4) and therapeutic intervention complications (n = 2). All patients underwent CEUS-guided microwave ablation comprising three phases: bleeding site localization, real-time ultrasound-guided ablation, and immediate postprocedural verification (CEUS: n = 6; DSA: n = 2). The protocol was approved by the institutional ethics committee with written informed consent. Results: All six patients achieved immediate hemostasis (mean 2.8 min) through CEUS-guided microwave ablation with 100% technical/clinical success. Preprocedural localization combined color Doppler and CEUS, while intraoperative real-time guidance ensured precise microwave needle placement. Post-ablation verification relied on CEUS (n = 6) with DSA confirmation in two cases. No major complications occurred; one patient reported transient abdominal pain resolving spontaneously. All patients remained stable during 7-day follow-up with no delayed complications. Conclusions: This study suggests that CEUS-guided microwave ablation is a rapid, minimally invasive, and effective option for iatrogenic hepatic hemorrhage, warranting further validation in larger cohorts.

The integration of artificial intelligence (AI) into ultrasound medicine has revolutionized medical imaging, enhancing diagnostic accuracy and clinical workflows. This review focuses on the applications, challenges, and future directions of AI technologies, particularly machine learning (ML) and its subset, deep learning (DL), in ultrasound diagnostics. By leveraging advanced algorithms such as convolutional neural networks (CNNs), AI has significantly improved image acquisition, quality assessment, and objective disease diagnosis. AI-driven solutions now facilitate automated image analysis, intelligent diagnostic assistance, and medical education, enabling precise lesion detection across various organs while reducing physician workload. AI’s error detection capabilities further enhance diagnostic accuracy. Looking ahead, the integration of AI with ultrasound is expected to deepen, promoting trends in standardization, personalized treatment, and intelligent healthcare, particularly in underserved areas. Despite its potential, comprehensive assessments of AI’s diagnostic accuracy and ethical implications remain limited, necessitating rigorous evaluations to ensure effectiveness in clinical practice. This review provides a systematic evaluation of AI technologies in ultrasound medicine, highlighting their transformative potential to improve global healthcare outcomes.

Background: Ultrasound is ideal for displaying intracranial great vessels but not intracranial microvessels and terminal vessels. Even with contrast agents, the imaging effect is still unsatisfactory. In recent years, significant theoretical advances have been achieved in super-resolution imaging. The latest commonly used ultrafast plane-wave ultrasound Doppler imaging of the brain and microbubble-based super-resolution ultrasound imaging have been applied to the imaging of cerebral microvessels and blood flow in small animals such as mice but have not been applied to in vivo imaging of the cerebral microvessels in monkeys and larger animals. In China, preliminary research results have been obtained using super-resolution imaging in certain fields but rarely in fundamental and clinical experiments on large animals. In recent years, we have conducted a joint study with the Xi'an Jiaotong University to explore the application and performance of this new technique in the diagnosis of cerebrovascular diseases in large animals.Objective: To explore the characteristics and advantages of microbubble-based super-resolution ultrasound imaging of intracranial vessels in rhesus monkeys compared with conventional transcranial ultrasound.Methods: First, the effectiveness and feasibility of the super-resolution imaging technique were verified by modular simulation experiments. Then, the imaging parameters were adjusted based on in vitro experiments. Finally, two rhesus monkeys were used for in vivo experiments of intracranial microvessel imaging.Results: Compared with conventional plane-wave imaging, super-resolution imaging could measure the inner diameters of cerebral microvessels at a resolution of 1 mm or even 0.7 mm and extract blood flow information. In addition, it has a better signal-to-noise ratio (5.625 dB higher) and higher resolution (~30-fold higher). The results of the experiments with rhesus monkeys showed that microbubble-based super-resolution ultrasound imaging can achieve an optimal resolution at the micron level and an imaging depth >35 mm.Conclusion: Super-resolution imaging can realize the monitoring imaging of high-resolution and fast calculation of microbubbles in the process of tissue damage, providing an important experimental basis for the clinical application of non-invasive transcranial ultrasound.

Cerebral ischemia seriously threatens human health and is characterized by high rates of incidence, disability and death. Developing an ideal animal model of cerebral ischemia that reflects the human clinical features is critical for pathological studies and clinical research. The goal of this study is to establish a local cerebral ischemia model in rhesus macaque, thereby providing an optimal animal model to study cerebral ischemia. Eight healthy rhesus monkeys were selected for this study. CT scans were performed before the operation to exclude cerebral vascular and intracranial lesions. Under guidance and monitoring with digital subtraction angiography (DSA), a microcatheter was inserted into the M1 segment of the middle cerebral artery (MCA) via the femoral artery. Then, autologous white thrombi were introduced to block blood flow. Immediately following embolization, multisequence MRI was used to monitor cerebrovascular and brain parenchymal conditions. Twenty-four hours after embolization, 2 monkeys were sacrificed and subjected to perfusion, fixation and pathological examination. The cerebral ischemia model was established in 7 rhesus monkeys; one animal died during intubation. DSA and magnetic resonance angiography (MRA) indicated the presence of an arterial occlusion. MRI showed acute local cerebral ischemia. HE staining revealed infarct lesions formed in the brain tissues, and thrombi were present in the cerebral artery. We established a rhesus macaque model of local cerebral ischemia by autologous thrombus placement. This model has important implications for basic and clinical research on cerebral ischemia. MRI and DSA can evaluate the models to ensure accuracy and effectiveness.

Cerebrovascular diseases pose a serious threat to human survival and quality of life and represent a major cause of human death and disability. Recently, the incidence of cerebrovascular diseases has increased yearly. Rapid and accurate diagnosis and evaluation of cerebrovascular diseases are of great importance to reduce the incidence, morbidity and mortality of cerebrovascular diseases. With the rapid development of medical ultrasound, the clinical relationship between ultrasound imaging technology and the diagnosis and treatment of cerebrovascular diseases has become increasingly close. Ultrasound techniques such as transcranial acoustic angiography, doppler energy imaging, three-dimensional craniocerebral imaging and ultrasound thrombolysis are novel and valuable techniques in the study of cerebrovascular diseases. In this review, we introduce some of the new ultrasound techniques from both published studies and ongoing trials that have been confirmed to be convenient and effective methods. However, additional evidence from future studies will be required before some of these techniques can be widely applied or recommended as alternatives.

Immune Regulatory Genes Are Major Genetic Factors to Behcet Disease: Systematic Review