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Song E, Huang Y, Huang N, Mei Y, Yu X, Rogers JA. Recent advances in microsystem approaches for mechanical characterization of soft biological tissues. Microsyst Nanoeng 2022; 8:77. [PMID: 35812806 PMCID: PMC9262960 DOI: 10.1038/s41378-022-00412-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 05/20/2022] [Accepted: 06/08/2022] [Indexed: 06/09/2023]
Abstract
Microsystem technologies for evaluating the mechanical properties of soft biological tissues offer various capabilities relevant to medical research and clinical diagnosis of pathophysiologic conditions. Recent progress includes (1) the development of tissue-compliant designs that provide minimally invasive interfaces to soft, dynamic biological surfaces and (2) improvements in options for assessments of elastic moduli at spatial scales from cellular resolution to macroscopic areas and across depths from superficial levels to deep geometries. This review summarizes a collection of these technologies, with an emphasis on operational principles, fabrication methods, device designs, integration schemes, and measurement features. The core content begins with a discussion of platforms ranging from penetrating filamentary probes and shape-conformal sheets to stretchable arrays of ultrasonic transducers. Subsequent sections examine different techniques based on planar microelectromechanical system (MEMS) approaches for biocompatible interfaces to targets that span scales from individual cells to organs. One highlighted example includes miniature electromechanical devices that allow depth profiling of soft tissue biomechanics across a wide range of thicknesses. The clinical utility of these technologies is in monitoring changes in tissue properties and in targeting/identifying diseased tissues with distinct variations in modulus. The results suggest future opportunities in engineered systems for biomechanical sensing, spanning a broad scope of applications with relevance to many aspects of health care and biology research.
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Affiliation(s)
- Enming Song
- Shanghai Frontiers Science Research Base of Intelligent Optoelectronics and Perception, Institute of Optoelectronics, Fudan University, Shanghai, 200433 China
- International Institute of Intelligent Nanorobots and Nanosystems, Fudan University, Shanghai, 200433 China
| | - Ya Huang
- Department of Biomedical Engineering, City University of Hong Kong, Hong Kong, 999077 China
| | - Ningge Huang
- Department of Materials Science, Fudan University, Shanghai, 200433 China
| | - Yongfeng Mei
- International Institute of Intelligent Nanorobots and Nanosystems, Fudan University, Shanghai, 200433 China
- Department of Materials Science, Fudan University, Shanghai, 200433 China
| | - Xinge Yu
- Department of Biomedical Engineering, City University of Hong Kong, Hong Kong, 999077 China
| | - John A. Rogers
- Querrey Simpson Institute for Bioelectronics, Department of Materials Science and Engineering, Departments of Biomedical Engineering, Neurological Surgery, Chemistry, Mechanical Engineering, Electrical Engineering and Computer Science, Northwestern University, Evanston, IL 60208 USA
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Chen Y, Ding JL, Babaiasl M, Yang F, Swensen JP. Characterization and modeling of a thermoplastic elastomer tissue simulant under uniaxial compression loading for a wide range of strain rates. J Mech Behav Biomed Mater 2022; 131:105218. [DOI: 10.1016/j.jmbbm.2022.105218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 03/04/2022] [Accepted: 04/02/2022] [Indexed: 11/16/2022]
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Dong BT, Huang S, Lyu GR, Qin R, Gu JH. Assessment of liver fibrosis with liver and spleen stiffness measured by sound touch elastography, serum fibrosis markers in patients with chronic hepatitis B. J Dig Dis 2021; 22:342-350. [PMID: 33851510 DOI: 10.1111/1751-2980.12991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Revised: 04/07/2021] [Accepted: 04/11/2021] [Indexed: 12/11/2022]
Abstract
OBJECTIVES To evaluate the performance of liver stiffness (LS) and spleen stiffness (SS) by using the sound touch elastography (STE) technique and compare with those of the splenic index, aspartate transaminase-to-platelet ratio index (APRI), fibrosis-4 (FIB-4) index, King's score and combined models for diagnosing and staging fibrosis in chronic hepatitis B (CHB). METHODS One hundred patients with CHB underwent STE and serological tests. LS and SS values were measured with STE technique, and splenic index was calculated. Staging of fibrosis was determined with liver biopsy. Correlations between the individual parameters and the stage of fibrosis were evaluated with the Spearman correlation analysis. The area under the receiver operating characteristic curve (AUROC) was calculated to analyze the performance of all methods. RESULTS Among all individual parameters, LS showed the highest AUROC for diagnosing fibrosis of ≥S2, ≥S3, and S4 stages (AUROC: 0.70, 0.86, and 0.96, respectively; all P < 0.05). The AUROC of combined model 1 (LS and SS) and 2 (LS, SS, APRI, FIB-4 index, King's score) for diagnosing ≥S2, ≥S3, and S4 fibrosis were 0.70, 0.86, 0.97, and 0.70, 0.86, 0.96, respectively, which were higher than those of APRI, FIB-4 index and the King's score (P < 0.05). No significant differences were found between two combined models and LS for staging fibrosis (P > 0.05). CONCLUSIONS LS measurement is reliable for diagnosing and staging fibrosis in CHB, with a better performance than SS, splenic index and serum biomarkers. It is also comparable with the performance of combined models.
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Affiliation(s)
- Bing Tian Dong
- Department of Ultrasound, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian Province, China
| | - Shu Huang
- Department of Ultrasound, Chenggong Hospital Affiliated to Xiamen University, Xiamen, Fujian Province, China
| | - Guo Rong Lyu
- Department of Ultrasound, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian Province, China
| | - Ran Qin
- Department of Ultrasound, Chenggong Hospital Affiliated to Xiamen University, Xiamen, Fujian Province, China
| | - Jiong Hui Gu
- Department of Ultrasound, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China
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Petet TJ, Deal HE, Zhao HS, He AY, Tang C, Lemmon CA. Rheological characterization of poly-dimethyl siloxane formulations with tunable viscoelastic properties. RSC Adv 2021; 11:35910-35917. [PMID: 35492759 PMCID: PMC9043277 DOI: 10.1039/d1ra03548g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 10/24/2021] [Indexed: 12/04/2022] Open
Abstract
Studies from the past two decades have demonstrated convincingly that cells are able to sense the mechanical properties of their surroundings. Cells make major decisions in response to this mechanosensation, including decisions regarding cell migration, proliferation, survival, and differentiation. The vast majority of these studies have focused on the cellular mechanoresponse to changing substrate stiffness (or elastic modulus) and have been conducted on purely elastic substrates. In contrast, most soft tissues in the human body exhibit viscoelastic behavior; that is, they generate responsive force proportional to both the magnitude and rate of strain. While several recent studies have demonstrated that viscous effects of an underlying substrate affect cellular mechanoresponse, there is not a straightforward experimental method to probe this, particularly for investigators with little background in biomaterial fabrication. In the current work, we demonstrate that polymers comprised of differing polydimethylsiloxane (PDMS) formulations can be generated that allow for control over both the strain-dependent storage modulus and the strain rate-dependent loss modulus. These substrates requires no background in biomaterial fabrication to fabricate, are shelf-stable, and exhibit repeatable mechanical properties. Here we demonstrate that these substrates are biocompatible and exhibit similar protein adsorption characteristics regardless of mechanical properties. Finally, we develop a set of empirical equations that predicts the storage and loss modulus for a given blend of PDMS formulations, allowing users to tailor substrate mechanical properties to their specific needs. We have generated novel formulations of polydimethyl siloxane with varying viscoelastic properties that can be used to study cellular response. We present equations that can be used to predict the storage and loss moduli of these polymers.![]()
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Affiliation(s)
- Thomas J. Petet
- Department of Biomedical Engineering, Virginia Commonwealth University, Richmond, VA, USA
| | - Halston E. Deal
- Joint Department of Biomedical Engineering, North Carolina State University, University of North Carolina, Chapel Hill, Raleigh, NC, USA
- Comparative Medicine Institute, North Carolina State University, Raleigh, NC, USA
| | - Hanhsen S. Zhao
- Department of Biomedical Engineering, Virginia Commonwealth University, Richmond, VA, USA
| | - Amanda Y. He
- Department of Biology, Duke University, Durham, NC, USA
| | - Christina Tang
- Department of Biomedical Engineering, Virginia Commonwealth University, Richmond, VA, USA
- Department of Chemical and Life Science Engineering, Virginia Commonwealth University, Richmond, VA, USA
| | - Christopher A. Lemmon
- Department of Biomedical Engineering, Virginia Commonwealth University, Richmond, VA, USA
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Wang XP, Wang Y, Ma H, Wang H, Yang DW, Zhao XY, Jin EH, Yang ZH. Assessment of liver fibrosis with liver and spleen magnetic resonance elastography, serum markers in chronic liver disease. Quant Imaging Med Surg 2020; 10:1208-1222. [PMID: 32550131 DOI: 10.21037/qims-19-849] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Background The accurate assessment of liver fibrosis is essential for patients with chronic liver disease. A liver biopsy is an invasive procedure that has many potential defects and complications. Therefore, noninvasive assessment techniques are of considerable value for clinical diagnosis. Liver and spleen magnetic resonance elastography (MRE) and serum markers have been proposed for quantitative and noninvasive assessment of liver fibrosis. This study aims to compare the diagnostic performance of liver and spleen stiffness measured by MRE, fibrosis index based on the 4 factors (FIB-4), aspartate aminotransferase-to-platelet ratio index (APRI), and their combined models for staging hepatic fibrosis. Methods One hundred and twenty patients with chronic liver disease underwent MRE scans. Liver and spleen stiffness were measured by the MRE stiffness maps. Serum markers were collected to calculate FIB-4 and APRI. Liver biopsies were used to identify pathologic grading. Spearman's rank correlation analysis evaluated the correlation between the parameters and fibrosis stages. Receiver operating characteristic (ROC) analysis evaluated the performance of the four individual parameters, a liver and spleen stiffness combined model, and an all-parameters combined model in assessing liver fibrosis. Results Liver stiffness, spleen stiffness, FIB-4, and APRI were all correlated with fibrosis stage (r=0.87, 0.64, 0.65, and 0.51, respectively, all P<0.001). Among the 4 individual diagnostic markers, liver stiffness showed the highest values in staging F1-4, F2-4, F3-4 and F4 (AUC =0.89, 0. 97, 0.95, and 0.95, all P<0.001). The AUCs of the liver and spleen stiffness combined model in the F1-4, F2-4, F3-4, and F4 staging groups were 0.89, 0.97, 0.95, and 0.96, respectively (all P<0.001). The corresponding AUCs of the all-parameters combined model were 0.90, 0.97, 0.95, and 0.96 (all P<0.001). The AUCs of the liver and spleen stiffness combined model were significantly higher than those of APRI, FIB-4 in the F2-4, F3-4, and F4 staging groups (all P<0.05). Both combined models were not significantly different from liver stiffness in staging liver fibrosis (all P>0.05). Conclusions Liver stiffness measured with MRE had better diagnostic performance than spleen stiffness, APRI, and FIB-4 for fibrosis staging. The combined models did not significantly improve the diagnostic value compared with liver stiffness in staging fibrosis.
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Affiliation(s)
- Xiao-Pei Wang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - Yu Wang
- Liver Research Center, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - Hong Ma
- Liver Research Center, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - Han Wang
- Liver Research Center, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - Da-Wei Yang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - Xin-Yan Zhao
- Liver Research Center, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - Er-Hu Jin
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - Zheng-Han Yang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
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Giuffrè M, Fouraki S, Campigotto M, Colombo A, Visintin A, Buonocore MR, Aversano A, Budel M, Tinè F, Abazia C, Masutti F, Crocè LS. Alanine aminotransferase and spleno-portal dynamics affect spleen stiffness measured by point shear-wave elastography in patients with chronic hepatitis C in the absence of significant liver fibrosis. J Ultrasound 2020; 24:67-73. [PMID: 32304009 DOI: 10.1007/s40477-020-00456-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Accepted: 03/27/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Spleen stiffness (SS) has gained a lot of interest in the context of liver cirrhosis and portal hypertension stratification. However, there is a paucity of data on confounding factors that may alter SS values. METHODS Between January 2018 and October 2019, we enrolled 120 healthy subjects and 117 patients with hepatitis C virus (HCV) infection who did not have significant liver fibrosis (i.e., F0-1). Abdominal ultrasound evaluation was performed on each individual to measure portal vein diameter, portal flow velocity, spleen bipolar diameter, and splenic area. We also performed liver and spleen elastography. RESULTS HCV patients had higher SS (p < 0.001), portal vein diameter (p = 0.031), portal flow velocity (p = 0.035), spleen bipolar diameter (p = 0.042) and area (p = 0.025), and ALT levels (p < 0.001). Linear regression models showed that SS increased by 3.220 kPa for each mm of portal vein diameter, by 0.7 kPa for each cm/s of portal flow velocity, by 2.239 kPa for each cm of spleen bipolar diameter, and by 0.233 kPa for each cm2 of spleen area. Patients with HCV infection were stratified according to median ALT levels (i.e. 32 IU/L). SS and spleno-portal axis parameters were significantly higher in patients with an ALT level > 32 IU/L. Besides, the relationship between SS and ALT was described by cubic polynomial regression according to the following equation: 11.735 + 0.404 (ALT)1 - 0.002 (ALT)2 + 4.26 × 10-6 (ALT)3. CONCLUSIONS Our results bring new light to the role of inflammation as a confounding factor for SS measurement. Therefore, particular attention should be paid to serum transaminase for a correct evaluation of spleen elastography.
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Affiliation(s)
- Mauro Giuffrè
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy.
| | - Sofia Fouraki
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Michele Campigotto
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Anna Colombo
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Alessia Visintin
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | | | - Alessandro Aversano
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Martina Budel
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Fabio Tinè
- Liver Clinic, Azienda Sanitaria Universitaria Giuliano-Isontina, Ospedale Cattinara, Trieste, Italy
| | - Cristiana Abazia
- Liver Clinic, Azienda Sanitaria Universitaria Giuliano-Isontina, Ospedale Cattinara, Trieste, Italy
| | - Flora Masutti
- Liver Clinic, Azienda Sanitaria Universitaria Giuliano-Isontina, Ospedale Cattinara, Trieste, Italy
| | - Lory Saveria Crocè
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
- Liver Clinic, Azienda Sanitaria Universitaria Giuliano-Isontina, Ospedale Cattinara, Trieste, Italy
- Italian Liver Foundation, Basovizza (Trieste), Italy
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Hu XD, Geng HY, Wang L, Xu HF, Su Y, Liang S, Qian LX. Supersonic Shear Wave Imaging of the Spleen for Staging of Liver Fibrosis in Rats. Ultrasound Med Biol 2017; 43:2343-2351. [PMID: 28705556 DOI: 10.1016/j.ultrasmedbio.2017.04.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Revised: 04/01/2017] [Accepted: 04/19/2017] [Indexed: 06/07/2023]
Abstract
The goal of the work described here was to explore the cause of spleen stiffness (SS) in hepatic fibrogenesis and evaluate the value of SS in liver fibrosis (LF) staging. LF was induced with carbon tetrachloride (CCl4) in rats (n = 40). Supersonic shear wave imaging and contrast-enhanced ultrasound were performed to determine liver stiffness (LS), SS and splenic hemodynamics. SS, LS and free portal pressure exhibited moderate correlations with fibrosis stage (r = 0.744-0.835, p < 0.001). Time-intensity curves of contrast-enhanced ultrasound for the spleen were presented as decreasing peak intensity and slope of decrease, and increasing time to peak. Splenic sinus dilation and congestion were observed on histopathologic analysis. The area under the receiver operating characteristic curve of SS was higher than that of LS for differentiating LF stages 0-2 from stages 3-4 (Z = 2.293, p = 0.02). SS is a reliable diagnostic marker for the assessment of LF in the CCl4 model, especially for severe fibrosis. Elevated portal pressure is the cause of increasing SS.
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Affiliation(s)
- Xiang-Dong Hu
- Department of Ultrasound, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Hui-Ying Geng
- Department of Ultrasound, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Lei Wang
- Department of Ultrasound, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Hu-Feng Xu
- Department of Ultrasound, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Yuan Su
- Department of Ultrasound, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Si Liang
- Department of Ultrasound, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Lin-Xue Qian
- Department of Ultrasound, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
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Xu SH, Li Q, Hu YP, Ying L. Development of a model based on biochemical, real‑time tissue elastography and ultrasound data for the staging of liver fibrosis and cirrhosis in patients with chronic hepatitis B. Mol Med Rep 2016; 14:3609-19. [PMID: 27573619 PMCID: PMC5042746 DOI: 10.3892/mmr.2016.5682] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2015] [Accepted: 06/22/2016] [Indexed: 12/21/2022] Open
Abstract
The liver fibrosis index (LFI), based on real‑time tissue elastography (RTE), is a method currently used to assess liver fibrosis. However, this method may not consistently distinguish between the different stages of fibrosis, which limits its accuracy. The aim of the present study was to develop novel models based on biochemical, RTE and ultrasound data for predicting significant liver fibrosis and cirrhosis. A total of 85 consecutive patients with chronic hepatitis B (CHB) were prospectively enrolled and underwent a liver biopsy and RTE. The parameters for predicting significant fibrosis and cirrhosis were determined by conducting multivariate analyses. The splenoportal index (SPI; P=0.002) and LFI (P=0.023) were confirmed as independent predictors of significant fibrosis. Using multivariate analyses for identifying parameters that predict cirrhosis, significant differences in γ‑glutamyl transferase (GGT; P=0.049), SPI (P=0.002) and LFI (P=0.001) were observed. Based on these observations, the novel model LFI‑SPI score (LSPS) was developed to predict the occurrence of significant liver fibrosis, with an area under receiver operating characteristic curves (AUROC) of 0.87. The diagnostic accuracy of the LSPS model was superior to that of the LFI (AUROC=0.76; P=0.0109), aspartate aminotransferase‑to‑platelet ratio index (APRI; AUROC=0.64; P=0.0031), fibrosis‑4 index (FIB‑4; AUROC=0.67; P=0.0044) and FibroScan (AUROC=0.68; P=0.0021) models. In addition, the LFI‑SPI‑GGT score (LSPGS) was developed for the purposes of predicting liver cirrhosis, demonstrating an AUROC value of 0.93. The accuracy of LSPGS was similar to that of FibroScan (AUROC=0.85; P=0.134), but was superior to LFI (AUROC=0.81; P=0.0113), APRI (AUROC=0.67; P<0.0001) and FIB‑4 (AUROC=0.719; P=0.0005). In conclusion, the results of the present study suggest that the use of LSPS and LSPGS may complement current methods of diagnosing significant liver fibrosis and cirrhosis in patients with CHB.
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Affiliation(s)
- Shi-Hao Xu
- Department of Ultrasonography, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, P.R. China
| | - Qiao Li
- Department of Ultrasonography, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, P.R. China
| | - Yuan-Ping Hu
- Department of Ultrasonography, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, P.R. China
| | - Li Ying
- Department of Ultrasonography, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, P.R. China
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