Mylab 70 xvision

Ultrasonography with sonoelastography was performed using a MyLab 70 XVision (ESAOTE, Genoa, Italy) device interfaced with a 13 MHz linear probe. The parameters were evaluated at the spastic gastrocnemius medialis and lateralis by conventional ultrasonography: muscle echogenicity graded on the Heckmatt scale (score range from I = normative to IV = very high echo intensity), muscle thickness (distance between the superficial and the deep aponeuroses) and posterior pennation angle (angle between fascicles and superficial aponeurosis) [7 (link),8 (link)]. The Achilles tendon of the affected leg was examined 2 to 6 cm proximal to the calcaneal insertion; thickness was measured at the greatest tendon width using conventional ultrasonography; percentage of hardness was evaluated by sonoelastography [17 (link)] (Figure 1).

A high-resolution ultrasonography equipment (Esaote My Lab 70X Vision) was used for the evaluation of endothelial function through a high-frequency transducer to obtain longitudinal images of the brachial artery. The transducer was positioned upon the brachial artery in the 1/3 arm size of superior antecubital fossa. Baseline images were recorded for 1 min, and this was immediately followed by a cuffing inflated up to 200 mmHg and kept for 5 min in order to characterize reactive hyperemia. Thirty seconds before the cuffing was released, new images started to be recorded for 3 min, considered endothelium-dependent dilation, and were analyzed by the Cardiovascular Suite™ software (Quipu, Italy). The software demands to specify the interest area of the arterial segment and flow using visual selection. Baseline and post-hyperemia diameter and flow were computed to obtain the percentage of dilation, volume, and shear stress (Thijssen et al., 2019 (link)).

We calculated the brachial artery FMD according to the American College of Cardiology guidelines [25 (link)]. We detected the edge of the borders of the brachial artery by a software installed on a high resolution ultrasonography device using a linear transducer 13,000 MHZ (MyLab 70 XVision, Biosound Esaote, USA). The measurement was conducted on right brachial artery 3–5 cm above the antecubital fossa just before cuff inflating and 60 s after cuff release. A cuff was inflated at least 50 mmHg above the systolic blood pressure around the right arm above the antcubial fossa for 5 min to produce a transient ischemia. The brachial FMD was calculated as percentage of alteration in brachial artery diameters induced by the shearing stress. All the measurements were performed in the end-diastolic phase coinciding with the R-wave of electrocardiogram. The average of the measurements during three consecutive cardiac cycles were considered as the final FMD score.

At T0 and at T2 (after twelve weeks), the patients underwent ultrasound evaluation of quadriceps rectus femoris thickness (QRFT) and quadriceps vastus intermedius thickness (QVIT) as this ultrasound approach seemed useful in the detection of muscle loss in CKD patients [43 (link),44 (link)]. This ultrasonographic evaluation was carried out by B-mode modulation with a 7.5 MHz transducer. The probe was placed perpendicular to the long axis of the muscle, which was covered with an abundant gel layer; minimal external pressure was exerted in order to prevent muscle compression. Three measurements were made bilaterally, in the supine position, with both knees in extension, at the level of two standardized points: the midpoint between the anterosuperior iliac spine and the upper limit of the patella and the boundary point between the lower third and the upper two-thirds of the quadriceps muscle. The values obtained were compared with the average of the measures evaluated in the reference population, as suggested by Sabatino et al. [45 (link),46 (link),47 (link)]. All ultrasounds were carried out by the same healthcare professional (A.N.) with an ultrasonographic experience of 15 years in order to reduce the bias related to intra-operator variability and with the same ultrasound equipment (Esaote MyLab70 XVision) with linear probe LA523.

A total of 98 patients underwent sonography using an "xVision" device (MyLab70xVision; Esaote Biomedica, Cologne, Germany). Depending on the region and vessel to be examined, the appropriate transducer was selected by the examiner (K.E., board-certified radiologist with 14 years of experience in ultrasound).
The following data were collected and evaluated for each patient undergoing ultrasound: date, region, total number of findings, structure of the vessel wall, and affected vessels. Regarding vessel wall characteristics, the examiners have also evaluated hypoechoic vessel wall thickening around the lumen, which was termed “halo sign” and suggested as pathognomonic for temporal arteritis. Vascular edema was diagnosed as soon as hypoechoic black fluid signal alterations were visible.

Ultrasonographic analysis of the carotid artery was performed with a high-resolution ultrasound scanner, equipped with a linear array 13 MHz transducer (MyLab 70 XVision, biosound esaote USA) as we reported in our previous study
[14 (link)]. Briefly, a rapid cross sectional scanning followed by a longitudinal scanning of the common carotid artery (CCA) was made in the first step to pinpoint the possible plaques. Then the dynamic sequence images were stored for measurement of CIMT. The CIMT was defined as the distance between the leading edge of the lumen-intima interface and the leading edge of the media-adventitia interface. For precise measurement of CIMT software (Vascular Tools 5, Medical Imaging Applications LLC, USA) was employed. The regions of interest were defined as 1.0 cm distal to the bifurcation, the bifurcation and 1.0 cm proximal to the internal carotid artery in both near and far walls. The CIMT was reported for each subject as the average of 12 measurements (6 measurements from the right and 6 from the left carotid artery).