8,960 results on '"ultrasonography, doppler, color"'
Search Results
2. Premenarchal ovarian torsion
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Wesley Eilbert and Henry Nguyen
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laparoscopy ,menarche ,ovarian torsion ,pediatrics ,ultrasonography, doppler, color ,Medicine - Abstract
Ovarian torsion is a common gynecologic emergency seen in women of all ages, mostly in reproductive women, resulting in ischemia and necrosis of the adnexal tissue. However, it is rare in premenarchal girls. This article reviews the limited published literature, and discusses special considerations about premenarchal ovarian torsion.
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- 2023
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3. Prenatal Ultrasound Diagnosis of Fetal Arteriovenous Malformations
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Xiaotan TAN, Hongxia YUAN
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arteriovenous malformations ,prenatal diagnosis ,ultrasonography, prenatal ,fetus ,ultrasonography, doppler, color ,Medicine - Abstract
Background Fetal arteriovenous malformations may occur in all parts of the body and are mainly diagnosed by color Doppler ultrasound. However, there are few reports at home and abroad on the types of arteriovenous shunts explored by prenatal ultrasound. Objective To investigate the diagnosis value of prenatal ultrasonography in fetal arteriovenous malformation. Methods Pregnant women with fetal arteriovenous malformations who underwent prenatal ultrasound screening in the Department of Ultrasound, Changsha Hospital for Maternal and Child Health Care from August 2013 to August 2021 were recruited. Color Doppler ultrasonography was used for fetal systematical ultrasound screening. The location, size, shape, and internal echoes of fetal arteriovenous malformation lesions were detected and described. The ultrasonographic features and types of arteriovenous malformations in different parts of patients were analyzed, and the results of follow-up were tracked. Results Prenatal ultrasound screening in this study identified sixteen cases with fetal arteriovenous malformations, of which six lesions were located in the fetal sacrococcygeal region (diagnosed as sacrococcygeal teratoma) , four were located in the fetal intracranial region (including three intracranial cranberg hemangiomas with Galen's vein tumors, one Galen's vein tumor) , three were located in the fetal limbs, soft tissues (including one Parkes Weber syndrome, two soft tissue hemangiomas) , two were located in fetal liver (diagnosed as hepatic arteriovenous fistula) and one was located in fetal lung (diagnosed as isolated lung with pulmonary arteriovenous fistula) . Arteriovenous malformation typing: 10 patients had simple type Ⅱ (10/16) , 3 patients had both type Ⅱ and type Ⅲa (3/16) , 1 patient had type Ⅰ (1/16) , 1 patient had type Ⅳ (1/16) , 1 patient had simple type Ⅲa (1/16) . Follow up showed that 10 induced labor, 3 were lost to follow-up, 2 were born at term and treated surgically, and 1 was stillborn. Conclusion The prognosis of fetal arteriovenous malformation is closely related to the location of lesion and blood flow distribution within the lesion. Prenatal ultrasound can detect a fetus with or without a focus of arteriovenous malformation, which is valuable for diagnosis and prognosis, and can help to detect the potential threat caused by arteriovenous malformation to the fetus.
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- 2022
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4. Value of Doppler evaluation of physically abnormal fistula: hemodynamic guidelines and access outcomes
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Seong Cho, Yu-Ji Lee, and Sung-Rok Kim
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ultrasonography, doppler, color ,angioplasty ,vascular access ,Medicine - Abstract
Background/Aims The strategy of access care at out center involves the use of ultrasound (USG) in case of physical examination (PE) abnormality. USG determines the need of angiography. This study investigated the possible association between the need for percutaneous transluminal angioplasty (PTA) and hemodynamic parameters of USG. The study also assessed the effects of this monitoring strategy on outcomes in comparison with a historical control. Methods A retrospective study of the medical records of 127 patients (65 PTA, 62 non-PTA) was conducted. Data were analyzed using logistic regression analysis and receiver operating characteristic curve. Fistula outcomes and intervention rates were calculated and compared with 100 historic controls. Results Logistic regression analysis showed that brachial artery flow volume (FV) < 612.9 mL/min or brachial artery resistance index (RI) > 0.63 was independently associated with the need for PTA. This monitoring strategy showed an a reduction in thromboses (0.02 ± 0.11 events/arteriovenous fistula [AVF]-year vs. 0.07 ± 0.23 events/AVF-year, p = 0.046), reduction in central venous catheter placement (0.01 ± 0.05 events/AVF-year vs. 0.06 ± 0.22 events/AVF-year, p = 0.010), reduction in access loss (0.02 ± 0.13 events/AVF-year vs. 0.19 ± 0.34 events/AVF-year, p = 0.015), and increase in access selective repair (0.49 ± 0.66 events/AVF-year vs. 0.21 ± 0.69 events/AVF-year, p = 0.003), compared to historic control. Conclusions There was significant stenosis if brachial artery FV was < 612.9 mL/min or RI was > 0.63 for PE abnormality. These parameters should be used as markers for assessing PTA risk in hemodialysis patients. Addition of USG to determine the need of angiography after detection of PE abnormality leads to decreases in access thrombosis, catheter placement, and access loss despite increasing access intervention rates compared to clinical monitoring.
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- 2019
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5. Utility of Hepatic 2D Shear-Wave Elastography in Monitoring Response to Image-Guided Intervention in Children With Chronic Budd-Chiari Syndrome: A Prospective Study
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Prasenjit Das, Rohan Malik, Kumble Seetharama Madhusudhan, Neha Dohare, and Sanjay Sharma
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Male ,Hepatic congestion ,medicine.medical_specialty ,Adolescent ,Budd-Chiari Syndrome ,Recurrence ,Humans ,Medicine ,Radiology, Nuclear Medicine and imaging ,Prospective Studies ,Guided intervention ,Ultrasonography, Doppler, Color ,Child ,Prospective cohort study ,Ultrasonography, Interventional ,Shear wave elastography ,business.industry ,General Medicine ,medicine.disease ,Treatment Outcome ,Liver ,Child, Preschool ,Budd–Chiari syndrome ,Elasticity Imaging Techniques ,Female ,Radiology ,business ,Follow-Up Studies - Abstract
Please see the Editorial Comment by Domen Plut discussing this article. Background: Image-guided interventions for Budd-Chiari syndrome (BCS) reduce hepatic congestion, thereby reducing liver stiff...
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- 2022
6. Can Color Doppler Ultrasound Challenge the Paradigm in Percutaneous Nephrolithotomy?
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Wencheng Li, Bryan J. Mathis, Ying Shi, and Xiong Yang
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Male ,medicine.medical_specialty ,Urology ,medicine.medical_treatment ,Nephrolithotomy, Percutaneous ,Punctures ,Kidney Calculi ,chemistry.chemical_compound ,medicine ,Humans ,Ultrasonography, Doppler, Color ,Percutaneous nephrolithotomy ,Nephrostomy, Percutaneous ,Creatinine ,business.industry ,Incidence (epidemiology) ,Fornix ,Color doppler ultrasound ,Surgery ,Treatment Outcome ,medicine.anatomical_structure ,chemistry ,Hemorrhagic complication ,Nephrostomy ,Female ,business ,Artery - Abstract
OBJECTIVES Compare color Doppler (Color) ultrasound-guided puncture to common type-B (Type-B) ultrasound-guided puncture in reducing the incidence of hemorrhagic complications of percutaneous nephrolithotomy (PCNL). MATERIALS AND METHODS A total of 348 patients who received PCNL from September 2017 to December 2018 were divided into Color (231 cases) and Type-B groups (117 cases). The avascular area of the target fornix was pinpointed in the Color group while the middle of the target fornix was the default puncture point in the Type-B group. Tract bleeding, nephrostomy tract creation time, operation time, postoperative hemoglobin (Hb) values and serum creatinine (Scr) concentrations, and stone-free rates were analyzed. RESULTS Color Doppler imaging revealed that 35.1% of the cases in the Color group (81/231) had variable artery positioning in the target fornix. Tract bleeding and postoperative Hb reduction in the Color group were significantly lower than the Type-B group (10.8% vs 24.8%, P=0.0007, and 4.87±8.58 vs 7.70±8.90 g/L, P=0.0044, respectively). The postoperative hospitalization of the Color group was also shortened (8.3±5.9 vs 9.7±3.0 d, P
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- 2022
7. A Nomogram for Predicting Venous Thromboembolism in Critically Ill Patients with Primary Intracerebral Hemorrhage
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Shucheng Liu, Jun Peng, Yilin Wang, and Bin Gao
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Male ,Multivariate statistics ,medicine.medical_specialty ,genetic structures ,Critical Illness ,urologic and male genital diseases ,Logistic regression ,Predictive Value of Tests ,medicine ,Humans ,Ultrasonography, Doppler, Color ,Aged ,Cerebral Hemorrhage ,Retrospective Studies ,Intracerebral hemorrhage ,Receiver operating characteristic ,business.industry ,Univariate ,Glasgow Coma Scale ,Regression analysis ,Venous Thromboembolism ,Middle Aged ,Nomogram ,medicine.disease ,Nomograms ,Emergency medicine ,Female ,Surgery ,Neurology (clinical) ,business - Abstract
Objective To develop and validate a nomogram for predicting the risk of venous thromboembolism in critically ill patients with primary intracerebral hemorrhage. Methods Patients ≥18 years old with primary intracerebral hemorrhage were screened within 24 hours of onset from January 2019 to April 2021. Univariate and multivariate logistic regression analyses were performed to screen out independent predictors that were significantly associated with venous thromboembolism. A nomogram was constructed based on the results of a multivariate regression analysis. Discrimination and calibration were used to evaluate performance of the nomogram. A decision curve analysis was used to assess its clinical utility. Results This study enrolled 369 patients. The nomogram included 3 predictors from the regression analysis: D-dimer, National Institutes of Health Stroke Scale score, and Glasgow Coma Scale score on admission. The area under the receiver operating characteristic curve was 0.794, indicating good discrimination of the nomogram. The nomogram demonstrated calibration curves with slight deviation from the ideal predictions. Decision curve analysis showed that the prediction nomogram was clinically useful. Conclusions This nomogram comprising D-dimer, National Institutes of Health Stroke Scale score and Glasgow Coma Scale score on admission can accurately predict the risk of venous thromboembolism in critically ill patients with intracerebral hemorrhage.
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- 2022
8. Effect of breathing on venous return during delayed cord clamping
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Ronny Knol, Stuart B. Hooper, Emma Brouwer, Arjan B. te Pas, Annie Kroushev, Arno A.W. Roest, Thomas van den Akker, and Pediatrics
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Male ,medicine.medical_specialty ,Umbilical Veins ,Time Factors ,Gestational Age ,Vena Cava, Inferior ,Hepatic Veins ,Inferior vena cava ,Umbilical cord ,neonatology ,03 medical and health sciences ,0302 clinical medicine ,030225 pediatrics ,Internal medicine ,Medicine ,Humans ,030212 general & internal medicine ,cardiovascular diseases ,Prospective Studies ,Ultrasonography, Doppler, Color ,Vein ,Original Research ,business.industry ,Respiration ,Infant, Newborn ,Obstetrics and Gynecology ,Gestational age ,General Medicine ,Blood flow ,medicine.anatomical_structure ,medicine.vein ,Inhalation ,Echocardiography ,cardiology ,Pediatrics, Perinatology and Child Health ,physiology ,Umbilical Cord Clamping ,Breathing ,Cardiology ,cardiovascular system ,Female ,business ,Venous return curve ,Ductus venosus ,Blood Flow Velocity - Abstract
Real-time echocardiographic monitoring of blood flow in the ductus venosus and hepatic vein was undertaken during perinatal transition with intact umbilical cord of term born infants. Antegrade flow increased during inspiration, preferentially directing blood flow from the ductus venosus into the right atrium.Objective To investigate the effect of spontaneous breathing on venous return in term infants during delayed cord clamping at birth. Methods Echocardiographic ultrasound recordings were obtained directly after birth in healthy term-born infants. A subcostal view was used to obtain an optimal view of the inferior vena cava (IVC) entering the right atrium, including both the ductus venosus (DV) and the hepatic vein (HV). Colour Doppler was used to assess flow direction and flow velocity. Recordings continued until the umbilical cord was clamped and were stored in digital format for offline analyses. Results Ultrasound recordings were obtained in 15 infants, with a median (IQR) gestational age of 39.6 (39.0-40.9) weeks and a birth weight of 3560 (3195-4205) g. Flow was observed to be antegrade in the DV and HV in 98% and 82% of inspirations, respectively, with flow velocity increasing in 74% of inspirations. Retrograde flow in the DV was observed sporadically and only occurred during expiration. Collapse of the IVC occurred during 58% of inspirations and all occurred caudal to the DV inlet (100%). Conclusion Spontaneous breathing was associated with collapse of the IVC and increased antegrade DV and HV flow velocity during inspiration. Therefore, inspiration appears to preferentially direct blood flow from the DV into the right atrium. This indicates that inspiration could be a factor driving placental transfusion in infants.
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- 2022
9. The Use of Color Duplex Ultrasound for Local Perforator Flaps in the Extremity
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Hyung Bae Kim, Changsik John Park, Hyunsuk Peter Suh, Joon Pio Hong, and Joon Hur
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Ultrasonography, Doppler, Duplex ,medicine.medical_specialty ,business.industry ,Treatment options ,Plastic Surgery Procedures ,Lower Extremity ,Color duplex ultrasound ,Medicine ,Surgery ,Complication rate ,Radiology ,Postoperative monitoring ,Deep fascia ,Ultrasonography, Doppler, Color ,business ,Perforator Flap ,Perforator flaps - Abstract
Background The local flaps, especially perforator and keystone flaps, are used as first-line treatment option in reconstruction of small tomoderate-sized defect of the extremity. However, the high complication rate associated with these flaps may hinder this usage. Methods This article reviews the technical and clinical aspect of using color duplex ultrasound )CDU) in the preoperative, intraoperative, and postoperative period for propeller and keystone flaps. Results CDU allows the surgeon to understand the anatomical aspect of the perforator such as the location, point of penetration on the deep fascia, subcutaneous pathway )axiality) and physiological aspect such as velocity and flow volume. Understanding and utilizing this information will allow accurate preoperative design, intraoperative decision making, and postoperative monitoring, leading to better outcome. Conclusion Carefully designed local perforator flaps based on anatomy and physiology using CDU will be a powerful armamentarium for reconstruction of the lower extremity.
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- 2021
10. Pulsatile tinnitus caused by an aberrant artery running over the surface of mastoid bone
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Wuqing Wang, Yue-Lin Hsieh, Ping Guo, and Xiaobing Xu
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Adult ,medicine.medical_specialty ,Sound Spectrography ,Vascular Malformations ,Hemodynamics ,Wall pressure ,Mastoid ,Tinnitus ,03 medical and health sciences ,0302 clinical medicine ,Pulsatile Tinnitus ,Image Processing, Computer-Assisted ,medicine ,Humans ,Local anesthesia ,Ultrasonography, Doppler, Color ,030223 otorhinolaryngology ,business.industry ,Acoustics ,Arteries ,General Medicine ,medicine.anatomical_structure ,Otorhinolaryngology ,030220 oncology & carcinogenesis ,Aberrant artery ,Female ,Surgery ,Radiology ,Objective pulsatile tinnitus ,business ,Ligation ,Blood Flow Velocity ,Artery - Abstract
Objective Pulsatile tinnitus (PT) caused by an aberrant artery is rare. We report an unprecedented cause of PT resulting from an aberrant artery coursing the mastoid surface, and qualitatively discuss the pathophysiology of PT. Methods This case study reports a 41-year-old woman who presented with persistent PT at her right retromastoid region. Contrast-enhanced computed tomography revealed an aberrant branch of the artery that coursed over the cortex of the mastoid bone. Surgical ligation of this aberrant artery was performed under local anesthesia. Results Intraoperative findings suggested that PT transmitted via bone-conduction route due to the direct contact of the vascular and mastoid surface. PT was completely resolved upon surgical removal of this causative segment. Ultrasonographic and hemodynamic analysis showed that the turbulent kinetic energy and high regional wall pressure were the major contributory factors causing PT. Spectro-temporal analysis showed that PT fluctuates at frequency 500~2000 Hz, which differs from those of venous PT. Conclusion Judicious preoperative and intraoperative assessments of PT ensure the surgical efficacy of PT. Objective ultrasonographic and computational studies can provide detailed hydroacoustic characteristics of PT.
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- 2021
11. Ocular blood flow and choroidal thickness in ocular hypertension
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Serdar Bayraktar, Mehmet Can Gezer, Tamer Takmaz, Ali İpek, and Yelda Yildiz Tasci
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Central retinal artery ,medicine.medical_specialty ,Visual acuity ,genetic structures ,Retinal Artery ,Optic disk ,Ocular hypertension ,Glaucoma ,Ciliary Arteries ,Ophthalmic Artery ,medicine.artery ,Ophthalmology ,medicine ,Humans ,Ultrasonography, Doppler, Color ,Intraocular Pressure ,business.industry ,Short posterior ciliary arteries ,medicine.disease ,eye diseases ,Ophthalmic artery ,Optic nerve ,Ocular Hypertension ,sense organs ,medicine.symptom ,business ,Blood Flow Velocity - Abstract
Ocular hypertension (OHT) is a clinical entity characterized by elevated intraocular pressure (IOP) without optic nerve damage. In the presence of other risk factors, OHT may progress to glaucoma. This study aimed to evaluate ocular blood flow (OBF) and choroidal thickness (CT), which may be markers and/or risk factors that could assess the progression of OHT to glaucoma. Age and gender matched 60 eyes of 32 patients with OHT and 61 eyes of 31 control patients were included for this study. All participants underwent a detailed ophthalmological examination including best-corrected visual acuity, IOP measurement with Goldmann applanation tonometry, gonioscopy, optic nerve evaluation with 78 D lens, and visual field test with Humphrey visual field analyzer. Retinal nerve fiber layer, ganglion cell complex, and central corneal thickness measurements were performed by optical coherence tomography (OCT). CT was measured with OCT in the fovea, 1.5 mm, 2 mm, 2.5 mm nasal and temporal to the fovea and from nasal and temporal to the optic disk. OBF data including peak systolic velocity (PSV), end-diastolic velocity (EDV), resistivity index (RI) and pulsatility index (PI) were measured with color Doppler imaging (CDI) from the ophthalmic artery (OA), central retinal artery (CRA), medial and lateral branches of short posterior ciliary arteries (MPCA, LPCA). Systolic (SBP) and diastolic arterial blood pressure were also noted. CT measurement at each point in the OHT group compared to the control group were found to be significantly thinner (p = 0.001). There was a decrement in CT from the fovea to the nasal and temporal retina in both groups. In the OHT group, there was a significant decrease in PSV and EDV of OA, CRA, MPCA, and LPCA, and a significant increase in PI and RI of measured arteries. (EDV p = 0.036, PI p = 0.006, RI p = 0.006 for OA and p = 0.001 for other arteries and all OBF measurements). There was a negative correlation between CT and age, IOP and axial length (AL) in OHT group (r = − 0.529, p = 0.001; r = − 0.258, p = 0.047; r = − 0.345, p = 0.007, respectively, for fovea). But there was no statistically significant correlation between CT and other measurements in the control group, except age (r = − 0.860 p = 0.001 for fovea). We found that OBF decrement and choroidal thinning in OHT group compared with controls. Interpretation both of CT measurements with OCT and OBF parameters with CDI and new imaging technologies may help to prevent and reduce the possible optic nerve damage.
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- 2021
12. Fetal pulmonary hemodynamics: Doppler reference values in low risk pregnancies
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Anatoly Ivanovich Ishenko, Graziano Clerici, Vitaly Alexandrovich Kaptilny, Maria Cristina Aisa, V. I. Tsibizova, and A. Cutuli
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medicine.medical_specialty ,Gestational Age ,Pulmonary Artery ,Normal pregnancy ,Ultrasonography, Prenatal ,symbols.namesake ,Pregnancy ,Reference Values ,medicine.artery ,Internal medicine ,Ductus arteriosus ,medicine ,Humans ,Ultrasonography, Doppler, Color ,Pulmonary hemodynamics ,Fetus ,medicine.diagnostic_test ,business.industry ,Hemodynamics ,Obstetrics and Gynecology ,Ultrasonography, Doppler ,Ductus Arteriosus ,medicine.anatomical_structure ,Reference values ,embryonic structures ,Pediatrics, Perinatology and Child Health ,Pulmonary artery ,cardiovascular system ,symbols ,Cardiology ,Female ,business ,Doppler effect ,Fetal echocardiography ,Blood Flow Velocity ,circulatory and respiratory physiology - Abstract
To investigate fetal pulmonary hemodynamics in normal pregnancy using pulsed and color Doppler ultrasonography and to define Doppler reference ranges values in the whole fetal pulmonary circulation during different gestational ages.A prospective observational study was conducted to evaluate 190 healthy singleton pregnancies between 20 and 38 weeks of gestation, including 10 cases for each gestational age. The main pulmonary artery, right pulmonary artery, left pulmonary artery, ductus arteriosus and pulmonary veins waveforms were evaluated. The waveform profile was studied for each pulmonary vessel investigated. We calculated the normal distribution of data of 12 Doppler parameters, their values were expressed as 5th, 25th, 50th, 75th and 95th centile.We report several pulmonary hemodynamic changes with the progression of pregnancy. We focused on the hemodynamic values of the parameters most useful in clinical practice and that would better describe the hemodynamic events of this vascular district.This study reports a complete description of the fetal pulmonary hemodynamics at different gestational ages. Many hemodynamic parameters show a typical change during gestation. The reference ranges described in this study may help in situations where is indicated to evaluate the pulmonary hemodynamics and to identify healthy fetuses from those affected by pathological conditions related mainly to fetal cardiovascular anomalies and/or feto-maternal pathologic conditions.
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- 2021
13. Analysis of Proteomic Characteristics of Peripheral Blood in Preeclampsia and Study of Changes in Fetal Arterial Doppler Parameters Based on Magnetic Nanoparticles
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Wenting Zhang, Fang Yang, Lei Qu, Shaoli Wang, Xundan Zhou, and Xiaoxia Hou
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Adult ,Proteomics ,Placental growth factor ,Middle Cerebral Artery ,Article Subject ,Adolescent ,Angiogenesis ,Computer applications to medicine. Medical informatics ,Cerebral arteries ,R858-859.7 ,Uterus ,Ultrasonography, Prenatal ,Umbilical Arteries ,General Biochemistry, Genetics and Molecular Biology ,Preeclampsia ,Andrology ,Young Adult ,Fetus ,Pre-Eclampsia ,Pregnancy ,medicine.artery ,medicine ,Humans ,Ultrasonography, Doppler, Color ,KEGG ,Magnetite Nanoparticles ,reproductive and urinary physiology ,General Immunology and Microbiology ,business.industry ,Applied Mathematics ,Computational Biology ,Umbilical artery ,Blood Proteins ,General Medicine ,medicine.disease ,medicine.anatomical_structure ,Case-Control Studies ,Modeling and Simulation ,Female ,business ,Blood Flow Velocity ,Research Article - Abstract
Background. Traditional mass spectrometry detection methods have low detection efficiency for low-abundance proteins, thus limiting the application of proteomic analysis in the diagnosis of preeclampsia. Magnetic nanomaterials have good superparamagnetism and have obvious advantages in the field of biological separation and enrichment. Aim. The objective of this study is to explore the value of superparamagnetic iron oxide nanoparticles in the proteomic analysis of preeclampsia. Materials and Methods. 42 patients and 40 normal pregnant women were selected in this study for analysis. Gene Ontology enrichment analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis were performed to evaluate the function of these differential proteins. Proteomic analysis was used to analyze the differential proteins. Color Doppler ultrasound technology was used to detect changes in the blood flow of the fetal umbilical artery and cerebral artery. Results. 16 differential proteins in the serum of pregnant women with preeclampsia and normal pregnant women were detected. The 16 proteins are mainly related to angiogenesis and endothelial function proteins, coagulation cascade proteins, placental growth factor, and so on. Biological function analysis revealed that these proteins are mainly enriched in the nuclear factor kB (NF-κB) signaling pathway. Moreover, our data suggested that compared with the fetus in the uterus of normal pregnant women, the umbilical artery S/D, PI, and RI of the fetus in preeclampsia were greatly increased, and the cerebral artery S/D, PI, and RI were greatly decreased. Conclusion. Biological function analysis revealed that 16 proteins are mainly enriched in the NF-κB signaling pathway. Compared with the normal group, the umbilical artery S/D, PI, and RI of the preeclampsia group were greatly increased, and the cerebral artery S/D, PI, and RI were all greatly reduced. Our findings provided a more comprehensive reference for us to study the mechanism of preeclampsia at the molecular level and also provide data support for the screening of relevant markers for early diagnosis of preeclampsia.
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- 2021
14. Using Ultrasound Color Doppler Twinkling to Identify Biopsy Markers in the Breast and Axilla
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Susheil Uthamaraj, James F. Greenleaf, Matthew W. Urban, Gina K. Hesley, Christine U. Lee, and Nicholas B. Larson
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Acoustics and Ultrasonics ,Radiological and Ultrasound Technology ,medicine.diagnostic_test ,business.industry ,Breast imaging ,Biopsy ,Ultrasound ,Biophysics ,Color doppler ,Axilla ,medicine.anatomical_structure ,Optical imaging ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Ultrasonography, Doppler, Color ,Artifacts ,business ,Nuclear medicine ,Breast ultrasound ,Twinkling ,Ultrasonography - Abstract
In breast radiology, ultrasound detection of biopsy markers or clips for localization purposes is often challenging, especially in the axilla. The purpose of this research was to test the hypothesis that the surface roughness of biopsy clips would elicit a twinkling signature on color Doppler, making them more readily identifiable by ultrasound. Ultrasound color Doppler imaging of 12 biopsy markers was performed and consensus scoring of the degree of twinkling (0 [no twinkling] to 4 [exuberant twinkling]) was obtained for each of the markers. The surface roughness characteristics of the markers were measured using 3-D coherence scanning interferometry. The 3 markers scoring at least 3 for twinkling in vitro were cork, Q and Vision. Of these 3 markers, only the cork marker scored a 4 ex vivo and in cadaveric tissue. Surface roughness metrics demonstrated a positive estimated correlation with the twinkling scores (rho = 0.33, 95% CI = [–0.48 to 0.84]). Of the 12 markers tested, the markers that twinkled corresponded to surface roughness measured with non-contact 3-D optical imaging. Qualitatively, lower color scales and color frequencies optimized twinkling, but the most specific qualitative predictor of confidence in twinkling was insensitivity to changes in color scale and color frequency values.
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- 2021
15. Giant bilateral axillary artery aneurysms with left complete obstructive thrombus in intravenous immunoglobulin-sensitive Kawasaki disease: a case report
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Yi-Xiang Lin, Lan He, Chen Chu, Li-Ping Xie, and Fang Liu
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Male ,medicine.medical_specialty ,Arterial Occlusive Diseases ,Case Report ,Diseases of the musculoskeletal system ,Mucocutaneous Lymph Node Syndrome ,Severity of Illness Index ,Pediatrics ,RJ1-570 ,Pseudoaneurysm ,Rheumatology ,Axillary artery ,medicine.artery ,medicine ,Immunology and Allergy ,Humans ,cardiovascular diseases ,Thrombus ,Brachial artery ,Ultrasonography, Doppler, Color ,Coronary artery aneurysm ,Systemic artery aneurysm ,Antithrombotic therapy ,Kawasaki disease ,business.industry ,Immunoglobulins, Intravenous ,Infant ,Thrombosis ,medicine.disease ,Collateral circulation ,Aneurysm ,Surgery ,medicine.anatomical_structure ,RC925-935 ,Echocardiography ,thrombus ,Pediatrics, Perinatology and Child Health ,Axillary Artery ,business ,Tomography, X-Ray Computed ,Artery - Abstract
Background Kawasaki disease (KD) is a systemic vasculitis that predominantly affects medium-sized arteries. In addition to well-known coronary artery aneurysms (CAAs), peripheral systemic artery aneurysms (SAAs) have also been sporadically reported. In the literatures, SAAs occurred mainly in untreated, intravenous immunoglobin (IVIG)-resistant, or severe refractory KD, and thrombotic events in SAAs were rarely reported. Case presentation A 10-month-old boy with a history of KD was referred to our hospital for suspected pseudoaneurysm of the axillary arteries. Four months prior to presentation, he had persistent fever, conjunctival congestion, and rash. On the 10th day of fever echocardiogram showed biliteral CAAs. He was then diagnosed with KD and given IVIG 2 g/kg and aspirin at a local hospital. His fever and symptoms soon subsided and he was discharged with low dose aspirin and dipyridamole. One month prior to presentation, his parents incidentally palpated swellings in his bilateral axillae. On admission, physical examination revealed a pulsatile swelling in his right axilla and a non-pulsatile swelling in the left with impalpable left brachial and radial pulses, cooler and less active left upper limb than the right one. While the pulses of other three limbs were normal. Ultrasound examination revealed giant bilateral axillary artery aneurysms (AAAs) with massive thrombus in the left. Angiography confirmed giant bilateral AAAs with left AAAs completely occluded and fine collateral vessels connecting to the distal brachial artery, in addition to giant bilateral multiple CAAs without stenoses. The patient was given intravenous prostaglandin for 10 days to allow for formation of collateral circulation, as well as aspirin, low molecular weight heparin (which was switched to warfarin before discharge) and metoprolol. At discharge, the temperature and movement of his left upper limb improved significantly. On follow-up at 7 months, his left upper limb further improved and was similar to the right with no occurrence of cardiovascular events. The images of CAAs and AAAs on echocardiogram and computerized tomography remained the same. Conclusions This case highlights the importance of evaluating peripheral SAAs in KD patients with CAAs, even if their course of treatment appears smooth. For both large non-aortic SAAs and CAAs in KD patients, antithrombotic therapy is of utmost importance.
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- 2021
16. Superficial glans ischemia after penile prosthesis successfully treated by conservative treatment
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Manuel Fernández-Arjona, Delfina Antonia Estéve-Sánchez, and Pablo Garrido-Abad
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Male ,medicine.medical_specialty ,Urology ,medicine.medical_treatment ,030232 urology & nephrology ,Ischemia ,Penile Implantation ,Conservative Treatment ,Pentoxifylline ,03 medical and health sciences ,0302 clinical medicine ,Vascularity ,030225 pediatrics ,medicine ,Humans ,Ultrasonography, Doppler, Color ,Glans ,business.industry ,Glans penis ,Postoperative complication ,Penile implant ,Penile prosthesis ,Middle Aged ,medicine.disease ,Surgery ,Treatment Outcome ,medicine.anatomical_structure ,Reproductive Medicine ,Penile Prosthesis ,medicine.symptom ,business ,Penis ,medicine.drug - Abstract
Glandular ischemia is an extremely uncommon dreaded postoperative complication of inflatable penile prosthesis surgery that may lead to penile gangrene and organ loss, whose incidence is difficult to determine. We report the case of a 56-year-old male admitted to our department with complaints of cold and painful glans penis after penile implant one month before. A color Doppler examination revealed the normal intracavernosal arteries with no vascularity in the superficial glans tissues. Due to the mild severity of the ischemia, conservative management was suggested, and consisted of oral pentoxifylline and hyperbaric therapy for 10 days, achieving a significant improvement at 4 months of follow-up.
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- 2021
17. Perfusion changes in the foot after a free fibula flap
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Mette Stueland Wolters, Christian T. Bonde, Jens H. Højvig, Lisa Toft Jensen, and Henrik Kehlet
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Male ,medicine.medical_specialty ,Computed Tomography Angiography ,Perfusion Imaging ,Mandible ,Free Tissue Flaps ,Transplant Donor Site ,Free fibula ,Ischemia ,medicine ,Humans ,Ultrasonography, Doppler, Color ,Photoplethysmography ,Early Ambulation ,Foot ,business.industry ,Middle Aged ,Plastic Surgery Procedures ,Surgery ,Treatment Outcome ,Fibula ,Regional Blood Flow ,Female ,business ,Perfusion ,Foot (unit) - Published
- 2021
18. Cardiometabolic risk is unraveled by color Doppler ultrasound of the clitoral and uterine arteries in women consulting for sexual symptoms
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D. Menafra, Flavia Sorbi, E. Maseroli, Sara Marchiani, V. Di Stasi, Nunzia Verde, Felice Petraglia, Irene Scavello, Mario Maggi, Sarah Cipriani, Valdo Ricca, Massimiliano Fambrini, Linda Vignozzi, Giulia Rastrelli, and S. Scannerini
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Adult ,medicine.medical_specialty ,Waist ,Science ,Female sexual dysfunction ,Context (language use) ,Clitoris ,Body Mass Index ,Surveys and Questionnaires ,medicine.artery ,Body Image ,medicine ,Humans ,Sexual Dysfunctions, Psychological ,Ultrasonography, Doppler, Color ,Uterine artery ,Metabolic Syndrome ,Multidisciplinary ,Obstetrics ,business.industry ,Cardiometabolic Risk Factors ,Middle Aged ,medicine.disease ,Uterine Artery ,Female ,Vascular Resistance ,Population study ,Medicine ,Metabolic syndrome ,business ,Body mass index ,Blood sampling - Abstract
Female sexual dysfunction (FSD) may be a mirror of a poor cardiometabolic state. In a small pilot study enrolling 71 women with FSD, we previously demonstrated that clitoral Pulsatility Index (PI) evaluated by using color Doppler ultrasound (CDU), reflecting vascular resistance, was associated with cardiometabolic risk factors. Data on uterine CDU in this context are lacking. First, to confirm previously reported data on the direct association between clitoral PI and cardiometabolic risk factors on a larger study population of women consulting for sexual symptoms; second, to investigate eventual similar correlations between cardiometabolic risk factors and CDU parameters of the uterine artery. We also ascertained whether uterine artery PI, similarly to what had previously been observed for clitoral artery PI, was directly related to body image uneasiness and psychopathological symptoms, assessed by validated questionnaires. N = 230 women consulting our clinic for sexual symptoms were examined with clitoral CDU and blood sampling and were asked to fill out the Female Sexual Function Index, the Middlesex Hospital Questionnaire (MHQ) and the Body Uneasiness Test (BUT). In a subgroup of women (n = 164), we also performed transvaginal CDU with measurement of uterine artery parameters. At multivariate analysis, we found a direct association between clitoral PI and body mass index (BMI) (p = 0.004), waist circumference (WC) (p = 0.004), triglycerides (p = 0.006), insulin (p = 0.029) and HOMA-IR (p = 0.009). Furthermore, a correlation between obesity and Metabolic Syndrome (MetS) and a higher clitoral PI was observed (p = 0.003 and p = 0.012, respectively). Clitoral PI was also correlated with MHQ-S (p = 0.010), a scale exploring somatized anxiety symptoms, and BUT-B Positive Symptom Distress Index (p = 0.010), a measure of body image concerns. Similarly, when investigating the uterine artery, we were able to demonstrate an association between its PI and BMI (p p = 0.001), insulin (p = 0.006), glycated haemoglobin (p = p = 0.009). Women diagnosed with obesity and MetS showed significantly higher uterine PI values vs. those without obesity or MetS (p = 0.001 and p = 0.004, respectively). Finally, uterine PI was associated with BUT-A Global Severity Index (p
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- 2021
19. Prospective study to analyse the efficiency of Acoustic Doppler v/s Colour Duplex Ultrasound in locating perforators for antero-lateral thigh flap in reconstructive head and neck surgery
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Vijay V. Haribhakti, Tushar S. Thorat, Vidita R. Powle, and Mayur K. Virarkar
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Male ,medicine.medical_specialty ,Lateral thigh flap ,Anterior superior iliac spine ,030230 surgery ,03 medical and health sciences ,symbols.namesake ,0302 clinical medicine ,Preoperative Care ,Humans ,Medicine ,Prospective Studies ,Ultrasonography, Doppler, Color ,Prospective cohort study ,business.industry ,Ultrasound ,Ultrasonography, Doppler ,Middle Aged ,Plastic Surgery Procedures ,Anterolateral thigh ,Surgery ,medicine.anatomical_structure ,Thigh ,Duplex (building) ,030220 oncology & carcinogenesis ,symbols ,Head and neck surgery ,Female ,Nuclear medicine ,business ,Head ,Perforator Flap ,Doppler effect ,Neck - Abstract
Summary Introduction The anterolateral thigh (ALT) flap has become the universal workhorse for Head and Neck reconstruction. Being a perforator-based flap, accurate planning by preoperative perforator localisation is clearly beneficial. Acoustic Doppler (AD) and Colour Duplex Ultrasound (CDU) are the most practicable methods of localisation available. We designed a prospective study to analyse the correlation between preoperative localisation (by AD and CDU) and intraoperative findings, factoring in the advantages of using a high frequency probe for CDU. Methods Thirty-three consecutive patients were analysed in a prospective, observational study. AD was first used to mark the perforator point and its distance measured from two anatomical landmarks, the Anterior Superior Iliac Spine (ASIS) and the ‘Reference line’ (a line joining ASIS with the superior patellar border). CDU was then carried out to mark the perforator position with two probes (9 and 14 MHz), and the above distances measured for both points. At surgery, the actual point of perforator entry was separately marked and the same two distances were measured. A note was also made of perforator characteristics such as size and flow rate. Results In 21/33 cases, there was a close concordance between pre- and intraoperative localisation (complete success). From the remaining 12 cases, the complete absence of perforator was found in one case, a small, unreliable perforator in 2 cases and a site disparity of > 2 cm between true and preop points in 9 cases. Conclusion No significant advantages were found with either a high frequency probe or indeed for CDU over AD. AD is sufficient for effective perforator localisation and should be routinely employed to accurately plan the anterior incision. CDU can be employed in cases where AD is unconvincing.
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- 2021
20. Endovascular management of a large renal artery aneurysm: a case report and review of the literature
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A. Ari Hakimi, Peter H. Connolly, and Alec Zhu
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Male ,medicine.medical_specialty ,Computed Tomography Angiography ,Urology ,medicine.medical_treatment ,urologic and male genital diseases ,Diagnosis, Differential ,Pseudoaneurysm ,Renal Artery ,Aneurysm ,medicine.artery ,Case report ,medicine ,Humans ,Embolization ,cardiovascular diseases ,Ultrasonography, Doppler, Color ,Renal artery ,Renal ,Incidental Findings ,Kidney ,medicine.diagnostic_test ,business.industry ,Endovascular Procedures ,Angiography ,Interventional radiology ,General Medicine ,Middle Aged ,Vascular surgery ,medicine.disease ,Embolization, Therapeutic ,Artery ,Kidney Neoplasms ,Diseases of the genitourinary system. Urology ,medicine.anatomical_structure ,Reproductive Medicine ,cardiovascular system ,Radiology ,RC870-923 ,business ,Magnetic Resonance Angiography - Abstract
Background A renal artery aneurysm is a rare clinical presentation that can be found incidentally on imaging or during workup for refractory hypertension. Its presentation can be similar to that of a renal artery pseudoaneurysm, but the etiologies of the two vascular lesions differ. We present a patient who had an incidental finding of a large renal artery aneurysm that was managed with endovascular embolization. We also describe the literature surrounding the etiology, presentation and management of both renal artery aneurysms and renal artery pseudoaneurysms. Case presentation A 62-year-old man was referred to a urologic oncologist for workup of a newly found renal mass. Initial imaging with computed tomography showed a homogenous, well-circumscribed mass arising from the right kidney. Further evaluation with Doppler ultrasonography demonstrated pulsatile flow within the renal mass that was concerning for a renal artery pseudoaneurysm. The patient initially underwent a diagnostic angiogram by interventional radiology and was found to have a true renal artery aneurysm. Interventional radiology considered placement of a covered stent or angioembolization, but treatment was deferred due to concern for compromising the patient’s renal function. Patient was subsequently transferred to a neighboring hospital for management by vascular surgery. After considering both open surgical and endovascular approaches, the patient ultimately underwent angioembolization of the renal artery aneurysm. Short-term follow-up showed successful exclusion of the aneurysm with minimal adverse effects to the patient. Conclusions Our case report documents a unique case of an incidentally found large renal artery aneurysm that was successfully managed with endovascular embolization. Renal artery aneurysms and renal artery pseudoaneurysms, which can present similarly on imaging, are important diagnostic considerations in a patient presenting with a new renal mass. While open surgical approaches can be used to repair aneurysms, endovascular approaches using stenting or angioembolization are safe and effective options for treating renal aneurysms and renal pseudoaneurysms.
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- 2021
21. Transcranial Doppler Ultrasonography in Pre-hospital Management of Stroke: Can it make a Difference?
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Sandro Sanguigni, Giovanni Malferrari, Piergiorgio Lochner, and Antonio Siniscalchi
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medicine.medical_specialty ,Stroke patient ,Ultrasonography, Doppler, Transcranial ,business.industry ,medicine.disease ,Hospitals ,Transcranial Doppler ultrasonography ,Transcranial Doppler ,Stroke ,Internal medicine ,Occlusion ,medicine ,Cardiology ,Humans ,Radiology, Nuclear Medicine and imaging ,Ultrasonography, Doppler, Color ,business ,Acute ischemic stroke - Abstract
The aim of this paper is to discuss the use of transcranial doppler in the pre-hospital management of stroke. In the pre-hospital organization, neurological defect scales are used, but they are often indicative of the occlusions of anterior circulation and not of the posterior circulation. Patients with posterior circulation stroke are sometimes not diagnosed and clinically treated. In the pre-hospital phase, the transcranial doppler may identify an occlusion of the large cerebral vessels and be useful for stroke patients, in particular those with posterior occlusions, for a more precise diagnosis and consequently for adequate treatment in the excellence centers for stroke.
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- 2021
22. Effect of calcium dobesilate on retrobulbar blood flow and choroidal thickness in patients with non-proliferative diabetic retinopathy
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Mohammad Reza Khalili, Hossein Ashraf, Maryam Akbari, Hamidreza Jahanbani-Ardakani, Mehrzad Lotfi, and Morteza Ghaffari
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Adult ,medicine.medical_specialty ,Central retinal artery ,Retinal Artery ,Blood–retinal barrier ,Calcium dobesilate ,Calcium Dobesilate ,Ciliary Arteries ,Ophthalmic Artery ,medicine.artery ,Ophthalmology ,Diabetes mellitus ,Diabetes Mellitus ,medicine ,Humans ,Ultrasonography, Doppler, Color ,Aged ,Diabetic Retinopathy ,business.industry ,Diabetic retinopathy ,Blood flow ,Middle Aged ,medicine.disease ,Ciliary arteries ,medicine.anatomical_structure ,Regional Blood Flow ,Ophthalmic artery ,business ,Blood Flow Velocity ,medicine.drug - Abstract
Diabetic retinopathy is one of the most common causes of blindness in work-aging adults and develops in one third of diabetic patients. Calcium dobesilate (CaD) treatment have protective effects on blood retinal barrier (BRB) and anti-oxidant as well as anti-inflammatory properties. To assess effects of CaD administration on retrobulbar blood flow and choroidal thickness in patients with diabetic retinopathy. In this quasi-experimental study, diabetic patients with diabetic retinopathy (DR) were recruited from Shahid Motahari and Poostchi ophthalmology clinic affiliated to Shiraz University of Medical Sciences. Patients were treated with CaD, 1 gr per day for seven days. Before and after CaD administration, retrobulbar blood flow and subfoveal choroidal thickness were assessed. Retrobulbar blood flow were evaluated by measuring peak systolic velocity (PSV), end diastolic velocity (EDV) and resistive index (RI) of ophthalmic artery (OA), central retinal artery (CRA) and short ciliary artery (SCA). In this study, 26 DR patients with a mean age of 56.15 ± 8.93 years and mean diabetes mellitus duration of 15.04 ± 7.64 years were enrolled. Subfoveal choroidal thickness was significantly increased from 316.08 ± 61.69 to 327.81 ± 58.03 after CaD treatment (P value
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- 2021
23. Pedal Acceleration Time (PAT): A Novel Predictor of Limb Salvage
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Matthew Dally, Jill Sommerset, Yolanda Vea, Riyad Karmy Jones, Desarom Teso, and Beejay Feliciano
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Male ,medicine.medical_specialty ,Time Factors ,Percutaneous ,Databases, Factual ,Limb salvage ,medicine.medical_treatment ,Ischemia ,030204 cardiovascular system & hematology ,Risk Assessment ,Amputation, Surgical ,030218 nuclear medicine & medical imaging ,Peripheral Arterial Disease ,03 medical and health sciences ,0302 clinical medicine ,Predictive Value of Tests ,Risk Factors ,Internal medicine ,Humans ,Medicine ,Ultrasonography, Doppler, Color ,Aged ,Retrospective Studies ,Aged, 80 and over ,Foot ,business.industry ,Endovascular Procedures ,Ultrasound ,General Medicine ,Intermittent Claudication ,Limb Salvage ,medicine.disease ,Peripheral ,body regions ,Treatment Outcome ,medicine.anatomical_structure ,Amputation ,Regional Blood Flow ,Ultrasonography, Doppler, Pulsed ,Cardiology ,Female ,Vascular Grafting ,Surgery ,Ankle ,Cardiology and Cardiovascular Medicine ,business ,Blood Flow Velocity ,Artery - Abstract
Background In the setting of Peripheral Arterial Disease (PAD), pedal arch interrogation by ultrasound has not been well described. Patients with noncompressible vessels and/or open wounds of the foot may preclude the use of ankle-brachial indices, toe pressure measurements, or TcPO2, respectively. We propose that pedal artery interrogations with Pedal Acceleration Time (PAT) can be a predictor for limb salvage in patients with Chronic Limb-Threatening Ischemia (CLTI). Methods A retrospective review of a prospectively kept database was performed from 2018 to 2019. Patients with pending amputation due to severe infection (WIFI infection class 2 and 3) were excluded from the study. We identified 73 limbs with CLTI that fit the inclusion criteria. Data included WIFI classification, age, gender, cardiovascular risk factors, PAT, ABI, and TBI when reliable, were collected. PAT measurements were categorized into 4 classifications; 1 (40–120 msec), 2 (121–180 msec), 3 (181–224 msec), and 4 (Greater than 225 msec). Statistical analyses were performed. Results Seventy-three limbs with CLTI were included in our study. All patients underwent arterial revascularization with either percutaneous technique or arterial bypass. Limb salvage was achieved in 59 (81%) of the 73 limbs. All 59 limbs had a 2-classification improvement in their PAT following interventions. A total of 14 (19%) limbs without improvement in their PAT underwent above ankle level amputations. An improvement in PAT classes to class 1 or 2 is associated with limb salvage. Conclusions Patients with noncompressible ankle pressures or nonobtainable toe pressures poses a challenge in the complete assessment of WIFI classification. Our group has shown that PAT can be used in the scoring system for severity of ischemia in conjunction with current WIFI classification. Our data suggests that limb salvage correlates with post procedure PAT in category 1 and 2. Therefore we propose that PAT be added as part of the WIFI classification.
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- 2021
24. Editor's Choice – A Comparison of Computed Tomography Angiography and Colour Duplex Ultrasound Surveillance Post Infrarenal Endovascular Aortic Aneurysm Repair: Financial Implications and Impact of Different International Surveillance Guidelines
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Soundrie Padayachee, Mark Tyrrell, Nicholas Thomas, Andrew J. Arnold, Luke Smith, Rachel Bell, and Hany Zayed
- Subjects
Male ,Reoperation ,medicine.medical_specialty ,Endoleak ,Computed Tomography Angiography ,medicine.medical_treatment ,Contrast Media ,Nice ,030204 cardiovascular system & hematology ,030230 surgery ,Endovascular aneurysm repair ,03 medical and health sciences ,Postoperative Complications ,0302 clinical medicine ,Cohen's kappa ,Humans ,Medicine ,Ultrasonography, Doppler, Color ,Aged ,Retrospective Studies ,Computed tomography angiography ,computer.programming_language ,Aged, 80 and over ,Finance ,Aortic aneurysm repair ,medicine.diagnostic_test ,business.industry ,Incidence (epidemiology) ,Endovascular Procedures ,Ultrasound ,Acute Kidney Injury ,Middle Aged ,Vascular surgery ,Population Surveillance ,Practice Guidelines as Topic ,Female ,Surgery ,Guideline Adherence ,Cardiology and Cardiovascular Medicine ,business ,computer ,Aortic Aneurysm, Abdominal ,Follow-Up Studies - Abstract
Objective Use of colour duplex ultrasound (CDUS) and computed tomography angiography (CTA) for infrarenal endovascular aortic aneurysm repair (EVAR) surveillance differs in internationally published guidelines. This study aimed firstly to compare CDUS detection of significant sac abnormalities with CTA. Secondly, a sensitivity analysis was conducted to compare financial estimates of the, predominantly CDUS based, local and Society of Vascular Surgery (SVS) protocols, the risk stratified European Society of Vascular Surgery (ESVS) protocol, and the CTA based National Institute of Health and Care Excellence (NICE) protocol. Methods Agreement between CDUS and CTA was assessed for detection of significant sac abnormalities. Surveillance protocols were extrapolated from published guidelines and applied to infrarenal EVAR patients active on local surveillance at a large, single centre. Surveillance intensity was dependent on presence of endoleak and subsequent risk of treatment failure in accordance with surveillance recommendations. Estimates for each surveillance protocol were inclusive of a range of published incidences of endoleak, contrast associated acute kidney injury (AKI), and excess hospital bed days, and estimated for a hypothetical five year surveillance period. Results The kappa coefficient between CDUS and CTA for detecting sac abnormalities was 0.68. Maximum five year surveillance cost estimates for the 289 active EVAR patients were £272 359 for SVS, £230 708 for ESVS, £643 802 for NICE, and £266 777 for local protocols, or £1 270, £1 076, £3 003, and £1 244 per patient. Differences in endoleak incidence accounted for a 1.1 to 1.4 fold increase in costs. AKI incidence accounted for a 3.3 to 6.2 fold increase in costs. Conclusion A combined CTA and CDUS EVAR surveillance protocol, with CTA reserved for early seal assessment and confirmatory purposes, provides an economical approach without compromising detection of sac abnormalities. AKI, as opposed to direct imaging costs, accounted for the largest differences in surveillance cost estimates.
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- 2021
25. Basics for performing a high-quality color Doppler sonography of the vascular access
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Gianfranco Lasalle, Mario Meola, Jose Ibeas, and Ilaria Petrucci
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pulse wave Doppler ,medicine.medical_specialty ,arterio-venous fistula ,030232 urology & nephrology ,Vascular access ,Arteriovenous fistula ,030218 nuclear medicine & medical imaging ,Upper Extremity ,B-mode ultrasound ,03 medical and health sciences ,0302 clinical medicine ,Original Research Articles ,Humans ,Medicine ,Ultrasonography, Doppler, Color ,Ultrasonography ,Doppler/B-mode setting ,business.industry ,B mode ultrasound ,Doppler parameters ,Ultrasound ,Color doppler ,medicine.disease ,Arterio-venous fistula ,medicine.anatomical_structure ,Vascular network ,Nephrology ,Arteriovenous Fistula ,Upper limb ,Surgery ,Radiology ,business ,Blood Flow Velocity - Abstract
In the last years, the systematic use of ultrasound mapping of the upper limb vascular network before the arteriovenous fistula (AVF) implantation, access maturation, and clinical management of late complications is widespread and expanding. Therefore, a good knowledge of theoretical outlines, instrumentation, and operative settings is undoubtedly required for a thorough examination. In this review, the essential Doppler parameters, B-Mode setting, and Doppler applications are considered. Basic concepts on the Doppler shift equation, angle correction, settings on pulse repetition frequency, operative Doppler frequency, gain are reported to ensure adequate and correct sampling of blood flow velocity. A brief analysis of the Doppler inherent artefacts (as random noise, blooming, aliasing, and motion artefacts) and the adjustment setting to minimize or eliminate the confounding artefacts are also considered. Doppler aliasing occurs when the pulse repetition frequency is set too low. This artefact is particularly frequent in vascular access sampling due to the high velocities range registered in the fistula’s different segments. Aliasing should be recognized because its correction is crucial to analyse the Doppler signals correctly. Recent advances in instrumentation are also considered about a potential purchase of a portable ultrasound machine or a top-of-line, high-end, or mid-range ultrasound system. Last, the pulse wave Doppler setting for vascular access B-Mode and Doppler assessment is summarized.
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- 2021
26. Case 21-2021: A 33-Year-Old Pregnant Woman with Fever, Abdominal Pain, and Headache
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Craig R. Audin, Melis N. Anahtar, Kathy M. Tran, and Andrea L. Ciaranello
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Adult ,Abdominal pain ,Pediatrics ,medicine.medical_specialty ,Fever ,Nausea ,Placenta ,Abortion ,Diagnosis, Differential ,Pregnancy ,Abdomen ,Humans ,Medicine ,Listeriosis ,Pregnancy Complications, Infectious ,Ultrasonography, Doppler, Color ,Fetal Death ,reproductive and urinary physiology ,business.industry ,Headache ,General Medicine ,medicine.disease ,Listeria monocytogenes ,Magnetic Resonance Imaging ,Ulcerative colitis ,Abdominal Pain ,medicine.anatomical_structure ,Vomiting ,Gestation ,Female ,Abortion, Missed ,medicine.symptom ,business - Abstract
A Pregnant Woman with Fever, Abdominal Pain, and Headache A 33-year-old pregnant woman with ulcerative colitis presented at 10 weeks of gestation with fever, nausea, vomiting, abdominal pain, and h...
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- 2021
27. Investigation of flow velocity in recipient perforator artery for a reliable indicator for the flap transfer with perforator to perforator anastomosis
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Shogo Nagamatsu, Isao Koshima, Hirofumi Imai, Kazunori Yokota, Ayano Sasaki, Shuhei Yoshida, and Toshio Uchiki
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medicine.medical_specialty ,Lower extremity lymphedema ,business.industry ,Anastomosis, Surgical ,Arteries ,Dissection (medical) ,Blood flow ,Plastic Surgery Procedures ,Anastomosis ,Lymphatic flow ,medicine.disease ,Surgery ,Vessel diameter ,medicine.anatomical_structure ,medicine ,Humans ,Flap survival ,Ultrasonography, Doppler, Color ,business ,Perforator Flap ,Artery - Abstract
Introduction In flap transfer with perforator to perforator anastomosis (FTPPA), encountering poor pulsation and blood flow in a recipient perforator intraoperatively often makes FTPPA impossible. This study sought to identify color and spectral Doppler ultrasonography (CSDUS) parameters that can aid reliable preoperative selection of a recipient perforator artery. Patients and methods The study enrolled 38 patients with lower extremity lymphedema who underwent vascularized lymphatic tissue transfer with perforator to perforator anastomosis for physiological lymphatic flow reconstruction. In all cases, three candidate recipient perforators were searched in each lower extremities, and vessel diameter and peak systolic flow velocity (PSFV) were measured. The inclusion criteria for candidates were a vessel diameter of >0.5 mm and a PSFV of >10 cm/s. These measures were compared with intraoperative findings, diameters and if there was pulsation and visible spurting evident. Results A total of 114 candidates were selected, and 52 of the candidates were dissected until suitable perforators were found. PSFV (cm/s) on CSDUS was ≥20.0 in 32 perforators (84.2%) and was 15.0-19.9 in 6 perforators (15.8%) in the group with pulsation and visible spurting evident, and 15.0-19.9 in one perforator (7.1%) and ≤ 14.9 in 13 perforators (92.9%) in the group without pulsation and visible spurting evident. There was a statistically significant correlation between preoperative PSFV and intraoperative pulsation and visible spurting evident after dissection (P = 0.021 × 10-3 ). The flap survival rate was 92.1%. Conclusion PSFV is an important preoperative determinant of the suitability of a recipient perforator artery for FTPPA.
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- 2021
28. Prediction of successful caudal epidural injection using color Doppler ultrasonography in the paramedian sagittal oblique view of the lumbosacral spine
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Min-Jong Ki, Ye Sull Kim, Cheol Jong Woo, Ji-Seon Son, A Ram Doo, and Seon Woo Yoo
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Lumbosacral spine ,media_common.quotation_subject ,Oblique projection ,Contrast Media ,Injections, Epidural ,Lumbar vertebrae ,Sensitivity and Specificity ,symbols.namesake ,Medicine ,Contrast (vision) ,Fluoroscopy ,Ultrasonography, Doppler, Color ,Clinical Research Articles ,Ultrasonography, Interventional ,media_common ,Lumbar Vertebrae ,medicine.diagnostic_test ,business.industry ,Sagittal plane ,Contrast medium ,Anesthesiology and Pain Medicine ,medicine.anatomical_structure ,symbols ,Equivalence Trial ,business ,Nuclear medicine ,Anesthesia, Caudal ,Low Back Pain ,Doppler effect - Abstract
Background: Ultrasound-guided caudal epidural injection (CEI) is limited in that it cannot confirm drug distribution at the target site without fluoroscopy. We hypothesized that visualization of solution flow through the inter-laminar space of the lumbosacral spine using color Doppler ultrasound alone would allow for confirmation of drug distribution. Therefore, we aimed to prospectively evaluate the usefulness of this method by comparing the color Doppler image in the paramedian sagittal oblique view of the lumbosacral spine (LS-PSOV) with the distribution of the contrast medium observed during fluoroscopy. Methods: Sixty-five patients received a 10-mL CEI of solution containing contrast medium under ultrasound guidance. During injection, flow was observed in the LSPSOV using color Doppler ultrasonography, following which it was confirmed using fluoroscopy. The presence of contrast image at L5-S1 on fluoroscopy was defined as “successful CEI.” We then calculated prediction accuracy for successful CEI using color Doppler ultrasonography in the LS-PSOV. We also investigated the correlation between the distribution levels measured via color Doppler and fluoroscopy. Results: Prediction accuracy with color Doppler ultrasonography was 96.9%. The sensitivity, specificity, positive predictive value, and negative predictive value were 96.7%, 100%, 100%, and 60.0%, respectively. In 52 of 65 patients (80%), the highest level at which contrast image was observed was the same for both color Doppler ultrasonography and fluoroscopy. Conclusions: Our findings demonstrate that color Doppler ultrasonography in the LS-PSOV is a new method for determining whether a drug solution reaches the lumbosacral region (i.e. , the main target level) without the need for fluoroscopy.
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- 2021
29. Contribution of pre-varicocelectomy color Doppler ultrasonography finding to surgery and its correlation with semen parameters
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Caner Ediz, Serkan Yenigürbüz, Suna Şahin Ediz, Mehmet Pehlivanoğlu, Muhammed Cihan Temel, Serkan Akan, and Omer Yilmaz
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Male ,medicine.medical_specialty ,Urology ,Varicocele ,030232 urology & nephrology ,Semen ,Physical examination ,Veins ,Correlation ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Color doppler ultrasonography ,Humans ,In patient ,Ultrasonography, Doppler, Color ,Surgical treatment ,030219 obstetrics & reproductive medicine ,medicine.diagnostic_test ,Abnormal semen ,business.industry ,Varicocelectomy ,Semen Parameters ,medicine.disease ,Diseases of the genitourinary system. Urology ,Number of Vein Ligated ,Semen Analysis ,RC870-923 ,Radiology ,Color Doppler Ultrasonography ,business - Abstract
Background: This study aimed to determine the contribution of color Doppler ultrasonography (CDUS) performed before varicocelectomy to the success of surgical treatment and to evaluate the correlation between CDUS findings and semen parameters. Methods: A total of 84 patients diagnosed with grade 3 left varicocele in our clinic between 2016 and 2018 were evaluated. The patients in whom the decision for varicocelectomy was based on only physical examination (PE) findings and abnormal semen analysis (SA) were defined as Group 1, while the patients undergoing varicocelectomy based on PE, CDUS and SA findings were defined as Group 2. The patients diagnosed with varicocele based on PE and CDUS findings who were included in a followup protocol due to normal semen parameters were defined as Group 3. Results: In Group 1, there was a total of 28 patients and the mean number of ligated internal spermatic veins was 4.53 (range, 2-10). In Group 2, there was a total of 30 patients and the number of ligated internal spermatic veins was 3.76 (range, 1-8). No statistically significant difference was found between Group 1 and 2 in terms of the number of internal spermatic veins ligated during varicocelectomy. No statistically significant correlation was found between semen parameters and the number of veins ligated during varicocelectomy in Group 1 and 2 and between semen parameters and CDUS findings group 2 and 3. Conclusions: In patients with primary grade 3 varicocele, diagnosed by physical examination there is no need for additional imaging in primary cases.
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- 2021
30. Arterial evaluation of systemic sclerosis patients with Doppler ultrasound: What did we find?
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Eren Erken, Suade Özlem Badak, Hülya Binokay, Esra Kayacan Erdoğan, and Bozkurt Gulek
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Adult ,Male ,medicine.medical_specialty ,Carotid arteries ,Cardiovascular risk factors ,Disease ,Carotid Intima-Media Thickness ,03 medical and health sciences ,0302 clinical medicine ,Rheumatology ,Predictive Value of Tests ,Risk Factors ,Internal medicine ,medicine ,Humans ,cardiovascular diseases ,030212 general & internal medicine ,Ultrasonography, Doppler, Color ,Prospective cohort study ,Aged ,Macrovascular disease ,030203 arthritis & rheumatology ,Scleroderma, Systemic ,business.industry ,Arteries ,Middle Aged ,medicine.disease ,Arterial occlusion ,Peripheral ,Carotid Arteries ,Cross-Sectional Studies ,Microvessels ,cardiovascular system ,Cardiology ,Female ,Doppler ultrasound ,Tunica Intima ,Tunica Media ,business - Abstract
AIM The aim of this study was to detect macrovascular findings in systemic sclerosis (SSc) by means of color Doppler ultrasonography (CDUS) and to evaluate the relationship between the laboratory and clinical findings in the setting of the disease. METHODS This was a cross-sectional study. Eighty-eight patients were included in the study. CDUS examinations of the bilateral carotid, vertebral, and peripheral arteries were performed. The presence of macrovascular involvement was investigated and recorded, and its relationships with the clinical, laboratory, and cardiovascular risk factors were evaluated. RESULTS An atheromatous plaque was found in 67.7% of the 1936 arteries examined by CDUS. Of these 1936 arteries, 37.4% demonstrated a narrowing of the intraluminal diameter. On the other hand, the carotid intima-media thickness (CIMT) was found to have increased in 55.7% of the patients. This increase was found to be statistically correlated with disease duration, the modified Rodnan Skin Thickness Score, and the Medsger Disease Activity Score. But no relation existed with the disease subtype, age, or cardiovascular risk factors. Arterial occlusion was detected in 10 patients. An association was found between the CIMT values and arterial occlusion. CONCLUSIONS In this study, we examined the arteries by means of CDUS, and we detected structural alterations in the peripheral and carotid arteries. We witnessed that these macrovascular changes had a close association with certain features of SSc. We think there is a need for broader prospective studies in order to evaluate the contribution of these factors to the macrovascular changes stated in the article.
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- 2021
31. Role of color flow Doppler ultrasound in the evaluation of acute scrotal pain
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Akshya Gupta and Vikram S. Dogra
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Male ,Acute scrotal pain ,endocrine system ,medicine.medical_specialty ,genetic structures ,endocrine system diseases ,Urology ,Endocrinology, Diabetes and Metabolism ,Pain ,Orchitis ,urologic and male genital diseases ,Diagnosis, Differential ,03 medical and health sciences ,0302 clinical medicine ,Endocrinology ,Scrotum ,medicine ,Humans ,Testicular torsion ,Ultrasonography, Doppler, Color ,Spermatic Cord Torsion ,Epididymitis ,030219 obstetrics & reproductive medicine ,urogenital system ,business.industry ,Color flow doppler ,Ultrasound ,Torsion (gastropod) ,medicine.disease ,Patient management ,medicine.anatomical_structure ,Reproductive Medicine ,Radiology ,business - Abstract
Color flow Doppler ultrasound is a critical tool in the assessment of the scrotum. Ultrasound is the first-line imaging modality and can rapidly differentiate between surgical and nonsurgical conditions, allowing for appropriate and prompt patient management. We review the role of color flow Doppler in the evaluation of acute scrotal pain, highlighting some of the most commonly seen pathologies such as epididymo-orchitis and testicular torsion.
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- 2021
32. Internal pudendal perforator artery flap harvesting without pre-operative imaging: Reliability and approach
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Raphael Sinna, N. Assaf, Swanie Dast, A. Lari, and Pierre-Antoine Giroux
- Subjects
Adult ,Male ,medicine.medical_specialty ,Routine ultrasound ,Dissection (medical) ,Perineum ,03 medical and health sciences ,0302 clinical medicine ,Operating time ,medicine ,Humans ,Ultrasonography, Doppler, Color ,Anthropometry ,business.industry ,Reproducibility of Results ,030208 emergency & critical care medicine ,Arteries ,Plastic Surgery Procedures ,medicine.disease ,Ischial tuberosity ,Pre operative ,Lithotomy position ,Surgery ,Anatomical landmark ,medicine.anatomical_structure ,Dimensional Measurement Accuracy ,030220 oncology & carcinogenesis ,Tissue and Organ Harvesting ,Buttocks ,Female ,Anatomic Landmarks ,business ,Perforator Flap ,Artery - Abstract
Since its initial description in 1996 by Yii and Niranjan, the internal pudendal perforator flap (also known as the Singapore flap, the gluteal fold flap, and the lotus petal flap) has become a workhorse in perineal soft tissue reconstruction. In 2001, Hashimoto described the presence of three to five perforators in the perineal anogenital triangle. The ischial tuberosity has thus become a useful anatomic landmark for the safe boundary of medial dissection during flap elevation, in order to avoid damaging the perforator vessels. The objective of the present study was to evaluate the perforators’ positions within the anogenital triangle by using color Doppler ultrasound. In a study of 15 subjects in the lithotomy position, we identified a total of 24 perforator vessels with a diameter greater than 5 mm. We noted the vessels’ positions using orthonormal measurements, according to the distance from the midline and the distance on a straight line between the two ischial tuberosities (i.e. consistent bony anatomic landmarks that are independent of the patient's height and body mass index). The mean distance between the ischial tuberosity and the internal pudendal perforator was 27.3 mm. Based on our present results, we consider that routine ultrasound identification and dissection of the perforators is not always required before pudendal flap harvesting. This decreases the operating time and simplifies the flap harvesting procedure.
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- 2021
33. Diagnostic Performance of a Sonographic Volume and Solid Vascular Tissue Score (VSVTS) for Preoperative Risk Assessment of Pediatric and Adolescent Adnexal Masses
- Author
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Lara Farras Roca, Hanna R. Goldberg, Christopher Z. Lam, Afsaneh Amirabadi, Sari Kives, Lisa Allen, Oscar M. Navarro, and Ebtehaj Alshehri
- Subjects
Adult ,medicine.medical_specialty ,Adolescent ,medicine.medical_treatment ,Preoperative risk ,Malignancy ,Risk Assessment ,Likelihood ratios in diagnostic testing ,Adnexal mass ,Decision Support Techniques ,03 medical and health sciences ,0302 clinical medicine ,030225 pediatrics ,Preoperative Care ,medicine ,Humans ,Ultrasonography, Doppler, Color ,Child ,Retrospective Studies ,Ontario ,030219 obstetrics & reproductive medicine ,Receiver operating characteristic ,business.industry ,Obstetrics and Gynecology ,Oophorectomy ,Retrospective cohort study ,General Medicine ,Middle Aged ,medicine.disease ,Sick child ,ROC Curve ,Adnexal Diseases ,Neoplasms, Vascular Tissue ,Pediatrics, Perinatology and Child Health ,Female ,Radiology ,business - Abstract
Study Objective To evaluate the diagnostic performance of a Volume and Solid Vascular Tissue Score (VSVTS) for preoperative risk assessment of pediatric and adolescent adnexal masses. Design A retrospective cohort study comprised of all female individuals who presented with an adnexal mass that was managed surgically between April 2011 and March 2016. Setting The Hospital for Sick Children (Toronto, Ontario, Canada). Participants Female individuals 1–18 years of age who presented to a large tertiary pediatric hospital with an adnexal mass that was managed surgically. Main Outcome Measures Main outcome measures included diagnostic performance of the VSVTS for malignancy via sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio (LR+), negative likelihood ratio (LR−), and receiver operating characteristic area-under-the-curve (AUC) analysis. Results A total of 179 masses in 169 subjects were included. The malignancy rate was 10.6%. The AUC for the VSTVS was 0.919. A VSTVS cut-off value of 4 achieved a sensitivity of 79% (95% CI 0.54-0.93), specificity of 88% (95% CI 0.82-0.93), PPV of 0.44 (95% CI 0.33-0.56), NPV of 0.97 (95% CI 0.94-0.99), LR+ of 6.77 (95% CI 4.18-10.97), and LR− of 0.24 (95% CI 0.10-0.57). Conclusions A sonographic scoring system based on the volume and presence of solid vascular tissue improves PPV for preoperative risk stratification of adnexal masses in the pediatric and adolescent population compared to existing ultrasound-only approaches. Further prospective research is needed to determine how best to incorporate components of such scoring systems into clinical management algorithms.
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- 2021
34. Dynamic carotid plaque imaging using ultrasonography
- Author
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Toby Richards, Efthyvoulos Kyriacou, Constantinos S. Pattichis, Maura Griffin, George Geroulakos, Joanna Michael, Andrew Nicolaides, and Argyrios A. Giannopoulos
- Subjects
Male ,Video Recording ,030204 cardiovascular system & hematology ,Severity of Illness Index ,Medical and Health Sciences ,0302 clinical medicine ,Diastole ,Risk Factors ,Carotid Stenosis ,Prospective Studies ,030212 general & internal medicine ,Ultrasonography, Doppler, Color ,Stroke ,Aged, 80 and over ,Hazard ratio ,Middle Aged ,Prognosis ,Plaque, Atherosclerotic ,Motion analysis ,Engineering and Technology ,Female ,Concordant ,Discordant ,Radiology ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,Carotid Artery, Internal ,Computer and Information Sciences ,medicine.medical_specialty ,Systole ,Risk Assessment ,Asymptomatic ,03 medical and health sciences ,Predictive Value of Tests ,Image Interpretation, Computer-Assisted ,Ultrasound ,medicine ,Humans ,Aged ,Rupture, Spontaneous ,Receiver operating characteristic ,business.industry ,medicine.disease ,Confidence interval ,Stenosis ,Cross-Sectional Studies ,Atherosclerotic carotid plaque ,Surgery ,Clinical Medicine ,business - Abstract
Objective Dynamic image analysis of carotid plaques has demonstrated that during systole and early diastole, all plaque components will move in the same direction (concordant motion) in some plaques. However, in others, different parts of the plaque will move in different directions (discordant motion). The aim of our study was (1) to determine the prevalence of discordant motion in symptomatic and asymptomatic plaques, (2) to develop a measurement of the severity of discordant motion, and (3) to determine the correlation between the severity of discordant motion and symptom prevalence. Methods A total of 200 patients with 204 plaques resulting in 50% to 99% stenosis (112 asymptomatic and 92 symptomatic plaques) had video recordings available of the plaque motion during 10 cardiac cycles. Video tracking was performed using Farneback's method, which relies on frame comparisons. In our study, these were performed at 0.1-second intervals. The maximum angular spread (MAS) of the motion vectors at 10-pixel intervals in the plaque area was measured in degrees. Plaques were classified as concordant (MAS, 120°). Results Motion was discordant in 89.1% of the symptomatic plaques but only in 17.9% of asymptomatic plaques (P < .001). The prevalence of symptoms increased with increasing MAS. For a MAS >120°, the hazard ratio for the presence of symptoms was 47.7 (95% confidence interval, 18.1-125.6) compared with the rest of the plaques after adjustment for the degree of stenosis and mean pixel motion. The area under the receiver operating characteristic curve for the prediction of the presence of symptoms using the MAS was 0.876 (95% confidence interval, 0.823-0.929). The use of the median MAS (120°) as a cutoff point classified 86% of the plaques correctly (sensitivity, 81.4%; specificity, 91.2%; positive predictive value, 90.2%; and negative predictive value, 83.0%). Conclusions The use of the MAS value to identify asymptomatic plaques at increased risk of developing symptoms and, in particular, stroke should be tested in prospective studies.
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- 2021
35. Color Doppler ultrasonographic evaluation of management of papulopustular rosacea
- Author
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Eliseo Fuentes, Ximena Wortsman, María Elena McNab, Andrea Cortés, Ariel Castro, and Roberto Bustos
- Subjects
Adult ,Male ,Dermatologic ultrasound ,medicine.medical_specialty ,Dermatology ,Administration, Cutaneous ,Ivermectin ,Metronidazole ,medicine ,Humans ,Papulopustular rosacea ,Ultrasonography, Doppler, Color ,Skin ,business.industry ,Color doppler ,Middle Aged ,medicine.disease ,Healthy Volunteers ,Treatment Outcome ,Rosacea ,Drug Therapy, Combination ,Female ,business ,Follow-Up Studies ,medicine.drug - Published
- 2021
36. Evaluation of Stone Features That Cause the Color Doppler Ultrasound Twinkling Artifact
- Author
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Eric Rokni, Scott A. Zinck, and Julianna C. Simon
- Subjects
Artifact (error) ,Materials science ,Acoustics and Ultrasonics ,Radiological and Ultrasound Technology ,Diagnostic ultrasound ,030232 urology & nephrology ,Biophysics ,Color shift ,Color doppler ultrasound ,medicine.disease ,030218 nuclear medicine & medical imaging ,Kidney Calculi ,03 medical and health sciences ,0302 clinical medicine ,Microbubbles ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Kidney stones ,Tomography ,Ultrasonography, Doppler, Color ,Artifacts ,Twinkling ,Biomedical engineering - Abstract
The color Doppler ultrasound twinkling artifact is a rapid color shift that appears on 43%-96% of kidney stones. Surface microbubbles on kidney stones are theorized to cause twinkling as exposure to elevated static pressures of 0.41-1.13 MPa (approximately 0.5-1 times diagnostic ultrasound pressure and 5-10 times ambient pressure) reduced twinkling. However, it is unclear what external and internal stone features support bubbles. Thirteen ex vivo kidney stones were scanned with color Doppler ultrasound at 2.5, 5 and 18.5 MHz. Select stones were imaged with environmental scanning electron microscopy or underwater micro-computed tomography to evaluate features that may cause twinkling. Results revealed that the lower frequencies produced larger volumes of twinkling. Condensation first occurred in the smallest (∼1 µm diameter) surface pores and may be indicative of where bubbles form. Gas pockets were seen inside two of three tested stones that may contribute to twinkling. Overall, these results provide evidence of cavity structures both externally and internally and their correlation to the twinkling artifact. This indicates that microbubbles may be present on and within kidney stones and may contribute to the twinkling artifact.
- Published
- 2021
37. Associations of Renal Augmented Velocity Index with Arterial Stiffness, Carotid Intima–Media Thickness and Blood Pressure, in Comparison with Renal Resistive Index
- Author
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Alice P.S. Kong, Juliana C.N. Chan, Kin Hung Liu, Ming Chung Lee, Ling Chen, and Winnie C.W. Chu
- Subjects
Adult ,Male ,medicine.medical_specialty ,Acoustics and Ultrasonics ,Biophysics ,Blood Pressure ,030204 cardiovascular system & hematology ,Carotid Intima-Media Thickness ,Velocity index ,03 medical and health sciences ,Renal Artery ,Vascular Stiffness ,0302 clinical medicine ,Internal medicine ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Ultrasonography, Doppler, Color ,Radiological and Ultrasound Technology ,business.industry ,Middle Aged ,medicine.disease ,Resistive index ,Cross-Sectional Studies ,Blood pressure ,Intima-media thickness ,Hypertension ,cardiovascular system ,Cardiology ,Arterial stiffness ,Female ,Vascular Resistance ,030211 gastroenterology & hepatology ,Aortic stiffness ,business ,Blood Flow Velocity - Abstract
The augmented velocity index (Avi) is a new Doppler index associated with arterial stiffness. We examined associations of renal Avi with blood pressure (BP), aortic stiffness and carotid intima-media thickness (IMT), and compared its performance with that of resistive index (RI). One hundred forty-seven volunteers were recruited. Renal Avi had significant positive correlations with systolic BP (r = 0.37, p0.001), diastolic BP (r = 0.2, p = 0.016), mean arterial pressure (r = 0.29, p0.001), pulse pressure (r = 0.31, p0.001), carotid-femoral pulse wave velocity (r = 0.49, p0.001) and carotid IMT (r = 0.23, p = 0.005). RI correlated positively with pulse pressure (r = 0.3, p0.001) only. After adjustments for co-variables, the associations remained similar. Patients with abnormal BP values (≥130/80 mm Hg), IMT and aortic stiffness (≥1 standard deviation of mean value) had higher Avi than those with normal values, but not RI. In conclusion, renal Avi had stronger associations with BP, arterial stiffness and carotid IMT than RI in apparently healthy volunteers, and was significantly increased in abnormal patients.
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- 2021
38. Unusual Fever, Headache, and Abdominal Pain in a Healthy Woman
- Author
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Po-Jen Hsiao, Chia-Yi Lin, and Ching-Hsiang Wang
- Subjects
Adult ,Abdominal pain ,medicine.medical_specialty ,2019-20 coronavirus outbreak ,COVID-19 Vaccines ,Fever ,Coronavirus disease 2019 (COVID-19) ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,ChAdOx1 COVID-19 (AstraZeneca) Vaccine ,Hepatic Veins ,Gastroenterology ,Clinical Challenges and Images in GI ,Hepatic Vein Thrombosis ,Budd–Chiari Syndrome ,ChAdOx1 nCoV-19 ,Internal medicine ,medicine ,Humans ,Ultrasonography, Doppler, Color ,Hepatology ,Hepatic vein thrombosis ,SARS-CoV-2 ,business.industry ,Headache ,COVID-19 ,Thrombosis ,medicine.disease ,Thrombocytopenia ,Abdominal Pain ,Platelet Factor 4 (PF4) Antibodies ,Budd–Chiari syndrome ,Female ,medicine.symptom ,Tomography, X-Ray Computed ,business - Published
- 2021
39. A 59-year-old man with persistent fever, aphasia and leg pain
- Author
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Alexandre Lafleur, Benoit M. Labbé, and Pierre-Luc Harvey-Michaud
- Subjects
Male ,medicine.medical_specialty ,Computed Tomography Angiography ,Deep vein ,Persistent fever ,Pain ,030204 cardiovascular system & hematology ,Fever of Unknown Origin ,Veins ,Diagnosis, Differential ,03 medical and health sciences ,0302 clinical medicine ,Aphasia ,Enterococcus faecalis ,medicine ,Humans ,030212 general & internal medicine ,Ultrasonography, Doppler, Color ,Gram-Positive Bacterial Infections ,Venous Thrombosis ,Practice ,Embolic Stroke ,Leg ,business.industry ,Anticoagulants ,Leg pain ,What Is Your Call?: Sepsis ,Endocarditis, Bacterial ,General Medicine ,Emergency department ,Middle Aged ,medicine.disease ,Magnetic Resonance Imaging ,Thrombosis ,Surgery ,medicine.anatomical_structure ,medicine.vein ,Echocardiography ,Chills ,Posterior tibial vein ,medicine.symptom ,business ,Aneurysm, Infected - Abstract
A 59-year-old man presented to the emergency department with fever and chills that began 6 weeks earlier, when a symptomatic deep vein thrombosis (DVT) of the right posterior tibial vein had been diagnosed. The patient had also noticed word-finding difficulties and mild headache for the week before
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- 2021
40. Breast Imaging Reporting and Data System Classification for Central-Type Intra-Ductal Papillary Masses: Current Problems and Evaluation of Modified Parameters
- Author
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Jianlun Zhang, Shumin Wang, Hui Zhang, and Yan Sun
- Subjects
Adult ,medicine.medical_specialty ,Acoustics and Ultrasonics ,Breast imaging ,Biophysics ,Breast Neoplasms ,030218 nuclear medicine & medical imaging ,Diagnosis, Differential ,Papilloma, Intraductal ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Predictive Value of Tests ,Humans ,Medicine ,Effective treatment ,Radiology, Nuclear Medicine and imaging ,Ultrasonography, Doppler, Color ,Aged ,Retrospective Studies ,Radiological and Ultrasound Technology ,business.industry ,Retrospective cohort study ,Middle Aged ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Female ,Ultrasonography, Mammary ,Radiology ,Ultrasonography ,business ,Duct (anatomy) - Abstract
The Breast Imaging Reporting and Data System (BI-RADS) standards have limitations regarding classifying and managing central intra-ductal papillary masses. Changes to the standards are necessary to provide early and effective treatment. To summarize the ultrasonographic imaging features of central mammary ductal papillary masses, this retrospective study included 56 participants. In identifying benign versus malignant lesions, the most significant indicators were angular edges and the long diameter of the tumor parallel to the duct. In the comparison of diagnostic efficacy for central mammary ductal tumors, the post-operative pathologic malignant upgrade rate of BI-RADS was 33.3%, and that of the new standard criteria was 14.2%. The angle of the wall of the tumor relative to the duct was most helpful. When BI-RADS is used to evaluate a papillary mass in a central duct, it is more accurate when the tumor is parallel to the duct than parallel to the skin.
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- 2021
41. Diagnosis of Interventional Transvaginal Maternal Diseases Based on Color Doppler Ultrasound
- Author
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Hongye Jiang, Lan Huang, and Canliang Wen
- Subjects
Medicine (General) ,medicine.medical_specialty ,Article Subject ,Biomedical Engineering ,Uterus ,Health Informatics ,030204 cardiovascular system & hematology ,Adnexal mass ,03 medical and health sciences ,R5-920 ,0302 clinical medicine ,Corpus Luteum ,Pregnancy ,Medical technology ,medicine ,Humans ,Ultrasonography, Doppler, Color ,R855-855.5 ,030219 obstetrics & reproductive medicine ,Clinical pathology ,Ectopic pregnancy ,business.industry ,Blood flow ,medicine.disease ,Pregnancy, Ectopic ,Pregnancy Complications ,medicine.anatomical_structure ,Fetal circulation ,Quality of Life ,Female ,Surgery ,Radiology ,Differential diagnosis ,business ,Corpus luteum ,Research Article ,Biotechnology - Abstract
In recent years, with the development of color Doppler ultrasound technology in obstetrics, this noninvasive, direct, convenient, and sensitive inspection method has become one of the best methods to observe the fetal circulation in the uterus. This paper discusses the clinical value of using transvaginal color Doppler ultrasound in the differential diagnosis of ovarian corpus luteum disease and ectopic pregnancy disease. This paper selects 100 cases of ectopic pregnancy and 100 cases of pregnant corpus luteum as the experimental research objects. Clinical analysis of transvaginal color Doppler ultrasonography was performed on all patients. In the process of measuring the patient’s ectopic pregnancy, the size of the patient’s adnexal mass is mainly measured, and the blood flow spectrum is measured. The clinical choice of transvaginal color Doppler ultrasound method to distinguish ectopic pregnancy disease and corpus luteum pregnancy disease can play a significant value. It can be effectively diagnosed according to the type of disease, then effective methods can be studied for clinical treatment, the quality of life of patients with the two diseases can be significantly improved, and the clinical application value of color Doppler ultrasound can be improved.
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- 2021
42. Associations among temporal and large artery abnormalities on vascular ultrasound in giant cell arteritis
- Author
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Julia A. Ford, Chang Xu, Sizheng Steven Zhao, Michael A. DiIorio, Sara K. Tedeschi, Daniel H. Solomon, PS Sobiesczcyk, Weixing Huang, and William P. Docken
- Subjects
Pathology ,medicine.medical_specialty ,Giant Cell Arteritis ,Immunology ,Subclavian Artery ,Vascular ultrasound ,Article ,03 medical and health sciences ,0302 clinical medicine ,Text mining ,Rheumatology ,medicine ,Humans ,Immunology and Allergy ,Distribution (pharmacology) ,030212 general & internal medicine ,Ultrasonography, Doppler, Color ,Retrospective Studies ,030203 arthritis & rheumatology ,business.industry ,food and beverages ,Large artery ,General Medicine ,medicine.disease ,Temporal Arteries ,Giant cell arteritis ,business - Abstract
OBJECTIVES: Giant cell arteritis (GCA) can manifest in cranial and/or extracranial arteries. We investigated the distribution of affected arteries on vascular ultrasound (VUS) among patients with new-onset or prior-onset GCA. METHODS: We retrospectively studied patients with either new-onset or prior-onset GCA and an abnormal VUS, 2013–2017. Trained vascular technologists imaged the bilateral temporal arteries and carotid, axillary, and subclavian arteries. Vascular medicine physicians interpreted the images. Vasculitis-related abnormalities in individual vessels and their distribution (temporal artery, large artery, or both) were evaluated. Phi coefficients (φ) and Fisher’s exact test were used to assess correlations among individual abnormal arteries. RESULTS: Among 66 GCA patients, 28.8% had prior-onset GCA (median duration 17.8 months). Acute arteritis on VUS was observed in the majority of patients with both new-onset GCA (72.3%) and prior-onset GCA (68.4%); the remainder had hyperechoic wall thickening without acute arteritis. Involvement of the temporal arteries only (45.5%) or large arteries only (34.8%) was more common than involvement of both (19.7%); this finding was similar in new-onset and prior-onset GCA. There were moderate positive correlations among temporal artery branches (φ=0.51–0.58, p
- Published
- 2021
43. Combined Use of Color Doppler Ultrasound and Contrast-Enhanced Ultrasound in the Intraoperative Armamentarium for Arteriovenous Malformation Surgery
- Author
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Rina Di Bonaventura, Giuseppe Maria Della Pepa, Alfredo Puca, Carmelo Lucio Sturiale, Alessio Albanese, Enrico Marchese, Giovanni Sabatino, and Kristy Latour
- Subjects
Adult ,Indocyanine Green ,Intracranial Arteriovenous Malformations ,Male ,medicine.medical_specialty ,Combined use ,Contrast Media ,Multimodal Imaging ,Complete resection ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Humans ,Fluorescein Angiography ,Ultrasonography, Doppler, Color ,Coloring Agents ,Ultrasonography ,Intraoperative Care ,Rupture, Spontaneous ,business.industry ,Ultrasound ,Arteriovenous malformation ,Color doppler ultrasound ,Indocyanine green videoangiography ,Middle Aged ,medicine.disease ,Cerebral Angiography ,Cerebral arteriovenous malformations ,030220 oncology & carcinogenesis ,Arteriovenous Fistula ,Female ,Surgery ,Neurology (clinical) ,Radiology ,business ,030217 neurology & neurosurgery ,Contrast-enhanced ultrasound - Abstract
Background Safety and efficacy in surgical treatment of cerebral arteriovenous malformations (AVMs) are dictated by thorough understanding of angioarchitectural features, intraoperative identification of feeding vessels, and appreciation of surrounding eloquent areas. Our aim was to describe the preliminary results of combined application of color Doppler ultrasound (CDUS) and contrast-enhanced ultrasound (CEUS) in a consecutive surgical series of AVM. We pointed out the tool's efficacy in distinguishing feeding from bystander vessels and in identifying pattern of venous drainage. We examined its role as an adjunct for semiquantitative evaluation of the nidus inflow. Methods We used combined CDUS and CEUS in patients surgically treated for cerebral AVMs. We adopted these techniques following a designed protocol to guide safer AVM resection as an adjunct to indocyanine green videoangiography. Intraoperative assessment by ultrasound was performed before, during, and following nidus resection. Results Four surgically treated cerebral AVMs availed of the ultrasound protocol. Postoperative conventional angiography showed complete resection of the AVMs. CDUS and CEUS proved to be valuable adjunctive tools to indocyanine green videoangiography and micro-Doppler in properly navigating and discerning vascular structures, especially vessel feeders from bystanders. The protocol allows us to identify flow direction, estimate blood velocity within the nidus, and appreciate flow modifications following temporary clipping. Ultimately, it allows us to evaluate the degree of nidus deafferentation, residual flow, restoration of venous drainage and absence of arteriovenous shunts. Conclusions The CDUS and CEUS protocol is safe and repeatable and works as real-time imaging, further supporting complete surgical resection of AVMs.
- Published
- 2021
44. Advances in applications of color Doppler ultrasonography in the andrological assessment of domestic animals: A review
- Author
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Faten Radwan, Haney Samir, and Gen Watanabe
- Subjects
Male ,Infertility ,Physiology ,Breeding ,Doppler imaging ,03 medical and health sciences ,0302 clinical medicine ,Food Animals ,Testis ,Color doppler ultrasonography ,Animals ,Medicine ,Ultrasonography, Doppler, Color ,Small Animals ,Animal species ,Physical Examination ,Ultrasonography ,030219 obstetrics & reproductive medicine ,Equine ,business.industry ,0402 animal and dairy science ,Testicular mass ,Ultrasonography, Doppler ,04 agricultural and veterinary sciences ,medicine.disease ,040201 dairy & animal science ,Breeding soundness examination ,Male fertility ,Metabolic rate ,Animal Science and Zoology ,business - Abstract
Compared to human cases, potential applications of Doppler imaging technology in farm animals' practice are still limited and are mostly concerned with females. Testicular blood perfusion (TBP) is the pathway through which all nutrients, oxygen, and regulatory agents pass through to the testis. TBP is crucial to the testis function because of the high metabolic rate and very low concentration of oxygen in the seminiferous tubules, which constitute about 70%-80% of the testicular mass. Color Doppler ultrasonography is one of the recent non-invasive technologies, which plays a vital role in the assessment of blood flow to the testis in various animal species. In the past 20 years, a significant number of studies have highlighted the importance of assessments of TBP using color Doppler ultrasonography to illustrate its potential uses for breeding soundness examination, diagnosis, and monitoring of infertility problems in farm animals. This review was aimed at providing, for the first time, updated knowledge on the potential clinical uses of color Doppler ultrasonography for the assessment of TBP in domestic animals. Additionally, a few essential details on the relationship between TBP and male fertility are discussed in this review. Furthermore, a number of caveats relating to the use of color Doppler ultrasonography are discussed, which collectively appear to constrain its routine, on-farm application for breeding soundness assessments, at least at the present. The new perspectives related to animal reproduction that researchers claim to do in further investigations are also discussed.
- Published
- 2021
45. Multimodal ultrasound parameters aided carotid plaque risk stratification in patients with asymptomatic carotid stenosis
- Author
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Fumin Wang, Wen He, Shuai Zheng, Yi Li, and Jinghan Zhang
- Subjects
Male ,medicine.medical_specialty ,030204 cardiovascular system & hematology ,Multimodal Imaging ,Risk Assessment ,Asymptomatic ,Stratification (mathematics) ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Humans ,Medicine ,Carotid Stenosis ,Radiology, Nuclear Medicine and imaging ,In patient ,Prospective Studies ,Ultrasonography, Doppler, Color ,Aged ,Radiological and Ultrasound Technology ,business.industry ,Ultrasound ,General Medicine ,Middle Aged ,Nomogram ,medicine.disease ,Plaque, Atherosclerotic ,Stroke ,Stenosis ,ROC Curve ,Stroke prevention ,Asymptomatic Diseases ,Risk stratification ,Cardiology ,Regression Analysis ,Female ,medicine.symptom ,business ,Carotid Artery, Internal ,030217 neurology & neurosurgery - Abstract
Background Risk stratification of asymptomatic carotid plaque remains an issue in stroke prevention in clinical practice. Purpose To investigate whether a multimodal ultrasound (MMU) model would help plaque risk stratification in patients with asymptomatic carotid stenosis. Material and Methods A prospective study was conducted of symptomatic and asymptomatic patients with > 50% proximal internal carotid artery (ICA) stenosis. All patients underwent MMU examination. Multivariable regression analyses were performed to identify parameters associated with ischemic vascular events (IVE). These parameters were used to develop a scoring nomogram to assess the probability of IVE. We elaborated the diagnostic performance of the MMU nomogram using receiver operating characteristic (ROC) curves. Results From December 2018 to December 2019, 98 patients (75 men, mean age 67 ± 8 years) were included; 50 were symptomatic and 48 were asymptomatic. Multivariable regression analyses revealed that plaque surface morphology (PSM) (odds ratio [OR] 2.99, 95% confidence interval [CI] 1.26–7.12, P = 0.013), intraplaque neovascularization (IPN) grades (OR 3.23, 95% CI 1.77–5.89, PConclusions In patients with proximal ICA > 50%, PSM, IPN grades, and CSD were independent variables associated with IVE. The MMU nomogram provided favorable value to risk stratification of IVE. Future large-scale studies with long-term follow-up are needed to validate these findings.
- Published
- 2021
46. Uterine Arteriovenous Malformations
- Author
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Francesco Giurazza, Mattia Silvestre, Gianluca Cangiano, Fabio Corvino, Raffaella Niola, Giuseppe De Magistris, Francesco Amodio, and Enrico Cavaglià
- Subjects
medicine.medical_specialty ,Fistula ,medicine.medical_treatment ,030218 nuclear medicine & medical imaging ,Arteriovenous Malformations ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Vaginal bleeding ,Embolization ,Ultrasonography, Doppler, Color ,Hysterectomy ,medicine.diagnostic_test ,business.industry ,Patient affected ,Uterus ,Ultrasound ,Myometrium ,Magnetic resonance imaging ,medicine.disease ,Embolization, Therapeutic ,Uterine Artery ,Urogenital Abnormalities ,Female ,Radiology ,medicine.symptom ,business ,030217 neurology & neurosurgery - Abstract
Uterine arteriovenous malformations are rare but may represent a life-threatening cause of vaginal bleeding. The typical patient affected is a multiparous woman during her thirties. The origin can be congenital or acquired, with the latter being more common after uterine surgery and presenting mainly as arteriovenous fistulous connections into the myometrium supplied by uterine arteries. The correct diagnosis of uterine arteriovenous malformations requires imaging findings of tubular and tortuous structures with mixed signal from arterial and venous flows; transvaginal color-Doppler ultrasound is the initial technique applied, then integrated with contrast-enhanced magnetic resonance or computed tomography. Multiple treatment approaches are available, including conservative-medical, endovascular embolization and surgery. Transarterial embolization represents the most applied, preserving childbearing capacity with negligible procedural complications; clinical and technical success rates are elevated, up to 90%. The goal of embolization is to occlude the point of fistula or the nidus and the application of multiple embolizing agents has been reported: despite there is no clear superiority of one over the others, liquids, especially those related to the dymethil-sulfoxide family, present relevant technical advantages. Surgery is nowadays to be considered when the endovascular approach fails and in these cases hysterectomy remains the common recommendation.
- Published
- 2021
47. Standardize routine angiography assessment of leg vasculatures before fibular flap harvest: lessons of congenital and acquired vascular anomalies undetected by color Doppler and physical examinations
- Author
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Zhuowei Tian, Yi Shen, Chunyue Ma, Jinbao Qin, Dan Zhu, Xingjun Qin, and Lei Wang
- Subjects
Adult ,Male ,medicine.medical_specialty ,Computed Tomography Angiography ,030230 surgery ,Surgical Flaps ,Contraindications, Procedure ,03 medical and health sciences ,0302 clinical medicine ,medicine.artery ,Preoperative Care ,Maxilla ,medicine ,Humans ,Popliteal Artery ,Radiology, Nuclear Medicine and imaging ,Ultrasonography, Doppler, Color ,Physical Examination ,Aged ,Retrospective Studies ,Computed tomography angiography ,Fibular flap ,Leg ,Radiological and Ultrasound Technology ,medicine.diagnostic_test ,business.industry ,Arteries ,030206 dentistry ,General Medicine ,Color doppler ,Fibular artery ,Middle Aged ,Plastic Surgery Procedures ,Tibial Arteries ,Fibula ,Angiography ,Female ,Radiology ,Mandibular Reconstruction ,business - Abstract
Background Fibular flaps have been widely used for mandibular and maxillary reconstructions. On occasion, anatomical variants of fibular arteries (FA) will be encountered. Purpose Although anatomical variants of FA during fibular harvest have been reported, controversy exists regarding whether simple color Doppler ultrasonography (CDU) and physical examinations (PE) are sufficient for early preoperative detection. Material and Methods A 10-year retrospective analysis in our department was performed to find the patients with various FA anomalies confirmed by computed tomography angiography (CTA) or intraoperative findings. Results A total number of 19 FA anomalies were found either pre- or intraoperatively in 16 patients, in whom three cases were with bilateral FA variants. Type IIIC variants, also called arteria peronea magna (great peroneal artery), were confirmed in two legs, while the majority (13 legs) had type IIIA hypoplastic/aplastic posterior tibialis arteries (PTA). Four legs had new type IIID (low FA and PTA bifurcations). Preoperative CDU and PE only suspected anomalies in two legs. Six cases proceeded with using the affected fibulas, within whom vascular grafts were used in half of them for lengthening the FA pedicle. Local ischemia, partial soleus muscle necrosis, and claudication were reported in one. Conclusions Routine CTA before every fibular harvest, rather than simple PE and CDU, should be added for screening contraindications and ensuring safety for fibular flap harvest.
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- 2021
48. Transcranial Color-Coded Sonography Criteria for Moderate and Severe Middle Cerebral Artery Stenosis
- Author
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Jingzhi Li, Ran Liu, Yue Zhao, Xiaojie Tian, Yang Hua, Wenbo Zhao, Yan Ma, and Jie Yang
- Subjects
Male ,Middle Cerebral Artery ,Acoustics and Ultrasonics ,Ultrasonography, Doppler, Transcranial ,Biophysics ,Arterial Occlusive Diseases ,Constriction, Pathologic ,Severity of Illness Index ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,medicine.artery ,Middle cerebral artery stenosis ,Humans ,Medicine ,Radiology, Nuclear Medicine and imaging ,Ultrasonography, Doppler, Color ,Aged ,Retrospective Studies ,Radiological and Ultrasound Technology ,medicine.diagnostic_test ,business.industry ,Ultrasound ,Digital subtraction angiography ,Middle Aged ,medicine.disease ,Stenosis ,Cross-Sectional Studies ,Cerebral hemodynamics ,Middle cerebral artery ,Female ,Mean flow velocity ,Nuclear medicine ,business ,030217 neurology & neurosurgery - Abstract
This study aimed to establish optimal criteria for evaluation of moderate (50%-69%) and severe (70%-99%) middle cerebral artery (MCA) stenosis with transcranial color-coded sonography (TCCS). A total of 375 cases provided 409 TCCS/digital subtraction angiography vessel pairs. Peak systolic velocity (PSV), end-diastolic velocity (EDV) and mean flow velocity (MFV) of the MCA were measured. The stenotic/distal MFV ratios (SDRs) were calculated. With digital subtraction angiography as a reference, for 50%-69% MCA stenosis, the optimal combined criteria were PSV ≥180 cm/s (sensitivity 95.7%, specificity 64.9% and overall accuracy 69.7%); EDV ≥75 cm/s (90.0%, 66.4% and 68.7%); MFV ≥110 cm/s (95.7%, 64.0% and 69.4%); and SDR ≥2.5 (88.6%, 71.3% and 76.3%). Criteria for 70%-99% MCA stenosis were PSV ≥240 cm/s (93.5%, 89.9% and 85.5%); EDV ≥100 cm/s (96.8%, 89.0% and 87.3%); MFV≥160 cm/s (91.9%, 92.8% and 92.2%); and SDR ≥4 (87.1%, 92.2% and 91.4%). Parameters of the MCA detected by TCCS, especially SDR, may increase accuracy in diagnosis of 50%-69% and 70%-99% MCA stenosis.
- Published
- 2021
49. Evolution of fetal cardiac imaging in 30 years of <scp>ISUOG</scp>
- Author
-
R. Chaoui
- Subjects
medicine.medical_specialty ,Fetus ,Radiological and Ultrasound Technology ,business.industry ,Obstetrics and Gynecology ,General Medicine ,History, 20th Century ,History, 21st Century ,Ultrasonography, Prenatal ,Fetal Heart ,Imaging, Three-Dimensional ,Reproductive Medicine ,Pregnancy ,Internal medicine ,Cardiology ,Humans ,Medicine ,Female ,Radiology, Nuclear Medicine and imaging ,Periodicals as Topic ,Ultrasonography, Doppler, Color ,business ,Cardiac imaging - Published
- 2021
50. Resolution brings women's health into focus
- Author
-
Beryl R. Benacerraf
- Subjects
Focus (computing) ,Radiological and Ultrasound Technology ,business.industry ,Resolution (electron density) ,Obstetrics and Gynecology ,General Medicine ,Data science ,Ultrasonography, Prenatal ,Imaging, Three-Dimensional ,Reproductive Medicine ,Pregnancy ,Humans ,Women's Health ,Medicine ,Female ,Radiology, Nuclear Medicine and imaging ,Ultrasonography, Doppler, Color ,business ,Genital Diseases, Female - Published
- 2021
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