BACKGROUND Severely elevated intracranial pressure due to various reasons,such as decreased cerebral perfusion,can lead to devastating neurological outcomes,such as brain herniation.Decompression craniectomy is a life...BACKGROUND Severely elevated intracranial pressure due to various reasons,such as decreased cerebral perfusion,can lead to devastating neurological outcomes,such as brain herniation.Decompression craniectomy is a life-saving procedure that is commonly performed for such a critical situation,but the changes in cerebral microvessels after brain herniation and decompression are unclear.Ultrafast power Doppler imaging(uPDI)is a new microvascular imaging technology that utilizes high frame rate plane/diverging wave transmission and advanced clutter filters.uPDI significantly improves Doppler sensitivity and can detect microvessels,which are usually invisible using traditional ultrasound Doppler imaging.CASE SUMMARY In this report,uPDI was used for the first time to observe the brain blood flow of a hypoperfusion area in a 4-year-old girl who underwent decompression craniectomy due to refractory intracranial hypertension(ICP)after malignant brain tumor surgery.B-mode imaging was used to verify the increased densities of the cerebral cortex and basal ganglia that were observed by computed tomography.CONCLUSION uPDI showed the local blood supplies and anatomical structures of the patient after decompressive craniectomy.uPDI is potentially a more intuitive and noninvasive method for evaluating the effects of severe ICP on cerebral microvessels.展开更多
Ankle involvement is frequent in patients with inflammatory rheumatic diseases, but accurate evaluation by physical examination is often difficult because of the complex anatomical structures of the ankle. Over the la...Ankle involvement is frequent in patients with inflammatory rheumatic diseases, but accurate evaluation by physical examination is often difficult because of the complex anatomical structures of the ankle. Over the last decade, ultrasound(US) has become a practical imaging tool for the assessment of articular and periarticular pathologies, including joint synovitis, tenosynovitis, and enthesitis in rheumatic diseases. Progress in power Doppler(PD) technology has enabled evaluation of the strength of ongoing inflammation. PDUS is very useful for identifying the location and kind of pathologies in rheumatic ankles as well as for distinguishing between inflammatory processes and degenerative changes or between active inflammation and residual damage. The aim of this paper is to illustrate the US assessment of ankle lesions in patients with inflammatory rheumatic diseases, including rheumatoid arthritis, spondyloarthritis, and systemic lupus erythematosus, focusing on the utility of PDUS.展开更多
Objective:?The aim of this study is to assess any potential relationship between perifollicular vascularity and occurrence of pregnancy in cases of stimulated IUI cycles using the subjective grading system by 2D trans...Objective:?The aim of this study is to assess any potential relationship between perifollicular vascularity and occurrence of pregnancy in cases of stimulated IUI cycles using the subjective grading system by 2D transvaginal power Doppler ultrasonography.?Design: A prospective cross sectional cohort study. Method: This is a prospective cross-sectional cohort study of 90 stimulated IUI treatment cycles. Selected women were prescribed clomiphene citrate combined with highly purified urinary follicle stimulating hormone. All patients underwent serial transvaginal ultrasound scans starting from day 6 to 7 of the cycle. Perifollicular Doppler blood flows were assessed in dominant follicles ≥18 mm. The patients then were categorized into 3 groups (high vascularity group {G3 & G4}, low vascularity group {G1 & G2} and mixed grades group). Other parameters measured included number of follicles ≥ 18 mm in both ovaries, endometrial thickness and estradiol (E2) level . Human chorionic gonadotropin (hCG) injection 10,000 IU IM was given to the patient when the dominant follicle reached 18 mm in diameter. At that time, the endometrium was evaluated as regards endometrial thickness. IUI was carried out using prepared/“washed” semen (husband). All patients received luteal support in the form of progesterone from day of IUI for 14 days. Serum Β-hCG was estimated 2 weeks after insemination. Results: In this study, from all 90 cases only 8 cases got pregnant with pregnancy rate of 8.88% (6 cases got pregnant in high grade vascularity group;2 cases in mixed grades group and no cases got pregnant?in low grade group). There was statistically significant difference among the 3 groups as regarding?the pregnancy rate (P value = 0.02). There is statistically significant difference in perifollicular resistance index (RI) and pulsatility index (PI) between pregnant and non pregnant cases (P value = 0.016 and 0.047 respectively). In this study, there is no statistically significant difference between pregnant and non pregnant cases as regarding endometrial thickness and E2 level at the day of hCG administration (P value = 0.39 and 0.76 respectively). Conclusion: Perifollicular blood-flow assessment by 2D transvaginal power Doppler is a good predictive for the outcome of stimulated IUI cycles.展开更多
Objective: To assess the preoperative serum levels of vascular endothelial growth factor (VEGF) in ovarian masses compared to normal controls and to find a correlation between VEGF and Doppler indices in ovarian masse...Objective: To assess the preoperative serum levels of vascular endothelial growth factor (VEGF) in ovarian masses compared to normal controls and to find a correlation between VEGF and Doppler indices in ovarian masses. Methods: The study was conducted from December 2009 to September 2012 in the oncology and ultrasound units in department of obstetrics and gynecology, Ain Shams University on 150 patients with ovarian masses. During preoperative workup, serum Ca-125 levels and serum VEGF levels were obtained. Ultrasonographic examination included two and three dimensional power Doppler ultrasound (3DPD). Laparotomic approaches were undertaken to obtain the final pathologic results. VEGF was measured in one hundred normal cases as controls. Results: Final ovarian pathology revealed seventy three malignant ovarian masses and seventy seven were benign. Serum Ca-125 levels in malignant cases were higher compared to those in benign cases (p < 0.001). Preoperative serum VEGF revealed higher levels in malignant ovarian masses than benign conditions and normal controls (p < 0.001). Three dimensional power Doppler indices, vascularization index (VI), flow index (FI) and vascularization flow index (VFI), correlated positively with serum VEGF levels. Conclusion: Preoperative serum VEGF revealed higher levels in malignant ovarian masses than benign conditions and normal controls. These levels positively correlated with the Doppler vascular indices of the masses.展开更多
Rheumatoid arthritis is a chronic multisystem disease of unknown cause. The characteristic feature of RA is persistent inflammatory synovitis. The natural history of disease is such that the early months of the diseas...Rheumatoid arthritis is a chronic multisystem disease of unknown cause. The characteristic feature of RA is persistent inflammatory synovitis. The natural history of disease is such that the early months of the disease are critical period during which reversible joint damage occurs. So early diagnosis of RA and appropriate drug application is the only way to save a patient from this crippling disease. In India, the cost of investigations is a significant factor for most of the patients. Ultrasonography or Power Doppler Ultra Sound (PDUS) has the advantage of being economic in spite of its sensitivity in assessing both inflammatory and destructive changes. The aim of the present study was to evaluate the diagnostic efficiency of PDUS in early rheumatoid arthritis. The study was performed with the patients attending Rheumatology Clinic. A total number of 106 patients of clinically suspected rheumatoid arthritis were studied as per selection criteria. Radiological examinations of hands were done by digital radiography and PDUS in a group of 53 patients, assessment of foot changes by PDUS and Digital Radiography were done in another similar group of 53 patients. Final diagnosis by ACR EULAR-2010 criteria is done for all the patients. The comparative study reveals that synovial vascularity as demonstrated by PDUS is much more effective in diagnosing early rheumatoid arthritis, both in hand and in feet than digital radiograph. PDUS of feet may yield earlier and better findings than hands, which is conventionally used in patients suffering from early rheumatoid arthritis.展开更多
To evaluate applicability of power Doppler sonography (PDS) in differential diag nosis of small hepatocellular carcinoma (SHCC) and adenomatous hyperplastic nodu le (AHN) Methods Twenty two cases of SHCC and 15 cas...To evaluate applicability of power Doppler sonography (PDS) in differential diag nosis of small hepatocellular carcinoma (SHCC) and adenomatous hyperplastic nodu le (AHN) Methods Twenty two cases of SHCC and 15 cases of AHN were investigated by PDS an d the findings were campared with those of digital subtraction angiography (DSA) Results The rates of arterial and portal flow in an afferent tumor vessel were 86 4% a n d 40 9% in SHCCs, respectively The rate of portal flow in an afferent tumor v essel was 60 0% in AHNs, while no arterial flow was detected ( P <0 01) In addition, PDS revealed a constant flow in an efferent tumor vessel (50 0%) c ontinuing to a portal branch in 10 (45 5%) of the 22 SHCCs cases to a hepatic v ein in 1 (4 5%) of the 22 SHCCs, but to nothing else in the AHNs ( P <0 01) Conclusions Power Doppler sonography is of value in distinguishing SHCC from AHN, and arteri al afferent tumor vessels from constant flow efferent tumor vessels at PDS展开更多
目的应用多模态超声评估老年人骨骼肌的肌肉质量、弹性硬度和血流灌注情况,分析其对肌少症的诊断价值。方法选取60岁以上肌少症患者和健康老年人作为肌少症组和对照组,分别使用肌骨超声、声触诊组织成像量化技术和能量多普勒超声对双侧...目的应用多模态超声评估老年人骨骼肌的肌肉质量、弹性硬度和血流灌注情况,分析其对肌少症的诊断价值。方法选取60岁以上肌少症患者和健康老年人作为肌少症组和对照组,分别使用肌骨超声、声触诊组织成像量化技术和能量多普勒超声对双侧肱二头肌和股直肌进行肌肉厚度、截面积、剪切波速度以及血流能量信号进行测量和评分,并参照双能X射线吸收法(dual energy X-ray absorptiometry,DEXA)的相对骨骼肌质量指数结果,分析多模态超声参数对肌少症的诊断价值。结果共纳入73例研究对象,其中肌少症组36例、对照组37例。肌少症组的年龄、肱二头肌和股直肌剪切波速度显著高于对照组(P<0.05);肱二头肌和股直肌厚度、截面积、血流能量信号评分显著低于对照组(P<0.05)。各多模态超声参数中,肌肉的剪切波速度诊断效能最佳,其中肱二头肌剪切波速度的受试者工作特征曲线的曲线下面积(area under curve,AUC)为0.96[95%CI(0.87,0.98)],诊断肌少症的敏感度和特异度分别为86.50%和98.89%;股直肌剪切波速度的AUC为0.91[95%CI(0.84,0.95)],敏感度和特异度分别为81.08%和90.38%。肱二头肌和股直肌厚度、截面积、血流能量信号评分与DEXA结果呈正相关,剪切波速度与DEXA结果呈负相关。结论多模态超声技术可评估老年人四肢骨骼肌的形态结构学、生物力学和微循环状态,对肌少症有良好的诊断价值,为肌少症的早期筛检提供客观、多维度的量化诊断指标。展开更多
文摘BACKGROUND Severely elevated intracranial pressure due to various reasons,such as decreased cerebral perfusion,can lead to devastating neurological outcomes,such as brain herniation.Decompression craniectomy is a life-saving procedure that is commonly performed for such a critical situation,but the changes in cerebral microvessels after brain herniation and decompression are unclear.Ultrafast power Doppler imaging(uPDI)is a new microvascular imaging technology that utilizes high frame rate plane/diverging wave transmission and advanced clutter filters.uPDI significantly improves Doppler sensitivity and can detect microvessels,which are usually invisible using traditional ultrasound Doppler imaging.CASE SUMMARY In this report,uPDI was used for the first time to observe the brain blood flow of a hypoperfusion area in a 4-year-old girl who underwent decompression craniectomy due to refractory intracranial hypertension(ICP)after malignant brain tumor surgery.B-mode imaging was used to verify the increased densities of the cerebral cortex and basal ganglia that were observed by computed tomography.CONCLUSION uPDI showed the local blood supplies and anatomical structures of the patient after decompressive craniectomy.uPDI is potentially a more intuitive and noninvasive method for evaluating the effects of severe ICP on cerebral microvessels.
文摘Ankle involvement is frequent in patients with inflammatory rheumatic diseases, but accurate evaluation by physical examination is often difficult because of the complex anatomical structures of the ankle. Over the last decade, ultrasound(US) has become a practical imaging tool for the assessment of articular and periarticular pathologies, including joint synovitis, tenosynovitis, and enthesitis in rheumatic diseases. Progress in power Doppler(PD) technology has enabled evaluation of the strength of ongoing inflammation. PDUS is very useful for identifying the location and kind of pathologies in rheumatic ankles as well as for distinguishing between inflammatory processes and degenerative changes or between active inflammation and residual damage. The aim of this paper is to illustrate the US assessment of ankle lesions in patients with inflammatory rheumatic diseases, including rheumatoid arthritis, spondyloarthritis, and systemic lupus erythematosus, focusing on the utility of PDUS.
文摘Objective:?The aim of this study is to assess any potential relationship between perifollicular vascularity and occurrence of pregnancy in cases of stimulated IUI cycles using the subjective grading system by 2D transvaginal power Doppler ultrasonography.?Design: A prospective cross sectional cohort study. Method: This is a prospective cross-sectional cohort study of 90 stimulated IUI treatment cycles. Selected women were prescribed clomiphene citrate combined with highly purified urinary follicle stimulating hormone. All patients underwent serial transvaginal ultrasound scans starting from day 6 to 7 of the cycle. Perifollicular Doppler blood flows were assessed in dominant follicles ≥18 mm. The patients then were categorized into 3 groups (high vascularity group {G3 & G4}, low vascularity group {G1 & G2} and mixed grades group). Other parameters measured included number of follicles ≥ 18 mm in both ovaries, endometrial thickness and estradiol (E2) level . Human chorionic gonadotropin (hCG) injection 10,000 IU IM was given to the patient when the dominant follicle reached 18 mm in diameter. At that time, the endometrium was evaluated as regards endometrial thickness. IUI was carried out using prepared/“washed” semen (husband). All patients received luteal support in the form of progesterone from day of IUI for 14 days. Serum Β-hCG was estimated 2 weeks after insemination. Results: In this study, from all 90 cases only 8 cases got pregnant with pregnancy rate of 8.88% (6 cases got pregnant in high grade vascularity group;2 cases in mixed grades group and no cases got pregnant?in low grade group). There was statistically significant difference among the 3 groups as regarding?the pregnancy rate (P value = 0.02). There is statistically significant difference in perifollicular resistance index (RI) and pulsatility index (PI) between pregnant and non pregnant cases (P value = 0.016 and 0.047 respectively). In this study, there is no statistically significant difference between pregnant and non pregnant cases as regarding endometrial thickness and E2 level at the day of hCG administration (P value = 0.39 and 0.76 respectively). Conclusion: Perifollicular blood-flow assessment by 2D transvaginal power Doppler is a good predictive for the outcome of stimulated IUI cycles.
文摘Objective: To assess the preoperative serum levels of vascular endothelial growth factor (VEGF) in ovarian masses compared to normal controls and to find a correlation between VEGF and Doppler indices in ovarian masses. Methods: The study was conducted from December 2009 to September 2012 in the oncology and ultrasound units in department of obstetrics and gynecology, Ain Shams University on 150 patients with ovarian masses. During preoperative workup, serum Ca-125 levels and serum VEGF levels were obtained. Ultrasonographic examination included two and three dimensional power Doppler ultrasound (3DPD). Laparotomic approaches were undertaken to obtain the final pathologic results. VEGF was measured in one hundred normal cases as controls. Results: Final ovarian pathology revealed seventy three malignant ovarian masses and seventy seven were benign. Serum Ca-125 levels in malignant cases were higher compared to those in benign cases (p < 0.001). Preoperative serum VEGF revealed higher levels in malignant ovarian masses than benign conditions and normal controls (p < 0.001). Three dimensional power Doppler indices, vascularization index (VI), flow index (FI) and vascularization flow index (VFI), correlated positively with serum VEGF levels. Conclusion: Preoperative serum VEGF revealed higher levels in malignant ovarian masses than benign conditions and normal controls. These levels positively correlated with the Doppler vascular indices of the masses.
文摘Rheumatoid arthritis is a chronic multisystem disease of unknown cause. The characteristic feature of RA is persistent inflammatory synovitis. The natural history of disease is such that the early months of the disease are critical period during which reversible joint damage occurs. So early diagnosis of RA and appropriate drug application is the only way to save a patient from this crippling disease. In India, the cost of investigations is a significant factor for most of the patients. Ultrasonography or Power Doppler Ultra Sound (PDUS) has the advantage of being economic in spite of its sensitivity in assessing both inflammatory and destructive changes. The aim of the present study was to evaluate the diagnostic efficiency of PDUS in early rheumatoid arthritis. The study was performed with the patients attending Rheumatology Clinic. A total number of 106 patients of clinically suspected rheumatoid arthritis were studied as per selection criteria. Radiological examinations of hands were done by digital radiography and PDUS in a group of 53 patients, assessment of foot changes by PDUS and Digital Radiography were done in another similar group of 53 patients. Final diagnosis by ACR EULAR-2010 criteria is done for all the patients. The comparative study reveals that synovial vascularity as demonstrated by PDUS is much more effective in diagnosing early rheumatoid arthritis, both in hand and in feet than digital radiograph. PDUS of feet may yield earlier and better findings than hands, which is conventionally used in patients suffering from early rheumatoid arthritis.
文摘To evaluate applicability of power Doppler sonography (PDS) in differential diag nosis of small hepatocellular carcinoma (SHCC) and adenomatous hyperplastic nodu le (AHN) Methods Twenty two cases of SHCC and 15 cases of AHN were investigated by PDS an d the findings were campared with those of digital subtraction angiography (DSA) Results The rates of arterial and portal flow in an afferent tumor vessel were 86 4% a n d 40 9% in SHCCs, respectively The rate of portal flow in an afferent tumor v essel was 60 0% in AHNs, while no arterial flow was detected ( P <0 01) In addition, PDS revealed a constant flow in an efferent tumor vessel (50 0%) c ontinuing to a portal branch in 10 (45 5%) of the 22 SHCCs cases to a hepatic v ein in 1 (4 5%) of the 22 SHCCs, but to nothing else in the AHNs ( P <0 01) Conclusions Power Doppler sonography is of value in distinguishing SHCC from AHN, and arteri al afferent tumor vessels from constant flow efferent tumor vessels at PDS
文摘目的应用多模态超声评估老年人骨骼肌的肌肉质量、弹性硬度和血流灌注情况,分析其对肌少症的诊断价值。方法选取60岁以上肌少症患者和健康老年人作为肌少症组和对照组,分别使用肌骨超声、声触诊组织成像量化技术和能量多普勒超声对双侧肱二头肌和股直肌进行肌肉厚度、截面积、剪切波速度以及血流能量信号进行测量和评分,并参照双能X射线吸收法(dual energy X-ray absorptiometry,DEXA)的相对骨骼肌质量指数结果,分析多模态超声参数对肌少症的诊断价值。结果共纳入73例研究对象,其中肌少症组36例、对照组37例。肌少症组的年龄、肱二头肌和股直肌剪切波速度显著高于对照组(P<0.05);肱二头肌和股直肌厚度、截面积、血流能量信号评分显著低于对照组(P<0.05)。各多模态超声参数中,肌肉的剪切波速度诊断效能最佳,其中肱二头肌剪切波速度的受试者工作特征曲线的曲线下面积(area under curve,AUC)为0.96[95%CI(0.87,0.98)],诊断肌少症的敏感度和特异度分别为86.50%和98.89%;股直肌剪切波速度的AUC为0.91[95%CI(0.84,0.95)],敏感度和特异度分别为81.08%和90.38%。肱二头肌和股直肌厚度、截面积、血流能量信号评分与DEXA结果呈正相关,剪切波速度与DEXA结果呈负相关。结论多模态超声技术可评估老年人四肢骨骼肌的形态结构学、生物力学和微循环状态,对肌少症有良好的诊断价值,为肌少症的早期筛检提供客观、多维度的量化诊断指标。
