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PubMed1996

[Color Doppler ultrasonography in the study of orbital and ocular vascular diseases].

Color Doppler flow imaging was performed in 10 healthy controls and in 32 patients with orbital and retinal vascular diseases in order to investigate ocular arterial supply. Abnormal changes of the orbital blood flow observed in case of dural fistula, orbital varicosis and choroidal melanoma is described. In patients with central retinal vein occlusion, substantial arterial flow disturbances were found, such as the reduction of the retinal artery systolic peak flow (p < 0.55) and absence of diastolic flow (p < 0.001). Abnormal changes of the retinal arterial blood flow (reduction of the systolic peak flow or even extinction of the Doppler signal) were also detected in patients with occlusion of the central retinal artery and in some cases of severe stenosis or occlusion of the internal carotid artery. The color Doppler flow imaging appears as a promising technique for the investigation of the vascular diseases of the eye. It may provide useful clues for the differential diagnosis of optic neuropathies and allows haemodynamic characterization of different vascular diseases of the eye such as diabetic retinopathy and glaucoma.

Aged↗
PubMed2003

[Color-Doppler ultrasonography in the diagnostic evaluation of erectile dysfunction].

UNLABELLED: Color-Doppler sonography (CDS) of the cavernosal arteries has received considerable attention since its description in 1985 by Lue et al. Color and Spectral Doppler analysis, provides a useful noninvasive means of evaluating both morphologic and hemodynamic penile abnormalities. CDS is the best method in diagnostic evaluation of patients with erectile dysfunction. It assesses the integrity of the arterial supply to the penis and provides some useful information on the veno-occlusive mechanism. Because the arterial diameter and flow rate change during the different phases of erection CDS is performed after pharmacostimulation with vasoactive agents. Purpose of this study is diagnostic evaluation patients with erectile dysfunction. PATIENTS AND METHOD: We studied 60 patients suspected for vasculogenic ED, and 30 patients suspected for psyhogenic ED, assessing the morphodynamic features of cavernosal arteries by Color-Doppler sonography and their response to contravaernosal injection of prostaglandin E1 (PgE1) and oral dose of Sildenafil citrate. Morphodynamic parameters evaluated by color Doppler sonography included: peak systolic velocity, endodiastolic velocity, inner arterial diameter, index and acceleration of penile blood flow. Patients were divided in the groups: A group (A1--10 patients < 35 years of age, A2--20 patients > 35 years of age) underwent pharmacotest with ICI PgE1; B group (B1--8 patients < 35 years of age, B2--22 patients 35 years age) were tested with oral dose of Sildenafil citrate and C group--30 patients who were also tested with the same drug. CONCLUSION: The CDS may be used to evaluate the hemodynamic parameters of the erectile dysfunction. Arterial insufficiency is suspected with poor blood flow, while veno-occlusive dysfunction is inferred in the face of adequate blood flow and poor erectile response.

Adult↗
PubMedDate not supplied

Diagnosis of arteriovenous malformation of the pancreas by color Doppler ultrasonography.

Arteriovenous malformation (AVM) of the pancreas is a rare disease, and once this silent disease develops portal hypertension it is too difficult for the physician to successfully control the disease. AVM is usually diagnosed by invasive diagnostic modalities, and noninvasive modalities should be developed for its diagnosis. We have experienced two cases of AVM of the pancreas, which were located at the pancreatic head and diagnosed by color Doppler ultrasonography (Doppler US). The two AVM lesions were detected as a mosaic pattern, and the lesions were connected to the main portal vein on Doppler US; the pulsatile waves were also observed in the mosaic lesions by the analysis of the Doppler spectrum. We determined the two patients suffered from congenital AVM of the pancreas, since they had no abnormal findings on past and physical histories, laboratory data, and other images. One patient refused surgery, and another underwent pancreatoduodenectomy. Histology of the resected specimen demonstrated the lesion was AVM of the pancreas. These cases support that the present modality is useful for the diagnosis of the pancreatic AVM as a noninvasive procedure, and we discuss the usefulness of noninvasive Doppler US which shows not only static but also hemodynamic informations.

Aged↗
PubMed1999

[Arterial hypertension of renovascular origin. The value of color Doppler ultrasonography in the detection of stenosis of the renal artery].

Color Doppler sonography is a performant method to detect direct signs of renal artery stenosis with a feasibility rate superior to 90%. The reliability of the method, evaluated with regard to the angiography as reference method, varies, according to the authors, between 80 and 90% with a sensitivity and a specificity between 85-90%. The investigation is above all dedicated to a population where prevalence of renal artery stenosis is high: hypertensive patient with lower limb arteriopathy, or with impairing of the renal function under angiotensin convertase inhibitor, or with hypertension resistant to a multi-therapy, young woman hypertension. The success of the method requires a trained operator, a modern equipment and a precise methodology: a fasting patient, patient positioning adapted to the spectral signal recording, peak velocity measurements at the anatomical sites of stenosis (ostium, first centimeters). Investigation length does not exceed 20 minutes. The exploration is totally atraumatic and does not require any contrast injection.

Angiography↗
PubMed1994

[Color-Doppler ultrasonography and hypertension. Functional assessment of the renal region].

Color-Doppler US can be used for the morphofunctional assessment of most arterial districts. In hypertension, color-Doppler US can be used to study the renal arteries for both the diagnosis of renovascular hypertension and better physiopathologic assessment of renal arterial blood flow in essential hypertension. To this purpose, we studied renal flow characteristics with the resistive index in both basal conditions and after pharmacologic stimulation with angiotensin-converting enzyme inhibitors. The resistive index was seen to rise in parallel with hypertension severity, as measured by mean arterial pressure; the change was statistically significant (p < 0.05). Values rose step by step from 57.4 (+/- 4.96) in the right renal artery and from 56.6 (+/- 4.18) in the left one in controls, up to 62.2 (+/- 6.6) in the right and 62.3 (+/- 7) in the left renal arteries of severe hypertensives. After pharmacologic stimulation in controls and in mild hypertensives, resistive index values rose significantly (+2.32 +/- 2.1 and +3.5 +/- 5.2, respectively), while in more advanced stages of the disease this index remained unvaried from a statistical point of view (+0.5 +/- 1.7 in moderate and -0.2 +/- 2.1 in severe hypertensives). These data can be explained by reduced capability of renal blood flow autoregulation, as a consequence of a defined vascular damage. In the follow-up of more severe stages of the disease, although pharmacologic treatment had been optimized and mean arterial pressure values reduced (109.08 vs. 118.25 mmHg), even after a prolonged therapeutic wash-out, an abnormal RI response persisted in controls (-1.79 +/- 2.62 vs. -0.94 +/- 1.64), due to persistent arteriolar damage. To date, it is still to be defined if our studies can be applied not only to populations but also to single patients.

Follow-Up Studies↗
PubMedDate not supplied

Intra-operative color Doppler ultrasonography for assessing splenic blood supply during spleen-preserving distal pancreatectomy: a case report.

A 67 year-old Japanese woman presented with a cystic tumorous lesion, measuring 5 cm in diameter, in the tail of the pancreas. She underwent a spleen-preserving distal pancreatectomy (SPDP), in which the splenic artery and vein were divided because they were involved in scar formation around the lesion. Intra-operative color Doppler ultrasonography (CDUS) confirmed that splenic circulation via collaterals (short gastric and left gastroepiploic vessels) was preserved throughout the salvaged spleen. Histology of the resected specimen showed localized pancreatitis with a pseudocyst without neoplastic tissue. The patient's post-operative course was uneventful with no evidence of splenic failure and she was discharged 20 days after the operation. A literature review suggests that SPDP without preserving the splenic artery and vein may result in failure of the preserved spleen due to inadvertent injury to the remaining collaterals. Based on the experience of our case, we think that intra-operative CDUS is useful for assessing splenic circulation after SPDP with division of the splenic artery and vein.

Aged↗
PubMed2002

Clinical value of color Doppler ultrasonography measurements of full-term newborns with perinatal asphyxia and hypoxic ischemic encephalopathy in the first 12 hours of life and long-term prognosis.

The cerebral blood flow velocities (CBFV) of infants with perinatal asphyxia and hypoxic ischemic encephalopathy (HIE) in the first 12 hours of their lives have been the chief focus of our concern in this study. Cerebral ischemia which can develop in the earlier hours of HIE, and the detection and diagnosis of this condition with color Doppler ultrasonography (cD-USG) will be put into discussion. Twenty-three full-term newborn infants who had perinatal asphyxia and HIE together with a control group constituting twenty full-term newborn infants who produced no problems, were included in our study. All of the infants underwent cD-USG in the postpartum period of the first 12 hours (mean 8.4 hours). Measurements being based upon peak systolic velocity (PSV), end diastolic velocity (EDV) and Pouecelout's resistive index (RI) in anterior and middle cerebral arteries were conducted. The infants, having been discharged from the unit they were followed up for mean 9.8 months in the outpatient clinic. PSV and EDV counts in the postpartum first 12 hours of 23 infants who were detected to have HIE were found to be significantly lower compared to the control group, whereas RI counts were found to be significantly higher (p < 0.05). The counts obtained from the right and left cerebral arteries of the infants with HIE were found to be corraleted with each others. The neonates in the patient group were observed to have gone through this prognosis: Three of them died, three of them had cerebral palsy, one of them had infantile spasms, and three of them had developmental retardation. When we compared the CBFV of the 10 neonates who had poor prognosis, retrospectively with the other 13 neonates who had good prognosis, PSV and EDV were found to be significantly lower and RI significantly higher (p < 0.05). In the light of the data we have obtained, cD-USG can be considered to be a highly practical device in evaluating CBVF of the infants with HIE. A skillful detection of the decrease in cerebral blood flow which can develop in the postasphyxial first 12 hours and the prospective treatments being based upon this approach would contribute to the diagnosis, treatment and prognosis of such cases.

Asphyxia Neonatorum↗
PubMed2003

Color Doppler ultrasonography: diagnosis of ectopic thyroid gland in patients with congenital hypothyroidism caused by thyroid dysgenesis.

The etiology of congenital hypothyroidism (CH) may play an important role in determining disease severity, outcome, and, therefore, its treatment schedule. Radionuclide imaging (RI) is currently the most precise diagnostic technique to establish the etiology of CH. Conventional ultrasound can identify an athyrotic condition at the normal neck position and has gained acceptance for the initial evaluation of CH; however, its ability in delineating ectopic thyroid is limited. We used color Doppler ultrasonography (CDU) to assess blood flow and morphology in the detection of ectopic thyroid in 11 CH patients disclosed by neonatal screening; thyroid glands were undetectable at the normal location by gray-scale ultrasonography (GSU). The patients studied consisted of two infants for initial investigation and nine children for reevaluating the cause of CH. All of the patients underwent GSU, CDU, RI, and magnetic resonance imaging (MRI) investigation. We set RI as the defining diagnostic test for detecting ectopic thyroid and compared the imaging of CDU with those of GSU and MRI. The results of RI showed 10 ectopic thyroids and one athyreosis. In the patients with ectopic thyroid, the sensitivity of CDU, GSU, and MRI for detecting ectopic thyroid was 90, 70, and 70%, respectively. We conclude that CDU is superior to GSU and MRI for detecting ectopic thyroid and that CDU may be adopted as the diagnostic tool for the initial investigation of suspected CH.

Adolescent↗
PubMed2000

[Diagnosis of swollen optic disks using color Doppler ultrasonography] .

The Goal of this study was prospective evaluation of the blood flow parameters-maximal systolic velocity (MSV), minimal diastolic velocity (MDV) and Pourcelot's resistivity index (RI) in patients with swollen optic dis. 63 patients (79 eyes) were examined with swollen optic disc-10 patients (17 eyes) with intracranial hypertension, 12 patients (14 eyes) with pseudoedema of disk of the optic nerve, 7 patients (7 eyes) with inflammation swollen optic disc, 3 patients (6 eyes) with pseudotumor cerebri, 8 patients (12 eyes) with arteritic anterior ischemic optic neuropathy (A-AION) and 23 patients (23 eyes) with nonarteritic anterior ischemic optic neuropathy (N-AION) and 23 patients (23 eyes) with nonarteritic anterior ischemic optic neuropathy (N-AION). All patients had ophthalmological examinations and Color Doppler ultrasonography in central retinal artery (CRA), posterior ciliary artery (PCA), ophthalmic artery (OA) and in central retinal vein (CRV). The blood flow parameters of the swollen optic disc and normal optic disc were not significant changed at intracranial hypertension, pseudooedema cerebri, inflammation swelling, and at pseudotumour od the optic disc. A-AION and N-AION acallocated significant changes of the blood velocities and resistivity index. A-AION: significant increasing resistivity index at CRA, CPA, significant decrease of MSV and MDV and difficult mapping of the CPA in Color doppler mapping. At the fellow eye (without swollen optic disc) was significant decreasing of the blood velocities of the CRA, CPA, but not so much as at the defective eye with swollen optic nerve disk. N-AION: defective eye with swollen optic disc--there were: nonsignificant decreasing of MSV, MDV, significant decreasing of MSV, MDV and increasing of resistivity index of the CRA, CPA at the fellow eye. AO was without significant changes. Color Doppler information allowed to specify diagnosis of A-AION and N-AION.

Blood Flow Velocity↗
PubMed2003

Ophthalmic artery color Doppler ultrasonography in mild-to-moderate preeclampsia.

OBJECTIVE: To evaluate the hemodynamic changes in mild-moderate preeclampsia using ophthalmic artery Doppler ultrasonography technique. METHODS: Ophthalmic artery pulsatility and resistivity indices were calculated in 30 mild-moderate preeclamptic women and 30 normotensive gravid women of matched gestational age. Student's t-test was performed to test the significance of difference. RESULTS: Both indices of peripheral resistance were found to be significantly lower in the ophthalmic arteries of mild-moderately preeclamptic women than those measured in normotensive gravid women at similar stage of pregnancy. In a small number patients whose disease progressed to severe preeclampsia, both indices increased. CONCLUSION: In patients with mild-moderate preeclampsia, ophthalmic artery color Doppler ultrasonography detects hemodynamic changes that are not present in normotensive gravid women. Reversal of Doppler patterns in a small number of patients with progressive disease supports the hypotheses suggesting the presence of early vasodilation and late vasospasm in the etiology of preeclampsia.

Adult↗
PubMed1993

Endometrial carcinoma in postmenopausal women: evaluation by transvaginal color Doppler ultrasonography.

OBJECTIVE: This study was conducted to evaluate the role of transvaginal color Doppler ultrasonography in detecting endometrial carcinoma in postmenopausal women and in evaluating the depth of myometrial invasion and tumor staging. STUDY DESIGN: A group of 750 postmenopausal women were examined by transvaginal color Doppler ultrasonography 1 day before the planned hysterectomy. Histopathologic and blood flow characteristics were evaluated. Analysis of variance was used to test the significance among the subgroups. RESULTS: Thirty-five women had endometrial carcinoma; 32 (91.4%) cases were detected by transvaginal color Doppler ultrasonography. Visualization of abnormal blood flow within the endometrium was 100% in the diagnosed cases with resistance index near or < 0.40, which constituted a statistically significant difference compared with that of endometrial hyperplasia. No flow was detected in normal, atrophic, and in 92% of cases with hyperplastic endometria. The color Doppler ultrasonography depicted 18 of 19 histologically proved cases of myometrial invasion. Three asymptomatic cases were discovered on the basis of morphologic and blood flow patterns. CONCLUSION: Transvaginal color Doppler ultrasonography can depict endometrial carcinoma, even in asymptomatic women, determine the depth of myometrial invasion, and help in tumor staging.

Endometrial Neoplasms↗
PubMed1995

[Mycotic aneurysm of the posterior tibial artery and pseudo-phlebitis: contribution of color Doppler ultrasonography].

Mycotic aneurysm of the posterior tibial artery and pseudophlebitis: role of color Doppler sonography A case of a 78-year-old male patient presenting with endocarditis caused by Streptococcus bovis and pseudophlebitis of the left lower limb is described. Color Doppler sonography ruled out thrombophlebitis and showed a large pulsatile mass of the posterior compartment of the leg due to a mycotic aneurysm of the posterior tibial artery. This aneurysm was confirmed by angiography and treated by surgery. The important role of color Doppler sonography for the diagnosis of this particular case is emphasized.

Aged↗
PubMed1997

[Diagnosis of shunt dysfunction after transjugular intrahepatic portosystemic shunt by color Doppler ultrasonography: usefulness change of maximum flow velocity in portal vein].

To clarify whether color doppler ultra sonography (CDUS) is useful for the diagnosis of shunt dysfunction after transjugular intrahepatic portosystemic shunt (TIPS), we investigated CDUS in 20 patients who were diagnosed as shunt dysfunction and 12 patients with patent shunt by follow-up portal pressure measurements. In patients with shunt dysfunction, maximum flow velocity in the portal vein (PV-Vmax) and maximum flow velocity in the shunt were significantly decreased in comparison to just after TIPS placement, but not in patients with patent shunt. Grade of color image of the shunt flow and flow direction in the portal vein branches were not significantly different between the shunt dysfunction group and the patent shunt group. Comparing the just after TIPS to the follow-up phase, the decreasing rate of PV-Vmax was negatively correlated with the increasing rate of portal vein pressure caused by shunt dysfunction. CDUS could detect shunt dysfunction in 95% sensitivity, 83% specificity and 91% overall accuracy on the basis of a diagnostic criterion for shunt stenosis : more than 40% decrease of PV-Vmax from just after TIPS insertion. These results suggest that follow-up observation using CDUS is useful for the diagnosis of shunt dysfunction after TIPS procedure, and PV-Vmax is an especially important indicator to detect shunt dysfunction.

Adult↗
PubMed1994

Quantitation of duodenogastric reflux and antral motility by color Doppler ultrasonography. Study in healthy volunteers and patients with gastric ulcer.

BACKGROUND: Our objective was to develop a simple, noninvasive method for evaluating duodenogastric reflux, along with antral motility and gastric emptying of a liquid meal. METHODS: Antral motility and gastric emptying were measured by ordinary ultrasonography after a meal of 400 ml consommé. Duodenogastric reflux was evaluated by means of color Doppler. In a preliminary in vitro study we demonstrated that the test meal (consommé) contained oil particles suitable as a marker for color Doppler. We then investigated duodenogastric reflux, antral motility, and gastric emptying of a liquid meal in 43 asymptomatic healthy volunteers and in 24 patients with gastric ulcer. RESULTS: This approach was feasible in 65 (97.0%) of the 67 subjects studied. Duodenogastric reflux was demonstrated in 26 (61.9%) of the 42 healthy volunteers and in 20 (87.0%) of the 23 patients with gastric ulcer. The frequency of the duodenogastric reflux and the reflux index were significantly increased in patients with gastric ulcer as compared with asymptomatic healthy volunteers. Gastric emptying and the motility index of antral contractions were significantly decreased in patients with gastric ulcer as compared with asymptomatic healthy volunteers. CONCLUSIONS: Ultrasonography with color Doppler is useful for evaluating abnormalities of gastroduodenal motility and can be used to understand the pathogenesis of such disorders.

Adult↗
PubMed2005

Are there adverse effects of herniorrhaphy techniques on testicular perfusion? Evaluation by color Doppler ultrasonography.

PURPOSE: To evaluate the efficacy of prosthetic meshes on testicular perfusion using color Doppler ultrasound (CDUS). MATERIALS AND METHODS: This study is a randomized prospective clinical trial with blind assessment of outcome. A total of 26 patients who underwent elective herniorrhaphy for groin hernia participated in the study. Each patient was randomly assigned to 1 of 2 groups: totally extraperitoneal preperitoneal hernia repair (TEP; n=13, mean age 46.7+/-1.6 years) or Lichtenstein hernia repair (LHR; n=13, mean age 54.2+/-2.7 years). Six of the patients had bilateral hernias (n=3 for each group). Blood flow indexes of the spermatic artery including end diastolic velocity (EDV), peak systolic velocity (PSV) and the resistive index (RI) were examined by CDUS. Ultrasound was performed just before the operations and repeated after 3 months. Kruskal-Wallis and Mann-Whitney U tests were used to evaluate the differences. RESULTS: No statistically significant differences were found between the preoperative and postoperative measurements which included blood flow parameters (PSV, EDV, and RI) of the testes (p>0.05). CONCLUSION: Neither the TEP or LHR technique had any decreasing effect on blood flow.

Adult↗
PubMedDate not supplied

[Color Doppler ultrasonography of short para-optic ciliary arteries in vascular glaucoma].

PURPOSE: To study color Doppler imaging in orbital vessels, especially para-optic short ciliary arteries, in patients with vascular glaucoma. PATIENTS AND METHODS: Twenty vascular normal or moderate elevated pressure glaucoma patients (6 with bilateral glaucoma, 9 with unilateral glaucoma et 5 with asymmetric glaucoma) underwent a color Doppler imaging (Accusson 128XP) in orbital arteries: common carotid, ophthalmic artery, central retinal artery, short para-optic ciliary arteries. Systolic and diastolic blood flow velocities were measured, and resistance index of Pourcelot and ratios between different parameters were calculated. RESULTS: In patients with unilateral glaucoma, ratios of systolic velocities between para-optic ciliary artery and common carotid, and ratio of Pourcelot index between para-optic ciliary artery and ophthalmic artery were increased in glaucomatous eyes. And Pourcelot index were statistically significant increased in all glaucomatous patients of the study compared with normal subjects. DISCUSSION AND CONCLUSION: Comparison of Pourcelot index and ratios between parameters makes color Doppler imaging more reliable, especially when analyse short para-optic ciliary arteries, which vascularize optic nerve. In these arteries Pourcelot index was increased in vascular glaucoma patients. Vascular risk factor should be taken into consideration in this form of glaucoma.

Aged↗
PubMed2003

[Twinkling artifact in color Doppler ultrasonography: pictorial essay].

The "twinkling" artifact is a color-flow sonographic artifact presenting as a rapidly changing color encoding behind a strongly reflecting structure. Recently, "twinkling" artifact has been described behind calcifications in various tissues, urinary and gallbladder stones, encrustated indwelling ureteral stents, strongly reflecting orbital structures and an intracranial microcoil. It is important to recognize this artifact as it could lead to misdiagnosis of vascular flow within a tissue. "Twinkling" artifact could be considered as an additional sonographic feature in the diagnosis of urinary and bile duct stones and encrustated indwelling ureteral stents. "Twinkling" artifact could also play a role in detecting the morphology or biochemical composition of urinary stones.

Artifacts↗