3D Doppler Ultrasonography Research Articles

#167 : Role of Endometrial Receptivity Using 3D Doppler Ultrasound on Pregnancy Outcome of IVF-FET Cycles

Background: The success of in vitro fertilization and embryo transfer (IVF-ET) cycles depends primarily on the quality of the embryo and the receptivity of the uterus. In addition to embryo quality the receptivity of the endometrium plays a role in the implantation process. Uterine receptivity is widely accepted as one of the main limiting factors in IVF outcomes. Endometrial thickness and endometrial pattern have been regarded as indicators for endometrial receptivity. Objective: To compare the ultra-sonographic endometrial characteristic in relation to blood flow on Doppler between pregnant and non-pregnant groups of FET patients in IVF/ ICSI cycles. Methods: This cross-sectional study is approved by the Institutional Ethical Committee (IEC) of Hameed Latif Hospital. Our study consists of 200 women who have come for FET cycle. On 18th day of period cycle, endometrial thickness, resistance index was obtained by transvaginal sonography. In the combined analysis, endometrial thickness groups (group 1: <9 mm; group 2: [Formula: see text]9 mm) were subdivided into two endometrial patterns (triple-line and diffused). The women were divided into the [Formula: see text]-HCG positive and [Formula: see text]-HCG negative groups. For statistical analysis chi-square and Fisher’s exact tests was used. Multiple logistic regression analysis and the receiver operating characteristic (ROC) curve analysis were applied to determine the best predictive variables. Results: The women in [Formula: see text]-HCG positive group were significantly younger as compared to [Formula: see text]-HCG negative group. Endometrial thickness was ¿ 9mm and RI was lower in group 1. A significant association was found between endometrial pattern and pregnancy outcome. (p-value = 0.01. ROC curve revealed that for ultrasound parameters the area under the curve was around 0.5. Conclusion: Endometrium pattern and thickness and resistive index on Doppler may better predictor for pregnancy; combined endometrial characteristics do not predict outcomes.

Terapia manual para la mejora del flujo sanguíneo de las arterias uterinas en el área vascular endometrial/subendometrial en mujeres infértiles mediante ultrasonografía tridimensional: estudio piloto

ObjectiveTo quantitatively assess the effect of physical therapy manual technique on endometrial volume and histogram values in infertile participants. MethodsPilot, analytical, interventional study, with a control group, developed at the Juana Crespo Clinic on 34 infertile participants.The endometrial and subendometrial volume of the uterus, Vascularization Indices (VI%), Vascularization Flow Index (VFI%) and Flow Index (IF%) were measured by 3D Doppler Ultrasonography, after applying the manual mobilization technique in soft tissue of the iliac fossa. ResultsIn the experimental group, the comparison of the total endometrial volumes before (M=41.09) and after the application of the physiotherapy technique (M=47.29) presented statistically significant differences, z=-3.946 (p<0.001), r=-, 73, like the study of histograms, reaching significant differences in the flow index (IF%) between the pre (M=35.22) and post (M=37.62) records, z=-2.849 (p<0.005), r=- 52. The vascularization flow index (IFV%) and the vascularization index (IV%) did not have significant differences between the pre and post time. Histograms IV%, IF%, IFV% indicate p<0.005. ConclusionsThe physiotherapy technique increases the total endometrial volumes and the endometrial IF% after its application, although the IV% and IFV% variables do not vary.

Full-visibility 3D imaging of oxygenation and blood flow by simultaneous multispectral photoacoustic fluctuation imaging (MS-PAFI) and ultrasound Doppler

We present a method and setup that provide complementary three-dimensional (3D) images of blood oxygenation (via quantitative photoacoustic imaging) and blood flow dynamics (via ultrasound Doppler). The proposed approach is label-free and exploits blood-induced fluctuations, and is implemented on a sparse array with only 256 elements, driven with a commercially available ultrasound electronics. We first implement 3D photoacoustic fluctuation imaging (PAFI) to image chicken embryo, and obtain full-visibility images of the vascular morphology. We obtain simultaneously 3D ultrasound power Doppler with a comparable image quality. We then introduce multispectral photoacoustic fluctuation imaging (MS-PAFI), and demonstrate that it can provide quantitative measurements of the absorbed optical energy density with full visibility and enhanced contrast, as compared to conventional delay-and-sum multispectral photoacoustic imaging. We finally showcase the synergy and complementarity between MS-PAFI, which provides 3D quantitative oxygenation (SO_2) imaging, and 3D ultrasound Doppler, which provides quantitative information on blood flow dynamics. MS-PAFI represents a promising alternative to model-based inversions with the advantage of resolving all the visibility artefacts without prior and regularization, by use of a straightforward processing scheme.

Unexpected leiomyosarcoma after total abdominal hysterectomy with indication uterine myoma in nullipara: a case report

Introduction: Uterine sarcomas are rare tumors, with 3-7% incidence. Abnormal uterine bleeding, abdominal or pelvic masses, and pain are the most common symptoms in the patient. Non-specific clinical symptoms or preoperative diagnostic techniques to differentiate uterine myoma and uterine sarcoma lead to the general diagnosis after surgery. The incidence of uterine sarcoma established from the literature was 0.09% -0.49% in women undergoing benign hysterectomy or myomectomy. The difficulty of diagnosing preoperative leiomyosarcoma is a challenge in itself. This case report aims to provide knowledge information with characteristics of a sonographic image with a non-hypervascularity encapsulated image and intraoperative findings with a regular smooth uterine surface, which is thought to be a uterine myoma is different from the anatomical pathology results, which indicate a leiomyosarcoma malignancy.Case description: Miss A, 47 years old with complaints of an enlarged stomach for two years, felt abdominal pain and complained about prolonged menstruation for four years. The patient was unmarried and had no previous history of surgery. Intraoperatively, there was posterior corpus adhesion with ascending colon and adhesion was performed. Large, fragile blood vessels appeared. Then it was decided to do a total abdominal hysterectomy—intraoperative hemorrhage 1200 cc. The results of the anatomic pathology showed a leiomyosarcoma. Furthermore, the patient was consulted to the oncology subdivision for a bilateral Salpingo-Oophorectomy procedure followed by chemotherapy. MRI, 3D Doppler sonography were required to increase the preoperative diagnosis of uterine sarcoma.Conclusion: Our case reported that a patient was diagnosed with uterine myoma and stage II hypertension. The patient showed common signs and symptoms. There was posterior corpus adhesion with ascending colon, and adhesion was performed. Theoretically, pelvic sonography is a first-line imaging study. MRI can be used to help differentiate uterine sarcomas from uterine myomas.

Role of the First Trimester Maternal Serum High Sensitivity C-Reactive Protein and Second Trimester Placental Volume Measurement by 3d Doppler Ultrasound in Early Detection of Preeclampsia

Background: Pre-eclampsia (PE) is a disorder of pregnancy characterized by the onset of high blood pressure and a significant amount of protein in the urine. It affects 2–8% of pregnancies worldwide. Complications include impaired liver function, kidney dysfunction, visual disturbances and red blood cell Breakdown. PE continues to be a major cause of maternal and fetal mortality. Thus, efforts at discovering reliable prediction models to identify those at risk at an early stage are critical. And since Placental maldevelopment plays a pivotal role in the pathogenesis of PE, therefore, evaluation of the placental volume and vascular flow indices using different techniques can contribute in the prediction of adverse pregnancy outcomes. Aim of the Work: to assess the ability of high sensitivity c reactive protein (Hs CRP) and 3D power Doppler of placental volume and vascular flow indices to predict Preeclampsia. Patients and methods: This is a prospective cohort study by multi operators conducted on 200 women with singleton pregnancy who underwent screening for eligibility and eventually included with respect to the inclusion criteria. The study has been done during the period from October 2015 till December 2016. 1st trimesteric serum level of HsCRP detection tests, 1st trimesteric abdominal ultrasonographic examination and 2nd trimesteric color-Doppler techniques were done and placental volume was measured and Follow up at delivery to confirm Pre-eclampsia has followed. Study Outcomes included the development of hypertention, limb edema or other of pre-eclampsia complication. Data were statistically analyzed using IBM© SPSS© Statistics version 23. Results: HsCRP was significantly (P≤ 0.05 and 0.01) high in Pre-eclampsia group compared to the normal pregnancy group. Moreover, Placental volume (PV), Vascularization index (VI), Flow index (FI) and Vascularization flow index (VFI) were significantly (P≤ 0.05 and 0.01) lower in Pre-eclampsia group than the normal pregnancy group.Conclusion: there was a statistically significant correlation between first-trimester HsCRP and the 2nd trimester placental volume and its vascular indices in the prediction of complications of uteroplacental insufficiency. Further studies with large number of patients have to be carried out to reach conclusive evidence of the significance Doppler in prediction of pre-eclampsi, .and HsCRP.

Three-dimensional Doppler ultrasound findings in healthy wrist and finger tendon sheaths - can feeding vessels lead to misinterpretation in Doppler-detected tenosynovitis?

BackgroundThe aim was to investigate the presence of feeding vessels in or in close proximity to extensor and flexor tendon sheaths at the wrists level and in finger flexor tendon sheaths in healthy controls, using 3D ultrasound (US), which may cause pitfalls, in order to ensure correct interpretation of Doppler signals when diagnosing tenosynovitis.MethodForty healthy participants (20 women and 20 men age 23-67 years) without prior history of arthritis, tendon diseases or present pain in their hands were included. Twenty participants had 3D Doppler US of the second and third finger and twenty of the right wrist. US was carried out using a GE Logiq E9 unit with a 3D US probe. The colour Doppler settings were to published recommendation.ResultsThe feeding vessels in or in close proximity to the tendon sheaths were found in the flexor and extensor tendons sheaths at least once in each participant. No significant difference in feeding vessels was seen between the radial and carpal level in the wrist (p = 0.06) or between the second and third flexor tendon sheath (p = 0.84).ConclusionDoppler findings in or in close proximity to the tendon sheaths were common in wrists and fingers in healthy participants. These feeding vessels can be a source of error, not only due to their presence but also because they may be interpreted as being inside the tendon sheath due to blooming and reverberations artefacts. These vessels should be taken into consideration when diagnosing Doppler tenosynovitis.

Can 3D power Doppler identify levator ani vascularization at its pubic insertion?

The levator ani is the most important muscle in the pelvic floor. This pilot study using 3D power Doppler aimed to identify normal vascularization of the puborectalis/pubovisceralis muscle at its insertion in nulliparous and premenopausal women. Forty nulliparous and premenopausal women were evaluated at the Gynecological Unit of a tertiary hospital. All women underwent a translabial ultrasound (US) with 3D power Doppler. Pubic insertion of the puborectalis/pubovisceralis muscle was assessed in the axial plane, and vascularization index (VI), flow index (FI), and vascularization-flow index (VFI) were calculated bilaterally. Volumes were analyzed offline by two independent observers, and interobserver agreement and correlation between variables was calculated. A high, statistically significant, correlation was found between the three US indices on each side (p < 0.005). No correlation was found between the US index and either of the demographic parameters of body mass index [(BMI), p > 0.241], or age (p > 0.398). The degree of correlation between the same index on the different sides was not statistically significant. Puborectalis/pubovisceralis muscle vascularization at its insertion can be identified using 3D Doppler US, but values differ substantially from those of the contralateral side.

Efficiency of three-dimensional Doppler ultrasonography in assessing nodal metastasis of head and neck cancer.

The aim of this study was to assess the clinical usefulness of three-dimensional (3D) color Doppler ultrasonography with a novel predictive model in the detection of cervical metastasis of untreated head and neck squamous cell carcinoma patients. We assessed cervical lymph node metastasis in 52 head and neck squamous cell carcinoma patients by 3D color Doppler ultrasonography, magnetic resonance imaging, and [(18)F] fluorodeoxyglucose positron emission tomography with computed tomography. Pathologic analysis was used as the gold standard for evaluation of these imaging modalities. The rate of correct N staging was 84.6% on ultrasonography, 55.8% on magnetic resonance imaging, and 71.2% on positron emission tomography/computed tomography. On a level-by-level basis, the ultrasonography had 78.9% sensitivity, 99.0% specificity, 93.8% positive predictive value, 96.0% negative predictive value, and 95.7% accuracy. It also showed the highest agreement to histology results as compared with magnetic resonance imaging and positron emission tomography/computed tomography (kappa value = 0.832, 0.506, and 0.537, respectively). 3D Doppler ultrasonography with our prediction model provides a rapid, low-cost, noninvasive, and reliable method with low inter-observation variations for detecting neck metastasis of head and neck squamous cell carcinoma patients.

GPU accelerated segmentation and centerline extraction of tubular structures from medical images

To create a fast and generic method with sufficient quality for extracting tubular structures such as blood vessels and airways from different modalities (CT, MR and US) and organs (brain, lungs and liver) by utilizing the computational power of graphic processing units (GPUs). A cropping algorithm is used to remove unnecessary data from the datasets on the GPU. A model-based tube detection filter combined with a new parallel centerline extraction algorithm and a parallelized region growing segmentation algorithm is used to extract the tubular structures completely on the GPU. Accuracy of the proposed GPU method and centerline algorithm is compared with the ridge traversal and skeletonization/thinning methods using synthetic vascular datasets. The implementation is tested on several datasets from three different modalities: airways from CT, blood vessels from MR, and 3D Doppler Ultrasound. The results show that the method is able to extract airways and vessels in 3-5 s on a modern GPU and is less sensitive to noise than other centerline extraction methods. Tubular structures such as blood vessels and airways can be extracted from various organs imaged by different modalities in a matter of seconds, even for large datasets.

Three‐dimensional doppler ultrasonography in assessing nodal metastases and staging head and neck cancer

This study built a simple prediction system by three-dimensional (3D) Doppler ultrasonography to evaluate the metastases of cervical lymph nodes and the preoperative initial stage of head and neck cancer. Retrospective review of cervical lymph node ultrasound features and prospective nodal staging of head and neck cancer. One hundred thirty-nine suspicious cervical lymph nodes, receiving 3D Doppler ultrasonography, were used to establish a predictive model. Then nodal metastasis was initially staged from 27 patients with head and neck cancer by this model. The prediction system was constructed by major (internal matting, vascularity pattern) and minor (age ≥ 40 years, short/long ratio ≥ 0.5) sign categories. Cervical lymph node was regarded as metastasis with the presence of one major and any of the other factors. The predictive model resulted in sensitivity of 91.9%, specificity of 88.2%, and accuracy of 89.2%. Then we evaluated the initial staging of patients with head and neck cancer by this model, and the rate of correct N staging was 92.6%. According to this prediction system, 3D Doppler ultrasonography definitely provides a rapid and reliable method for initial staging of head and neck cancer.

OP02.05: 3D Doppler ultrasonography in asymptomatic and symptomatic women after medical termination of pregnancy

OP02.05: 3D Doppler ultrasonography in asymptomatic and symptomatic women after medical termination of pregnancy

Prenatal Diagnosis of Small-Bowel Volvulus Using 3-Dimensional Doppler Sonography

Volvulus is generally a condition that occurs in the pediatric age group, commonly associated with intestinal malrotation. The intrauterine occurrence of this condition is a rare occasion, and only a few cases have been reported. Precise diagnosis is hampered by the extensive differential diagnoses of fetal intra-abdominal masses observed during sonographic examination. However, detection of the whirlpool sign facilitates sonographic diagnosis of this condition. We report a case of intestinal volvulus that occurred in utero diagnosed definitively with 2-dimensional and 3-dimensional (3D) Doppler sonography. To our knowledge, there is no previous report of such a case that was diagnosed by 3D Doppler sonography in the English literature.

AGU-WS-10 Cartographic MRI of prostate cancer

Comparison of 1.5 MRI imaging with dynamic contrast enhancement using full time point computer aided analysis. Findings were correlated with biopsy and 3D power Doppler sonography. Prospective study of 359 biopsy proven patients over two years. All exams were performed on Siemens 1,5T unit after 3D Doppler sonography using GE Voluson 730 System within one week period. 287 patients revealed the tumor (s) at 1,5 Tesla with an 80 % corrélation. 323 patients demonstrated biopsy confirmation using computer aided contrast enhancement for a 90 % corrélation. 3D power Doppler ultrasound demonstrated a 92 % corrélation with biopsy findings in 330 patients. Cartographie MRI improves diagnosis by 11 % over standard 1,5T imaging. 3D power Doppler ultrasound has a similar accuracy to cartographie dynamic MRI.