Accuracy Of Color Doppler Ultrasonography Research Articles

Diagnostic Accuracy of Peroperative Color Doppler Ultrasonography for Determining the Nature of Anterolateral Thigh Flap Perforators

Objective: To determine the diagnostic accuracy of color Doppler ultrasonography for diagnosing septocutaneous nature of anterolateral thigh flap perforators taking peroperative findings as gold standard among patients undergoing soft tissue reconstruction. Methodology: A total number of 100 patients undergoing soft tissue reconstruction using antero-lateral thigh flap perforators at plastic surgery unit, Pak Italian Modern Burn Center, Multan and fulfilling the selection criteria were approached. An informed consent were taken from them before enrolling in the study. Information regarding their demographic data were noted in the proforma. A high frequency color Doppler ultrasound was done by the consultant radiologist to determine the nature of the perforator (as per operational defination) and the results were noted in the proforma. The anterolateral thigh thin flap was undermined, but kept in situ. The elevation was performed either on superficial or sub-facial plane depending upon situation and surgical plan, and the points of emergence through the deep fascia and nature of its perforators, as they appeared during surgery, was noted in the proforma. Results: Age distribution of the patients was done, it showed that out of 100 patients, 17 %( n=17) were in age group of 15-27 years and 83%( n=83) were in age group of 28-40 years and mean age was calculated as 33.96±5.72 years. Gender distribution of the patients was done, it showed that 88 %( n=88) were male whereas 12 %( n=12) were females. In this study, Sensitivity and specifity of septocutaneous nature of perforator was 78.41% and 83.33% respectively and PPV was 97.18% and NPV was 34.48% and accuracy was 79%. Conclusion: Color doppler ultrasonography is the reliable test for the prediction of nature of anterolateral thigh flap perforator.

Diagnostic accuracy of color doppler Ultrasonography and FNAC in differentiating benign and malignant cervical lymphadenopathies at Birat Medical College Teaching Hospital, Morang, Nepal

Introduction: Among various imaging modalities useful in diagnosis of cervical lymphadenopathies, Color Doppler ultrasound (CDUS) is useful to evaluate and determine the presence of vascularity, resistance, direction, and velocity of blood flow in lymph nodes. It can determine the morphological and vascular nature of lymphadenopathies which will further help in the differentiation between benign and malignant nodes. Methods: This study was conducted on 61 patients referred to the Department of radiodiagnosis and imaging of BiratMedcical College for an ultrasound of cervical lymphadenopathy. These patients had subsequently undergone FNAC examination. Color Doppler sonographic procedures were done with an 11L linear probe with a frequency of 4.5-12MHz and CDUS evaluation of lymph nodes for Resistive Index and Peak systolic velocity were carried out and correlated with FNAC findings. Results: Among 61 lymph nodes, 52 were benign and 9 were malignant in the Color Doppler study where the final diagnosis by FNAC showed 53 benign and 8 malignant nodes. RI above the cutoff value of 0.5 had 83.3% sensitivity, 79.6% specificity, 50% PPV and 95.1% NPV. PSV above the cutoff value of 16cm/sec had 66.6% sensitivity, 95.9% specificity, 80.0% PPV and 92.2% NPV with diagnostic accuracy of 91.8%. Conclusion: Morphological features of the nodes such as shape, absence of echogenic hilum, abnormal vascular pattern, and Doppler indices cutoff values of 0.5 and 16cm/s respectively for RI and PSV were sensitive and specific for the diagnosis of malignant lymph nodes.

Role of Color Doppler Ultrasound in Antenatal Diagnosis of Placenta Accreta in Patients with Previous Cesarean Scar

Morbidly adherent placenta is asignificant cause of maternal morbidity , mortality and massive obstetric hemorrhage. It is defined as an abnormal placental adherence either in whole or in part of the placenta to the underlying uterine wall. It is a potentially life threatening condition responsible for 7-10% of maternal mortality.Is to evaluate the accuracy of Color Doppler Ultrasonography in antenatal diagnosis of placenta previa accreta in patients with previous cesarean sections. The study included 60 pregnant females after 28 week of gestation from obstetrics and gynecology department of Banha University hospital during a period from (1st of December 2018 to 30th November 2019) with suspected history and ultrasonographic findings of placenta accreta. Gray-scale B-mode transabdominal sonography and Color Doppler Ultrasound scans were done. The overall accuracy of diffuse or focal lacunar flow was 73.3%, vascular lakes with turbulent flow 70%, Hypervascularity of serosa bladder interface 62% and markedly dilated vessel over peripheral sub-placental zone 71% in doppler ultrasound. Color Doppler does not appear to improve the accuracy of Gray-Scale so, it is suggested to use both Gray scale ultrasound and Color Doppler in all cases of placenta previa with previous C.S to find out features that suggest presence of placenta accreta

Is color Doppler ultrasonography reliable in diagnosing adnexal torsion? A large cohort analysis

Introduction Color Doppler ultrasonography (CDU) is widely used to diagnose adnexal torsion (AT). However, its validity remains questionable due to its low sensitivity. Our study aimed to evaluate the accuracy of CDU for the preoperative diagnosis of AT. Material and methods The electronic medical records of patients who were taken to the operating room with the diagnosis of suspected AT were reviewed. Patients having surgically/pathologically-proven AT were compared with patients who were found to have a different pathology at the time of surgery. CDU validity was assessed using a 2 × 2 table and compared with a diagnostic model that consists of the Doppler findings, patient’s age, and previous surgical history. Results AT was diagnosed correctly in 74.6% of cases. Absent Doppler flow was seen in only 18.6% of cases. Although its specificity and positive predictive value were high, CDU had very low sensitivity and negative predictive value. The combined diagnostic model exceeded CDU alone in terms of diagnostic accuracy. Conclusions The use of CDU alone is not a reliable modality to exclude AT. Absent Doppler flow is a sign of ovarian necrosis. Clinical correlation between CDU findings and the patient’s symptoms makes the diagnosis of AT more timely and accurate.

Diagnostic Accuracy of Color Doppler Ultrasonography among Patients Having Deep Vein Thrombosis by Taking Venography as Gold Standard

Objective: To assess the diagnostic accuracy of Color Doppler ultrasonography in patients with Deep Venous Thrombosis by using venography as gold standard at Radiology department of Civil Hospital Karachi.
 Methodology: This cross-sectional study was carried out from August 2014 to March 2015 at Radiology Unit, Civil Hospital Karachi. Patients of either gender with deep venous thrombosis were included based on clinical examination and observation. For Doppler ultrasound, the combinations of spectral scanning, color compression, and grey scale were used. Potential anomalies including existing or non-existing thrombus along with its magnitude were evaluated. Color Doppler Sonographic results included incompressible, lack of phasicity, site of flow space and absence of increasing trend. Scan diagnosis was subsequently contrasted with venographic reports and recorded in self-made proforma. Data was analyzed by using SPSS version 20.
 Results: Total 104 patients were studied and their average age was 52.4±9.4 years. Males and females were 56% and 44% respectively. Color Doppler ultrasonography findings showed 99% sensitivity and 80% specificity. Positive predictive value 99% and negative predictive value 80% and accuracy was 98%.
 Conclusion: Color Doppler ultrasonography is cost-effective, efficient, safe, and non-invasive method to diagnose the deep venous thrombosis of acute nature.

Sensitivity, Specificity, and Accuracy of Color Doppler Ultrasonography for Diagnosis of Retinal Detachment.

PurposeThis study evaluated the sensitivity, specificity, and diagnostic accuracy of Color Doppler Ultrasonography (CDUS) in patients with suspected retinal detachment (RD) who underwent surgery.Methods In this prospective, observational clinical study, 65 eyes of 65 consecutive patients with suspected RD with opaque media were included. Following a standardized protocol, CDUS of the retina of the affected eye was performed. The sensitivity, specificity, and diagnostic accuracy of CDUS were determined and compared to the findings during surgery.ResultsThe mean age of patients (18 men and 47 women) was 52.36 years (range: 8–77 years). The sensitivity, specificity, and overall accuracy of ocular CDUS were 91.3%, 88.1%, and 89.2%, respectively. The false-negative rate (negative CDUS images but presence of RD at operation) was 3.1% (2/65) and the false-positive rate (positive CDUS images but absence of RD at operation) was 7.7% (5/65).ConclusionCDUS of the retina could be considered as a promising tool in the diagnosis of RD in patients with opaque media.

<p>Color Doppler Ultrasonography in Evaluating the Outcomes of Pyeloplasty in Ureteropelvic Junction Obstruction</p>

PurposeTo evaluate the accuracy of Color Doppler ultrasonography for diagnosing post pyeloplasty elimination of obstruction in Ureteropelvic Junction Obstruction patients.MethodologyPatients with the diagnosis of UPJO enrolled in the study and underwent open pyeloplasty. Three to 6 months after the operation, patients were recalled and underwent isotope scan as the gold standard test and renal color Doppler ultrasonography to assess the success rate of pyeloplasty.ResultsA total of 39 patients were evaluated and analyzed. The average follow-up time for patients was 9.1 months. The success rate of surgery in the study population was 100%. The mean RI of the affected side before the operation was 0.69 ± 0.01 and after the pyeloplasty, it reached to 0.65 ± 0.01. The difference between the mean RI of the affected side before and after the operation is 0.04 (P < 0.001). Age, type and severity of obstruction and the technique of surgery did not have any impact on these parameters. The difference between the RI of the affected and healthy side was termed ΔRI. ΔRI before and after the operation was 0.084 and 0.014, respectively. The decrease of ΔRI in the case of pyeloplasty is 0.07 on average (P < 0.001), which can be predicted for pyeloplasty success.DiscussionColor Doppler ultrasonography can be used as a non-invasive, fast, non-expensive, and available modality for evaluating the outcome of pyeloplasty instead of the nuclear scan or IVP.

Color Doppler ultrasound in diagnosis of placenta accreta

peripartum hysterectomy. The strict etiology is indefinite, but it has been postulated to be correlated to the injury of the decidua basalis, which allows for the placental attack into the myometrium.Purpose: To evaluate the accuracy of color Doppler ultrasonography in the diagnosis of placenta accreta and to compare it with the diagnostic accuracy of both 2D Ultrasonography and MRI.Material and Methods: A prospective study was done at Obstetrics and Gynecology Department of Tanta University Hospital, Egypt. The study included 100 patients with suspected placenta accreta based on 2D ultrasonography, color Doppler and MRI. The intraoperative findings of each case were compared with the preoperative imaging findings.Results: Sensitivity for the diagnosis of placenta accreta was (100%) for color Doppler ultrasound, (93.7%) for 2D ultrasound and (75 %) for MRI. Specificity was (66.6 %) with color Doppler and (77.7%) for 2D ultrasound and (55.5%) for MRI. The highest positive predictive value (PPV) was found in 2-D ultrasound (88%), MRI had the lowest PPV (75%), while color Doppler had 84%PPV. Negative predictive value (NPV) was (100%), (87.5%), (55.5%) for color Doppler, 2D ultrasound and MRI, respectively.Conclusion: Color Doppler Ultrasound is the most accurate imaging modality in the diagnosis of placenta accreta. Its accuracy, when combined with 2D ultrasound, would increase and provides the best available modality for diagnosis of placenta accreta

Accuracy of color Doppler ultrasonography and magnetic resonance imaging in diagnosis of placenta accreta: A survey of 82 cases

Placenta adhesive disorder (PAD) is one of the most common causes of postpartum hemorrhage and peripartum hysterectomy. The main risk factors are placenta previa and prior uterine surgery such as cesarean section. Diagnosis of placenta adhesive disorders can lead to a decrease of maternal mortality and morbidities. The purpose of this study was to compare the accuracy of color Doppler ultrasonography and magnetic resonance imaging (MRI) in the diagnosis of PADs. In this is cross-sectional study, Eighty-two pregnant women who were high risk for PAD underwent color Doppler ultrasound and MRI after 18 weeks of gestation. The sonographic and MRI findings were compared with the final pathologic or clinical findings. P<0.05 was considered statistically significant. Mean maternal age was 31.42±4.2 years. The average gravidity was third pregnancy. 46% of patients had placenta previa. The history of the previous cesarean section was seen in 79 cases (96%). The diagnosis of placenta adhesive disorder was found in 17 cases (21%). Doppler sonography sensitivity was 87% and MRI sensitivity was 76% (p=0.37). Doppler sonography specificity was 63% and MRI specificity was 83% (p=0.01). Women with high-risk factors for PAD should undergo Doppler ultrasonography at first. When results on Doppler sonography are equivocal for PAD, MRI can be performed due to its high specificity.

Using dynamic infrared thermography to optimize color Doppler ultrasound mapping of cutaneous perforators.

The high technical demands associated with perforator flaps demand a precise preoperative identification and evaluation of perforator vessels. Color Doppler Ultrasonography (CDU) and Dynamic Infrared Thermography (DIRT) are currently used for preoperative perforator mapping. Each individual technique has advantages and disadvantages. The purpose of this paper is to analyze the value of combining the two methods in order to optimize the process of preoperative perforator mapping. CDU and DIRT were used for preoperative perforator mapping in 10 pigs. The results were compared to intraoperative findings. Total number of perforators, localization, and identification of the dominant perforator was analyzed for each method. The examination time was recorded for each procedure. Both methods had a high sensitivity in determining the number and localization of perforators when compared to those identified during surgery. DIRT produced a higher number of false positive results. CDU accurately identified the emergence of the perforators in the fascia in all cases. Both methods correctly identified the dominant perforator. The sensitivity, positive predictive value, and accuracy of CDU were 93.56%, 97%, and 91.30% respectively and for DIRT 95.05%, 80.67%, and 77.41% respectively. The average examination was 39.76 minutes for CDU and 10.24 minutes for DIRT. The average time taken into account for the analysis of a single perforator in order to confirm DIRT findings was 1.83 minutes. Preoperative perforator mapping has become a compulsory step in nearly all reconstructive procedures. In our study, both CDU and DIRT correctly identified the dominant perforator in all cases. By combining the two examinations overall mapping time can be reduced significantly. A reduced examination time translates into increased patient compliance and a lower procedure cost. The combined mapping technique facilitates the selection of the ideal perforator in all cases. Correctly identifying the dominant perforator preoperatively reduces operative time, lowers complication rates and ensures an overall better result.

OP09.05: A prospective study on the diagnostic accuracy of color Doppler ultrasonography in the differentiation of benign and malignant ovarian neoplasms

<scp>OP09</scp>.05: A prospective study on the diagnostic accuracy of color Doppler ultrasonography in the differentiation of benign and malignant ovarian neoplasms

Evaluation of Color Doppler Ultrasonography in Diagnosing Hepatic Alveolar Echinococcosis

To assess the accuracy of color Doppler ultrasonography in diagnosing hepatic alveolar echinococcosis, 129 patients were examined at the First Affiliated Hospital of Xinjiang Medical University between July 2004 and June 2010. Those patients suspected of having hepatic alveolar echinococcosis were examined and diagnosed by color Doppler ultrasound. All the cases were compared with the gold standard. The findings of their sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, negative likelihood ratio and 95% confidence interval were recorded. Sensitivity: 95% (95% confidence interval: 90.7%–99.3%); specificity: 20.7% (95% confidence interval: 6.0%–35.4%); positive predictive value: 80.5%; negative predictive value: 54.5%; positive likelihood ratio: 1.2: negative likelihood ratio: 0.2. Our study indicates that color Doppler ultrasonography, when used in diagnosing hepatic alveolar echinococcosis, has high sensitivity although specificity is low. Color Doppler ultrasound is, thus, considered to be an efficient means for diagnosing hepatic alveolar echinococcosis.

Diagnostic accuracy of color doppler ultrasonography in evaluation of cervical lymph nodes in oral cancer patients

To assess the diagnostic accuracy of color doppler ultrasonography (CDUS) in differentiating metastatic from reactive lymph nodes in oral cancer patients. Study comprised 80 adult subjects with oral cancer, divided in two groups based on clinical criteria. Group I included 40 patients with clinically suspected metastatic cervical lymph nodes, Group II included 40 patients with clinically suspected reactive cervical lymph nodes. Study population was evaluated with CDUS for color flow signals and intranodal vascular resistance (Pulsatility Index and Resistivity Index), followed by Fine Needle Aspiration Cytology, used as a standard, to confirm the etiology of the lymph node enlargement. Chi-Square Test (SPSS 15.0 version) was used to evaluate the significance of the parameters used between the two study groups. Sensitivity of CDUS by vascular flow pattern was 94.1%, specificity of 100%, with accuracy of 95.4% and by vascular indices the sensitivity was 81.4%, specificity of 100%, and accuracy of 85.5%, with statistically significant correlation.(P < 0.05) CDUS plays a definitive role as an adjunct to clinical evaluation of differentiating metastatic from reactive cervical lymph involvement in patients with oral cancer as it aid in grading and staging of oral cancer and can determine the treatment plan prognosis and morbidity by diminishing the possibility nodal dissection.

Use of Color Doppler Ultrasonography for the Prediction of Malignancy in Follicular Thyroid Neoplasms

The purpose of this systematic review was to obtain summary estimates of the diagnostic accuracy of color Doppler ultrasonography (CDU) in predicting malignancy in thyroid follicular neoplasms (FNs). We searched Medical Subject Headings together with the search terms "follicular," "thyroid," and "Doppler" in the MEDLINE, Web of Science, and Excerpta Medica databases as well as the Latin American and Caribbean Health Sciences Literature database, after which we performed manual searches of the reference lists to locate additional studies. There were no language restrictions. We included studies that assessed the diagnostic accuracy of CDU in identifying malignancy in thyroid FNs. The assessments of the quality and extraction of data were performed by 3 independent reviewers. We included 4 studies, which collectively evaluated 457 thyroid FNs, 67 of which had been classified as malignant based on the evaluation of surgical biopsy samples. Moderate, rich, predominant, or exclusive internal flow on CDU of thyroid FNs was considered indicative of malignancy. The overall sensitivity of CDU was 85% (95% confidence interval [CI], 74%-93%), with an overall specificity of 86% (95% CI, 82%-89%). The overall prevalence was 14.7%, and the positive and negative predictive values were 51% and 97%, respectively. The positive likelihood ratio was 6.07, and the negative likelihood ratio was 0.18. Predominant internal flow seen on CDU is associated with malignancy of thyroid FNs. Absence of internal flow or predominantly peripheral flow indicates a low probability of thyroid FN malignancy.

Deep Venous Thrombosis of the Extremity Diagnosed by Color Doppler Ultrasonography after Isolated Limb Perfusion

Isolated limb perfusion (ILP) is used to treat locally advanced sarcoma and melanoma of the extremities. ILP is associated with a 1.7% to 10% incidence of deep venous thrombosis (DVT). The aim of the study was to examine the effect of ILP on the peripheral venous system and to evaluate the diagnostic accuracy of color Doppler ultrasonography (US). A total of 26 patients with locally advanced sarcoma or melanoma of the extremities received a total of 38 ILP. The patients were evaluated preoperatively and postoperatively by color Doppler US as a noninvasive venous measurement. We used a color Doppler US system (SSA-270A, Toshiba) with a 7.5-MHz linear transducer for gray-scale imaging and a 5-MHz vascular transducer for color Doppler imaging. Seventeen patients underwent single ILP while the others were treated with multiple ILPs. Color Doppler US showed a reflux flow in three (7.9%) patients and DVT occurred subsequently in these patients. Color Doppler US is a noninvasive and clinically useful diagnostic technique in the diagnosis of extremity DVT. We recommend anticoagulant therapy in patients with reflux on ultrasonographic examination.

Power Doppler Improves the Diagnostic Accuracy of Color Doppler Ultrasonography in Cold Thyroid Nodules: Follow-Up Results

The usefulness of a recent color Doppler (CD) ultrasonography technique, named power Doppler (PD), was evaluated in the diagnosis of thyroid nodules showing low or absent uptake of ^99mTc-pertechnetate, in order to investigate the possibility to improve the diagnostic accuracy of ultrasonography. The rationale was the evidence that at PD the color map displays the total integrated Doppler power in color, while CD generally displays an estimate of the mean Doppler shift. The vascular patterns recorded at PD and CD evaluation of 322 thyroid nodules were compared to the results of cytology and/or histology, when surgery was performed. In respect to the results of cytology, PD has a higher sensitivity (100 vs. 91%) and specificity (95.1 vs. 86.2%) than CD. A similar result was found when PD and CD were compared to the results of histology, sensitivity being 100 vs. 89% and specificity 98.1 vs. 93.7%, respectively. During the follow-up the 2 nodules considered false positive at PD resulted to be tumoral lesions. On this basis, the final specificity of PD in our series was 100%. In conclusion, in the current series including 322 thyroid nodules characterized by a low or absent uptake of ^99mTc-pertechnetate, PD seems to provide a better characterization of thyroid nodules, possibly allowing a more accurate selection of the patients to subject to fine-needle biopsy.

Assessment of right hepatic artery involvement in patients with biliary tract cancer using color Doppler ultrasonography.

The accuracy of color Doppler ultrasonography (CDUS) in diagnosing right hepatic artery (RHA) involvement was preoperatively evaluated in 28 patients with biliary tract cancer. When a tumor partially or completely surrounded the RHA, the circumferential involvement was diagnosed as positive. With B-mode ultrasonography imaging alone in the 10 nonsurgical patients, the correspondence rates with angiography for the presence of invasion, absence of invasion, and overall were 33%, 0%, and 10%, respectively. However, CDUS allowed clearer visualization of the RHA than did B-mode imaging, and the correspondence rates of CDUS with angiography were 100%, 43%, and 60%, respectively. In the 13 surgical patients, the accuracy levels of B-mode imaging, CDUS, computed tomography, and angiography for the detection of RHA involvement were 46%, 77%, 58%, and 92%, respectively, when compared with surgical and histopathologic findings. Although the accuracy of CDUS was lower than that of angiography, it can be performed repeatedly and noninvasively. CDUS is expected to be useful for the initial assessment of RHA involvement.