Color Doppler Energy Research Articles

Ultrasound and Doppler Diagnostic Capabilities of Lymph Nodes in Thyroid Cancer

nodular lesions, autoimmune thyroiditis and neoplastic processes are the leading diseases of the thyroid gland (TG), when it is characterized by the cervical lymph nodes (LN) enlargement. They can undergo macro- and microscopic changes due to inflammatory processes of bacterial or viral origin, benign and malignant lesions of the neck, head and mediastinum. Doppler ultrasonography (US) plays a significant role among the new methods of screening for altered LN and differential diagnosis of pathological processes. The aim of this work is to determine the prospects for the use of LN lesions’ ultrasound diagnostics in inflammatory and oncological processes of the TG. Ultrasound diagnostics was performed to determine Doppler signs (EDV, PSV, RI) and changes in neck LN in 175 patients with and without TG pathologies. According to the results of histopathology, the patients were divided into 4 groups: 46 healthy patients without any thyroid pathology, 44 patients with inflammatory thyroid diseases, 42 patients with thyroid cancer but without metastatic LN involvement, 43 patients with metastatic LN involvement – Thyroid cancer. B-mode ultrasound diagnostic data demonstrated positive complementation with echostructural signs and changes in vascularization. It manifested in a wide range of velocities and atypical angioarchitectonics. 13 (31%) patients had increased vascularization with PSV – 23-45 cm/s, EDV – 14- 8 cm/s, RI – 0.32-0.46. It shows the progression of proliferative processes without necrotic changes in the hilus and its periphery. In 18 (43%) patients dynamic Doppler observation indicated the appearance of accelerated blood flow and an atypical vascular concentration outside nodular capsules. It is an indicator of the cancer spread. Color Doppler mapping and energy Doppler coding of cervical metastases are important diagnostic techniques, that qualitatively and quantitatively complements and details B-mode ultrasound diagnosis.

Hybrid descriptor for placental maturity grading

Placental maturity grading (PMG) is quite essential to assess fetal growth and maternal health. To this date, PMG has mostly relied on the subjective judgment of the clinician, which is time-consuming and may cause wrong estimation due to redundancy and repeatability of the process. To tackle it, we propose an automatic method to stage placental maturity via deep hybrid descriptors based on B-mode ultrasound (BUS) and color Doppler energy (CDE) images. Specifically, convolutional descriptors extracted from multiple deep convolutional neural networks (DCNNs) and hand-crafted features are integrated to get the hybrid descriptors for grading performance boosting. First, different models with various feature layers are combined to obtain hybrid descriptors from images. Second, the transfer learning strategy is also utilized to enhance the grading performance via the deeply represented features. Third, extracted descriptors are encoded by Fisher vector (FV). Finally, we use support vector machine (SVM) as the classifier to grade placental maturity. The experimental results demonstrate that our proposed method could achieve good performance in PMG.

Role of Color Doppler and Three-dimensional Ultrasound in Infertility

Color Doppler is emerging as a valuable diagnostic imaging modality in the field of medicine, primarily infertility. Reproductive disorders, including infertility and spontaneous abortions/miscarriages, have emerged as major public health problem(s) worldwide. Color Doppler energy imaging is a high throughput technology based on the total integral of energy frequency spectrum. Color Doppler is a high-throughput, sophisticated imaging technique for the assessment of uterine anomalies, intrauterine pathology, tubal patency, polycystic ovaries, ovarian follicular monitoring, endometrial receptivity, failed or an ectopic pregnancy, male infertility and uterine, endometrial and ovarian vascularity. Assessments of the utero-ovarian pulsatility indices (PIs), resistance indices (RIs), and endometrial color signals are important determinants of in vitro fertilization (IVF) cycles and pregnancy rates. With many clinical/scientific research experience in the field of reproductive medicine, I strongly believe that an overall public health model needs to be designed in managing infertility patients; therefore, major issues such as cost effectiveness and technical artifacts should address so as to achieve an accurate clinical diagnosis, successful IVF outcome/pregnancy, and overall patient satisfaction in a clinical rehearse setting. Simple, safe efficient and affordable diagnostic modalities should be incorporated at infertility clinics coupled with well-designed patient counseling sessions and community-based public health awareness campaigns conducted so as to reduce the morbidity and mortality rates associated with reproductive disorders. Three dimension (3-D) ultrasound is a new imaging modality which is being introduced into clinical practice. It has been proved that 3-D ultrasound is a very highly reproducible technique. With 3-D ultrasound, a volume of a region of interest can be acquired and stored. This volume can be further analyzed in several ways, such as navigation, multiplanar display and surface rendering or volume calculation. Power Doppler ultrasound, in combination with 3-D ultrasound, allows for a whole assessment of relevant vessels and quantitative assessment of vessel density and perfusion within a specified area. Faridpur Med. Coll. J. Jul 2018;13(2): 97-100

Specific features of joint ultrasound study in patients with rheumatoid arthritis

To study the specific features of joint ultrasound readings in rheumatoid arthritis (RA) in relation to its duration. A total of 162 patients (mean age, 43.54±11.1 years) with a mean RA duration of 3.22±3.13 years were examined. Gray-scale ultrasound study (USS) of hand and ankle joints was performed using color Doppler energy imaging. Group 1 included 78 patients with a RA duration of less than 2 years; Group 2 consisted of 84 patients with a RA duration of more than 2 years. Joint USS diagnosed osteochondral erosions twice more frequently than conventional radiography. 82% of the patients with RA were found to have synovitis; 77% had thickening of the synovial membrane (SM) with hypervascularization, the vascularization intensity scores of 2-3 being predominant; and 54% had tenosynovitis of the carpal extensor tendon. Effusion into the joint cavity, SM hypervascularization scores of 2-3, and tenosynovitis were most common in Group 1. SM thickening and osteochondral erosions were prevalent in Group 2. Joint USS revealed that angiogenesis and inflammation were dominant in the patients with a RA duration of less than 2 years and the proliferative-destructive processes were prevalent in those with a RA duration of more than 2 years. Identifying the predominance of pathophysiological processes in each specific patient with RA will be able to individualize therapy and to improve the prognosis of the disease.

Automatic placental maturity grading via hybrid learning

Fetal viability, gestational age, and complicated image processing have made evaluating placental maturity a tedious and time-consuming task. Despite various developments, automatic placental maturity still remains as a challenging issue. To address this issue, we propose a new method to automatically grade placental maturity from B-mode ultrasound (BUS) and color Doppler energy (CDE) images based on a hybrid learning architecture. We also apply an improved pyramidal shift invariant feature transform (IPSIFT) descriptor using a coarse-to-fine scale representation for visual feature extraction. These local features are then clustered by a generative Gaussian mixture model (GMM) to incorporate high order statistics. Next, the clustering representatives are encoded and aggregated via Fisher vector (FV). Instead of using traditional FV, an end-to-end deep training strategy is developed to fine-tune the GMM parameters to boost evaluation performance. A multi-view fusion technique is also developed for feature complementarity exploration. Extensive experimental results demonstrate that our method delivers promising performance in placental maturity evaluation and outperforms competing methods.

Multi-modal and multi-layout discriminative learning for placental maturity staging

Placental maturity staging is a challenging task due to complex imaging procedure, fetal and gestational age variations. To address this issue, we extract features not only from B-mode gray-scale ultrasound (US) images, but also from color Doppler energy (CDE) images. Based on these features, we propose a method to automatically determine the placental maturity by harnessing multi-view and multi-layout discriminative learning fusion. Specifically, we devise a multi-view technique to generate features of complementary information. Scale invariant features are extracted from image locally, and a Gaussian mixture model (GMM) is then applied to summarize the high-level information features. The clustering representatives from GMM are encoded via a multi-layout Fisher vector (MFV) instead of traditional Fisher vector (FV) to aggregate features based on their spatial information. We apply a multi-layout feature encoding method to improve the staging performance using discriminative learning technique. Extensive experimental results demonstrate that our method achieves promising performance in placental maturity staging and outperforms existing methods.

Emerging role of Color Doppler in Infertility Management: A Public Health perspective

Color Doppler is emerging as a valuable diagnostic imaging modality in the field of reproductive medicine, primarily infertility. Reproductive disorders, including infertility and spontaneous abortions/miscarriages, have emerged as major public health problem(s) worldwide. Color Doppler energy imaging is a high throughput technology based on the total integral of energy frequency spectrum. We extracted the most relevant articles (comprehensive reviews and original research articles) for inclusion in our review by performing a comprehensive literature search using the Pubmed (last accessed on 2015 April 28) scientific database. Color Doppler is a high-throughput, sophisticated imaging technique for the assessment of uterine anomalies, intrauterine pathology, tubal patency, polycystic ovaries, ovarian follicular monitoring, endometrial receptivity, failed and/or ectopic pregnancy, male infertility, and uterine, endometrial, and ovarian vascularity. Assessments of the uteroovarian pulsatility indices (PIs), resistance indices (RIs), and endometrial color signals are important determinants of in vitro fertilization (IVF) cycles and pregnancy rates. With our clinical/scientific research experience in the field of reproductive medicine, we strongly believe that an overall public health model needs to be designed in managing infertility patients; therefore, major issues such as cost-effectiveness and technical artifacts should be addressed so as to achieve an accurate clinical diagnosis, successful IVF outcome/pregnancy, and overall patient satisfaction in a clinical research setting. Simple, safe, efficient, and affordable diagnostic modalities should be incorporated at infertility clinics coupled with well-designed patient counseling sessions and community-based public health awareness campaigns conducted so as to reduce the morbidity and mortality rates associated with reproductive disorders.

Ultrasound vascular enhancement technology in the detection of fetal pulmonary vein

Objective To investigate the ultrasound vascular enhancement technology(VET)in the ultrasound detection of fetal pulmonary vein.Methods According to gestational age,289 cases of fetal pulmonary vein were divided into group A(15 to 22 weeks,n =89),group B(23 to 30 weeks,n =152),group C(31 to 38 weeks,n =48).In these groups,VET technology,two-dimensional echocardiography (2DE),color Doppler flow imaging(CDFI),color Doppler energy(CDE)were simultaneously detected.VET technology Results were compared with the other three methods,and compared in different gestational age groups.Results Four fetal pulmonary veins in different groups of gestational week were displayed as following:In group A,2DE showed 11 cases(12.36％),CDFI 38 cases(42.70％),CDE 42 cases (47.19％),VET 70 cases(78.65％),compared with 2DE,CDFI and CDE,the positive rate of VET was significantly higher(P＜0.05).In group B,2DE showed 36 cases(23.68％),CDFI 75 cases(49.34％),CDE 82 cases(53.95 ％),VET 145 cases 95.39(％),compared with 2DE,CDFI and CDE,the positive rate of VET was significantly higher(P＜0.05).In group C,2DE showed 16 cases(33.33％),CDFI 30 cases (62.50 ％),CDE 32 cases(66.67 ％),VET 29 cases(60.42 ％),compared with 2DE,the positive rate of VET was significantly higher(P＜0.05);compared with CDFI and CDE,the positive rate of VET was no significant difference(P＞0.05).The display rate of four fetal pulmonary veins in group B was the highest,and the positive display rate in group A was significantly higher than in group C(P＜0.05).Conclusions VET can significantly improve the display rate of the fetal pulmonary vein,and locate inspection of fetal pulmonary vein.The best time for fetal pulmonary vein to check is the second trimester. Key words: Ultrasonography,prenatal; Fetus; Pulmonary veins; Vascular enhancement technology

Role of endometrial blood flow assessment with color Doppler energy in predicting pregnancy outcome of IVF-ET cycles

This is a prospective study of 182 women (38 yrs or younger) undergoing IVF-ET. Endometrial thickness, echo pattern and blood flow on transvaginal ultrasonography were recorded eight hours prior to hCG administration. The patients were divided into three groups: A (n = 10) with undetectable endometrial blood flow; B (n = 82) with sub-endometrial blood flow; C (n = 90) with both endometrial and sub-endometrial blood flow. According to IVF-ET outcomes, all patients were re-divided into three groups: 1 non-pregnancy (n = 92); 2 intrauterine pregnancy with live fetus (n = 70); 3 others (n = 20 including biochemical pregnancy, embryonic diapause, ectopic pregnancy and miscarriage). Intrauterine pregnancy with live fetus in Group C (62.2%) was much higher than that in Group A and B (0% and 17.1%, p less than or equal to 0.001). The implantation rate (33.2%) was much higher than that in Group A and B (0% and 19.90%, p less than or equal to 0.001). The pulsatility index, resistance index, and S/D of endometrial spiral arteries were 0.1 +/- 0.2, 0.6 +/- 0.1 and 2.5 +/- 0.4 in Group 2, which were much lower than those in Group 1 and Group 3 (p1-2 less than 0.001, p2-3 less than 0.05). The patients with detectable endometrial blood flow had higher clinical pregnancy rates and implantation rates.

CA 125 serum values in surgically treated endometriosis patients and its relationships with anatomic sites of endometriosis and pregnancy rate

Endometriosis is a benign gynecologic disease defined as the presence of functional endometrial glands and stroma outside the uterine cavity, causing dysmenorrhea, dyspareunia, menstrual irregularities, and infertility. Serum CA-125 measurement is now a consolidated method for diagnosing this condition, and its interpretation has posed a number of problems, particularly regarding utility in diagnosing minimal-mild endometriosis, whereas its value as a diagnostic aid in moderate-severe stages is well recognized. In our cohort, serum CA-125 values were significantly elevated in patients with ovarian and mixed endometriosis lesions (median levels 48 U/mL), compared with those who had exclusively extraovarian foci (median levels 27 U/mL), and so the correlation between this marker and the surgical and pathologic finding of ovarian and deep endometriosis was found to be statistically significant; however, the location did not affect the fertility rate.

Assessment of Achilles enthesitis in the spondyloarthropathies by colour Doppler energy ultrasound in the context of the ‘enthesis organ’

Objectives: To identify the characteristic features of Achilles enthesitis of the spondyloarthropathies (SpA) detectable by colour Doppler energy ultrasound (CDEU) in the context of the ‘enthesis organ’.Methods: Seventy patients with SpA and 15 healthy subjects were clinically evaluated and underwent CDEU examination of the Achilles entheses. The CDEU images were evaluated according to five distinctive CDEU features of enthesitis in the context of the enthesis organ.Results: Fifty-six of the 70 SpA patients (80%) showed at least one abnormal finding of the enthesitis on CDEU examination, affecting 91 of 140 Achilles entheses examined (65%). Only 22 of 140 Achilles entheses (15.7%) showed abnormal vascularization in the peri-sesamoidal and periosteal areas or in the area of enthesis fibrocartilage. In addition, 67 (47.9%) and 18 (12.9%) of 140 Achilles entheses examined showed cortical bone irregularities and erosions, respectively, at areas of the periosteal and the enthesis fibrocartilage. Sixteen (88.9%) of 18 clinically detected Achilles enthesitis and six (75%) of eight Achilles entheses with swelling on clinical examination presented corresponding abnormalities on CDEU examination. The Doppler twinkling artefact (TA) was observed consistently in all normal entheses and completely disappeared upon stabilization of the probe application. The C-reactive protein (CRP) level was higher in the patients with cortical bone erosion than in those without erosion.Conclusions: This study demonstrates the characteristic features of enthesitis detectable by CDEU in the context of the enthesis organ and shows a good correlation with clinical as well as with laboratory findings.

Evaluation of renal vascularization using amplitude-coded Doppler ultrasound

To evaluate the benefit of "Colour Doppler Energy" (CDE) or "Power Doppler" applications in healthy kidneys and in renal disease including paediatric assessment. Ten healthy volunteers (range: neonate to adults) were studied using conventional colour Doppler sonography (CDS) and CDE in order to evaluate the visibility of intrarenal vasculature. In addition, ten children and ten adults with known renal disease were evaluated. The findings were compared to clinical, scintigraphic and biopsy results. CDE showed far better visualisation of intrarenal vasculature than CDS. CDE demonstrated focal and diffuse reduced cortical perfusion with an overall accuracy of 95% and a sensitivity of 88%. In 7 healthy volunteers cortical vasculature was visualised throughout the kidney. In 3 infants incomplete visualisation was obtained because of motion artifacts. In the diseased kidneys, CDE findings correlated well with clinical findings, scintigraphy results and biopsy findings. CDE can be successfully applied to adults and infants demonstrating renal vasculature in healthy kidneys and in kidneys with focally or diffusely altered perfusion.

3-D reconstruction of intracranial vessels using a color Doppler energy method--initial experiences

Transcranial Doppler sonography and colour Doppler imaging provide good information on the basal arterial brain vessels, but cannot provide images comparable to angiographic images. However, comparable displays could be achieved by a 3-dimensional calculation of images collected by a computer. These images of intracranial vessels are supplied by the new Doppler imaging modality Colour Doppler Energy (CDE). Tilting of the acquired data can then be oriented analogous to angiography, CT and MRI projections. Initial results with this method are very promising.

Color Doppler Energy にて腫瘍内の血流を評価できた肺癌の1例

Color Doppler Energy にて腫瘍内の血流を評価できた肺癌の1例

The clinical application of color doppler energy in predicting pregnancy outcome during frozen thawed embryos transfer cycles

The clinical application of color doppler energy in predicting pregnancy outcome during frozen thawed embryos transfer cycles

Natural history of periocular capillary haemangiomas: changes in internal blood velocity and lesion volume

Although the clinical characteristics of childhood periocular capillary haemangiomas are well known, serial measurements of blood velocity and lesion size are unknown. This investigation was designed to measure the changes in maximum blood velocity and estimated size of lesion in children with capillary haemangioma not requiring active intervention. Retrospective case-note review for a cohort of children with capillary haemangioma involving the eyelid and orbit. Children with periocular capillary haemangioma, under the care of the Orbital unit at Moorfields Eye Hospital between 1996 and 2005, were monitored clinically and with repeated ultrasonographic examination. Volume estimates were calculated as an ovoid based on the three maximum orthogonal measurements for the haemangioma, and blood velocity was assessed by Colour Flow Mapping, Colour Doppler Energy Imaging, and Spectral Doppler techniques using a Sequoia 512 Acuson scanner. Twenty-four children (12 boys) had initial assessment by 18 months of age, and the haemangioma increased in size in 14/24 (58%), the increase being between 4 and 931% of initial volume estimate. The largest measured size for an individual haemangioma appears inversely related to the child's age at measurement, this mirroring a similar trend in measurements for the maximum blood velocity. Blood velocity measurements also tend to decrease with time, the peak velocity being before 1 year of age in the majority (15/24; 62%). In many children, both volume estimates and blood velocities show a cyclic variation-this occurring with increasing intervals between the maxima, before a final decay in both parameters. Although, for the whole group, there was no correlation (correlation coefficient=0.29) between estimated size and measured blood velocity, some individual children showed a significant correlation between the two parameters. The age at maximum blood velocity appeared to precede the age at maximum volume in most children, and in many there was an orbital anomaly detectable on ultrasonographic examination, even with complete clinical resolution of the haemangioma. Ultrasonographic examination of periocular capillary haemangiomas show that these lesions have a very high blood velocity in feeding vessels-about 2-3 orders of magnitude greater than normal capillary beds-and that the velocity and volume of such lesions undergo a cyclic variation during their natural history. Evidence suggests that both velocity and volume decrease with time, although often not returning to zero on ultrasonography (unlike the clinical resolution of the lesions). In most children, blood velocity peaks before volume estimates and this might suggest that decreasing perfusion leads to later tissue atrophy and involution of the haemangioma.

P-533: The clinical application of color Doppler energy in predicting pregnancy outcome during in vitro fertilization and embryos transfer cycles

P-533: The clinical application of color Doppler energy in predicting pregnancy outcome during in vitro fertilization and embryos transfer cycles

Evaluation of Color Doppler Energy in the Diagnosis of Hashimoto's Thyroiditis

本文对30例病理学证实的桥本甲状腺炎患者进行了彩色多谱勒能量图(CDE)检查,发现本病多表现为甲状腺弥漫性增大,实质回声不均匀减低,呈网格样改变,实质内血流丰富呈现火海征,血流速度高于正常对照组,但低于甲亢组.本文结果表明,桥本甲状腺炎彩色多谱勒能量图检查具有较高的特征性,能为临床明确诊断提供重要依据。

Two-Dimensional and Three-Dimensional Ultrasound Differential Diagnosis of Endometrial Hyperplasia and Endometrial Adenocarcinoma

Measurements of endometrial thickness and volume with two-dimensional (2D) and three-dimensional (3D) ultrasonography (US) showed significant differences between endometrial hyperplasias and endometrial adenocarcinomas. Our results indicate that in spite of the subjective nature of its evaluation, tissue homogeneity evaluated with ultrasound is an excellent parameter to use in the differential diagnosis of endometrial lesions. Our observations indicate that neither ultrasound determination of border sharpness, degree of vascular density, nor vascular flow impedance of malignant lesions yields significant differences between different degrees of myometrial invasion. The use of color Doppler energy (CDE) with echoenhancing agent is useful only to increase endometrial vascular visibility by 11.9% in cases of hyperplasia. We did not detect differences in impedance between endometrial hyperplasias with or without atypia, even when echoenhancing agents were used.

Color Doppler energy prediction of malignancy in adnexal masses using logistic regression models.

The aim of this study was to assess the usefulness of color Doppler energy in the preoperative diagnosis of ovarian malignancy using multivariate logistic regression analysis. One hundred and thirty adnexal masses were studied with transvaginal B-mode, color energy, and pulsed Doppler ultrasonography before surgery in order to develop a model that could be used to determine malignancy. Each ultrasonographic variable (tumor size, wall thickness, septal structure, echogenicity, papillary projection, density (solid or not)) was included individually or combined together as part of the Sassone ultrasound score. Intratumoral blood flow velocity waveforms were obtained to determine pulsatility index and resistance index and a more subjective parameter, location of tumor vascularity, was also assessed. Menopausal status and serum CA 125 levels were also entered as categorical variables. Sonographic parameters were entered alone, then associated with menopausal status and CA 125 serum levels, and finally with Doppler energy measurements. Our model was then validated in a group of 68 adnexal masses and compared to the model of Alcazar. Eighteen adnexal masses (13.8%) were malignant or of low malignant potential. Multivariate analysis showed that papillary projection of the tumor wall, cyst with solid parts, resistance index with a cut-off value of 0.53, CA 125, and central blood flow location, were the only factors to be independent predictors of malignancy. Menopausal status was not an independent factor. For the final model including the Doppler energy parameter the best sensitivity and specificity were 83% and 93%, respectively, at a cut-off value of 10% probability of malignancy compared to 83% and 87% for the morphological variables alone. Validation of the model showed its diagnostic performance to be as good as that reported in the original population and better than the model of Alcazar. Sonographic analysis of adnexal masses including color Doppler energy shows the best predictive properties according to histological diagnosis, and improves preoperative diagnosis of malignancy.