Color Doppler Ultrasound Guidance Research Articles

Real-time Ultrasound-Guided Manual Testicular Detorsion: A Case Report.

IntroductionAcute testicular torsion is a surgical emergency due to acute testicular ischemia. Manual testicular detorsion is a testis-saving, bedside therapeutic when performed correctly and in a timely fashion. This procedure is most commonly performed blindly with pain relief as the endpoint for detorsion. However, up to one-third of patients continued to show signs of residual torsion in the operating room even using pain relief as the stopping point for the procedure.Case ReportWe present a case demonstrating the utility of color Doppler ultrasound to confirm complete manual detorsion in a 14-year-old male with acute testicular torsion. The patient underwent 360-degree detorsion and had relief of pain; however, color Doppler demonstrated incomplete return of flow to the testis. After an additional 180-degree turn was made, color Doppler demonstrated complete return of normal vascular flow to the torsed testis.ConclusionWhen it comes to testicular viability, timely restoration of blood flow to the testicle is of utmost importance. Manual detorsion is a non-invasive intervention that can be quickly and effectively performed at the bedside. Moreover, using color Doppler ultrasound guidance can ensure that physicians detorse in the proper direction and to completion, by providing instant visualization of restorative flow and ensuring reperfusion of the testis while awaiting definitive surgical management.

The clinical application of color Doppler ultrasound in guiding the puncture of new internal fistula in deep arteriovenous

Objective To investigate the clinical value of color Doppler ultrasound guidance in the puncture of new internal fistula in deep arteriovenous of hemodialysis patients. Methods Selected thirty patients with arteriovenous fistula not less than 5 mm deep in the Department of Hemodialysis Room of Wuhan First Hospital, and they were divided into observation group and control group by the method of random number generator in IBM SPSS Statistics 22.0 software, with 15 patients in each group. The control group was treated with conventional blind puncture by experienced nurses (849 times), while the observation group was treated with color Doppler ultrasound guided puncture (855 times). By comparing two groups of deep arteriovenous fistula in new fistula patients within 6 months of the one-time success rate of puncture, the incidence of adverse events such as subcutaneous hematoma, bleeding, pain, interruption or postponement of treatment, and accidental injury to arteries caused by puncture errors of internal fistula, and the patient′s satisfaction with the puncture and dialysis results was evaluated to observe the advantage of color Doppler ultrasound guidance in clinical application of deep arteriovenous new fistula puncture. Results The success rate of one-time puncture for internal fistula puncture in observation group was 98.95% (846/855), which was significantly higher than that in control group 81.27% (690/849), and the difference was statistically significant (χ2 = 149.753, P 0.05). The total incidence of adverse events caused by internal fistula puncture errors in the two groups was 1.99% (17/855) and 22.97% (195/849), respectively, and the difference was statistically significant (χ2=172.126, P < 0.01). The average rank of satisfaction in observation group was 1 261.25, which was higher than control group 440.86, and the difference was statistically significant (Z=-38.107, P < 0.01). Conclusions Color Doppler ultrasound guidance in the puncture of new internal fistula in deep arteriovenous of hemodialysis patients has important clinical application value. It can significantly improve the success rate of one-time new internal fistula puncture, reduce the occurrence of adverse events due to puncture failure, and reduce patient′s pain, which is worthy of clinical promotion. Key words: Doppler ultrasound; Arteriovenous fistula; Applied

Reducing postoperative morbidity of mini-invasive percutaneous nephrolithotomy: Would it help if blood vessels are left unharmed during puncture? A CONSORT-prospective randomized trial.

Background:The aim of this study was to provide a randomized controlled trial comparing single B-mode ultrasound guidance and color doppler ultrasound guidance in minimally invasive percutaneous nephrolithotomy.Methods:Three hundred patients with renal calculus were prospectively randomly assigned into 2 groups. In group 1 (150 patients), minimally invasive percutaneous nephrolithotomy (m-PCNL) were managed with single B-mode ultrasound guidance; In group 2 (150 patients), m-PCNL were managed with color Doppler ultrasound guidance and a needle bracket in order to guide placement at a target location beneath the skin. The characteristics of patients, operation, complications and prognosis, including body temperature, urine culture, and hematologic tests after the operation were recorded and compared.Results:Our vessel-sparing technique showed a statistically significant decrease in hemoglobin drop, postoperative procalcitonin values, the frequency of postoperative fever, systemic inflammatory response syndrome, and urosepsis (P < .05).Conclusion:Using color Doppler ultrasound in real time and a needle bracket to detect and avoid main renal blood vessels decreased incidences of hemorrhagic complications and postoperative infection.

Clinical Evaluation of Color Doppler Ultrasound in Selecting the Optimal Treatment Modality for Infantile Hemangioma.

Objective We investigated the efficacy and safety of 1064 nm Nd: YAG laser, intense pulsed light (IPL), and lauromacrogol injection in the treatment of hemangioma, in order to evaluate the value of color Doppler ultrasound guidance in choosing the optimal treatment modality. Methods Infantile patients who were clinical diagnosed as hemangiomas were randomly divided into group A, who had color Doppler ultrasound examinations before the treatment, and group B who had the treatment without ultrasound evaluation. Patients in the group A were assigned into subgroups according to the depth of lesion by sonography: group A-1 for those who had a lesion depth <1.2 mm, and took intense pulsed light therapy; group A-2 for those who had a lesion depth ≥1.2mm and < 3 mm, and took long pulse 1064 nm Nd:YAG laser therapy; group A-3 for those who had a lesion depth ≥3mm and <5 mm, and were treated by IPL combined with long pulse 1064 nm Nd:YAG laser treatment; Group A-4 for those who had a lesion depth ≥5 mm, and took lauromacrogol injection therapy. Patients in the group B took long pulse 1064 nm Nd:YAG laser treatment without preoperative ultrasound evaluation. The efficacy and adverse reactions of the treatments between the groups were evaluated and compared statistically.Results Totally 113 patients with 128 skin lesions were enrolled in this study, 85 in the group A (mean age 6.8±7.9 months) and 28 in the group B (mean age 6.9±9.9 months). The mean depth of hemangioma was 3.3±1.1 mm in the group A, ranging from 0.5-7.8 mm, with 0.8±0.4 mm, 2.2±0.4 mm, 4.2±0.6 mm and 6.2±0.7 mm in group A1, A2, A3 and A4, respectively. The cure rates and effective rates in the group A were significantly higher than those in the group B (cure rates: 64.5% vs 56.3%, U=3.378, P=0.045; effective rates: 89.5% vs 78.1%, U=4.163, P=0.041). The adverse effect rates of the group A (vesicle 20.0%, pigmentation 46.9%, scarring 17.7%) were lower than those of the group B (vesicle 21.9%, pigmentation 60.4%, scarring 25.0%). Incidences of pigmentation and scarring were statistically significantly different (U=3.884, P=0.034, and U=4.016, P=0.032 respectively) between the two groups.Conclusion With the guidance of color Doppler ultrasound, the efficacy and safety of long pulse 1064 nmNd:YAG laser, intense pulsed light, and lauromacrogol injection in the treatment of infantile hemangioma have better outcomes compared to laser treatment alone without preoperative ultrasound examination.

The clinical efficacy in decreasing hemorrhagic complication by B-ultrasound combined with color Doppler ultrasound guidance in percutaneous nephrolithotomy

Objective To evaluate the clinical significance of using B-ultrasound combined with color Doppler ultrasonography guidance in percutaneous nephrolithotomy (PCNL) to decease the incidence of hemorrhagic complication. Methods A total of 323 patients with renal or urethral stones who had undergone PCNL were retrospectively categorized into 2 groups. Group 1 (147 patients) underwent PCNL with single B-ultrasound guidance while group 2 (176 patients) underwent PCNL with combined B-ultrasound and color Doppler ultrasound guidance. The clinical characteristics and complications, especially hemorrhagic complications in the two groups were recorded and compared. Results There were no statistical significances in age [(53.2±12.9 ) years vs. (54.7±9.1 ) years], hight [(165.1±8.5) cm vs. (164.6±6.9) cm], weight[ (66.1±19.2) kg vs. (64.9±16.3) kg], stone burden [(680.5±56.4) mm2 vs.(654.0±76.9) mm2], operative time[(117.6±55.1) min vs. (121.4±54.3) min], stone-free rate (90.7% vs. 91.3%), or postoperative hospital stay [(4.9±2.2)d vs.( 4.7±1.7 )d] between the two groups. In the B-ultrasound combined color Doppler ultrasound guidance group, the rate of blood transfusion (1.1% vs.3.4%) and super-selective embolization (0 vs.3.4%) was significantly lower than that of the single B-ultrasound guidance group. Besides, the incidents of renal arteriovenous fistula (0 vs. 2.0%), pseudoaneurysm (0 vs. 2.0%), and perirenal hematoma (0 vs. 1.4%) were significantly lower in the B-ultrasound combined color Doppler ultrasound guidance group than that of the single B-ultrasound guidance group. Conclusion Using B-ultrasound combined color Doppler ultrasound guidance during PCNL resulted in the real-time detection and avoidance of the renal blood vessels during puncture and decreased the incidence of hemorrhagic complications. Key words: B-ultrasound combined with color Doppler ultrasound guidance; Percutaneous nephrolithotomy; Urinary calculi; Hemorrhagic complications

A Comparative Study of Clinical Value of Single B-Mode Ultrasound Guidance and B-Mode Combined With Color Doppler Ultrasound Guidance in Mini-invasive Percutaneous Nephrolithotomy to Decrease Hemorrhagic Complications

To compare the clinical value of single B-mode ultrasonography and B-mode combined with color Doppler ultrasonography in the guidance of mini-invasive percutaneous nephrolithotomy (m-PCNL) to decrease the incidence of hemorrhagic complications. A total of 297 patients with renal stones who had undergone m-PCNL were retrospectively categorized into 2 groups. Group 1 (187 patients) underwent m-PCNL with single B-mode ultrasound guidance and group 2 (110 patients) underwent m-PCNL with combined B-mode and color Doppler ultrasound guidance. The clinical characteristics of the patients, intraoperative and postoperative characteristics, complications, especially hemorrhagic complications, and blood transfusion rate were recorded and compared. No statistically significant differences in age, height, weight, stone burden, operative time, stone-free rate, or length of postoperative hospital stay were found between the 2 groups. In group 2, a statistically significant decrease in the transfusion rate was found compared with group 1 (P <.05). In group 1, 5 patients (2.6%) required a blood transfusion, 2 (1.1%) developed a renal arteriovenous fistula and required embolotherapy, 2 (1.1%) developed hemorrhage and required embolotherapy after surgery, 16 (8.6%) developed capillary hemorrhage during surgery but had no hemorrhage postoperatively. However, no serious hemorrhagic complications were found in group 2. Only 3 patients (2.7%) developed capillary hemorrhage during surgery, and no hemorrhage occurred postoperatively. Using combined B-mode and color Doppler ultrasound guidance during in m-PCNL resulted in the real-time detection and avoidance of the renal blood vessels during puncture and decreased the incidence of hemorrhagic complications, especially in the patients with a solitary and compensative kidney.

Color Doppler Ultrasound Guidance During Renal Angioplasty and Stenting

Purpose:To investigate whether an imaging technique combining color Doppler ultrasonography and selective renal artery digital subtraction angiography reduces contrast requirements in patients with progressive renal insufficiency undergoing renal artery angioplasty and stenting.Methods:Eight patients (5 men; mean age 58 years) with renal artery stenosis and renal insufficiency underwent percutaneous transluminal angioplasty and stenting under color Doppler ultrasound guidance.Results:Color Doppler ultrasound imaging yielded the information necessary for verifying catheter position, stent placement and expansion, and hemodynamics after revascularization. The combined imaging technique considerably reduced contrast requirements to only 10 mL in each case. No worsening of renal function was seen in any patient.Conclusions:The combined imaging procedure uses low doses of contrast agent and is especially suited to patients with renal dysfunction undergoing percutaneous renal revascularization.

Tratamiento de seudoaneurisma pancreático por punción directa y embolización

We report the case of a patient with recurrent acute pancreatitis who developed a pseudoaneurysm of the hepatic artery, leading to hemorrhage and biliary obstruction due to compression. Given that treatment by endovascular embolization and surgery was impossible, following percutaneous biliary drainage, embolization was performed by direct percutaneous coil embolization with spongostan, under color Doppler ultrasound guidance. After a follow-up period of five years, the patient presents no evidence of disease.

Percutaneous biopsy of liver tumors with color Doppler US guidance.

Percutaneous liver biopsy is a well-established procedure. Aim of this study was to investigate the usefulness of color Doppler ultrasound (US) for guiding percutaneous biopsy of liver tumors in patients at high risk of bleeding. Forty-seven patients with severe, uncorrectable coagulopathy (platelet count < 50 x 10(9)/L and/or prothrombin time ratio [normal/patient] < 50%) were submitted to percutaneous biopsy of focal liver lesions using a 21 G cutting needle. The procedure was guided by color Doppler US, avoiding the needle cross into any liver or tumor vessel. Biopsy material was adequate for pathological reading in 46/47 cases (97.9%). No major post-biopsy complication was observed. In particular, no case of hemoperitoneum was detected on US examinations performed 2 hours after biopsy. Minor complications (including one subcapsular hematoma) occurred in 4 patients (8.5%). Color Doppler US can safely guide percutaneous liver biopsy in patients at high-risk of bleeding.