Conventional Color Doppler Sonography Research Articles

Ultrasonographic Detective Flow Imaging for Evaluating Parathyroid Adenoma in Patients with Primary Hyperparathyroidism

Detective flow imaging (DFI) is a new imaging technology that displays low-velocity blood flow, which is difficult to visualize on conventional color Doppler ultrasonography (CDU). In this study, we compared the usefulness of DFI with that of CDU and methoxy-isobutyl-isonitrile (MIBI) scintigraphy for detecting parathyroid adenoma (PA) in patients with primary hyperparathyroidism (PHPT). From March 2021 to March 2023, 87 PHPT patients underwent surgery, and 66 had a single PA. We performed preoperative conventional ultrasonography with CDU, MIBI scintigraphy, and DFI for 42 patients (5 males and 37 females; mean age: 61.6 ± 15.4 years). MIBI scintigraphy detected PA in 85.7% (36/42) patients, and both CDU and DFI detected PA in all patients. The rates of vascularity in PA detected by CDU and DFI were 71.4% (30/42) and 85.7% (36/42), respectively. Vascularity was detected by DFI in 6 patients who were negative for vascularity on MIBI scintigraphy. Furthermore, DFI detected blood supply in 6 of the 12 patients with undetectable blood supply on CDU. Fisher's exact test revealed that high or low blood flow, as determined by DFI, was significantly associated with detection of feeding vessels in PA by CDU (P < 0.001). DFI was useful for preoperative detection of PA blood flow.

Comparison of superb microvascular imaging to conventional color Doppler ultrasonography in depicting renal cortical microvasculature

PurposeThe aim of the study was to compare Superb Microvascular Imaging (SMI) to conventional color Doppler ultrasonography (CDUS) and power Doppler ultrasonography (PDUS) in depicting kidney cortical microvasculature. MethodsUsing 3.5 MHz curve-linear array ultrasound transducer and manufacturer recommended color Doppler settings (Canon Medical Systems) for KIDNEY sonography, we performed kidney CDUS, PDUS, and SMI in 20 healthy adults (10 man and 10 women, mean age 27 years). Color Doppler signals in all color Doppler images were quantified by counting color pixel intensity, calculating area ratio of color to total region of interest (AR), and measuring distance of cortical end vessel to the kidney capsule. We used one-way analysis of variance (ANOVA) and post-hoc to test the difference in color pixel intensity, AR, and distance of cortical end vessel to the kidney capsule among SMI, CDUS, and PDUS and in all paired groups. ResultsThe differences in color pixel intensity, AR, and distance of cortical end vessel to the kidney capsule were significant among CDUS, PDUS, and SMI, as well as in all paired groups (P < 0.001). Color pixel intensity and AR in SMI were significantly higher than CDUS and PDUS (p < 0.001). The distance of cortical end vessel to the kidney capsule in SMI was significantly less than in CDUS and PDUS (p < 0.001). Inter- and intra-observer reliability of quantifying color Doppler images was good (Intraclass correlation coefficient: 0.79–0.92). ConclusionOur results suggest that SMI seems more sensitive than CDUS and PDUS in depicting kidney cortical microvasculature.

Expanding Role of US in Diagnosis of Portal Hypertension and Cirrhotic Complications

Color Doppler Ultrasonography (CD-US) has an advantage of being non-invasiveness, so many attempts to investigate the hemodynamic alterations in cirrhosis and the response to medical treatment of portal hypertension as well as morphologic change of liver have been made. In particular, any CD-US parameter that could be a suitable substitute for the invasive current gold standard for assessing portal hypertension by measuring hepatic venous pressure gradient (HVPG) and hepatic fibrosis evaluated by liver biopsy, would be highly desirable. The presence of intrahepatic shunts resulting from portal hypertension can be helpful to diagnosis of portal hypertension and cirrhosis through novel characteristic CD-US index. It has been recently suggested that the extent of abnormality in Doppler hepatic vein (HV) waveform is associated with degree of HVPG as well as severity of hepatic fibrosis, and a change in HV waveform is closely correlated with that in HVPG. Abnormal flattened HV wave form is thought to be due to hemodynamically blunting the effect of variations in central venous pressure during the cardiac cycle, which is arising from increased HV inflow via intrahepatic shunts secondary to portal hypertension. Moreover, under microbubble contrast enhancement, CD-US detection of decreased hepatic vein transit time due to presence of intrahepatic shunts can be useful to assess the severity of portal hypertension and grade of fibrosis. However, for being reproducible and accurate, a cooperative training program of operators with strict examination protocol would be helpful to reduce the rate of intra-and inter-observer variation. Consequently, developments of novel CD-US indices and techniques are ongoing to overcome the limitations of conventional CD-US methods in diagnosis of portal hypertension and cirrhosis, and some of them are enough to potentially allow widespread clinical use.

Utility of Real-Time Shear Wave Elastography in the Assessment of Testicular Torsion.

Real-time shear-wave elastography (SWE) is a newly developed method which can obtain the stiffness of tissues and organs based on tracking of shear wave propagation through a structure. Several studies have demonstrated its potential in the differentiation between diseased and normal tissue in clinical practices, however the applicability to testicular disease has not been well elucidated. We investigated the feasibility and reproducibility of SWE in the detection of testicular torsion. This prospective study comprised 15 patients with complete testicular torsion. Results obtained from SWE along with conventional gray-scale and color Doppler sonography and post-operative pathology were compared. The results revealed that (i) the size of injured testis was increased and the twisted testis parenchyma was heterogeneous. The blood flow signals in injured testis were barely visible or absent; (ii) The Young’s modulus, including Emean, Emax, Emin and SD values in the border area of torsional testis were higher than those of normal testis (Emean, 78.07±9.01kPa vs 22.0±5.10kPa; Emax,94.07±6.53kPa vs 27.87±5.78kPa; Emin, 60.73±7.84 kPa vs 18.90±4.39kPa; SD, 7.67±0.60 kPa vs 2.30±0.36 kPa, [P<0.05]); The Emax and SD values in the central area of the torsional testis were higher than the corresponding area of the normal testis (Emax, 8.23±0.30 kPa vs 3.97±0.95kPa; SD, 1.5±0.26kPa vs 0.67±0.35kPa,[P<0.05]) and Emin values was lower than those of normal testicles(0.93±0.51kPa vs 1.6±0.36kPa; [P<0.05]); (iii) The Young's modulus measurement between two physicians showed good agreement. The pathological findings were accordance with SWE measurement. SWE is a non-invasive, convenient and high reproducible method and may serve as an important alternative tool in the diagnosis and monitoring the progression of the acute scrotums, in additional to conventional Doppler sonography.

Contrast-Enhanced Ultrasonography in the Early Period After Kidney Transplantation Predicts Long-Term Allograft Function

IntroductionReal-time contrast-enhanced sonography (CES) can assess microvascular tissue perfusion using gas-filled microbubbles. The purpose of the study was to evaluate the feasibility of early CES in predicting long-term kidney allograft function in comparison to color Doppler ultrasonography (CDUS). MethodsWe prospectively studied 68 consecutive kidney transplant recipients using CES and conventional CDUS investigation 1 week after transplantation. Transplant tissue perfusion imaging was performed by low-power imaging during intravenous administration of the sonocontrast SonoVue. Renal tissue perfusion was assessed quantitatively using flash replenishment kinetics of microbubbles to estimate renal blood flow (RBF). The obtained sonography values were correlated with clinical data 1 week up to 1 year after transplantation. ResultsIn contrast with conventional CDUS resistive indices, RBF estimated by CES 1 week posttransplantation significantly correlated with kidney function after 1 year (r = 0.67; P < .001). Determination of RBF by CES revealed a significant correlation with donor age but not recipient age, whereas conventional CDUS resistive index was significantly correlated to recipient age (r = 0.54; P < .001) but not donor age. Furthermore RBF was associated with vascular fibrosis and intimal thickening of the engraftment biopsies. ConclusionThis is the first prospective study demonstrating the prognostic value of CES early after kidney transplantation. In contrast with CDUS, CES reveals information about kidney allograft perfusion independent of recipient vascular compliance.

Three-dimensional high-definition flow in the diagnosis of placental lakes

Placental lakes are sonolucent areas often found in the normal placenta. Most of them are asymptomatic. They are sometimes related to placenta accreta or intrauterine fetal growth restriction, among other conditions. Although Doppler sonography is useful for evaluating noxious placental lakes, it is not easy to adapt Doppler studies to conventional two-dimensional color Doppler sonography because of the low-velocity blood flow and high vascularity in the placenta. Here, we demonstrate how three-dimensional high-definition imaging of flow provides a novel visual depiction of placental lakes, which helps substantially with the differential diagnosis. As far as we know, there have been no previous reports of observation of placental lakes using three-dimensional high-definition imaging of flow.

Role of contrast enhanced ultrasound in characterization of focal liver lesions

AimThe purpose of the study was to describe the enhancement patterns of focal liver lesions (FLLs) on contrast enhanced sonography (CEUS), assessing the potential of this technique for characterizing the lesions and to compare its diagnostic accuracy with conventional baseline sonography including color Doppler. Materials and methodsBetween August 2009 and July 2010, 50 patients with FLLs underwent gray scale sonography, color Doppler and CEUS. The enhancement patterns of these FLL’s were analyzed throughout the arterial phase, the portal venous phase and the extended portal venous phase (the late parenchymal phase). The final diagnosis was established on the basis of histopathologic examination or CT/MRI imaging. ResultsOut of these 50 FLLs, 33 were malignant (4 hepatocellular carcinoma and 29 metastasis) and 17 were benign (5 hemangioma, 5 abscess, 2 cyst and 1 each of FNH, focal fat sparing area, focal fatty infiltration, adenoma and benign/granulomatous lesion). The enhancement patterns after injecting microbubble contrast agent allowed characterization of FLLs. The malignant lesions showed intratumoral and/or peritumoral vascularity during the arterial phase and perfusion defect during the late parenchymal phase. Contrast enhanced sonography improved sensitivity in detecting malignancy (CEUS vs. baseline sonography, 100% vs. 81.8%). ConclusionCEUS improves detection and characterization of FLLs. It should be used as problem solving tool in cases where conventional gray scale and color Doppler sonography are non-diagnostic.

Intrarenal Color Doppler Ultrasonography in the Diagnosis of Accessory Renal Artery Stenosis

Conventional color Doppler ultrasonography of main renal artery is a valuable non invasive tool in screening and diagnosing patients with renal artery stenosis. However, this technique suffer a set back from many limitations. Color Doppler ultrasonography examination of intrarenal branch arteries using the parameters like, acceleration time, acceleration time ratio, and acceleration index with additional sampling from upper and lower pole of kidney has shown good results in diagnosis of renal artery stenosis. We successfully diagnosed accessory renal artery stenosis in two patients using intrarenal Doppler technique. We conclude, intra renal Color Doppler ultrasonography with additional sampling from upper and lower pole is most accurate method for diagnosis of significant RAS including accessory RAS. Nepalese Journal of Radiology; Vol. 2; Issue 2; July-Dec. 2012; 59-64 DOI: http://dx.doi.org/10.3126/njr.v2i2.7687

Contrast-enhanced ultrasonography using Sonazoid(®) is useful for diagnosis of malignant ovarian tumors: comparison with Doppler ultrasound.

The purpose of this study was to assess the usefulness of Sonazoid(®)-enhanced ultrasonography (US) in the diagnosis of ovarian cancer in comparison with Doppler US. Twenty-five ovarian tumor patients who were scheduled to undergo surgery were recruited for this study. The day before the operation, each patient was evaluated with color and power Doppler and baseline US during intravenous infusion of Sonazoid. Each lesion was classified as "benign" or "malignant" on the basis of specific criteria for a Doppler signal or Sonazoid-enhanced pattern. The reference standard was the histology of surgically removed adnexal tumors. Twenty patients were diagnosed with malignant tumors (invasive cancer, n=15; metastatic cancer, n=1; borderline tumor, n=4), and the remaining five were diagnosed with benign tumors. Sonazoid-enhanced US correctly depicted the presence or absence of intratumoral blood flow in all patients with an accuracy of 92%. Color Doppler ultrasound depicted the malignancies with an accuracy of 64%, and power Doppler ultrasound depicted them with an accuracy of 76%. Our study suggests that Sonazoid-enhanced US is superior to conventional color Doppler US for the diagnosis of malignant ovarian tumors, but not to power Doppler US. The data and their interpretation in our study should be taken with some degree of caution because of the small number of subjects. Further studies involving a larger sample size would be needed to confirm these findings.

Preliminary experience of contrast-enhanced ultrasound with high mechanical index in the diagnosis of renal artery stenosis

Objective To evaluate the value of contrast-enhanced ultrasound (CEUS) with high mechanical index(MI) in the diagnosis of renal artery stenosis(RAS). Methods Twenty-one patients with RAS including 3 patients after renal transplantation were studied. Ultrasound contrast agent SonoVue was used and MI was set at about 1 when the CEUS was performed. All patients were examined with conventional color Doppler sonography and CEUS. The diagnostic results of ultrasound were compared with those of intravenous digital subtraction angiography ( DSA), CT angiography(CTA) and MR angiography (MRA). Results The sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of conventional color Doppler sonography were 85. 7%, 57. 1 % , 80. 0% , 66. 7% and 76. 2%, respectively, those of CEUS were 100%, 66.7%, 88.2%, 100% and 90.5%, respectively. Conclusions CEUS with high MI which improves the imaging of renal artery depicts the margin of the vascular lumen directly and clearly. It may be more helpful in the diagnosis of RAS. Key words: Ultrasonography; Microbubbles; Renal artery stenosis

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.

Metastatic Alveolar Soft Part Sarcoma of the Breast

Journal of Ultrasound in MedicineVolume 25, Issue 7 p. 929-932 Case Report Metastatic Alveolar Soft Part Sarcoma of the Breast Hyo Soon Lim MD, Corresponding Author Hyo Soon Lim MD [email protected] Department of Diagnostic Radiology, Chonnam National University Hwasun Hospital, Jeollanam-do, KoreaAddress correspondence to Hyo Soon Lim, MD, Department of Diagnostic Radiology, Chonnam National University Hwasun Hospital, 160 Ilsim-ri, Hwasun-eup, Hwasun-gun, Jeollanam-do 519-809, Korea.Search for more papers by this authorSuk Hee Heo MD, Suk Hee Heo MD Department of Diagnostic Radiology, Chonnam National University Hwasun Hospital, Jeollanam-do, KoreaSearch for more papers by this authorJin Gyoon Park MD, Jin Gyoon Park MD Department of Diagnostic Radiology, Chonnam National University Hospital, Gwang-Ju, Korea.Search for more papers by this authorHeoung Keun Kang MD, Heoung Keun Kang MD Department of Diagnostic Radiology, Chonnam National University Hwasun Hospital, Jeollanam-do, KoreaSearch for more papers by this author Hyo Soon Lim MD, Corresponding Author Hyo Soon Lim MD [email protected] Department of Diagnostic Radiology, Chonnam National University Hwasun Hospital, Jeollanam-do, KoreaAddress correspondence to Hyo Soon Lim, MD, Department of Diagnostic Radiology, Chonnam National University Hwasun Hospital, 160 Ilsim-ri, Hwasun-eup, Hwasun-gun, Jeollanam-do 519-809, Korea.Search for more papers by this authorSuk Hee Heo MD, Suk Hee Heo MD Department of Diagnostic Radiology, Chonnam National University Hwasun Hospital, Jeollanam-do, KoreaSearch for more papers by this authorJin Gyoon Park MD, Jin Gyoon Park MD Department of Diagnostic Radiology, Chonnam National University Hospital, Gwang-Ju, Korea.Search for more papers by this authorHeoung Keun Kang MD, Heoung Keun Kang MD Department of Diagnostic Radiology, Chonnam National University Hwasun Hospital, Jeollanam-do, KoreaSearch for more papers by this author First published: 01 July 2006 https://doi.org/10.7863/jum.2006.25.7.929Citations: 5Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat Citing Literature Volume25, Issue7July 2006Pages 929-932 RelatedInformation

Real-Time Contrast-Enhanced Sonography of Renal Transplant Recipients Predicts Chronic Allograft Nephropathy

Real-time contrast-enhanced sonography (RT-CES) can assess microvascular tissue perfusion using gas-filled microbubbles. The study was performed to evaluate the feasibility of RT-CES in detecting chronic allograft nephropathy (CAN) in comparison to color Doppler ultrasonography (CDUS). A total of 26 consecutive renal transplant recipients were prospectively studied using RT-CES and conventional CDUS. Transplant tissue perfusion imaging was performed by low-power imaging during i.v. administration of the sonocontrast Optison. Renal tissue perfusion was assessed quantitatively using flash replenishment kinetics of microbubbles to estimate renal blood flow A *beta (A = peak signal intensity, beta= slope of signal intensity rise). In contrast to conventional CDUS resistance and pulsatility indices, renal blood flow estimated by CES was highly significant related to S-creatinine (r =-0.62, p = 0.0004). Determination of renal blood flow by CES reached a higher sensitivity (91% vs. 82%, p < 0.05), specificity (82% vs. 64%, p < 0.05) and accuracy (85% vs. 73%, p < 0.05) for the diagnosis of CAN as compared to conventional CDUS resistance indices. Perfusion parameters derived from RT-CES significantly improve the early detection of CAN compared to conventional CDUS. RT-CES using low-power real-time perfusion imaging is a feasible method to evaluate microvascular perfusion in renal allograft recipients.

Assessment of Obstruction in Adult Ureterocele by Means of Color Doppler Duplex Sonography

Aim: The purpose of this study is to present a method for identifying a ureteral obstruction in unilateral orthotopic ureterocele by means of conventional sonography and color Doppler duplex sonography. We focus on the measurement of the ureterocele dimensions, the degree of dilation it causes to the ipsilateral upper urinary tract, the registration of urine out-flow from the ureteral orifice into the bladder and its spectral analysis. Material and Method: Over 2 years at our institutions, 8 adult patients (7 women, 1 man) were diagnosed as having a single system orthotopic ureterocele. Four of them presented with lumbar pain, dysuria and recurrent urinary tract infections, while the remainder were asymptomatic and diagnosed accidentally. The diagnosis was based on serial sonography of the upper and lower urinary tract confirmed by intravenous pyelography and cystoscopy. We also performed color Doppler duplex sonographic evaluation of the urine jets ejected from both ureteral orifices into the bladder. Using the flow spectral study we analyzed the waveforms and measured their duration and flow rate. The study was completed with a comparative analysis of the data obtained from both ureteral orifices. Results: Cystic dilation of the lower ureteric extremity into the bladder was presented in all cases. Upper urinary tract dilation, of various grades, was present in 4 of 8 patients. Differences in urine jets between those derived from the ureterocele and those from the healthy contralateral ureteral orifice were significant in those patients with dilation of the upper urinary tract. The differences concerned mainly the frequency and symmetry of the jets as well as the pattern, duration and velocity of their waves. The 4 above-mentioned patients, with dilated upper urinary tracts and waveforms differentiated from the contralateral ones, were characterized as obstructive. On the other hand, the remaining 4 patients with subclinical ureterocele showed insignificant differences in urine jets and waveforms, and were found to be non-obstructive. Conclusion: Conventional sonography of the urinary tract in combination with color Doppler duplex sonography of the ureteral jets can be used in an attempt to diagnose and evaluate a unilateral orthotopic (single system) ureterocele and assess the necessity of intervention to identify the obstruction.

The Surgical Treatment of Peyronie's Disease: Replacement of Plaque by Free Autograft of Buccal Mucosa

Objectives: The aim of this work was the evaluation of clinical results of the use of buccal mucosa for replacement of Peyronie's disease plaque. Patients and methods: Twenty-six patients with Peyronie's disease were under observation. All the patients underwent the following investigations before and periodically within 3 years after the treatment: International Index of Erectile Function (IIEF-5), manual examination of plaque, autophotography of erect penis, conventional and power color Doppler sonography of penis, Peno-Brachial Index (PBI) before and its increase (IPBI) after the intracavernous injection of papaverin, Peak Systolic Velocity (PSV), end diastolic velocity (EDV), Resistance Index (RI), Sexual Encounter Profile questions (SEP-2 and SEP-3), measurements of penile length and curvature angle in the phase of rigidity. After stabilization in plaque's development (mean time 2.0 ± 0.1 years) the patients underwent a surgery by means of excision of plaque and its replacement by free autograft of buccal mucosa. Results: After the surgical treatment (with mean follow up observation of 3.2 ± 0.1 years) in 24 patients out of 26 (92.3%) the complete straightening of penis occurred, in two (7.7%) cases a residual curvature (<10°) remained, in four patients (15.4%) the shortening of penis (by 1 cm) and in two patients (7.7%) a partial reduction of erectile power were observed. Conclusion: Buccal mucosa showed high properties of adaptation and revascularization, good anatomical and functional clinical results by replacement of indurative plaque, it kept a stable elasticity without shrinkage; the method is simple and can be recommended for wide use in clinics for surgical treatment of Peyronie's disease.

Advanced dynamic flow -- a new method of vascular imaging in prenatal medicine. A pilot study of its applicability.

Vascular imaging by means of colour Doppler sonography is an established method in prenatal diagnostics, especially in fetal echocardiography. In recent years, new techniques for the imaging of vessels have been developed, attaining B-scan quality. One example of such techniques is the Advanced Dynamic Flow. The goal of the study was the comparison of the practical application of ADF under routine conditions with the established colour Doppler method, on the same machine. Comparison of conventional colour Doppler sonography with Advanced Dynamic Flow. a prospective, systematic study. We used a representative cross-section through the fetal vessels and also carried out complete fetal echocardiography. Between January 1 (st), 2002 and December 31 (st), 2002, 100 pregnant women between the 12 (th) to 40 (th) gestational week were examined. The success rate for visualisation of blood flow was the same or higher for Advanced Dynamic Flow in all areas, compared with conventional colour Doppler. These results could also be achieved in fetal echocardiography. The Advanced Dynamic Flow technique is a new method for vascular imaging with B-scan quality. It offers high resolution, good lateral discrimination and high sensitivity. The present prospective study has demonstrated that ADF achieves better vascular imaging than conventional colour Doppler sonography. The fact that ADF offers an almost three-dimensional imaging of vessels is particularly valuable. The ease of use of the ADF technique qualifies this method as a serious alternative to conventional colour Doppler sonography.

椎骨動脈起始部病変検出における超音波検査の限界

Arteriosclerosis of the vertebral artery preferentially affects the area near its origin, and sometimes can become a cause of embolism. The purpose of this study was assess the validity of conventional color Doppler sonography compared to selective angiography for evaluating the origin of the vertebral artery. A retrospective study of 120 vertebral arteries was undertaken. Sixty patients with cerebrovascular disorders were studied by conventional color Doppler sonography and selective arterial angiography. The lesions were classified into 6 groups morphologically on the basis of angiography: normal, hypoplastic, occluded, kinked, coiled and stenosed. Color Doppler imaging enabled good documentation of vertebral artery flow on the right in 93% and on the left in 97%, and of the vertebral artery wall on the right in 70% and on the left in 52 (<0.05). Occlusion and hypoplasty were detected in all 15 vessels with a specificity of 94.3%, but false positive results were obtained in one vessel due to technical difficulties. Thirteen of these 15 vessels were kinked and coiled. Moderate stenosis (<70%) could not be evaluated, but stenosis exceeding 80% was diagnosed in two cases with a specificity of 100%. Diagnosis of moderate stenosis of the origin of the vertebral artery remains difficult. Duplex sonography seems a viable option for evaluation of the vertebral artery, and for quantifying vertebro-basilar stroke.

Assessment of endometrial edema and echotexture in natural and hormonally manipulated estrus in mares

Since luteal vascularization plays a decisive role for the function of the corpus luteum (CL), the investigation of luteal blood flow (LBF) might give valuable information about the physiology and patho-physiology of the CL. To quantify LBF, usually Power mode color Doppler ultrasonography is used. This method detects the number of red blood cells moving through the vessels and shows them as color pixels on the B-mode image of the CL. The area of color pixels is measured with computer-assisted image analysis software and is used as a semiquantitative parameter for the assessment of LBF. Although Power mode is superior for the evaluation of LBF compared to conventional color Doppler ultrasonography, which detects the velocity of blood cells, it is still not sufficiently sensitive to detect the blood flow in the small vessels in the center of the bovine CL. Therefore, blood flow can only be measured in the bigger luteal vessels in the outer edge of the CL. Color Doppler ultrasonographic studies of the bovine estrous cycle have shown that plasma progesterone (P4) concentration can be more reliably predicted by LBF than by luteal size (LS), especially during the CL regression. During the midluteal phase, cows with low P4 level showed smaller CL, but LBF, related to LS, did not differ between cows with low and high P4 levels. In contrast to non-pregnant cows, a significant rise in LBF was observed three weeks after insemination in pregnant cows. However, LBF was not useful for an early pregnancy diagnosis due to high LBF variation among cows. When the effects of an acute systemic inflammation and exogenous hormones on the CL are examined, the LBF determination is more sensitive than LS assessment. In conclusion, color Doppler ultrasonography of the bovine CL provides additional information on luteal function compared to measurements of LS and plasma P4, but its value as a parameter concerning assessment of fertility in cows has to be clarified.

Clinical evaluation of pulsatile flow detection for qualitative diagnosis of hepatic tumors complicated with liver cirrhosis

An apparatus for pulsatile flow detection (PFD), by which all characteristic pulsatile flow alone is selectively visualized in the same color in color Doppler ultrasonography, has recently been developed. Detection of pulsatile flow is derived from changes in the velocity, variance, and power values of blood flow. We evaluated both the accuracy of selective visualization of pulsatile flow in a single color and the clinical usefulness of this method in patients with hepatic tumors associated with liver cirrhosis. The subjects were 13 patients with hepatocellular carcinoma and 3 patients with adenomatous hyperplasia who underwent both conventional color Doppler ultrasonography and PFD. In the intratumoral blood flow in patients with hepatocellular carcinoma, pulsatile flow, indicated in green and confirmed by color Doppler ultrasonography as flowing into the tumor, and continuous blood flow, indicated in red or blue, were visualized by PFD. This method will contribute to qualitative diagnosis and treatment of tumors complicated with liver cirrhosis and the choice of treatment for those tumors.

Amplitude-coded color doppler ultrasonography in pediatrics

The goal of this study was to evaluate the use of amplitude coded colour Doppler sonography (aCDS) in infants and children. We analysed our own experiences in 270 patients (mean age: 6.3 years, range: newborn--16 years) with various paediatric aCDS applications. The aCDS results of 460 individual investigations were correlated with conventional CDS results, clinical findings and the results of other imaging modalities. Additionally, relevant literature is reviewed and discussed. ACDS is a valuable tool in paediatric sonography. It enriches the diagnostic field of ultrasound, particularly in regard to renal, abdominal, oncological and small part applications. ACDS could successfully be performed in 92.4% of investigations. Overall accuracy was 86.6% (in regard to the total number), sensitivity was 92% (calculated for the number of successful investigations), additional diagnostic information was gained in 18.6% to 48% of patients--depending on the field of application. ACDS is applicable to the majority of infants and children, in spite of the risk of motion artefacts. It is a valuable addition to conventional paediatric ultrasound and colour Doppler sonography. In conjunction with new modalities like three-dimensional sonography, harmonic imaging and ultrasound contrast agents it promises to continuously widen sonographic diagnostic potential.