Doppler Ultrasound Findings Research Articles

The correlation between metabolic dysfunction-associated steatotic liver disease (MASLD) grades and hemodynamic alterations of the portal, hepatic, and splenic vein and spleen size.

Metabolic dysfunction-associated steatotic liver disease (MASLD), formerly known as non-alcoholic fatty liver disease (NAFLD), is the most prevalent chronic liver condition worldwide, affecting over 25% of the population. Fatty infiltration in MASLD leads to hemodynamic changes in hepatic circulation, which can be quantitatively assessed using Color Doppler Ultrasonography (US). In this study, we aimed to investigate the correlation of Color Doppler US findings of the portal, hepatic, and splenic venous system within various degrees of MASLD. Between 2021 and 2024, 104 patients referred to Mousavi Hospital at Zanjan University of Medical Sciences were enrolled. Participants were divided into four groups based on the degree of hepatic fatty infiltration on biopsy results: normal, grade 1, grade 2, and grade 3, with 26 subjects in each group (13 men and 13 women). All patients were biopsy proved. Gray-scale and Color Doppler US were used to assess portal and splenic vein peak systolic velocity (PSV), portal and splenic vein diameter, hepatic vein waveform, and spleen size. The Spearman rank correlation was employed to evaluate the relationship between these variables under non-parametric conditions. A significant negative correlation was found between portal vein PSV and MASLD grade (r = - 0.499, p = 0.000). A significant difference was also observed in hepatic venous waveform abnormality between different grades of MASLD (p = 0.043). Accordingly, portal vein PSV and splenic vein PSV had a significantly positive correlation (r = 0.209, p = 0.033). We also observed a positive correlation between the portal vein and splenic diameter (r = 0.210, p = 0.032). Increasing MASLD severity is associated with reduced portal vein PSV and more pronounced abnormalities in hepatic vein flow. Routine assessment of portal and hepatic vein flow using Color Doppler US is recommended to accurately diagnose and monitor the effects of MASLD on hepatic circulation, potentially improving disease management and patient outcomes.

Ultrasound and magnetic resonance imaging (MRI) features of angioleiomyoma.

Vascular leiomyoma or angioleiomyoma is a rare benign tumor which belongs to the group of benign smooth muscle tumors. They are commonly located at the extremities, usually presented as a painful solitary lesion in the subcutaneous tissue. To date, very few reports describe its characteristics from an imaging point of view, especially their ultrasound characteristics, making it difficult to do a pre-surgical diagnosis. Our purpose is to describe the clinical, pathologic and imaging features of angioleiomyoma [ultrasound, Doppler ultrasound and magnetic resonance imaging (MRI) findings]. We retrospectively reviewed from the pathology database from Hospital Universitario Fundación Alcorcón, Madrid, Spain, the clinical histories of 139 patients who had surgical excision and histologic diagnosis of angioleiomyoma during the last 17 years, from May 31st 2006 to April 17th 2023. Of those patients, we focused on 50 who had soft tissue angioleiomyoma with imaging study [ultrasonography (US) and/or MRI] performed in our institution, making a descriptive cross-sectional study. In our series, a very characteristic ultrasonographic and US Doppler pattern was found. It consists in the presence of a well defined, homogeneous and highly vascularized soft tissue tumor, sometimes with the presence of a feeding vessel. When the described US features appear in a mobile and elastic subcutaneous slow growing tumor on an extremity, the diagnosis of angioleiomyoma should be considered as highly probable.

Association Between Physical Examination, Doppler Ultrasound, and Histological Findings and Varicocele Diagnosis in Kidney Donors: A Cross-Sectional Study

Background: Varicocele is a leading cause of male infertility. Left-sided nephrectomy has been associated with an increased risk of varicocele. Objectives: This study aimed to report the frequency and investigate the association between physical examination, Doppler ultrasonography, histological findings, and varicocele diagnosis in kidney donors who underwent left-sided nephrectomy. Methods: This cross-sectional study included adult males who underwent nephrectomy. The study compared the results of physical examination, ultrasound, and histological findings of the diameter of the left spermatic vein and pampiniform venous plexus. The chi-square test was used to assess differences in the diagnosis and grading of varicocele between the different methods. Results: Fifty males with a mean age of 36.6 years were included. Through physical examination, 42% were diagnosed with varicocele, with most cases classified as grade II. Ultrasound examination revealed that 46% had varicocele, with the majority also being grade II. Histological findings showed that most cases had intact valves (54%), followed by lax and incompetent valves (32%), and no valves (4%). There was a significant difference between the physical examination diagnosis of varicocele and the histological findings (P = 0.04), whereas the difference was not significant for Doppler ultrasound (P = 0.07). Conclusions: In kidney donors, there was a notable discrepancy in varicocele diagnosis between physical examination and histological findings, unlike ultrasound. Larger observational studies are recommended to further assess this association and explore alternative methods for varicocele diagnosis.

Effects of Neck Radiation Therapy on Carotid Arteries in Patients with Head and Neck Carcinoma

Background: Radiotherapy is a main treatment modality for cancers of the head and neck (HNC). However, it can cause a number of complications, including carotid artery damage.This study aimed to determine the effect of head and neck radiotherapy on carotid Doppler ultrasound findings in patients with HNC treated at Imam Hossein University Hospital. Materials and Methods: This research is a descriptive-longitudinal and prospective study conducted in 2022 on patients with HNC undergoing neck radiotherapy. In this study, before the initiation of radiotherapy, the patients underwent neck carotid artery Doppler ultrasound and various parameters including peak systolic velocity (PSV), end-diastolic velocity (EDV), internal carotid artery/common carotid artery (ICA/CCA) PSV, the number of plaques, intimal thickness, and percentage of carotid diameter stenosis, were recorded. The Doppler ultrasound was repeated six months later, addressing the same characteristics, and the collected data were compared. Results: Of 49 investigated patients, 32 (65.3%) were male (mean age=59.46 years). PSV, EDV, and ICA/CCA ratios showed no statistically significant difference 6 months following the completion of radiotherapy compared to the initial investigation. On the other hand, the percentage of carotid artery stenosis, the middle intimal membrane thickness, and the number of vascular plaques increased significantly (P<0.05). Conclusion: Carotid artery stenosis due to radiotherapy seems to be a common complication; however, radiotherapy probably has minimal effects on other ultrasound parameters of carotid arteries including EDV, PSV, and ICA/CCA ratio.

B-mode, Doppler, and Elastography abdominal ultrasound in Tamandua tetradactyla.

The aim of this study was to describe the normal B-mode, Doppler, and 2D Shear Wave Elastography ultrasonographic findings of some abdominal structures in a six-month-old male Southern Tamandua (Tamandua tetradactyla). The animal was found and rescued by the environmental police after being discovered in the wild near its mother, who had died in a car accident. For the ultrasonographic exams, the animal's abdominal region was shaved, and only physical restraint was used. In the B-mode exam, the urinary bladder, small intestine, kidneys, left adrenal gland, stomach, liver, and gallbladder were located and evaluated. Doppler examination obtained spectral tracings of the arcuate and renal arteries of both kidneys. Elastography assessed the stiffness of the renal cortex, liver, and spleen. The ultrasound examination provided an adequate evaluation and novel findings of the Southern Tamandua abdominal structures without invasiveness.

Evaluation of the effect of SARS-CoV-2 infection on Doppler ultrasound and placental findings of pregnant women: a systematic review and meta-analysis.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can infect the human placenta and has been shown to have an adverse effect on Doppler ultrasound parameters and placental features. However, the specific effects of the SAS-CoV-2 infection on the fetal-placental unit in pregnant women remain unclear. The aim of this systematic review and meta-analysis was to evaluate the impact of SARS-CoV-2 infection on Doppler ultrasound and placental findings in pregnant women. A systematic search was conducted using four electronic databases (PubMed, Embase, Scopus, and Cochrane Library) to select publications published in peer-reviewed journals written in English. Odds ratios (ORs) were calculated, along with their 95% confidence intervals (CIs). Heterogeneity was assessed using Cochrane Q and I2 statistics and the appropriate P-value. The analysis used RevMan 5.3. This meta-analysis included 1,210 pregnant women from 10 case-control studies. SARS-CoV-2-infected pregnant women exhibited higher likelihoods of placental abnormalities (OR, 2.62; 95% CI, 1.66 to 4.13), aberrant Doppler values (OR, 1.95; 95% CI, 1.16 to 3.27), an abnormal cerebroplacental ratio (OR, 2.68; 95% CI, 1.52 to 4.75), altered fetoplacental circulation (OR, 1.56; 95% CI, 1.07 to 2.28), and increased placental thickness and placental venous lakes (OR, 1.85; 95% CI, 1.25 to 2.72). According to this meta-analysis, pregnant women infected with SARS-CoV-2 are more likely to experience altered Doppler ultrasonography parameters and placental abnormalities, including increased placental thickness, placental venous lakes, altered fetoplacental circulation, and cerebroplacental ratio. However, the limited number of case-control studies requires larger sample sizes to validate and enhance the evidence.

Effectiveness of Compound Dilong Capsules in Patients with Asymptomatic Cerebral Carotid Artery Stenosis: A Retrospective Case-Control Study.

Asymptomatic cerebral carotid artery stenosis (ACCAS) benefits from secondary prevention via statins and antiplatelets; nonetheless, the impact of medication alone is often limited. Evidence has suggested enhanced therapeutic outcomes when Chinese patent medicine-specifically, compound dilong capsules (CDC)-is integrated with conventional secondary prevention measures. We retrospectively analyzed 319 ACCAS patients from January 2018 to December 2022 at Xuanwu Hospital, Capital Medical University. Depending on the clinical outcomes-improvement or stabilization versus progression-patients were classified into effective or ineffective treatment groups. Patient medical records and questionnaire responses were the primary data sources. The study accounted for demographic variables, clinical history, and medication details, with the primary focus on CDC use and its duration. Treatment outcomes were gauged alongside Transcranial color-coded sonography and Carotid Doppler ultrasonography findings. We employed both univariate and multivariate statistical methods to assess the data. CDC administration (aOR=2.51, 95% CI 1.39-4.54, P=0.002) and extended usage beyond six months (aOR=3.54, 95% CI 1.71-7.32, P=0.001) demonstrate a statistically significant correlation with treatment efficacy. Gender (aOR=2.54, 95% CI 1.30-5.00, P=0.007), hypertension management (aOR=0.56, 95% CI 0.33-0.95, P=0.031), and antiplatelet therapy with aspirin (aOR=9.53, 95% CI 1.15-78.89, P=0.037) or clopidogrel (aOR=9.97, 95% CI 1.10-90.12, P=0.041) also influenced the therapeutic outcome significantly. Incorporating CDC as part of a secondary prevention strategy for over six months can beneficially modulate and limit the progression of vascular stenosis in ACCAS. These findings underscore the value of combining traditional Chinese medicine with modern pharmacological interventions in ACCAS management.

Assessment of childhood intracranial pressure: a comparative study of transcranial Doppler ultrasound indices and findings at ventriculoperitoneal shunt.

This study compares transcranial Doppler (TCD) Pulsatility Index (PI) and Resistivity Index (RI) with intra-operative CSF opening pressure measured by manometric technique during ventriculoperitoneal (V-P) shunt in children with hydrocephalus. It was a prospective, hospital-based study performed among patients diagnosed with hydrocephalus. Patients had TCD ultrasonography before V-P shunt. The TCD sonography was repeated within 1week post-op, and at 1month post-op. The PI and RI were retrieved after insonating the middle cerebral artery. Ventricular CSF opening pressure was measured. Associations between TCD indices and CSF pressure were determined using the t-test and the Wilcoxon rank /Mann-Whitney tests where the normality test failed. A p-value of < 0.05 was considered significant for associations. Fifty-two patients were enrolled with a mean age of 9.9 ± 11.5months. Of these, 41 (78.8%) were aged ≤ 12months. The mean CSF opening pressure was 21.4 ± 9.0. When raised, ICP was defined as opening pressure > 15cm of H2O, high PI (≥ 1.19), and high RI (> 0.8) diagnosed it with a sensitivity of 55% and 50%, respectively. The mean pre-operative PI (1.17 ± 0.56) reduced to 0.96 (Z = - 2.032, p = 0.042), while that of RI (0.66 ± 0.17) also decreased to 0.58 (t = 2.906, p = 0.044) after V-P shunt surgery. A strong positive correlation exists between a reduction in PI and RI after V-P shunt (r = 0.743, p = 0.014). Both PI and RI significantly decrease following V-P shunt, but a single reading has a poor sensitivity in predicting ICP.

Soft tissue vascular tumor-like lesions in adults: imaging and pathological analysis pitfalls per ISSVA classification

ObjectivesTo compare the magnetic resonance imaging (MRI) and Doppler ultrasound (DUS) findings with the pathological findings of soft tissue vascular tumors (STVTs) according to the 2018 ISSVA (International Society for the Study of Vascular Anomalies) classification to differentiate vascular tumors from vascular malformations.MethodsThis retrospective study included patients with STVTs who underwent contrast-enhanced MRI and pathological analysis at our hospital between 2010 and 2020. The presumptive diagnosis based on the on-site imaging and histological analysis was compared with imaging and histological analysis conducted off-site utilizing the ISSVA criteria.ResultsThis study included 31 patients with 31 vascular tumors located in the head and neck (n = 3), trunk (n = 2), and extremities (n = 26). The off-site pathological analysis confirmed benign vascular tumors in 54.8% of cases (non-involuting congenital hemangioma: 35.5%; epithelioid hemangioma: 13%; pyogenic granuloma: 3%; and spindle cell hemangioma: 3%). Based on the off-site histological analysis, 25.8% were reclassified as having a vascular malformation whereas three had other benign lesions. Only phleboliths were associated with a vascular malformation (p = 0.03). The concordance between off-site MRI and pathological findings was fair (k = 0.3902 (0.0531–0.7274)), whereas that between on-site and off-site pathological analyses was poor (k = −0.0949 (−0.4661 to 0.2763)).ConclusionBenign vascular tumors have non-specific imaging features on imaging with some overlap with atypical vascular malformations. Therefore, histological analysis is recommended. Imaging and pathological analyses should be performed in accordance with the ISSVA classification to minimize inter-observer discrepancies.Critical relevance statementImaging features of benign vascular tumors on MRI are non-specific, leading to discrepancies with pathological findings and potential overlap with atypical vascular malformations. Imaging and histological analyses should be performed in accordance with ISSVA guidelines to improve patient management.Key PointsThe imaging features of benign vascular tumors are non-specific.Histological analysis is recommended for soft tissue vascular tumors in adults.Analyses of soft tissue vascular tumors should be performed in accordance with ISSVA guidelines.Graphical

Advancing arteriovenous fistula needling: The role of physical exam and doppler ultrasound.

The success of haemodialysis (HD) critically depends on the effective use of arteriovenous fistulas (AVFs). The precise needling technique is vital to minimise complications and ensure functional vascular access. This study assesses the effectiveness of a nursing consultation protocol, which integrates physical examination (PE) with Doppler Ultrasound (DUS), in preparing patients for the first AVF needling. A cross-sectional analysis at a Portuguese National Health Service Hospital engaged thirty new HD patients, four HD needling experienced nurses and one HD vascular access nurse. This study examines the accuracy of PE in assessing the matured AVF by the four nurses compared to a trained vascular access nurse encompassing systematic PE and DUS. The primary data incorporated AVF characteristics derived from PE (inspection, palpation, and auscultation) and DUS findings (vein depth, diameter, and blood flow). A secondary focus was evaluating the change in nurses' perceived needling complexity following the nursing consultation. The nursing consultation significantly enhanced the identification of crucial AVF features, such as accessory veins (p = 0.002), and improved the accuracy of AVF morphology assessments. This led to identifying longer needling tracks (p = 0.031) and a higher number of safe needling points (p = 0.016). Nurses reported a notable reduction in perceived complexity and potential adverse events following this method (p = 0.027). Integrating structured PE with DUS in a nursing consultation framework significantly improves the preparation for AVF needling. This approach enhances the efficiency and safety of AVF needling and boosts nurse confidence and patient care in HD settings.

Dynamic observation and risk factors analysis of deep vein thrombosis after hip fracture.

To dynamically observe the occurrence of deep vein thrombosis (DVT) after a hip fracture and analyze of the risk factors affecting the dynamic alteration of DVT. Data of patients with hip fractures from January 1, 2017 to August 31, 2021 were collected. Patients were divided into DVT and non-DVT groups according to their daily Doppler ultrasonography findings. Survival analysis was used to describe dynamic changes in DVT occurrence with time. Log-rank tests were used to compare the influence of individual factors of patients with DVT occurrence, and a Cox proportional hazards regression model was used to identify the risk factors affecting the dynamic alteration of DVT occurrence. A total of 331 patients were included: 148(44.7%) had preoperative DVT, and 143 (96.6%) had DVT in the first 3days after admission. The probability of DVT was 0.42 on Day 1, 0.11 on Day 2, 0.10 on Day 3, 0.08 on Day 4, 0.20 on Day 5, and 0.00 on Day 6-7, with a median survival time of 3.30 d. Age>70 years, intertrochanteric fracture, admission hemoglobin<130g/L, and admission hematocrit<40% had a significantly higher occurrence rate of DVT. A hematocrit level of <40% (Hazard Ratio 2.079, 95% Confidence Interval:1.148-3.764, P = 0.016) was an independent risk factor for DVT. DVT after hip fractures mainly occurred in the first three days after admission, the trend was stabilized within one week, and day 1 had the highest rate of DVT incidence. Age, fracture type, HGB level, and Hct level affected dynamic occurrence of DVT. At constant other factors, Hct<40% was 2.079-fold incidence in the risk of preoperative DVT formation than those with Hct≥40% after hip fracture.

Early Morbidities of Hypoxia-Ischemic Encephalopathy in Term Neonates With a Resistive Index as a Prognostic Indicator.

Background Acidosis, hypoxemia, and hypercarbia are symptoms of a syndrome known as perinatal asphyxia that occurs during the first and second stages of labor and shortly after delivery due to poor gas exchange. The Doppler technique is a non-invasive way to assess the risk of neurodevelopment damage in hypoxic-ischemic encephalopathy (HIE) that may be done at the patient's bedside without disturbing them. The study aims to evaluate cranial ultrasound findings in HIEand investigate the role of resistive index (RI) values assessed by color Doppler transcranial ultrasonography in predicting early morbidities in neonates with HIE within 72 hours of life. Methodology Prospective observational research was carried out at the north Karnataka region's tertiary newborn critical care unit. The study included 54 infants with HIE in total. The male-to-female ratio was 1.7:1, with 34 (63%) male and 20 (37%) female newborns. Results About 32 instances had grade I HIE, 8 had grade II HIE, and 14 had grade III HIE. In 35 instances (64.81%), the RI was normal; in 19 cases (35.19%), it was abnormal. Increased periventricular density and cerebral parenchyma echo density were common Doppler ultrasonography findings. Roughly 93% of people survived, and 7% of people died from HIE. Seizures (12.96%) and acute renal damage (33.33%) were the most frequent consequences. Conclusion In instances of HIE, the RI was revealed to be a favorable predictive indicator for newborn prognosis. Counselingand educating parents about early morbidities, anticipated long-term consequences, and the need for follow-up will all benefit from it. Additionally, color Doppler is a practical and secure diagnostic method for determining a newborn's level of HIE.

#822 Effect of renal Doppler ultrasound on the detection of nutcracker syndrome in children presenting orthostatic proteinuria

Abstract Background and Aims To assess the Doppler sonographic findings of the left renal vein (LRV) in children with orthostatic proteinuria compared to normal urine children. Method Renal Doppler ultrasound examinations were routinely performed on 50 consecutive children with orthostatic proteinuria and 53 normal urine children who have visited to the pediatric nephrology clinic at Severance hospital. The peak velocity (PV) was measured at the hilar portion of the left renal vein (LRV) and at the LRV between the aorta and the superior mesenteric artery. Results Age and sex did not differ between the two groups. The peak velocity ratios between aortomesenteric and hilar portions were 7.79+/−2.65 in children with orthostatic proteinuria and 6.32+/−3.01 in healthy normal children (p=0.01). The protein/creatinine ratio in the first morning urine did not differ between the two groups (0.09+/−0.03 in children with orthostatic proteinuria and 0.08+/−0.02 in healthy normal children (p = 0.144). However, the protein/creatinine ratio in the afternoon urine in children with orthostatic proteinuria (0.49+/−0.46) was significantly higher than that in healthy normal children (0.10+/−0.04) (p &amp;lt; 0.001). The peak velocity ratios between aortomesenteric and hilar portions positively correlated with the protein/creatinine ratio between the afternoon urine and the first morning urine (R = 0.21, P = 0.034). Conclusion Nutcracker syndrome may be an important cause of orthostatic proteinuria in children. Renal Doppler ultrasound of the LRV may be a useful screening tool in patients with suspected orthostatic proteinuria to evaluate whether the cause is nutcracker syndrome.

Correlation Between Outpatient Preliminary Diagnosis of Venous Insufficiency and Venous Doppler Ultrasound Findings: A Retrospective Cohort Study

Background: This retrospective cohort study delves into the correlation between outpatient preliminary diagnoses of venous insufficiency and venous Doppler ultrasound findings. Methods: Conducted at our hospital from 01.0102018 to 31.12.2018, the study scrutinized patient records to gauge the concordance between clinical diagnoses and Doppler ultrasound results. Results: Among the 92 patients included in the analysis, Doppler ultrasound confirmed venous insufficiency diagnoses in 46.74% of cases. More than half of the patients who were initially suspected to have venous insufficiency had normal radiological findings. This suggests that during outpatient treatments, physical examination may not be given enough consideration due to the high number of patients. Moreover, it can be a time-consuming and labor-intensive process. Furthermore, our findings suggest that there is a strong correlation between venous reflux in a lower extremity vein and its impact on adjacent veins. Conclusions: The study highlights the crucial importance of Doppler ultrasonography in improving diagnostic precision, particularly for patients who have not undergone a thorough physical examination in the outpatient clinic. The study also finds that changes in flow due to venous insufficiency primarily affect adjacent veins.

AMALRIC TRIANGULAR SIGN AND CAROTID DOPPLER ULTRASONOGRAPHIC FINDINGS IN CENTRAL RETINAL ARTERY OCCLUSION.

The aim of this study was to determine the incidence of the Amalric triangular sign (ATS) in patients with central retinal artery occlusion and investigate its association with visual function and carotid Doppler ultrasonography findings. A retrospective chart review was conducted on 21 eyes from 21 patients with complete central retinal artery occlusion. Best-corrected visual acuity and carotid Doppler ultrasonography findings [peak systolic velocity, end-diastolic velocity, and resistance index (RI) = (PSV - EDV)/PSV] were investigated. Three patients (14%) exhibited the ATS. Best-corrected visual acuity at first visit was significantly worse in ATS-positive patients than in ATS-negative patients (P = 0.024). Doppler waveform analysis of the common carotid artery showed that ATS-positive patients had a significantly lower end-diastolic velocity [P = 0.009, median 10 (range 9-10) vs. 17 (13-24) m/second] and significantly higher resistance index [P = 0.021, median 0.80 (range 0.79-0.83) vs. 0.72 (0.66-0.82)] than did ATS-negative. The Amalric triangular sign was observed in three patients with central retinal artery occlusion, who showed worse best-corrected visual acuity at the first visit than did those without the ATS. Carotid Doppler ultrasonography revealed that ATS-positive patients had a significantly higher resistance index and lower end-diastolic velocity at the common carotid artery than did ATS-negative, indicating steno-occlusive changes in the internal carotid artery.

Clinical characteristics of testicular torsion and factors influencing testicular salvage in children: A 12-year study in tertiary center

BACKGROUND Testicular torsion is the most common acute scrotum worldwide and mainly occurs in children and adolescents. Studies have demonstrated that the duration of symptoms and torsion grade lead to different outcomes in children diagnosed with testicular torsion. AIM To predict the possibility of testicular salvage (TS) in patients with testicular torsion in a tertiary center. METHODS We reviewed the charts of 75 pediatric patients with acute testicular torsion during a 12-year period from November 2011 to July 2023 at the Suzhou Hospital of Anhui Medical University. Univariate and multivariate logistic regression analyses were used to determine independent predictors of testicular torsion. The data included clinical findings, physical examinations, laboratory data, color Doppler ultrasound findings, operating results, age, presenting institution status, and follow-up results. RESULTS Our study included 75 patients. TS was possible in 57.3% of all patients; testicular torsion occurred mostly in winter, and teenagers aged 11-15 years old accounted for 60%. Univariate logistic regression analyses revealed that younger age (P = 0.09), body mass index (P = 0.004), torsion angle (P = 0.013), red blood cell count (P = 0.03), neutrophil-to-lymphocyte ratio (P = 0.009), and initial presenting institution (P &lt; 0.001) were associated with orchiectomy. In multivariate analysis, only the initial presenting institution predicted TS (P &lt; 0.05). CONCLUSION The initial presenting institution has a predictive value for predicting TS in patients with testicular torsion. Children with scrotal pain should be admitted to a tertiary hospital as soon as possible.

Diagnostic Accuracy of Doppler Ultrasound in Ectopic Pregnancy

Objective: To evaluate the diagnostic accuracy of Doppler ultrasound in the detection of ectopic pregnancy. Methodology: This prospective observational study was conducted at PESSI Hospital, I-12, Islamabad, in collaboration with different hospitals for data collection. The study was carried out over a period of one year from October 2021 to September 2022. All pregnant women aged &gt;17 years presenting with symptoms of ectopic pregnancy, regardless of parity, were included. All patients underwent color Doppler ultrasound using a dedicated machine. Subsequently, the patients were followed until they underwent surgical management, and the operative findings were meticulously recorded. Data were collected using a pre-designed proforma and analyzed with SPSS version 20. Results: The mean age of the participants was 31.53 years, and the average gestational age was 6.03 weeks. 35.0% of the participants had a positive family history. According to color Doppler ultrasound findings, the majority of cases (96.7%) were identified as positive for ectopic pregnancy, while surgical findings confirmed ectopic pregnancy in 93.3% of cases. The sensitivity of color Doppler ultrasound was 100%, specificity was 60%. The positive predictive value (PPV) was 94% and negative predictive value (NPV) was 100%, suggesting that it was 100% accurate in ruling out ectopic pregnancy. Conclusion: Color Doppler ultrasound was found to be a highly sensitive, reliable, and noninvasive tool in diagnosing ectopic pregnancy. However, the findings cannot be definitively applied due to limitations, particularly the small sample size. Further large-scale studies are strongly recommended for validation and confirmation of the findings.

A Study of Valvular Incompetencies in the Lower Limb Veins Using Doppler Ultrasound Findings.

Varicose veins (VV) are one of the most common pathologies associated with the venous system of the lower limb. In the Indian population, its incidence is higher, and it is one of the most commonly encountered cases in the hospital. The study aimed to note the widely affected anatomical structure in male and female varicose patients using Doppler ultrasound (DU) examination findings. A total of 200 Doppler ultrasound reports of varicose patients were retrospectively analyzed and categorized based on the affected structure. The demographic data of all cases, such as age, sex, brief history, signs, symptoms, and affected side of the lower limb, was noted. Anatomical structures causing venous refluxes in the saphenous systems, junctions, and perforating venous systems were noted. Pearson's correlation coefficient was applied to find out its association. Out of 200 Doppler reports studied, 133 (67%) were male and 67 (33%) were female patients. The majority, 180 (90%) cases, belonged to C1-C3 stages according to the Clinical, Etiology, Anatomy, and Pathological (CEAP) classification, while 20 (10%) were in C4-C5 stages. Male patients aged between 31 and 40 years were predominantly affected, with their left side being affected most commonly. In female patients, the older age group of 50-60 years was predominantly affected.Great saphenous reflux in the groin due to incompetent terminal valve was noted in 126 (63%) cases. In the perforator venous (PV)system,defects in the medial leg perforator (189 (95%)), posterior leg (92(46%)), and thigh perforator (20 (10%)) were noted. In the present study, the occurrence of varicose veins is due to the involvement of superficial, deep, and perforator veins with varying percentages. Among the structures, the medial leg perforator was predominantly involved, followed by other perforators. Since most patients were in C1-C3 stages, the involvement of deep veins was noted minimally.

Torsion of the undescended testis in a healthy adult male

Introduction. Torsion of undescended testis (UDT) in adults is rare, with only several published cases so far, and represents a urological emergency. Case outlines. We present a case of UDT torsion in 31-year-old, otherwise healthy, man who had right-side inguinal pain for six hours before he was admitted to hospital. Swelling was palpable in the area of the right groin region. The diagnosis was established based on Doppler ultrasound and exploratory surgery findings. A right-sided orchiectomy was performed. According to the available data, there are no published cases on this topic in the region. Conclusion. Although torsion of the UDT is a rare condition, it must be considered when symptoms of abdominal pain or swelling and pain in the groin region occur. Orchiectomy is suggested.

The role of ultrasound and mitofusin-2 levels to predict pregnancy outcomes in patients with severe preeclampsia: a case-control study.

The aim of this study was to evaluate mitofusin-2 levels and fetal Doppler ultrasonography effects in patients with severe preeclampsia. This single-center case-control study was conducted in the gynecology service of the university hospital in Van. A total of 90 pregnant women aged 18-40 years were included in the study. Of these, 30 are normal, 30 have mild preeclampsia, and 30 are pregnant with severe preeclampsia. In this study, especially in severe preeclampsia patients, serum mitofusin-2 levels and important fetal Doppler flows such as uterine arterial pressure, umbilical arterial pressure, and 1st and 5th minute Apgar scores, birth weight, and the relationship between postnatal outcomes such as week of birth and the number of patients in the neonatal intensive care unit were investigated. There was a significant difference between the three groups in terms of mitofusin-2 levels, which was the highest in the group (p<0.05). Maternal serum mitofusin-2 levels were positively correlated with uterine arterial pressure (r=0.543, p=0.007), umbilical arterial pressure (r=0.238, p=0.008), diastolic blood pressure, and systolic blood pressure (p<0.001). Receiver operating characteristic curve of mitofusin-2 in predicting preeclampsia is as follows: optimal cutoff 1.6 ng/mL; area under the curve: 0.861; 95%CI: 0.786-0.917; sensitivity: 83.9%; and specificity: 70.0%, (p≤0.001). A one-unit increase in mitofusin-2 resulted in a statistically significant 4.21-fold increase in preeclampsia risk. This study recommends the use of mitofusin-2 together with fetal Doppler ultrasound findings as a reliable indicator of preeclampsia severity.