Peak Systolic Velocity Values Research Articles

Association between Breast Arterial Calcification on Mammography and Impaired Ocular Perfusion: A Novel Study Using Color Doppler Ultrasonography.

To investigate the relationship between the mammography-detected breast arterial calcification (BAC) and orbital color Doppler ultrasonography (CDUS) results. Our single-center study, included female patients who applied to our hospital between January and May 2022 and underwent mammography and orbital CDUS examinations. Two radiologists evaluated the mammograms, grouped the patients as BAC (+) and BAC (-), and performed orbital CDUS. Continuous variables obtained from CDUS were compared according to the presence of BAC. Also, receiver operating characteristics (ROC) analysis was used to determine the orbital CDUS threshold values for the presence of BAC. A total of 119 women were included with a median age of 62 years, 57 (47.90%) had BAC. Orbital CDUS examination was performed on both eyes of 119 patients (238 eyes in total). Peak systolic velocity (PSV) and end-diastolic velocity (EDV) values of the ophthalmic artery (OA) (P < .001) and EDV of the central retinal artery (CRA) (P < .001) were significantly lower in patients with BAC. Pulsatile index (PI) and resistive index (RI) values of OA (P < .001) and CRA (P < .001) were higher in patients with BAC. In ROC analysis, the cut-off values for the presence of BAC were calculated as OA PI ≥1.415 and OA RI ≥0.755 (P < .001); CRA PI ≥1.135 and CRA RI ≥0.655 (P < .001). Orbital perfusion disorders may be observed in patients with vascular calcification detected on routine mammography. Therefore, a more detailed evaluation of patients with BAC detected on mammography with orbital CDUS may enable early detection and treatment of ocular vascular problems.

Hemodynamic profiles in idiopathic intracranial hypertension: Doppler ultrasonography as a diagnostic tool for pulsatile tinnitus

Purpose: This study aims to evaluate the role of ophthalmic Doppler ultrasonography (USG) in differentiating IIH patients with and without bilateral PT by analyzing hemodynamic changes in the orbital vessels. Materials and Methods: A prospective, single-center, case-control study was conducted at Harran University from November 2023 to June 2024. The study included 20 IIH patients. Participants underwent clinical assessments, ophthalmic evaluations, brain imaging, lumbar puncture, and transorbital sonography. IIH patients were categorized into PT (n=8) and non-PT (n=12) groups. Doppler USG measured end-diastolic velocity (EDV), peak systolic velocity (PSV), time-averaged velocity (TAV), resistive index (RI), pulsatility index (PI), and systolic to the diastolic ratio (S/D) of the central retinal artery. Results: Significant differences were observed in left eye EDV and TAV, with lower values in the PT group. Although not statistically significant, right-eye EDV and TAV also trended lower in the PT group. Additionally, both eyes' PSV values showed a trend toward statistical significance, being lower in the PT group. ROC curve analysis identified optimal thresholds for left eye EDV (5.35; sensitivity 75%, specificity 83.33%) and TAV (9; sensitivity 50%, specificity 91.67%). Conclusion: Orbital Doppler USG reveals distinct hemodynamic profiles in IIH patients with PT, suggesting EDV and TAV as potential biomarkers. Larger cohort studies are needed to validate and clarify IIH-PT mechanisms.

Analysis of the relationship between VEGF, NLRP3 inflammatory complex, EPO levels, and ocular hemodynamics in patients with primary open-angle glaucoma

ObjectiveOur study aimed to investigate the relationship between vascular endothelial growth factor (VEGF), NOD-like receptor thermal protein domain associated protein 3 (NLRP3) inflammatory complex, erythropoietin (EPO) levels, and ocular hemodynamics in patients diagnosed with primary open-angle glaucoma (POAG).MethodsThis is a prospective observational study. Patients diagnosed with POAG at The Sixth Hospital of Wuhan hospital between November 2022 and February 2023were enrolled.The patients were categorized into three groups based on the average visual field defect (mean deviation, MD) value: severe injury group (MD > 12 dB, 93 cases), moderate injury group (7 ≤ MD ≤ 12 dB, 89 cases), and mild injury group (MD < 7 dB, 85 cases). The levels of VEGF, NLRP3 inflammatory complex, EPO, and ocular hemodynamics were compared among the groups. Furthermore, the relationship between VEGF, NLRP3, EPO levels, and ocular hemodynamics in patients with POAG was analyzed using Pearson correlation analysis. After adjusting for confounding factors such as age and gender, multivariate Logistic regression analysis was performed with the ocular hemodynamics indexes being used as dependent variables, and VEGF, NLRP3, ASC, Caspase-1, and EPO being used as independent variables.ResultsA total of267 patients with POAG were enrolled. There were no significant differences in sex, age, body mass index, systolic blood pressure, diastolic blood pressure, smoking, alcohol consumption, and blood glucose between the two groups (P > 0.05). The levels of NLRP3, ASC, Caspase-1, and EPO in the severe and moderate injury groups were higher than those in the mild injury group, whereas the VEGF levels were lower in the severe and moderate groups compared to the mild group, showing significant differences (P < 0.05). The severe group exhibited higher levels of NLRP3, ASC, Caspase-1, and EPO than the moderate group, while the VEGF levels were lower in the severe group compared to the moderate group, showing significant differences (P < 0.05). The peak systolic velocity(PSV) and resistance index (RI) were higher in the severe and moderate groups than in the mild group, whereas the EDV was significantly lower in the severe and moderate groups compared to the mild group (P < 0.05). The severe group exhibited higher PSV and RI values compared to the moderate group, while the EDV was lower in the severe group compared to the moderate group, showing significant differences (P < 0.05). Pearson correlation analysis was performed to examine the relationship between VEGF, NLRP3, EPO levels, and ocular hemodynamics in patients with POAG. VEGF, NLRP3, ASC, Caspase-1, and EPO showed positive correlations with PSV and RI, and negative correlations with EDV in patients with POAG. Regression analysis showed that VEGF, NLRP3, ASC, Caspase-1 and EPO were significantly correlated with ocular hemodynamics in POAG (all P < 0.001).ConclusionWe demonstrated that the levels of VEGF, NLRP3 inflammatory complex, and EPO were highly associated with ocular hemodynamics in patients diagnosed with POAG.

The use of ultrasound for noninvasive monitoring of anesthetic effects in renal ischemia-reperfusion injury.

Compared with the use of ultrasound for noninvasive monitoring of the anesthetic sodium pentobarbital versus tribromoethanol in an animal model of renal ischemia-reperfusion injury in rats. Adult rats were randomly assigned to a renal ischemia-reperfusion injury model, and preoperative anesthetics were administered as either sodium pentobarbital or tribromoethanol. Color Doppler ultrasound and spectral Doppler ultrasound were used to detect changes in respiratory rate and heart rate during and after the surgery, as well as measure renal hemodynamic parameters including peak systolic velocity, end-diastolic velocity, and resistance index. The frequency of changes in respiration and heart rate was significantly higher in the sodium pentobarbital anesthesia group compared to the tribromoethanol anesthesia group. The peak systolic velocity and end-diastolic velocity values in the sodium pentobarbital anesthesia group were significantly lower than those in the tribromoethanol group. However, the resistance index in the sodium pentobarbital group was higher than that in the tribromoethanol group. Ultrasound can be used to dynamically monitor the effects of anesthesia during the experiment, including changes in respiratory rate and heart rate, as well as semi-quantitatively monitor hemodynamic changes in the kidneys, which indirectly reflects whole-body hemodynamic changes in rats.

The effect of endoscopic renal and ureteral stone surgeries on renal blood flow in children: a prospective trial

Aim: To assess the impact of endoscopic stone surgeries on renal perfusion and blood flow in children. Materials and methods: Children who underwent percutaneous nephrolithotomy (PCNL), retrograde intrarenal surgery (RIRS), ureterorenoscopy (URS), endoscopic combined intrarenal surgery (ECIRS) were included to the study. Renal Doppler ultrasonography (RDUS) was performed one day before the operation, and on the postoperative 1st day and 1st month. Peak systolic velocity (PSV) and end-diastolic velocity (EDV) were measured, and resistive index (RI) was calculated with the (PSV-EDV)/PSV formula. RDUS parameters were compared before and after surgery and between ipsilateral and contralateral kidneys. Results: A total of 45 children with a median age was 8 (2–17) years were included (15 (33.3%) girls, 30 (66.7%) boys). PCNL was performed in 13 children (28.9%), RIRS 11 (24.4%), URS 12 (26.7%), and ECIRS 9 (20%). There was no significant difference in renal and segmental PSV, EDV and RI values of operated kidney in the preoperative, postoperative periods. There was no significant difference between RDUS parameters of the ipsilateral and contralateral kidneys in preoperative or postoperative periods. PSV and EDV values were significantly higher in the 1st postoperative month in the group without preoperative DJ stent than in the group with DJ stent (p = 0,031, p = 0,041, respectively). However, RI values were similar. The mean RI were below the threshold value of 0.7 in each period. Conclusion: RDUS parameters didn’t show a significant difference in children. Endoscopic surgeries can be safely performed in pediatric stone disease.

The effect of fetal renal artery Doppler ultrasound on neonatal outcomes in fetuses with ureteropelvic junction type obstruction

Objective: Fetal urinary tract dilatation (UTD) is one of the common fetal problems with remarkable difficulties in diagnosis and management in the antenatal and postnatal periods. This study aimed to determine the value of Doppler ultrasound assessment of the renal arteries in fetuses with ureteropelvic junction type hydronephrosis (UPJO) for the prediction of neonatal outcomes of infants. Materials and Methods: Fetal renal artery Doppler values were evaluated in pregnant women between 28-32 weeks. Measurements were taken for Doppler values and the fetal obstruction and were classified through the utilization of UTD classification. Based on postnatal ultrasound, these infants were grouped by UTD classification. Results: There was a statistically significant difference between the left renal artery Systolic/Diastolic (S/D) Ratio and bilateral renal artery Peak Systolic Velocity (PSV) values of the control and patient groups, (p&amp;lt;0.05). PSV values were higher in the patient group. The difference between the pulsality index, resistive index, and right renal artery S/D values of the control and patient groups was not statistically significant (p&amp;gt;0.05). Conclusion: Fetal renal artery Doppler is not effective in predicting the degree of hydronephrosis and renal damage in postnatal follow-up of fetuses with a diagnosis of UPJO.

A Comparative Analysis of Follicular Diameter Assessment Versus Doppler Ultrasound in Predicting Ovulation Timing for the Infertility Treatment: Insights From a Prospective Study.

Background Infertility remains a significant challenge affecting millions of couples worldwide, with ovulation abnormalities being a common underlying cause. Pharmacological methods, such as clomiphene citrate, are often used to stimulate ovulation. However, the optimal timing for sexual intercourse during ovulation induction remains contentious. Objectives This study aimed to compare the efficacy of transvaginal ultrasonography (TVS) for measuring follicle size with Doppler ultrasound for assessing changes in blood flow to predict the timing of ovulation. Methods We conducted a comparative analysis involving 64 women undergoing infertility therapy. Participants were evaluated using both TVS to measure follicle diameter and Doppler ultrasound to assess perifollicular blood flow dynamics. The primary outcomes measured included ovulation rates, resistive index (RI) values, peak systolic velocity (PSV) values, and conception rates. Results The analysis showed comparable age distributions between the TVS and Doppler groups. There was no significant correlation between follicle diameter and ovulation when assessed by TVS. However, Doppler ultrasound revealed a substantial association between perifollicular blood flow dynamics and ovulation. Higher ovulation rates were linked to lower RI values and higher PSV values, indicating their potential as predictors of ovulation. Additionally, higher conception rates were positively correlated with increased vascularity in Zone 4 of the endometrium. Conclusion Doppler ultrasonography indices, particularly RI and PSV values, provide critical insights into perifollicular blood flow dynamics and endometrial vascularity, which can enhance the effectiveness of fertility treatments. While these findings highlight the potential of Doppler ultrasound in predicting ovulation and improving treatment outcomes, further research is required to understand the underlying mechanisms and validate these results for personalised treatment strategies.

(322) Predictors of Erection Reversal After Penile Doppler Ultrasound

Abstract Introduction Erection hardness (EH) is a physiologic response graded subjectively on the Erection Hardness Grading Scale during penile Doppler ultrasound (PDUS). Objective This study aims to gather data on the reversal rate following persistent EH sufficient for penetration or higher after PDUS and identify associated predictors. Methods The study population consisted of (i) men with poor response to PDE5i and ICI or (ii) who need curvature assessment due to Peyronie’s disease (PD), (iii) and underwent penile duplex Doppler ultrasound (PDUS), (iv) using a vasoactive agent redosing schedule were included and reviewed retrospectively. Patients with incomplete data were excluded. We performed a descriptive assessment of demographics and comorbidities, including a history of cancer, PD, depression, or anxiety. EH was evaluated by a sexual medicine-trained physician for each case and reported before and 30 minutes after PDUS. EH was assessed on a scale between 0 (no erection) to 10 (erection hard as a rock), with 6 being good enough for penetration. We also described the number of injections, the dose, and PDUS hemodynamic parameters, including peak systolic velocity (PSV) and end-diastolic velocity (EDV). Arterial insufficiency (AI) diagnosis was made with PSV values ≤25 cm/sec bilaterally and corpora veno-occlusive dysfunction (CVOD) with EDV values ≥5 cm/sec bilaterally. We also reported a reversal procedure rate performed due to persistent erection after PDUS, and predictors were assessed. Factors entered into the model included: patient age, EH for PDUS (8 or greater), and dose of vasoactive agent used (Table 1). A p-value ≤0.05 was considered statistically significant. Results 2439 individuals were included. The median age of 59 (50,67) years. 12% had diabetes, 13% reported ≥ 3 comorbidities, 44% had prostate cancer, 17% had a history of depression, and 14% had a history of anxiety. 44% described PD. The vasoactive agent used for PDUS was Trimix 86% and 14% others. The median dose used was 20 (10, 50), and the median of injections applied was 2 (1, 2). The EH median was 8 (6, 9) for PDUS, and 65% had an EH of 8 or greater. The PDUS diagnosis was normal in 62% of the patients; 8% had AI, 29% had CVOD, and 1% had AI+CVOD. The reversal procedure rate was 41%. In the MVA, significant predictors of erection reversal were higher vasoactive agent dose used, age 50 years or younger, and EH 8 or greater for PDUS (Table 1). Conclusions Erection reversal in our redosing PDUS was highly prevalent; predictors of reversal were younger age, greater EH for PDUS, and higher vasoactive agent dose. Disclosure No.

(321) Penile Doppler Ultrasound (PDUS) Procedure Anxiety and Its Impact on the Erection Hardness (EH) and Corporo-venocclusive Dysfunction (CVOD) Diagnosis

Abstract Introduction Procedure anxiety is an excessive fear of medical, dental, or surgical procedures that result in acute distress or interference with completing necessary procedures. Previous work has shown that anxiety affects penile hemodynamics. Objective This study aims to examine the impact of PDUS procedure anxiety on the erection hardness (EH) achieved during and after PDUS and the diagnosis of CVOD. Methods The patient population included (i) men with poor response to erectogenic agents or (ii) who need curvature assessment due to Peyronie’s disease (PD), (iii) who underwent PDUS, (iv) using ICI vasoactive agent redosing schedule. We performed a descriptive assessment of demographics and comorbidities. We reported EH reached before and 30 minutes after PDUS, which was evaluated by a sexual medicine-trained physician for each case. EH was measured on a 0 (no erection) to 10 (erection hard as a rock). We also described the number of injections, the dose, and PDUS hemodynamic parameters, including peak systolic velocity (PSV) and end-diastolic velocity (EDV). Arterial insufficiency (AI) diagnosis was made with PSV values ≤30 cm/sec bilaterally, and CVOD diagnosis with EDV values ≥5 cm/sec bilaterally. A visual analog scale (VAS) evaluated the anxiety related to the procedure using a single question: “How anxious are you about your PDUS procedure?” This was measured on a 0 (not at all anxious) to 10 (extremely anxious) Likert scale. 7 or higher was defined as high anxiety, 4 to 6 as moderate anxiety, 1 to 3 as mild anxiety, 0 was no anxiety. We compared the EH pre and post-PDUS and the prevalence of CVOD based on the procedure anxiety category (high vs. no high anxiety). Predictors of persistent EH (6/10 or higher) after PDUS was analyzed using a logistic regression model. Factors entered into the model included: patient age, PD, and procedure high anxiety. A p-value ≤0.05 was considered statistically significant. Results 162 individuals were included. The median age of 65 (59,72) years. 19% had diabetes, 19% reported ≥ 3 comorbidities, 10% had a history of depression, and 11% had a history of anxiety. 72% had prostate cancer, 6% had bladder cancer, 3% had other cancer, and 19% had no cancer history. 35% reported PD. The VAS procedure anxiety median was 3 (1, 5), on which 22% reported no anxiety, 34% mild, 26% moderate, and 18% high anxiety. For men with high anxiety procedure, the median EH before and after PDUS was 6 (4, 8) and 5 (2, 8), respectively; 62% had CVOD diagnosis, 48% remained with an EH 6 or greater after PDUS, and 45% needed a reversal injection. No significant differences were observed compared to men without high anxiety procedures. In the MVA, only age significantly predicted EH 6 or greater after PDUS (Table 1). Conclusions High PDUS Procedure Anxiety does not affect EH pre and post-PDUS, CVOD diagnosis, or reversal rate after PDUS. Only younger age significantly predicted persistent EH 6 or greater after PDUS. Disclosure No.

Normal Portal Vein Diameter (PVD) and Peak Systolic Velocity (PSV) in Healthy Iranian Children

Background: It is crucial to determine the normal Portal Vein Diameter (PVD) in different populations, and ages since changes in the size of the vein are used as an index in the diagnosis of some diseases. Therefore, it is important to determine its normal size. In this regard, the present study aimed to investigate the PVD and Peak Systolic Velocity (PSV) in healthy Iranian children. Methods: The present descriptive-analytical study examined 250 healthy Iranian children who visited the Imaging Center of the Children Medical Center of Excellence. The PVD and PSV were examined by a radiologist using a Doppler ultrasound. Children were classified intofive age groups: under one month, 1 month to 2 years, 2 to 6 years, 6 to 10 years, and 10 to 18 years, and the above-mentioned indices were measured and compared in them. Statistical analysis was conducted using SPSS 26 employing the Mann-Whitney, Kolmogorov-Smirnov, and Kruskal-Wallis tests. Results: In children under one month, one month to 2 years, 2-6 years, 6-10 years, and 10-18 years of age, the mean values of PVD were 4.08, 5.64, 6.14, 7.50, and 8.32 mm, and the mean PSV values were 19.26, 22.20, 21.68, 22.86, and 21.48, respectively. The mean PVD and PSV increased with increasing age; however, no statistically significant difference was found between the mean values of the indices in both boys and girls (P = 0.18). Conclusions: The PVD and PSV in healthy Iranian children were relatively similar to their non-Iranian counterparts, and the mean values increased with age. Additionally, no significant difference was found between the mean values of PVD and PSV in boys and girls based on gender.

Correlation between Ultrasound Peak Systolic Velocity and Angiography for Grading Internal Carotid Artery Stenosis.

(1) Background: The success of carotid revascularization depends on the accurate grading of carotid stenoses. Therefore, it is important for every vascular center to establish its protocols for the same. In this study, we aimed to determine the peak systolic velocity (PSV) thresholds that can predict moderate and severe internal carotid artery (ICA) stenoses. (2) Methods: To achieve this, we enrolled patients who underwent both duplex ultrasound (DUS) and invasive carotid artery digital subtraction angiography (DSA). The degree of ICA stenosis was assessed using the North American Symptomatic Carotid Endarterectomy Trial (NASCET) and the European Carotid Surgery Trial (ECST) protocols. The PSV thresholds were determined using receiver operating characteristic (ROC) curves. (3) Results: Our study included 47 stenoses, and we found that the PSV cut-off for predicting ≥70% NASCET ICA stenoses was 200 cm/s (sensitivity 90.32%, specificity 93.75%). However, PSV did not correlate significantly with ≥50% NASCET ICA stenoses. On the other hand, the optimal PSV threshold for predicting ≥80% ECST ICA stenoses was 180 cm/s (sensitivity 100%, specificity 81.82%). (4) Conclusions: Based on our findings, we concluded that PSV is a good and simple marker for the identification of severe stenoses. We found that PSV values correlate significantly with severe NASCET and ECST stenoses, with 200 cm/s and 180 cm/s PSV thresholds. However, PSV was not reliable with moderate NASCET stenoses. In such cases, complementary imaging should be used.

Utility of Colour Flow Doppler Ultrasonography to Differentiate Gestational Transient Thyrotoxicosis and Graves Disease in Pregnancy.

Accurate diagnosis of the etiology of thyrotoxicosis in pregnancy is important to guide appropriate treatment. The role of thyroid blood flow velocities by color Doppler to differentiate between Graves' disease (GD) in pregnancy and gestational transient thyrotoxicosis (GTT) is not well explored. This study evaluated inferior thyroid artery (ITA)-peak systolic velocity (PSV) as a marker for differential diagnosis of thyrotoxicosis in pregnancy. Fifty-six pregnant patients with thyrotoxicosis (30 with GTT and 26 with GD) along with 30 age-matched healthy euthyroid pregnant subjects were enrolled. Thyroid ultrasound examinations and color Doppler was performed by an ultrasound scanner. The studies of the right and left ITAs were performed with Doppler, and the PSV and End diastolic velocity (EDV) values were obtained from the right and left ITA. The mean total T4 value in GD and GTT were almost similar (25.04 ± 2.43 vs 23.25 ± 2.81, P value = 0.14). Beta HCG levels were significantly higher in cases of GTT as compared to GD (152946 ± 26694 vs 120608 ± 21244 mIU/ml, P < 0.0001). The ITA-PSV and EDV in patients with GTT were significantly lower than those of pregnant patients with GD (right: 22.5 ± 6.8 and 8.3 ± 2.3; left: 22.97 ± 6.3 and 8.13 ± 2.01; P < 0.001). receiver-operating-characteristic (ROC) curve demonstrated an optimal cutoff value of mean right ITA-PSV of 35 cm/sec to differentiate GTT from GD during pregnancy, with 84.6% and 93.3% sensitivity and specificity. Thyroid artery velocities can help to differentiate between GD and GTT. The cutoff point of mean ITA-PSV at 35 cm/s had an excellent value in differentiating between the two, with good sensitivity and specificity.

Evaluation of ovarian reserve in unexplained ınfertile cases: a case-controlled study

BackgroundThe aim of this study was to evaluate the effectiveness of current ovarian reserve tests in unexplained infertile cases.Material and methodsThis case–control study was conducted on 70 unexplained infertile women who were included in a tertiary university hospital. Both groups of basal FSH, estradiol, antimullerian hormone (AMH), inhibin B, ovarian volume, total antral follicle count (AFC), ovarian volume, and ovarian stromal blood flow (peak systolic velocity (PSV), S/D (systole and diastole ratio), resistance index (RI), and pulsatility index (PI)) values were compared.ResultsThe mean AMH, inhibin B, PSV, and stromal blood flow values of the control group patients were higher than those in the unexplained infertility group. However, the values of the means of RI and PI of the cases in the control group were lower than those in the infertility group. When PI’s value was ≥ 2.00, its sensitivity was 65.7%, and its specificity was 64.3%. In the case of the RI, its value was ≥ 0.745, its sensitivity was 65.7%, and its specificity was 62.9%. In order to show ovarian reserve in unexplained infertile cases, the sensitivity values can be sorted from high to low as follows: PI > RI > estradiol > FSH > ovarian volume > AFC > inhibin B > stromal blood flow > PSV > S/D.ConclusionIn the unexplained infertile patient group with normal ovarian reserve test results, basal estradiol, decreased PI, and RI values may be used as good ovarian reserve predictors.

Accuracy of a portable hemoglobinometer (HemoCue) to measure fetal hemoglobin values during in utero transfusion

Objectives The current recommended treatment for severe fetal anemia is in utero transfusion (IUT). During this procedure, the evaluation of the necessary volume of transfused blood is based on regular measurement of fetal hemoglobin (FHb) concentration. The gold standard measurement is performed in the biology laboratory. A rapid medical test such as HemoCue® is an effective way to predict FHb concentration. It would reduce the time to obtain results and therefore the procedure duration. To evaluate the accuracy of HemoCue® to measure FHb during IUT, we compared Hb levels obtained by HemoCue® and by our biology laboratory. Methods This retrospective study involved all pregnant women who had undergone an IUT in the university hospital of Clermont-Ferrand, France, during the period from 1 January 2010 to 6 June 2021. The FHb level was evaluated by two methods, a rapid medical test, HemoCue®, and a standard method in the biology laboratory. Results We obtained 244 pairs of results from HemoCue® and our laboratory, of 90 IUT procedures. The correlation between the two sets of results was excellent, with Lin’s concordance correlation coefficient of 0.979. However, we established that the measurements were not significantly modified by IUT number, puncture time, cause of fetal anemia, estimated fetal weight, gestational age, and delay between two IUT or middle cerebral artery peak systolic velocity values. Conclusion Our results allowed to extend the relevance of FHb measurements by HemoCue® during IUT.

DIAGNOSTIC VALUE OF ADDITIONAL MARKERS FOR ACUTE KIDNEY INJURY IN PRETERM NEONATES WITH PATENT DUCTUS ARTERIOSUS

DIAGNOSTIC VALUE OF ADDITIONAL MARKERS FOR ACUTE KIDNEY INJURY IN PRETERM NEONATES WITH PATENT DUCTUS ARTERIOSUS

SAT468 Assessment of Peak Systolic Velocity of Various Thyroid Arteries

Abstract Disclosure: K. Raju: None. K. Ibrahim: None. M. Morkos: None. Objective: Peak systolic velocity (PSV) assessment is a useful bedside tool in the evaluation of patients presenting with thyrotoxicosis. Graves’ disease is characterized by increased PSV values, and it was previously reported that inferior arteries had higher PSV as compared to the superior arteries. We aimed to assess the peak systolic velocity (PSV) in the superior and inferior thyroid arteries bilaterally in patients with Graves’ disease and determine the arteries with the highest values. Research and Design Methods: This is a retrospective cross-sectional study of patients diagnosed with Graves’ disease at an academic outpatient endocrinology clinic from August 2019 to November 2022. The peak systolic velocities were measured using spectral Doppler ultrasound at the superior and inferior thyroid arteries bilaterally. Descriptive statistics, Chi square, and t-test were utilized to describe and compare data. Results: We identified 58 patients who presented for initial assessment of Graves’ disease, 48 (82.8%) were newly diagnosed and presented for initial assessment, 45 (77.6%) were female, 36 (62.1%) Caucasian, and 18 (31.0%) African American. Mean age (± standard deviation) 44.6 ± 13.9 years, TSH 0.27 ± 0.85 (reference range [ref] 0.4 - 4.2), free T4 2.2 ± 1.6 (ref 0.6 - 1.5), and total T3 242.9 ± 169.9 (ref 80 - 179). The mean PSV at the right inferior artery (RIA; n=43) 40.2 ± 18.3 cm/sec, right superior artery (RSA; n=37) 40.0 ± 24.5 cm/sec, left inferior artery (LIA; n=45) 38.2 ± 15.1 cm/sec, and left superior artery (LSA: n=33) 35.1 ± 17.2 cm/sec (P=0.16). The highest PSV was in the LIA in 32.8% of patients, followed by RSA (22.4%), RIA (20.7%), and LSA (15.5%). There was no statistically significant difference between right versus left or superior versus inferior arteries (P=0.17). Seven patients (12.1%) had elevated PSV in superior thyroid arteries while having normal values in the inferior thyroid arteries. Conclusion: PSV assessment of the four thyroid arteries in patients with Graves’ disease did not reveal a consistent pattern. Assessment of the superior and inferior thyroid arteries bilaterally is recommended to avoid missing the artery with the highest PSV. Presentation Date: Saturday, June 17, 2023

Ultrasound characteristics of Hashimoto’s thyroiditis in the subclinical stages of the disease

ObjectiveTo investigate the prognostic value of indicators from b-mode ultrasound, color Doppler ultrasound, and strain elastography of the thyroid gland in the diagnosis of Hashimoto's thyroiditis (HT). MethodsIn 70 euthyroidal patients with HT, demographic characteristics, serum thyroid profile and ultrasound parameters, including thyroid gland size, vascularity and stiffness (elastography strain index) of the parenchyma, and flow indices of the superior and inferior thyroid artery were recorded. The control group consisted of 70 age and weight matched euthyroid individuals with negative anti-thyroid antibodies (anti-TPO and anti-Tg). ResultsA significant difference was observed between the two groups in total thyroid size (ml, median ± standard deviation, SD) 7.86 ± 2.9 in HT vs. 6.35 ± 2.7 ml in controls, p = 0.003) and parenchymal vascularity which was increased in patients with HT (p < 0.001). Tissue strain index was higher in the HT group but without reaching statistical significance In logistic regression, thyroid size (odds ratio 1.20, 95% confidence interval: 1.02–1.41, p = 0.022) demonstrated significant prognostic value for the presence of HT. No differences were found between the two groups, regarding the peak systolic velocity (PSV), end-diastolic volume (EDV), pulsatility index (PI) and resistive index (RI) values of the thyroid arteries. In the ROC analysis (AUC 0.653, p = 0.002), a thyroid size >7.3 ml exhibited sensitivity of 61.43% and specificity of 72.6% for the diagnosis of HT. ConclusionPatients with HT exhibit larger thyroid size and increased intrathyroidal vascularity on ultrasound prior to the manifestation of hypothyroidism compared to the healthy population. Flow indices of the superior thyroid artery do not have prognostic value in the diagnosis of HT.

The performance of duplex ultrasonography for the assessment of renal artery stenosis in Takayasu’s arteritis patients

BackgroundThis study intends to analyze the hemodynamic parameters of the renal artery in patients with Takayasu’s arteritis (TAK) to explore the diagnostic efficacy of duplex ultrasonography in assessing the involved renal artery in TAK patients.MethodsOne hundred fifteen TAK patients with 314 renal arteries were retrospectively analyzed, who were admitted to Peking Union Medical College Hospital between 2017 and 2022. These patients underwent both renal artery ultrasonography and angiography within a 4-week period. Specifically, the study compared seven ultrasonic parameters across groups categorized by the severity of renal artery stenosis (RAS), including noninvolvement, < 50% stenosis, 50–69% stenosis, and 70–99% stenosis. Receiver operating characteristic (ROC) curves were employed to determine the optimal threshold values for renal artery peak systolic velocity (RPSV), renal-aortic PSV ratio (RAR), and renal-interlobar PSV ratio (RIR) in order to diagnose various degrees of RAS in TAK patients.ResultsStatistically significant differences were observed in RAR and RIR among the four groups (all P < 0.05). However, no statistically significant differences were found in RPSV and AT between the moderate stenosis group (50–69% stenosis) and the severe stenosis group (70–99% stenosis). The discrimination of interlobar PSV (IPSV) and interlobar RI (IRI) was not significant, and IEDV did not show statistical significance among the four groups.For TAK patients, the recommended thresholds of RPSV for the diagnosis of renal artery involvement (RAI), ≥ 50% RAS, and ≥ 70% RAS were determined to be 143 cm/s, 152 cm/s, and 183 cm/s, respectively. The sensitivities, specificities, and accuracies of these thresholds were all found to be greater than 80%. Additionally, the optimal thresholds of RIR for detecting RAI, ≥ 50% RAS, and ≥ 70% RAS were determined to be 4.6, 5.6, and 6.4, respectively, with satisfactory diagnostic efficiencies. The areas under the curve (AUCs) for RPSV and RIR were calculated to be 0.908 and 0.910, respectively, for the diagnosis of ≥ 50% RAS, and 0.876 and 0.882 for the diagnosis of ≥ 70% RAS. When the aortic PSV is greater than or equal to 140 cm/s, the RAR exhibits inadequate diagnostic efficacy. Conversely, when the aortic PSV is less than 140 cm/s, a RAR value of 2.2 or higher can be employed as the diagnostic threshold for identifying RAS of 70% or greater, with a sensitivity of 84.00%, specificity of 89.93%, and an overall accuracy of 89.08%.ConclusionIn the present study, it has been demonstrated that RPSV and RIR possess substantial diagnostic value as ultrasonic parameters for diagnosing RAS in TAK patients. Furthermore, when assessing the diagnostic efficacy of RAR, it is crucial to consider the severity of aortic stenosis as a determining factor.

Serum folic acid: an effective indicator for arteriogenic erectile dysfunction.

The present study is the first to explore the correlation between serum folic acid (FA) level and penile arterial peak systolic velocity (PSV) as measured via penile color Doppler ultrasonography (PDU), which directly reflects endothelial function in the penile artery. A total of 244 consecutive erectile dysfunction (ED) patients and 72 healthy controls, recruited from the Andrology department and the Healthy Physical Examination Center of our hospital, respectively, from June 2020 to April 2022, were included in the study. Serum FA was measured in ED patients and healthy controls, and PDU examinations were conducted for all eligible ED patients. The Pearson method was used to evaluate the correlation between FA levels and PDU parameters in ED patients. A receiver operating characteristic (ROC) curve analysis was also performed to calculate the sensitivity and specificity of these parameters for prediction of arteriogenic ED. After the PDU test, the average serum FA level among patients diagnosed with arteriogenic ED was 8.08 ± 2.64 ng/ml, lower than the average of 10.78 ± 2.87 ng/ml among healthy controls. There were no statistically significant inter-group differences on any basic parameters, including age, body mass index, fasting blood glucose, total cholesterol, and triglyceride. For further analysis, we divided the arteriogenic ED group into three subgroups by PSV range to compare serum FA levels among these subgroups. The mean FA levels in each of these groups were 5.97 ± 1.51ng/ml, and 8.21 ± 2.37ng/ml, and 10.55 ± 2.56ng/ml, while the corresponding PSV values were 15.75 ± 2.39cm/s, 23.53 ± 2.19cm/s, and 32.72 ± 1.64cm/s. Overall, a positive correlation between PSV and FA level was found among patients with arteriogenic ED (r=0.605, P<0.001). Furthermore, when FA level was used, with a cut-off value of 10.045 ng/ml, as a criterion to distinguish patients with arteriogenic ED from healthy controls, the area under the curve (AUC) was 0.772 (95% confidential interval: [0.696, 0.848]), for a sensitivity of 0.611 and specificity of 0.824. Serum FA level is positively correlated with PSV in ED patients, and has the ability to distinguish patients with arteriogenic ED from healthy controls. Taking these findings together, FA deficiency should be regarded as an independent risk factor for arteriogenic ED.

Increased quality of life predictive factors after cardiac resynchronization therapy in heart failure patients.

This study aimed to investigate the effects of cardiac resynchronization therapy (CRT) treatment on clinical and echocardiographic findings, the quality of life (QoL) in heart failure (HF) patients, and to identify possible predictors of improvement in QoL. A total of 97 patients (73 males and 24 females, mean age 62.8±10.6 years) with HF who underwent CRT implantation were included in this study. Demographic characteristics, laboratory findings, transthoracic echocardiography, and quality of life assessment of the MOS 36- Item Short-Form Health Survey (SF-36 score) data were recorded at baseline, and 6 months after CRT. Baseline and 6th-month data were compared. The data of groups with and without improvement in QoL were analyzed, and predictors of improvement in QoL were determined. According to the criteria for response to CRT, we observed good response at 6 months follow-up in at least two-thirds of heart failure patients. Significant improvement was observed in the SF-36 score of 67 patients who underwent CRT, and the procedure was considered successful in terms of improvement in QoL in these patients. In this group, baseline ejection fraction (EF), tricuspid annular plane systolic excursion (TAPSE), and right ventricular lateral peak systolic velocity (RV-lateral-S) values were significantly higher. TAPSE and RV lateral-S values were found to be significant in predicting the improvement in QoL after CRT [OR: 1.77 (1.00-3.14), 2.61 (1.02-6.69), respectively, p<0.05]. The cut-off values of these predictive factors were found to be 15.5 for TAPSE and 9.65 for RV lateral-S. In our study, we found that TAPSE and RV Lateral-S were predictors of improved quality of life in patients who underwent CRT. Routine evaluation of right ventricular functions before the procedure can provide significant improvement in quality of life as well as clinical symptoms.