Power Doppler Angiography Research Articles

Three‐dimensional power Doppler transanal ultrasonography, to monitor haemorrhoidal blood flow after Doppler‐guided ALTA sclerosing therapy

The study aimed to use power Doppler imaging (PDI) transanal ultrasonography to produce three-dimensional power Doppler angiography images of haemorrhoidal tissue and to monitor the effects of Doppler-guided aluminium potassium sulfate and tannic acid (DGALTA) sclerotherapy. Ninety-six haemorrhoids in 43 patients were examined using PDI transanal ultrasonography, and DGALTA sclerotherapy was performed from April 2011 to April 2012. DGALTA sclerotherapy was conducted using a four-step injection process with pulse wave Doppler ultrasound under perianal local anaesthesia. A three-dimensional power Doppler angiography image of the blood flow in haemorrhoidal tissue was produced using PDI transanal ultrasonography. The cross-sectional area of blood flow in the haemorrhoidal tissue (PDI area) significantly decreased after DGALTA sclerotherapy. The PDI areas in the preoperative state and 1 and 3 months after treatment were 0.35±0.27, 0.03±0.05 and 0.04±0.05 cm(2) (P<0.0001). A three-dimensional power Doppler angiography image of the haemorrhoidal tissue was technically possible and showed blood flow in the haemorrhoidal tissue to be significantly decreased after DGALTA sclerotherapy.

Three-Dimensional Angioultrasonography for the Prediction of Malignancy in Ovarian Masses

Objective: To determine the efficacy of the angiographic indexes of 3D power Doppler angiography (3D-PDA) for the diagnosis of malignancy in complex ovarian masses. Methods: A prospective, observational study of 72 patients with complex adnexal mass. Results: In the morphological study, 3D ultrasound showed sensitivity, specificity, PPV, NPV, PLHR and NLHR of 84.6%, 81.9%, 85.1%, 81.8%, 4.65 and 0.19. No differences in vascular indexes (VI, FI, VFI) between malignant and benign masses were found: VI 5.38 (CI 95% 3.06-7.7) vs. 6.29 (CI 95% 4.41-8.17) (p = 0.53); FI 29.6 (CI 95% 25.17-34.08) vs. 33.8 (CI 95% 30.03-37.3) (p = 0.15); VFI 1.68 (CI 95% 0.94-2.42) vs. 2.37 (CI 95% 1.49-3.25) (p = 0.24). When analysed according to different stages, VI was higher in patients with more advanced stages of disease; 4.34 (95% CI 2.21-6.47) vs. 7.38 (95% CI 4.7-10.06) (p = 0.11). FI was significantly lower in patients with early stages of disease; FI 29.07 (95% CI 21.49-36.68) vs. 36.46 (95% CI 32.31-40.62) (p = 0.04). For VFI, differences were not significant, although there was a strong trend; VFI 1.47 (95% CI 0.67-2.28) vs. 2.86 (95% CI 1.57-4.16) (p = 0.11). 3D-PDA indexes were significantly higher in patients with positive adenopathies. Conclusion: 3D-PDA values increase progressively, but not significantly, with the stage of the disease.

The Role of Fetal Neurology in the Progress of Perinatal Medicine

The prevalence of cerebral palsy has not decreased despite major improvements in clinical care in antenatal/ neonatal period as well as intrapartum period. In about 70% of cases, cerebral palsy results from events occurring before birth that can disrupt normal development of the brain. The antepartum risk factors should include fetal brain mal development and intrauterine brain injuries, which are unclassifiable into congenital brain anomalies and may exist inconspicuously during pregnancy and even after birth. Especially, neuronal migration disorder and acquired brain damage in utero should be responsible for postnatal neurological impairment. Imaging technologies including three dimensional ultrasound have been remarkably improved and contributed to prenatal evaluation of fetal Central Nervous System (CNS) development and assessment of CNS abnormalities in utero. In this article, objective and precise imaging diagnoses of fetal CNS including migration disorders and acquired brain damages. Furthermore, 3D bidirectional power Doppler angiography has depicted fine cerebral vessels of medullary veins which may relate with timing of insult as well as with postnatal neurological prognosis. It is promising to clarify the developmental mechanism of CNS damages with advanced ultrasound diagnostic techniques in the near future. Postnatal unexplained neurological deficits may strongly relate with intrauterine brain development therefore fetal neurology has great responsibility and an important role in perinatal medicine.

Contrast Enhanced Transrectal Ultrasound for the Detection of Prostate Cancer: A Randomized, Double-Blind Trial of Dutasteride Pretreatment

The identification of clinically significant disease is crucial for optimal treatment of prostate cancer. Selective detection of prostate cancer with increased microvessel density is possible with contrast enhanced ultrasound. Preliminary studies suggest that pretreatment with a 5α-reductase inhibitor may improve the efficiency of contrast enhanced ultrasound targeted biopsy. This study was designed to quantify prostate cancer detection with contrast enhanced ultrasound with or without short-term pretreatment with dutasteride. In this randomized, double-blind, placebo controlled trial of oral dutasteride pretreatment, contrast enhanced ultrasound findings were graded and used to direct targeted biopsy (up to 6 cores per prostate). A blinded 12-core systematic biopsy was subsequently performed on every subject based on standard medial and lateral sampling of each sextant. Of 311 subjects who underwent randomization, 272 completed participation. Positive biopsies were obtained in 276 of 3,264 (8.5%) systematic cores and 203 of 1,237 (16.4%) targeted cores (OR 2.1, 95% CI 1.7-2.6, p <0.001). ROC analysis for the detection of all prostate cancers demonstrated an increase in diagnostic accuracy from pre-contrast imaging to contrast enhanced ultrasound (A(z) 0.60 vs 0.64, p = 0.005). For the detection of high grade cancer (Gleason score 7 or greater) ROC analysis demonstrated improved accuracy for pre-contrast imaging (A(z) 0.74) and contrast enhanced ultrasound (A(z) 0.80, p = 0.0005). For the detection of high grade cancer with greater than 50% biopsy core involvement, excellent accuracy was demonstrated with pre-contrast and contrast enhanced ultrasound, A(z) 0.83 and 0.90, respectively (p = 0.001). Pretreatment with dutasteride had no significant impact on the detection of prostate cancer (p = 0.97). Contrast enhanced ultrasound targeted biopsy provides a significant benefit for the detection of high grade/high volume prostate cancer.

Decreased endometrial vascularity in patients with antiphospholipid antibodies–associated recurrent miscarriage during midluteal phase

To explore uterine arterial impedance and endometrial-subendometrial vascularity determined by two-dimensional Doppler ultrasonography (2D-DU) and three-dimensional ultrasonography and power Doppler angiography (3D-PDA) between patients with antiphospholipid antibodies-associated recurrent miscarriage (aPL-RM) and normal fertile women, and to further investigate the relationship between these parameters and endometrial microvessel density (MVD). Prospective observational study. Tertiary-care fertility center. A total of 109 aPL-RM patients (aPL-RM group) and 49 normal fertile women (control group). Uterine measurement by transvaginal ultrasonography and endometrial MVD in the midluteal phase was assessed for both groups. Endometrial thickness, volume, and MVD, uterine arterial pulsatility index (PI) and resistance index (RI), and the vascularization index (VI), flow index (FI), and vascularization flow index (VFI) of endometrial and subendometrial regions were measured on day 7 of a natural cycle after ovulation. Both groups had similar endometrial thickness, volume, and MVD and uterine arterial PI and RI. Endometrial VI, FI, VFI, and subendometrial FI were significantly reduced in the aPL-RM group compared with the control group. None of the uterine arterial 2D-DU and endometrial-subendometrial 3D-PDA parameters correlated with the endometrial MVD in both groups. Endometrial and subendometrial vascularity was significantly impaired in aPL-RM patients during natural midluteal phase compared with normal fertile women, and endometrial MVD did not correlate with any of the acquired vascularity parameters.

P18.10: Assessment of the intra‐ and inter‐ observer reliability of placental vascularity using three‐dimensional ultrasound and power Doppler angiography (3D‐PDA)

P18.10: Assessment of the intra‐ and inter‐ observer reliability of placental vascularity using three‐dimensional ultrasound and power Doppler angiography (3D‐PDA)

OP24.08: Three‐dimensional power Doppler angiography as a diagnostic tool in endometrial cancer

A. Testa1, L. Savelli2, I. E. Timor-Tritsch3, A. Ercoli4, C. Exacoustos5, E. Epstein6, B. R. Benacerraf7, M. Mailath-Pokorny8, C. Moruzzi1, I. De Blasis1, M. Ludovisi1, F. Fabbri9, D. Timmerman10, L. Valentin11 1Catholic University of the Sacred Heart, Rome, Italy; 2Department of Obstetrics and Gynecology, University of Bologna, Bologna, Italy; 3New York University School and Medical Center, New York City, NY, USA; 4Department of Gynecology, Policlinico Abano Terme, Abano Terme (PD), Italy; 5Department of Obstetrics and Gynecology, Universita degli Studi di Roma Torvergata, Rome, Italy; 6Department of Obstetrics and Gynecology, Karolinska University Hospital, Stockholm, Sweden; 7Obstetrics Gynecology & Repro. Bio, Harvard Medical School, Boston, MA, USA; 8Department of Obstetrics and Gynecology, Division of Obstetrics and Fetomaternal Medicine, Vienna, Austria; 9Dep Obstetrics and Gynecology, University of Bologna, Bologna, Italy; 10Dep Obstetrics and Gynecology, University Hospital KU Leuven, Leuven, Belgium; 11Dep Obstetrics and Gynecology, Skane University Hospital, Malmo, Sweden

OP33.08: Evaluation of fetal cerebral blood perfusion using power Doppler ultrasound angiography (3D‐PDA) in normal and growth‐restricted fetuses (IUGR)

The aim of the present study was to explore the possible use of 3D Power Doppler Angiography (3D PDA) using VOCALTM software (GE Healthcare, USA) assessing different fetal cerebral regions in normal and growth restricted fetuses (IUGR). 77 AGA and 55 IUGR (24–36 ws gestation). IUGR were divided in 3 groups: group 1 (n = 28): Late onset IUGR (> 34 ws) with normal bidimensional Doppler flow analysis, group 2 (n = 11): early onset IUGR (< 34 ws) with abnormal umbilical artery (UA) pulsatilty index (PI), normal middle cerebral artery (MCA) PI and normal ductus venosus (DV) PI, group 3 (n = 16): early onset IUGR (< 34 ws) with abnormal umbilical artery (UA) pulsatilty index (PI), abnormal MCA PI and pathological DV PI. Two regions of interest (ROI) were defined within the fetal brain. The first ROI (zone 1) is anterior respect the cavum septi pellucidi (CSP). The second ROI (zone 2) is obtained tracing a contour between the temporal bones as wide as the CSP. 3D-PDA vascular indexes (VI = vascularization, FI = flow, VFI = vascularization and flow) were determined in both areas for both AGA and IUGR fetuses by one operator. VFI values demonstrated increased blood flow in frontal zone compared to control group (AGA) in “early onset IUGR” (in both groups 2–3 with and without abnormal 2D MCA findings). VI and VFI values demonstrated increased blood flow in frontal zone and decreased blood flow in temporal zone compared to control group (AGA) in “late onset IUGR” with preferential increment in bloody supply to the frontal region to protect general cognitive functions. 3DPDA analysis could be considered a valid method to identify earlier vascular redistribution in IUGR fetuses comparing to 2D velocimetry. 3DPDA could become an additional parameter to adjust the monitoring intervals in the evaluation of high risk fetuses.

OP33.09: The effect of maternal vitamin D concentration on fetal bone

Objectives: The aim of the present study was to explore the possible use of 3D Power Doppler Angiography (3D PDA) using VOCALTM software (GE Healthcare, USA) assessing different fetal cerebral regions in normal and growth restricted fetuses (IUGR). Methods: 77 AGA and 55 IUGR (24–36 ws gestation). IUGR were divided in 3 groups: group 1 (n = 28): Late onset IUGR (>34 ws) with normal bidimensional Doppler flow analysis, group 2 (n = 11): early onset IUGR (<34 ws) with abnormal umbilical artery (UA) pulsatilty index (PI), normal middle cerebral artery (MCA) PI and normal ductus venosus (DV) PI, group 3 (n = 16): early onset IUGR (<34 ws) with abnormal umbilical artery (UA) pulsatilty index (PI), abnormal MCA PI and pathological DV PI. Two regions of interest (ROI) were defined within the fetal brain. The first ROI (zone 1) is anterior respect the cavum septi pellucidi (CSP). The second ROI (zone 2) is obtained tracing a contour between the temporal bones as wide as the CSP. 3D-PDA vascular indexes (VI = vascularization, FI = flow, VFI = vascularization and flow) were determined in both areas for both AGA and IUGR fetuses by one operator. Results: VFI values demonstrated increased blood flow in frontal zone compared to control group (AGA) in ‘‘early onset IUGR’’ (in both groups 2–3 with and without abnormal 2D MCA findings). VI and VFI values demonstrated increased blood flow in frontal zone and decreased blood flow in temporal zone compared to control group (AGA) in ‘‘late onset IUGR’’ with preferential increment in bloody supply to the frontal region to protect general cognitive functions. Conclusions: 3DPDA analysis could be considered a valid method to identify earlier vascular redistribution in IUGR fetuses comparing to 2D velocimetry. 3DPDA could become an additional parameter to adjust the monitoring intervals in the evaluation of high risk fetuses.

Quantification of utero-placental vascularization in a rabbit model of IUGR with three-dimensional power Doppler angiography

ObjectivesOur objective was to evaluate the 3D power Doppler angiography (PDA) in terms of feasibility and ability to detect placental hypo-perfusion in an experimental rabbit model of intrauterine growth restriction (IUGR). Study design14 pregnant females were treated with NG-nitro-L-arginine methylester (L-NAME), a nitric oxide synthase inhibitor, from day 24 to day 28 of gestation, to induce an IUGR. Concomitantly, 8 pregnant rabbits were used as controls. On day 28, 3D power Doppler indices were quantified in each utero-placental unit. Morphological examination of the placentas for the control group (n = 4) and the L-NAME group (500 mg/day, n = 4) were performed with immunohistochemical staining to discriminate the fetal capillaries in the labyrinthine area. ResultsA total of 180 live fetuses were obtained, 108 from the L-NAME group and 72 from the control group. G28 fetal weight was significantly lower in the L-NAME group than in the control group (27.40 ± 0.55 g vs 33.14 ± 0.62 g, p < 0.0001). In the L-NAME group the vascularization index (VI), flow index (FI) and vascularization flow index (VFI) were significantly lower than in the control group (2.6 [1.4; 6.0] vs 7.6 [3.5; 12.6], p < 0.05; 28.7 [26.5; 31.3] vs 32.9 [28.3; 38.1], p < 0.05; 0.8 [0.4; 1.8] vs 2.5 [1.1; 4.1], p < 0.05, for VI, FI and VFI, respectively). Morphological examinations revealed a substantial disorganization of the placental vascular architecture in the L-NAME group. ConclusionThis experimental study demonstrates that quantitative 3D PDA indices are sensitive enough to detect placental vascular insufficiency in an experimental rabbit model of IUGR.

Assessment of endometrial volume and vascularization using transvaginal 3D power Doppler angiography in women with postmenopausal bleeding

ObjectiveTo compare the usefulness of 3D power Doppler angiography (3D-PDA) and endometrial thickness measurement by 2D Doppler ultrasound in the distinction of benign from malignant disease in postmenopausal women with abnormal uterine bleeding (AUB) and an endometrial thickness greater than 4.5mm. MethodsForty-eight women with AUB and an endometrial thickness greater than 4.5mm on 2D ultrasound underwent 3D-PDA. The endometrium and a 5-mm subendometrial “shell” were evaluated at rotation angles of 9° and 30°. Endometrial volume, vascularity index, flow index, and vascularization flow index were obtained. ResultsThe histologic findings were normal or benign for 38 women (79%) and malignant for 10 (21%). All vascular indices were significantly higher in the group with malignancies except for the vascularization flow index. There were no differences in the values obtained using the 9° or the 30° angle. Receiver-operating characteristics curves were traced for all indices. The vascularity index had the best area under the curve (0.78), 77.8% sensitivity, and 82.6% specificity. The areas under the curve were smaller for the shell than for the endometrium. Conclusion3D-PDA was not found better than 2D ultrasound at distinguishing benign from malignant disease in women with AUB and an endometrial thickness greater than 4.5mm.

The preoperative assessment of deep myometrial invasion by three‐dimensional ultrasound versus MRI in endometrial carcinoma

To evaluate the usefulness of three-dimensional ultrasound (3D US), magnetic resonance imaging (MRI) and three-dimensional power Doppler angiography (3D-PDA) in the preoperative assessment of myometrial invasion in endometrial carcinoma. A prospective observational study. University hospital. Twenty consecutive patients diagnosed with endometrial carcinoma. Preoperative 3 T MRI and 3D US examinations were performed, and the depth of myometrial invasion was assessed. The vascularity indices, vascularization index, flow index and vascularization flow index, were calculated by 3D-PDA. The results were compared with the final histopathology report after a surgical staging. In detecting deep myometrial invasion, the sensitivity of 3D US, MRI and their combination was 50, 91.7 and 100%, respectively. The specificity was 87.5, 50 and 50%, respectively. There were no significant differences in the 3D-PDA vascularity indices between the two groups. MRI appears to be more sensitive than 3D US in detecting deep invasion, while 3D US has a better specificity.

OS047. Quantification of placental vascularization in a rabbit model ofIUGR with three-dimensional power doppler angiography

Placental dysfunction is known to be a major cause of pregnancy complications, such as perinatal loss, preeclampsia, and intrauterine growth restriction (IUGR). Inadequate remodeling of the spiral arteries resulting in decreased blood flowto the placenta has been implicated in the pathophysiology of preeclampsia and IUGR. 3D power Doppler angiography (PDA) is a noninvasive and safe way to study blood flow within an organ or region of interest. The aim of this study was to evaluate PDA as a method to quantify placental perfusion in a pharmacological rabbit model of vascular IUGR induced by inhibition of NO synthesis. Our objective was to evaluate the 3D power Doppler angiography (PDA) in terms of feasibility and ability to detect placental hypo-perfusion in an experimental rabbit model of intrauterine growth restriction (IUGR). Fourteen pregnant females were treated with NG-nitro-L-arginine methylester (L-NAME), a nitric oxide synthase inhibitor, from day 24 to day 28 of gestation, to induce an IUGR. Concomitantly, 8 pregnant rabbits were used as controls. On day 28, 3D power Doppler indices were quantified in each uteroplacental unit. A total number of 180 live fetuses were obtained, 180 from the L-NAME group and 72 from the control group. G28 fetal weight was significantly lower in the L-NAME group than in the control group (27.40±0.55g vs 33.14±0.62g,p<0.0001). In the L-Name group the vascularization index (VI) was significantly lower than in the control group (2.6 [1.4;6.0] vs 7.6 [3.5;12.6],p<0.05). Similar results were obtained for the Flow Index (FI) and the Vascularization Flow Index (VFI). The number of fetuses considered as small for gestational age (SGA;weight<10th centile) was significantly higher in the L-NAME group than in the control group (47/108 vs 7/72,p<0.0001). The VI was significantly lower in the SGA group than in the eutrophic group (3.46 [0.46;5.9] vs 7.50 [4.22;10.9] p<0.05). Similar results were obtained for FI and VFI. This experiment study demonstrates that quantitative 3D PDA indices are sensitive enough to detect placental vascular insufficiency in an experimental model of IUGR.

Preoperative assessment of endometrial carcinoma by three‐dimensional power Doppler angiography

Preoperative evaluation of the depth of myometrial invasion in endometrial carcinoma is challenging. The objective of this study was to evaluate the usefulness of three-dimensional power Doppler angiography (3D-PDA) in this setting. Sonographic and histological data on 100 consecutive cases of endometrial carcinoma were analyzed. The endometrial and myometrial vascular indices VI (vascularization index), FI (flow index) and VFI (vascularization flow index) were calculated by 3D-PDA. The results were compared with a complete surgical staging. The mean ( ± SD) age of patients was 67.1 ± 8.8 (range, 33-87) years. Forty-six patients had deep (≥ 50%) myometrial invasion. Eight patients had metastases, seven of them with deep invasion. Three patients were found to have carcinomas of non-uterine origin on histology, and these were excluded from further statistical analysis. The median endometrial and myometrial vascular indices were higher in the group with deep invasion than in the group without. Following multivariable analysis of the indices only the endometrial FI was independently associated with deep invasion (OR, 1.061; 95% CI, 1.023-1.099; P = 0.001). However, a greater endometrial volume was also an independent predictor of deep invasion (OR, 1.109; 95% CI, 1.011-1.215; P = 0.028). Our study suggests that endometrial and, to a lesser degree, myometrial vascular indices and endometrial volume correlate with the depth of myometrial invasion in endometrial carcinoma.

OC01.03: How does the IVF treatment protocol affect subendometrial blood flow prior to ovulation?

Objectives: To compare subendometrial blood flow prior to ovulation in the natural menstrual cycle with blood flow prior to HCG administration in the IVF treatment cycle in subfertile women. Hypothesis: IVF treatment causes an increase in blood flow, and women who subsequently conceive have higher endometrial blood flows pre HCG. Methods: 118 women with regular menstrual cycles were prospectively recruited. TV US in the late follicular phase (ovuln1to-2) of the natural cycle and in the morning prior to HCG administration in IVF cycle. A 3D dataset of the uterus was acquired using power Doppler angiography. Using VOCAL (9◦) the endometrial volume was measured using 9 degree rotation steps. 3, 5 and 7 mm shells were selected to represent the subendometrium. The standardised vascularity indices were measured as described previously. The Wilcoxon signed ranks test was used to analyse data. Results: 105 women were included. 13 women excluded due to cycle cancellation or non attendance. None of the indices were normally distributed. 50 (48%) women subsequently had a positive pregnancy test. All sub endometrial blood flow indices were significantly higher in the treatment cycle eg: pre ovulatory 3 mm subendometrial sVI in IVF cycle 24.5 ± 7.3% compared with 12.7 ± 5.5% in natural cycle (P < 0.01). Women who subsequently conceived did not demonstrate significantly higher vascular indices than women who did not conceive for any of the subendometrial parameters studied. We therefore accepted the hypothesis that IVF treatment is associated with an increase in subendometrial vascularity, but rejected the hypothesis that there was a difference in these indices between women who conceive and those who do not. Conclusions: IVF treatment is associated with an increase in subendometrial vascularity. We have shown that there is no difference in these indices between women who conceive and those who do not. Further studies are in progress to assess whether these indices fall at the time of embryo transfer as we have shown in the mid luteal phase, and whether this fall is predictive of pregnancy.

P28.05: Three‐dimensional power Doppler angiography (3DPD) in adnexal masses: re‐analysis of prospective collected data

S. Guerriero1, J. Alcazar2, S. Ajossa1, M. Pascual3, F. Sedda1, M. Pilloni1, A. Piras1, C. Peddes1, A. Piras1, B. Soggiu1, B. Olartecoechea2, M. Auba2, A. M. Paoletti1 1Department of Obstetrics and Gynecology, University of Cagliari, Cagliari, Italy; 2Deparment of Obstetrics & Gynecology, University of Navarra, Pamplona, Spain; 3Deparment of Obstetrics & Gynecology, Institut Universitari Dexeus, Barcelona, Spain

P23.13: Magnetic resonance fetal lung volumetry for predicting postnatal short‐term outcome in congenital left diaphragmatic hernia

Results: We demonstrated a correlation between PSV of renal artery, PI and vmax of renal vein and gestational age (GA). In addition our results showed that there were no correlation between gestational age and 3-D power Doppler vascular parameters (VI, FI, VFI). Conclusions: Our study indicates that fetal renal blood flow increase with the advancement of gestational age and that bidimensional sonography is more reliable than three-dimensional power Doppler angiography for the study of fetal renal vasculature.

OP36.09: Changes in amniotic fluid and umbilical cord serum proteomic profiles in fetuses with intrauterine growth restriction and Doppler velicimetry abnormalities

Objectives: The aim of this study is to evaluate three dimensional cerebroplacental ratio (CPR 3D) using 3D power Doppler angiography (3D PDA) in the intrauterine monitoring of the growth restricted fetuses (IUGR). Methods: Cerebroplacental ratio (CPR), the ratio between PI of MCA and PI of umbilical artery (UA), is a better predictor for adverse outcome than a single vessel considered alone. We defined CPR 3DPDA as the ratio between vascular indices of a region of fetal brain (ROI) and the vascular indices of the placenta using 3DPDA methodology. The ROI evaluated were a ‘frontal zone’, sprinkled mainly by anterior cerebral artery, obtained tracing a contour passing through the anterior side of cavum septum pellucido (CSP) surrounding part of temporal and frontal bone. Then a second ROI obtained tracing a contour from temporal bones of the width of CSP included (’temporal zone’) sprinkled by middle cerebral artery MCA. We considered 3DPDA vascular indexes (VI = vascularisation FI = flow, VFI = vascularisation and flow). We enrolled 33 IUGR fetuses and 81 adeguate for gestational age, as control cases (24–38 weeks). IUGR fetuses were divided into 2 groups: group 1, IUGR with normal flussimetry of umbilical artery (UA) and MCA; group 2, IUGR with abnormal UA-PI (mean > 2 SD) and abnormal MCA-PI (PI < 2 SD). We calculated the 2D CPR and the CPR 3D of the frontal and temporal cerebral zones for all vascular indexes. Results: Values of 2D CPR were in accordance with the expected ones. CPR 3D, applying VI and VFI, both in frontal and temporal zone demonstrated a statistically significant different values compared with control cases. Conclusions: CPR 3D can be considered a new parameter: it demonstrates the vascular redistribution in frontal and temporal zones during the ‘brain sparing effect’ in IUGR fetuses also in the group of IUGR fetuses without bidimensional pathological flussimetry.

P23.11: Comparison between bidimensional sonography and three dimensional power Doppler angiography (VOCALTM) for assessment of fetal renal blood flow in normal gestation

P23.11: Comparison between bidimensional sonography and three dimensional power Doppler angiography (VOCALTM) for assessment of fetal renal blood flow in normal gestation

Three-dimensional power doppler angiography as a three-step technique for differential diagnosis of adnexal masses: A prospective study

Three-dimensional power doppler angiography as a three-step technique for differential diagnosis of adnexal masses: A prospective study