Power Doppler Techniques Research Articles

Contrast-Free Super-Resolution Power Doppler (CS-PD) Based on Deep Neural Networks.

Super-resolution ultrasound microvessel imaging based on ultrasound localization microscopy (ULM) is an emerging imaging modality that is capable of resolving micrometer-scaled vessels deep into tissue. In practice, ULM is limited by the need for contrast injection, long data acquisition, and computationally expensive postprocessing times. In this study, we present a contrast-free super-resolution power Doppler (CS-PD) technique that uses deep networks to achieve super-resolution with short data acquisition. The training dataset is comprised of spatiotemporal ultrafast ultrasound signals acquired from in vivo mouse brains, while the testing dataset includes in vivo mouse brain, chicken embryo chorioallantoic membrane (CAM), and healthy human subjects. The in vivo mouse imaging studies demonstrate that CS-PD could achieve an approximate twofold improvement in spatial resolution when compared with conventional power Doppler. In addition, the microvascular images generated by CS-PD showed good agreement with the corresponding ULM images as indicated by a structural similarity index of 0.7837 and a peak signal-to-noise ratio (PSNR) of 25.52. Moreover, CS-PD was able to preserve the temporal profile of the blood flow (e.g., pulsatility) that is similar to conventional power Doppler. Finally, the generalizability of CS-PD was demonstrated on testing data of different tissues using different imaging settings. The fast inference time of the proposed deep neural network also allows CS-PD to be implemented for real-time imaging. These features of CS-PD offer a practical, fast, and robust microvascular imaging solution for many preclinical and clinical applications of Doppler ultrasound.

Normal placental structural anatomy: ultrasound and doppler features elucidated with US-MR image fusion and ferumoxytol-enhanced MRI.

To elucidate ultrasound features of normal placental anatomy through correlation of gray-scale and ultrasound Doppler with ferumoxytol-enhanced MRI features using US-MR image fusion. All patients referred to MR for ultrasound findings worrisome for PAS (placenta accreta spectrum) were included in this retrospective study. MR studies included a ferumoxytol-enhanced T1-weighted MRI. Ultrasound imaging included gray-scale, color Doppler, power Doppler, and spectral Doppler techniques. After the MR, US-MRI fusion was performed by co-registering a MR acquisition to real-time US, which allowed precise, point-to-point correlation of placental features. Fourteen patients at risk for PAS were studied using the US-MR image fusion. At delivery, there were six cases without PAS (gestational age range: 24weeks 3days to 34weeks 0days), and these composed the study cohort. Placental features that were on high signal intensity on post-ferumoxytol acquisitions represent spaces with maternal blood flow and corresponded to hypoechoic areas on ultrasound created by a paucity of reflective interfaces (villi). Color and spectral Doppler allowed the separation of maternal and fetal circulations in individual perfusional domains and demonstrated spiral artery inflow, circulation around the villous tree, and return of blood flow to the basal plate. Recognizable histopathologic features by ultrasound included the central cavity, villous tree, and venous return channels. Internal placental architecture can be discerned on ultrasound. This anatomy can be correlated and confirmed with ferumoxytol-MR through US-MR fusion. Understanding this structural anatomy on ultrasound could serve as a basis to identify normal and abnormal placental features.

Does a Caesarean Section Scar Affect Placental Volume, Vascularity and Localization?

Caesarean section is associated with an increased risk of abnormal placental implantation and adverse pregnancy outcomes in subsequent pregnancies. Besides the placenta accrete spectrum, only a few of the previous studies focused on other placental development alterations in the scarred uterus. We assessed placental development deviations in the uterus with a Caesarean section scar by evaluating placental volume (PV) and vascular flow indexes. From 1 January 2021 until 31 March 2022, placental volumes and vascularization indexes (VI, FI, VFI) were prospectively measured by 3D power Doppler and VOCAL techniques in 221 patients attending the first trimester screening program. We also calculated the placental quotient to standardize PV to the gestational age. No statistically significant differences in the values of placental volume, placental quotient and placental vascularization indexes were detected between women with previous Caesarean section delivery or women with vaginal delivery. FI was significantly lower in nulliparous in the first trimester. The results of our study suggest that 3D placental evaluation was not able to detect placental development alteration in the uterus with a Caesarean section scar. Future research needs to verify whether 3D power Doppler and Vocal techniques can provide more information if used in an earlier gestational age.

Usefulness of Ultrasound Examination in the Assessment of the Nail Apparatus in Psoriasis.

The assessment of psoriatic nail changes in everyday practice is based exclusively on clinical symptoms that do not reflect the entire disease process in the nail apparatus. The use of imaging methods, especially widely available and inexpensive ultrasonography, creates the possibility of additional revealing and assessing grayscale of morphological changes of the ventral nail plate, nail bed, and matrix, as well as the attachment of the finger extensor tendon to the distal phalanx. What is more, it enables the assessment of inflammation severity in the power Doppler technique. A qualitative classification of nail plate morphological changes corresponding to the severity of psoriatic nail changes has been developed so far and attempts are being made to develop a quantitative method to assess not only the presence of changes but also the severity of inflammation. Nail ultrasonography is not commonly performed, although published studies indicate the possible use of this technique in the assessment of psoriatic changes in nail structures. It can be particularly useful in subclinical changes imaging, preceding clinical manifestation of psoriatic nail changes, enthesopathy: subclinical and in the course of psoriatic arthritis, as well as in the assessment of treatment efficacy. This review article aims to summaries the research on ultrasonography of the nail apparatus which has been carried out so far, taking into account its applicability in clinical practice.

Comparison between placental 3D power Doppler and uterine artery pulsatility index in early prediction of pre-eclampsia

Aim of the work: To compare between placental 3D Power Doppler vascular indices and uterine artery pulsatility index in early prediction of preeclampsia. Methods: The prospective comparative observational cohort study included 200 women in their first trimester at 11–14 weeks of pregnancy divided into 2 groups. 100 women with no risk factor to develop preeclampsia (control group), 100 women with any risk factor to develop preeclampsia (case group). All women were examined by 3D abdominal ultrasound, Blood flow in placenta was examined using 3D power Doppler technique for the placental vascular indices. Uterine artery pulsatility index was also assessed. All Patients were followed up to the end of their pregnancies and their medical files reviewed to obtain whether patients developed preeclampsia and other hypertensive disorders. Results: Overall, 17 women developed pre-eclampsia while 183 women remained normotensive (7 out of 100 women in the control group and 10 out of 100 women in the case group). In both groups the women with pre-eclampsia had significantly lower placental vascular indices (vascularization-index, flow index, and vascularization flow index) compared with the normotensive women. In contrast, women with pre-eclampsia in both groups had significantly high mean uterine pulsatility index compared with the normotensive women.

Evaluation of ultrasonography as a diagnostic tool in the management of periapical cysts and granulomas: A clinical study.

PurposeThe aim of this study was, firstly, to determine the concordance of ultrasonographic and histopathological diagnoses in patients in whom apical resection was already indicated. Secondly, this study aimed to determine whether lesions were periapical granulomas or cysts, and to compare them after root canal treatment using ultrasonography and periapical radiographs.Materials and MethodsIn the first stage of the study, ultrasonographic and histopathologic diagnoses of 10 lesions were compared. Secondly, the periapical radiographs and ultrasonographic images of 44 lesions were measured. The presence of internal vascularity was determined by ultrasonographic color and power Doppler modes. Follow-up examinations of healing after root canal treatment were performed using ultrasonography and periapical radiographs, and these modalities were compared.ResultsIn the periapical granuloma and cyst groups, the measurement values decreased for all variables. There was no significant difference in the dimensional changes of lesions between the 2 groups, and ultrasonography and periapical radiographs were compatible. The pre-diagnoses were compared with histopathological diagnoses and were found to be compatible.ConclusionThe ultrasonographic color and power Doppler techniques could be an effective method for diagnosing periapical lesions as cysts or granulomas. After root canal treatment of granulomas and cysts, the dimensional shrinkage and healing patterns appear to be similar. Ultrasonography and periapical radiographs were consistent in terms of dimensional comparisons, and ultrasonography may be an alternative method for follow-up of the healing of periapical lesions.

Assessment of Three Dimensional Color Power Doppler Technique for Detecting Fetal Renal Vascular Perfusion in Pregnant Women with Gestational Hypertension

Assessment of Three Dimensional Color Power Doppler Technique for Detecting Fetal Renal Vascular Perfusion in Pregnant Women with Gestational Hypertension

Seeing the unseen with superb microvascular imaging: Ultrasound depiction of normal dermis vessels.

Current color- and power-Doppler techniques cannot demonstrate vascularization of the dermis. Aim of this prospective study was to investigate whether the new superb vascular imaging (SMI) technique improves the ultrasound (US) depiction of dermis vessels in healthy volunteers. SMI was compared side-by-side to conventional power-Doppler (PD) imaging. Thirty adult subjects (18 men and 12 women, mean age 45 years old) were evaluated with US at level of five body areas: forehead, forearm, palm, buttock, and thigh. The vascular index (VI) was employed to objectively quantify the difference between SMI and PD imaging in terms of dermis flow amount. Forehead VI was higher for SMI than for PD in 93% of cases, forearm VI was higher for SMI than for PD in 97% of cases, palm VI was higher for SMI than for PD in 87% of cases, buttock VI was higher for SMI than for PD in 100% of cases, thigh VI was higher for SMI than for PD in 100% of cases. SMI-detected vascular signals in 100% of the body areas. PD failed to show any flow signals from the forehead in 23% of cases, forearm in 37% of cases, palm in 33% of cases, buttock in 47% of cases, and thigh in 50% of cases. SMI can demonstrate normal dermis vascularization whereas conventional PD cannot. SMI is a sensitive and promising technique in the study of dermis abnormalities, particularly when quantifying the disease activity is important.

Detecting the accuracy of three dimensional power Doppler (3DPD) vascular indices for prenatal diagnosis of morbidly adherent placenta in patients with placenta previa

Objective: The study`s objective was to assess the accuracy of prenatal 3-dimensional power Doppler analysis of vascular and flow placental indices to predict the morbidly adherent placenta objectively.Background: Traditionally, 2D ultrasound have been used for the diagnosis of a suspected morbidly adherent placenta previa. Recently ,3D power Doppler technique was introduced to diagnose morbidly adherent placenta (MAP).Study Design: A prospective study executed among women with placenta previa between 28 and 32 weeks of gestation. Patients were examined by 2D ultrasounds which was used in management decisions. 3D Power Doppler vascular, flow and vascular flow indices were measured during the same examination after tracing of maximum placental thickness; data were blinded to obstetricians. Histopathology was used to confirm MAP. Severe morbidly adherent placenta was described as increta/percreta on histopathology, blood loss >2L, and >2 units of PRBC transfused. Sensitivities, specificities, predictive values, and likelihood ratios were calculated.Results: Our results showed that the 3D Doppler VI ≥ 16 predicted MAP with a 100% sensitivity ,100% specificity which are better than those of 2D ultrasound (60.0% and 89.1% respectively).Sever MAP occurred in 51.2% of MAP and 3D Doppler of VI > 33.1 predicted sever MAP with a sensitivity of 73.9% and specificity of 86.4%, which was superior to 2D ultrasound.Conclusion: In placenta previa patients, the vascular index accurately predicts the morbidly adherent placenta. Furthermore, vascular and vascular flow indices of 3D power Doppler were more predictive of severe cases of morbidly adherent placenta compared to 2D ultrasound.

Measurement of the Internal Carotid Artery Cross-Sectional Area: Systematic Differences Depending on Grayscale, Power Doppler, and Color Doppler Techniques.

To determine how measurements of the internal carotid artery (ICA) cross-sectional area will differ systematically when obtained by grayscale, color Doppler, and power Doppler imaging. A total of 451 patients had greater than 40% diameter stenosis in at least a single ICA. Anteroposterior and transverse luminal diameters were measured in 609 arteries on grayscale, color, and power Doppler transverse images of the carotid bulb and proximal and distal ICAs. Cross-sectional areas were calculated and compared by a repeated-measures analysis of variance model to assess for significant differences. Mean ICA cross-sectional areas ± SDs as measured by grayscale, power Doppler, and color Doppler imaging were 122 ± 81, 122 ± 79, and 125 ± 79 mm2 , respectively. The mean ICA area estimated by color Doppler imaging was significantly greater than that estimated by power Doppler imaging (P < .0001) and grayscale imaging (P = .02). Area estimates on grayscale and power Doppler images were not significantly different (P = .99). After accounting for the correlation of repeated measurements within single vessels, color Doppler estimates of the luminal area were on average 3.44 and 9.5 mm2 greater than grayscale and power Doppler estimates. Relative cross-sectional area estimates were on average 9.4% greater with color Doppler imaging at smaller luminal diameters (<60 mm2 ) compared with larger luminal diameters. Measurements of the ICA cross-sectional area by color Doppler imaging were significantly greater than those obtained by power Doppler or grayscale imaging. This difference should be considered when stenosis estimates are confirmed or graded by luminal measurements.

Superb Microvascular Imaging in Low-Grade Inflammation of Knee Osteoarthritis Compared With Power Doppler: Clinical, Radiographic and MRI Relationship

We compared the assessment of active synovitis in knee osteoarthritis (OA) by utilising superb microvascular imaging (SMI) and conventional power Doppler (cPD) techniques, and then correlated each technique with paients' symptoms, radiographic features and magnetic resonance imaging (MRI)-detected synovitis. A subgroup of participants with symptomatic knee OA underwent dynamic ultrasound assessment for semi-quantitative scores for SMI and cPD in the suprapatellar, medial and lateral parapatellar knee recesses. Knee pain and other symptoms were evaluated with the knee injury and osteoarthritis outcome score (KOOS). OA severity was assessed using the Kellgren and Lawrence grade (KLG) on radiograph and effusion-synovitis and Hoffa's synovitis score of MRI osteoarthritis knee score on non-contrast–enhanced MRI sequences. The χ2 test and κ statistics were conducted to compare detectability of SMI and cPD for low-grade inflammation, and the Spearman's correlation and Fisher's r to z transformation were conducted to compare correlations of both techniques with symptoms and imaging severity. A total of 89 participants were included in the analyses. SMI increased the detection rate by 25.5% for grade 0 cPD, by 35.4% for grade 1 cPD and by 9% for grade 2 cPD. SMI showed significant correlations with KOOS symptoms, KLG, MRI effusion-synovitis and Hoffa's synovitis scores (r = –0.24 [–0.45, –0.01]; r = 0.31 [0.10, 0.50]; r = 0.49 [0.33, 0.63]; and r = 0.54 [0.37, 0.68]). The cPD was significantly correlated with KOOS pain, other symptoms, MRI effusion-synovitis and Hoffa's synovitis (r = –0.23 [–0.44, –0.01]; r = –0.29 [–0.49, –0.06]; r = 0.46 [0.28, 61], r = 0.46 [0.25, 0.63]). However, no significant differences were detected in their extent of correlations. SMI can detect low-grade inflammation implicated in OA disease better than cPD and reveal a significant correlation with symptoms, radiographic features and MRI synovitis. The added clinical value of SMI over cPD is still not clear.

P07.10: Are the results of vascularisation index obtained with 3D power Doppler and 4D power Doppler technology comparable?

The aim of the study was to answer the question whether results of vascularisation indices (VI) are comparable when using 3D power Doppler and 4D power Doppler ultrasound techniques in an ovary as in vivo model. 78 ovaries were evaluated in the first part of the menstrual cycle using power Doppler (PD) techniques. Two records were made for every ovary: 3D PD and 4D PD record. Next, for every ovary the VI were calculated using 3D record and then, the same vascularisation index was calculated as a mean value of two values: VI max and VI min obtained with 4D STIC technology. The results obtained in both techniques were similar with a mean value of VI equal to 14.507, standard deviation 4,569 and a median value of VI equal to 14,797 for 3D VI, and accordingly mean VI equal to 14,678, standard deviation eqial to 4,705 and median VI PD equal to 14,293 for VI = (Vmax+Vmin)/2 obtained with 4D method. The values of VI obtained using the 4D method as the average value during one heart cycle are statistically comparable to values obtained by the 3D method. There are no statistically significant differences between VI PD values obtained with 4D PD option and 3D PD option, however 4D method should be considered as a better option as it is less dependent on acquisition time. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.

Sonographic assessment of nerve blood flow in diabetic neuropathy.

To undertake sonographic assessment of nerve blood flow in people with Type 2 diabetes and correlate the findings with neuropathy severity scores and electrophysiological measurements. Median and tibial nerve ultrasound scans were undertaken in 75 people with diabetes and 30 aged-matched controls without diabetes, using a high-resolution linear probe at non-entrapment sites. Nerve blood flow was quantified using power Doppler techniques to obtain the vessel score and the maximum perfusion intensity. Neuropathy severity was assessed using a total neuropathy score. Diabetic nerves had higher rates of nerve blood flow detection (28%) compared to the control group (P < 0.0001). Significant correlations were found between nerve blood flow measurements and nerve size (P <0.001), reported sensory symptoms (P < 0.05) and neuropathy severity scores (P < 0.001). The cohort with diabetes had significantly larger median (8.5 ± 0.3 mm2 vs 7.2 ± 0.1 mm2 ; P < 0.05) and tibial nerves (18.0 ± 0.9 mm2 vs 12.8 ± 0.5 mm2 ; P < 0.05) compared with controls. Peripheral nerve hypervascularity is detectable by ultrasonography in moderate to severe diabetic neuropathy with prominent sensory dysfunction.

025 The utility of nerve blood flow in the assessment of peripheral neuropathy

IntroductionAnimal and human studies of diabetes have shown significant alterations in nerve blood flow (NBF), which may also play a role in the development of neuropathy. However, the non-invasive assessment of NBF in human subjects has remained elusive until the recent technological advancements in ultrasound (US) technology. We undertook sonographic assessment of NBF in 75 patients with type 2 diabetes and correlated the findings with neuropathy severity scores and electrophysiological parameters.MethodsBlinded median and tibial nerve ultrasound scans were performed at non-entrapment sites using a high-resolution linear probe. NBF was quantified using power Doppler techniques to obtain the vessel score (VSc) and maximum perfusion intensity (MPI). Routine nerve conduction studies were performed, and neuropathy severity was assessed using the total neuropathy score (TNS). Aged- and gender-matched controls were enrolled.ResultsDiabetic nerves had higher rates of NBF detection (28%) compared to the control group (p&lt;0.0001). Significant correlations were found between NBF parameters and nerve size (p&lt;0.001), reported sensory symptoms (p&lt;0.05) and neuropathy severity scores (p&lt;0.001). The cohort with diabetes had significantly larger median (8.5 ± 0.3 mm2 vs. 7.2 ± 0.1 mm2, p&lt;0.05) and tibial (18.0 ± 0.9 mm2 vs. 12. 8 ±0.5 mm2, p&lt;0.05) nerves compared to controls.ConclusionsPeripheral nerve hypervascularity is detectable by US in moderate to severe diabetic neuropathy with prominent sensory dysfunction. Consistent with previous studies, the sonographic detection of NBF is a pathological finding.

Role of multi-parametric ultrasound in transient perivascular inflammation of the carotid artery syndrome.

The term "carotidynia" has been used to describe a symptom or a nosologic entity characterized by pain in the lateral neck region and over the carotid bifurcation. Recent advances in diagnostic imaging and the introduction of diagnostic criteria have led to the adoption of term "Transient perivascular inflammation of the carotid artery" (TIPIC) syndrome. A retrospective analysis of the Radiology Department's database was performed to identify cases with the diagnosis of TIPIC syndrome. The purpose was to identify ultrasound images including B-mode technique, colour, power Doppler technique and contrast-enhanced ultrasound (CEUS). In total, five patients with the diagnosis of TIPIC syndrome are presented in this review. TIPIC syndrome is a clinic-radiologic entity characterized by pain over the carotid area, a symptom referring to a wide differential diagnosis where imaging plays a crucial role for proper diagnosis and treatment. Characteristic imaging findings on conventional ultrasound and CEUS are presented in this review. TIPIC syndrome can be investigated with virtually any imaging modality. Ultrasound typically reveals perivascular infiltration and a hypoechoic intimal plaque, while no significant luminal narrowing is appreciated. Computed tomography angiography and magnetic resonance angiography also demonstrate these vascular wall changes primarily affecting the distal common carotid artery, the carotid bulb and possibly the internal carotid artery proximal part. Contrast enhancement is a very characteristic and constant finding of TIPIC lesions, suggestive of the inflammatory nature of the disease and can be appreciated on computed tomography angiography and magnetic resonance angiography. CEUS has been recently used and successfully observed contrast enhancement of the lesions, similar to computed tomography angiography and magnetic resonance angiography. Ultrasound remains the first-line modality for the evaluation of TIPIC syndrome, capable of providing all the information needed, especially if supplemented with the administration of microbubbles so that the enhancement of lesions can be evaluated.

Significant association between joint ultrasonographic parameters and synovial inflammatory factors in rheumatoid arthritis

BackgroundUltrasonography (US) can directly demonstrate joint inflammation, including grayscale (GS) signs of synovial hypertrophy and power Doppler (PD) techniques to demonstrate increased blood flow and vascularization. Recently, echogenicity, especially hypoechoic synovium, has also been associated with local inflammatory activity. However, only a few studies have demonstrated correlation between histopathologic and immunopathologic evaluation and US findings. The aim of this study was to clarify whether joint US findings including synovial hypertrophy, vascularity, and echogenicity can accurately characterize synovial pathophysiology in patients with active rheumatoid arthritis (RA).MethodsA total of 44 patients with RA were included, both treated (n = 25) and untreated (n = 19) and scheduled for US examination of the knee joint with synovial fluid (SF) aspiration and two treated patients also underwent synovial biopsy. US images were quantitatively analyzed using grayscale assessment of synovial hypertrophy and PD for vascularity and echogenicity. Levels of nine SF cytokines and growth factors were also measured.ResultsBoth US synovial hypertrophy and PD vascularity significantly correlated with SF inflammatory cytokine levels such as IL-6, IL-8, IL-1β and IL-10 in untreated patients. Angiogenic factors, including vascular endothelial growth factor (VEGF), only correlated with PD vascularity. In the treated patients, the associations between synovial hypertrophy and any cytokines were diminished, although synovial vascularity and echogenicity correlated with IL-6 and VEGF (p < 0.05). Histopathologic analysis revealed that hypoechogenicity of the synovium correlated with marked infiltration of lymphocytes and hypervascularity.ConclusionsWe demonstrated the pathophysiological origins of US findings in the joint. The degree of US vascularity of the synovium correlated with local inflammatory cytokine levels and angiogenetic factors in patients with active RA. Synovial echogenicity, and not hypertrophy, correlated with inflammation, especially in treated patients with RA.

Can 3-Dimensional Power Doppler Indices Improve the Prenatal Diagnosis of a Potentially Morbidly Adherent Placenta in Patients With Placenta Previa?

(Am J Obstet Gynecol. 2017;217(2):202.e1–202.e13) The incidence of morbidly adherent placenta (MAP), a condition that can result in life-threatening hemorrhage and other maternal morbidities, has been on the rise. Traditionally, 2-dimensional (2D) ultrasound has been used to diagnose MAP and severe MAP (increta and percreta). This diagnosis is subjective as it relies on clinician interpretation of the ultrasound examination. This study aimed to evaluate the ability of a 3D power Doppler technique to diagnose MAP and severe MAP, as compared with gray-scale 2D ultrasound.

Examination of the vascularization of fetal kidney with three-dimensional power Doppler technique in pregnancies complicated by increased maternal blood pressure.

The goal of this study was to investigate the fetal renal vascularization during the third trimester of gestation and the perinatal outcome in pregnancies diagnosed with hypertension. Depending on the medical history, the cases were divided into two groups: chronic hypertension (CHT) group and gestational hypertension (GHT) group. The vascularization and the volume of kidneys were observed in prenatal period by three-dimensional ultrasound. We monitored gestations and perinatal complications. Renal volume and vascularization were detected in 45 cases complicated by GHT and 21 cases with CHT during the 20-month study period. The alteration in fetal renal volume and vascularization may be an in utero cause of subsequent intrauterine and neonatal complications, such as cesarean section because of fetal distress (36%), perinatal infection (24%), treatment in neonatal intensive care unit (39%), or increased perinatal mortality (1%) in affected cases. The results demonstrate that fetuses with depressed vascularization of medullae had 1.5 times the risk of an abnormal outcome compared with the control group. The volume of kidneys had a strong correlation with their vascularization. Detailed ultrasound examinations of renal parenchyma appear to be useful for the prenatal diagnosis of intrauterine hypoxia, allowing the detection of potential pathological fetal conditions in utero.

Value of Placental Volume and Vascular Flow Indices as Predictors of Early and Late Preeclampsia at First Trimester

Introduction: We evaluated the utility of placental volume and three-dimensional (3D) vascular flow indices to predict early and late preeclampsia. Material and Methods: In 1,004 pregnancies attending routine care, we recorded first-trimester screening program for aneuploidy (FTSA) parameter and measured uterine artery pulsatility index (uterine-a PI). Placental volume and vascular flow indices were obtained using 3D power Doppler and VOCAL techniques. Results: Placental volume was lower and uterine-a PI was higher in both early and late preeclampsia groups versus nonaffected pregnancies. The prediction rate of placental volume in late preeclampsia was higher than that of uterine-a PI (AUROC 0.707 vs. 0.581, p < 0.011). The inclusion of placental volume improved significantly the prediction rate of total and late preeclampsia in the models constructed with maternal characteristics, FTSA, and uterine-a PI (AUROC 0.745 vs. 0.818, p < 0.004, and 0.740 vs. 0.812, p < 0.012, respectively). The inclusion of vascular indices did not improve the predictive value of these models. Discussion: Placental volume was an independent predictor of total, early, and late preeclampsia and its inclusion in combined predictive models significantly improved prediction rates. Reduced placental volume observed at first trimester in women with early and late preeclampsia suggests that these entities are the clinical expression of a similar pathophysiological process.

P25.07: Three‐dimensional power Doppler ultrasound examination in pregnancies complicated by intrauterine growth restriction

Our goal was to examine placental vascularisation using 3-dimensional power Doppler (3-DPD) technique in the second and third trimester of pregnancies complicated by intrauterine growth restriction (IUGR). Vascularisation of placentas was assessed in the second and third trimester of 52 pregnancies complicated by IUGR as well as 171 normal pregnancies using 3-DPD technique. We have evaluated the correlation between specific parameters and gravidity, parity, body-mass index, placental localisation, estimated fetal weight, birth weight, emerging intrauterine complications, umbilical cord arterial pH and Apgar score. We applied sonobiopsy and volumes were analysed with Virtual Organ Computer-aided Analysis (VOCAL) programme. 3-DPD vascularisation indices of the placenta showed significant differences between the study group and control group. Placental vascularisation is lower in pregnancies complicated by IUGR than in normal ones. Deterioration of the vascularisation correlates to perinatal outcome. The examination of placental vascularisation by 3-DPD technique can be a method to distinguish perinatal complication in IUGR pregnancies.