Resistive Index Research Articles

Kangaroo Mother Care: A Low-cost Intervention for Improving Cerebral Hemodynamics in Preterm Babies

Background Kangaroo mother care (KMC) has been utilized extensively for the care of infants with low birth weight and babies born prematurely. However, changes in cerebral blood flow (CBF) during KMC interventions are not known clearly. Hence, this study was done, in clinically stable premature babies, to study the changes in cerebral hemodynamics after KMC sessions. Methods It was a prospective study, done without a control group, with a pre-post test design. In our study, an assessment of 104 stable preterm newborns was done, before and after KMC. CBF parameters, which included mean velocity (MV), resistive index (RI) and pulsatility index (PI) were assessed using doppler ultrasonography in middle cerebral artery. Results Both PI and RI were found to be significantly decreased after KMC sessions. Their values, before and after KMC, were 2.06 ± 0.83 versus 1.67± 1.06 ( p value .04) and 0.88 ± 0.27 versus 0.75 ± 0.37 ( p value .04), respectively. On the other hand, MV of blood flow was found to be increased after KMC (33.47 ± 18.16 vs. 40.46 ± 19.49; p value .01). Thus, there is an increase in CBF parameters after KMC. Conclusion There is an increase in CBF after providing KMC, thereby having a positive influence on the structure and development of the premature infant’s brain.

ГЕМОДИНАМИКА ГОЛОВНОГО МОЗГА У НОВОРОЖДЕННЫХ ОТ МАТЕРЕЙ С ФЕТОПЛАЦЕНТАРНОЙ НЕДОСТАТОЧНОСТЬЮ

Objective. To determine the state of brain structures and blood flow parameters in the ventricular system in newborns whose mothers suffered from placental insufficiency using neurosonography and Doppler ultrasound. Material and methods. The study involved 96 newborns from mothers with placental insufficiency (the main group) and 30 healthy newborns (the control group). The diagnostic tools included a neurosonographic assessment of the anterior and middle cranial fossae, as well as Doppler ultrasound of the anterior and middle cerebral arteries, vein of Galen blood flow velocity assessment, systolic/diastolic ratio (S/D), resistive index (Ri) and pulsatility index (PI). Results. The comparative analysis of blood flow in the anterior cerebral artery and the vein of Galen did not reveal statistically significant differences between the main and control groups. While examining the middle cerebral artery, despite the absence of statistically significant differences in blood flow velocities compared with the control group, resistive index (Ri), pulsatility index (Pi) and systolic/diastolic ratio (S/D) showed statistically significant differences. This indicates increased vascular resistance in newborns from the main group. Conclusion. It is essential to combine Doppler ultrasound and neurosonography in order to make an objective assessment of the state of the newborns central nervous system from mothers with placental insufficiency. The study revealed impairment of hemodynamics in the middle cerebral arteries pool in newborns from the main group. To assess cerebral hemodynamics, it is preferable to use the Ri, Pi and S/D indices.

The value of renal color Doppler ultrasound as an objective tool in the diagnosis of renal affection in SLE patients

BackgroundSystemic lupus erythematosus (SLE) is an autoimmune disease with diverse manifestations, which resembles a clinical challenge to be managed. Lupus nephritis is a life-threatening condition as about 10% of patients develop chronic kidney disease.Aim of the workTo assess the role of resistive index (RI) as a noninvasive parameter in detecting renal affection in SLE patients.ResultsA case–control study included 3 matched groups: 30 patients, 15 SLE with no renal affection, and 15 SLE lupus nephritis patients, who were selected, diagnosed according to ACR criteria 2019 for SLE, beside 15 age- and gender-matched healthy controls without any risk factors of chronic diseases. Written informed consent was obtained from all the three groups, and the study was approved by ethical committee. There was a statistically significant increase in both SLEDAI and renal SLEDAI scores, serum BUN, creatinine, urinary pus cells, RBCs, casts and proteins, 24-h urinary proteins, and protein/creatinine ratio beside a statistically significant increase in both right and left resistive indices in the group of lupus nephritis than the other group. There was highly statistically significant difference between SLE without nephritis and SLE with nephritis regarding renal echogenicity. There was statistically significant positive correlation between average RI and SLEDAI, rSLEDAI, serum creatinine, BUN, 24-h urinary proteins, protein/creatinine ratio, and renal echogenicity. Relation between renal echogenicity and demographic, laboratory, and clinical data was highly statistically significant with rSLEDAI, serum creatinine, BUN, 24-h urinary proteins, and P/C ratio. Our study highlighted that the best cutoff point of Rt average RI to detect SLE with nephritis group was found > 0.68 with sensitivity of 86.7% and specificity of 100.0%, while the best cutoff point of left average RI to detect SLE with nephritis group was found > 0.7 with sensitivity of 80.0% and specificity of 100.0%.ConclusionRenal RI is a noninvasive technique that can be used for detection renal disease activity in SLE patients, together with renal parenchymal echogenicity by grayscale US.

Artificial gravity: an effective countermeasure for microgravity-induced headward fluid shift?

Long-duration spaceflight is associated with pathophysiological changes in the intracranial compartment hypothetically linked to microgravity-induced headward fluid shift. This study aimed to determine whether daily artificial gravity (AG) sessions can mitigate these effects, supporting its application as a countermeasure to spaceflight. Twenty-four healthy adult volunteers (16 men) were exposed to 60 days of 6° head-down tilt bed rest (HDTBR) as a ground-based analog of chronic headward fluid shift. Subjects were divided equally into three groups: no AG (control), daily 30-min intermittent AG (iAG), and daily 30-min continuous (cAG). Internal carotid artery (ICA) stroke volume (ICASV), ICA resistive index (ICARI), ICA flow rate (ICAFR), aqueductal cerebral spinal fluid flow velocity (CSFV), and intracranial volumetrics were quantified at 3 T. MRI was performed at baseline, 14 and 52 days into HDTBR, and 3 days after HDTBR (recovery). A mixed model approach was used with intervention and time as the fixed effect factors and the subject as the random effect factor. Compared with baseline, HDTBR was characterized by expansion of lateral ventricular, white matter, gray matter, and brain + total intracranial cerebral spinal fluid volumes, increased CSFv, decreased ICASV, and decreased ICAFR by 52 days into HBTBR (All Ps < 0.05). ICARI was only increased 14 days into HDTBR (P < 0.05). Neither iAG nor cAG significantly affected measurements compared with HDTBR alone, indicating that 30 min of daily exposure was insufficient to mitigate the intracranial effects of headward fluid shift. Greater AG session exposure time, gravitational force, or both are suggested for future countermeasure research.NEW & NOTEWORTHY Brief exposure to continuous or intermittent artificial gravity via short-arm centrifugation was insufficient in mitigating the intracranial pathophysiological effects of the headward fluid shift simulated during head-down tilt bed rest (HDTBR). Our results suggest that greater centrifugation session duration, gravitational force, or both may be required to prevent the development of spaceflight-associated neuro-ocular syndrome and should be considered in future ground-based countermeasure studies.

Characteristics of pulse wave velocity and its correlation with cardiovascular disease risk factors in healthy individuals.

Cardiovascular disease (CVD) is a major cause of human mortality and has become the leading cause of death worldwide. Existing studies indicate that structural and functional damage to the main arteries represents a significant risk factor for early vascular lesions and many CVDs. This study aimed to explore characteristics of carotid-femoral pulse wave velocity (cfPWV) and its correlation with cardiovascular disease risk factors in healthy individuals. Convenience sampling was used to collect demographics, risk factors, and laboratory examinations from 501 healthy individuals who underwent health checkups at our healthcare center from August 2020 to January 2021. Pearson correlation coefficients were used to examine the correlations between cfPWV and various parameters in both sexes. Multiple linear regression analysis was used to investigate the factors potentially influencing cfPWV. A statistically significant difference in cfPWV between sexes was observed only in the age group of subjects 38-47 years old. The results of the univariate analysis showed that in males, cfPWV was positively correlated with age, blood pressure, heart rate, and alcohol consumption and was negatively correlated with tehe resistive index. In females, cfPWV was positively correlated with age, blood pressure, heart rate, alanine aminotransferase, urea, creatine, uric acid, fasting blood glucose, triglycerides, total cholesterol, and heart rate. The results of multivariable analysis indicated that age, systolic blood pressure, heart rate, and alcohol consumption were influencing factors for cfPWV in males, while age, systolic blood pressure, heart rate, and creatinine were influencing factors for cfPWV in females (P <0.05 for all). In healthy individuals, the distribution patterns of cfPWV values vary by sex and age. In the elderly population, especially elderly women, enhanced monitoring and regular follow-ups are recommended to prevent the development and progression of CVDs in high-risk individuals at an early stage.

Effect of low-dose aspirin on mid-luteal phase uterine Artery blood flow in women with unexplained recurrent pregnancy loss

Objectives: As a possible therapy for recurrent pregnancy loss, this study sought to ascertain if low-dose aspirin was effective in increasing uterine artery blood flow. Study Design: This investigation was structured as a single-arm clinical trial Patients and Methods: All participants were aged 39 years or younger and had no prior or current indications of abnormal glucose tolerance, thyroid dysfunction, hyperprolactinemia, or Antiphospholipid antibody syndrome. Bilateral assessments of the Systolic/Diastolic (S/D) ratio, Resistive Index (RI), and Pulsatility Index (PI) were conducted in the chosen patients in the mid-luteal phase, before to and following a minimum of two weeks of low-dose aspirin administration. Results: The results of this investigation showed significant variation in the S/D and PI prior to and following aspirin administration. There was no discernible shift in RI. The analysis revealed a statistically significant reduction in uterine artery PI after aspirin administration (1.92±0.29) compared to the pre-treatment value (2.22±0.27), with a p-value of 0.0001. Remarkably, the pulsatility indices of the left and right uterine arteries did not significantly differ from one another. Conclusion: For women who have a history of miscarriages, low-dose aspirin can be recommended as an adjuvant therapy as it effectively improves uterine artery blood flow in these patients. However, more well-designed research is required to ascertain whether improved pregnancy outcomes are correlated with improved uterine perfusion. The current study supported the aspirin guideline for women with a history of recurrent miscarriages by showing that aspirin treatment resulted in a reduction in uterine artery PI.

Longitudinal assessment of transcranial Doppler imaging in children with sickle cell disease without neurological symptoms

IntroductionStroke is one of the most devastating complications of sickle cell disease (SCD). Transcranial Doppler Imaging (TCDI) is the least invasive screening method to predict patients at risk for developing stroke in the disease. After a 10-year follow-up, we longitudinally assessed the TCDI in children with SCD without neurological symptoms.Methods25 out of 43 pediatric patients with SCD studied 10-year previously were recruited. The remaining 18 patient were not available for follow-up, but their initial data are presented for comparison. TCDI scanning was carried out using a phased-array transducer of 1–3 MHz through the trans-temporal window. Peak systolic velocity (PSV), end-diastolic velocity (EDV), time-averaged mean of the maximum velocity (TAMMV), resistive index (RI), and pulsatility index (PI) were obtained in the anterior and posterior Circle of Willis vessels.ResultsThe highest initial and follow-up TAMMV (mean ± SD) were: 77.3 ± 20.9 and 71.6 ± 9.9 in the t-ICA, 94.3 ± 25.8 and 82 ± 18.2 in the MCA, 76.6 ± 25.6 and 70.6 ± 10.7 in the ACA, and 59.1 ± 15.8 and 63.9 ± 8.5 in the PCA, respectively. There was no statistically significant difference between initial and follow-up SCD data for all vascular parameters in all vessels on each side (P > 0.05) except for RI and PI (P < 0.05). There was significant correlation between TAMMV, PSV, and EDV (P = 0.001).ConclusionThere are no absolute Doppler velocity changes between the initial and follow-up period over the years. There is a possibility that PSV and EDV could be used in parallel with TAMMV Subclinical vascular degeneration is not suggested by these vascular measures.

Gross morphological and ultrasonographic dimensions of normal feline kidney with reference to resistive index

Ultrasonography with color Doppler is the most quantitative analysis method for intra-renal parameters. There is a wide variation between authors in the measurement site and referencing the inter-lobar resistivity index (RI) in felines. Our objective is to morphometrically and ultrasonographically investigate the normal renal dimensions and vasculatures and draw up a normal reference value for the renal inter-lobar artery resistivity index (RI) using a Pulsed wave-Doppler ultrasonography. A total of twelve adult domestic cats were sedated and treated according to IACUC regulation guidelines to be examined using Doppler ultrasound. The same cats were used for morphometric investigation and divided into three groups regarding the used technique. The size difference between the right and left kidneys is slight, measuring 17 g (weight), 3.65 ± 0.06 cm (length), 2.54 ± 0.08 cm (width), and 2.21 ± 0.03 cm (thickness) for the right kidney, and about 15 g, 3.42 ± 0.06 cm, 2.32 ± 0.05 cm, and 2.13 ± 0.03 cm for the left one, respectively. There are three patterns of renal arteries’ point of origin. The mean RI values of both kidneys were 0.57 ± 0.08 (0.50–0.67) in the right kidney and 0.60 ± 0.08 (0.51–0.69) in the left kidney. The gross examination and ultrasonography measurements did not have a statistically different effect on the actual renal dimensions. Moreover, 0.69 is considered the standard resistivity index (RI) threshold of the feline inter-lobar artery with no correlation to the animal’s body weight.

High-frequency ultrasound for assessing the renal characteristics of spontaneous type 2 diabetes mellitus db/db mice.

There are few ultrasonographic studies on the spontaneous T2DM db/db mouse. Our objective was to dynamically investigate and assess renal morphological and hemodynamic changes in spontaneous type 2 diabetes mellitus db/db mice through high-frequency ultrasound. Eighteen male db/db mice (the model group) and twelve male db/+ mice (the control group) were included. Body weight and fasting blood glucose were measured at the ages of 8, 16 and 32 weeks. High-frequency ultrasound examinations were conducted at the same ages. Compared with those in the control group, H&E and Masson staining revealed pathological changes in the renal tissue of the db/db mice at 16 weeks of age, and the lesions were significantly aggravated at 32 weeks of age. The body mass of the mice in the model group increased significantly at 8, 16 and 32 weeks of age, and the kidney volume measured by ultrasound also increased with age. Compared with those of the control group, the blood flow scores determined via power Doppler were significantly different. The peak systolic velocity (PSV), end diastolic velocity (EDV), and resistive index (RI) of the renal artery and the PSV, EDV, and RI of the segmental artery were significantly different at the 16th week compared with those that at the eighth week. The results of high-frequency ultrasound revealed that the renal hemodynamics of db/db mice changed at the sixteen weeks.

Shear-Wave Elastography Improves Diagnostic Accuracy in Chronic Kidney Disease Compared to Conventional Ultrasound.

Non-invasive tests are increasingly demanded for diagnosing and prognostication of chronic kidney disease (CKD). Shear-wave elastography (SWE), an emerging technique for measuring tissue stiffness, shows promise for distinguishing between individuals with different stages of renal fibrosis. This study aimed to compare the diagnostic accuracy of two-dimensional SWE (2D-SWE) and conventional ultrasound for detecting CKD, employing renal biopsy as the gold standard. From May 2020 to October 2023, this prospective study included 30 healthy volunteers and 169 patients with CKD who had undergone 2D-SWE and conventional ultrasound of both kidneys. Cortical and medullary stiffness, cortical pixel intensity, renal length, parenchymal and cortical thickness, interlobar artery peak systolic velocity, end-diastolic velocity (EDV), and resistive index were measured. The diagnostic accuracy of 2D-SWE and conventional ultrasound was compared using the receiver operating characteristic curve (ROC) and Delong test. For diagnosing CKD, the area under the ROC (AUC) of cortical stiffness (0.96 [95% CI, 0.93, 0.99]) was significantly higher than that of all conventional ultrasound parameters, including EDV (0.78 [95% CI, 0.71, 0.86]) and cortical thickness (0.74 [95% CI, 0.67, 0.80]). The sensitivity of cortical stiffness (91%) was significantly higher than that of EDV (68%) and cortical thickness (53%). No significant difference was found in the specificity of cortical stiffness (96%) compared to that of EDV (79%) and cortical thickness (100%). Two-dimensional SWE showed higher diagnostic accuracy than that of conventional ultrasound for detecting CKD.

Administration of melatonin nanoparticles improves testicular blood flow, echotexture of testicular parenchyma, scrotal circumference, and levels of estradiol and nitric oxide in prepubertal ossimi rams under summer heat stress.

Environmental heat stress (HS) impairs reproductive efficiency in farm animals. This study investigated, for the first time, how the melatonin and melatonin nanoparticles treatment affected the testicular hemodynamics, testicular volume, echotexture [Pixel intensity (PIX) and integrated density (IND)], scrotal circumference, serum concentration of testosterone (T), estradiol (E2), nitric oxide (NO), and total antioxidant capacity (TAC) in prepubertal Ossimi ram lambs in hot climatic conditions. The lambs undergoing examination had a temperature humidity index (THI) of 87.05 ± 1.70, indicating severe HS condition. Fifteen prepubertal Ossimi ram lambs were exposed to a single s.c injection of either nano melatonin (nano melatonin group; 20mg/ram; n = 5) or melatonin suspended in two ml of corn oil (melatonin group; 40mg/ram; n = 5) or two ml of corn oil (control group; n = 5). Blood collection and ultrasonographic assessment of the testes and supratesticular arteries (STAs) were conducted immediately before treatment (W0) and once weekly for six successive weeks after nano melatonin and melatonin injection (W1-W6). Results revealed decreases (P < 0.05) in the Doppler indices (resistive index; RI and pulsatility index; PI) of the testicular arteries at most time points of the study in the nano melatonin and melatonin groups. PIX of testicular parenchyma was significantly increased (P ˂ 0.05) in the treated groups compared to the control one. IND of testicular parenchyma increased significantly in the nano melatonin group compared to the melatonin and control groups. Testicular volume and scrotal circumference significantly increased (P < 0.05) in nano melatonin and melatonin groups compared to the control one. T concentration did not significantly (P > 0.05) change in the treated groups compared to the control group. E2, NO, and TAC concentrations increased (P < 0.05) in the treated groups compared to the control one. In conclusion, this study extrapolated that administrations of melatonin or nano melatonin can ameliorate the effects of environmental HS in prepubertal Ossimi ram lambs with a more protective effect and lower dose of nano melatonin.

Assessment of renal artery stenosis using renal fractional flow reserve and correlation with angiography and color Doppler ultrasonography: data from FAIR-pilot trial.

Renal fractional flow reserve (rFFR), a hemodynamic evaluation indicator for functional measurement, could be used for the detection of significant renal artery stenosis (RAS). In this study, we evaluated the correlation between color Doppler ultrasonography (CDU), angiography and rFFR in assessing RAS and to validate cut-off points of ultrasound parameters for significant RAS with rFFR<0.8. A total of 77 renal artery lesions from 58 patients with at least unilateral RAS were included into this study. All patients were participated in Fractional Flow Reserve to Determine the Appropriateness of Percutaneous Renal Artery Intervention in Atherosclerosis Renal Hypertension Patients (FAIR)-pilot study (NCT05732077). The rFFR was measured through a pressure wire after renal hyperemia induced by dopamine. Peak systolic velocity (PSV), renal-to-aortic ratio (RAR), resistive index (RI) and side-to-side differences of the intrarenal resistive indices (ΔRI) were obtained by CDU. The rFFR showed good correlation with both CDU and angiography assessment methods. Among CDU parameters, the best correlation was observed in rFFR with PSV (rho = -0.668, P < 0.0001) and RAR (rho = -0.597, P < 0.001). With a rFFR<0.80 as cut-off value for significant RAS, we computed sensitivity, specificity, and area under the curve (AUC) of CDU parameters. The most predicting cut-off points of CDU parameters were calculated as PSV for 2.415 m/s, RAR for 4.495, RI for 0.605 and ΔRI for 0.04, respectively. A PSV > 2.415 m/s provided a sensitivity of 90%, specificity of 75%, accuracy of 81% and AUC of 0.84 for detecting RAS with rFFR<0.8.

Resistive index of central retinal artery, aortic arterial stiffness and OCTA correlated parameters in the early stage of fabry disease

This study aimed to evaluate the impact of Fabry disease (FD) on retinal microvasculature using optical coherence tomography angiography (OCTA), arterial stiffness, and the resistive index (RI) of the central retinal artery (CRA) in early disease stages. Twenty-nine genetically confirmed FD patients and twenty-six healthy controls were enrolled. Vessel density (VD) values of the superficial, deep, and choriocapillaris plexuses (SCP, DCP, and CC) were measured via OCTA. CRA RI was studied using color Doppler and grayscale sonography, and aortic pulse wave velocity (PWV) was assessed with the Complior method. CRA RI was significantly lower in the control group compared to the Fabry group (p < 0.001). Central VD was found to be significantly higher in the control group compared to the Fabry group in all the retinal layers (SCP (p < 0.001), DCP (p < 0.005), CC (p < 0.001)). PWV was significantly higher in the Fabry group than in the control group (p = 0.03). Fabry disease patients demonstrate elevated arterial stiffness, increased CRA RI, and diminished retinal microvascular density compared to healthy controls, indicating early ocular damage. Continuous monitoring and targeted screening for organ impairment are crucial in FD management. Identifying biomarkers for assessing ocular vascular involvement and treatment response is imperative. Further research is needed.

A Study of Fibroid Vascularization and Vascular Indices With Three-Dimensional Power Doppler and Superb Microvascular Imaging and the Correlation With Heavy Menstrual Bleeding.

Objective The objective of the study was to evaluate fibroid vascularization and vascular indices with three-dimensional (3D) power Doppler and superb microvascular imaging (SMI) and its correlation with heavy menstrual bleeding (HMB). Material and methods A total of 75 women with intramural uterine fibroid: 50 with HMB (Group A) and 25 without HMB (Group B)were recruited for the study. All participants were subjected to transabdominal and transvaginal color Doppler ultrasound. A 3D Power Doppler was used to measure Doppler Indices and flow rate in uterine arteries and the dominant vessel of fibroid. SMI was also used to determine vascularity in the dominant fibroid and to grade the vascularity. Results A significant association was observed between Doppler indices in the dominant feeding vessel of fibroid and HMB. Flow rates, namely peak systolic velocity (PSV) and end-diastolic velocity (EDV) were significantly higher. Contrarily, resistance measured as Resistive Index (RI) and Pulsatility Index (PI) was lower in Group A than in Group B. The mean PSV of the dominant feeding vessel in group A was 26.42 ± 4.57and in group B was 14.56 ± 3.17, with p-value < 0.0001. For EDV, the median value (25th-75th percentile) in women with HMB was 6.76 (6.152-8.74) vs 3.99 (3.2-5.95)in womenwithout HMB (p < 0.0001). A significant association was observed between uterine artery Doppler indices (specifically, PSVand EDV) and HMB. However, no significant association was found between RI and PI of the uterine artery and HMB. In the study of the vascular pattern on SMI, the percentage of women exhibiting both central and peripheral vascularity in Group A and Group B were 72% and 4%, respectively (p< 0.0001). Women in Group A showed a significantly higher proportion of grade 2 and grade 3 vascularity (76% and 20%, respectively), whereas only 4% showed grade 1 vascularity. Conversely, in Group B, all the women showed grade 1 vascularity (p <0.001). Conclusion Doppler indices in the dominant feeding vessel of fibroid show a positive correlation with HMB. In the study of the vascular pattern on SMI, a significant proportion of women with HMB exhibited both peripheral and central vascularity and a higher grade. Most women with symptomatic fibroids are of childbearing age and fertility preservation is at times their prime concern. Fibroid vascularization assessed with 3D power Doppler ultrasound and the new advanced SMU tool may prove to be useful in the prediction of response to various non-surgical management options of uterine leiomyoma and thus aid in counseling and appropriate patient selection.

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.

Blood Flow of the Infraspinatus Muscle in Individuals With and Without Shoulder Pain and Myofascial Trigger Points: A Color Doppler Ultrasound and Reliability Study.

Myofascial trigger points (MTrPs) are potential contributors to shoulder pain and can lead to local ischemia and hypoxia, thus causing pain. Color Doppler ultrasound (US) has been used to examine the vascular environment around MTrPs, but has not been used to examine blood flow impairments in patients with shoulder pain and MTrPs. The reliability of color Doppler US for measuring infraspinatus muscle blood flow also has not been established. This study aimed to investigate differences in blood flow between individuals with and without shoulder pain and the reliability of Doppler US for measuring infraspinatus muscle blood flow. Forty participants were enrolled, 20 with shoulder pain and MTrPs and 20 without. Color Doppler US examination was performed twice on each participant to measure peak systolic velocity (PSV), end-diastolic velocity (EDV), resistive index (RI), and pulsatile index (PI) of the infraspinatus muscle. The symptomatic participants had significantly higher PSV (ie, impaired blood flow) than the asymptomatic participants. There were no significant between-group differences in EDV, RI, and PI. The results also demonstrated good-to-excellent intra-rater reliability for color Doppler US measurements of PSV, EDV, RI, and PI for both groups. This study demonstrated differences in blood flow near MTrPs in the infraspinatus muscle between individuals with and without shoulder pain. It also established good-to-excellent reliability of color Doppler US in measuring infraspinatus muscle blood flow. These findings suggest color Doppler US is a useful tool to identify vascular impairments for shoulder pain associated with MTrPs.

Does the resistive index of the radial artery change after arterial cannulation in patients undergoing abdominal surgery? A prospective observational study.

To evaluate the flow at the cannulation site in the radial artery, the resistive indices (RIs) before cannula insertion and 6 h after decannulation were measured (primary outcome). The secondary outcomes were measurement of the artery size by anteroposterior (AP) diameter at the insertion site, RI and AP diameter at a point 4 cm proximal and in the ipsilateral ulnar artery before insertion and 6 h after cannula removal. In 96 patients requiring an arterial line during surgery, peak systolic velocity (PSV) and end-diastolic velocity (EDV) were measured to derive RI using a linear ultrasound transducer. The RI was measured at R1 (insertion point), R2, 4 cm proximal to R1, and U1 on the ipsilateral ulnar artery. The AP diameter of the arteries at baseline R10, R20 and U10 was measured and repeated 6 h after removal of the cannula, R16, R26 and U16. RI or AP diameter in R1 or R2 did not differ pre- and post-cannulation. Mean R10 1.143 [standard deviation (SD: 0.239)] versus R16 1.181 (SD: 0.260) m/sec [mean difference (MD): -0.0372 (95% confidence interval (CI): -0.098, 0.023), P = 0.230]. Mean AP diameter at baseline versus 6 h decannulation 0.177 (SD: 0.042) versus 0.172 (SD: 0.045) cm [MD: 0.005 (95% CI: 0.003, 0.013), P = 0.222] was also similar. The mean PSV in U10 versus U16 was higher: 0.480 (SD: 0.178) versus 0.528 (SD: 0.316) m/sec [MD: 0.120 (95% CI: -0.185, -0.054), P = 0.002] and AP diameter was also higher than baseline (P = 0.001). The flow in the radial artery did not change following cannulation. The PSV and AP diameter in the ulnar artery increased after decannulation, suggesting a compensatory increase in flow.

Correlation Between Serum Markers and Midluteal Phase Doppler Assessment of Uterine Arterial Blood Flow in Unexplained Recurrent Pregnancy Loss.

This study aimed to determine changes in uterine artery Doppler parameters in unexplained recurrent pregnancy loss (URPL) and to explore serum markers possibly associated with them. This retrospective case-control study included 107 URPL women and 107 control women. The mean pulsatility index (PI), resistive index (RI), and systolic-to-diastolic values for uterine arteries in URPL women were significantly higher than those in the controls (P < 0.05). The cutoff values of PI and RI differentiating the women with URPL from the controls were confirmed by ROC and Youden's index. Given a PI cutoff value of 2.6, the prevalence of URPL was significantly elevated in the high-PI group (74.58%) compared with that in the low-PI group (40.65%, P < 0.0001), with sensitivity and specificity of 63% and 69%, respectively. With an RI cutoff value of 0.86, the prevalence of URPL in the high-RI group (65.28%) was significantly elevated compared with that in the low-RI group (42.25%, P = 0.001), with sensitivity and specificity of 66% and 75%, respectively. The levels of serum D-dimers and anticardiolipin antibody (ACA)-IgM in URPL women were significantly higher than those in the controls. A positive correlation existed between the levels of ACA-IgM and uterine artery RI in URPL women (r = 0.43, P < 0.01). These results indicated that URPL women may be at a relatively high risk of a prothrombotic state, and the increased ACA-IgM deserves attention for its role in the elevated uterine artery Doppler parameters in URPL women.

Ultrasonographic Assessment of Testicular Biometry and Arterial Blood Flow in Pre- and Postpubertal Miranda Donkeys: Correlations With Semen Quality Parameters.

The main goals of this study were to document and compare the normal ranges of testicular haemodynamic parameters in pre- (aged 8-12 months; n = 4) and postpubertal (aged 24-259 months; n = 16) Miranda donkeys in the breeding season, and to correlate animal biometric data and testicular Doppler indices with basic semen quality parameters of sexually mature jacks. Colour and pulsed-Doppler ultrasonography were employed to assess blood flow in the left and right distal supratesticular artery (DsTA) and their marginal branches (marginal arteries-MA). Peak systolic velocity (PSV), end diastolic velocity (EDV), pulsatility index (PI) and resistive index (RI) were evaluated in both blood vessels, and TAMV (time-averaged mean velocity), TABF (total arterial blood flow) and TABF rate (TABF-R) were calculated for MA. The mean diameter of MA was greater (p < 0.05; 0.24 ± 0.05 vs. 0.19 ± 0.05 cm; mean ± SD) but TABF-R was less (p < 0.05; 0.004 ± 0.004 vs. 0.02 ± 0.01 mL/s/cm3) in sexually mature donkeys compared with prepubertal animals. Apart from RI values for the right testicle of prepubertal donkeys, PI and RI were consistently greater (p < 0.05) in DsTA compared with MA. Significant correlations were found among select biometric and haemodynamic attributes of the testes (height, width and length, TV, TTV and PSV-ST) and ejaculate characteristics (volume, sperm defects-total, head and midpiece) in sexually mature donkeys (n = 8). The present results highlight the importance of scrotal ultrasonography for the reproductive assessment of jacks and provide reference values, based on the available subpopulation of Miranda donkeys that can be used in their clinical and reproductive management and research, or conservation programmes.

Doppler Evaluation of Uterine Blood Flow in Patients with Unexplained Recurrent Pregnancy Loss.

This study aimed to analyze uterine artery and spiral artery hemodynamics in patients with unexplained recurrent pregnancy loss (URPL) with varying pregnancy outcomes. 174 pregnant women with URPL and 144 pregnant women without adverse pregnancy histories were enrolled in this retrospective study. Based on pregnancy outcomes, these patients were divided into two groups: normal pregnancy outcomes (URPL-N, n=138) and adverse pregnancy outcomes (URPL-A, n=36). Control group participants were categorized into normal pregnancy outcomes (CON-N, n=129) and adverse pregnancy outcomes (CON-A, n=15). We compared uterine artery and spiral artery hemodynamics during different stages of gestation and the predictive value of these parameters for pregnancy outcomes. URPL-N group had fewer pregnancy losses and lower BMI compared to URPL-A group (P< 0.05). Spiral artery hemodynamics in URPL-N and CON-N groups were lower than those in URPL-A and CON-A groups during the mid-luteal phase, 11-13weeks, 15-17weeks, and 19-21weeks of gestation, respectively. Uterine artery hemodynamics ((Pulsatility index (mPI), resistive index (mRI), and systolic-to-diastolic ratio (mS/D)) in the mid-luteal period were lower in URPL-N group than URPL-A group. Similarly, in CON-N group were lower than CON-A group. The URPL-A and CON-A groups had higher uterine artery and spiral artery hemodynamics when compared to the URPL-N and CON-N groups. Spiral artery hemodynamics exhibited larger areas under the ROC curve compared to uterine artery parameters. Abnormal hemodynamics in these arteries may contribute to URPL and adverse pregnancy outcomes. Spiral artery hemodynamics are more reliable predictors of pregnancy outcomes than uterine artery parameters.