Significant Differences In Peak Systolic Velocity Research Articles

A Comparative Study of Transcranial Color-Coded Doppler (TCCD) and Transcranial Doppler (TCD) Ultrasonography Techniques in Assessing the Intracranial Cerebral Arteries Haemodynamics.

Cerebrovascular disease (CVD) poses a major public health and socio-economic burden worldwide due to its high morbidity and mortality rates. Accurate assessment of cerebral arteries' haemodynamic plays a crucial role in the diagnosis and treatment management of CVD. The study compared a non-imaging transcranial Doppler ultrasound (TCD) and transcranial color-coded Doppler ultrasound (with (cTCCD) and without (ncTCCD)) angle correction in quantifying middle cerebral arteries (MCAs) haemodynamic parameters. A cross-sectional study involving 50 healthy adults aged ≥ 18 years was conducted. The bilateral MCAs were insonated via three trans-temporal windows (TTWs-anterior, middle, and posterior) using TCD, cTCCD, and ncTCCD techniques. The MCA peak systolic velocity (PSV) and mean flow velocity (MFV) were recorded at proximal and distal imaging depths that could be visualised on TCCD with a detectable spectral waveform. A total of 152 measurements were recorded in 41 (82%) subjects with at least one-sided open TTW across the three techniques. The mean PSVs measured using TCD, ncTCCD, and cTCCD were 83 ± 18 cm/s, 81 ± 19 cm/s, and 93 ± 21 cm/s, respectively. There was no significant difference in PSV between TCD and ncTCCD (bias = 2 cm/s, p = 1.000), whereas cTCCD yielded a significantly higher PSV than TCD and ncTCCD (bias = -10 cm/s, p < 0.001; bias = -12 cm/s, p ≤ 0.001, respectively). The bias in MFV between TCD and ncTCCD techniques was (bias = -0.5 cm/s; p = 1.000), whereas cTCCD demonstrated a higher MFV compared to TCD and ncTCCD (bias = -8 cm/s, p < 0.001; bias = -8 cm/s, p ≤ 0.001, respectively). TCCD is a practically applicable imaging technique in assessing MCA blood flow velocities. cTCCD is more accurate and tends to give higher MCA blood flow velocities than non-imaging TCD and ncTCCD techniques. ncTCCD is comparable to non-imaging TCD and should be considered in clinical cases where using both TCD and TCCD measurements is needed.

Effect of delayed cord clamping on cerebral hemodynamics in preterm infants

BackgroundUnstable cerebral hemodynamics is an important cause of intracranial hemorrhage in premature infants. The increased blood flow of delayed cord clamping (DCC) compared to immediate cord clamping (ICC) is equivalent to 1/3-1/4 of newborn blood volume. Our objective was to assess whether the increased blood flow causes fluctuations in cerebral blood flow and how. MethodsThis experiment was a prospective, observational study. Neonatologists selected preterm infants eligible for inclusion and exclusion, and divided them into DCC group and ICC group according to the way of umbilical cord ligation performed by obstetrics department, and matched them 1:1 according to gestational age. The peak systolic velocity （PSV) ，end diastolic velocity (EDV)，and resistance index (RI) of middle cerebral artery was measured by Mindray M9 color ultrasonic diagnostic instrument within 1 h, 24±1 h, 48±1 h, 72±1 h, respectively. ResultsThere was no significant difference in PSV, EDV and RI in middle cerebral artery between DCC group and ICC group (P > 0.05). There were no significant differences between groups and time (P > 0.05). The hemoglobin and hematocrit in DCC group were higher than those in ICC group within 2 h after birth (P < 0.05). (P > 0.05). ConclusionDCC can increase hemoglobin and hematocrit in preterm infants, but does not cause cerebral blood flow fluctuation within a certain range. DCC is a safe method of placental transfusion.

Ocular pulse amplitude and hemodynamic in controlled asymmetric glaucoma: a cross-sectional study

Purpose: The aim of this study was to explore the relationship between glaucoma severity, ocular pulse amplitude (OPA), and hemodynamic variables.&#x0D; Methods: Thirty-one Asymmetric primary open-angle glaucoma (POAG) cases (one eye with better MD, fellow eye with worst MD) who applied to the glaucoma outpatient clinic of Gulhane Military Medical Faculty Hospital between January 1, 2006, and June 30, 2007, were included in this cross-sectional study. Patients using beta-blockers or alpha-adrenergic agonists were excluded. The patients went on using glaucoma medications. Asymmetricity was assessed if a visual field means deviation (MD) difference ≥6 decibels existed between the eyes. Mean MD and pattern standard deviation, diurnal OPA, and intraocular pressure( IOP) (7 am, 9 am, 11 am, 1 pm, 3 pm, 5 pm, 7 pm, 9 pm,11 pm, 1 am, 4 am), central corneal thickness, peak systolic velocity (PSV), end-diastolic velocity (EDV), PSV/EDV, pulsatility index (PI), resistivity index (RI) for internal carotid artery and ophthalmic artery were measured with color Doppler ultrasonography.&#x0D; Results: The differences in mean diurnal IOP and mean diurnal OPA between the eyes were statistically insignificant. Each diurnal IOP and OPA values and coefficient of variability of diurnal IOP and OPA were statistically insignificant between the groups. There was no significant difference in PSV, EDV, PSV/EDV, PI, and RI between the better-MD and worse-MD eyes. The correlations between mean IOP/mean OPA, and each diurnal IOP/OPA values were insignificant.&#x0D; Conclusion: These results suggest that ocular hemodynamics are affected after a critical point in the evolution of glaucoma. The severity of glaucoma is not directly related to pulsatile ocular blood flow.

Effect of delayed cord clamping and umbilical cord milking on cerebral hemodynamics in preterm infants: a randomized double-blind controlled trial

Objective To compare the effect of delayed cord clamping (DCC) versus umbilical cord milking (UCM) on cerebral blood flow in preterm infants. Methods This was a single-center, prospective, double-blind, randomized controlled trial. A total of 46 preterm infants, with a gestational age of 30-33+6 weeks, who were born in Suining Central Hospital from November 2, 2018 to November 15, 2019 were enrolled and randomly divided into DCC group and UCM group, with 23 infants in each group. The primary outcome indexes included cerebral hemodynamic parameters[peak systolic velocity (PSV), end-diastolic velocity (EDV), and resistance index (RI)] measured by ultrasound within 0.5-1 hour, (24±1) hours, (48±1) hours, and (72±1) hours after birth. Secondary outcome indexes included hematocrit, hemoglobin, red blood cell count, and serum total bilirubin levels on the first day after birth and the incidence rate of intraventricular hemorrhage during hospitalization. Results A total of 21 preterm infants in the DCC group and 23 in the UCM group were included in the statistical analysis. There was no significant difference in PSV, EDV, and RI between the two groups at all time points after birth (P > 0.05). There was also no significant difference between the two groups in the hematocrit, hemoglobin, red blood cell count and total bilirubin levels on the first day after birth, and the incidence rate of intraventricular hemorrhage during hospitalization (P > 0.05). Conclusions DCC and UCM have a similar effect on cerebral hemodynamics in preterm infants with a gestational age of 30-33+6 weeks.

Difference between near-field and far-field of middle cerebral artery doppler pulsatility index and peak systolic velocity: a prospective study

Objective: We purposed to investigate the difference between near-field and far-field of PI (pulsatility index) and peak systolic velocity (PSV) of the middle cerebral artery (MCA) that are important in the management of fetal growth restriction and fetal anemia. Methods: This prospective study was conducted with 130 single uncomplicated pregnancies. Doppler was applied to near-and far-field of proximal MCA while PSV and PI were recorded and compared between two sides as well as according to body mass index (BMI) and gestational weeks of participants. Results: There was no statistically significant difference between near and far-fields of MCA PI (P = 0.75). However, a statistically significant difference in PSV was observed (P = 0.03), and this was especially noticeable in women with normal BMI (P = 0.009). On the other hand, there was no difference between MCA PI or PSV in women with a BMI higher than 25. Also, no significant difference was observed between groups, which were subcategorized according to gestational weeks. Conclusions: Our data suggest that the far-field PSV values may be higher than near-field MCA PSV values; sonographers should bear in mind that while far and near-field PSV can differ, conversely MCA PI can safely be assessed from both the near and far-fields of MCA in case of technical difficulty.

Characteristics of pleomorphic adenomas, adenolymphomas, and malignant tumors of the salivary glands on color doppler ultrasonography and contrast enhanced ultrasonography.

To provide a comprehensive description of the quantitative and qualitative characteristics of pleomorphic adenomas, adenolymphomas, and malignant tumors of the salivary glands on color doppler ultrasonography and contrast-enhanced ultrasonography (CEUS). 64 patients with 35 pleomorphic adenomas, 24 adenolymphomas, and 12 malignant tumors were enrolled in this study. All patients were examined by color doppler ultrasonography and CEUS before operation. In color Doppler ultrasonography, degree of vascularity, peak systolic velocity (PSV) and the vascular resistance index (RI) were obtained. In CEUS, type of enhancement, rim enhancement and area of enhancement were assessed. After the time-intensity curves (TIC) were drawn, the time to peak enhancement (TTP), peak intensity (PI) and the time from peak to one half (TFP) were calculated for the tumors and surrounding salivary parenchyma. Postoperatively, histopathologic examination of surgical specimens was used as the gold standard. Color Doppler ultrasonography showed no significant differences in PSV between tumors, significantly less adenolymphomas had Grade 0-1 vascularity compared to pleomorphic adenomas, and the RI was significantly lower in adenolymphomas compared to pleomorphic adenomas and malignant tumors. CEUS had acceptable diagnostic sensitivity, specificity, and accuracy for differential diagnosis of pleomorphic adenomas and adenolymphomas based on the diagnostic criteria of rim enhancement and slow wash-out rate, respectively. The sensitivity, specificity, and accuracy for differential diagnosis of malignant tumors based on the diagnostic criteria of an ill-defined enhancement margin, an enlarged enhancement area or a fast wash-in rate were also satisfactory. Accurate diagnosis of salivary gland tumors in clinical practice can be increased using color Doppler ultrasound and CEUS in combination with a case history and other imaging.

Doppler velocimetry in fetal rats exposed to enoxaparin and unfractionated heparin (UFH) during pregnancy.

To evaluate the effects of enoxaparin and unfractionated heparin (UFH) administered in prophylactic and therapeutic doses on fetal vessels in healthy pregnant Wistar rats, according to Doppler velocimetry measurements. Fifty animals were assigned to one of five groups: controls (saline), prophylactic and therapeutic enoxaparin (1 and 2 mg/kg/day, respectively), and prophylactic and therapeutic UFH (72 and 400 UI/kg/day, respectively). Uterine horns were examined by ultrasound for identification of live fetuses. A sample of these fetuses underwent Doppler velocimetry. Spectral curves, peak systolic velocity (PSV), pulsatility index (PI), and resistance index (RI) of the middle cerebral artery, ductus venosus, and umbilical artery were investigated. Differences were considered statistically significant when p<0.05. No significant differences in PSV, PI, or RI values were observed among the groups. Doppler velocimetry measurements revealed no significant effects of enoxaparin or unfractionated heparin on fetal vessels in pregnant Wistar rats.

The Optimal Velocity Criterion in the Diagnosis of Unilateral Middle Cerebral Artery Stenosis by Transcranial Doppler

We evaluated the optimal flow velocity of transcranial doppler (TCD) in detecting unilateral middle cerebral artery (MCA) stenosis and stenosis grading by magnetic resonance angiography (MRA) as the reference standard. 302 nonconsecutive patients with unilateral MCA stenosis detected by TCD underwent MRA of the intracranial arteries. The peak systolic velocity (PSV), mean flow velocity (MFV), and end-diastolic velocity (EDV) of each MCA were recorded. 604 MCA were categorized into four groups depending on the stenosis severity: normal MCA (n = 319, 52.8%), mild stenosis (n = 94, 15.6%), moderate stenosis (n = 66, 10.9%), and severe stenosis (n = 125, 20.7%). Significant differences in PSV, MFV, and EDV between these four groups were observed (P < 0.001, respectively). The optimal cutoff velocities for detecting MCA stenosis were: PSV = 160 cm/s, MFV = 100 cm/s, EDV = 60 cm/s; the optimal cutoff points to distinguish mild from moderate stenosis were: PSV = 200 cm/s, MFV = 120 cm/s, EDV = 80 cm/s; the cutoffs to distinguish moderate from severe stenosis were: PSV = 280 cm/s, MFV = 180 cm/s, EDV = 110 cm/s. Using PSV as the diagnostic criteria, the correlation for diagnosing MCA stenosis using TCD and MCA was good (Kappa number κ = 0.668); using as MFV criteria, κ = 0.641. The optimal cutoff PSV values in stenosis grading on TCD were 160, 200, and 280 cm/s. The optimal cutoff MFV values were 100, 120, and 180 cm/s. PSV is more accurate than MFV in detecting and grading MCA stenosis.

Intestinal Blood Flow by Doppler Ultrasound: The Impact of Gestational Age and Time from First Enteral Feeding in Preterm Neonates

To explore whether superior mesenteric artery (SMA) peak systolic velocity (PSV) on Doppler ultrasound varies by gestational age (GA) and time from first enteral feeding and has an impact on feeding intolerance. Preterm neonates were assigned to three GA groups at birth, group I: 31 to 356/7 weeks, group II: 27 to 306/7 weeks, and group III: ≤ 266/7 weeks. SMA PSV and clinical and feeding parameters were assessed before and after enteral feed, with the first enteral feed designated as time 1, time 2 = 1 to 4 days (after first feed), time 3= 5 to 7 days, time 4 = 8 to 14 days, and time 5 = 15 to 28. Forty-one patients completed the study (group I: n = 17, group II: n = 12, group III: n = 12). There was no significant difference in SMA PSV change after feeding between groups at the start of enteral feeding (p = 0.12). There were differences in change in SMA PSV after feeding at times 2, 3 and 5 (p = 0.003, p = 0.004, p = 0.009, respectively). Patients with feeding intolerance exhibited a smaller increase in SMA PSV after feeding. There were significant differences in PSV by GA group. SMA PSV change after feeding was lower in patients who had feeding intolerance compared with those who did not.

Correlation Between Doppler Parameters and Renal Cortical Fibrosis in Lupus Nephritis: A Preliminary Observation

To assess the relationship between renal Doppler parameters and renal cortical fibrosis in lupus nephritis (LN), we retrospectively reviewed 24 patients with LN underwent both renal color Doppler sonography and renal biopsy. The angle-corrected Doppler parameters, including peak systolic velocity (PSV), end diastolic velocity (EDV) and resistive index (RI) at the main and interlobar renal arteries were measured. The Doppler parameters and PSV and EDV ratios of the interlobar artery to main renal artery were compared with histopathologic analysis of the kidney biopsy specimen. On the basis of renal cortical fibrosis, the 24 cases of LN were divided into two groups: mild (6%–25%) renal cortex fibrosis (n = 13) and moderate (26%–50%) renal cortex fibrosis (n = 11). An independent-samples two tailed t test was used to statistically analyze the differences in PSV, EDV and RI between the two groups. Receiver operating characteristic was analyzed for assessing the accuracy of interlobar artery PSV and EDV in predicting moderate renal cortical fibrosis. In our result, both PSV and EDV in moderate renal cortex fibrosis were lower than that in mild renal cortex fibrosis. There were statistically significant differences in PSV and EDV at the interlobar artery, EDV and RI at the main renal artery, and PSV and EDV ratios of the interlobar artery to main renal artery between the two groups (all p < 0.05). The area under receiver operating characteristic curves of PSV and EDV for predicting >26% renal cortical fibrosis was 0.96 and 0.90, respectively. The optimal cutoff values for differentiating >26% renal cortical fibrosis from those <25% were PSV 30 cm/s (sensitivity = 0.92; specificity = 1) and EDV 13 cm/s (sensitivity = 0.77; specificity = 1). Therefore, the values of PSV and EDV at the interlobar artery can potentially be used as hemodynamic indicators of renal cortical fibrosis, which may non-invasively assist in monitoring the progression of renal cortical fibrosis in LN, especially in patients with contraindications to renal biopsy.

Color Doppler Ultrasound in the pre-histological determination of the biological character of major salivary gland tumors

The aim of the study was to assess the use of color Doppler ultrasound in the pre-histological determination of the biological features of salivary gland tumors. Ninety-six patients with major salivary gland tumors of unknown histology were examined and operated on in our clinics. They were pre-operatively examined using ultrasound imaging with color Doppler. Peak systolic velocity (PSV) was measured and pulsatility index (PI) and resistive index (RI) were calculated on the pulsed wave traces. The Doppler flow parameters were correlated with clinical stage and tumour type (benign/carcinoma) as confirmed by final histological diagnosis. For the correlations, the tumors were categorized into 3: benign (group I), malignant stages I+II (group II), malignant stages III+IV (group III). The average PSV value was 22.15 cm/s for benign and 32.74 cm/s for all malignant tumors. The average RI value was 0.77 for benign and 0.86 for all malignant tumors. The average PI value for benign tumors was 2.85 and 3.14 for all malignant tumors. No significant differences between benign and malignant tumors in terms of SV and PI values were found. The RI values for benign tumors differed significantly from those of malignant ones (P=0.021). There were no significant differences in average PSV, PI and RI values in relation to salivary gland tumor group - I, II, III. There was no confirmation of the reported applicability of PSV and PI values in differenting benign from malignant tumors. We were not able to demonstrate significant differences in Doppler flow parameters PSV and PI between benign tumors and carcinomas. Only the RI could be used to differentiate them. There were also no significant differences in PSV, PI and RI values between low (I+II) and high (III+IV) clinical tumour stage.

Color duplex sonography in severe transplant renal artery stenosis: a comparison of end-to-end and end-to-side arterial anastomoses

Objective The aim of this study was to investigate differences in Doppler parameters between severe transplant renal artery stenosis (TRAS, arterial lumen reduction >80%) with end-to-end (EE) arterial anastomosis and that with end-to-side (ES) arterial anastomosis. Methods We retrospectively reviewed color duplex sonography (CDUS) and digital subtraction angiography (DSA) images in 38 patients with severe TRAS (19 cases with EE and 19 cases with ES) between January 1, 2000, and December 31, 2006. Doppler parameters were analyzed, including peak systolic velocity (PSV) in the iliac artery, PSV at the arterial anastomosis, PSV in the transplant renal artery, PSV ratio of the stenotic artery/artery proximal to the stenosis, and acceleration time (AT) in the artery distal to the stenosis (in the intrarenal artery). All 38 cases with severe TRAS were initially diagnosed with CDUS and confirmed by DSA. Results There were significant differences in PSV in the stenotic artery ( P<.01), PSV in the iliac artery ( P<.001), and PSV ratios of stenotic artery/artery proximal to the stenosis ( P<.001) between arterial anastomosis of EE and that of ES. There was no statistically significant difference in AT in the intrarenal artery between the two types of anastomosis ( P>.05). Conclusion Significantly different PSVs in the stenotic artery, the iliac artery, and the PSV ratio between EE and ES arterial anastomoses should be considered in the interpretation of CDUS when screening for severe TRAS. Different criteria of CDUS need to be established depending on the type of arterial anastomosis in order to improve the accuracy in diagnosing severe TRAS.