Transabdominal Color Doppler Ultrasonography Research Articles

The Diagnostic Accuracy of Transabdominal and Transvaginal Color Doppler Ultrasound for Pregnant Women with Vasa Previa and Velamentous Cord Insertion.

Objective The objective of this study is to evaluate feasibility and accuracy of transabdominal color Doppler ultrasound (TA-CDUS) and transvaginal color Doppler ultrasound (TV-CDUS) as screening methods for pregnant women with vasa previa (VP) and velamentous cord insertion (VCI). Methods A retrospective diagnostic accuracy study was performed on 5,434 pregnant women from 2018 to 2021, who underwent both TA-CDUS and TV-CDUS. Diagnostic performance of TA-CDUS and TV-CDUS was determined using specificity, positive predictive value (PPV), negative predictive value (NPV), accuracy, and positive and negative likelihood ratios (LR+ and LR−), using the delivery information (gross examination) as the “Gold-standard”. Patient records were reviewed for demographics and diagnosis. Results The combination of VP and VCI was diagnosed in 37/5434 (0.68%) women at delivery. The sensitivity, specificity, PPV, NPV, and overall test accuracy of TA-CDUS were 72.97%, 99.85%, 77.14%, 99.81%, and 99.67%, respectively, for diagnosing VP with VCI. The corresponding values for TV-CDUS were 89.19%, 99.87%, 82.50%, 99.93%, and 99.80%, respectively. Moreover, the sensitivity of combination of TA-CDUS and TA-CDUS in determining VP with VCI was 97.30%, specificity 99.98%, PPV 97.30%, NPV 99.98%, and accuracy 99.96%. No significant difference in the misdiagnosis and missed diagnosis was found between the examination by TA-CDUS and TV-CDUS. Conclusions Both TA-CDUS and TV-CDUS can be acceptable diagnostic tools for assessment of pregnant women with VP and VCI, with a better application of TV-CDUS with higher accuracy. The combination of TA-CDUS and TV-CDUS could provide an objective imaging basis for choosing clinical treatment strategies and predicting prognosis.

Value of Transabdominal Combined Transvaginal Color Doppler Ultrasonography in the Distinguish between Uterine Adenomyoma and Uterine Fibroids.

Objective To investigate the value of transabdominal combined transvaginal color Doppler ultrasonography in the diagnosis of uterine adenomyoma. Methods A total of 80 patients with suspected uterine adenomyoma in our hospital from January 2019 to December 2021 were selected as the study subjects. All of them were examined by transabdominal color Doppler ultrasound (TA-CDUS) and transvaginal color Doppler ultrasound (TV-CDUS), and the postoperative pathological examination results were taken as the gold standard to analyze the diagnostic efficacy of different examination methods for uterine adenomyoma. Results By postoperative pathological biopsy, 46 cases (57.50%) were diagnosed as positive and 34 cases (42.50%) were diagnosed as negative, including 29 cases of uterine adenomyoma and 5 other cases. The sensitivity, accuracy, and negative predictive value of TA-CDUS combined with TV-CDUS in the diagnosis of adenomyoma were higher than those of TA-CDUS (P < 0.05), and the Kappa value between TA-CDUS and pathological diagnosis was 0.923, which was higher than the 0.615 between TV-CDUS and pathological diagnosis. TA-CDUS combined with TV-CDUS showed that there were significant differences in the distribution of Adier blood flow grades between patients with uterine adenomyoma and uterine fibroids (P < 0.05), and the Adier blood flow grades of patients with uterine adenomyoma were mainly grade 0 and grade I; and the resistance index (RI), peak systolic velocity (Vs), and pulsatile index (PI) in patients with uterine adenomyoma were higher than those in patients with uterine fibroids (P < 0.05). Conclusion Compared with TA-CDUS, TA-CDUS combined with TV-CDUS is more sensitive and accurate in the diagnosis of uterine adenomyoma and has a good consistency with pathological diagnosis results. Attention should be paid to the blood flow parameter values in the differential diagnosis of uterine fibroids.

Reliability of the application of transvaginal color Doppler ultrasound in the identification of pelvic tumors in women of childbearing age.

BackgroundRecently, transvaginal color Doppler ultrasound (TVCDU) has been widely used in the diagnosis of pelvic tumors. This study aimed to assess the reliability of the application of TVCDU in the identification of pelvic tumors in women of childbearing age.MethodsThe clinical data of 209 patients with pelvic tumors at childbearing age admitted to our hospital from January 2016 to December 2019 were retrospectively analyzed. The ultrasound signs, color Doppler ultrasound score (CDUS), and resistance index (RI) of benign and malignant pelvic tumors diagnosed by TVCDU were analyzed. The value of transabdominal color Doppler ultrasound (TACDU) and TVCDU in the diagnosis of benign and malignant pelvic tumors was calculated.ResultsThere were 150 cases with benign pelvic tumors and 59 cases with malignant tumors. Most benign tumors had an intact capsule and regular shape, were mainly cystic, and were rarely accompanied by ascites; meanwhile, malignant tumors were mostly non-capsular and irregular in shape, mainly solid or cystic, and were often accompanied by ascites. There were significant differences in the above-mentioned ultrasound signs between benign and malignant tumors (P<0.05). The CDUS score of benign pelvic tumors was significantly lower than that of malignant tumors, and the RI value was significantly higher than that of the malignant tumors (P<0.05). The sensitivity, specificity, and accuracy of TACDU in the diagnosis of benign pelvic and malignant tumors were 83.33%, 84.75%, and 83.73%, respectively; and the sensitivity, specificity, and the accuracy of TVCDU in the diagnosis of benign pelvic and malignant tumors were 95.33%, 88.14%, and 93.30%, respectively; thus TVCDU had a superior performance compared to TACDU, especially in sensitivity and accuracy (P<0.05).ConclusionsThe sensitivity and accuracy of TVCDU in the differential diagnosis of benign pelvic and malignant tumors in women at childbearing age were significantly higher than those of TACDU. The combined application of CDUS and RI can further improve the accuracy in the diagnosis of pelvic tumors.

Utility of Transabdominal Ultrasonography Enhanced by Oral Cellulose-Based Contrast Agent in Depicting Varices at Cardia and Fundus

The use of transabdominal color Doppler ultrasound after oral administration of an oral cellulose-based contrast agent (TUS-OCCA) in depicting varices at the cardia and fundus was explored. Both gastroscopy and transabdominal color Doppler ultrasound (TUS) were performed for this purpose, with gastroscopy serving as the gold standard. Patients were assigned by TUS protocol to one of three groups: TUS + empty stomach (TUS-ES); TUS + oral water intake (TUS-OW); and TUS-OCCA. TUS-based grading of varices reflected venous diameters and blood flow velocities, designated as follows: Ux = difficulty discerning gastric fundus and cardia or delineating varices; U0 = no detectable varices; U1 = diameter <5 mm, flow rate <10 cm/s; U2 = diameter <5 mm, flow rate ≥10 cm/s; U3 = diameter 5–10 mm, flow rate <10 cm/s; U4 = diameter 5–10 mm, flow rate ≥10 cm/s; and U5 = diameter >10 mm, any flow rate. Between August 2016 and August 2019, 239 patients with cirrhosis were enrolled prospectively, including bleeding (n = 71) and non-bleeding (n = 168) groups. Varices were directly observed in 10.5% (25/239) of TUS-ES group members, compared with 59.2% (58/98) of the TUS-OW group and 89.6% (104/116) of the TUS-OCCA group; all detection rates differed significantly (TUS-OCCA > TUS-OW > TUS-ES, p < 0.05). TUS-based grading (as defined) revealed the following patient distribution: Ux, n = 34; U0, n = 18; U1, n = 50; U2, n = 41; U3, n = 16; U4, n = 46; U5, n = 34. In grading by variceal diameter, overall correspondence between TUS and gastroscopy was 93% (174/187). TUS-OCCA greatly improved rates of detection of varices at the cardia and fundus, offering a new method by which diagnosis and quantitative grading may be achieved and affording an excellent, non-invasive approach to dynamic follow-up.

Vorticity in lower urinary tract can be assessed and associates with urinary tract morphology in men.

The aim of this study is to develop a method to evaluate the fluid dynamics of urine flow in the lower urinary tract (LUT), especially that of vorticity. This investigation included three sub-studies to demonstrate urine flow in the entire LUT. First, we attempted to observe vorticity generation in the urinary bladder during spontaneous voiding using transabdominal color Doppler ultrasonography (CDUS). Second, we performed transrectal CDUS to evaluate the vorticity of urine flow in the prostatic urethra. Patients with prostate cancer were enrolled before robotic surgery and divided into the vorticity and non-vorticity groups based on CDUS findings for comparisons of longitudinal urethral diameter and prostatic urethral angle. Third, the vorticity of the voided urine stream was observed using a high-speed video-camera. Micturition was done in a standing position while synchronously monitored for urine flow using uroflowmetry. Vorticity formation could be dynamically demonstrated in the urinary bladder and prostatic urethra using CDUS. The prostatic urethral angle of the vorticity group was more than that of the non-vorticity group. High-speed video recording could clearly capture vorticity and spiral shape generation in voided urine. The distance from the external urethral orifice to the first twist changed in accordance with urine flow rate. In a series of sub-studies, this investigation proved vorticity generation in the LUT and voided urine. Vorticity was detectable in the LUT and in voided urine using CDUS and a high-speed video-camera. Vorticity generation might be associated with urethral morphology.

Feasibility of transabdominal Doppler ultrasonography for studying ovarian blood flow characteristics in cycling gilts.

The aim of this study was to assess ovarian blood flow characteristics by applying transabdominal color Doppler ultrasonography during the course of the estrous cycle in gilts. Estrus and ovulation were synchronized in 15 pubertal gilts. During their consecutive spontaneous estrous cycle the gilts were sonographically scanned daily and ovarian blood flow was determined by imaging perfused areas of the ovarian hilus and the ovarian tissue. Recorded video clips were then analyzed for the parameters perfused area (Amix), blood flow velocity (vmix) as well as resistance (RIvmix) and pulsatility index (PIvmix) using the software PixelFlux®. All blood flow parameters showed an estrous cycle dependent course, with Amix and vmix being highest in diestrus, followed by proestrus, while RIvmix and PIvmix patterns were inversely proportional. Transabdominal color Doppler ultrasonography proved feasible to study ovarian perfusion characteristics in pubertal gilts. The ovarian blood flow was dependent on the stage of estrous cycle and highest in diestrus. The results of this study encourage the use of color Doppler ultrasonography to also investigate reasons of ovary-caused infertility including corpus luteum insufficiency or seasonal effects on ovary function.

Transabdominal color doppler ultrasonography: A relevant approach for assessment of effects of uterine torsion in buffaloes.

Aim:The present study was conducted on advanced pregnant buffaloes suffering from uterine torsion to assess the status of fetus and uterus by transabdominal ultrasonography, and the findings were compared with normal advanced pregnant buffaloes.Materials and Methods:The study was conducted on 20 clinical cases of uterine torsion and 20 normal advanced pregnant buffaloes (control group). The lower ventral area just lateral to linea alba (on both sides of the udder) in standing animals was scanned transabdominally by the two-dimensional convex transducer for various ultrasonographic findings. The data collected were statistically analyzed by “one-way ANOVA” and “independent sample t-test” using computerized SPSS 16.0 software program.Results:Transabdominal ultrasonography revealed dead fetus in 95% uterine torsion cases and proved useful in imaging internal structures of fetuses while no dead fetus was reported in the control group. Size of umbilicus was found significantly decreased (p<0.05) in uterine torsion group in comparison to control animals, but the decrease in placentomal area was marginal (p>0.05) in uterine torsion group. Average thickness of the uterine wall and mean pixel values of fetal fluids (echogenicity) were found significantly increased (p<0.05) in uterine torsion affected buffaloes in comparison to control group.Conclusion:Status of fetus (whether live or dead), internal status of uterus, and its contents could be determined by transabdominal ultrasonography in uterine torsion cases and thus determining the prognosis of the uterine torsion cases before going for further manipulations. This will also help in taking all the precautions to avoid death of the fetus.

Comparison of the early diagnostic value of TACDS and TVCDS in tubal pregnancy

Objective To compare the early diagnostic value of between transabdominal color Doppler ultrasound(TACDS)and transvaginal color Doppler ultrasound(TVCDS)in tubal pregnancy. Methods Clinical data of 112 cases which were diagnosis of tubal pregnancy by operation and postoperative pathologic examination were retrospectively ananlyzed. The accuracy of clinical diagnosis of tubal ectopic pregnancy were compared between TACDS group and TVCDS group. Results 75 cases and 108 cases were diagnosed of tubal pregnancy in TACDS group and TVCDS group,respectively. The diagnostic accuracy were 66.96%and 96.43%,respectively. There was evident difference between the TACDS group and TVCDS group(χ2=32.511 8,P=0.000). Conclusion Compared with TACDS, TVCDS has high accurate for early diagnosis of tubal pregnancy, which can provide characteristic images and objective basis for the diagnosis and treatment of tubal ectopic pregnancy. Key words: Pregnancy, Tubal; Ultrasonography, Doppler, Color; Diagnosis

Role of Doppler US and MRI in diagnosis of placenta accreta

The aim of this work is to evaluate the role of Doppler US and MRI in the diagnosis of placenta accreta. Patients and methodsDuring period between 2012 to 2013, 120 pregnant patients with previous cesarean section were investigated by ultrasound and Doppler and then in suspected cases MRI was obtained (10 cases). The Sonographic and MRI diagnoses were compared with the final pathologic or operative findings or with both. ResultsThe mean age of this study group was 29years ranging from 20 to 40. Among patients with confirmed placenta accreta, the mean age was 32.25 ranging from 25 to 40years. The mean parity of patients ranged from 1 to 6 with a mean of 1.6. Among patients with placenta accreta, the mean parity ranged from 2 to 6 with a mean of 3.75. The total number of cases with placenta accreta in this study was 4, all of which were previa. This was out of a total of 25 cases of placenta previa. Transabdominal US features were the presence of intraplacental lacunae (sonolucencies), loss of retroplacental clear zone and disruption of bladder–uterine serosa interface with smallest myometrial thickness <1mm over site of placental implantation by using color Doppler ultrasonography, the most prominent color Doppler feature in this study was the presence of intraplacental lacunar flow. Magnetic resonance imaging accurately predicted placenta accreta in 4 of 4 cases with placenta accreta and correctly ruled out placenta accreta in the rest six cases. ConclusionIn conclusion, data of the present study show that the use of transabdominal color Doppler ultrasonography complemented by MRI in suspected cases improves the diagnostic accuracy in prediction of placenta accreta in patients with previous cesarean delivery.

The positive and negative predictive value of transabdominal color Doppler ultrasound for diagnosing ovarian torsion in pediatric patients

PurposeThe purposes of this study were to (1) determine the positive and negative predictive value (NPV) of transabdominal color Doppler ultrasound (CDU) for diagnosing ovarian torsion (OT) in pediatric patients and 2) identify predictors of a false-positive CDU result for OT. MethodsAn IRB-approved retrospective chart review was performed on all female patients who underwent transabdominal CDU evaluation of the ovaries (664 CDUs in 605 patients) for acute abdominal pain. CDU reports were categorized as positive for OT if the report stated “cannot rule out torsion” or “positive for torsion.” ResultsThere were 47 false-positive ultrasounds, 3 false negatives, 11 true positives, and 603 true negatives for OT. Sensitivity was 78.6%, specificity 92.3%, positive predictive value (PPV) 19.0%, and NPV 99.5%. False-positive CDU when compared to true positives were more common in older patients (p=0.004) and were more commonly read as “cannot rule out torsion” (p<0.001). Ovarian cysts were larger in true-positive CDU than in false-positive CDU (p<0.001). However, cyst presence/absence did not predict a true positive result. ConclusionTransabdominal CDU has a low PPV and a high NPV for ovarian torsion in pediatric patients. False-positive results are more common in older patients and associated with small ovarian cysts.

Relationship between Microscopic Hematuria and Inferior Vena Cava Reflux on Color Doppler Ultrasonography

We examined the relationship between microscopic hematuria and inferior vena cava (IVC) reflux. Transabdominal color Doppler ultrasonography of the IVC was performed in the supine position with the convex probe positioned perpendicular to the upper abdominal wall, and the extent of reflux into the IVC with each heart beat was examined near the diaphragm. A total of 171 patients were studied who had no diseases that could cause hematuria, and no symptomatic gross hematuria. The relationship between the existence and severity of IVC reflux and urine occult blood was examined. The 98 males included 50 subjects without IVC reflux and 48 with reflux, while the 73 females included 24 without IVC reflux and 49 with IVC reflux, respectively. The occurrence of IVC reflux was unrelated to age, but the prevalence of reflux was significantly higher in females than males. As the grade of IVC reflux increased, there was an increase in the prevalence and the severity of hematuria in both males and females. In conclusion, IVC reflux could be related to the occurrence of microscopic hematuria. Renal or urinary tract congestion secondary to IVC reflux may be one of the factors contributing to hematuria.

Relationship between Urological Disease and Inferior Vena Cava Reflux on Color Doppler Ultrasonography.

The possible relationship between urological disease and inferior vena cava (IVC) reflux was examined. Transabdominal color Doppler ultrasonography of the IVC was performed. The patient was placed supine and the convex probe was positioned in vertical to the upper abdominal wall. Then the extent of reflux in the IVC accompanying each heart beat was examined near the diaphragm. A total of 403 patients (202 males and 201 females aged 12-90 years) were studied. The relationship between the existence of IVC reflux or its severity and urological disease was examined. The 202 males included 104 and 98 subjects without and with IVC reflux, respectively, while the 201 females included 64 and 137 subjects without and with IVC reflux, respectively. The prevalence of IVC reflux was significantly higher in females than males. Chronic prostatitis (18/21 subjects) in males and stress incontinence (22/23 subjects) in females were significantly related to the existence of IVC reflux. Conversely, urolithiasis was related to lack of IVC reflux in females. IVC reflux may be positively or negatively related to the occurrence of some urological diseases. Pelvic congestion secondary to IVC reflux may be one of the factors contributing to chronic prostatitis and stress incontinence.

Transabdominal color Doppler ultrasonography for the diagnosis of small intestinal and vesical varices in a patient successfully treated with percutaneous transhepatic obliteration.

A 52-year-old asymptomatic female was admitted to our hospital in January 2008 with enlarged esophageal varices due to alcoholic liver cirrhosis. Color Doppler ultrasonographic examination showed images of vessels on the small intestinal wall around the umbilical area and the anterior wall of the bladder. Images of the vessels were obtained for the small intestinal wall and the anterior wall of the bladder with computed tomography. Percutaneous transhepatic portography was performed, and hepatofugal blood flow was observed in the inferior epigastric vein connected to the superior mesenteric vein and the contrast medium passed into the small intestinal varices and the vesical varices, which drained into the right ovarian vein. Percutaneous transhepatic obliteration was then successfully performed via the afferent veins of the small intestinal varices and vesical varices. One week after the treatment, color Doppler ultrasonography showed a remarkable decrease in blood flow in the varices.

Diagnosis of Gastric Varices and Evaluation of the Effectiveness of Treatment Using Transabdominal Color Doppler Ultrasonography

The aim of this study was to evaluate the hemodynamics of gastric varices using transabdominal color Doppler ultrasonography (CDUS). Using CDUS, we evaluated 41 consecutive patients with gastric varices. We examined color flow images and measured the velocity of gastric variceal blood flow using fast Fourier transform analysis. In addition, we compared detection rates of gastric varices and their outflow vessels using CDUS and computed tomography (CT). Gastric varices were detected with CDUS in 41 of 41 patients (100%), and outflow vessels were detected in 34 (82.9%). Of these, 32 were gastrorenal shunts (GRSs), and 2 were GRSs and subphrenic veins. The velocity of the large and coil-shaped varices (mean +/- SD, 23.0 +/- 5.8 cm/s; n = 13) was significantly higher than that of the enlarged and tortuous varices (14.1 +/- 4.3 cm/s; n = 28; P < .001). With CT, gastric varices were detected in 41 of 41 patients (100%), and outflow vessels were detected in 38 (92.7%). Color Doppler ultrasonographic and CT findings were in complete agreement in 35 of 41 patients (85.4%). A total of 11 patients with a high risk of variceal rupture underwent balloon-occluded retrograde transvenous obliteration, and CDUS and CT findings after treatments were consistent. Transabdominal CDUS is a useful noninvasive modality for the diagnosis of gastric variceal hemodynamics and for evaluation of the therapeutic effects of gastric variceal treatment.

Contrast-Enhanced Ultrasonographic Assessment of the Response of Ménétrier Disease toHelicobacter pyloriEradication Therapy

Recent improvement in ultrasonographic devices, techniques, and contrast agents has allowed more detailed investigation of the vascularity and inflammatory characteristics of gastrointestinal tract diseases, and investigators have reported that contrast-enhanced ultrasonography (CEUS) is as useful as endoscopic ultrasonography (EUS) for evaluation of the pathogenesis of gastrointestinal tract disease. 1 There have been a few reports that transabdominal color Doppler ultrasonography is useful in the diagnosis of Menetrier disease and evaluation of the therapeutic response, 2 but there have been no reports on CEUS evaluation of Menetrier disease. In addition, it has been reported that Helicobacter pylori infection plays an important role in Menetrier disease, and eradication therapy can provide a cure. 3 We report a case of Menetrier disease cured by H pylori eradication therapy in which the therapeutic response was assessed by CEUS.

Value of transabdominal ultrasonography in preoperative assessment of gastric carcinoma

To investigate the value of transabdominal ultrasonography (TAUS) in preoperative assessment of TNM stage and tumor angiogenesis for patients with gastric carcinoma. Sixty- four patients with gastric carcinoma preoperatively underwent TAUS, in whom transabdominal color Doppler ultrasonography was used for measuring color Doppler vascularity index (CDVI) of each tumor in 37 cases and microvessel density (MVD) was evaluated by using immunohistochemical staining of surgical specimens with anti- CD34 antibody. The overall accuracy rate was 56.0% for T staging of gastric carcinoma (T (1) 2/3 cases, T (2) 28.6% , T (3) 73.1% , T (4) 50.0% , respectively) by TAUS. The diagnostic accuracy rate was 63.3% for lymph node status of gastric carcinoma. The diagnostic sensitivity and specificity for lymph node metastasis was 37.9% and 100% respectively. The overall accuracy for N staging of gastric carcinoma was 57.1% (N (0) 100% , N (1) 16.7% , N (2) 35.3% , respectively). The diagnostic sensitivity and specificity for determining distant metastases was 58.3% and 100% respectively. The CDVI of gastric carcinoma determined by color Doppler ultrasonography was significantly correlated to vascular invasion (P=0.0418), a linear correlation between CDVI and MVD was determined by logistic regression analysis (r=0.5628, P< 0.01). TAUS can be a routine diagnostic approach for preoperative gastric carcinoma patients.

Trombosis venosa mesentérica: manifestaciones clínicas, terapia y evolución

Mesenteric vein thrombosis (MVT) is uncommon and accounts for 5-10% of all mesenteric ischemic events. In 80% of cases, an etiologic factor is found. The clinical presentation varies and the diagnosis is made based on imaging studies. The treatment involves anticoagulation alone or in combination with surgery. To describe the clinical characteristics of patients with MVT. Retrospective and prospective review of all cases with MVT, treated between 1995-2001. The clinical presentation, imaging studies, treatment and outcome were evaluated. 29 cases of MVT were reviewed (14 females, age 56 +/- 15 years). Twenty two patients (76%) had recognizable risk factors. The main symptoms were abdominal pain (86%) and vomiting (55%). The diagnosis of acute mesenteric ischemia was suspected on admission only in 6 patients (21%). Thirteen patients underwent transabdominal color Doppler ultrasonography and the diagnosis was confirmed for 11 of these (85%). Twenty out of 24 patients (85%) studied with computed tomography, had positive signs of MVT. Twenty one patients (72%) received anticoagulation, 10 of whom also underwent surgery. Four patients (14%) received surgical treatment alone. Four patients were not treated. Seven patients (24%) died. MVT is difficult to identify. It is necessary to have a high degree of suspicion in patients who have risk factors. The diagnosis is made with imaging studies. The treatment consists of early anticoagulation and surgical intervention when indicated.

Prenatal Diagnosis of Placenta Previa Accreta by Transabdominal Color Doppler Ultrasound

Prenatal Diagnosis of Placenta Previa Accreta by Transabdominal Color Doppler Ultrasound

Ultrasonographic detection of ureteral jets in normal pregnancy

Objective: Our purpose was to determine the impact of normal physiologic urodynamic alterations of pregnancy on the detection of ureteral jets into the bladder with use of transabdominal color Doppler ultrasonography. Study Design: We conducted a prospective cohort study of 125 healthy asymptomatic gravid women without any history of past or current renal disease, all with singleton pregnancies between 13.4 and 37.7 weeks' gestation. Right and left ureteral jets were recorded over a 5-minute period with use of color Doppler transabdominal ultrasonography and a full bladder. Each kidney was graded by the severity of the hydronephrosis. No hydronephrosis was grade 0, mild hydronephrosis was grade 1, and moderate hydronephrosis was grade 2. There were no cases of severe hydronephrosis. Results: There were 56 grade 0 cases on the right versus 93 grade 0 cases on the left ( p < 0.0001), 53 versus 30 grade 1 cases (right vs left, p < 0.003) and 16 versus 2 grade 2 cases (right vs left, p < 0.0009). In the subgroup where both kidneys were grade 0 the mean number of right ureteral jets 5 mm was 14.7 versus 15.1 for the left ureteral jets ( p = 0.73). In the grade 1 subgroup mean right versus left ureteral jets was 15.4 versus 16.6 ( p = 0.65). For the grade 2 subgroup mean right versus left ureteral jets was 15.5 versus 21.0 ( p = 0.32). There were 4 of 125 unilateral absent ureteral jets on the right versus 0 of 125 on the left ( p = 0.122). Conclusion: Our data demonstrate that ureteral jets can be readily detected during pregnancy independent of the gestational age. In addition, it does not appear that the physiologic urodynamic alterations of pregnancy affect the frequency or symmetry of ureteral jets. Thus identification of ureteral jets can be used in the workup of suspected urolithiasis in pregnant patients. (Am J Obstet Gynecol 1998;178:1194-8.)

Color Doppler sonographic findings in patients with transitional cell carcinoma of the bladder and renal pelvis.

The purposes of this study were (1) to evaluate the color Doppler sonographic findings in patients with transitional cell carcinoma of the bladder and renal pelvis, (2) to determine if color Doppler sonography could predict tumor grade and stage, and (3) to determine whether tumor vascularity is related to size. A total of 15 patients with 16 bladder transitional cell carcinomas and one patient with renal pelvic transitional cell carcinoma were evaluated prospectively with transabdominal color Doppler ultrasonography. The presence or absence of visible vascularity and the resistive index were correlated with tumor size, cytologic grade, and tumor stage. Statistical analysis was performed with Fisher's exact test. Seven (41%) of 17 tumors had visible vascularity: five (45%) of 11 high-grade transitional cell carcinomas were vascular, whereas two (33%) of six low-grade transitional cell carcinomas were vascular (P = 1.00). Three of five (60%) of the invasive lesions were vascular, but the vascularity was not predictive of tumor stage (P = 0.593). The vascular high-grade tumors tended to have more numerous and larger visible vessels than the vascular low-grade lesions. No tumor smaller then 23 mm was vascular, but the size of the tumor was not predictive of the vascularity (P = 0.1172). The resistive index was measurable in six tumors, but it was not predictive of grade or stage. Color Doppler ultrasonography is not helpful clinically in the evaluation of transitional cell carcinoma as tumor grade, stage, and size are not related to vascularity.(ABSTRACT TRUNCATED AT 250 WORDS)