Use Of Doppler Ultrasonography Research Articles

Reasons for Requesting Ultrasonography: A Retrospective Study.

The aim of this study is to evaluate (i) the reasons for requesting ultrasonography (USG) in a dentistry faculty and (ii) the scanning regions, the type of probe used, and the use of Doppler USG. USG request forms of patients who applied to our radiology clinic for USG were analyzed retrospectively. According to the clinical information of the patients in the request forms, the reasons for requesting USG were divided into four groups: soft tissue swelling, soft tissue calcification, lymph node, and other examinations. Data were statistically compared between sex (female and male) and age groups (≤40-years-old and ˃40-years-old). The USG request forms of 50 patients were obtained. The mean patient age was 45.06±14.50 years. Twenty-six patients were female (52%), while twenty-four patients were male (48%). Soft tissue swelling, soft tissue calcification, lymph node, and other examinations were noted as the reasons for requesting USG in 42%, 26%, 18%, and 14% of the patients, respectively. The most scanned regions were the submandibular (56%), parotid (16%), and cheek (10%) regions. Extraoral probe was used more frequently than intraoral probe (78% vs. 22%). Doppler USG was used in most patients (98%). A statistically significant difference was found between age groups and calcification examination (p<0.05). The reasons for requesting USG were mostly soft tissue swelling, soft tissue calcification, and lymph node examinations. The most commonly scanned region and used type of probe were the submandibular region and extraoral probe, respectively. Doppler USG was used in most patients.

Use of Doppler ultrasonography for selection of recipients in embryo transfer programs in horses

We aimed to evaluate the impact of corpus luteum (CL) and uterine characteristics accessed by B-mode and Color-Doppler ultrasonography in recipient mares at the time of embryo transfer (ET) on pregnancy outcomes. Recipient mares (n = 110), between days 3–9 after spontaneous ovulation, received a fresh embryo. Immediately before ET, the reproductive system was assessed by transrectal palpation for the following parameters: uterine tone (0–3), CL echogenicity (0–6), CL type (homogeneous, trabecular or anechoic center), luteal area (cm2), uterine echogenicity (0–3), uterine edema (0–3), luteal blood perfusion (0–100%) and uterine blood perfusion (1–4). Additionally, a blood sample was collected by puncture of the jugular vein for plasma P4 dosage. Retrospectively, recipients were classified according to the luteal area (small [≤ 6 cm2] or large [> 6 cm2]), luteal blood perfusion (low [≤ 55%] or high [> 55%]), and plasma concentration of P4 (low ≤ 9.98 ng/mL or high > 9.98 ng/mL). Pregnancy diagnosis was performed at 12 and 30 days of gestation. Luteal blood perfusion was significantly higher (P = 0.04) in pregnant recipients (n = 83) than in non-pregnant recipients (n = 27). Overall P/ET was higher (P ≤ 0.02) in mares with high luteal blood perfusion and high P4. Luteal blood perfusion was the most adequate significant (P = 0.01) predictor of pregnancy compared with the luteal area and plasma P4 concentration. Only luteal blood perfusion showed a linear (P = 0.03) and cubic (P = 0.004) effect on P/ET. In conclusion, CL blood perfusion determined by color-Doppler can be used in real-time to select recipients with the greatest chance of maintaining pregnancy in equine ET programs.

Intraoperative Contrast-Enhanced Ultrasonography (Io-CEUS) in Minimally Invasive Thoracic Surgery for Characterization of Pulmonary Tumours: A Clinical Feasibility Study.

The intraoperative detection of solitary pulmonary nodules (SPNs) continues to be a major challenge, especially in minimally invasive video-assisted thoracic surgery (VATS). The location, size, and intraoperative frozen section result of SPNs are decisive regarding the extent of lung resection. This feasibility study investigates the technical applicability of intraoperative contrast-enhanced ultrasonography (Io-CEUS) in minimally invasive thoracic surgery. In this prospective, monocentric clinical feasibility study, n = 30 patients who underwent Io-CEUS during elective minimally invasive lung resection for SPNs between October 2021 and February 2023. The primary endpoint was the technical feasibility of Io-CEUS during VATS. Secondary endpoints were defined as the detection and characterization of SPNs. In all patients (female, n = 13; mean age, 63 ± 8.6 years) Io-CEUS could be performed without problems during VATS. All SPNs were detected by Io-CEUS (100%). SPNs had a mean size of 2.2 cm (0.5-4.5 cm) and a mean distance to the lung surface of 2.0 cm (0-6.4 cm). B-mode, colour-coded Doppler sonography, and contrast-enhanced ultrasound were used to characterize all tumours intraoperatively. Significant differences were found, especially in vascularization as well as in contrast agent behaviour, depending on the tumour entity. After successful lung resection, a pathologic examination confirmed the presence of lung carcinomas (n = 17), lung metastases (n = 10), and benign lung tumours (n = 3). The technical feasibility of Io-CEUS was confirmed in VATS before resection regarding the detection of suspicious SPNs. In particular, the use of Doppler sonography and contrast agent kinetics revealed intraoperative specific aspects depending on the tumour entity. Further studies on Io-CEUS and the application of an endoscopic probe for VATS will follow.

State of Regional Blood Flow in Patients with Varying Degrees of Anatomical and Functional Disorders of Periodontal Tissues

Background: The aim of this research was to determine the functional state of regional blood flow in young people with varying degrees of anatomical and functional disorders of periodontal tissues. Methods and Results: One hundred and thirty-five young patients with varying degrees of anatomical and functional disorders of periodontal tissues (AFDP) and 52 controls with intact periodontium were examined. All patients with AFDP were divided into three groups: Group 1 included 33 patients in the compensation stage (low degree of periodontal risk, intact periodontium, no clinical symptoms, pale pink gums, no bleeding on probing, dentogingival attachment is not disturbed); Group 2 included 38 patients in the sub-compensation stage (average degree of periodontal risk, disorders of the mucogingival complex, without clinical symptoms); and 64 patients in the decompensation stage (high degree of periodontal risk, disorders of the mucogingival complex, the presence of clinical symptoms, individual or combined signs of periodontal pathology, gingival recession (Class I and II according to Miller's classification). We studied the regional blood flow of periodontal tissues, which was assessed by an ultrasound Doppler graph in a non-invasive way. The parameters of linear (PSV, peak systolic velocity) and volumetric (Qs, maximum systolic volume velocity) velocities of blood flow, as well as the parameters of the wall vascularization (PI, pulsation index; RI, resistance index). Results: The PSV increased statistically significantly with a load compared to rest in the control and sub-compensation groups and decreased in the decompensation group with a load, compared to the rest condition. The PSV increased relative to the control in the subcompensation and decompensation groups in rest and under load. The Qs indicator showed a similar trend in the groups. Qs significantly increased under load, compared to the rest condition in the control, compensation, and subcompensation groups, and decreased in the decompensation group. The Qs values, in comparison with the control, increased in the subcompensation and decompensation groups in the rest condition and under load. The PI increased with the load relative to the rest condition in the control, compensation, and decompensation group. At the same time, PI decreased under the load, compared to the rest condition, in the subcompensation group. In comparison with the control, the PI values decreased in the subcompensation and decompensation groups in the rest condition and under load. The RI significantly changed only in the subcompensation group under load, compared to the rest condition. Only RI values decreased significantly in the subcompensation group under load, compared to the control. Conclusion: The use of Doppler ultrasonography in assessing the state of regional blood flow of periodontal tissues is a highly informative and non-invasive method. The velocity characteristics (linear and volumetric velocities) of blood flow are important diagnostic indicators, allowing the most rapid and reliable assessment of the degree of anatomical and functional disorders of periodontal tissues.

Usefulness of pulsatility and resistive index for detection of mares with and without endometritis

Endometritis, a condition which causes inflammatory or degenerative alterations of the endometrium, is one of the most serious causes of infertility or subfertility in equine reproduction, whether associated or not with the presence of infectious agents (Mattos et al. Revista Brasileira de Reprodução Animal. 2003; 27:150-156). A complementary diagnosis, carried out with the use of Doppler ultrasonography (US), will enable an assessment of local blood flow and a more accurate analysis of the physiology of the ovaries and uterus (Ginther et al. Animal Reproduction Science. 2007; 102:314-321; Ferreira et al. Ciência Rural. 2011; 41:1063-1069). The main purpose of the present study was to assess potential alterations in the uterine vasculature of mares with clinical or subclinical endometritis and mares with no endometritis. Twenty-one mares were organized into three groups: CG: without endometritis; GCE: with clinical endometritis; GSE: with subclinical endometritis. In the latter group, mares had no alteration in the B-mode US but had positive cytology and/or bacterial and/or fungal culture. Based on this, the estrous cycle was closely observed until the preovulatory follicle appeared and subsequently, samples were collected for cytological examination, bacterial and fungal culture. After the induction and detection of ovulation, B-mode transrectal US and spectral-mode Doppler US of the left and right uterine arteries near the bifurcation with internal iliac arteries was undertaken.These ultrasound examinations were performed on a daily basis, until the next ovulation so that the complete estrous cycle could be assessed. Statistical analysis was performed by means of ANOVA using the Tukey test for one factor. According to the results of this study, no statistical difference was found in the evaluation of the pulsatility index between groups of mares without endometritis (158.71±38.27) and with subclinical endometritis (166.60±41.68) and between groups with subclinical (166.60±41.68) and clinical endometritis (171.27±44.75). However, a significant statistical difference was observed in the pulsatility index between groups of mares without endometritis (158.71±38.27) and mares with clinical endometritis (171.27±44.75) (p<0.01). As for the evaluation of the resistive indices, no statistical difference was observed between the groups of mares with subclinical (0.72±0.08) and clinical (0.72±0.08) endometritis. However, a statistically significant difference was identified in the resistive index between groups of mares without endometritis (0.69±0.07) and subclinical endometritis and clinical endometritis (p<0.01). Thus, the indexes evaluated were inversely proportional to vascular perfusion. It is concluded that spectral mode Doppler ultrasonography can be used as a complementary diagnostic tool in the identification of subclinical and clinical endometritis, by evaluating vascular perfusion of the uterine arteries.

Pulse wave Doppler ultrasound of umbilical cord in experimentally induced pregnancy toxemia in sheep

Contrary to its widespread use in human cases, the use of Doppler ultrasonography is only recently becoming prevalent in farm animals. This study aimed to determine the effects of maternal metabolic and clinical changes on fetal hemodynamics during pregnancy toxemia with the doppler examination of umbilical cord. In the study twenty ewes with a single healthy fetus were included in the study. At the end of the 120th day of pregnancy, 20 single-bearing pregnant ewes were randomly categorized into two groups. Ewes in the control group were fed to meet all nutritional requirements. On the other contrary, the experimental ewes were fed to meet equivalent to 50 % of the daily needs and then fasted for 96 h. Doppler ultrasonographic examinations of umbilical cord were performed once every two days and once a day during fasting. Beta hydroxybutyric acid (BHBA) concentration was measured by taking blood from sheep on examination days. Pulse systolic velocity (PSV), end diastolic velocity (EDV), PSV/EDV, pulsatility index (PI), resistance index (RI), and fetal heart rate (FHR) as well as BHBA values and how those parameters has changed over time (time by treatment effect) due to energy deprivation during pregnancy were evaluated using repeated measure analysis of variance. No clinical signs were observed in both toxemia and control groups during restricted feeding. BHBA concentration increased and there was a significant time, time by treatment and main effect of treatment effect between groups. No significant main effect of treatment and time by treatment interaction was observed in the changes of PI, RI, FHR, and systolic/diastolic velocity values over time in both groups. FHR was reduced over time, and there was a significant time effect in FHR in both groups. Although doppler indices didn't increase, both PSV and EDV values increased significantly in the pregnancy toxemia group compared with the controls (Time P = 0.03, time by treatment interaction P < 0.05) and the main effect of treatment P < 0.05). The marked increase in blood velocities (PSV and EDV) in the umbilical cord is probably due to the compensatory functioning for excessive energy deprivation of the fetus. Therefore, PSV and EDV might be a valuable indicator for evaluating the fetus's health status during the management of the PT.

Comparing the Effectiveness of Propranolol versus Atenolol in Inducing Clinical Clearance in the Treatment of Infantile Haemangioma: A Randomised Controlled Trial.

Despite the excellent clinical efficacy of oral propranolol in the management of infantile haemangiomas (IHs), there is a need to further evaluate other beta blockers that may be equally efficacious but result in lesser adverse effects. We compared the efficacy and short-term safety of atenolol, a hydrophilic cardio-selective beta blocker, with propranolol, in the treatment of IHs. Sixty patients with complicated and/or cosmetically significant IHs were randomised into two groups, oral propranolol group (2 mg/kg/day) and the oral atenolol (1 mg/kg/day) group, respectively, for 9 months. Patients were assessed clinically, by the use of Doppler ultrasonography (USG) and measurement of serum hypoxia-inducible factor 1 alpha (HIF-1α). Twenty-two of 30 patients achieved complete clearance in the propranolol group (0.73; 95% CI = 0.54 to 0.87) compared with 13 of 25 patients in the atenolol group (0.52; 95% CI = 0.31 to 0.72). The mean time to achieve Physician Global Assessment Score 5 (PGA5) (25.00 ± 8.87 weeks) was significantly lesser in the propranolol group versus the atenolol group (31.69 ± 7.01 weeks; log-rank = 0.04). The two groups were comparable in terms of adverse effect profile, degree of volume reduction in USG and reduction in HIF-1α levels. Propranolol (2 mg/kg/day) is better than atenolol (1 mg/kg/day) in inducing complete clinical clearance of IH although the results need to be reproduced in larger studies.

Doppler ultrasound investigation of female infertility.

This study reviewed recent advances in the use of Doppler ultrasonography for the management and prediction of female infertility outcomes of assisted reproductive technology (ART). Color or power Doppler and three-dimensional power Doppler ultrasound can be used to measure vessels near the ovaries, uterus, and endometrium to assess blood flow. Increased blood flow and reduced resistance to the ovaries, uterus, and endometrium are associated with improved pregnancy outcomes, and their measurement has been suggested as a key factor in ART procedural outcomes. Perifollicular vascularity indices can help predict oocyte quality and maturity. Likewise, endometrial and uterine vascularity could be associated with endometrial receptivity and may assist with embryo transfer timing and pregnancy outcome predictions. With the advancement of Doppler ultrasound technology, this highly potent examination will be used more widely in routine clinical settings for the treatment of female infertility.

Amniocentesis-When It Is Clear That It Is Not Clear.

The current study aims to identify correlations between blood contamination of samples collected during amniocentesis and certain factors dependent on the instruments used (thickness of the needle used to aspirate the fluid), the location of the placenta, and uterine vascularity (more pronounced in multiparous patients). The study included 190 patients in the second trimester of pregnancy who met one of the criteria for invasive prenatal diagnosis (age over 35 years, high risk in first trimester screening, history of pregnancies with genetic abnormalities, etc.). The amniotic fluid samples collected from these patients were analyzed in terms of blood contamination of the amniotic fluid aspirated with maternal cells Results: Of the patients in whom the procedure was performed using 21 G size needles, 16 samples (13.33% of the total) were contaminated. None of the samples collected from patients where a 20 G needle was used were contaminated. There was a statistically significant association between the lack of contamination and the use of Doppler ultrasound in multiparous patients with anterior placenta in whom a 21-gauge needle was used for amniocentesis. There is an increased rate of sample contamination (statistically significant) when using 21 G needle sizes and a significant difference in contamination between primiparous and multiparous patients, with contamination being more frequent in multiparous patients. The use of Doppler ultrasonography may benefit the procedure, as the contamination rate was significantly reduced when used during amniocentesis.

The Use of Doppler Ultrasonography in the Examination of Testicles in Dogs

Abstract Doppler ultrasonography is method suitable for observing and measuring the blood supply of many organs. Its principle is the change in the frequency of wave blood that moves with respect to the source of the wave (probe). In a testicular examination, the use of Doppler can also be very useful for detecting abnormalities or pathological conditions. The aim is just to characterize the flow in arteria testicularis in clinically healthy dogs aged 1-5 years. Twelve dogs were included in the study, of which 6 were rough collies weighing approximately 23 kg and 6 were standard dachshunds weighing approximately 9 kg. The pulsatility index (PI) and resistance index (RI) of a.testicularis, as well as the dimensions of the testicles - height and depth, were assessed by ultrasonographic examination using the ALOKA ProSound Alpha 6 ultrasonographic device (Hitachi-Aloka, Japan). The statistical evaluation of the results shows that the differences between the averages of both measurements of PI and RI indices are highly significant, so the weight of the individual had a high effect on the measured values of PI and RI indices. The depth of the testicles was also directly related to the increasing values of PI and RI indices and to the weight of the dogs, in contrast to their height, which did not show any statistical significance in this respect. The measured values and findings may in the future also serve as a basis for determining reference values in testicular ultrasonography according to the weight of dogs, which may be beneficial in clinical status assessment, diagnosis of various pathological conditions, or predicting spermatogenesis and fertility of the individuals.

Cardiovascular Disease Prevention in Patients With Atherosclerotic Renovascular Disease-Induced Resistant Hypertension: Further Considerations for 24-Hour BloodPressure Profiles.

Cardiovascular Disease Prevention in Patients With Atherosclerotic Renovascular Disease-Induced Resistant Hypertension: Further Considerations for 24-Hour BloodPressure Profiles.

Applied Use of Doppler Ultrasonography in Bovine Reproduction

The use of Doppler ultrasonography to quantify blood vascularization in reproductive organs has increased over the past decade. Doppler technology has predominantly been explored in research settings to evaluate uterine blood flow and to assess follicular and luteal blood perfusion. Recent research has also explored the use of Doppler technology in applied reproductive management for both the beef and dairy industries and has focused on the use of luteal color Doppler ultrasonography to evaluate embryo transfer recipients and perform early pregnancy diagnosis. Although significant progress has been made and current literature indicates a strong potential for the applied use of Doppler ultrasonography to increase reproductive efficiency in the cattle industry, uptake of this technology is still currently limited. This review summarizes the recent developments in the applied use of color Doppler ultrasonography for reproductive management in both beef and dairy cattle herds.

MO769: Utility of Doppler Ultrasonography in the Evaluation of Arteriovenous Fistula, a Nephrologists Perspective

Abstract BACKGROUND AND AIMS An arteriovenous (AV) fistula is preferred for long-term haemodialysis vascular access. AV fistula creation requires adequate arterial and venous anatomy to support its creation and a sufficient time interval to allow the AV fistula to mature prior to its use. Failure to mature remains a problem highlighting the importance of the perioperative evaluation of the fistula. Ultrasound and colour doppler are a rapid, non-invasive and repeatable tools that can be used for the early diagnosis of vascular complications. METHOD A prospective, observational study was conducted at a tertiary hospital in South India. All the patients with arteriovenous fistulas made in the upper limb between the time period of June 2021–August 2021 were included. A preoperative doppler mapping and assessment of the upper lime was done by the nephrology team and two DUS exams in the post-operative period. RESULTS In our study, a total of 134 patients were evaluated with a mean age of 51.89 ± 13.7 years. The total number of males in the study was 115 (85.8%). The aetiology of end-stage renal disease (ESRD) was predominantly nondiabetic in origin seen in 56.7% of the patients. Ischaemic heart disease was seen in 36 patients. There were 116 brachiocephalic,18 radiocephalic AV fistulas in our group of patients. The overall success rate of the fistula was 79.9%. The average vein diameter in patients with successful AV fistula was 3.03 ± 1.05 mm and was 2.25 ± 0.9 mm in those who had a failed fistula. The average blood flow measurement in the proximal artery supplying the fistula was 479.42 ± 113.1 mL/min in the immediate post-op period and 1055.88 ± 227.6 mL/min at 6 weeks. There was a significant difference (P&amp;lt;0.05) in the blood flow measurement between those who achieved primary patency versus those with failure to mature. CONCLUSION It is essential for a practicing nephrologist to be acquainted with the technique of doppler to assess AV fistula to assess for maturity and to see for.

Lower extremity amputations due to diabetes; risk factors for reamputations and the role of imaging methods in determining the level of amputation

PurposeTo reveal the causes of reamputation of patients who underwent amputation due to diabetic foot and identify the role of imaging methods in determining the level of amputation. MethodIncluded in the study were 167 patients who underwent amputation due to diabetic foot between January 2018 and January 2021. The patients were divided into two groups. Patients who did not need reamputation were included in Group I, and patients who needed reamputation were included in Group II. The following information regarding the patients were evaluated: age, gender, the amputated side, duration of diabetes mellitus (DM), presence of chronic renal failure (CRF), need for hemodialysis, Charlson Comorbidity Score (CCS), American Society of Anesthesiologists (ASA) score, presence of diabetic neuropathy, smoking, HbA1C, albumin, C-reactive protein (CRP), erythrocyte sedimentation ratio (ESR), lymphocyte-monocyte ratio (LMR), neutrophile/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), platelet-monocyte ratio (PMR), presence of diabetic foot necrosis, Exitus status of the patient and doppler ultrasonography (D-USG) and computed tomography angiography (CTA) results. ResultsThe mean age of the patients was 60.69 ± 16.37 years. No statistically significant difference was found between the groups in terms of age, gender, the amputated side, duration of DM, presence of CRF, need for hemodialysis, CCS, smoking, HbA1C, albumin, ESR, LMR, NLR, PLR, PMR or exitus status. However, a statistically significant difference was found between the groups in terms of the ASA score, neuropathy due to DM, CRP, and presence of diabetic foot necrosis (P = 0.012, P = 0.038, P = 0.000, and P = 0.026, respectively). It was found that the use of D-USG in determining the level of amputation statistically reduced the need for reamputation (P = 0.013). ConclusionsAccording to the results of the study, diabetic neuropathy, the CRP value, ASA score, and the presence of a wound on the heel increases the possibility of reamputation. Compared to CTA, D-USG provides more reliable results in determining the level of amputation due to diabetic foot.

Role of Uterine Artery Doppler Ultrasound in Predicting Pre-Eclampsia in High-Risk Women.

Background and objectivePre-eclampsia (PE) is a major cause of maternal morbidity and mortality. The utility of Doppler ultrasonography (U/S) in predicting PE has not been extensively explored. This study aimed to determine the role of Doppler U/S in predicting PE among high-risk women.MethodologyThis was a retrospective observational study conducted at the Department of Obstetrics and Gynecology of Abbasi Shaheed Hospital in Karachi, over a period of one year, from January 2019 till December 2019. A total of 325 women were initially screened for risk factors for PE. Among them, 75 women were eventually found to have risk factors for PE and hence included in the study. Uterine artery Doppler U/S was performed to evaluate uterine artery’s flow velocity waveforms. They were then used to calculate the presence of diastolic notch and resistance index (RI). At each antenatal visit, the risk factors for PE such as BP, proteinuria, and signs and symptoms were noted. Women were labeled to have PE if they developed hypertension (BP >140/90) after 20 weeks of gestation in combination with proteinuria.ResultsTwenty women (28%) had a normal Doppler flow of the uterine arteries. In 54 (72%) women, a unilateral/bilateral RI >0.58 was observed, and 29 women (38.7%) had a bilateral Rl >0.58. Notching of the uterine artery was also observed in 42 (26.7%, unilateral/bilateral) and in 22 (29.3%) bilaterally. Among the 75 women, BP of 140/90 mmHg along with proteinuria was observed in 56 (76.7%) cases, which were hence diagnosed as PE. Based on the cutoff of Rl and notching of the uterine artery, the overall sensitivity, specificity, and positive and negative predictive values (PPV and NPV) of Doppler U/S in predicting PE were 71.4%, 26.3%, 23.8%, and 74.1%, respectively. As far as individual Doppler U/S indices were concerned, RI >0.58 (unilateral/bilateral) was found to be most sensitive (71%), while the presence of uterine artery notch (unilateral/bilateral) was most specific in predicting PE.ConclusionAbnormal Doppler U/S has good overall sensitivity in predicting PE. Among individual Doppler indices, notching of uterine arteries had a better specificity compared to high RI.

Effect of cloprostenol sodium dose on luteal blood flow and volume measurements in Holstein heifers with both day-4 and day-10 corpora lutea

Establishment of a vascular system within the corpus luteum (CL) is critical for progesterone (P4) secretion. Measurement of luteal blood flow (LBF) may be a feasible way to determine luteolysis induced with cloprostenol sodium (CLO). Our overall objective was to establish timelines to assess luteolysis via Doppler ultrasonography. Estrous cycles were synchronized in 11- to 12-mo-old Holstein heifers (n = 37). Heifers were injected CLO at a random stage of the estrous cycle 12 d from treatment. Gonadotropin-releasing hormone (GnRH) was administered 2 (d -10) and 8 d (d -4) after the initial CLO. This satisfied the study objective of inducing simultaneous presence of CL at d 4 of development (D4 CL) and CL at d 10 of development (D10 CL) on the day of treatment with different CLO doses (hereafter referred to as d 0). Heifers were randomly assigned to 1 of 5 treatments on d 0: negative control (NC) consisting of no treatment with CLO (n = 8); a quarter dose of CLO (0.125 mg; n = 8); half dose of CLO (0.25 mg; n = 8); full dose of CLO (0.5 mg; n = 8); or positive control (PC) consisting of 4 doses of 0.5 mg of CLO at 24-h intervals starting at d 0 (n = 5). Data collection was performed at d 0 (before and 1 h after treatment) and 2, 4, 6, and 8 d following treatment, to determine luteal volume (LV), LBF, and circulating concentrations of P4. Both NC and PC were efficient in mimicking physiological scenarios that occur during normal luteal development and luteolysis. Heifers that received PC had complete LBF disappearance of both D4 and D10 CL between d 2 and 4 after the first of 4 CLO treatments given 24 h apart (average 4.0 ± 0.0 and 3.2 ± 0.7 d, respectively). Complete LBF disappearance was used as a luteolysis marker. Treatment with different doses of CLO did not impair luteal development of the D4 CL. However, concurrent complete LBF disappearance for D10 CL in heifers treated with half (5/8 heifers) and full doses of CLO (8/8 heifers) resulted in less LBF in the half dose, and less LV and LBF in the full-dose treatment, in D4 CL at d 8 post-treatment, compared with NC. Treatment with various doses of CLO induced an acute increase in LBF 1 h after treatment, regardless of dose in D10 but not in D4 CL. We found a lack of dose response in LV reduction of D4 and D10 CL. Interestingly, LV of the D10 CL decreased in untreated NC between d 0 and 8 after treatment (d 10-18 of luteal development). Assessment with color Doppler ultrasound was sensitive enough to identify dose-response patterns in Holstein heifers (absence, partial, or complete luteolysis) following various doses of CLO. Variability in time to complete LBF disappearance of mature D10 CL following a full dose of CLO limits the use of Doppler ultrasonography to detect luteolysis at a single time point following treatment.

Calcified carotid artery atheroma and stroke risk assessment. Use of Doppler ultrasonography as a secondary marker: a meta-analysis.

Objective: Calcified carotid artery atheroma (CCAA) detected by panoramic radiographs has been suggested as an accurate biomarker for cerebrovascular accidents (CVAs). However, there has not been agreement on the relationship between CCAA and risk for stroke or other CVA. Method and materials: The question asked was, "Are patients with CCAA detected on panoramic radiographs more likely to get a stroke or CVA in the future compared to those who do not have CCAA and, further, would Doppler ultrasonography of the neck obtained secondary to panoramic radiography in suspected individuals add value to this association with stroke or CVA?" This meta-analysis was conducted by searching PubMed, Ovid Medline, Dentistry & Oral Sciences Source, CINAHL, Web of Science, Google Scholar, and ClinicalTrials.gov. Six studies that met the inclusion criteria were included in the final analysis; three used panoramic radiography and the rest used panoramic radiography and ultrasonography. Multiple random effect meta-analyses were conducted using RevMan 5.2 software. Conclusion: Evidence from this meta-analysis shows that although detection of CCAA via panoramic radiography to predict risk for stroke may be comparable to Doppler ultrasonography, risk prediction is somewhat more significant when diagnostic confirmation is made using Doppler ultrasonography than panoramic radiography alone. Clinical implications: Because stroke risk assessment is complicated and comprises many additional systemic factors beyond calcification of the carotid artery, CVA prediction is more reliable when Doppler ultrasonography is used after panoramic radiography. Managing hypertension, diabetes, and smoking habit are far more important in risk management of patients with CCAA detection on panoramic radiography.

Effects of Sedation with Medetomidine and Dexmedetomidine on Doppler Measurements of Ovarian Artery Blood Flow in Bitches.

Simple SummaryAlpha-2 agonists have widely been used in dogs as sedative and preanesthetic agents. These drugs have successfully been used in many different reproductive surgical procedures in dogs, including ovariectomy (OV) and ovariohysterectomy (OVH). The main problem associated with the alpha-2 agonists’ use is their dose-dependent cardiovascular effects and the changes induced on organ perfusion. Nowadays, the use of Doppler ultrasonography is the most commonly used method to assess physiological and pathological organ perfusion in veterinary medicine as it is a noninvasive technique. In bitches, Doppler ultrasonography has shown its usefulness to assess placental, ovarian and uterine blood flow during normal and abnormal pregnancy. We compared the ovarian artery flow velocity by duplex Doppler ultrasound before and after sedation with two commonly used alpha-2 agonists: medetomidine and dexmedetomidine. The results showed that the administration of medetomidine or dexmedetomidine induced an important decrease in blood flow velocities in the ovarian artery. Hence, their use could be indicated in surgeries to avoid excessive bleeding of the ovarian pedicle.The aim was to evaluate if medetomidine and dexmedetomidine affected arterial ovarian blood flow in dogs. The dogs were randomly assigned to two different groups. In Group 1, medetomidine (10 µg/kg) was administered intramuscularly and, in Group 2, dexmedetomidine (5 µg/kg) was used. After a preliminary exam, arterial blood pressure (BP) was measured and a duplex Doppler ultrasonographic examination of both ovarian arteries was performed. Twenty minutes after the administration of medetomidine or dexmedetomidine, BP and ovarian Doppler ultrasonography were repeated. High quality tracings of ovarian artery flow velocity were obtained in all dogs and Doppler parameters: Peak Systolic Velocity (PSV), End Diastolic Velocity (EDV) and Resistive Index (RI) were measured before and after drug administration in the left (LO) and right (RO) ovaries. PSV and EDV values decreased significantly after drug administration (p < 0.05) compared to the non-sedated values, but no differences were found between the LO and RO (p > 0.05). The RI was not affected by drugs administration in neither of the groups studied (p > 0.05). In conclusion, the administration of medetomidine or dexmedetomidine causes a decrease in blood flow velocity in the ovarian artery and may be a good choice to avoid excessive bleeding prior surgeries in which ovariectomy.

Usefulness of Doppler sonography in aesthetic medicine.

IntroductionIn recent years, ultrasonography has been used in an increasing number of fields, such as dermatology, aesthetic medicine and cosmetology. For skin imaging, research has shown the usefulness of both classic scanners equipped with linear transducers, and high-frequency scanners with mechanical transducers. An increasing number of reports indicating high usefulness of Doppler sonography have been published recently. The aim of this study was to assess the usefulness of high-frequency Doppler imaging in the diagnosis of vascular complications after aesthetic procedures using tissue fillers.Materials and methodsA total of 12 women aged 19–48 years (mean age 36.08 years) who had undergone hyaluronic acid treatment were included in the study group. Ultrasound scans were performed using standard ultrasound scanners, i.e. Philips Epiq 5 with a linear transducer and Samsung RS85 with linear transducers and Doppler Microflow Imaging option. Ultrasound scans were performed to assess the presence of blood flow using Color Power Doppler (CPA). Pulsed-Wave Doppler was used only for arteries. If no blood flow was recorded with Color Power Doppler, Microflow Imaging was used.ResultsDoppler ultrasound showed normal blood flow despite reported symptoms in 3 cases. Vascular stenosis was found in 2 patients. In the other 7 patients, Doppler ultrasound showed no blood flow at the sites where complications developed.ConclusionsSkin ultrasound with Doppler options is a useful tool in the diagnosis of aesthetic medicine complications.

Clinical application of pulsatility index

Pulsatility index (PI) is defined as the difference between the peak systolic flow and minimum diastolic flow velocity, divided by the mean velocity recorded throughout the cardiac cycle. It is a non-invasive method of assessing vascular resistance with the use of Doppler ultrasonography. It was first introduced in 1974 by Gosling and King and is also known as the Gosling Index. PI as a method of examining macrocirculation has a variety of clinical applications. For instance, in diabetic patients, it has been measured on the common carotid, middle cerebral or renal arteries to help predict complications such as cerebrovascular disease or nephropathy. In hypertensive patients, it has been used to assess complications and assess the chronicity of the disease. To our knowledge, despite the diverse use of this ultrasonographic parameter, there is a deficiency in reports that would comprehensively summarize its clinical applications. Based on our extensive review of the literature and the gathered information, we conclude that pulsatility index (PI) is an easy to obtain parameter with a broad range of both, research and clinical applications. It has been widely used in the assessment of macrocirculation in highly prevalent chronic medical conditions, such as hypertension, both type 1 and type 2 diabetes and thyroid disorders.