Value Of Color Doppler Imaging Research Articles

Usefulness of orbital colour Doppler ultrasound in vascular-related monocular vision loss.

Acute, painless, monocular vision loss (APMVL) usually has a vascular aetiology. We conducted a prospective observational study from 2011 to 2018 to analyse the added value of colour Doppler imaging to assess orbital vessel blood flow in the diagnosis of APMVL. The study included 67 patients (39 [58.2%] men; mean age, 65.9 years [SD 13.7]) with APMVL evaluated at the Neurosonology Laboratory within the first 5 days of symptom onset, who were classified as having either transient or persistent monocular blindness. The blood flow in the ophthalmic and central retinal arteries was assessed using colour Doppler ultrasound with a linear 7.5-MHz transducer. Thirty-three (49.3%) patients presented transient monocular blindness, with reduced blood flow in either the ophthalmic or central retinal artery. The group with persistent vision loss included 24 cases of central retinal artery occlusion (CRAO) and 10 cases of ischaemic optic neuropathy (35.8% and 14.9%, respectively, of the total sample). These patients were older and had a higher prevalence of hypertension and mild carotid atherosclerosis. Orbital colour Doppler ultrasound (OCDUS) clarified the mechanism/cause of the ischaemia in 11 (16.4%) patients and showed abnormal flow in 46 (68.7%) patients, confirming the vascular origin in 19 (57.6%) of the transient monocular blindness cases. Lower peak systolic velocity was observed in patients with CRAO (p < 0.001), and a velocity < 10 cm/s in the central retinal artery was independently associated with the diagnosis of CRAO. OCDUS can be helpful in confirming the vascular cause and identifying the aetiology of APMVL.

Predictive value of color Doppler imaging of central retinal artery in outcome of corneal graft

AbstractPurpose To assess the value of color Doppler imaging (CDI) of the Central Retinal Artery (CRA) in predicting visual acuity post corneal graft procedures.Methods Forty‐seven eyes of 47 patients with severe corneal disease that require corneal graft were included in a retrospective cohort study. At baseline, CDI were performed for all eyes and hemodynamic parameters of the CRA were measured: Resistive Index (RI) and peak systolic velocity (PSV). All eyes underwent B mode Echography: Analysis of vitreo‐ retinal morphology, macula, and papilla. Inclusion criteria were the following: Corneal graft for any etiology, Best Corrected visual acuity (BCVA) less than 0.8 Log MAR, and no correct visualization of the fundus at preoperative clinical examination.Results 2 DALK (Depth Anterior Lamellar Keratoplasty), 2 DSEAK (Descemet stripping automated endothelial keratoplasty) and 43 PK (Penetrating Keratoplasty) were performed. After 12 mouths of follow‐up: 41.5% of eyes (Group A) had visual acuity improvement (BCVA equal or superior to 2 lines Log MAR scale compared to baseline) and 58.5 % of eyes (Group B)had no improvement. The mean (SD) PSV was 15.00 ± 8.72 in group A and 11.04 ± 5.39 in the group B with significative difference (p=0.032). The mean (SD) RI was 0.68 ± 0.11 in group A and 0.67 ± 0.06 in the group B with no significative statistical difference (p=0.864). However a Pearson correlation test showed a significative negative correlation between RI and BCVA (p=0.046).Conclusion In eyes with opaque cornea, the RI and PSV of the CRA may reliably predict prognosis in corneal graft. Discovering bad CDI parameters in advance allows avoiding post‐operative disappointments.

The value of color Doppler imaging and intralesional steroid injection in pediatric orbital capillary hemangioma

BackgroundTo evaluate color Doppler imaging (CDI) as the primary imaging modality in the diagnosis of pediatric orbital capillary hemangioma. MethodsThis is a retrospective study of 36 consecutive cases of orbital capillary hemangiomas between January 2006 and July 2011. Data on demographic details, clinical findings, gray-scale ultrasonography, CDI characteristics, treatment, and follow-up period were reviewed. ResultsThe mean age of onset was 7 weeks. Twenty-nine (81%) lesions presented as eyelid masses, whereas seven (19%) presented as exophthalmos. Nineteen (53%) tumors were located on the upper eyelid, seven (19%) on the lower eyelid, six (17%) in the medial canthus, and one on both upper and lower eyelids. Ultrasonography depicted a heterogeneous, well-defined, irregular tumor with a low or moderate echogenicity. All lesions presented with abundant color blood flow on CDI. The intralesional blood flow had a mean peak systolic velocity of 37.5 ± 24.5 cm/second, and a mean resistance index of 0.69 ± 0.16, representing a shift in the pulse Doppler toward high velocity and high resistance. After a single intratumoral injection of betamethasone, 18 cases (50%) resolved. Additionally, 15 (42%) and four (11%) cases resolved after two injections and three injections, respectively. Only three (8%) masses persisted after three injections within the follow-up period. ConclusionThe blood flow characteristics of CDI play a vital role in the differentiation of orbital capillary hemangiomas from other orbital lesions. The availability and lack of adverse effects of CDI enable its utilization in the early clinical diagnosis of pediatric orbital capillary hemangioma.

Color Doppler Imaging Analysis of Retrobulbar Blood Flow Velocities in Primary Open-Angle Glaucomatous Eyes: A Meta-Analysis

BackgroundTo analyze the diagnostic value of color Doppler imaging (CDI) of blood flow in the retrobulbar vessels of eyes with primary open-angle glaucoma (POAG).MethodsPertinent publications were retrieved from the Cochrane Central Register of Controlled Trials, PubMed and the ISI Web of Knowledge up to October 2012. Changes in peak systolic velocity (PSV), end diastolic velocity (EDV) and resistive index (RI) of the ophthalmic artery (OA), central retinal artery (CRA) and short posterior ciliary artery (SPCA) of POAG eyes and normal controls were evaluated by CDI. Subgroup analyses were conducted according to whether patients received IOP-lowering drugs treatment and were defined as treated and untreated.ResultsPSV and EDV were statistically significantly reduced in the OA of POAG eyes (P = 0.0002; P<0.00001; respectively), with significant heterogeneity (Pheterogeneity<0.00001, I2 = 94%; Pheterogeneity<0.00001, I2 = 85%; respectively). Similar results were demonstrated for the CRA (P<0.00001; respectively) and SPCA (P = 0.005; P<0.00001; respectively), with significant heterogeneities for both the CRA (Pheterogeneity<0.00001, I2 = 81%; Pheterogeneity<0.00001, I2 = 98%; respectively) and the SPCA (Pheterogeneity<0.00001, I2 = 96%; Pheterogeneity<0.00001, I2 = 93%; respectively). Significant increases in RI were found in all retrobulbar vessels (P<0.00001; respectively), with significant heterogeneities (Pheterogeneity<0.00001, I2 = 95%; Pheterogeneity<0.00001, I2 = 94%; Pheterogeneity<0.00001, I2 = 97%; respectively).ConclusionsThis meta-analysis suggests that CDI is a potential diagnostic tool for POAG.

Color Doppler sonography in liver surgery. Status of perioperative monitoring

Resection of liver tumours is not always successful despite detailed diagnostic work-up preoperatively. In our study we compared the predictive value of colour Doppler imaging of the liver with other radiological examinations for tumour staging, surgical decision making and postoperative complications. From 1/95 to 6/1997 we investigated 76 patients with liver tumours; 60 patients with liver metastases, 13 with primary liver carcinomas and 3 with benign lesions. Resectability was defined in colour Doppler imaging by tumour localisation, distance of the tumour to the central vessels and blood flow in the portal vein. CT-scan in all patients and angiography in patients with central tumour localisation was performed. The preoperative results were compared to intraoperative ultrasound and surgical examination. 108 out of 118 intrahepatic lesions were found preoperatively using high-resolution ultrasound. Ultrasound and CT-scan achieve comparable results in delineating pathologic changes in the liver. Considering only the liver findings and local resectability in 76 patients, the sensitivity achieved for B-mode-ultrasound was 77.6% (59/76); for CT-scan 78.9% (61/76) and for colour Doppler imaging 86.4% (66/76). 31 out of 76 laparotomies were terminated after exploration. Resectability was correctly predicted by ultrasound in 55 (72.4%) and by CT-scan in 57 (73.7%) patients. Colour Doppler imaging improved the ultrasound results in up to 62 (81.6%) patients. Unsuspected not resectable tumour growth was found in 9 patients with local/regional recurrences, in 4 patients with peritoneal spread and in one patient with multiple bilateral liver metastases. Using high-resolution ultrasound systems the preoperative detection of lesions in the liver achieves the results of CT-scan. Little isoechogenic lesions, peritoneal spread and locoregional recurrences can be missed by ultrasound examination. Colour Doppler imaging shows compared with B-mode and CT-scan a higher sensitivity for the detection of the infiltration of hilar structures and can take place of more invasive methods in preoperative liver investigations. Considering functional and morphological aspects colour Doppler imaging makes an essential contribution to the planning of liver surgery. Using lung passing contrast media the determination of tumour vascularisation and perioperative quantification of liver perfusion is possible. The use of the intraoperative ultrasound is justified to determine resection limits, detection of smallest non-palpable lesions and to control perfusion after vascular reconstruction. In experienced hands colour Doppler imaging gives valuable preoperative information with excellent cost-benefit ratio.

Performance of colour Doppler imaging discriminating normal tension glaucoma from healthy eyes

Previous studies have shown decreased retrobulbar blood flow in normal tension glaucoma (NTG) compared to healthy controls. This study evaluates the ability of colour Doppler imaging (CDI) to identify patients with NTG. Sixty-two patients with untreated NTG (mean age 57+/-14 years) and 40 age-matched controls (mean age 58+/-9 years) were included in a prospective cross-sectional institutional study. Peak systolic velocity (PSV), end-diastolic velocity (EDV), and resistive indices (RI=(PSV-EDV)/PSV) of the ophthalmic artery (OA), central retinal artery (CRA), and short posterior ciliary arteries (PCAs) were measured by means of CDI. Using receiver operating characteristic (ROC) curves, sensitivity was determined at 90% specificity. Patients with NTG showed significantly decreased PSV (P<0.0001) and EDV (P<0.0001) of the CRA, significantly decreased EDV of the nasal (P=0.004) and temporal (P=0.002) PCA, and significantly increased RI of the temporal (P=0.003) PCAs compared to healthy controls. Sensitivity values at 90% specificity were calculated: PSV of the CRA, 30.6%; EDV of the CRA, 48.4%; EDV of the nasal PCA, 43.9%; EDV of the temporal PCA, 45.9%; and RI of the temporal PCA, 39.3%. The power to identify NTG using CDI reaches 48% sensitivity at 90% specificity. Further longitudinal studies are needed to determine the prognostic value of CDI in glaucoma.

Orbital color Doppler imaging in Behçet’s disease with or without ocular involvement

To investigate the value of color Doppler imaging (CDI) of orbital vasculature in the assessment of ocular involvement in patients with Behçet's disease (BD) without clinical ophthalmologic abnormalities. CDI of the orbital vessels were performed on 26 eyes of 13 patients who were diagnosed as having BD with ocular involvement (group 1), 65 eyes of 33 patients who had BD without ocular involvement (group 2) and 40 eyes of 20 healthy volunteers (group 3). Peak systolic (PSV) and end-diastolic (EDV) blood flow velocities and resistivity index (RI) measurements were obtained for the ophthalmic artery (OA) and central retinal artery (CRA). The mean velocity of the central retinal vein (CRV) was also measured. For the OA, PSV and EDVs were significantly lower and RIs were significantly higher in group 2 than in control subjects. In group 1, only the EDVs of OA were significantly lower than in healthy subjects. For the CRA, PSV and EDVs were significantly lower, and RIs were significantly higher in both BD groups than those in group 3. When group 1 and group 2 were compared, the differences between PSV, EDV and RI measurements for the CRA and OA were statistically insignificant. There was no significant difference in blood flow velocity of the CRV between the three groups. Major hemodynamic changes were observed in the ophthalmic vasculature of Behçet's patients with or without ocular involvement by CDI. CDI may detect ocular blood flow alterations before initial clinical manifestations.

The value of color doppler imaging in patients with primary open angle asymmetric glaucoma

the value of color doppler imaging in patients with primary open angle asymmetric glaucoma

Predictive value of colour Doppler imaging in a prospective study of visual field progression in primary open‐angle glaucoma

To assess the value of colour Doppler imaging (CDI) of the ophthalmic artery (OA) and short posterior ciliary arteries (SPCAs) in prognosis of disease progression in patients with primary open-angle glaucoma (POAG). A total of 49 eyes of 49 patients with POAG were included in a prospective cohort study. At baseline and every 6 months for 36 months, we measured the resistive indices (RIs) of the OA and SPCAs using CDI, visual field examination, intraocular pressure (IOP) and blood pressure measurements. The predictive capacity of the RIs of these vessels was investigated by Cox regression. Receiver operating characteristics curves were plotted for the OA and SPCAs RIs, and predictive values, likelihood ratios and post-test probabilities were calculated. After 36 months, 23 eyes had progressed. In the eyes that progressed, the mean (SD) RI was 0.82 (0.007) for the OA and 0.73 (0.006) for the SPCAs; in the eyes that did not progress the mean RI was 0.70 (0.007) for the OA and 0.63 (0.006) for the SPCAs. The optimal points for the RIs were 0.72 for the OA and 0.65 for the SPCAs. With these cut-off points, the positive post-test probability was 90.5% in the OA. In eyes with POAG and elevated IOP, the RIs of the OA or SPCAs may reliably predict visual field progression.

Evaluation of color Doppler imaging of ophthalmic tumors based on histopathologic findings

To examine retrospectively the diagnostic and differential diagnostic value of color Doppler imaging (CDI) in cases of suspected intraocular and orbital tumors. Color Doppler examination (using Acuson 128, Philips-ATL UM-9, HDI 3000, 5000, Siemens Elegra, GE Logiq9) was performed in a total of 194 patients (177 intraocular, 17 orbital tumors). The results were compared to the clinical findings (routine examination, conventional ultrasound examination) and the results of angiography (FLAG, ICG). Furthermore, in 73 cases histopathology records were obtained for comparison. Signs of blood flow could be detected in 137 cases (71%); the Doppler spectrum was low resistance in the large majority (130) of these cases. In cases where histopathology records were available, 60 of the 73 (82%) showed good concordance between the CDI diagnosis and the pathological results. CDI gave false positive results in 3, and false negative findings in 10 cases; the latter occurred mainly in small iris or ciliary body tumors. Using CDI, blood flow is demonstrable in the majority of intraocular and orbital tumors, especially if the tumor diameter is larger than 3 mm. CDI flow detection, however, is less reliable for iris or ciliary body tumors.

Detection of deep-vein thrombosis by color Doppler imaging in stroke patients

AbstractThis study was performed in 60 consecutive patients with hemiplegia and/or hemiparesis in order to assess the diagnostic value of color Doppler imaging (CDI) in the diagnosis of deep-vein thrombosis (DVT). 27 men and 33 women ranging in age from 53 to 85 years were introduced into the study. The patients with stroke were examined by both venography and CDI. Contrast venography was considered as the standard diagnostic method for DVT. We found no statistically significant difference between CDI and contrast venography in the detection of DVT. Venography showed the presence of DVT in 21 patients. CDI was positive in 16 of these 21 patients (sensitivity: 76%). CDI was normal in 32 of the 34 patients with a negative venogram (specificity: 94%). The sensitivity of the CDI for proximal vein thrombosis was 80% where it is 66% for calf vein thrombosis. Although CDI is not so sensitive and specific as contrast venography, it is used because it is a non-invasive method.

Color Doppler imaging is a valuable tool for the diagnosis and management of uterine vascular malformations.

The aim of this study was to assess the spontaneous outcome of uterine vascular malformations detected with ultrasonography and color Doppler, and to investigate the predictive value of color Doppler imaging as to which patients require invasive treatment. This was a prospective observational study conducted between January 1999 and February 2001 comprising all consecutive patients diagnosed with a uterine vascular malformation by ultrasonography and color Doppler imaging. Spectral analysis included measurement of flow velocities, pulsatility index (PI) and resistance index (RI). Close follow-up was arranged in all cases and the outcomes were recorded. A total of 30 consecutive patients with uterine vascular malformations were included in the study. Spectral analysis of the vessels in the vascular malformations within the myometrium and endometrium revealed the presence of a low-impedance and high-velocity flow. The average values for PI, RI, peak systolic velocity (PSV) and time-averaged maximum velocity (TAMXV) were 0.50, 0.38, 0.63 m/s and 0.46 m/s, respectively. Eight patients (27%) eventually required embolization of the uterine arteries and three of them had true arteriovenous malformations confirmed at angiography. PSV values of >/= 0.83 m/s were associated with higher probabilities of further treatment, such as an embolization, whereas no vascular malformation with a PSV value < 0.39 m/s required embolization. Conservative management is possible in more than two-thirds of patients presenting with uterine vascular malformations diagnosed by color Doppler sonography. Despite considerable overlap, PSV values appear to be useful in distinguishing between low- and high-risk patients.

Identification of feeding arteries to establish the intra- or extraparotid location of jugulodigastric nodules: value of color Doppler sonography.

The objective of our study was to determine the value of color Doppler imaging as an adjunct to gray-scale sonography to reveal the intra- or extraparotid origin of jugulodigastric nodules of uncertain location. Forty nodules in the jugulodigastric area from 38 patients were imaged with gray-scale, color, and power Doppler sonography. Nodules receiving vessels from salivary glands were assumed to be intraglandular; those accepting vessels from paraparotid spaces were considered to arise from outside the gland. Imaging results were correlated with biopsy and surgical findings. In 38 of 40 cases, color and power Doppler sonography displayed discrete feeding arteries leading to the nodules: 25 nodules had one supplying artery, nine received two arteries, and four had three or more arteries. Intraparotid nodules received vessels from the gland in 20 cases. In two cases, the source of vessels was indeterminate. In two malignant tumors, multiple arteries derived from both the parotid and the neck spaces. All 14 extraparotid nodules received the arterial supply from paraparotid spaces. Color Doppler sonography enabled prediction of the intraglandular location of the nodules in 91% of cases and the extraglandular location in 87.5% of cases. The correct diagnosis was achieved in 34 of 40 nodules, with a global accuracy of 85%. Color Doppler sonography can help to assess the intra- or extraparotid location of jugulodigastric nodules. In practice, this technique can support the diagnosis when gray-scale sonography raises doubts about the origin of a jugulodigastric nodule.

Color Doppler Imaging in the Diagnosis of the Acute Scrotum

To determine the value of color Doppler imaging (CDI) in the diagnosis of acute scrotum. We evaluated 102 consecutive patients referred to our institution with scrotal pain. All patients were evaluated by physical examination, ultrasound with stethoscopic Doppler followed by CDI. Radionuclide scanning was performed only in 14 patients. Patients with a diagnosis of testicular torsion by CDI underwent surgical exploration. Patients with CDI diagnosis of epididymorchitis were treated with intravenous antibodies and underwent repeat CDI evaluation after treatment. Of the 102 patients evaluated ages 11-44, CDI diagnosed 18 patients with testicular torsion and 78 patients with epididymorchitis. Cases of testicular torsion were found to have absent flow on CDI. CDI findings of normal or increased flow were present in all patients with epididymorchitis. All cases of torsion were confirmed on surgical exploration, 11 patients underwent orchidopexy and 7 patients underwent orchiectomy. No cases of testicular atrophy were encountered on long-term follow-up in patients with epididymorchitis. Diagnoses in the remaining patients were testicular tumor 1, testicular abscess 2, scrotal hematoma 2 and incarcerated hernia 1. CDI was found to be 100% sensitive and 100% specific in the diagnosis of the acute scrotum. We found CDI to be more accurate and reliable than physical examination in conjunction with gray-scale ultrasound and Doppler stethoscopic examination in the differential diagnosis of the acute scrotum. CDI is practical and can be performed in a rapid manner. CDI should become an integral part of the urologist's armamentarium in the differential diagnosis of the acute scrotum.

The value of colour Doppler imaging in assessing flow through ventriculo-peritoneal shunts.

So far, Doppler ultrasonography has had little application in paediatric neurosurgery. The incidental observation of normally invisible CSF flow from the peritoneal end of a ventriculo-peritoneal (V-P) shunt on colour Doppler during a conventional abdominal ultrasound examination in one of our patients suggested that colour Doppler imaging might be of potential interest. Using a 10-5 MHz broad-band linear array transducer, conventional 2D and Doppler (spectral and colour-coded) ultrasonography was performed in 17 patients with V-P shunts, who were aged 3 months to 12 years. In all, 20 examinations were performed, because 2 patients had repeat examinations before and after shunt revision. In 13 examinations (65%) CSF flow was identified through the shunt tube. Flow velocities between 5 and 7 cm/s were measured. No flow was seen in 7 examinations (35%), 3 of which (15%) were performed before revisions for a blocked shunt. Further in vitro studies with simulated shunt/ventricular system model demonstrated that although clear CSF is not ultrasonically visible, the presence of particulate matter, such as choroid plexus debris, can generate a satisfactory Doppler signal with the probe insonating over the length of the tubing. In the presence of clear CSF, turbulence generated at junction points of the shunt system or at the exit of the peritoneal tube can be visualised well with Doppler ultrasonography, presumably due to generation of microbubbles. The clinical implications for the management of shunt obstruction are discussed.

The role of color duplex ultrasound in diagnosis and differential diagnosis of carotid body tumors

Currently the diagnosis of tumorous lesions of the carotid bifurcation is the domain of magnetic resonance imaging (MRI) and digital subtraction angiography (DSA). So far, colour Doppler imaging (CDI) has not been playing an important part in this field. The aim of this study was to define the diagnostic value of CDI in the evaluation of these tumours related to the big arteries and to compare the different imaging techniques. 6 female patients with suspected tumours of the carotid bifurcation were examined with CDI. Additionally 5 MRI examinations and 3 preoperative diagnostic DSA examinations were performed in the same patients. Pathologically, there were 4 typical carotid body tumours, 1 neuroma of the sympathetic trunk and 1 multifocal paraganglioma of the neck. In carotid body tumours we found a characteristic broadening of the bifurcation with shifting of the internal carotid artery posteriorly and laterally and of the external carotid artery anteriorly and medially. The highly vascularized tumour is surrounded by the arteries. This combination of ultrasound findings was absent in cases of sympathetic neuroma and multifocal paraganglioma. No additional information was achieved with MRI and DSA. CDI and MRI evaluation revealed the same diagnostic value in cases of vascularised tumours of the carotid bifurcation. CDI proved to be as accurate as DSA in the imaging of the big arteries and their relationship to the tumour, as well as of the small tumour feeding vessels. Therefore DSA may be omitted as an invasive diagnostic tool in the diagnosis of carotid body tumours.

Evaluation of patency of a ureteral stent: value of color Doppler imaging.

Evaluation of patency of a ureteral stent: value of color Doppler imaging.

Diagnosis and follow up of deep venous thrombosis in pregnancy: Value of color doppler imaging (CDI): [formula omitted], A. Lederer, H. Rabl, G. Stark, R. Wildling. Department of Radiology, University of Graz, Austria

Diagnosis and follow up of deep venous thrombosis in pregnancy: Value of color doppler imaging (CDI): [formula omitted], A. Lederer, H. Rabl, G. Stark, R. Wildling. Department of Radiology, University of Graz, Austria

Diagnosis of portal vein thrombosis: value of color Doppler imaging.

This study was undertaken to determine the accuracy of color Doppler imaging in the diagnosis of portal vein thrombosis. Two hundred fifteen patients were studied with color Doppler imaging to determine patency of the main portal vein. Sonographic findings were confirmed in 75 patients, aged 19 to 66 years. Correlation with angiography was obtained in 13 patients, and surgical correlation was obtained in the remaining 62. Nine patients had portal vein thrombosis on the basis of these gold standards. Sonograms were classified as showing either patency or thrombosis, depending on the ability to show color flow within the main portal vein. Agreement between sonography and angiography or surgery was found in 69 patients (61 patent, eight thrombosed). One patient with a patent portal vein at sonography was found to have a thrombosed vessel at surgery, whereas five patients without portal venous flow at sonography had patent vessels at angiography (one patient) or surgery (four patients). Overall sensitivity and specificity for detection of portal vein thrombosis were 89% and 92%, with an accuracy of 92%, a false-negative rate of 0.11, a negative predictive value of 0.98, and a positive predictive value of 0.62. We postulate that the majority of errors in our study occurred in vessels that, although patent, had only sluggish flow, which could not be resolved because of technical limitations. We conclude that color Doppler imaging is a valuable screening procedure for the assessment of portal vein patency. If the sonogram shows a patent portal vein, no further studies are required. However, a lack of demonstrable flow does not always indicate thrombosis, and other imaging studies should be performed for confirmation.