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Magdalena PG, Bartłomiej B, Robert T, Małgorzata S, Hsing-Kuo W, Sebastian K. Acute fatigue-induced alterations in hamstring muscle properties after repeated Nordic hamstring exercises. Sci Prog 2024; 107:368504241242934. [PMID: 38592327 PMCID: PMC11005512 DOI: 10.1177/00368504241242934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/10/2024]
Abstract
This study aimed to investigate the impact of the Nordic hamstring exercises (NHE) on acute fatigue-induced alterations in the mechanical and morphological properties of hamstring muscles. The second aim was to define the blood flow and perfusion after NHE in recreational active volunteers. Twenty-two individuals volunteered to participate in the study. This study investigated fatigue outcomes: rate of perceived exertion (RPE) scale and average force generated during NHE; mechanical properties (stiffness); morphological properties (thickness, pennation angle, and fascicle length), and vascularity index (VI) of the semitendinosus (ST) and biceps femoris long head (BFLH) at baseline, immediately post-exercise and 1-h post-exercise. The NHE fatigue procedure consisted of six bouts of five repetitions. The results showed an increase in thickness and pennation angle of BFLH and ST immediately post-exercise and a decrease in thickness and pennation angle of BFLH and ST 1-h post-exercise. While the fascicle length of BFLH and ST decreased immediately post-exercise and increased 1-h post-exercise. The VI for two muscles increased immediately post-exercise and after 1-h post-exercise. Moreover, we found a relationship between RPE and average force, that is, as RPE increased during NHE, average force decreased. In conclusion, eccentric NHE exercises significantly and acutely affect BFLH and ST. The NHE fatigue protocol significantly affected the mechanical and morphological properties of BFLH and ST muscles, changing their thickness, fascicle length, pennation angle, and VI.
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Affiliation(s)
| | - Bogdański Bartłomiej
- Doctoral School, Gdansk University of Physical Education and Sport, Gdańsk, Poland
| | - Trybulski Robert
- ProvitaZory Medical Center, Zory, Poland
- Department of Medical Sciences, The Wojciech Korfanty Upper Silesian Academy, Katowice, Poland
| | - Smoter Małgorzata
- Department of Basic Physiotherapy, Gdansk University of Physical Education and Sport, Gdansk, Poland
| | - Wang Hsing-Kuo
- School and Graduate Institute of Physical Therapy, National Taiwan University, Taipei, Taiwan
- Center of Physical Therapy, National Taiwan University Hospital, Taipei, Taiwan
| | - Klich Sebastian
- Department of Paralympic Sport, Wrocław University of Health and Sport Sciences, Wrocław, Poland
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Mehta R, Agrawal A, Aroojis A, Lavande A, Karnik A. Perfusion Changes in Acute Septic Arthritis of the Hip Joint During Infancy Using Doppler USG. Indian J Orthop 2024; 58:98-106. [PMID: 38161395 PMCID: PMC10754777 DOI: 10.1007/s43465-023-01044-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 11/07/2023] [Indexed: 01/03/2024]
Abstract
Objectives To quantitatively assess vascularity changes of acute septic hips in infants using Doppler ultrasonography. To compare these findings with asymptomatic hips, and establish a correlation for accurate diagnosis between these findings. Methods In this prospective case-control study, we included all children under 1 year of age with a diagnosis of acute septic arthritis of the hip in the case group. For the control group, we enrolled apparently healthy, full-term neonates and infants not affected with any hip pathology. Doppler ultrasound of the medial femoral circumflex artery of the hip joint was done using a single Phillips HDI 5000 sonography machine. Following parameters were studied: peak systolic velocity (PSV), resistive index (RI), pulsatility index (PI), and systolic to diastolic ratio (SD ratio). Results Doppler signals and spectral waveforms were obtainable in 100% of hips in both groups. A statistically significant difference was found between the cases and controls with respect to their PSVs, RIs, PIs and SD ratios. The most striking difference was found between the PSVs of the two groups, whose mean was 6.18 in the control group and 11.8 in the case group. No significant correlation between age/gender and any of the 4 parameters was found. Conclusion Doppler parameters are useful in raising suspicion of onset in the diagnosis of septic arthritis. No correlation was found between age or gender and any parameter in control group. These baseline values can be held valid for all children below the age of 7 months.
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Affiliation(s)
- Rujuta Mehta
- Department of Paediatric Orthopaedics, Bai Jerbai Wadia Hospital for Children, Acharya Donde Marg, Parel, Mumbai, 400012 India
- Nanavati Max Super Specialty Hospital, Mumbai, India
| | | | - Alaric Aroojis
- Department of Paediatric Orthopaedics, Bai Jerbai Wadia Hospital for Children, Acharya Donde Marg, Parel, Mumbai, 400012 India
| | | | - Alka Karnik
- Nanavati Max Super Specialty Hospital, Mumbai, India
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Malferrari G, Merli N, Inchingolo V, Siniscalchi A, Laterza D, Monaco D, Arnone G, Zini A, Prada F, Azzini C, Pugliatti M. Role of Advanced Hemodynamic Ultrasound Evaluation in the Differential Diagnosis of Middle Cerebral Artery Stenosis: Introducing Morphological Criteria. ULTRASOUND IN MEDICINE & BIOLOGY 2023; 49:2428-2435. [PMID: 37550172 DOI: 10.1016/j.ultrasmedbio.2023.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 06/28/2023] [Accepted: 07/09/2023] [Indexed: 08/09/2023]
Abstract
OBJECTIVE The aim of the work described here was to determine the possible impact of the new technique advanced hemodynamic ultrasound evaluation (AHUSE) in identification of severe intracranial stenosis. Transcranial Doppler (TCD) and transcranial color-coded Doppler (TCCD) provide reliable velocimetric data, the indirect analysis of which allows us to obtain information on the patency of vessels and assumed stenosis range. However, very tight stenoses (>95%) cannot be detected with velocimetric criteria because of spectrum drops and the absence of high velocities, so that the right curve of the Spencer equation cannot be solved. Likewise, high velocities are not detected when analyzing morphologically long stenosis. Furthermore, the current classifications based on velocimetric criteria do not provide any categorization on stenoses with multiple acceleration points (MAPs). METHODS With this Technical Note we aim to introduce, in addition to velocimetric criteria, more morphological criteria based on TCCD with the algorithm of AHUSE to optimize the characterization of intracranial stenosis (IS). TCCD-AHUSE relies on intensity-based next-generation techniques and can be used to identify IS with MAPs and simultaneously perform a morphological assessment of the stenosis length. RESULTS We introduce a new technical ultrasound (U) approach that we tested in a sample of four different types of stenoses combining velocimetric data and AHUSE using Esaote Microvascularization (MicroV) technique to the M1 tract of the middle cerebral artery (MCA). CONCLUSION The authors believe that a multiparametric evaluation is more sensitive and supports the clinician by introducing the morphological concept, not just the velocimetric concept, to differentiate the IS pattern of MCA. The potential for developing a diagnostic/prognostic algorithm is discussed.
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Affiliation(s)
- Giovanni Malferrari
- Stroke Unit and Neurology Unit, Azienda Unità Sanitaria Locale-IRCCS, Reggio Emilia, Italy.
| | - Nicola Merli
- Department of Neuroscience and Rehabilitation, University of Ferrara, Italy
| | - Vincenzo Inchingolo
- Neurology Unit, Fondazione IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Antonio Siniscalchi
- Department of Neurology and Stroke Unit, Annunziata Hospital, Cosenza, Italy
| | - Domenico Laterza
- Neurology and Stroke Unit, Nuovo Ospedale degli Infermi, Biella (BI), Italy
| | - Daniela Monaco
- Department of Emergency Neurology and Stroke Unit, "S. Spirito" Hospital, Pescara, Italy
| | - Giorgia Arnone
- IRCCS Istituto delle Scienze Neurologiche di Bologna, UOC Neurologia e Rete Stroke Metropolitana, Ospedale Maggiore, Bologna, Italy
| | - Andrea Zini
- IRCCS Istituto delle Scienze Neurologiche di Bologna, UOC Neurologia e Rete Stroke Metropolitana, Ospedale Maggiore, Bologna, Italy
| | - Francesco Prada
- Acoustic Neuroimaging and Therapy Lab, Fondazione IRCCS Istituto Neurologico C. Besta, Milano, Italy; Department of Neurological Surgery, University of Virginia, Charlottesville, VA, USA; Focused Ultrasound Foundation, Charlottesville, VA, USA
| | - Cristiano Azzini
- Stroke Unit and Neurology Unit, S. Anna University Hospital, Ferrara Italy
| | - Maura Pugliatti
- Department of Neuroscience and Rehabilitation, University of Ferrara, Italy; S. Anna University Hospital, Ferrara Italy
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Childs C, Nwaizu H, Bullivant E, Willmott J, Davies M, Ousey K, Soltani H, Jacques R. Cutaneous Perfusion Dynamics of the Lower Abdomen in Healthy Normal Weight, Overweight and Obese Women: Methods Development Using Infrared Thermography with Applications for Future Wound Management after Caesarean Section. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5100. [PMID: 36982008 PMCID: PMC10048797 DOI: 10.3390/ijerph20065100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 03/09/2023] [Accepted: 03/09/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Evidence has shown an association between obesity and an increased risk of wound infection after caesarean section. This study was designed to examine if abdominal subcutaneous adiposity impacts upon cutaneous perfusion dynamics. METHODS Mild cool challenge, followed by real-time video thermography, was developed to map the appearance of abdominal 'hot spots'. Correspondence of marked 'spots' with audible Doppler and colour and power Doppler ultrasound was performed. RESULTS 60 healthy, afebrile, women (20-68 years; BMI 18.5-44 kg/m2) were recruited. Hot spot appearance consistently corresponded with audible Doppler sounds. Colour and power Doppler ultrasound revealed vessels at depths of 3-22 mm. No statistically significant interactions for BMI, abdominal circumference or environmental parameters were observed for hot spot count. The temperature of cold stimulus was significant for effects on spot count, but only for the first minute (p = 0.001). Thereafter, effects on spot numbers were not significant. CONCLUSIONS Cutaneous 'perforator' mapping of the abdomen (via hot spot appearance) in healthy women, as a potential and future method for risk of perfusion-dependent wound healing complications, reveals that bedside mapping of skin perfusion is feasible over a short interval. Hot spot number was not influenced by BMI or indicators of central fat distribution (abdominal circumference) indicating variability in an individual's vascular anatomy. This study provides the underpinning methodology for personalised perfusion assessment after incisional surgery which may be a more reliable indicator of potential healing complications than body habitus as is currently the norm.
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Affiliation(s)
- Charmaine Childs
- Centre for Applied Health & Social Care Research, Health Research Institute, Sheffield Hallam University, Sheffield S10 2BP, UK (E.B.)
| | - Harriet Nwaizu
- Centre for Applied Health & Social Care Research, Health Research Institute, Sheffield Hallam University, Sheffield S10 2BP, UK (E.B.)
| | - Elizabeth Bullivant
- Centre for Applied Health & Social Care Research, Health Research Institute, Sheffield Hallam University, Sheffield S10 2BP, UK (E.B.)
| | - Jon Willmott
- Semiconductor Materials and Devices Research Group, Department of Electronic and Electrical Engineering, University of Sheffield, Sheffield S10 2TN, UK; (J.W.); (M.D.)
| | - Matthew Davies
- Semiconductor Materials and Devices Research Group, Department of Electronic and Electrical Engineering, University of Sheffield, Sheffield S10 2TN, UK; (J.W.); (M.D.)
| | - Karen Ousey
- Institute of Skin Integrity and Infection Prevention, University of Huddersfield, Huddersfield HD1 3DH, UK;
| | - Hora Soltani
- Centre for Applied Health & Social Care Research, Health Research Institute, Sheffield Hallam University, Sheffield S10 2BP, UK (E.B.)
| | - Richard Jacques
- Medical Statistic Group, School of Health and Related Research (ScHARR), University of Sheffield, Sheffield S1 4DA, UK;
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Chu B, Chen Z, Shi H, Wu X, Wang H, Dong F, He Y. Fluorescence, ultrasonic and photoacoustic imaging for analysis and diagnosis of diseases. Chem Commun (Camb) 2023; 59:2399-2412. [PMID: 36744435 DOI: 10.1039/d2cc06654h] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Biomedical imaging technology, which allows us to peer deeply within living subjects and visually explore the delivery and distribution of agents in living things, is producing tremendous opportunities for the early diagnosis and precise therapy of diseases. In this feature article, based on reviewing the latest representative examples of progress together with our recent efforts in the bioimaging field, we intend to introduce three typical kinds of non-invasive imaging technologies, i.e., fluorescence, ultrasonic and photoacoustic imaging, in which optical and/or acoustic signals are employed for analyzing various diseases. In particular, fluorescence imaging possesses a series of outstanding advantages, such as high temporal resolution, as well as rapid and sensitive feedback. Hence, in the first section, we will introduce the latest studies on developing novel fluorescence imaging methods for imaging bacterial infections, cancer and lymph node metastasis in a long-term and real-time manner. However, the issues of imaging penetration depth induced by photon scattering and light attenuation of biological tissue limit their widespread in vivo imaging applications. Taking advantage of the excellect penetration depth of acoustic signals, ultrasonic imaging has been widely applied for determining the location, size and shape of organs, identifying normal and abnormal tissues, as well as confirming the edges of lesions in hospitals. Thus, in the second section, we will briefly summarize recent advances in ultrasonic imaging techniques for diagnosing diseases in deep tissues. Nevertheless, the absence of lesion targeting and dependency on a professional technician may lead to the possibility of false-positive diagnosis. By combining the merits of both optical and acoustic signals, newly-developed photoacoustic imaging, simultaneously featuring higher temporal and spatial resolution with good sensitivity, as well as deeper penetration depth, is discussed in the third secretion. In the final part, we further discuss the major challenges and prospects for developing imaging technology for accurate disease diagnosis. We believe that these non-invasive imaging technologies will introduce a new perspective for the precise diagnosis of various diseases in the future.
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Affiliation(s)
- Binbin Chu
- Suzhou Key Laboratory of Nanotechnology and Biomedicine, Institute of Functional Nano and Soft Materials (FUNSOM), Soochow University, Suzhou, Jiangsu 215123, China.
| | - Zhiming Chen
- Department of Ultrasound, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215006, China.
| | - Haoliang Shi
- Suzhou Key Laboratory of Nanotechnology and Biomedicine, Institute of Functional Nano and Soft Materials (FUNSOM), Soochow University, Suzhou, Jiangsu 215123, China.
| | - Xiaofeng Wu
- Department of Ultrasound, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215006, China.
| | - Houyu Wang
- Suzhou Key Laboratory of Nanotechnology and Biomedicine, Institute of Functional Nano and Soft Materials (FUNSOM), Soochow University, Suzhou, Jiangsu 215123, China.
| | - Fenglin Dong
- Department of Ultrasound, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215006, China.
| | - Yao He
- Suzhou Key Laboratory of Nanotechnology and Biomedicine, Institute of Functional Nano and Soft Materials (FUNSOM), Soochow University, Suzhou, Jiangsu 215123, China.
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Natale F, Molinari R, Covino S, Golino P, Cimmino G. The Color Encoding System used in Color-Doppler Echographic Imaging is Different from the Original Christian Doppler's Principles. J Cardiovasc Echogr 2022; 32:229. [PMID: 36994127 PMCID: PMC10041398 DOI: 10.4103/jcecho.jcecho_33_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Accepted: 06/02/2022] [Indexed: 03/31/2023] Open
Affiliation(s)
- Francesco Natale
- Department of Cardiology, Hospital “AOU Monaldi”, University of Campania Luigi Vanvitelli, Naples
- Department of Cardiology, University of Campania Luigi Vanvitelli, Caserta, Italy
| | - Riccardo Molinari
- Department of Cardiology, Hospital “AOU Monaldi”, University of Campania Luigi Vanvitelli, Naples
- Department of Cardiology, University of Campania Luigi Vanvitelli, Caserta, Italy
| | - Simona Covino
- Department of Cardiology, Hospital “AOU Monaldi”, University of Campania Luigi Vanvitelli, Naples
- Department of Cardiology, University of Campania Luigi Vanvitelli, Caserta, Italy
| | - Paolo Golino
- Department of Cardiology, Hospital “AOU Monaldi”, University of Campania Luigi Vanvitelli, Naples
- Department of Cardiology, University of Campania Luigi Vanvitelli, Caserta, Italy
| | - Giovanni Cimmino
- Department of Cardiology, Hospital “AOU Monaldi”, University of Campania Luigi Vanvitelli, Naples
- Department of Cardiology, University of Campania Luigi Vanvitelli, Caserta, Italy
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Purkerson JM, Everett CA, Schwartz GJ. Ammonium chloride-induced acidosis exacerbates cystitis and pyelonephritis caused by uropathogenic E. coli. Physiol Rep 2022; 10:e15471. [PMID: 36151614 PMCID: PMC9508385 DOI: 10.14814/phy2.15471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 09/01/2022] [Indexed: 06/16/2023] Open
Abstract
Acute pyelonephritis caused by uropathogenic E. coli (UPEC) can cause renal scarring and lead to development of chronic kidney disease. Prevention of kidney injury requires an understanding of host factors and/or UPEC adaptive responses that are permissive for UPEC colonization of the urinary tract. Although some studies have suggested urine acidification limits UPEC growth in culture, other studies have described acid-resistance mechanisms (AR) in E. coli such as the CadC/CadBA module that promotes adaptation to acid and nitrosative stress. Herein we confirm and extend our previous study by demonstrating that despite urine acidification, metabolic acidosis induced by dietary ammonium chloride (NH4 Cl-A) exacerbates cystitis and pyelonephritis in innate immune competent (C3H-HeN) mice characterized by: (1) markedly elevated UPEC burden and increased chemokine/cytokine and NOS2 mRNA expression, (2) accumulation of intravesicular debris noninvasively detected by Power Doppler Ultrasound (PDUS), and (3) collecting duct (CD) dysfunction that manifests as a urine concentration defect. Bladder debris and CD dysfunction were due to the inflammatory response, as neither was observed in Tlr4-deficient (C3H-HeJ) mice. The effect of NH4 Cl-A was unrelated to acidosis as dietary administration of hydrochloric acid (HCl-A) yielded a comparable acid-base status yet did not increase UPEC burden. NH4 Cl-A increased polyamines and decreased nitric oxide (NO) metabolites in urine indicating that excess dietary ammonium shifts arginine metabolism toward polyamines at the expense of NO synthesis. Furthermore, despite increased expression of NOS2, NO production post UPEC infection was attenuated in NH4 Cl-A mice compared to controls. Thus, in addition to induction of metabolic acidosis and urine acidification, excess dietary ammonium alters the polyamine:NO balance and thereby compromises NOS2-mediated innate immune defense.
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Affiliation(s)
- Jeffrey M. Purkerson
- Pediatric NephrologyUniversity of Rochester Medical CenterRochesterNew YorkUSA
- Strong Children's Research CenterUniversity of Rochester Medical CenterRochesterNew YorkUSA
| | - Coralee A. Everett
- Pediatric NephrologyUniversity of Rochester Medical CenterRochesterNew YorkUSA
- Strong Children's Research CenterUniversity of Rochester Medical CenterRochesterNew YorkUSA
| | - George J. Schwartz
- Pediatric NephrologyUniversity of Rochester Medical CenterRochesterNew YorkUSA
- Strong Children's Research CenterUniversity of Rochester Medical CenterRochesterNew YorkUSA
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Ultrasonography for the diagnosis of carpal tunnel syndrome: an umbrella review. J Neurol 2022; 269:4663-4675. [PMID: 35639198 DOI: 10.1007/s00415-022-11201-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 05/15/2022] [Accepted: 05/16/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Numerous sonographic modalities and parameters have been used to diagnose carpal tunnel syndrome (CTS), with varying accuracy. Our umbrella review aimed to summarize the evidence from systematic reviews and meta-analyses regarding the use of ultrasound imaging to diagnose CTS. METHODS Systematic reviews and meta-analyses meeting the inclusion criteria were searched in PubMed, Embase, Medline, Web of Science, and Cochrane databases from inception to March 2022. Critical appraisal, data extraction, and synthesis were performed in accordance with the criteria for conducting an umbrella review. RESULTS Sixteen reviews were included. Three reviews were classified as high quality, one as moderate, four as low, and eight as critically low. The cross-sectional area (CSA) of the median nerve at the carpal tunnel inlet demonstrated the best reliability and diagnostic accuracy among multiple parameters. A cutoff CSA value of 9-10.5 mm2 gave the highest diagnostic performance in the general population. The degree of CSA enlargement was correlated with CTS severity. Sonoelastography and Doppler ultrasound might provide additional insights into CTS evaluation as median nerve stiffness and vascularity at the wrist were increased in these patients. CONCLUSIONS Sonography is a reliable tool to diagnose CTS, with inlet CSA being the most robust parameter. Sonoelastography and Doppler ultrasound can serve as auxiliary tools to confirm CTS diagnoses. Further studies are needed to expand the use of sonography for diagnosing CTS, especially in the presence of concomitant neuromuscular disease(s).
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Visalli C, Vinci SL, Mondello S, Kobeissy F, Salamone I, Coglitore A, Trimarchi R, Tessitore A, Impellizzeri P, Mormina E. Microvascular imaging ultrasound (MicroV) and power Doppler vascularization analysis in a pediatric population with early scrotal pain onset. Jpn J Radiol 2021; 40:192-201. [PMID: 34515926 DOI: 10.1007/s11604-021-01194-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 09/01/2021] [Indexed: 11/30/2022]
Abstract
INTRODUCTION The power Doppler is a useful tool in the evaluation of pediatric acute scrotal pain. Nonetheless, it may have some inherent limitations in scrotal vascularization analysis, potentially causing unnecessary surgery. The microvascular imaging ultrasound (MicroV) is an innovative Doppler technique able to improve the detection of very low flow. This retrospective study aims to compare both power Doppler and MicroV in the evaluation of a pediatric population with early-stage scrotal pain onset, first in testis vascularization analysis, and second in their diagnostic performances. MATERIALS AND METHODS 69 patients met the following inclusion criteria, age < 18-year-old, a clinical diagnosis of acute scrotal disease, pain onset ≤ 6 h, ultrasound examination (including B-mode, power Doppler, and MicroV), 3-months follow-up. For both power Doppler and MicroV, through a defined vascularization scale, it was evaluated the agreement in vascularization detection, and the sensitivity and specificity in US diagnostic abilities. RESULTS Retrospective diagnoses were of 8 testicular torsion, 15 orchi-epididymitis, and 46 children with other scrotal conditions. Power Doppler provided inconclusive US evaluation in 37.68% of the cases, while MicroV only in the 1.45% (p < 0.0001). Testicular torsion and orchi-epididymitis were identified, respectively, with MicroV in 100% (sensitivity, specificity, PPV, NPV, and accuracy of 100%) and 80% of patients (80% sensitivity, 100% specificity and PPV, 94.73% NPV, 95.65% accuracy); with power Doppler the identification was, respectively, of 87.5% (87.5% sensitivity, 100% specificity and PPV, 98.38% NPV and accuracy) and of 73.3% (73.33% sensitivity, 98.14% specificity, 91.66% PPV, 92.98% NPV, 92.75% accuracy). CONCLUSIONS Our findings indicate that MicroV is a reliable technique in vascularization detection of pediatric testes, being able also to detect vascularization in healthy testicles with no-flow at power Doppler examination. Moreover, MicroV could be a valuable ally in the US diagnostic of children with early-stage scrotal pain onset.
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Affiliation(s)
- Carmela Visalli
- Department of Biomedical and Dental Sciences and of Morphofunctional Imaging, University of Messina, AOU Policlinico Universitario "G. Martino", Via Consolare Valeria 1, 98122, Messina, Italy
| | - Sergio Lucio Vinci
- Department of Biomedical and Dental Sciences and of Morphofunctional Imaging, University of Messina, AOU Policlinico Universitario "G. Martino", Via Consolare Valeria 1, 98122, Messina, Italy
| | - Stefania Mondello
- Department of Biomedical and Dental Sciences and of Morphofunctional Imaging, University of Messina, AOU Policlinico Universitario "G. Martino", Via Consolare Valeria 1, 98122, Messina, Italy
| | - Firas Kobeissy
- Department of Psychiatry and Neuroscience, McKnight Brain Institute, University of Florida, Gainesville, FL, USA.,Department of Biochemistry and Molecular Genetics, American University of Beirut, Beirut, Lebanon
| | - Ignazio Salamone
- Department of Biomedical and Dental Sciences and of Morphofunctional Imaging, University of Messina, AOU Policlinico Universitario "G. Martino", Via Consolare Valeria 1, 98122, Messina, Italy
| | - Alessandra Coglitore
- Department of Biomedical and Dental Sciences and of Morphofunctional Imaging, University of Messina, AOU Policlinico Universitario "G. Martino", Via Consolare Valeria 1, 98122, Messina, Italy.
| | - Renato Trimarchi
- Department of Biomedical and Dental Sciences and of Morphofunctional Imaging, University of Messina, AOU Policlinico Universitario "G. Martino", Via Consolare Valeria 1, 98122, Messina, Italy
| | - Agostino Tessitore
- Department of Biomedical and Dental Sciences and of Morphofunctional Imaging, University of Messina, AOU Policlinico Universitario "G. Martino", Via Consolare Valeria 1, 98122, Messina, Italy
| | - Pietro Impellizzeri
- Department of Human Pathology in Adults and Developmental Age, Division of Pediatric Surgery, University of Messina, Messina, Italy
| | - Enricomaria Mormina
- Department of Biomedical and Dental Sciences and of Morphofunctional Imaging, University of Messina, AOU Policlinico Universitario "G. Martino", Via Consolare Valeria 1, 98122, Messina, Italy
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Saß B, Pojskic M, Zivkovic D, Carl B, Nimsky C, Bopp MHA. Utilizing Intraoperative Navigated 3D Color Doppler Ultrasound in Glioma Surgery. Front Oncol 2021; 11:656020. [PMID: 34490080 PMCID: PMC8416533 DOI: 10.3389/fonc.2021.656020] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 07/23/2021] [Indexed: 01/23/2023] Open
Abstract
Background In glioma surgery, the patient’s outcome is dramatically influenced by the extent of resection and residual tumor volume. To facilitate safe resection, neuronavigational systems are routinely used. However, due to brain shift, accuracy decreases with the course of the surgery. Intraoperative ultrasound has proved to provide excellent live imaging, which may be integrated into the navigational procedure. Here we describe the visualization of vascular landmarks and their shift during tumor resection using intraoperative navigated 3D color Doppler ultrasound (3D iUS color Doppler). Methods Six patients suffering from glial tumors located in the temporal lobe were included in this study. Intraoperative computed tomography was used for registration. Datasets of 3D iUS color Doppler were generated before dural opening and after tumor resection, and the vascular tree was segmented manually. In each dataset, one to four landmarks were identified, compared to the preoperative MRI, and the Euclidean distance was calculated. Results Pre-resectional mean Euclidean distance of the marked points was 4.1 ± 1.3 mm (mean ± SD), ranging from 2.6 to 6.0 mm. Post-resectional mean Euclidean distance was 4.7. ± 1.0 mm, ranging from 2.9 to 6.0 mm. Conclusion 3D iUS color Doppler allows estimation of brain shift intraoperatively, thus increasing patient safety. Future implementation of the reconstructed vessel tree into the navigational setup might allow navigational updating with further consecutive increasement of accuracy.
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Affiliation(s)
- Benjamin Saß
- Department of Neurosurgery, University of Marburg, Marburg, Germany
| | - Mirza Pojskic
- Department of Neurosurgery, University of Marburg, Marburg, Germany
| | - Darko Zivkovic
- Department of Neurosurgery, University of Marburg, Marburg, Germany
| | - Barbara Carl
- Department of Neurosurgery, University of Marburg, Marburg, Germany.,Department of Neurosurgery, Helios Dr. Horst Schmidt Kliniken, Wiesbaden, Germany
| | - Christopher Nimsky
- Department of Neurosurgery, University of Marburg, Marburg, Germany.,Center for Mind, Brain and Behavior (CMBB), Marburg, Germany
| | - Miriam H A Bopp
- Department of Neurosurgery, University of Marburg, Marburg, Germany.,Center for Mind, Brain and Behavior (CMBB), Marburg, Germany
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Edwards S, Sivan M. High volume distension injection (HVDI) for chronic mid-portion Achilles tendinopathy: A service evaluation of clinical outcomes. JOURNAL OF ORTHOPAEDICS, TRAUMA AND REHABILITATION 2020. [DOI: 10.1177/2210491720979321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Purpose: High Volume Distension Injection (HVDI) is a treatment adjunct in chronic mid-portion Achilles tendinopathy. This study analysed whether HVDI is safe and effective in an outpatient clinic setting. Methods: Retrospective service evaluation of 18 participants over 18 months. Ultrasound-guided saline, corticosteroid and bupivacaine was injected to disrupt vasculo-neural ingrowth, with post-procedure eccentric exercises. Mean follow-up was 8 weeks. Outcomes used were Numeric rating Scale (NRS) of pain, tendon thickness and Modified Ohberg score (MOS) of neovascularisation measured on Ultrasound and Doppler imaging. Results: Mean reduction in NRS was 5.30 ± 2.53 ( P < 0.001). Mean tendon thickness reduction was 0.21 ± 0.17 cm ( P < 0.001). Median MOS improved from 2.00 ± 2.00 to 1.00 ± 3.00 ( P = 0.009). No complications occurred. 11 participants had successful primary HVDI, 3 responded to a second injection. Two non-responders were referred for surgery and two referred for alternative therapy by patient preference. Conclusion: Significant reduction in pain, tendon thickness and neovascularity was observed in 78% of patients. Recurrence in 39%. HVDI with eccentric training is safe and effective intervention in outpatient clinic setting.
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Affiliation(s)
- Samuel Edwards
- Faculty of Biological Sciences, University of Leeds, Leeds, UK
| | - Manoj Sivan
- Leeds Institute of Rheumatology and Musculoskeletal Medicine, University of Leeds, Leeds, UK
- Musculoskeletal Service, Leeds Community Healthcare NHS Trust, UK
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12
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Ten B, Kara T, Kaya Tİ, Yılmaz MA, Temel G, Balcı Y, Türsen Ü, Esen K. Evaluation of facial artery course variations and depth by Doppler ultrasonography. J Cosmet Dermatol 2020; 20:2247-2258. [PMID: 33171021 DOI: 10.1111/jocd.13838] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 10/23/2020] [Accepted: 11/02/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND As deep nasolabial folds (NLF) are associated with facial aging, there is an increasing demand for esthetic correction with filler injections. Understanding the anatomy of the angular artery (AA) and facial artery (FA) around the NLF region is essential for ensuring the safety of dermal filler injections into the NLF. The purpose of this study was to provide detailed vascular anatomical information on the course and depth of AA and FA around NLF using Doppler ultrasound on live cases. METHODS FA was observed from the origin level adjacent to the mandible corpus to the end of its terminal branch AA in 168 hemifaces of 84 cases with Doppler ultrasonography. RESULTS We made a classification of the FA course based on the NLF. The minimum and maximum depths of the FA along its course were measured in 84 cases. The results showed that its course may be highly superficial (2.5 mm at the mandibular origin, 3.7 mm at the cheilion, 3.7 mm at the nasal ala) or it may follow a very deep course near the periosteum (15.0 mm at the mandibular origin, 18.7 mm at the cheilion, 23.5 mm at the nasal ala). FA depth was varied between 5.98 mm and 6.62 mm at the mandibular origin, between 8.36 mm and 9.20 mm at the cheilion, between 9.52 mm and 10.51 mm at the nasal ala at a 95% confidence interval. CONCLUSIONS This study suggests that there is no absolutely safe depth or region for nasolabial fold filler injections.
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Affiliation(s)
- Barış Ten
- Department of Radiology, Mersin University Faculty of Medicine, Mersin, Turkey
| | - Taylan Kara
- Department of Radiology, Mersin University Faculty of Medicine, Mersin, Turkey
| | - Tamer İrfan Kaya
- Department of Dermatology, Mersin University Faculty of Medicine, Mersin, Turkey
| | - Mustafa Anıl Yılmaz
- Department of Dermatology, Mersin University Faculty of Medicine, Mersin, Turkey
| | - Gülhan Temel
- Department of Biostatistics, Mersin University Faculty of Medicine, Mersin, Turkey
| | - Yüksel Balcı
- Department of Radiology, Mersin University Faculty of Medicine, Mersin, Turkey
| | - Ümit Türsen
- Department of Dermatology, Mersin University Faculty of Medicine, Mersin, Turkey
| | - Kaan Esen
- Department of Radiology, Mersin University Faculty of Medicine, Mersin, Turkey
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Spiral artery blood flow during pregnancy: a systematic review and meta-analysis. BMC Pregnancy Childbirth 2020; 20:680. [PMID: 33176723 PMCID: PMC7656690 DOI: 10.1186/s12884-020-03150-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Accepted: 07/31/2020] [Indexed: 11/10/2022] Open
Abstract
Background Downstream remodeling of the spiral arteries (SpA) decreases utero-placental resistance drastically, allowing sustained and increased blood flow to the placenta under all circumstances. We systematically evaluated available reports to visualize adaptation of spiral arteries throughout pregnancy by ultra-sonographic measurements and evaluated when this process is completed. Methods A systematic review and meta-analysis of spiral artery flow (pulsatility index (PI), resistance index (RI) and peak systolic velocity (PSV)) was performed. English written articles were obtained from Pubmed, EMBASE and Cochrane Library and included articles were assessed on quality and risk of bias. Weighted means of Doppler indices were calculated using a random-effects model. Results In healthy pregnancies, PI and RI decreased from 0.80 (95% CI: 0.70–0.89) and 0.50 (95% CI: 0.47–0.54) in the first trimester to 0.50 (95% CI: 0.45–0.55, p < 0.001) and 0.39 (95% CI: 0.37–0.42, p < 0.001) in the second trimester and to 0.49 (95% CI: 0.44–0.53, p = 0.752) and 0.36 (95% CI: 0.35–0.38, p = 0.037) in the third trimester, respectively. In parallel, PSV altered from 0.22 m/s (95% CI: 0.13–0.30 m/s) to 0.28 m/s (95% CI: 0.17–0.40 m/s, p = 0.377) and to 0.25 m/s (95% CI: 0.20–0.30 m/s, p = 0.560) in the three trimesters. In absence of second and third trimester Doppler data in complicated gestation, only a difference in PI was observed between complicated and healthy pregnancies during the first trimester (1.49 vs 0.80, p < 0.001). Although individual studies have identified differences in PI between SpA located in the central part of the placental bed versus those located at its periphery, this meta-analysis could not confirm this (p = 0.349). Conclusions This review and meta-analysis concludes that an observed decrease of SpA PI and RI from the first towards the second trimester parallels the physiological trophoblast invasion converting SpA during early gestation, a process completed in the midst of the second trimester. Higher PI was found in SpA of complicated pregnancies compared to healthy pregnancies, possibly reflecting suboptimal utero-placental circulation. Longitudinal studies examining comprehensively the predictive value of spiral artery Doppler for complicated pregnancies are yet to be carried out.
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14
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Smith E, Azzopardi C, Thaker S, Botchu R, Gupta H. Power Doppler in musculoskeletal ultrasound: uses, pitfalls and principles to overcome its shortcomings. J Ultrasound 2020; 24:151-156. [PMID: 32683646 DOI: 10.1007/s40477-020-00489-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 06/05/2020] [Indexed: 11/26/2022] Open
Abstract
Power Doppler (PD) is used widely in musculoskeletal ultrasound, especially in the assessment of structures for evidence of inflammation and in evaluating soft tissue neoplasms. We reinforce and delineate the three cardinal principles of optimising PD assessment in order to avoid false positive or false negative results; namely (1) Optimal gain settings (2) Adequate transducer pressure, and (3) Proper patient/anatomical structure-of-interest positioning with complete tissue relaxation.
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Affiliation(s)
- E Smith
- Department of Musculoskeletal Radiology, The Royal Orthopedic Hospital, Bristol Road South, Northfield, Birmingham, UK
| | - C Azzopardi
- Department of Musculoskeletal Radiology, The Royal Orthopedic Hospital, Bristol Road South, Northfield, Birmingham, UK
| | - S Thaker
- Department of Radiology, Kettering General Hospital, Kettering, UK
| | - R Botchu
- Department of Musculoskeletal Radiology, The Royal Orthopedic Hospital, Bristol Road South, Northfield, Birmingham, UK.
| | - H Gupta
- Department of Musculoskeletal Imaging, Leeds Teaching Hospital, Leeds, UK
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15
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Acute scrotal pain in pediatric patients: diagnosis with an innovative Doppler technique (MicroV). Emerg Radiol 2020; 28:209-214. [PMID: 32591921 DOI: 10.1007/s10140-020-01812-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Accepted: 06/19/2020] [Indexed: 10/24/2022]
Abstract
Acute scrotal pain is one of the most frequent symptoms in pediatric patients visited in the Emergency Department. Ultrasonography with color and power Doppler represents the first-line method that clinicians use to carry out the differential diagnosis between spermatic cord torsion and inflammation, but sensitivity and specificity are 63-100% and 97-100%, respectively; this variability may be related to operator's experience and testis vascular hemodynamics and also to machine performance and patient age. Recent technological innovations have made possible to create a new Doppler mode called ultrasound microvascular imaging. This technique exploits algorithms capable of separating low frequencies of static tissue artifacts from ones of very weak flows. It is known as MicroV (from Esaote) and Superb microvascular imaging (from Toshiba). It provides both macrocirculation vascular maps, as a typical Doppler feature, and microcirculation vascular maps. Furthermore, the use of background subtraction could improve the visibility of small vascular structures. We report a case of a pediatric patient suffering from acute scrotal pain assessed ultrasonographically with this innovative Doppler technique (MicroV) that may give more confidence in detecting testicular vascular signals if compared with traditional Doppler techniques.
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16
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Galgano SJ, Lockhart ME, Fananapazir G, Sanyal R. Optimizing renal transplant Doppler ultrasound. Abdom Radiol (NY) 2018; 43:2564-2573. [PMID: 30121777 DOI: 10.1007/s00261-018-1731-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Doppler ultrasound is routinely used for the post-operative evaluation of renal transplant patients. Knowledge of the surgical anatomy and application of a robust technique are important for appropriate evaluation of a transplanted kidney. In this review article, we discuss the surgical anatomy of renal transplantation, techniques to optimize image acquisition, as well as commonly associated pitfalls with Doppler ultrasound evaluation of renal grafts.
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17
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Malferrari G, Pulito G, Pizzini AM, Carraro N, Meneghetti G, Sanzaro E, Prati P, Siniscalchi A, Monaco D. MicroV Technology to Improve Transcranial Color Coded Doppler Examinations. J Neuroimaging 2018; 28:350-358. [DOI: 10.1111/jon.12517] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Revised: 04/06/2018] [Accepted: 04/11/2018] [Indexed: 11/30/2022] Open
Affiliation(s)
- Giovanni Malferrari
- Stroke Unit, Neurology Unit; Azienda Unità Sanitaria Locale - IRCCS; Reggio Emilia Italy
| | - Giuseppe Pulito
- Department of Anaesthesia and Resuscitation Service - Vito Fazzi Hospital; Lecce Italy
| | | | - Nicola Carraro
- Neurology Clinic; Department of Head and Neck - Integrated University Healthcare Company; Trieste Italy
| | - Giorgio Meneghetti
- Department of Neurosciences; University of Padua School of Medicine; Padova Italy
| | - Enzo Sanzaro
- Stroke Unit; Department of Medicine - Umberto I Hospital; Siracusa Italy
| | | | | | - Daniela Monaco
- Stroke Unit; Department of Medicine - Spirito Santo Hospital; Pescara Italy
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18
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Karimzadeh H, Karami M, Bazgir N, Karimifar M, Yadegarfar G, Mohammadzadeh Z. Ultrasonographic findings of rheumatoid arthritis patients who are in clinical remission. JOURNAL OF RESEARCH IN MEDICAL SCIENCES : THE OFFICIAL JOURNAL OF ISFAHAN UNIVERSITY OF MEDICAL SCIENCES 2018; 23:38. [PMID: 29887906 PMCID: PMC5961277 DOI: 10.4103/jrms.jrms_308_17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Revised: 07/05/2017] [Accepted: 01/17/2018] [Indexed: 12/03/2022]
Abstract
BACKGROUND The aim of this study was to recognize the findings of ultrasonography (US) in remitted rheumatic arthritis (RA) patients for detection subclinical arthritis. MATERIALS AND METHODS This descriptive study was conducted during 2016 in a rheumatology center. A total of 70 patients with remitted RA were included in the study. Sonography was performed on all 70 patients who did not show any clinical arthritis in clinical examination to find synovitis and effusion were evaluated with gray scale and hyperemia with power Doppler US. RESULTS Nearly 44.3% (n = 31) of our patients had positive sonography results including 20% synovitis, 21.4% hyperemia, and 18.6% (n = 13) effusion. A total of 1960 joints of 70 patients were evaluated, in which 3.2% (n = 63) of joints had positive sonography findings including 1.2% synovitis, 1.5% hyperemia, and 1.1 with effusion. CONCLUSION US can diagnosis subclinical arthritis in patients with remitted RA who does not show any joint involvement in clinical examination.
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Affiliation(s)
- Hadi Karimzadeh
- Department of Internal Medicine, Isfahan Bone Metabolic Disorders Research Center, School of Medicine, Isfahan University of Medical Science, Isfahan, Iran
| | - Mehdi Karami
- Department of Radiology, Medical School, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Nasrin Bazgir
- Department of Internal Medicine, Isfahan Bone Metabolic Disorders Research Center, School of Medicine, Isfahan University of Medical Science, Isfahan, Iran
- Department of Internal Medicine, Mostafa Khomyni Hospital, Ilam University of Medical Sciences, Ilam, Iran
| | - Mansour Karimifar
- Department of Rheumatology, Medical School, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ghasem Yadegarfar
- Department of Biostatistics, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Zohrea Mohammadzadeh
- Department of Radiology, Medical School, Isfahan University of Medical Sciences, Isfahan, Iran
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19
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Rabba S, Grulke S, Verwilghen D, Evrard L, Busoni V. B-mode and power Doppler ultrasonography of the equine suspensory ligament branches: A descriptive study on 13 horses. Vet Radiol Ultrasound 2018; 59:453-460. [PMID: 29498123 DOI: 10.1111/vru.12610] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Revised: 11/21/2017] [Accepted: 11/30/2017] [Indexed: 11/29/2022] Open
Abstract
Ultrasonography is routinely used to achieve the diagnosis of equine suspensory ligament desmopathy. In human medicine, power Doppler ultrasonography has also been found to be useful for the diagnosis of tendon/ligament injuries. The aim of this prospective, pilot study was to assess the presence or absence of power Doppler signal in suspensory ligament branches and compare B-mode findings with power Doppler findings in suspensory ligament branches of lame and non-lame limbs. Thirteen horses were used (eight lame horses, with lameness related to pain in the suspensory ligament branches, and five non-lame horses). Ten lame limbs and 24 sound limbs were assessed by B-mode and power Doppler ultrasonography. The severity of power Doppler signal was scored by two independent readers. The B-mode ultrasonographic examination revealed abnormalities in branches of lame limbs and in branches of sound limbs. Suspensory ligament branches that were considered normal in B-mode showed no power Doppler signal. However, power Doppler signal was detected in suspensory ligament branches that were abnormal in B-mode, both in lame and sound limbs. Power Doppler scores were subjectively higher in suspensory ligament branches of lame limbs and in branches with more severe B-mode changes. Findings supported the use of power Doppler as an adjunctive diagnostic test for lame horses with suspected suspensory desmopathy.
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Affiliation(s)
- Silvia Rabba
- Faculty of Veterinary Medicine, Department of Clinical Sciences of Companion Animals and Equids, Diagnostic Imaging Section, University of Liège, Liège, Belgium.,Department of Diagnostic Imaging, Istituto Veterinario di Novara, Granozzo con Monticello, Italy
| | - Sigrid Grulke
- Faculty of Veterinary Medicine, Department of Clinical Sciences of Companion Animals and Equids, Equine Surgery Section, University of Liège, Liège, Belgium
| | - Denis Verwilghen
- Faculty of Veterinary Medicine, Department of Clinical Sciences of Companion Animals and Equids, Equine Surgery Section, University of Liège, Liège, Belgium.,Veterinary Teaching Hospital, Department of Veterinary Sciences, Faculty of Science, University of Sydney, Sydney, Australia
| | - Laurence Evrard
- Faculty of Veterinary Medicine, Department of Clinical Sciences of Companion Animals and Equids, Diagnostic Imaging Section, University of Liège, Liège, Belgium
| | - Valeria Busoni
- Faculty of Veterinary Medicine, Department of Clinical Sciences of Companion Animals and Equids, Diagnostic Imaging Section, University of Liège, Liège, Belgium
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20
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Xu H, Zhang Y, Zhang H, Wang C, Mao P. Comparison of the clinical effectiveness of US grading scoring system vs MRI in the diagnosis of early rheumatoid arthritis (RA). J Orthop Surg Res 2017; 12:152. [PMID: 29041980 PMCID: PMC5646118 DOI: 10.1186/s13018-017-0653-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2017] [Accepted: 10/02/2017] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND As an irreversible disease, a treatment delay can negatively affect treatment response in rheumatoid arthritis (RA). Ultrasound and MRI have played an important role in assessing disease progression and response to treatment in RA for many years. The present study was designed to compare the diagnostic efficacy of ultrasound grading and MRI in early RA. METHODS In this retrospective study, 62 early RA patients within 12 months of symptom onset were included. DAS28, rheumatoid factor (RF), CRP, ESR, and anti-cyclic citrullinated peptide antibody (CCP) of the patients were measured. Bilateral hand joints and wrists were examined by ultrasonography (US) and MRI; diagnosis outcome was compared. Relationship between DAS28 scores, laboratory parameters, and ultrasound findings were analyzed. RESULTS Ultrasound and MRI had an equivalent diagnosis value in synovitis, joint effusion, and tenosynovitis. The detection rate of synovitis, arthroedema, and tenosynovitis on ultrasound and MRI was very close (P > 0.05). The detection rate of bone erosion was lower in ultrasonography than that in MRI (P < 0.05). There were significant differences between power Doppler ultrasonography (PDUS) and gray-scale ultrasonography (GSUS) in the diagnosis of synovitis (χ 2 = 3.92, P < 0.05); the sensitivity of GSUS was better than that of PDUS (P < 0.05). PDUS was positively correlated with DAS28, ESR, CRP, and CCP (P < 0.01), but not correlated with RF and disease duration (P > 0.05). GSUS was positively correlated with RF and CRP (P < 0.01), but not correlated with DAS28, CCP, ESR, and disease duration (P > 0.05). Bone erosion was positively correlated with disease duration, CCP, and RF (P < 0.01) and was not correlated with DAS28, ESR, and CRP (P > 0.05). CONCLUSION Ultrasonography has a high reliability in the diagnosis of early RA in synovitis, joint effusion, tenosynovitis, and bone erosion. Ultrasonography and clinical and laboratory parameters had a great correlativity. Both ultrasound and MRI are effective techniques. In view of the advantages of low cost and convenience, ultrasound may be a better choice during early RA diagnosis.
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Affiliation(s)
- Huajun Xu
- Department of Ultrasound, The Second Affiliated Hospital of Soochow University, San Xiang Road 1055, Suzhou, 215004 China
- Department of Ultrasound, Huzhou Central Hospital, Hong Qi Road 198, Huzhou, 313000 China
| | - Yingchun Zhang
- Department of Ultrasound, The Second Affiliated Hospital of Soochow University, San Xiang Road 1055, Suzhou, 215004 China
| | - Huimei Zhang
- Department of Radiology, Huzhou Central Hospital, Hong Qi Road 198, Huzhou, 313000 China
| | - Caishan Wang
- Department of Ultrasound, The Second Affiliated Hospital of Soochow University, San Xiang Road 1055, Suzhou, 215004 China
| | - Pan Mao
- Department of Ultrasound, The Second Affiliated Hospital of Soochow University, San Xiang Road 1055, Suzhou, 215004 China
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21
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Yamasato K, Zalud I. Three dimensional power Doppler of the placenta and its clinical applications. J Perinat Med 2017; 45:693-700. [PMID: 28306539 DOI: 10.1515/jpm-2016-0366] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Accepted: 02/09/2017] [Indexed: 11/15/2022]
Abstract
The aim of this review is to discuss three dimensional (3D) power Doppler of the placenta and its clinical applications. There is a strong clinical need to develop noninvasive, simple and widely available methods of evaluating in vivo placental function to assess fetal wellbeing. While conventional ultrasound is a proven tool in the evaluation of fetal structural anomalies and health, its ability to assess placental function, especially prior to the onset of fetal compromise, is the subject of ongoing investigation. Three dimensional power Doppler has the ability to detect vascularity and blood flow with greater detail than conventional ultrasound, which has led to its investigation in preeclampsia, fetal growth restriction, and other placental vascular abnormalities. While more data are needed on the optimal imaging protocol and its predictive ability for clinical outcomes, 3D power Doppler is emerging as a promising new technology that will improve the evaluation of placental function.
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22
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Altinkilic B, Pilatz A, Diemer T, Wolf J, Bergmann M, Schönbrunn S, Ligges U, Schuppe HC, Weidner W. Prospective evaluation of scrotal ultrasound and intratesticular perfusion by color-coded duplex sonography (CCDS) in TESE patients with azoospermia. World J Urol 2017; 36:125-133. [PMID: 28429094 DOI: 10.1007/s00345-017-2039-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2016] [Accepted: 04/13/2017] [Indexed: 11/28/2022] Open
Abstract
PURPOSE The objective of this study was to assess whether CCDS might improve the outcome of testicular sperm retrieval in patients with azoospermia. Furthermore, we evaluated potential sonographic alterations of the testis before and after trifocal and Micro-TESE. METHODS 78 patients were enrolled prospectively: 24 with obstructive azoospermia (OA) and 54 with non-obstructive azoospermia (NOA). 31 of 54 patients in the NOA group had negative surgical sperm retrieval. Testicular volume, hormonal parameters and sonographical findings were compared before and after TESE. The spermatogenetic score was determined for all retrieval sites. CCDS was performed at the upper, middle and lower segment of the testis. Ultrasound parameters and peak systolic velocity (PSV) were measured pre- and post-operatively. RESULTS Testicular volume and epididymal head size were significantly increased in OA patients compared to NOA patients. Ultrasound parameters were comparable between NOA patients with and without successful sperm retrieval. A higher intratesticular PSV was significantly correlated with a better spermatogenic score in the corresponding sonographic position. However, after adjustment for other clinical confounders, PSV does not show a significant influence on the spermatogenic score. Testicular volume decreased significantly in all patients post-operatively after 6 weeks (p < 0.001). Finally, the PSV significantly increased in all patients 24 h after surgery and nearly returned to baseline levels after 6 weeks (p < 0.001). CONCLUSIONS A higher intratesticular PSV may be helpful as a pre-operative diagnostic parameter in mapping for better sperm retrieval, but CCDS does not help to predict successful testicular sperm retrieval after adjustment for other clinical confounders.
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Affiliation(s)
- Bora Altinkilic
- Department of Urology, Pediatric Urology and Andrology, Justus-Liebig University Giessen, Rudolf-Buchheim-Str. 7, 35392, Giessen, Germany.
| | - Adrian Pilatz
- Department of Urology, Pediatric Urology and Andrology, Justus-Liebig University Giessen, Rudolf-Buchheim-Str. 7, 35392, Giessen, Germany
| | - Thorsten Diemer
- Department of Urology, Pediatric Urology and Andrology, Justus-Liebig University Giessen, Rudolf-Buchheim-Str. 7, 35392, Giessen, Germany
| | - Julia Wolf
- Department of Urology, Pediatric Urology and Andrology, Justus-Liebig University Giessen, Rudolf-Buchheim-Str. 7, 35392, Giessen, Germany
| | - Martin Bergmann
- Institute of Veterinary Anatomy, Histology and Embryology, Justus-Liebig University Giessen, Frankfurter Str. 98, 35392, Giessen, Germany
| | - Sarah Schönbrunn
- Department of Statistics, TU Dortmund University, Dortmund, Germany
| | - Uwe Ligges
- Department of Statistics, TU Dortmund University, Dortmund, Germany
| | - Hans-Christian Schuppe
- Department of Urology, Pediatric Urology and Andrology, Justus-Liebig University Giessen, Rudolf-Buchheim-Str. 7, 35392, Giessen, Germany
| | - Wolfgang Weidner
- Department of Urology, Pediatric Urology and Andrology, Justus-Liebig University Giessen, Rudolf-Buchheim-Str. 7, 35392, Giessen, Germany
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Heres HM, Arabul MU, Rutten MCM, Van de Vosse FN, Lopata RGP. Visualization of vasculature using a hand-held photoacoustic probe: phantom and in vivo validation. JOURNAL OF BIOMEDICAL OPTICS 2017; 22:41013. [PMID: 28117865 DOI: 10.1117/1.jbo.22.4.041013] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Accepted: 01/03/2017] [Indexed: 06/06/2023]
Abstract
Assessment of microvasculature and tissue perfusion can provide diagnostic information on local or systemic diseases. Photoacoustic (PA) imaging has strong clinical potential because of its sensitivity to hemoglobin. We used a hand-held PA probe with integrated diode lasers and examined its feasibility and validity in the detection of increasing blood volume and (sub) dermal vascularization. Blood volume detection was tested in custom-made perfusion phantoms. Results showed that an increase of blood volume in a physiological range of 1.3% to 5.4% could be detected. The results were validated with power Doppler sonography. Using a motorized scanning setup, areas of the skin were imaged at relatively short scanning times ( < 10 ?? s / cm 2 ) with PA. Three-dimensional visualization of these structures was achieved by combining the consecutively acquired cross-sectional images. Images revealed the epidermis and submillimeter vasculature up to depth of 5 mm. The geometries of imaged vasculature were validated with segmentation of the vasculature in high-frequency ultrasound imaging. This study proves the feasibility of PA imaging in its current implementation for the detection of perfusion-related parameters in skin and subdermal tissue and underlines its potential as a diagnostic tool in vascular or dermal pathologies.
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Affiliation(s)
- H Maarten Heres
- Eindhoven University of Technology, Cardiovascular Biomechanics Group, Department of Biomedical Engineering, The Netherlands
| | - Mustafa Umit Arabul
- Eindhoven University of Technology, Cardiovascular Biomechanics Group, Department of Biomedical Engineering, The Netherlands
| | - Marcel C M Rutten
- Eindhoven University of Technology, Cardiovascular Biomechanics Group, Department of Biomedical Engineering, The Netherlands
| | - Frans N Van de Vosse
- Eindhoven University of Technology, Cardiovascular Biomechanics Group, Department of Biomedical Engineering, The Netherlands
| | - Richard G P Lopata
- Eindhoven University of Technology, Cardiovascular Biomechanics Group, Department of Biomedical Engineering, The Netherlands
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Dori A, Abbasi H, Zaidman CM. Intramuscular blood flow quantification with power doppler ultrasonography. Muscle Nerve 2016; 54:872-878. [PMID: 26994405 DOI: 10.1002/mus.25108] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/15/2016] [Indexed: 11/05/2022]
Abstract
INTRODUCTION Quantification of blood flow to muscle using ultrasound is limited to large vessels. Small vessel intramuscular blood flow cannot be quantified using ultrasound without specialized methods or intravenous contrast. METHODS We describe a technique using power Doppler to quantify postcontraction hyperemia in intramuscular vessels that can be used at the bedside. RESULTS In 11 healthy subjects, postcontraction intramuscular blood flow in the forearm flexors and tibialis anterior muscles increased with stronger and repeated contractions. Intravascular blood flow measured by pulsed Doppler in the brachial artery similarly increased. Three patients with muscular dystrophies showed a negligible increase of postcontraction intramuscular blood flow. CONCLUSIONS Intramuscular blood flow can be quantified using power Doppler ultrasonography; it increases following contraction and may be reduced in patients with muscular dystrophies. This quantitative, noninvasive technique can be applied at the bedside and may facilitate studies of disease impact on intramuscular blood flow. Muscle Nerve 54: 872-878, 2016.
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Affiliation(s)
- Amir Dori
- Department of Neurology, Talpiot Medical Leadership Program, Chaim Sheba Medical Center, Tel HaShomer, and Joseph Sagol Neuroscience Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel, 52621. .,Department of Neurology, Washington University School of Medicine, St. Louis, Missouri, USA.
| | - Hiba Abbasi
- Department of Neurology, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Craig M Zaidman
- Department of Neurology, Washington University School of Medicine, St. Louis, Missouri, USA
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Avigo C, Flori A, Armanetti P, Di Lascio N, Kusmic C, Jose J, Losi P, Soldani G, Faita F, Menichetti L. Strategies for non-invasive imaging of polymeric biomaterial in vascular tissue engineering and regenerative medicine using ultrasound and photoacoustic techniques. POLYM INT 2016. [DOI: 10.1002/pi.5113] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Affiliation(s)
- Cinzia Avigo
- Institute of Clinical Physiology; National Research Council; via G. Moruzzi 1 56124 Pisa Italy
| | - Alessandra Flori
- Institute of Clinical Physiology; National Research Council; via G. Moruzzi 1 56124 Pisa Italy
| | - Paolo Armanetti
- Institute of Clinical Physiology; National Research Council; via G. Moruzzi 1 56124 Pisa Italy
| | - Nicole Di Lascio
- Institute of Clinical Physiology; National Research Council; via G. Moruzzi 1 56124 Pisa Italy
| | - Claudia Kusmic
- Institute of Clinical Physiology; National Research Council; via G. Moruzzi 1 56124 Pisa Italy
| | - Jithin Jose
- Institute of Clinical Physiology; National Research Council; via G. Moruzzi 1 56124 Pisa Italy
| | - Paola Losi
- Institute of Clinical Physiology; National Research Council; via G. Moruzzi 1 56124 Pisa Italy
| | - Giorgio Soldani
- Institute of Clinical Physiology; National Research Council; via G. Moruzzi 1 56124 Pisa Italy
| | - Francesco Faita
- Institute of Clinical Physiology; National Research Council; via G. Moruzzi 1 56124 Pisa Italy
| | - Luca Menichetti
- Institute of Clinical Physiology; National Research Council; via G. Moruzzi 1 56124 Pisa Italy
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The Role of Power Doppler Ultrasonography as Disease Activity Marker in Rheumatoid Arthritis. DISEASE MARKERS 2015; 2015:325909. [PMID: 26063952 PMCID: PMC4433665 DOI: 10.1155/2015/325909] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2015] [Accepted: 04/07/2015] [Indexed: 11/28/2022]
Abstract
Structural damage in rheumatoid arthritis (RA) occurs early if inflammation is not treated promptly. Treatment targeted to reduce inflammation, in particular, that of synovial inflammation in the joints (synovitis), has been recommended as standard treat-to-target recommendations by rheumatologists. The goal is to achieve disease remission (i.e., no disease activity). Several accepted remission criteria have not always equated to the complete absence of true inflammation. Over the last decade, musculoskeletal ultrasonography has been demonstrated to detect subclinical synovitis not appreciated by routine clinical or laboratory assessments, with the Power Doppler modality allowing clinicians to more readily appreciate true inflammation. Thus, targeting therapy to Power Doppler activity may provide superior outcomes compared with treating to clinical targets alone, making it an attractive marker of disease activity in RA. However, more validation on its true benefits such as its benefits to patients in regard to patient related outcomes and issues with standardized training in acquisition and interpretation of power Doppler findings are required.
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Sultan LR, Xiong H, Zafar HM, Schultz SM, Langer JE, Sehgal CM. Vascularity assessment of thyroid nodules by quantitative color Doppler ultrasound. ULTRASOUND IN MEDICINE & BIOLOGY 2015; 41:1287-1293. [PMID: 25677641 DOI: 10.1016/j.ultrasmedbio.2015.01.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2014] [Revised: 11/25/2014] [Accepted: 01/01/2015] [Indexed: 06/04/2023]
Abstract
Our objective was to assess the role of quantitative Doppler vascularity in differentiating malignant and benign thyroid nodules. Color Doppler images of 100 nodules were analyzed for three metrics: vascular fraction area, mean flow velocity index and flow volume index in three regions (nodule center, nodule rim and surrounding parenchyma). Vascular fraction area and flow volume index were higher in malignant than benign nodules in both the central and rim regions, whereas flow velocity index was equivalent in both regions. Of the three vascularity metrics studied, the vascular fraction area of the central region was most effective in predicting malignancy, with a sensitivity of 0.90 ± 0.05, specificity of 0.88 ± 0.13, positive predictive value of 0.84 ± 0.14, negative predictive value of 0.92 ± 0.03 and accuracy of 0.89 ± 0.08. Quantitative Doppler vascularity of the nodule center yielded a high level of discrimination between benign and malignant nodules and, thus, has the greatest potential to contribute to gray-scale assessment of thyroid cancer.
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Affiliation(s)
- Laith R Sultan
- Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Hui Xiong
- Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Hanna M Zafar
- Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Susan M Schultz
- Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Jill E Langer
- Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Chandra M Sehgal
- Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
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Abstract
BACKGROUND The purposes of this study were to determine the morphological features and conceptualize the anatomical definition of the angular artery (AA) as an aid to practical operations in the clinical field. MATERIALS AND METHODS Thirty-one hemifaces from 17 Korean cadavers and 26 hemifaces from 13 Thai cadavers were dissected. RESULTS The topography of the AA was classified into 4 types according to its course: Type I (persistent pattern), in which the AA traverses the lateral side of the nose (11%); Type II (detouring pattern), in which the AA traverses the cheek and tear trough area (18%); Type III (alternative pattern), in which the AA traverses the medial canthal area through a branch of the ophthalmic artery (22.8%); and Type IV (latent pattern), in which the AA is absent (26.3%). CONCLUSION The findings of this study will contribute toward improved outcomes for cosmetic surgery involving the injection of facial filler by enhancing the understanding of AA anatomy.
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Uchida T, Shigihara N, Takeno K, Komiya K, Goto H, Abe H, Sato J, Honda A, Fujitani Y, Watada H. Characteristics of patients with graves disease and intrathyroid hypovascularity compared to painless thyroiditis. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2014; 33:1791-1796. [PMID: 25253825 DOI: 10.7863/ultra.33.10.1791] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
OBJECTIVES The purpose of this study was to assess the frequency and sonographic and laboratory characteristics of Graves disease with intrathyroid hypovascularity in Japanese patients and to compare these characteristics in patients with painless thyroiditis. METHODS A total of 194 consecutive patients with Graves disease and 21 patients with painless thyroiditis were enrolled. The patients underwent thyroid volume measurement, mean superior thyroid artery peak systolic velocity (PSV) measurement, power Doppler sonography, and proper blood testing to discriminate between Graves disease and painless thyroiditis. Based on the power Doppler sonographic findings, they were divided into 4 groups: from pattern 0 (most hypovascular thyroid) to pattern III (most hypervascular thyroid). Comparisons of multiple thyroid parameters were made among the groups. RESULTS The prevalence of Graves disease with pattern 0 (n = 27) was 13.9% among the patients with Graves disease. The sonographic and laboratory data for patients with Graves disease and pattern 0 were compared to those of the 21 patients with painless thyroiditis, which typically shows intrathyroid hypovascularity. Free triiodothyronine and thyroxine levels and the superior thyroid artery PSV were significantly lower in patients with Graves disease and pattern 0 than those with patterns I, II, and III (P < .05). The thyroid volume and thyrotropin receptor antibody level were significantly lower in patients with Graves disease and pattern 0 than those with pattern III. In the comparison between patients with Graves disease and pattern 0 and those with painless thyroiditis and pattern 0, apart from thyrotropin receptor antibody, only the superior thyroid artery PSV was different. CONCLUSIONS Although the clinical features of patients with Graves disease and intrathyroid hypovascularity were similar to those patients with painless thyroiditis, the superior thyroid artery PSV showed a moderate ability to discriminate these patients.
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Affiliation(s)
- Toyoyoshi Uchida
- Department of Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, Tokyo, Japan.
| | - Nayumi Shigihara
- Department of Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Kageumi Takeno
- Department of Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Koji Komiya
- Department of Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Hiromasa Goto
- Department of Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Hiroko Abe
- Department of Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Junko Sato
- Department of Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Akira Honda
- Department of Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Yoshio Fujitani
- Department of Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Hirotaka Watada
- Department of Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, Tokyo, Japan
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Abstract
STUDY DESIGN Cross-sectional observational study. OBJECTIVES To investigate the presence of soft tissue hyperemia in plantar fasciitis with power Doppler ultrasound. BACKGROUND Localized hyperemia is an established feature of tendinopathy, suggesting that neurovascular in-growth may contribute to tendon-associated pain in some patients. The presence of abnormal soft tissue vascularity can be assessed with Doppler ultrasound, and a positive finding can assist with targeted treatment plans. However, very little is known regarding the presence of hyperemia in plantar fasciitis and the ability of routine Doppler ultrasound to identify vascular in-growth in the plantar fascia near its proximal insertion. METHODS This observational study included 30 participants with plantar fasciitis unrelated to systemic disease and 30 age- and sex-matched controls. Ultrasound examination was performed with a 13- to 5-MHz linear transducer, and power Doppler images were assessed by 2 blinded investigators. RESULTS Hyperemia of the plantar fascia was present in 8 of 30 participants with plantar fasciitis and in 2 of 30 controls. The between-group difference for hyperemia, using a 4-point scale, was statistically significant, with participants with plantar fasciitis showing increased Doppler ultrasound signal compared to controls (Mann-Whitney U, P = .03). However, the majority of participants with plantar fasciitis with evidence of hyperemia demonstrated very mild color changes, and only 3 were found to have moderate or marked hyperemia. CONCLUSION Mild hyperemia can occur with plantar fasciitis, but most individuals will not exhibit greater soft tissue vascularity when assessed with routine Doppler ultrasound. Clinicians treating plantar fasciitis should not consider a positive Doppler signal as essential for diagnosis of the condition but, rather, as a feature that may help to refine the treatment plan for an individual patient.
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Polisca A, Zelli R, Troisi A, Orlandi R, Brecchia G, Boiti C. Power and pulsed Doppler evaluation of ovarian hemodynamic changes during diestrus in pregnant and nonpregnant bitches. Theriogenology 2013; 79:219-24. [DOI: 10.1016/j.theriogenology.2012.08.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2012] [Revised: 08/05/2012] [Accepted: 08/10/2012] [Indexed: 11/15/2022]
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Diagnostic accuracy of small intestine ultrasonography using an oral contrast agent in Crohn's disease: comparative study from the UK. Clin Radiol 2011; 67:553-9. [PMID: 22212635 DOI: 10.1016/j.crad.2011.11.005] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2011] [Revised: 11/09/2011] [Accepted: 11/17/2011] [Indexed: 12/16/2022]
Abstract
AIM To evaluate the usefulness of small intestine contrast-enhanced ultrasonography (SICUS) using an oral contrast agent in routine clinical practice by assessing the level of agreement with the established techniques, small bowel follow-through (SBFT) and computed tomography (CT), and diagnostic accuracy compared with the final diagnosis in the detection of small bowel Crohn's disease (CD) and luminal complications in a regional centre. MATERIALS AND METHODS All symptomatic known or suspected cases of CD who underwent SICUS were retrospectively reviewed. The level of agreement between SICUS and SBFT, CT, histological findings, and C-reactive protein (CRP) level was assessed using kappa (κ) coefficient. Sensitivity was demonstrated using the final diagnosis as the reference standard defined by the outcome of clinical assessment, follow-up, and results of investigations other than SICUS. RESULTS One hundred and forty-three patients underwent SICUS of these 79 (55%) were female. Eighty-six (60%) were known to have CD and 57 (40%) had symptoms suggestive of intestinal disease with no previous diagnosis. Forty-six (55%) of the known CD patients had had at least one previous surgical resection. The sensitivity of SICUS in detecting active small bowel CD in known CD and undiagnosed cases was 93%. The kappa coefficient was 0.88 and 0.91 with SBFT and CT, respectively. SICUS detected nine patients who had one or more small bowel strictures and six patients with a fistula all detected by SBFT or CT. CONCLUSION SICUS is not only comparable to SBFT and CT but avoids radiation exposure and should be more widely adopted in the UK as a primary diagnostic procedure and to monitor disease complications in patients with CD.
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Kurdziel KA, Lindenberg L, Choyke PL. Oncologic Angiogenesis Imaging in the clinic---how and why. IMAGING IN MEDICINE 2011; 3:445-457. [PMID: 22132017 PMCID: PMC3224985 DOI: 10.2217/iim.11.31] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
The ability to control the growth of new blood vessels would be an extraordinary therapeutic tool for many disease processes. Too often, the promises of discoveries in the basic science arena fail to translate to clinical success. While several anti angiogenic therapeutics are now FDA approved, the envisioned clinical benefits have yet to be seen. The ability to clinically non-invasively image angiogenesis would potentially be used to identify patients who may benefit from anti-angiogenic treatments, prognostication/risk stratification and therapy monitoring. This article reviews the current and future prospects of implementing angiogenesis imaging in the clinic.
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Kiessling F, Gaetjens J, Palmowski M. Application of molecular ultrasound for imaging integrin expression. Am J Cancer Res 2011; 1:127-34. [PMID: 21547155 PMCID: PMC3086608 DOI: 10.7150/thno/v01p0127] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Stabilized microbubbles with a size between 1-5 µm are used as ultrasound contrast agents in the clinical routine. They have shown convincing results for the vascular characterization of tissues as well as in echocardiography. Due to their size, microbubbles strictly remain intravascular where they can be detected with high sensitivity and specificity. This qualifies them for intravascular molecular imaging. Many studies have been published reporting on the successful use of microbubbles conjugated to specific ligands for target identification in vivo. Among them, there are several promising examples on how to use molecular ultrasound for the imaging of integrin expression. This review provides an overview on the composition of ultrasound contrast agents that can be used for molecular imaging and their detection by ultrasound using destructive and non destructive methods. Furthermore, concrete examples are given on the use of molecular ultrasound to characterize integrin expression on vessels. These cover oncological applications where integrin targeted microbubbles were used to identify and characterize tumor angiogenesis and to assess tumor response to antiangiogenic drugs as well as to radiotherapy. In addition, increased accumulation of integrin targeted microbubbles was found during vascular reformation in ischemic tissues as well as in vulnerable atherosclerotic plaques. In summary, there is clear evidence from preclinical studies that integrin targeted ultrasound imaging is a valuable tool for the characterization of a broad spectrum of diseases. Thus, more efforts should be put into translating this promising technology into the clinics.
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Richards PJ, McCall IW, Day C, Belcher J, Maffulli N. Longitudinal microvascularity in Achilles tendinopathy (power Doppler ultrasound, magnetic resonance imaging time-intensity curves and the Victorian Institute of Sport Assessment-Achilles questionnaire): a pilot study. Skeletal Radiol 2010; 39:509-21. [PMID: 19711073 DOI: 10.1007/s00256-009-0772-0] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2009] [Revised: 06/17/2009] [Accepted: 07/27/2009] [Indexed: 02/02/2023]
Abstract
AIM To evaluate the imaging of the natural history of Achilles tendinopathy microvascularisation in comparison with symptoms, using a validated disease-specific questionnaire [the Victorian Institute of Sport Assessment-Achilles (VISA-A)]. METHOD A longitudinal prospective pilot study of nine patients with post-contrast magnetic resonance imaging (MRI), time-intensity curve (TIC) enhancement, ultrasound (US) and power Doppler (PD) evaluation of tendinopathy of the mid-Achilles tendon undergoing conservative management (eccentric exercise) over 1 year. RESULTS There were five men and four women [mean age 47 (range 30-62) years]. Six asymptomatic tendons with normal US and MRI appearance showed less enhancement than the tibial metaphysis did and showed a flat, constant, but very low rate of enhancement in the bone and Achilles tendon (9-73 arbitrary TIC units). These normal Achilles tendons on imaging showed a constant size throughout the year (mean 4.9 mm). At baseline the TIC enhancement in those with tendinopathy ranged from 90 arbitrary units to 509 arbitrary units. Over time, 11 abnormal Achilles tendons, whose symptoms settled, were associated with a reduction in MRI enhancement mirrored by a reduction in the number of vessels on power Doppler (8.0 to 2.7), with an improvement in morphology and a reduction in tendon size (mean 15-10.6 mm). One tendon did not change its abnormal imaging features, despite improving symptoms. Two patients developed contralateral symptoms and tendinopathy, and one had more abnormal vascularity on power Doppler and higher MRI TIC peaks in the asymptomatic side. CONCLUSIONS In patient with conservatively managed tendinopathy of the mid-Achilles tendon over 1 year there was a reduction of MRI enhancement and number of vessels on power Doppler, followed by morphological improvements and a reduction in size. Vessels per se related to the abnormal morphology and size of the tendon rather than symptoms. Symptoms improve before the Achilles size reduces and the restoration of normal imaging over time.
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Affiliation(s)
- Paula J Richards
- University Hospital of North Staffordshire NHS Trust (UHNS), Stoke on Trent, Staffordshire, UK.
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Krejčí K, Zadražil J, Tichý T, Al-Jabry S, Horčička V, Štrebl P, Bachleda P. Sonographic findings in borderline changes and subclinical acute renal allograft rejection. Eur J Radiol 2009; 71:288-95. [DOI: 10.1016/j.ejrad.2008.04.021] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2007] [Revised: 02/01/2008] [Accepted: 04/21/2008] [Indexed: 02/05/2023]
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KAISER MARIEJOËLLE, HAUZEUR JEANPHILIPPE, BLACHER SILVIA, FOIDART JEANMICHEL, DEPREZ MANUEL, ROSSKNECHT ALEXANDRA, MALAISE MICHELG. Contrast-enhanced Coded Phase-inversion Harmonic Sonography of Knee Synovitis Correlates with Histological Vessel Density: 2 Automated Digital Quantifications. J Rheumatol 2009; 36:1391-400. [DOI: 10.3899/jrheum.080584] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Objective.To use contrast-enhanced coded phase-inversion harmonic B-mode sonography to assess the acoustic enhancement of the synovial area of the knee; and to compare the data with the histological vessel density.Methods.Eleven patients eligible for a knee arthroscopy were studied. Acoustic quantification was carried out by a digital image analysis program that detects the time-dependent increase [intensity (time) = k × time + C] of gray-level intensity in all the pixels of a specific region of interest (ROI) following intravenous injection of the microbubble contrast agent sulfur hexafluoride. Echo-guided synovial biopsies were carried out in the same ROI. Synovial vessel areas were quantified after Factor VIII immunostaining of synovial biopsies using an automated digital image analysis.Results.Significant (p < 0.05) correlations were observed between histological vessel density and percentage of the synovial area with a k value > 0.01 (r = 0.93) and kmaxvalues (r = 0.79), as well as between the 2 latter parameters (r = 0.72). The histological vessel density and the 2 acoustic parameters were also significantly correlated with the logarithm of erythrocyte sedimentation rate (r = 0.77, r = 0.87, r = 0.67, respectively) and with log C-reactive protein serum concentration (r = 0.69, r = 0.83, r = 0.62, respectively).Conclusion.Contrast-enhanced coded phase-inversion harmonic B-mode sonography coupled with an appropriate data analysis method is a new tool to identify and quantify vessel density in knee synovitis.
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Kuo WH, Chen CN, Hsieh FJ, Shyu MK, Chang LY, Lee PH, Liu LYD, Cheng CH, Wang J, Chang KJ. Vascularity change and tumor response to neoadjuvant chemotherapy for advanced breast cancer. ULTRASOUND IN MEDICINE & BIOLOGY 2008; 34:857-866. [PMID: 18374468 DOI: 10.1016/j.ultrasmedbio.2007.11.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2007] [Revised: 11/01/2007] [Accepted: 11/09/2007] [Indexed: 05/26/2023]
Abstract
For advanced breast cancer with severe local disease (ABC) (stage III/IV), neoadjuvant chemotherapy improves local control and surgical outcome. However, about approximately 20 to 30% of advanced cancers show either no or poor response to chemotherapy. To prevent unnecessary treatment, a capability of predicting clinical response to neoadjuvant chemotherapy of ABC is highly desirable. Vascularity index (VI) of breast cancers was derived from the quantification results in 30 ABC patients by using power Doppler sonography. Power Doppler sonography evaluation was performed every one to two weeks during chemotherapy. The overall response rate for 30 advanced patients tested was 70%, when 50% or more reduction in tumor size was the objective clinical response. Chemotherapy response was unrelated to the original tumor size (p = 0.563) or chemotherapy agents used (p = 0.657). The median VI for all 30 patients was 4.99%. The response rates for hypervascular tumors vs. hypovascular tumors, based on initial median value, were 86.7% and 53.3%, respectively (p = 0.109). The average VIs in responders and nonresponders were 7.67 +/- 4.77% and 4.01 +/- 3.82% (p = 0.052). There was a tendency for responders who have a relatively high initial vascularity. The VI change in responder group shows a pattern of initial increasing in vascularity followed by decreasing in vascularity. All patients (17/17) with a VI increment of >5% during chemotherapy had good chemotherapy response, whereas in patients with a VI increment of <5%, the response rate was 30.8% (4/13) (p < 0.001). For patients with a peak VI of >10% during chemotherapy, the response rate was 94.1% (16/17). However, in patients with a peak VI of <10%, the response rate was 38.5% (5/13) (p = 0.001). This prediction was made mostly within one month (25.47 +/- 12.96 d for VI increments >5% and 25.44 +/- 12.41 d for VI increased to >10%). In the meantime, the differences in size reduction shown in B-mode sonography were insignificant between responders and nonresponders (patient group with VI increment >5%, p = 0.308; patient group with peak VI >10%, p = 0.396). In conclusion, we propose that VI as determined by using power Doppler sonography is a good and inexpensive clinical tool for monitoring vascularity changes during neoadjuvant chemotherapy in ABC patients. Two parameters--VI increment >5% and peak VI >10%--are potential early predictors for good responses to neoadjuvant chemotherapy within one month in patients with ABC.
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Affiliation(s)
- Wen-Hung Kuo
- Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan
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Collado P, Naredo E, Calvo C, Crespo M. Role of power Doppler sonography in early diagnosis of osteomyelitis in children. JOURNAL OF CLINICAL ULTRASOUND : JCU 2008; 36:251-253. [PMID: 18286515 DOI: 10.1002/jcu.20395] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
We describe 2 children complaining of leg pain associated with elevated C-reactive protein levels in whom power Doppler (PD) sonography suggested the diagnosis of early osteomyelitis. PD sonography detected increased blood flow that resulted in a high-intensity signal area adjacent to the symptomatic tibia surface. Antibiotic therapy led to prompt improvement. These cases suggest that PD sonography is useful in the evaluation of possible early osteomyelitis in children.
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Affiliation(s)
- Paz Collado
- Department of Rheumatology, Hospital Severo Ochoa, Avda. de Orellana S/N 28911, Madrid, Spain
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Vulpio C, Bossola M, De Gaetano A, Maresca G, Di Stasio E, Spada PL, Romitelli F, Luciani G, Castagneto M. Ultrasound patterns of parathyroid glands in chronic hemodialysis patients with secondary hyperparathyroidism. Am J Nephrol 2008; 28:589-97. [PMID: 18277066 DOI: 10.1159/000116875] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2007] [Accepted: 01/07/2008] [Indexed: 12/28/2022]
Abstract
BACKGROUND The role ofparathyroid glands (PTG) ultrasonography (US) in hemodialysis patients with secondary hyperparathyroidism (SHPT) is still controversial. The present study aimed at evaluating the relationship between US findings and SHPT degree as well as therapeutic outcome. METHODS Twenty hemodialysis patients with moderate SHPT and 15 with severe SHPT underwent US to assess the PTG number, maximum longitudinal diameter (MLD), structural (1-hypoechoic, 2-slight heterogeneous, 3-high heterogeneous, 4-nodular) and vascular patterns (1-slight, 2-medium and 3-high). RESULTS PTG number, MLD and US patterns were correlated with iPTH levels. MLD of patients with moderate or severe SHPT was 7.2 +/- 2.3 and 15 +/- 5.1 mm (p < 0.001). Most patients with moderate SHPT showed a single PTG with an MLD <9 mm associated with 1-2 structural and vascular pattern, whereas patients with severe SHPT exhibited more than one PTG with MLD >9 mm and 3-4 structural and vascular patterns. Thirteen patients were responders to treatment and 22 nonresponders. In nonresponders, a higher number of PTG was observed as well as higher echostructural and vascular patterns. In 14 patients who underwent parathyroidectomy, no differences were found between PTG US MLD and pathology diameter. All PTG with evidence of 3-4 structural and vascular score at ultrasound showed nodular hyperplasia at pathological examination. CONCLUSIONS The adopted classification of US findings is correlated with SHPT degree and therapeutic outcome and might be an adjunctive predictive method useful to assess the SHPT severity and to plan the therapeutic strategy.
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Affiliation(s)
- Carlo Vulpio
- Istituto Clinica Chirurgica, Università Cattolica del Sacro Cuore, Roma, Italia.
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Boesen MI, Boesen A, Koenig MJ, Bliddal H, Torp-Pedersen S. Ultrasonographic investigation of the Achilles tendon in elite badminton players using color Doppler. Am J Sports Med 2006; 34:2013-21. [PMID: 16870820 DOI: 10.1177/0363546506290188] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND The most frequent injuries in badminton players are in the lower extremities, especially in the Achilles tendon. HYPOTHESIS The game of badminton may be related to abnormal intratendinous flow in the Achilles tendon as detected by color Doppler ultrasound. To a certain extent, this blood flow might be physiological, especially when examined after match. STUDY DESIGN Cohort study (prevalence); Level of evidence, 3. METHODS Seventy-two elite badminton players were interviewed regarding Achilles tendon pain (achillodynia) in the preceding 3 years. Color Doppler was used to examine the tendons of 64 players before their matches and 46 players after their matches. Intratendinous color Doppler flow was graded from 0 to 4. The Achilles tendon was divided into dominant (eg, right side for right-handed players and vice versa) and nondominant side and classified as midtendon, preinsertional, and calcaneal areas. RESULTS Of 72 players, 26 had experienced achillodynia in 34 tendons, 18 on the dominant side and 16 on the nondominant side. In 62% of the players with achillodynia, the problems had begun slowly, and the median duration of symptoms was 4 months (range, 0-36 months). Thirty-five percent had ongoing pain in their tendons for a median duration of 12 months (range, 0-12 months). Achillodynia was not associated with the self-reported training load or with sex, age, weight, singles or doubles players, or racket side. Forty-six players were scanned before and after match. At baseline, color Doppler flow was present in the majority of players, and only 7 (16%) players had no color Doppler flow in either tendon. After match, all players had some color Doppler flow in 1 or both tendons. Achillodynia and color Doppler flow were related in the nondominant Achilles tendon (chi-square, P = .008). The grades of Doppler flow also increased significantly after match in the preinsertional area in both the nondominant (P = .0002) and dominant (P = .005) side tendons. CONCLUSION A large proportion of the players had experienced achillodynia and habitually played with a degree of pain that demanded medication. The self-reported pain was associated with increased intratendinous color Doppler flow in the nondominant Achilles tendon. Doppler flow was found in most players before and in all players after the match and therefore may in part be a physiological response to activity.
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Carbó S, Rosón N, Vizcaya S, Escribano F, Zarcero M, Medrano S. Can ultrasound help to define orthopedic surgical complications? Curr Probl Diagn Radiol 2006; 35:75-89. [PMID: 16701119 DOI: 10.1067/j.cpradiol.2006.03.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
This article aims to describe and illustrate the usefulness of ultrasound in detecting complications of orthopedic implants, metal fixation devices, and other surgical material, with an emphasis on soft-tissue pathology.
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Affiliation(s)
- Sonia Carbó
- SDI Hospital General de Granollers, Barcelona, Spain.
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Boesen MI, Torp-Pedersen S, Koenig MJ, Christensen R, Langberg H, Hölmich P, Nielsen MB, Bliddal H. Ultrasound guided electrocoagulation in patients with chronic non-insertional Achilles tendinopathy: a pilot study. Br J Sports Med 2006; 40:761-6. [PMID: 16807305 PMCID: PMC2564389 DOI: 10.1136/bjsm.2006.027334] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND High resolution colour Doppler ultrasound shows intratendinous Doppler activity in patients with chronic Achilles tendinopathy. Treatment of this neovascularisation with sclerosing therapy seems to relieve the pain. However, the procedure often has to be repeated. OBJECTIVE To investigate the effect of electrocoagulation of the neovessels on tendon pain and tendon vascularity in patients with chronic Achilles tendinopathy. METHODS Colour Doppler ultrasound guided electrocoagulation was used on vessels in the ventral portion of the Achilles tendon in 11 patients (seven men, four women, mean age 41 years) with painful chronic mid-portion Achilles tendinosis. A unipolar coagulation device was used. RESULTS One patient dropped out after two months (dissatisfied with the results). The remaining 10 patients (91%) were satisfied. These 10 patients were still satisfied at six months of follow up and had returned to their previous level of activity. All 10 patients were "cured" after one treatment. The patient who dropped out received two treatments because of lack of progress. There was significantly reduced pain (Likert pain scale, 0-10) during activity, from a median of 7 (range 4 to 10) at baseline to 0 (0 to 8) at six months' follow up (p<0.005); and at rest, from 1.5 (1 to 5) to 0 (0 to 8) (p = 0.005). In all patients, vascularisation was unchanged at the six months follow up, with no significant change in semiquantitative or quantitative colour scoring. CONCLUSIONS Coagulation in the area with vessels entering the tendon appears to be effective treatment for painful chronic mid-tendinous Achilles tendinopathy. No effect on the intratendinous Doppler activity could be detected, suggesting that the effect is independent of changes in blood flow. Localisation of hyperaemia appears to be the key to the pathology and for targeting the treatment. One explanation could be that the effect is obtained by destruction of nerves accompanying the vessels.
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Lee SI, Lee SY, Yoo WH. The usefulness of power Doppler ultrasonography in differentiating primary and secondary Raynaud’s phenomenon. Clin Rheumatol 2006; 25:814-8. [PMID: 16391889 DOI: 10.1007/s10067-005-0167-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2005] [Revised: 10/28/2005] [Accepted: 11/07/2005] [Indexed: 11/25/2022]
Abstract
The objectives of this study were to assess a usefulness of power Doppler ultrasonography (PDU) and compare the diagnostic value of PDU to nailfold capillaroscopy (NFC) in the patients with clinically diagnosed Raynaud's phenomenon (RP) and healthy controls. Forty-one patients with primary (n=19), secondary RP (n=22), and ten healthy controls underwent PDU and NFC examinations on the same day. Microvascularity was evaluated using PDU before and after cold challenges, and the PDU signals were qualitatively graded on a scale of 1-4. According to the change of microvascularity before and after cold challenges, the findings of PDU were classified into three groups: (1) 'pattern I' (normal microvascularity over grade 3 both before and after cold challenges), (2) 'pattern II' (decreased microvascularity to grade 1 or 2 only after cold challenge), and (3) 'pattern III' (decreased microvascularity of grade 1 or 2 both before and after cold challenges). PDU confirmed the presence of RP in all patients with clinically diagnosed RP and yielded a correct classification in 88.9% of the all persons analyzed (normal=100%, primary RP=89.5%, secondary RP=77.3%). The analysis was performed to assess the degree of agreement between the final diagnoses obtained by PDU and NFC. A good correlation rate was observed between PDU and NFC examinations in differentiating primary from secondary RP (Kappa=0.658, p<0.01). In conclusion, PDU examination with a cold challenge is a useful and reliable method to diagnose RP and discriminate between primary and secondary RP.
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Affiliation(s)
- Sang Il Lee
- Division of Rheumatology, Department of Internal Medicine, Chonbuk National University Medical School, and Research Institute of Clinical Medicine, San 2-20, Geumam-dong, Deokjin-gu, Jeonju, Jeonbuk, 561-180, Republic of Korea.
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Kabakci N, Igci E, Secil M, Yorukoglu K, Mungan U, Celebi I, Kirkali Z. Echo contrast-enhanced power Doppler ultrasonography for assessment of angiogenesis in renal cell carcinoma. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2005; 24:747-53. [PMID: 15914678 DOI: 10.7863/jum.2005.24.6.747] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
OBJECTIVE Tumoral growth is an angiogenesis-dependent event. Although there are studies about the importance of histopathologic angiogenesis in various malignancies, the assessment of the angiogenesis by radiologic techniques is not well established. The aim of this study was to investigate the efficacy of echo contrast-enhanced power Doppler ultrasonography (PDUS) in determining the angiogenic status of renal cell carcinoma (RCC). METHODS Power Doppler ultrasonography was performed before and after intravenous administration of an echo contrast agent in 42 patients with renal masses. Twenty-one of these renal masses were diagnosed as RCC histopathologically, and these 21 patients were reevaluated retrospectively. The color pixel ratios of selected images were calculated as the ratio of the number of pixels showing power Doppler signals to the total number of pixels within the lesion. The results were compared with the histopathologic microvessel density (MVD). RESULTS A significant correlation was found between color pixel ratio and MVD values in both PDUS techniques. The use of the echo contrast agent improved this correlation and P values (Spearman rho from 0.436 to 0.551; P from .048 to .01). CONCLUSIONS Color pixel ratio values reflect the MVD in RCC. Therefore, these results suggest that preoperative quantification of angiogenesis can be possible with the help of PDUS in RCC.
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Affiliation(s)
- Neslihan Kabakci
- Department of Radiology, Faculty of Medicine, Dokuz Eylul University, 35340 Inciralti, Izmir, Turkey.
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Walther M, Radke S, Kirschner S, Ettl V, Gohlke F. Power Doppler findings in plantar fasciitis. ULTRASOUND IN MEDICINE & BIOLOGY 2004; 30:435-440. [PMID: 15121244 DOI: 10.1016/j.ultrasmedbio.2004.01.006] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2003] [Revised: 01/13/2004] [Accepted: 01/22/2004] [Indexed: 05/24/2023]
Abstract
The study was performed to characterize the power Doppler ultrasonographic (PDU) findings in plantar fasciitis using a 7.5 MHz linear transducer. Both feet of 20 patients who had a clinical and ultrasound (US) diagnosis of unilateral plantar fasciitis were evaluated with PDU. The pain level was assessed with a visual analogue scale (VAS). A total of 20 healthy volunteers were evaluated as a control group. Moderate or marked hyperemia was found in PDU in the plantar fascia and the surrounding soft tissue along the first cm distally from the insertion in 8 (40%) of the 20 symptomatic heels and in 1 patient (5%) on the asymptomatic side. Moderate or marked hyperemia was associated with a history of less than 6 months and high pain levels. The difference between both groups was significant (p < 0.05). PDU improves the value of US as a noninvasive technique for the diagnosis of plantar fasciitis, providing additional information on local hyperemia.
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Affiliation(s)
- Markus Walther
- Department of Orthopedic Surgery, University of Wuerzburg, Wuerzburg, Germany.
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Kuwa T, Cancio LC, Sondeen JL, Matylevich N, Jordan BS, McManus AT, Goodwin CW. Evaluation of Renal Cortical Perfusion by Noninvasive Power Doppler Ultrasound During Vascular Occlusion and Reperfusion. ACTA ACUST UNITED AC 2004; 56:618-24. [PMID: 15128134 DOI: 10.1097/01.ta.0000075331.21241.80] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND Urine output, a frequently used resuscitation end point, is presumed to represent renal cortical perfusion. However, no noninvasive method for direct measurement of renal perfusion exists. Power Doppler ultrasound (PDUS) is a method that reportedly is sensitive to low-velocity and microvascular blood flow and can depict it. This study aimed to develop a quantitative technique for PDUS image analysis, and to evaluate the ability of PDUS to quantify cortical perfusion during renal ischemia induced by vascular occlusion. METHODS A method was developed to determine the mean gray-scale intensity of PDUS images from within the renal cortex (PDUS image intensity). This index was hypothesized to represent renal cortical microvascular blood flow. Renal cortical blood flow was determined using fluorescent microspheres in five swine. Renal artery flow was measured with an ultrasonic flow probe. Power Doppler ultrasound was performed at baseline; at 75%, 50%, and 25% of baseline renal artery flow; and during reperfusion. RESULTS Subjectively, PDUS images showed decreases in image intensity corresponding to renal artery occlusion and increases after reperfusion. Cortical blood flow correlated well with renal artery flow (n = 25; r2 = 0.868) and with PDUS image intensity (n = 25; r2 = 0.844). CONCLUSION Noninvasive power Doppler ultrasound image intensity correlated well with invasively measured renal cortical blood flow, and may be useful during resuscitation of injured and critically ill patients.
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Affiliation(s)
- Toshiyuki Kuwa
- U.S. Army Institute of Surgical Research, Fort Sam Houston, TX, USA
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Demirel K, Kapucu O, Yücel C, Ozdemir H, Ayvaz G, Taneri F. A comparison of radionuclide thyroid angiography, (99m)Tc-MIBI scintigraphy and power Doppler ultrasonography in the differential diagnosis of solitary cold thyroid nodules. Eur J Nucl Med Mol Imaging 2003; 30:642-50. [PMID: 12612810 DOI: 10.1007/s00259-003-1124-2] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2002] [Accepted: 01/04/2003] [Indexed: 11/30/2022]
Abstract
We prospectively studied 43 patients with solitary cold thyroid nodules greater than 1.5 cm in diameter to determine the comparative diagnostic value of radionuclide thyroid angiography (RTA), technetium-99m methoxyisobutylisonitrile ((99m)Tc-MIBI) scintigraphy and power Doppler ultrasonography (PDUS) in the differentiation of benign and malignant thyroid nodules. Perfusion of the nodules in RTA was compared with the perfusion in the surrounding normal thyroid tissue and classified as follows: 0, avascular; 1, hypovascular; 2, isovascular; 3, hypervascular. (99m)Tc-MIBI uptake in the nodules compared with that in surrounding thyroid tissue was scored for both early and delayed images as follows: 0, cold; 1, decreased; 2, equal; 3, increased. PDUS patterns were classified as nodule vascularisation patterns. The malignancy criteria were set as follows: hypervascular nodule with rapid washout in RTA; complex ring sign with anarchic structure or delta sign in PDUS, and positive retention and increased uptake in the nodule in the early and delayed (99m)Tc-MIBI images. These data were compared with the histopathological results. Histology revealed thyroid carcinoma in nine patients (five cases of papillary carcinoma, three of follicular carcinoma and one of medullary carcinoma) and benign conditions in 34 patients (30 cases of nodular goitre, three of lymphocytic thyroiditis and one of follicular adenoma). Sensitivity, specificity and accuracy were, respectively, 0.89, 1.00 and 0.97 for RTA, 1.00, 0.76 and 0.81 for PDUS, and 0.67, 0.91 and 0.86 for (99m)Tc-MIBI scintigraphy (when nodules with increased uptake in both the early and the delayed images and a positive retention index were considered as malignant). RTA, (99m)Tc-MIBI scintigraphy and PDUS could be helpful in the preoperative assessment of solitary cold thyroid nodules. In this study, RTA was found to be the most accurate and specific method for differentiation of malignant from benign thyroid nodules.
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Affiliation(s)
- Koray Demirel
- Department of Nuclear Medicine, Gazi University School of Medicine, Ankara, Turkey.
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