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1.
Medicine (Baltimore) ; 103(10): e37372, 2024 Mar 08.
Artigo em Inglês | MEDLINE | ID: mdl-38457566

RESUMO

This study aimed to investigate the value of placental real-time shear wave elastography combined with three-dimensional power Doppler index (3D-PDI) in the prediction of preeclampsia. We conducted a retrospective study selecting 60 pregnant women diagnosed with preeclampsia as the experimental group and 60 normal pregnant women as the control group from January 2021 to December 2022. The elastic modulus values of different regions of the placenta and placental 3D-PDI were detected and compared between the two groups. The ROC curve was used to evaluate the diagnostic value of each parameter, alone or in combination, for preeclampsia. The study findings demonstrated that the elastic modulus values of different regions of the placenta and 3D-PDI of the two groups have statistical significance. The values of SWE, VI, FI, and VFI are different in prediction of preeclampsia, and the combination of various parameters can improve the prediction value. Overall, our study provides a valuable method for the prediction of preeclampsia with the advantages of non-invasiveness, efficiency, and simplicity.


Assuntos
Técnicas de Imagem por Elasticidade , Pré-Eclâmpsia , Gravidez , Feminino , Humanos , Placenta/diagnóstico por imagem , Pré-Eclâmpsia/diagnóstico por imagem , Estudos Retrospectivos , Técnicas de Imagem por Elasticidade/métodos , Ultrassonografia Pré-Natal/métodos , Imageamento Tridimensional/métodos , Ultrassonografia Doppler
3.
Comput Biol Med ; 171: 108033, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38430739

RESUMO

BACKGROUND AND OBJECTIVE: Atrioventricular valve disease is a common cause of heart failure, and successful surgical or interventional outcomes are crucial. Patient-specific fluid-structure interaction (FSI) modeling may provide valuable insights into valve dynamics and guidance of valve repair strategies. However, lack of validation has kept FSI modeling from clinical implementation. Therefore, this study aims to validate FSI simulations against in vitro benchmarking data, based on clinically relevant parameters for evaluating heart valve disease. METHODS: An FSI model that mimics the left heart was developed. The domain included a deformable mitral valve of different stiffnesses run with different inlet velocities. Five different cases were simulated and compared to in vitro data based on the pressure difference across the valve, the valve opening, and the velocity in the flow domain. RESULTS: The simulations underestimate the pressure difference across the valve by 6.8-14 % compared to catheter measurements. Evaluation of the valve opening showed an underprediction of 5.4-7.3 % when compared to cine MRI, 2D Echo, and 3D Echo data. Additionally, the simulated velocity through the valve showed a 7.9-8.4 % underprediction in relation to Doppler Echo measurements. Qualitative assessment of the velocity profile in the ventricle and the streamlines of the flow in the domain showed good agreement of the flow behavior. CONCLUSIONS: Parameters relevant to the diagnosis of heart valve disease estimated by FSI simulations showed good agreement when compared to in vitro benchmarking data, with differences small enough not to affect the grading of heart valve disease. The FSI model is thus deemed good enough for further development toward patient-specific cases.


Assuntos
Doenças das Valvas Cardíacas , Modelos Cardiovasculares , Humanos , Modelagem Computacional Específica para o Paciente , Ultrassonografia Doppler , Valva Mitral/diagnóstico por imagem , Doenças das Valvas Cardíacas/diagnóstico por imagem , Hemodinâmica/fisiologia , Simulação por Computador
4.
Sci Rep ; 14(1): 5919, 2024 03 11.
Artigo em Inglês | MEDLINE | ID: mdl-38467666

RESUMO

The aim of this study was to investigate the pulmonary vasculature in baseline conditions and after maternal hyperoxygenation in growth restricted fetuses (FGR). A prospective cohort study of singleton pregnancies including 97 FGR and 111 normally grown fetuses was carried out. Ultrasound Doppler of the pulmonary vessels was obtained at 24-37 weeks of gestation and data were acquired before and after oxygen administration. After, Machine Learning (ML) and a computational model were used on the Doppler waveforms to classify individuals and estimate pulmonary vascular resistance (PVR). Our results showed lower mean velocity time integral (VTI) in the main pulmonary and intrapulmonary arteries in baseline conditions in FGR individuals. Delta changes of the main pulmonary artery VTI and intrapulmonary artery pulsatility index before and after hyperoxygenation were significantly greater in FGR when compared with controls. Also, ML identified two clusters: A (including 66% controls and 34% FGR) with similar Doppler traces over time and B (including 33% controls and 67% FGR) with changes after hyperoxygenation. The computational model estimated the ratio of PVR before and after maternal hyperoxygenation which was closer to 1 in cluster A (cluster A 0.98 ± 0.33 vs cluster B 0.78 ± 0.28, p = 0.0156). Doppler ultrasound allows the detection of significant changes in pulmonary vasculature in most FGR at baseline, and distinct responses to hyperoxygenation. Future studies are warranted to assess its potential applicability in the clinical management of FGR.


Assuntos
Retardo do Crescimento Fetal , Feto , Gravidez , Feminino , Humanos , Retardo do Crescimento Fetal/diagnóstico por imagem , Estudos Prospectivos , Feto/diagnóstico por imagem , Feto/irrigação sanguínea , Ultrassonografia Doppler , Simulação por Computador , Ultrassonografia Pré-Natal/métodos , Idade Gestacional
5.
Placenta ; 148: 44-52, 2024 Mar 25.
Artigo em Inglês | MEDLINE | ID: mdl-38367314

RESUMO

INTRODUCTION: Early utero-placental vascular development impacts placental development and function throughout pregnancy. We investigated whether impaired first-trimester utero-placental vascular development is associated with pathologic features of the postpartum placenta. METHODS: In this prospective observational study of 65 ongoing pregnancies, we obtained three-dimensional power Doppler ultrasounds of the placenta at 7, 9 and 11 weeks of gestation. We applied VOCAL software to measure placental volume (PV), virtual reality based segmentation to measure utero-placental vascular volume (uPVV) and applied a skeletonization algorithm to generate the utero-placental vascular skeleton (uPVS). Vascular morphology was quantified by assigning a morphologic characteristic to each voxel in the uPVS (i.e. end-, bifurcation-, crossing- or vessel point). Following delivery, placentas were measured and histologically examined according to the Amsterdam criteria to assess maternal vascular malperfusion (MVM). We used linear mixed models to estimate trajectories of PV, uPVV and uPVS development. Multivariable linear regression analysis with adjustments for confounders was used to evaluate associations between PV, uPVV and uPVS development and features of the postpartum placenta. RESULTS: We observed no associations between first-trimester PV development and measurements of the postpartum placenta. Increased first-trimester utero-placental vascular development, reflected by uPVV (ß = 0.25 [0.01; 0.48]), uPVS end points (ß = 0.25 [0.01; 0.48]), bifurcation points (ß = 0.22 [0.05; 0.37]), crossing points (ß = 0.29 [0.07; 0.52]) and vessel points (ß = 0.09 [0.02; 0.17]) was positively associated with the postpartum placental diameter. uPVV was positively associated with postpartum placental weight. No associations were found with MVM. DISCUSSION: Development of the first-trimester utero-placental vasculature is associated with postpartum placental size, whereas placental tissue development contributes to a lesser extent.


Assuntos
Placenta , Placentação , Recém-Nascido , Gravidez , Feminino , Humanos , Placenta/diagnóstico por imagem , Placenta/irrigação sanguínea , Primeiro Trimestre da Gravidez , Imageamento Tridimensional/métodos , Ultrassonografia Doppler/métodos , Ultrassonografia Pré-Natal/métodos
7.
J Matern Fetal Neonatal Med ; 37(1): 2318604, 2024 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-38373847

RESUMO

OBJECTIVE: To investigate midbrain growth, including corpus callusum (CC), cerebellar vermis (CV) and cortical development in late fetal growth restriction (FGR) depending on uterine artery (UtA) Pulsatility Index (PI) values. METHODS: This was a prospective study including singleton fetuses with late FGR characterized by abnormal cerebral placental ratio (CPR). According to UtA PI values, the FGR fetuses were subdivided into normal ≤95th centile) and abnormal (>95th centile). Neurosonography was performed at 33-44 weeks of gestations to assess CC and CV lengths and the depth of Sylvian fissure (SF), parieto-occipital (POF) and calcarine fissures (CF). Neurosonographic variables were normalized for fetal head circumference size. RESULTS: The study cohort included 60 fetuses with late FGR, 39 with normal UtA PI and 21 with abnormal PI values. The latter group showed significant differences in CC (median (interquartile range) normal 35.9 (28.49-45.53) vs abnormal UtA PI 25.31(19.76-35.13) mm; p < 0.0022), CV (normal 25.78 (18.19-29.35) abnormal UtA PI 17.03 (14.07-24.16)mm; p = 0.0067); SF (normal 10.58 (8.99-11.97)vs abnormal UtA PI 7.44 (6.23-8.46) mm; p < 0.0001), POF (normal 6.85 (6.35-8.14) vs abnormal UtA PI 4.82 (3.46-7.75) mm; p < = 0.0184) and CF (normal 04.157 (2.85-5.41) vs abnormal UtA PI 2.33 (2.49-4.01)); p < 0.0382). CONCLUSIONS: Late onset FGR fetuses with abnormal UtA PI showed shorter CC and CV length and delayed cortical development compared to those with normal uterine PI. These findings support the existence of a link between abnormal brain development and changes in utero placental circulation.


Assuntos
Recém-Nascido Pequeno para a Idade Gestacional , Placenta , Recém-Nascido , Gravidez , Humanos , Feminino , Estudos Prospectivos , Terceiro Trimestre da Gravidez , Estudos Transversais , Ultrassonografia Pré-Natal , Retardo do Crescimento Fetal/diagnóstico por imagem , Ultrassonografia Doppler , Mesencéfalo , Feto , Idade Gestacional , Artéria Uterina/diagnóstico por imagem
8.
BMC Cancer ; 24(1): 224, 2024 Feb 16.
Artigo em Inglês | MEDLINE | ID: mdl-38365653

RESUMO

BACKGROUND: Breast ultrasound is highly sensitive, but its specificity is not as high for detecting malignant lesions. Auxiliary modalities like elastography, Color and Power Doppler ultrasound are used as adjuncts to yield both a high sensitivity and specificity. Superb microvascular imaging (SMI) is a newer modality with more accuracy for detecting breast lesions. In this study, our goal was to investigate the role of SMI as an adjunct to ultrasound and find a suitable combination model for the evaluation of breast masses. METHODS: In this cross-sectional study, 132 women with 172 breast masses who underwent ultrasound-guided biopsy were included.. The ultrasound features of the lesion, the strain ratio in strain elastography, the number of vessels for each lesion, their morphology and distribution in Doppler and Power Doppler ultrasound and SMI were recorded for each lesion. A vascular score and a vascular ratio were defined. RESULTS: In the histologic examination, 31 lesions (18%) were malignant and 141 lesions (82%) were benign. The vascular score was more accurate than the vascular ratio in all three modalities. The predictive ability of strain ratio was higher than Doppler and Power Doppler ultrasound and SMI. Adding SMI alone to ultrasound increased the specificity from 46.10% to 61.2% and the accuracy from 55.80% to 70.11%. In the combination of ultrasound with other modalities, the best was the combination of ultrasound, strain elastography, and SMI; which yielded a specificity and sensitivity of 100% and 74.4%, respectively. CONCLUSION: Adding SMI and STE modalities as adjuncts to ultrasound lowers the chance of missing malignant lesions and reduces unnecessary biopsies of breast lesions. A study with a larger sample size using this combination model to evaluate the accuracy with greater precision is recommended.


Assuntos
Neoplasias da Mama , Técnicas de Imagem por Elasticidade , Feminino , Humanos , Estudos Transversais , Sensibilidade e Especificidade , Ultrassonografia/métodos , Ultrassonografia Doppler , Técnicas de Imagem por Elasticidade/métodos , Microvasos/diagnóstico por imagem , Biópsia Guiada por Imagem , Diagnóstico Diferencial , Neoplasias da Mama/diagnóstico por imagem
9.
J Feline Med Surg ; 26(2): 1098612X231216350, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38381465

RESUMO

OBJECTIVES: A comparative assessment of systolic blood pressure (BP) measurement agreement and precision in two commonly used non-invasive BP devices was carried out in conscious cats. METHODS: Systolic BP measurements were obtained from 50 conscious cats as part of their clinical investigations. All measurements were taken by the same operator and were performed according to the American College of Veterinary Internal Medicine (ACVIM) consensus guidelines. The same cuff location and cuff size were used for paired measurements. The order of device use was randomised, and an arousal score was assigned during each procedure. Precision was assessed using standard deviation and coefficient of variance comparisons. Agreement was assessed using graphical and statistical comparisons of derived 'delta mean' and 'mean of means' data. RESULTS: A total of 50 cats aged between 3 months and 15 years were enrolled (29 domestic shorthair, seven domestic longhair, three British Shorthair, two Ragdoll, two Sphynx, two Persian, one Siamese, one Burmese, one Russian Blue, one Maine Coon and one Oriental) with a body weight in the range of 1.2-6.2 kg. BP measurements were in the range of 95-179 mmHg. Oscillometric measurements were associated with lower arousal scores. The Doppler device demonstrated superior repeatability precision. Body weight, sex, cuff size, cuff location, arousal score and the order in which the devices were used had no significant effect on precision or agreement. Correlation between the two devices was 0.0837 and agreement was considered clinically acceptable (<10 mmHg) in 32/50 (64%) cats. Of the 18 cats with suboptimal agreement, the oscillometric mean BP was higher in 14 (78%) cats. CONCLUSIONS AND RELEVANCE: Based on this study sample, suboptimal agreement between paired CAT+ Doppler and SunTech Vet20 oscillometric BP measurements in 36% of conscious cats suggests that these devices should not be used interchangeably. Compared with Doppler, oscillometric measurements were consistently higher, particularly at higher blood pressures. Further studies are required to assess which device has superior accuracy in conscious cats.


Assuntos
Doenças do Gato , Hipertensão , Humanos , Gatos , Animais , Pressão Sanguínea , Ultrassonografia Doppler/veterinária , Hipertensão/veterinária , Peso Corporal , Estado de Consciência
10.
PLoS One ; 19(2): e0298060, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38359058

RESUMO

Fetal growth restriction (FGR) is one of the leading causes of perinatal morbidity and mortality. Many studies have reported an association between FGR and fetal Doppler indices focusing on umbilical artery (UA), middle cerebral artery (MCA), and ductus venosus (DV). The uteroplacental-fetal circulation which affects the fetal growth consists of not only UA, MCA, and DV, but also umbilical vein (UV), placenta and uterus itself. Nevertheless, there is a paucity of large-scale cohort studies that have assessed the association between UV, uterine wall, and placental thickness with perinatal outcomes in FGR, in conjunction with all components of the uteroplacental-fetal circulation. Therefore, this multicenter study will evaluate the association among UV absolute flow, placental thickness, and uterine wall thickness and adverse perinatal outcome in FGR fetuses. This multicenter retrospective cohort study will include singleton pregnant women who undergo at least one routine fetal ultrasound scan during routine antepartum care. Pregnant women with fetuses having structural or chromosomal abnormalities will be excluded. The U-AID indices (UtA, UA, MCA, and UV flow, placental and uterine wall thickness, and estimated fetal body weight) will be measured during each trimester of pregnancy. The study population will be divided into two groups: (1) FGR group (pregnant women with FGR fetuses) and (2) control group (those with normal growth fetus). We will assess the association between U-AID indices and adverse perinatal outcomes in the FGR group and the difference in U-AID indices between the two groups.


Assuntos
Feto , Placenta , Feminino , Humanos , Gravidez , Biometria , Estudos de Coortes , Desenvolvimento Fetal , Retardo do Crescimento Fetal/diagnóstico por imagem , Retardo do Crescimento Fetal/epidemiologia , Feto/diagnóstico por imagem , Feto/irrigação sanguínea , Idade Gestacional , Estudos Multicêntricos como Assunto , Placenta/diagnóstico por imagem , Estudos Retrospectivos , Ultrassonografia Doppler , Ultrassonografia Pré-Natal/métodos , Artérias Umbilicais/diagnóstico por imagem
11.
J Matern Fetal Neonatal Med ; 37(1): 2322610, 2024 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-38418205

RESUMO

OBJECTIVES: To assess the predictive accuracy of three-dimensional (3D) power Doppler combined with two-dimensional (2D) Doppler ultrasonography in detecting fetal growth restriction (FGR). METHODS: The study was conducted on singleton pregnancies presenting for growth ultrasound examinations between 20 and 40 weeks of gestation. 63 patients with FGR were enrolled and matched 1:1.8 for gestational age with normal fetuses. Both groups were further divided into subgroups, with 32 weeks as the threshold-early-onset and late-onset FGR groups, and corresponding control groups. Conventional 2D Doppler parameters and standardized 3D power Doppler measurements of the placenta, including vascularization index (VI), flow index (FI), and vascularization-flow index (VFI) were obtained for each patient. RESULTS: (1) The average gestational weeks of delivery and birth weight of newborns in early-onset and late-onset FGR case groups were lower than those in control groups, while the incidence of placenta previa and adverse pregnancy outcomes were higher than those in control groups. (2) The biparietal diameter, head circumference, abdominal circumference, femur length, estimated fetal weight, middle cerebral artery systolic/diastolic velocity ratio (S/D), pulsatility index (PI), resistance index (RI), and placental blood perfusion indices of vascular index (VI), flow index (FI), vascular flow index (VFI), and cerebro-placental ratio (CPR) of the early-onset and late-onset FGR case groups were all lower than those of the control group. Moreover, the S/D, PI, and RI of the umbilical and uterine arteries were higher than those of the corresponding control group. (3) For early-onset FGR, the area under the curve (AUC) of the umbilical artery PI was the largest (0.861), exhibiting the highest predictive value. When combined with the placental blood perfusion index, the AUC was 0.789. For late-onset FGR, the AUC of the CPR was 0.861. After integrating the placental blood perfusion index, the AUC increased to 0.877. The positive likelihood ratio (PLR) of combined 2D Doppler indexes (21.938) and negative likelihood ratio (NLR) of VFI (0.565) were the highest in the early-onset FGR group. The PLR of combined 3D Doppler indexes (8.536) and NLR of VFI (0.557) were the highest in the late-onset FGR group. CONCLUSIONS: The combination of 3D Doppler indices with 2D Doppler ultrasonography demonstrated superior predictive value in diagnosing late-onset FGR compared to other conventional indicators. The 3D Dower index, VFI, has a good true-negative predictive value for both early- and late-onset FGR.


Assuntos
Retardo do Crescimento Fetal , Placenta , Gravidez , Humanos , Recém-Nascido , Feminino , Retardo do Crescimento Fetal/diagnóstico por imagem , Placenta/diagnóstico por imagem , Placenta/irrigação sanguínea , Relevância Clínica , Ultrassonografia Pré-Natal/métodos , Ultrassonografia Doppler/métodos , Idade Gestacional
12.
Eur J Obstet Gynecol Reprod Biol ; 295: 18-24, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38325239

RESUMO

BACKGROUND: The evidence-based management of human labor includes the antepartum identification of patients at risk for intrapartum hypoxia. However, available evidence has shown that most of the hypoxic-related complications occur among pregnancies classified at low-risk for intrapartum hypoxia, thus suggesting that the current strategy to identify the pregnancies at risk for intrapartum fetal hypoxia has limited accuracy. OBJECTIVE: To evaluate the role of the combined assessment of the cerebroplacental ratio (CPR) and uterine arteries (UtA) Doppler in the prediction of obstetric intervention (OI) for suspected intrapartum fetal compromise (IFC) within a cohort of low-risk singleton term pregnancies in early labor. METHODS: Prospective multicentre observational study conducted across four tertiary Maternity Units between January 2016 and September 2019. Low-risk term pregnancies with spontaneous onset of labor were included. A two-step multivariable model was developed to assess the risk of OI for suspected IFC. The baseline model included antenatal and intrapartum characteristics, while the combined model included antenatal and intrapartum characteristics plus Doppler anomalies such as CPR MoM < 10th percentile and mean UtA Doppler PI MoM ≥ 95th percentile. Predictive performance was determined by receiver-operating characteristics curve analysis. RESULTS: 804 women were included. At logistic regression analysis, CPR MoM < 10th percentile (aOR 1.269, 95 % CI 1.188-1.356, P < 0.001), mean UtA PI MoM ≥ 95th percentile (aOR 1.012, 95 % CI 1.001-1.022, P = 0.04) were independently associated with OI for suspected IFC. At ROC curve analysis, the combined model including antenatal characteristics plus abnormal CPR and mean UtA PI yielded an AUC of 0.78, 95 %CI(0.71-0.85), p < 0.001, which was significantly higher than the baseline model (AUC 0.61, 95 %CI(0.54-0.69), p = 0.007) (p < 0.001). The combined model was associated with a 0.78 (95 % CI 0.67-0.89) sensitivity, 0.68 (95 % CI 0.65-0.72) specificity, 0.15 (95 % CI 0.11-0.19) PPV, and 0.98 (0.96-0.99) NPV, 2.48 (95 % CI 2.07-2.97) LR + and 0.32 (95 % CI 0.19-0.53) LR- for OI due to suspected IFC. CONCLUSIONS: A predictive model including antenatal and intrapartum characteristics combined with abnormal CPR and mean UtA PI has a good capacity to rule out and a moderate capacity to rule in OI due to IFC, albeit with poor predictive value.


Assuntos
Trabalho de Parto , Artéria Uterina , Feminino , Humanos , Recém-Nascido , Gravidez , Hipóxia , Artéria Cerebral Média/diagnóstico por imagem , Valor Preditivo dos Testes , Resultado da Gravidez , Terceiro Trimestre da Gravidez , Estudos Prospectivos , Fluxo Pulsátil , Ultrassonografia Doppler , Ultrassonografia Pré-Natal , Artérias Umbilicais/diagnóstico por imagem , Artéria Uterina/diagnóstico por imagem
13.
Comput Biol Med ; 171: 108192, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38417384

RESUMO

Doppler echocardiography is a widely utilised non-invasive imaging modality for assessing the functionality of heart valves, including the mitral valve. Manual assessments of Doppler traces by clinicians introduce variability, prompting the need for automated solutions. This study introduces an innovative deep learning model for automated detection of peak velocity measurements from mitral inflow Doppler images, independent from Electrocardiogram information. A dataset of Doppler images annotated by multiple expert cardiologists was established, serving as a robust benchmark. The model leverages heatmap regression networks, achieving 96% detection accuracy. The model discrepancy with the expert consensus falls comfortably within the range of inter- and intra-observer variability in measuring Doppler peak velocities. The dataset and models are open-source, fostering further research and clinical application.


Assuntos
Aprendizado Profundo , Velocidade do Fluxo Sanguíneo , Ecocardiografia Doppler/métodos , Valva Mitral/diagnóstico por imagem , Ultrassonografia Doppler
14.
Ultrasound Med Biol ; 50(4): 484-493, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38242743

RESUMO

OBJECTIVE: Current medical ultrasound systems possess limited sensitivity in detecting slow and weak blood flow during the early stages of rheumatoid arthritis (RA), leading to potential misdiagnosis. Ultrafast Doppler is capable of detecting slow and weak flow. This study was aimed at evaluating the diagnostic value of ultrafast Doppler for RA. METHODS: Thirty-three RA patients (19 established, 14 early stage) and 15 healthy participants were enrolled. A programmable imaging platform with ultrafast Doppler capability was used. The benchmark was a clinical system with conventional Doppler imaging. Standardized dorsal long-axis scanning of both wrists was performed. Both ultrafast and conventional power Doppler (PD) images were quantitatively analyzed with computer assistance and semiquantitatively scored with the Outcome Measures in Rheumatology (OMERACT) scoring system. RESULTS: Ultrafast PD revealed more blood area than conventional PD in both RA wrists and healthy wrists. Ultrafast PD OMERACT was positive in 65 of 66 RA wrists and 26 of 30 healthy wrists (sensitivity [SEN] = 0.985, accuracy [ACC] = 0.719), while conventional PD OMERACT was positive in 28 of 66 RA wrists and 0 of 30 healthy wrists (SEN = 0.424, ACC = 0.604). Ultrafast PD revealed a higher synovial PD area, dilated vessels and PD brightness in RA wrists. Peak synovial PD brightness had the best diagnostic value for RA (area under the receiver operating characteristic curve = 0.802, SEN = 0.909, ACC = 0.813). For early-stage RA patients, ultrafast peak synovial PD brightness had higher sensitivity and accuracy than conventional PD indexes. CONCLUSION: Ultrafast PD had an increase of 0.561 in sensitivity and 0.209 in accuracy when compared with conventional PD. With its high sensitivity, ultrafast PD can detect early synovitis and identify RA patients during the early phase.


Assuntos
Artrite Reumatoide , Sinovite , Humanos , Artrite Reumatoide/complicações , Artrite Reumatoide/diagnóstico por imagem , Ultrassonografia Doppler/métodos , Sinovite/complicações , Sinovite/diagnóstico por imagem , Ultrassonografia/métodos , Curva ROC
15.
Clin Imaging ; 107: 110087, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38241966

RESUMO

The yin-yang sign, also known as the Pepsi sign, is used to describe the classic appearance of bidirectional blood flow within an aneurysm or pseudoaneurysm sac on color Doppler ultrasound. The corresponding spectral Doppler finding is a "to-and-fro" waveform, caused by inflow to the aneurysm/pseudoaneurysm sac during systole and outflow during diastole. It is important to recognize this sign in order to quickly identify the presence of an aneurysm or pseudoaneurysm and prevent complications such as expansion and rupture.


Assuntos
Falso Aneurisma , Aneurisma , Masculino , Humanos , Falso Aneurisma/diagnóstico por imagem , Falso Aneurisma/etiologia , Yin-Yang , Aneurisma/complicações , Ultrassonografia Doppler
16.
Artigo em Inglês | MEDLINE | ID: mdl-38261486

RESUMO

We propose burst-wave-aided, contrast-enhanced, active Doppler ultrasonography for visualizing lymph vessels. This technique forces ultrasound contrast agents (UCAs) to move using the acoustic radiation force induced by burst waves with low amplitude while suppressing their destruction. Using a flow phantom, we measured the average, decrease rate of echo intensity [i.e., pulse intensity integral (PII)], and the velocity of individual contrast agents, which directly affects the performance of imaging and tracking contrast agents under stationary flow conditions. Comparison with pulse-inversion Doppler without exposure to the burst wave demonstrated that the velocity of the contrast agents could be enhanced up to several tens of millimeters per second by the effect of the burst wave, maximizing the echo intensity extracted by a clutter filter. The contrast ratio (CR), defined as the ratio of the contrast echo to the phantom echo outside the channel, did not change appreciably, even when the lower cut-off velocity of the clutter filter was increased up to 10 mm/s. This implies a better robustness against the motion of the tissue. In addition, the performance for detecting contrast agents (i.e., echo intensity) was superior or similar to that of pulse-inversion Doppler, even in undesirable conditions where the flow had a velocity component in the opposite direction to that of the acoustic radiation force. The echo intensity was lower or the same as that in pulse-inversion Doppler, demonstrating the potential for suppressing the destruction of contrast agents and enabling long-term observations. From these results, we expect that the proposed method will be beneficial for visualizing lymph vessels.


Assuntos
Meios de Contraste , Microbolhas , Ultrassonografia , Ultrassonografia Doppler/métodos , Angiografia , Imagens de Fantasmas , Velocidade do Fluxo Sanguíneo
19.
Pediatr Radiol ; 54(2): 347-356, 2024 02.
Artigo em Inglês | MEDLINE | ID: mdl-38191809

RESUMO

Pediatric intracranial arteriovenous shunts are rare vascular malformations that can be diagnosed prenatally or postnatally, as an incidental finding or due to complications. We propose a review of cerebral vascular malformations in newborns and infants with special emphasis on neurosonography and Doppler ultrasound as the first diagnostic method. Sonography can thus contribute in the planning of further studies that are always necessary, and in post-therapy follow-up.


Assuntos
Veias Cerebrais , Malformações Vasculares , Lactente , Criança , Humanos , Recém-Nascido , Seguimentos , Ultrassonografia , Veias Cerebrais/diagnóstico por imagem , Malformações Vasculares/diagnóstico por imagem , Malformações Vasculares/terapia , Ultrassonografia Doppler
20.
Abdom Radiol (NY) ; 49(4): 1103-1112, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38219253

RESUMO

PURPOSE: To evaluate the response to nifedipine administration measured by changes in hepatic arterial (HA) flow on post-operative Doppler ultrasound (US) to predict short-term complications and long-term outcomes in liver transplant (LT) patients. METHODS: Patients who underwent LT with post-operative Doppler US within 3 days between 1 January 2005 and 31 December 2015 were included in this retrospective single center study. The patients who received and did not receive nifedipine during the Doppler US comprised the study and control groups, respectively. A positive response to nifedipine was defined as the detection of HA flow when none was present initially or a reduction in HA resistive index (RI) ≥ 0.1 after nifedipine administration. The rates of re-transplantation, re-operation, percutaneous intervention (PCI), and overall survival (OS) were recorded. Cox proportional hazards regression was used to evaluate the association of clinic-demographic variables and Doppler findings with the outcome measures. RESULTS: 444 LT patients (305 M/139F, mean age 51.7 ± 17.4 years, mean interval between LT-Doppler US 1.12 ± 0.9 days) are presented. 220 patients comprised the nifedipine study group [n = 157/220 (71.4%) responder, n = 63/220 (28.6%) nonresponder] and 224 patients comprised the control group. There was no difference in re-transplantation or PCI rates between the groups (all p-values ≥ 0.2 and ≥ 0.08, respectively). The responder group had a lower rate of re-operation vs. the control group (15.9% vs. 24.1%, p = 0.03) and nonresponder group (15.9% vs. 31.8%, p = 0.004). 1-year and 2-year OS were similar between the groups (all p-values > 0.37). CONCLUSION: Short-term complication rates and long-term outcomes for patients with liver transplant who responded to nifedipine administration on Doppler US are similar to those who did not require nifedipine administration. A lack of response to nifedipine was associated with a higher re-operation rate.


Assuntos
Transplante de Fígado , Intervenção Coronária Percutânea , Humanos , Lactente , Transplante de Fígado/efeitos adversos , Nifedipino/uso terapêutico , Estudos Retrospectivos , Artéria Hepática/diagnóstico por imagem , Ultrassonografia Doppler
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